Acute Mountain Sickness in the High-Altitude Urgent Care Clinic

Purpose:

Mountain sports have become more popular and adventure seekers are traveling to the top of the world in search of their passion. With more travel to higher and higher altitudes for outdoor recreation, military, and rescue operations requiring an ascent to high altitudes, with little or no time for acclimatization, it is imperative to understand the effects of altitude and low gas pressures on the human body. Health care providers are being presented with questions of prevention and treatment of high-altitude medical problems, as well as the effects of altitude on preexisting conditions. The 2012-2013 ski season at Red River and Angel Fire, New Mexico, had a cumulative diagnostic rate of acute mountain sickness of 4.3%. The existing literature as outlined in this study has shown that the diagnostic rate should at least be 20%. 

Methods:

The purpose of this study was to explore whether or not the incidence of AMS is being underdiagnosed in individuals who have experienced a rapid ascent in altitude and to determine if those with a history of vascular headaches are at risk for AMS. The data collection included completion of the LLS and the patient’s sex, age, race, zip code of residence, time of departure from residence, time of arrival to

altitude, altitude gained, days at altitude, history of migraine headache, onset of migraine headache at altitude, history of cluster headache, onset

of cluster headache at altitude, history of altitude illness, and the onset of AMS.

 Results:

 Two hundred and thirteen subjects (107 female and 106 male) were entered into the study. Ninety-four subjects (44.1%) were found to have an LLS score indicating AMS, with an additional 15 (7.0%) experiencing HAH. Out of the 41 subjects with a history of migraine headaches, 22 (53.66%) had positive LLS scores for AMS or signs/symptoms of HAH. In regard to those 8 with a history of cluster headaches all 8 (100%) had positive LLS scores for AMS or signs/symptoms of HAH.

 Conclusion:

This study showed that by using the LLS to screen for AMS during the review of systems interview process, the diagnostic rate of AMS will be

increased, possibly by catching the subtle, mild cases and preventing them from progressing to more moderate and severe AMS that would be

missed by a distracting injury or illness. Furthermore, the study goes on to suggest, as have other studies, which individuals with a history of

vascular headaches are at risk for developing AMS. Additionally, our study has shown that those with a history of cluster headaches are more at

risk than those with a history of migraine headaches.