High-Altitude Medical

HANDBOOK

Asthma at high altitude requires special attention and proper medical preparation. Bronchial hyperreactivity in the mountains can be triggered by various factors that need to be recognized and managed.

FACTORS TRIGGERING BRONCHIAL HYPERREACTIVITY

Key factors include:

➤ Cold – increased breathing of cold air can trigger an asthma attack.

➤ Physical exertion – affects 60–80% of asthmatics; excessive effort should be avoided.

➤ Hypoxia (low oxygen levels) – reduced oxygen in the air can worsen asthma symptoms.

➤ Low humidity – drying of the airway mucosa increases hyperreactivity.

➤ Reduced air density – affects breathing ease and can increase airway sensitivity.

Bronchial constriction at high altitude worsens hypoxia, which can contribute to Acute Mountain Sickness (AMS) and High-Altitude Pulmonary Edema (HAPE).

ASTHMA AT DIFFERENT ALTITUDES

Up to 2000 m – fewer allergens and thinner air make breathing easier, reducing infection risk.

Above 2500 m – air is colder and drier, increasing the risk of asthma exacerbation.

3500–5000 m – asthma attack risk decreases thanks to the beneficial effects of acclimatization. Higher steroid hormone levels and fewer airborne allergens help reduce bronchial hyperreactivity. Some studies suggest that hypoxia increases sympathetic activity, which lowers airway sensitivity to cold air.

RECOMMENDATIONS FOR ASTHMATICS

➤ Use spacers, BUFF-style face coverings, or dedicated breathing masks to protect your airways from cold air and wind.

➤ Keep physical exertion moderate, avoiding hyperventilation.

➤ Avoid passive altitude gain (e.g., cable cars) because sudden hypoxia may increase airway sensitivity.

➤ Protect yourself from upper respiratory tract infections.

➤ Monitor airway function with a PEF (Peak Expiratory Flow) meter.

PREPARATION BEFORE THE TRIP

➤ If asthma is not well-controlled, high-altitude travel is not recommended.

➤ Those most at risk are asthmatics who need inhalers more than three times per week or plan heavy exertion at altitude.

➤ Check that vaccinations are up to date, including flu shots.

➤ Bring spare inhalers, spacers, and steroid medications.

➤ Know your personal asthma triggers and avoid them during the trip.

➤ Gradually increase physical endurance, starting with low exertion at lower altitudes.

ASTHMA DURING THE TRIP

➤ Always carry all inhalers with you.

➤ Prevent problems – do not overexert, take medications as prescribed, and if necessary, descend to lower altitude.

➤ Avoid anti-inflammatory drugs such as aspirin or ibuprofen, which may worsen bronchial reactions.

REFERENCES:

• Travel at high altitude – www.medex.org.uk

• Journal of Travel Medicine 2010; Volume 17 (Issue 1): 48–62; K. Mieske et al.; Journeys to High Altitude—Risks and Recommendations for Travelers with Preexisting Medical Conditions

• High Altitude Medicine & Biology 2009, Volume 10, Number 2: 117–121; A. Cogo, G. Fiorenzano; Bronchial Asthma: Advice for Patients Traveling to High Altitude

-------

WANT TO LEARN MORE?

If you want to better prepare your health for trekking or a high-altitude expeditions, check out the expanded guide in the ebook "High-Altitude Medicine for Trekkers and Climbers" >>

-----

Gain practical skills for handling emergencies in the mountains through our online training "High-Altitude First Aid" >> - prepared for those planning trips to high altitudes.

-----

 For a detailed list of what to include in your expedition medical kit and step-by-step instructions for assembling your personal first aid set, see the ebook "High-Altitude Expedition Medical Kit Guide" >>

PLANNING A TREK OR A HIGH-ALTITUDE EXPEDITION?

If you would like to check whether your health condition allows you to safely participate in a trek or high-altitude expedition, consider booking a medical consultation >> or using a telemedical expedition package >>

This allows you to assess potential health risks in advance, prepare properly fot altitude, and increase your safety during the expedition.

The company was established in 2004. The goal of MedEverest is education in the field of mountain medicine and the dangers of high altitudes. I deal with all medical aspects of staying at high altitude. I organize medical support for trekking and high-altitude expeditions.

Specialist Medical Practice Medeverest Robert Szymczak based in Gdańsk (80-360), at ul. Bolesława Krzywoustego 19F, NIP: 5841943576, REGON: 220148318.

All rights reserved. Copying content and photos is prohibited. Information obligation before consenting to data processing.(see).

Also checkStore regulations >> Implementation: ColinMedia.eu >>