CLINICAL QUERIES: Preparing for travel to high altitudes
R. Bryan Simon RN, CNOR, FAWM
Debbie A. Simon RN, CNOR, FAWM

September 2012 
Volume 42  Number 9
Pages 66 - 67
  PDF Version Available!

My friends and I are planning a trip to Peru, including Cuzco and Machu Picchu. We're concerned about altitude illness. How should we prepare for this trip?-F.V., ONTARIOR. Bryan Simon, RN, CNOR, FAWM, and Debbie A. Simon, RN, CNOR, FAWM, respond: People traveling above 8,200 feet (2,500 meters) risk developing altitude illness, which is increasingly common today due to the greater speed and ease of transportation to remote areas. Within 1 day, a person can travel from sea level in North America to Cuzco at 11,154 feet (3,400 meters), which gives the body little time to adjust.1 Preparing properly, knowing the signs and symptoms, and having a flexible travel schedule will help you avoid altitude illness and enjoy your trip.During an ascent to altitude, people undergo physiologic changes that help them adapt to the decreasing barometric pressure and inspired oxygen concentrations. These mechanisms, known as acclimatization, include an increased respiratory rate immediately on arrival at altitude, an increased production of alkaline urine starting within hours, and within a week, an increase in circulating red blood cells.2,3 If ascent is too rapid to allow acclimatization, a person may develop altitude illness. A person's susceptibility is increased by a history of altitude illness or respiratory disease as well as by extreme exercise, alcohol consumption, dehydration, and use of some sleep aid medications.The three types of altitude illness are acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE).AMS, the most common type of altitude-related illness, usually begins 6 to 24 hours after arrival. It's best described by its signs and symptoms, usually a headache and one or more of the following: fatigue, weakness, loss of appetite, nausea, vomiting, dizziness, or insomnia.4,5Preventing AMS through slow ascent is best, but if signs and symptoms have already developed, descent is always the best solution. If signs and

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