Round Annapurna Trekking Profile

Acute Mountain Sickness and worse (HACE, HAPE)

AMS Signs:
Headache, often with loss of appetite, nausea, vomiting, tiredness, dizziness, disturbed sleep.

What to do?
Stay at height for 1-3 days or descend, diamox (250mg every 12 hrs).

HACE Signs:
Severe headache, loss of balance / coordination, staggering, irrational behavior, confusion, drowsiness, coma, death (sometimes in a few hours).

What to do?
Check with straight-line heel-to-toe walking. HACE victims cannot do it. Descend immediately, even at night, at least 1000m with someone else, oxygen, Gamow bag, keep patient warm, diamox.

HAPE Signs:
Breathlessness (even at rest), dry cough / pink or rusty spit, blue lips / nails, very tired, low fever, gurgling breath, drowsy, coma, death.

What to do?
Check with straight-line heel-to-toe walking. HACE victims cannot do it. Descend immediately, even at night, at least 1000m with someone else, oxygen, Gamow bag, keep patient warm, diamox and nifedipine.

Prevention:
Ascend slow (300-500m / day), don’t exert yourself, eat high carbohydrate foods, drinks lots (water not beer), locals recommend garlic soup, avoid alcohol and caffeine.

For information when in Manang:
Visit HRA (Himalayan Rescue Association) doctor’s talk at 3 pm (March – April, October – November)

Safety First
Sprains and strains
Probably the most common accident in the area. Steep terrain and rough trails may cause many people strain their knees and ankles. Remember: stretch before you start walking, take your time, avoid trekking in the night time, and bring joint support bandages if you require them.

Health Posts
There are at least one health post in every VDC of the ACA. This facility is open to trekkers who require medicinal attention. A novel way you can help the Health post is to leave any unwanted medicines at the center at the end of your trek. This may help other fellow trekkers who need urgent medical care.

Rescue operation – how to be prepared?
If you are trekking with a trekking agency then they should be able to organize a rescue evacuation for you quickly. If not, the following precautions may prevent a long wait for a helicopter for resque during emergency.
• Have travel insurance and carry your insurance policy number with you.
• Carry a credit card with you
• Register with your embassy in Kathmandu so they know your activities – registration with embassy ( for free at KEEP office) will speed up rescue
• Register at all police and ACAP check-posts and register with lodge that you stay in
• Carry a first aid kit and avoid trekking on your own

Other problems
Sick
Doctors at VDC health posts – Foreign doctors in Manang (March – April, late September – early December) at HRA.