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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).

The summit of Mount Kenya
The summit of Mount Kenya

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

Climbing Mount Kenya requires careful acclimatization

Climbing Mount Kenya requires careful acclimatization

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!!!

Nelion - the summit tower of Mount Kenya
Nelion - the summit tower of Mount Kenya

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.

Peak of Nelion of Mount Kenya - view from the foot

Peak of Nelion of Mount Kenya - view from the foot

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.

The summit of Nelion at dawn, as seen from Point Lenana
The summit of Nelion at dawn, as seen from Point Lenana

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


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From the very beginning of our activity, here nearly 16 years, the first Principle of work of School of mountaineering and rock-climbing of MCS AlexClimb is the Safety Priority. On the basis of this Principle all process of training is based, all programs and rounds are developed and carried out only within this main principle. We consider that at professional approach to development of programs, at personal discipline and correctly put motivation - occupations by mountaineering and rock-climbing are COMPLETELY safe. And from the return - all troubles and accidents in our sport come from nonprofessionalism, from ignorance or neglect by elementary standards of safety, from irrational motivation, from revaluation of own forces and opportunities. All these prerequisites we COMPLETELY EXCLUDE in our work - ours Rock-climbing, Ice climbing and Mountaineering are based on one Principle - the Safety Priority. In rock-climbing, mountaineering and ice climbing, the Priority of Safety of MCS AlexClimb-is your personal security and comfort irrespective of, than we are engaged - we train muscles and we work technology of the movement in the sports hall and on the rock climbing wall, we make the way through snowstorm to top or we relax on golden sand of the Caribbean beach after hot day of trainings on rocks. The Safety priority - the main credo of School of mountaineering and rock-climbing of MCS AlexClimb.

AlexClimb Rule #2 - Leave No Trace

Closely interacting with Nature, working with the active programs in mountains, woods, lakes and rivers, we perfectly understand the importance of carefull and respectfull bahavior towards the Nature, for its resources. From the very beginning of our outdoor-activity we adopted rules of  Leave No Trace technique - the standard of behavior of the person accepted in all the civilized world in relation to environment and especially - to the wild nature. After all on the relation of people to the nature near which they exist, itself can draw dalekoidushchy conclusions on the relation of these people to... Where and as we didn't travel - we don't reserve any garbage, we try to reduce whenever possible our influence on environment to a minimum. We clear earlier zagryazyonny tourist parking of the left garbage, we take out and we take out to utilization places that to us other people left there. We consider that only thus, at personal individual consciousness of each citizen, each tourist, climber or autotraveller, we will be able to keep the nature surrounding us in its state, natural, suitable for life, - in it pledge of the healthy future for ourselves and our children.

AlexClimb Rule #3 - Sober Concious

The position of AlexClimb Mountain and rockclimbing School regarding healthy lifestyle is quite clear - we consider that only sober consciousness is capable to fill sincere emotions,  to sympathize, to enjoy life in all its variety. Bright various enjoyable life is possible only on condition of keeping the absolute sobriety and purity of consciousness. Any way of obscuring our perception of reality is intended to do harm to our consciousness and bring harm to our physical health, to replace the true values by false ones, to destroy us physically - to turn us into flabby, weak, senseless, gray herd with empty hazy eyes. We don't force anybody to our point of view, everyone has a God's gift of making his own choice and to destroy himself if that is what he wants... But in AlexCilimb Mountain Climbing School we accept quite certain and very simple set of rules: neither alcohol, nor drugs.