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Soroche - Altitude Sickness Cusco

Also known as acute evil height, it is basically consequence of the lack of oxygen. It happens habitually in people none acclimated who ascend over the 2.000 msnm. in less than 1 or 2 days. The tourist who arrives to Cusco in airplane are the most prone to undergo altitude sickness. The symptoms usually happen within the first 48 hours of the ascent (although also much later) and include from headache, nauseas, vomits, lack of appetite, sensation of breathlessness, alterations of the dream, vertigo, palpitations and problems of acute concentration to edema of lung. Usually it appears from 6 or 10 h of exhibition to the hypoxia and is more frequent in minors of fifty years and subjects that reside habitually to less than 900 ms of altitude. As far as the hypoxia, a very common error is to think that the atmospheric oxygen amount or concentration falls with the altitude. In fact the oxygen concentration always is the same (approx 21%) independent of the reached altitude, which falls is the denominated partial oxygen pressure and, in this way, the bioavailability of the same. Although it is known that the hypoxia is the cause of Altitude sickness, the exact mechanism by which it still causes this one it is not known.

Altitude Sickness Cusco

Symptoms of Altitude sickness

  • Migraine (headache).
  • Nauseas and vomits.
  • Anorexy  (lacking of appetite).
  • APhysical exhaustion.
  • Upheavals of the dream. They can be or drowsiness or insomnia. Also episodes of nocturnal sudden dyspnea can appear (to awake abruptly with breathlessness sensation) due to the denominated breathing of Cheyne-Stokes during the dream.

The most serious manifestations (and potentially lethal) of the acute mountain evil are the Pulmonary Edema of Altitude and the Cerebral Edema of Altitude.

Diagnosis of Altitude sickness. The scale of the Lake Louise

To practical effects (in the mountain, over the 2500 msnm) the appearance of anyone of the previous symptoms that cannot be explained for other reasons must be considered   Altitude sickness and act consequently: to stop ascending and, if the symptoms do not improve, lowering, to lose altitude as rapidly as possible at least until the level where symptoms did not appear. The diagnosis of the MAM is clinical, this, based on the “general" appreciation of the state of the subject since any symptom does not exist that, by itself, it identifies the MAM of unequivocal form. One resorts generally to tables of symptoms, each of them with different score. If the total sum of the obtained points surpasses certain threshold considers criterion MAM diagnosis, as well as the gravity of the same. Among all these tables the most used it is the denominated scale of the Lake Louise, who is divided in a questionnaire of self-evaluation (subjective) and a clinical valuation (objective). As much in the questionnaire as in the clinical valuation, the term “grave" normally it means "incapacitante".

Prevention of Altitude sickness. Acclimatization

The state of form or the physical training, by excellent that these are, absolutely do not prevent Altitude sickness. This one can take place to levels of only 2500 ms of altitude and it is known that the susceptibility to the same is inversely proportional at the age of the subject, probably due to the maturity of the nervous system. The drug use is not recommended either to prevent it, but progressively to adapt to the hypoxia of altitude by means of denominated process acclimatization. A typical scheme of acclimatization can be the following one:

  • Pass at least two nights between the 2,500 and the 3,000 msnm.
  • Over 2,500 msnm do not exceed 600 daily ms of unevenness at the time of lying down, although during the day altitudes have been reached superiors.
  • Each 1 km of unevenness would be due to spend one second night to the same altitude that the previous night.
  • Over 3,500 msnm is due to raise calmadamente, without realizing intense efforts, exceeding the 300 or 400 daily ms of unevenness and resting a day by each two of ascent.
  •  Over 5 km of altitude there is no guarantee of which a suitable acclimatization prevents the appearance of pulmonary or even cerebral Altitude sickness and edema, embolias etc. For ascents to great altitude the acclimatization must be practically “personalized" and it depends to a great extent on the predisposition of the subject to the MAM.

It is very important to consider that, in spite of following an acclimatization calendar scrupulously; Altitude sickness can appear at any time. Before anyone of its symptoms it is necessary to stop ascending immediately and, if the symptoms do not improve, as rapidly as possible losing altitude, at least until the level where symptoms did not appear. Also it is very important to stay perfectly hydrated (to drink at least 4 or 5 daily Ls of liquid) and one diet varied rich in carbohydrates.

When we traveled to Cusco, Puno, Arequipa or any other city on the mountain range of Peru we must consider the following thing:

1.- Arriving by airplane at zones of height: It is recommended to avoid all heavy and/or abundant food, gaseous, Coca cola, coffee, cigarettes. You should take tablets of Coramina Glucosada, which can be acquired without medical prescription in any pharmacy. A tablet in the mouth is placed and will feel a fast improvement one is due to take on a daily basis from 2 to 3 liters of natural water and mates of grass, to maintain a hydration suitable.
2.- It is precise to maintain a diet highly light and rich carbohydrate energetic, without fats, in small amounts and several times to the day. To avoid rare meals to which the organism is not customary.
3.- After the arrival to the zone of height, it is precise to rest and to sleep every time you can.
4.- It is recommended to take a coca tea or very hot and concentrate with drops of lemon, if they are to disposition caramels or coca toffes, it is also recommended to chew coca leafs.
5.- Drink always a cup of hot coca tea with lemon, after the meals; at night it is recommended to take chamomile or anise tea.
6.- The coca tea, as well as caramels, toffes, cakes and chocolates done with coca leafs are very useful during the day, to avoid ingesting them before sleeping.

Treatment

If in spite of taking preventive measures the altitude sickness appears, ingests abundant liquids. Paracetamol is ideal against the headache and the coramina stops the feelings of nauseous.
The Acetazolamida (250 mg 2 - 4 times a day by oral route, maximum permissible dose: 1,000 mg/day) is very effective to fight the disease and to accelerate the acclimatization. In all the cases it is preferable to consult with a doctor and to observe the contraindications. Do not wait to feel sick to ask for oxygen. You can find it in some hotels, pharmacies and in the hospitals. to do it, l/min asks for oxygen to a 2-3 min.

Arriving to Cusco In airplane

EIt is very important to walk slowly and do not make great physical efforts, remembers that you are at 3.400 m.s.n.m. The idea is to rest some hours after landing. If you feel that you need oxygen, you can ask for it in the same airport.


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