AMS prevention is important in trying to avoid altitude sickness, but it is also important to realize that all the prevention in the world may not help you completely avoid AMS, but it will at least help. What works for person A may not work for person B. Therefore, an experienced doctor / coach must work with you to develop an individualized program.

Expose yourself to lower oxygen levels before hand

There are many ways to adapt to higher altitudes your own home. One way is within altitude tent and a hypoxic generator. A hypoxic generator is a machine that takes room air and is able to deliver a lower concentration of oxygen that it will deliver into a sealed tent. Exposing yourself for several days to lower oxygen concentrations this will cause adaptations in the body allowing you to do better at altitude.

Oxygen tent

Medications

The key to preventing AMS is a gradual ascent that allows for adequate acclimatization. Travel from sea level to 10,000 feet or more should include a rest day at a moderate altitude (5,000 to 6,000 feet). If this is not possible, then acetzolamide or dexamethasone prophylaxis should be considered. Combining the two drugs is more effective than either alone.

Diamox (acetazolamide)

Dexamethasone

Viagra (nitric oxide)

Ibuprofen

Tylenol

Salt tablets

Iron pills

Optimize iron and hemoglobin levels

O2 – Oxygen

Have oxygen on hand. I guarantee this is going to be a big subject in this year’s Dakar Rally. As flying with oxygen is very difficult, bringing oxygen to the Rally is going to be a challenging task.

oxygen concentrator

Typical oxygen concentrator

There are several ways to have oxygen available at a sporting event. The most obvious way is to have portable oxygen tanks filled with oxygen. The ASO medical tent will surely have oxygen on hand for those who may need it. But they will only have limited supplies and there is no way they can carry enough for everybody in the bivouac. The other way to deliver oxygen to yourself is through a machine called an oxygen concentrator. An oxygen concentrator takes room air, pressurizes it, runs it through a special type of mineral filter called Zeolite and separates the oxygen from the nitrogen delivering a nearly pure concentration of oxygen. There are different size machines and you should do whatever you can to obtain one and bring it with you. The oxygen concentrator’s will run off a regular generator and several people can use oxygen from the same concentrator. And one of the benefits is that you do not run out of oxygen since it is being made continuously. If you really know what you’re doing the oxygen concentrator can be used to fill tanks as well.

Places like O2CRS supply portable oxygen concentrators that will supply an oxygen percentage of 95 to 98% pure oxygen.  These special oxygen concentrators are portable, light and can plug into any outlet or AC adapter in a car. If you do some research, you should be able to find a store in your town. Obtaining these machines is much more difficult in Europe!

Serious medical conditions associated with AMS
A very severe condition of AMS is called cerebral edema and pulmonary edema. Altered consciousness and loss of coordination (ataxia) are the hallmarks of this cerebral edema. Victims are confused, disoriented, and show impaired judgment. This renders them unable to care for their basic needs, such as eating and dressing themselves. Within a day of losing coordination, high altitude cerebral edema victims slip into a coma and death results without proper medical care. Heart rates and ventilation typically increase while lips and nail beds turn blue. Difficulty breathing at rest and audible chest congestion signal a serious deterioration in one’s condition. Cold temperatures are an additional risk factor since they increase pulmonary artery pressures. Fortunately, these conditions are rare and seen more in high altitude mountain climbers.