On August 5th, 2017 a 17-year-old boy from Salem, Utah— who would have celebrated his 18th birthday on August 6th, passed away from acute mountain sickness (AMS) while on a Scout high-adventure trip to the High Uintas.
Douglas Julian, the boy’s father, wrote in a journal-like letter what is was like to hear the devastating news of his son passing away from something so treatable as AMS:
“I recall the feeling that it felt as if someone had taken a large drill bit and bored a hole in my chest,” writes Julian. “It has been just over two months since my son has passed away and that pain from that metaphoric hole in my heart is still present; I suppose I will have to try and get used to it… I don’t think it will be leaving anytime soon…”
“It felt as if someone had taken a large drill bit and bored a hole in my chest. I hurt badly and I could not make the pain go away…“
When leaders from the Scout trip recounted the story to Julian, he identified points at which his son should have gotten down to a lower elevation in order to recover just fine; however, Scout leaders did the best that they could— even discussing altitude sickness and determining it wasn’t the cause of the son’s illness… no one could have known the tragic events that would occur that day. As a loving father, Julian just wants what happened to his boy and him to never happen to anyone else.
Awareness and education— Julian knows— is the best way to prevent another tragedy. Therefore, Julian wants all Boy Scouts and adventure-lovers alike to first be aware that AMS can be very serious if not treated correctly. Second after awareness, Julian is on a mission to educate people about the signs and symptoms of AMS and how to properly treat them.
What is Altitude Sickness?
At high elevations, the air around you becomes “thinner” and the pressure needed to push oxygen into your lungs is reduced, disabling your body from getting enough oxygen from the air around you. This is called hypobaric hypoxia.
Those who begin to suffer from acute mountain sickness (AMS) may experience a headache, loss of appetite, nausea, and vomiting, shortness of breath, inflamed hands and face, or weakness.
One of the leaders on Doug’s hiking trip recounts that, at first, Doug had a small cough that worsened the next day, but was thought to simply be a cold coming on— especially since one of the other boys on the trip had a cold. Doug had also brought a few packs of Rolaids because it was normal for him to get nauseous when camping at higher elevations, said the leader….another reason perhaps his symptoms weren’t acted upon immediately. However, Friday night the same leader did discuss altitude sickness with Doug but determined it wasn’t what he was suffering from.
Doug’s Father writes:
On Friday Doug did not improve, in fact, he stayed behind from hiking to another lake for some fishing fun due to feeling under the weather. As his father, I would have realized that this was not normal for Doug…he rarely missed a chance to fish as he a passion for fishing. At this point, Doug could have walked down the mountain and still recovered nicely from the elevation sickness.
How to Treat Acute Mountain Sickness
In retrospect, Doug experienced all of the first signs of AMS; a headache, chest pain and nausea. The problem was, though, that these symptoms were misdiagnosed as normal side effects of hiking or as signs of a cold. Sleeping with the symptoms can aggravate the sickness because it allows the fluid to build in your lungs.
In the article “How to combat altitude sickness” from the Scouting magazine, one doctor stated, “If you get a headache at altitude, assume it’s being caused by the altitude and not something else,” says Dr. Chris Davis, medical director of the Colorado Clinic for Altitude and Mountain Medicine.
If someone in your troop or hiking group has a headache accompanied by any other symptom, it qualifies as AMS, so get to a lower elevation and wait until the effects pass. By doing something so simple as walking back down the trail, lives can be saved.
S.A.M.P.L.E (Symptoms. Allergies. Medications. Past Medical History. Last Ins and Outs. Events Leading up to This.) on the Scout Backpacking Community website is a great checklist that helps leaders be able to better identify what is causing the patient’s illness.
The BSA Safety Moments also just published an article on what altitude sickness is, the different types or phases and how to prevent and treat it.
Steps You Can Take to Prevent Altitude Sickness
When traveling to areas of no communication, have a satellite communication device to summon help quickly. When going to elevations above 8,000 ft: have a pulse oximeter (they’re only $11 at Walmart and could save your life) to check oxygen levels and supplemental oxygen. Also, ascend in stages to allow time for your body to acclimate to the change in pressure and oxygen content in the air.
Are you getting ready for your Philmont Trek and a summit of Baldy Mountain? Perhaps you live close to sea level and plan to hike the John Muir Trail in the Sierra Nevada range, Kings Peak in the Uinta range, or some 14ers in Colorado. These trips might result in symptoms or effects of acute mountain sickness (AMS), high-altitude pulmonary edema (HAPE), or high-altitude cerebral edema (HACE), which if untreated could result in death. As altitude is gained, air grows “thinner,” and less oxygen is inhaled with each breath.
Acute Mountain Sickness
- Have you recently arrived at an altitude of 6,000 feet or higher? Look for signs of AMS, such as headaches, loss of normal appetite, nausea (with or without vomiting), insomnia, and an unusual weariness and exhaustion.
- The treatment is to descend or to stop ascending and wait for improvement before going higher. Continuing to ascend in the presence of symptoms is not recommended. If the illness progresses, descent is needed.
High-Altitude Cerebral Edema
- Be watchful for loss of coordination (e.g., an inability to walk a straight line or stand straight with feet together and eyes closed).
- Signs and symptoms often include a severe headache unrelieved by rest and medication, bizarre changes in personality, seizures, and coma.
High-Altitude Pulmonary Edema
- HAPE symptoms often appear initially as a dry cough, soon followed by shortness of breath, even at rest. Shortness of breath becomes more pronounced, with chest pain as fluid collects in the lungs.
- The cough may become productive and with frothy sputum early on that may turn reddish.
Preparation: Discuss your planned climb with your health care provider while undergoing a pre-participation exam (Part C of the Annual Health and Medical Record). Improve your fitness with regular hikes while carrying a load in anticipation of your climb.
Staged ascent: If possible, your first camp should be no higher than 8,000 feet. Increase no more than 1,000 to 1,500 feet per day. When starting out higher than 9,000 feet, spend two nights acclimating to that altitude before proceeding higher. Proceed higher during the day, but return to a lower elevation to sleep (climb high, sleep low).
Appropriate exercise level: Until acclimated, exercise moderately, avoid intensity, and be alert to shortness of breath and fatigue.
Hydration: To offset increased fluid losses at high altitudes, stay well-hydrated.
Evacuation: Stop ascending until AMS symptoms resolve. If you suspect the onset of HACE or HAPE, evacuate rapidly to a lower altitude (descending at least 1,000 to 1,500 feet) and get evaluated by a physician as soon as possible.