High-altitude pulmonary edema
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Attention! In December 2020, there were two mountaineer deaths on the Mount Kenya route due to High-altitude pulmonary edema (HAPE).
I really hope that this information will not be useful to you, but whoever is warned is armed. Having personal experience in this matter, I will describe this phenomenon and give clear recommendations on what to do.
High-altitude pulmonary edema is one of the unobvious dangers of the mountains, which gathers its victims every year. This is not a pathology, it happens at altitudes of more than 3000 m with physically healthy, often experienced and trained climbers and is an complicated form of acute mountain sickness. The physiology of high-altitude pulmonary edema in medicine has been poorly studied; treatment and prevention should be guided on the basis of experience and analysis of the cases that have occurred.
Causes: Insufficient acclimatization, accelerated acclimatization schedule, fast altitude gain
Signs: usually, before the onset of an acute form, there are all signs of insufficient acclimatization - poor sleep, headache, tachycardia. However, these signs always accompany acclimatization and it is far from a fact that they may be followed by a complication as an edema.
Attention!!! It is vital not to miss the moment of the onset of the disease! The first and main sign of the pulmonary edema is dry characteristic sound on deep exhalation. At the end of exhalation, a crunch is heard, as if from crumpled paper. If this sign is detected, immediately start descent and evacuation!!!
At altitude, pulmonary edema develops extremely quickly - from the appearance of the first signs, you have no more than 12 hours to save the life! 12 hours is a conditional value - it depends on the individual characteristics of the patient, on the altitude at which the edema began. Usually, at the beginning of the disease, the victim feels weak but can still move independently. Many people miss vital moments in hope that everything will pass by itself. But if edema has begun, then the situation will worsen with every minute - after 6-8 hours, the sick person is no longer able to move independently. Death can occur in 12-14 hours.
The main and fatal mistake is attempts to treat high-altitude pulmonary edema at the altitude where the disease began.
In no case try to cure high-altitude edema at the altitude where it started!
It is treated in only one way - an immediate descent! As a rule, recovery begins immediately after descending 1000 m or more. The lower you go, the more likely a favorable outcome is.
Be careful to yourself and each other. Especially in the mountains.
The author of the text and photos - Alex Trubachev
Your professional international mountain guide and climbing coach
MCS EDIT 2024