Slow down on the plateau, especially when you first arrive; Don't overeat, drink more water.
Don't arrange the itinerary too tightly, leave some time for your body to adapt; If you want to go outdoors or climb a mountain, the rising height should not exceed 1000 meters every day.
Prepare some commonly used drugs: Jing Tian Honghua Capsule, acetazolamide, furosemide, semisone, etc. It is best to take it three or four days before entering Tibet, or take it according to the doctor's advice, which can greatly alleviate altitude sickness after entering Tibet. These drugs are very cheap and are sold in ordinary pharmacies.
Never enter Tibet with a cold, and try not to take a bath within two days after entering Tibet, so as not to catch cold and consume physical strength.
The weather in Tibetan areas is changeable, and you can experience four seasons in one day. Bring enough warm clothes and wear them layer by layer to adapt to the rapidly changing temperature and prevent colds and their complications.
Drugs and chemical reagents
Zangnuojing Tianhua Capsule: Prevent and relieve altitude sickness, improve hypoxia tolerance and relieve physical fatigue.
Rhodiola and its preparation: Tibetan traditional health food, which is helpful to enhance physical fitness and relieve altitude sickness. Take it 7 days before entering the plateau.
Baifuning: It helps to control the headache caused by altitude sickness.
American ginseng: It helps to relieve fatigue, enhance physical fitness and reduce altitude sickness.
Quick-acting Jiuxin Pill: Take it when altitude sickness occurs, which helps to relieve altitude sickness.
Danshen Dripping Pills: Treating Cardiovascular Diseases. Helps to alleviate altitude sickness.
The symptoms of altitude sickness can be eliminated within 1-2 days for people with strong adaptability to altitude, and it takes 3-7 days for people with weak adaptability. If you can adapt, you can drink more butter tea, which also has a certain effect on relieving altitude sickness.
insurance
China People's Health Insurance Company took the lead in launching "medical insurance for plateau specific diseases" for the whole country, and no longer exempted the common diseases of plateau tourism-acute altitude cerebral edema and acute altitude pulmonary edema. According to some surveys, 30% of people who enter Tibet will have altitude sickness, and in severe cases, they may have extremely harmful acute altitude edema or acute altitude edema. The insurance period of this product is 30 days, and people aged 3-70 can take out insurance. The product rate is "88 yuan Insurance 1 10,000". Once the insured is hospitalized for treating acute high altitude cerebral edema and acute high altitude pulmonary edema during the plateau travel, PICC Health will fully bear the hospitalization expenses and emergency medical expenses within 3 days before admission. Since August 8, 2006, this type of insurance has been officially listed for sale.
preventive measure
How to avoid or reduce altitude sickness?
Most people have mild or severe altitude sickness when they first arrive at the plateau. What kind of people generally have no rules to follow. The best way to avoid or reduce altitude sickness is to face it with a good attitude. Many reaction symptoms are caused by psychological effects or psychological effects. For example, people who are afraid of the plateau and lack the mental preparation and determination to overcome it will have more chances to have altitude sickness. It is suggested that when you first arrive at the plateau, don't walk fast, let alone run or run, and don't do manual labor to avoid overeating and increase the burden on digestive organs. Don't drink and smoke, eat more foods rich in vitamins such as vegetables and fruits, drink plenty of water, keep warm and take fewer baths to avoid catching a cold and wasting energy. Don't take oxygen at first, try to adapt yourself, otherwise you may never be able to live without oxygen at the plateau.
The severity of altitude sickness varies from person to person Generally speaking, young people are better than middle-aged and elderly people, children and teenagers. For people who live in low-altitude areas (such as the eastern coastal areas) for a long time, when they go to the plateau for the first time, there will be slight precursors of altitude sickness above 2000 meters, such as easy hunger, headache and insomnia. At this time, they need to be careful not to catch a cold. When the altitude exceeds 3000 meters, many people will have obvious altitude sickness, such as panting and purple lips. People who have been engaged in physical exercise for a long time and are healthy can persist to about 4400 meters. However, to be on the safe side, if it is the first time to go to the plateau and the destination is above 3000 meters, it is recommended to make some preparations in advance. If you have enough time, I suggest that you don't rush at altitude, rest for one to three days at about 3500 meters, and then enter a higher altitude area after adapting, which can greatly reduce the intensity of altitude sickness. [2]
You can take some altitude sickness drugs and health food to relieve altitude sickness:
Zangnuojing Tianhua Capsule: Prevent and relieve altitude sickness, improve hypoxia tolerance and relieve physical fatigue.
Rhodiola and its preparation: Tibetan traditional health food, which is helpful to enhance physical fitness and relieve altitude sickness. Take it 7 days before entering the plateau.
Baifuning (note that it is an additive, like Fenbid, it is a phenol coffee tablet): It helps to control headaches caused by altitude sickness, and Fenbid phenol coffee tablets are also available to travelers.
American ginseng: It helps to relieve fatigue, enhance physical fitness and reduce altitude sickness.
Quick-acting Jiuxin Pill: Take it when altitude sickness occurs, which helps to relieve altitude sickness.
Danshen Dripping Pills: Treating Cardiovascular Diseases. Helps to alleviate altitude sickness.
The symptoms of altitude sickness can be eliminated within 1-2 days for people with strong adaptability to altitude, and it takes 3-7 days for people with weak adaptability. If you can adapt, you can drink more butter tea, which also has a certain effect on relieving altitude sickness. [ 1]
Some people may experience altitude sickness when they first travel to the plateau. Symptoms include headache, chest tightness, shortness of breath, palpitation, nausea and vomiting, cyanosis of lips, insomnia, dreaminess and high blood pressure. These symptoms are obvious in the first day or two, and will gradually reduce or disappear in the future; However, due to fatigue, colds, upper respiratory tract infections and other reasons, there are also very few people whose symptoms may gradually worsen and develop into high altitude pulmonary edema or high altitude cerebral edema. Areas above 3000 meters above sea level are called plateau areas. It is characterized by low air pressure and low oxygen concentration in the air, which easily leads to human hypoxia, causing altitude sickness including acute altitude sickness, altitude pulmonary edema, altitude cerebral edema and so on. Headache, dizziness, palpitation, shortness of breath and other reactions will occur when you enter the plateau above 3000 meters in a short time. Severe cases include loss of appetite, nausea, vomiting, insomnia, fatigue, abdominal distension and chest tightness. Check for slight cyanosis of lips and facial edema. It's called acute altitude sickness. People often advocate oxygen inhalation to relieve discomfort. Of course, oxygen inhalation can temporarily relieve chest tightness, shortness of breath, dyspnea and other symptoms, but after stopping oxygen inhalation, the symptoms will reappear. This has delayed the time to adapt to the plateau. We advocate that if the above symptoms are not serious, especially during rest, it is best not to take oxygen. This will help you adapt to the plateau environment more quickly. Just entering the plateau, don't overeat, so as not to increase the burden on the digestive organs and make them adapt to this environment well. It's best not to drink or smoke. Eat more foods rich in vitamins such as vegetables and fruits. However, it must also be noted that if the above symptoms become more and more serious after entering the plateau, especially during rest, you should immediately take oxygen and go to the hospital for treatment. Prevent the adverse consequences caused by "acute high altitude pulmonary edema". Prescription to prevent altitude sickness: take Danshen tablets two weeks or a month before departure, three times a day, three tablets each time. In addition, it is best to take American ginseng tablets with you. Taking it when you have altitude sickness can relieve discomfort. In addition, the oxidation and antioxidant capacity of healthy standard body in the long-term living environment are roughly the same (the oxidation capacity of people with diseases is much higher than the antioxidant capacity), but after entering the plateau, the total amount of oxidative decomposition to maintain normal metabolism remains unchanged, while the total amount of oxygen intake decreases and the antioxidant capacity weakens, so altitude sickness will occur to varying degrees. Therefore, in addition to taking the above drugs to prevent altitude sickness, it is best to prepare foods containing antioxidants and vitamins, such as vitamin E, vitamin C, asta (abbreviated as astaxanthin), β -carotene and so on. And eat grapes (including grape seeds), radish (containing β-carotene) and shredded radish to stir-fry shrimp (a common home-cooked dish in plateau areas, shrimp contains the strongest antioxidant astaxanthin, and radish contains β-carotene). Especially the "donkey friends" who travel on the road are prone to fatigue after driving for a long time, so it is necessary to strengthen the supplement of standby altitude sickness drugs and antioxidant foods.
The key to overcoming altitude sickness is to overcome your inner fears. Never rely on oxygen.
Precautionary points
For tourists at high altitude, the prevention of altitude sickness is an important life-threatening problem. Prevention points and simple first aid knowledge should be understood in advance.
Do a good job in physical examination to prevent altitude sickness, and do a good job in the hospital you want to go to before traveling at altitude. Patients with chronic obstructive pulmonary disease, interstitial lung disease, various respiratory insufficiency, organic heart disease, cerebrovascular disease, hypertension, gastrointestinal diseases, neuropsychiatric diseases, severe chronic diseases, etc. Not suitable for plateau tourism. When the safety is uncertain, hypoxia test should be carried out.
Physical and mental preparation
⑴ Psychological preparation: To eliminate the fear, you can learn about the plateau environment, characteristics and medical care knowledge from books and experienced tourists, and enhance your self-confidence.
(2) do adaptive exercise. Such as mountain climbing, long-distance running, walking with load, etc. , increase vital capacity and enhance adaptability. (3) Understand the local climate characteristics, bring enough clothes, pay attention to cold and warmth, and avoid acute upper respiratory tract infection.
In order to prevent altitude sickness, adaptive training should pay attention to:
(1) Keep a good attitude, eliminate unnecessary fear of plateau, avoid excessive mental stress, and let your body get a full rest.
(2) avoid catching a cold. The plateau climate is cold, and the temperature difference between day and night is large. After catching cold, the body is prone to respiratory tract infection and acute altitude sickness.
(3) Avoid strenuous activities and heavy physical labor in the first two days, and climb slowly, which is conducive to the gradual adaptation of the body.
(4) Eating high-sugar and high-quality protein food is beneficial to overcome the adverse effects of hypoxia.
5] Do not smoke, drink or drink less to reduce the consumption of oxygen.
[6] It is best to take health care products for preventing altitude sickness for 3-5 days after entering the plateau. [ 1]
Altitude sickness, that is, altitude sickness, means that people who are not used to it quickly enter the plateau area above 3000 meters. Due to the decrease of oxygen partial pressure at atmospheric pressure, the body's tolerance to anoxic environment is reduced, and it is difficult to adapt to it, resulting in hypoxia, which leads to a series of altitude disorders. Of course, in addition to the factors of altitude hypoxia, there are also bad weather such as wind, rain, snow, cold and strong ultraviolet radiation, which will aggravate the altitude imbalance and cause different degrees of altitude imbalance.
After a period of adaptation, the body can undergo a series of adaptive changes, such as increasing ventilation, so that the oxygen utilization rate of tissues reaches or approaches the normal level; Accelerate the heart rate and increase the pumping capacity of the heart, thereby increasing the amount of bleeding per minute and improving the hypoxia; Increase the amount of red blood cells and hemoglobin to increase the oxygen carrying capacity, so as to ensure the body's oxygen supply. However, some people are sensitive to the partial pressure of hypoxia in the air and have poor adaptability, and a series of symptoms and changes in functional metabolism will occur, which is also called acute altitude sickness. It is divided into acute altitude sickness, high altitude pulmonary edema, high altitude cerebral edema, high altitude retinal hemorrhage and chronic altitude sickness abroad, and it is divided into acute altitude sickness and chronic altitude sickness at home. For individuals, the onset is often mixed and difficult to distinguish, and it is more prominent at a certain stage in the whole onset process.
Symptom judgment
Some people who enter the plateau for the first time will have symptoms such as headache, dizziness, dizziness, tinnitus, general fatigue, difficulty walking and difficulty falling asleep within 24 hours at an altitude of 3000 meters. In severe cases, there are symptoms such as abdominal distension, loss of appetite, nausea, vomiting, palpitation, shortness of breath, chest tightness, purple complexion, swelling of lips or face. When these symptoms appear, you should stay at the original height and rest for 3~5 days, or immediately lower the height by hundreds of meters, which can generally return to normal.
It is reported that the incidence below 3500m accounts for 37% ~ 5 1%, and the incidence between 3600m and 5000m reaches 50%. This shows that the higher the altitude, the higher the incidence of altitude sickness.
Severe altitude sickness is very harmful to human body. Therefore, after entering the plateau, altitude sickness should be considered if the following symptoms appear:
1. Severe headache, palpitation, shortness of breath, chest tightness, loss of appetite, nausea, vomiting, cyanosis of lips and nails.
2. Consciousness trance, cognitive ability plummeted. Mainly in the calculation difficulty. Do a simple addition problem before entering the platform period and record the time spent. When symptoms appear, repeat the same calculation problem. If it takes longer than before, it means that altitude sickness has occurred.
3. hallucinating, feeling warm, and often walking behind others aimlessly.
Symptom analysis
Altitude sickness includes acute altitude sickness and chronic altitude sickness. After entering the plateau from the plain or entering the higher altitude area from the plateau, a series of hypoxia manifestations appear in a short time, which is called acute altitude sickness. Chronic altitude sickness is a phenomenon that some people can't adapt through long-term continuous adjustment, resulting in a series of clinical symptoms. Chronic altitude sickness is also called "body dysfunction". It is generally believed that after entering the plateau for three months, there are still some or all symptoms of altitude sickness, which can be regarded as chronic altitude sickness.
The symptoms of altitude sickness are generally pain, palpitation, shortness of breath, loss of appetite, burnout, fatigue, dizziness, nausea, vomiting, abdominal distension, diarrhea, chest tightness, insomnia, dizziness, lethargy, dizziness, numbness of hands and feet, convulsions and so on. Signs include increased heart rate, deepening breathing, mild abnormal blood pressure, edema of face or limbs, cyanosis of lips, etc. The clinical manifestations of chronic altitude sickness are varied, and the symptoms can be part of the above manifestations, or most or all of them. Symptoms sometimes appear, sometimes disappear, and generally disappear after returning to flat low altitude areas, which has many similarities with the clinical manifestations of acute altitude sickness. [ 1]
Main pathology
The problem of mountain adaptation is mainly due to the decrease of plateau air pressure and oxygen partial pressure, which leads to the decrease of alveolar oxygen partial pressure.
altitude stress
Hypoxemia, hypoxemia, the decrease of oxygen partial pressure leads to the decrease of alveolar oxygen partial pressure, and the amount of oxygen delivered to the blood decreases. So it immediately caused several reactions in the body. With the increase of breathing frequency, more air is inhaled into the lungs; Heart rate and cardiac output increase to increase arterial blood flow through the lungs and body; The body gradually increases the production of red blood cells and hemoglobin, and improves the ability of blood to transport oxygen. Even with these adjustments, people who have recently reached the platform period can't play their normal physiological functions. It is determined that at an altitude of 5500 meters, a person's ability to complete sports is only 53% of that at sea level.
Emergency treatment
Altitude sickness seriously threatens people's lives and health. How can we find out in time and help each other on the spot?
high altitude pulmonary edema
High altitude pulmonary edema is a common severe altitude sickness with an incidence of about 3%. It usually occurs above 4000 meters, and it often happens quickly 3-48 hours after climbing, and then in 3- 10 days. The important inducement is respiratory infection caused by cold, fatigue and decreased resistance. When you have a headache, chest tightness, varying degrees of cough (dry cough at first, then phlegm), and difficulty breathing, you can't lie flat. In severe cases, pink foam will be coughed up, and finally sputum will be produced.
altitude stress
When the rescuer puts his ear close to the chest wall of the patient, he can hear the gurgling breathing sound of the lungs (medically called wet rales). At this time, the patient is frightened, flustered, cyanosis in mouth, lips and face, and in severe cases, hematuria or gradual unconsciousness. Severe pulmonary edema will worsen rapidly, and the patient will be in a coma and die within a few hours.
The first-aid measures for on-site pulmonary edema are to rest in an absolute semi-recumbent position, with legs drooping, and immediately take oxygen, preferably oxygen containing 50%~70% alcohol at a flow rate of 6 ~ 8 liters/minute; Take furosemide (furosemide) 40mg/day immediately. The use of furosemide may cause slight nausea, diarrhea, drug eruption, blurred vision, upright vertigo, muscle spasm, thirst and so on. Be careful not to use too much at first, and you can increase it to 80 mg twice a day according to the situation. Nifedipine reduces pulmonary edema. Antibiotics and dexamethasone 4 mg can be used to prevent and treat upper respiratory tract infection (only once orally). You can use a small amount of sedatives when you are upset. Keep warm and don't drink a lot of water. After initial first aid, the condition was stable and quickly moved to a lower altitude. In case of respiratory or cardiac arrest, perform cardiopulmonary resuscitation immediately.
Avoid catching a cold
It should be noted that colds should be avoided as much as possible in plateau areas. When you catch a cold at high altitude, you will have the illusion of fever temperature. The temperature of body temperature is often lower than the actual temperature 1 degree, which is easily overlooked. Even a slight respiratory infection can increase the risk of high altitude pulmonary edema. So keep warm. After entering the plateau, reduce the number of baths or not take a bath. When you find the first symptoms of a cold, take anti-cold medicine immediately. If you take anti-cold medicine after two days, it is generally ineffective.
Patients with recurrent high altitude pulmonary edema are susceptible, and the incidence rate of men is five times that of women. If pulmonary edema has occurred before, we recommend not to climb mountains above 3000 meters.
High altitude brain edema
It is another kind of severe altitude sickness, which has an acute onset and often occurs at night. The incidence rate is low, but the mortality rate is high. Its symptoms: in addition to early altitude sickness, there are severe headaches, vomiting and even jet vomiting; Gradually trance, poor sense of orientation, personal convulsions, incontinence, and finally lethargy to coma. A few people may have retinal hemorrhage.
In the past, mountain friends always judged whether there was brain edema by experience. The usual method is to let people suspected of brain edema walk in a straight line to judge whether their directional ability is poor. From a scientific point of view, this method is not desirable! The brain tissue of patients with cerebral edema has been seriously deprived of oxygen. At this point, people in a trance state are likely to fall to the ground immediately and fall into a coma. This inspection method that aggravates the damage is risky. The correct judgment method is to let the patient lie in a semi-supine position and guide him to point to the nose, ears, eyes and so on. According to the instructions, see if his movements can be accurate. Once there is no, it means that brain edema may have occurred.
If brain edema and coma are found, oxygen containing 5% carbon dioxide should be given quickly and continuously until waking up, and oxygen should be given intermittently after waking up. Conditional use of hypertonic glucose, mannitol, adrenocortical hormone, cytochrome C and other treatments can reduce brain edema and promote recovery. Central nervous system stimulants such as lobeline hydrochloride and nikethamide can be used as appropriate. Pay attention to the balance of water, salt and electrolyte and the necessary anti-infection measures. After the condition is stable, immediately go down the mountain and rush to the hospital.
respiratory alkalosis
In the anoxic environment, people will improve the anoxic state by accelerating and deepening breathing, which will increase the exhaled carbon dioxide and lead to respiratory alkalosis. Respiratory alkalosis not only constricts cerebral vessels, but also leads to loss of consciousness and brain edema at high altitude. The most effective way to prevent respiratory alkalosis is to roll the newspaper into a cone, tear a small hole with a diameter of 1-2 cm at the tip of the cone, and stick the cone-shaped newspaper close to the face, so that the exhaled gas can be sucked back, that is, the exhaled carbon dioxide can be sucked back again, thus improving the pH in the body and correcting respiratory alkalosis.
There is no need to be reluctant to face the plateau.
Not everyone who climbs the plateau will have altitude sickness. The incidence and recovery speed of altitude sickness are related to the individual's compensatory adaptability, which varies greatly among individuals. People who have no altitude sickness this time may not be unresponsive when they climb the plateau next time. Some people have altitude sickness every time. These people are sensitive or highly prone to altitude sickness. What needs to be reminded here is that altitude sickness cannot be overcome by repeated exercise. Therefore, in order to ensure good health, it is suggested that people who are prone to altitude sickness should not continue to climb such high-altitude areas. Fitness mountaineering in low-altitude areas can also cultivate sentiment and exercise.