Altitude sickness is no joke! Higher and higher: why mountain air is dangerous

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It is well known from the physics course that with increasing altitude above sea level, atmospheric pressure decreases. If up to an altitude of 500 meters no significant changes in this indicator are observed, then when reaching 5000 meters the atmospheric pressure decreases almost by half. As atmospheric pressure decreases, the partial pressure of oxygen in the air mixture also drops, which immediately affects the performance of the human body. The mechanism of this effect is explained by the fact that blood saturation with oxygen and its delivery to tissues and organs is carried out due to the difference in partial pressure in the blood and alveoli of the lungs, and at altitude this difference decreases.

Up to an altitude of 3500 - 4000 meters, the body itself compensates for the lack of oxygen entering the lungs by increasing breathing speed and increasing the volume of inhaled air (depth of breathing). Further climb for full compensation negative impact, requires the use of medications and oxygen equipment (oxygen cylinder).

Oxygen is necessary for all organs and tissues human body during metabolism. Its consumption is directly proportional to the activity of the body. Lack of oxygen in the body can lead to the development of mountain sickness, which in extreme cases - swelling of the brain or lungs - can lead to death. Mountain sickness manifests itself in symptoms such as: headache, shortness of breath, rapid breathing, some painful sensations in muscles and joints, appetite decreases, restless sleep etc.

Height tolerance is very individual indicator, determined by features metabolic processes body and fitness.

Greater role in the fight against negative impact altitude plays a role in acclimatization, during which the body learns to deal with lack of oxygen.

• The body's first reaction to a decrease in pressure is an increase in heart rate, an increase in blood pressure and hyperventilation of the lungs, and the expansion of capillaries in the tissues occurs. Reserve blood from the spleen and liver is included in the blood circulation (7 - 14 days).

• The second phase of acclimatization is to increase the amount produced bone marrow erythrocytes almost double (from 4.5 to 8.0 million erythrocytes per mm3 of blood), which leads to better tolerance to altitude.

The consumption of vitamins, especially vitamin C, has a beneficial effect at altitude.

2. Rototaev P. S. R79 Conquered giants. Ed. 2nd, revised and additional M., “Thought”, 1975. 283 p. from maps; 16 l. ill.

Atmospheric pressure is the force of pressure of an air column per unit area. It is calculated in kilograms per 1 cm 2 of surface, but since previously it was measured only with mercury manometers, it is conventionally accepted to express this value in millimeters of mercury (mmHg). Normal atmospheric pressure is 760 mmHg. Art., or 1.033 kg/cm 2, which is considered to be one atmosphere (1 ata).

By doing individual species Work sometimes requires working at high or low atmospheric pressure, and these deviations from the norm are sometimes within significant limits (from 0.15-0.2 ata to 5-6 ata or more).

The effect of low atmospheric pressure on the body

As you rise to altitude, atmospheric pressure decreases: the higher you are above sea level, the lower the atmospheric pressure. So, at an altitude of 1000 m above sea level it is equal to 734 mm Hg. Art., 2000 m - 569 mm, 3000 m -526 mm, and at an altitude of 15000 m - 90 mm Hg. Art.

With reduced atmospheric pressure, there is increased and deepening of breathing, increased heart rate (their strength is weaker), a slight drop in blood pressure, and changes in the blood are also observed in the form of an increase in the number of red blood cells.

The adverse effect of low atmospheric pressure on the body is based on oxygen starvation. It is due to the fact that with a decrease in atmospheric pressure, the partial pressure of oxygen also decreases, therefore, with the normal functioning of the respiratory and circulatory organs, less oxygen enters the body. As a result, the blood is not sufficiently saturated with oxygen and does not fully deliver it to organs and tissues, which leads to oxygen starvation (anoxemia). Such changes occur more severely when rapid decline atmospheric pressure, which happens during rapid takeoffs to high altitudes, when working on high-speed lifting mechanisms (cable cars, etc.). Rapidly developing oxygen starvation affects brain cells, which causes dizziness, nausea, sometimes vomiting, loss of coordination of movements, decreased memory, drowsiness; reduction of oxidative processes in muscle cells due to lack of oxygen is expressed in muscle weakness, rapid fatigue.

Practice shows that climbing to an altitude of more than 4500 m, where the atmospheric pressure is below 430 mm Hg, without oxygen supply for breathing is difficult to endure, and at an altitude of 8000 m (pressure 277 mm Hg) a person loses consciousness.

Blood, like any other liquid, upon contact with a gaseous medium (in in this case in the alveoli of the lungs) dissolves a certain part of the gases - the higher their partial pressure, the greater the saturation of the blood with these gases. When atmospheric pressure decreases, partial pressure changes components air and, in particular, its main components - nitrogen (78%) and oxygen (21%); As a result, these gases begin to be released from the blood until the partial pressure equalizes. During a rapid decrease in atmospheric pressure, the release of gases, especially nitrogen, from the blood is so great that they do not have time to be removed through the respiratory system and accumulate in the blood vessels in the form of small bubbles. These gas bubbles can stretch tissue (even to the point of small tears), causing sharp pain, and in some cases, form gas clots in small vessels, impeding blood circulation.

The complex of physiological and pathological changes, arising as a result of a decrease in atmospheric pressure, is called altitude sickness, since these changes are usually associated with an increase in altitude.

Preventing altitude sickness

One of the widespread and effective measures to combat altitude sickness is the supply of oxygen for breathing when ascending to high altitudes (over 4500 m). Almost all modern aircraft flying on high altitude, and especially spaceships, are equipped with sealed cabins, where, regardless of the altitude and atmospheric pressure outside, the pressure is maintained constant at a level that fully ensures the normal condition of the flight crew and passengers. This is one of the radical solutions to this issue.

When performing physical and intense mental work in conditions of low atmospheric pressure, it is necessary to take into account the relatively rapid onset of fatigue, therefore periodic breaks should be provided, and in some cases, a shortened working day.

To work in conditions of low atmospheric pressure, the physically strongest persons, absolutely healthy, mainly men aged 20 - 30 years, should be selected. When selecting flight personnel, mandatory testing is required for the so-called altitude qualification tests in special chambers with reduced pressure.

Training and hardening play an important role in the prevention of altitude sickness. It is necessary to play sports, systematically perform one or another physical work. The diet of those working at low atmospheric pressure should be high-calorie, varied and rich in vitamins and mineral salts.

Helpful information:

The Earth's air envelope, which is a mixture of various gases, exerts pressure on the earth's surface and all objects located on it. At sea level, every 1 cm 2 of any surface experiences a pressure of the vertical column of the atmosphere equal to 1.033 kg. Normal pressure is considered to be 760 mm Hg. Art. at sea level at 0°. The value of atmospheric pressure is also determined in bars. One normal atmosphere is equal to 1.01325 bar. One millibar is equal to 0.7501 mm Hg. Art. A weight of approximately 15-18 tons presses on the surface of the human body, but a person does not feel it, since the pressure inside the body is balanced by atmospheric pressure. Normal daily and annual fluctuations in air pressure are 20-30 mmHg. Art., do not have a noticeable effect on the well-being of healthy people.

However, in elderly people, as well as in patients with rheumatism, neuralgia, hypertension before sharp deterioration weather is often observed bad feeling, general malaise, exacerbation of chronic diseases. These painful phenomena appear to occur as a result of the decrease in atmospheric pressure and other changes in meteorological factors that accompany bad weather.

As you rise in altitude, atmospheric pressure decreases; the partial pressure of oxygen in the air contained in the alveoli also decreases (i.e., that part of the total air pressure in the alveoli that is due to oxygen). These data are illustrated in Table 6.

From Table 6 it can be seen that as atmospheric pressure decreases with height, the value of the partial pressure of oxygen in the alveolar air also decreases, which at an altitude of about 15 km is practically equal to zero. But already at an altitude of 3000-4000 m above sea level, a decrease in the partial pressure of oxygen leads to an insufficient supply of oxygen to the body (acute hypoxia) and the occurrence of a number of functional disorders. Headaches, shortness of breath, drowsiness, tinnitus, a feeling of pulsation of the vessels of the temporal region, impaired coordination of movements, pallor of the skin and mucous membranes, etc. appear. Disorders from the central nervous systems s are expressed in a significant predominance of excitation processes over inhibition processes; there is a deterioration in the sense of smell, a decrease in auditory and tactile sensitivity, a decrease visual functions. This entire symptom complex is usually called altitude sickness, and if it occurs when climbing mountains, mountain sickness (Table 6).

There are five height tolerance zones:
1) safe, or indifferent (up to a height of 1.5-2 km);
2) a zone of full compensation (from 2 to 4 km), where some functional changes in the body are quickly eliminated due to the mobilization of the body’s reserve forces;
3) zone of incomplete compensation (4-5 km);
4) a critical zone (from 6 to 8 km), where the above violations intensify, and death may occur in the least trained people;
5) a lethal zone (above 8 km), where a person can exist for no more than 3 minutes.

If the pressure changes quickly, then functional disorders occur in the ear cavities (pain, tingling, etc.), which can result in rupture eardrum. To eliminate oxygen? fasting use special equipment that adds oxygen to the inhaled air and protects the body from possible disorders caused by hypoxia. At altitudes above 12 km, only a pressurized cabin or a special spacesuit can provide sufficient partial pressure of oxygen.

It is known, however, that people living in mountain villages at high altitudes, employees of high-mountain stations, as well as trained climbers who rise to an altitude of 7000 m above sea level and more, and pilots who have undergone special training, experience an addiction to others atmospheric conditions; their impact is balanced by compensatory functional changes reactivity of the body, which primarily includes adaptation of the central nervous system. Phenomena from the hematopoietic, cardiovascular and respiratory systems also play a significant role (an increase in the number of red blood cells and hemoglobin, which are oxygen carriers, an increase in the frequency and depth of breathing, and blood flow speed).

Increased pressure does not occur under normal conditions; it is observed mainly when performing production processes at great depths under water (diving and so-called caisson work). For every 10.3 m of immersion, the pressure increases by one atmosphere. While working at high blood pressure There is a decrease in pulse rate and pulmonary ventilation, decreased hearing, pale skin, dry mucous membranes of the nasal and oral cavities, indentation of the abdomen, etc.

All these phenomena are significantly weakened and ultimately disappear completely with a slow transition to normal atmospheric pressure. However, if this transition is carried out quickly, then severe pathological condition, called decompression sickness. Its origin is explained by the fact that when staying in conditions high pressure(starting from about 90 m) a large amount of dissolved gases (mainly nitrogen) accumulate in the blood and other body fluids, which, when quickly leaving the high pressure zone to normal, are released in the form of bubbles and clog the lumen of small blood vessels. As a result of the emerging gas embolism a number of disorders are observed in the form of itching of the skin, damage to the joints, bones, muscles, changes in the heart, pulmonary edema, various types paralysis, etc. in rare cases observed fatal outcome. To prevent decompression sickness, it is necessary, first of all, to organize the work of caisson workers and divers in such a way that the exit to the surface is carried out slowly and gradually to remove excess gases from the blood without the formation of bubbles. In addition, the time spent by divers and caisson workers on the ground must be strictly regulated.

As soon as a person climbs the mountains and overcomes a certain altitude barrier (usually from 2500 m above sea level), he is faced with reduced atmospheric pressure and reduced oxygen content. Once in such a hostile environment, the body begins to adapt to what is happening. The process is accompanied by a deterioration in health, painful condition. It's called altitude sickness, and the period while the body adapts to high altitudes is acclimatization.

Essentially mountain sickness is high-altitude hypoxia, which is aggravated by physical activity and harsh conditions external environment in the mountains: physical stress, cold, limited nutrition, high humidity.

As you gain altitude, each breath contains less and less oxygen. With increasing physical activity in the mountains, the body's need for oxygen further increases. During the process of acclimatization human body tries to adapt, and the following arise:

• rapid breathing, increasing gas exchange in the lungs;
• the number of red blood cells increases and the blood carries more oxygen;
• the heart rate increases and blood pressure increases, the flow of arterial blood to the brain and muscles.

Changes in metabolic processes and blood composition are actually acclimatization. The main acclimatization occurs in the first 2-3 days in the mountains. After this, a person can get by with less oxygen in the air and spend energy more efficiently.

The occurrence of altitude sickness is influenced not only by altitude, but also by a number of other environmental factors:

Environmental factors that provoke miner

Coldand inhumidity forced to inhale frequently and in small portions, increasing hypoxia. In addition, with hypothermia, edema also occurs, as with high-altitude edema of the lungs and brain, which significantly reduces the compensatory capabilities of the body.

Wind hurricane force seriously impairs breathing and increases hypothermia.

In a cold, wet climate, altitude sickness symptoms will appear at lower altitudes than in a dry, warm climate.💧 In Kamchatka and Patagonia, altitude sickness manifests itself already at an altitude of 1000-1500 m above sea level. ur. m. In the Alps - from 2500 m, in the Caucasus from 3000 m, in the Andes from 4000 m. ☀For comparison, let's take mountains in a dry continental climate: nand in the Tien Shan the “miner catches” at 3500 m, in the Pamirs from 4500 m, in the Himalayas it spares up to 5000 m.

"Death Zone"

If averaged, then at an altitude of 3500 meters there are unpleasant symptoms. Above 4500 meters, regardless of a person’s physical fitness, Negative consequences influence of altitude. When exceeding 6500 meters, acclimatization does not occur; this altitude is called "death zone".

While the body is undergoing restructuring, the person suffers from hypoxia. Brain cells are especially susceptible to lack of oxygen. It is for this reason that headaches are so common among climbers.

What affects the symptoms of mountain sickness?

ANDindividual characteristics of the body. People who were born/lived in the mountains tolerate heights much better. A striking example to that are the Sherpas in Nepal, who, without oxygen cylinders, carry to Everest and not only almost all the belongings of climbers and expeditions, and sometimes even the climbers themselves :).

Among the inhabitants of the plains (like you and me) there are also organisms that are more or less resistant to altitude. But this stability can only be tested in the field.

Age. It is well known that the older a person is, the easier it is for him to endure the “miner”. Most likely this is due to general decline oxygen needs.

Floor. It is believed that it is more difficult for men to adapt to high altitude conditions, while women are generally more stress-resistant and more easily “switch” to efficient energy consumption.

General condition of the body. The matter is especially aggravated by chronic or acute diseases respiratory tract, problems with the liver, spleen and kidneys, diabetes.

« INhigh altitude experience relieves symptoms, although is not a determining factor. For example, an experienced climber with bronchitis will tolerate heights much worse than a healthy beginner.

Psychological stability. Experienced climbers compare altitude sickness to alcohol intoxication, only very strong and lasting. Based on this, many can imagine what awaits in the High Mountains :). Only there is no salvation or cure for this. You will have to endure, and a positive attitude will be very useful.

External factors

Dialing speed height. It’s clear here: the faster we rise, the worse it will be. You need to give yourself time to rebuild and adapt.

Physical effort during the ascent. Muscles need oxygen to work, which is already insufficient. The more blood goes to the muscles, the less there is for everything else. Due to excessive exertion, pulmonary or cerebral edema can easily develop (extreme forms of mountain sickness, which we will discuss below).

Time spent at altitude. If adaptation proceeds correctly, then in 2-4 days your health will be closer to normal. However, mountaineering complications signal that the body cannot cope with acclimatization and every hour spent at altitude aggravates the situation.

This rule works up to the so-called “death zone”, or up to ~ 6500m, above which adaptation is impossible. And here it’s important to get down quickly.

“Internal” factors in the development of mountain sickness

There are a number of things that can and should be controlled to relieve symptoms:

Alcohol and caffeine They VERY greatly reduce resistance, mainly due to impaired exchange of water and salts. We strongly recommend that you avoid consuming these substances while climbing.

Violation of water-salt regime still occurs at high altitudes, because the body increases blood volume, and physical activity and changes in the cell membrane shift the balanceNa, KAndCa. aggravateuhThatIt’s not worth it - it accelerates the development of edema.

PIf you have kidney problems, the risk of developing pulmonary and cerebral edema increases.

Poor nutrition . The digestive system is one of the first to suffer from the miner; the absorption of water, proteins, vitamins and especially fats decreases. It is vital for a climber to replenish fluids, salts, vitamins, carbohydrates and proteins. Therefore, the diet should be varied, healthy and light.Eliminate complex fats - they still won’t be digested.Get energy from simple and complex carbohydrates, on the 2-3rd day, be sure to introduce proteins into the diet, add a little salt to the water. Drink vitamins and dietary supplements with calcium and potassium.

>> Absolutely irreplaceable hot sweet hour with lemon. Vitamin C increases the body's resistance to altitude.

>> Read more about food distribution and metabolism in the article: Nutrition in the mountains.

Obesity often accompanied by changes in metabolism, liver problems, etc. Overweight people find it more difficult to deal with the effects of altitude.

P problems with blood flow rotation . Even minor bleeding can have a detrimental effect on the climber, leading to hypothermia, hypoxia, and edema.

ABOUTwill specifically note chronic problems with the blood storage organs: liver and spleen. It was from here on the first dayHigh-altitude hypoxia releases red blood cells, which provides the “first level” of protection and adaptation. If you have problems with these organs, you need to think twice before climbing.

Pulmonary and cerebral edema

Ironically, it is precisely the mechanisms of adaptation of the body to high altitudes that can lead to serious problems with health. The increase in blood pressure and total blood volume does not last indefinitely - there is a limit called compensatory barrier. Staying at altitude after the limit is reached leads to swelling of tissues - primarily the brain and lungs. When the compensation limit is reached, vascular permeability increases and cell membranes, and high blood pressure enhances this effect: blood plasma enters the tissues, and the blood thickens. This causes swelling. The most dangerous are cerebral edema and pulmonary edema.

Pulmonary edema

or High altitude pulmonary edema (HAPE)- V Nonvascular fluid begins to accumulate in the alveoli of the lungs, and lung volume decreases. As a result, hypoxia increases. Signs:

• Attacks of severe, painful suffocation.
• Severe shortness of breath even without physical activity.
• A sharp increase in breathing (shallow, bubbling, audible at a distance).
• Rapid heartbeat due to lack of oxygen.
• First, coughing, and then a cough with severe wheezing and the production of foamy sputum, Pink colour; etc.

With absence medical care may be fatal. Death comes due to asphyxia due to excessive foaming.

Brain swelling

orHigh altitude cerebral edema ( HACE) . There is a for the same reasons. The released fluid begins to put pressure on the cerebral cortex from the inside, pushing it into the skull, which leads to disruption nerve centers and can be fatal.

Death comes due to compression of the cerebellum into the spinal cord trunk or due to compression of the cortex by the cranial vault.

Breathing at altitude

Also, at high altitudes, climbers wake up at night because they can’t breathe.

To saturate the body with oxygen, breathing quickens, why the level carbon dioxide falls. But CO 2 plays important role in the regulation of breathing - stimulates the respiratory center in the brain. While the climber is awake, inhalation/exhalation is regulated by consciousness, and during sleep - only respiratory center. Therefore, at night there is a phenomenon called Cheyne-Stokes breathing: breathing stops for a few seconds (the brain’s reaction to a lack of CO 2), and then is replaced by a series of rapid deep breaths and shallow exhalations (response to falling O 2 levels).

In fact, the climber regularly wakes up from severe suffocation, which passes within a minute or two after consciousness regains control of breathing and the person calms down.

Breathing problems are a normal reaction to lack of oxygen.

Prevention of altitude sickness

What should you do to minimize the symptoms of altitude sickness in high altitude conditions? There is a minimum set of three rules:

1. Never continue climbing mountains if you have symptoms of altitude sickness.
2. Be sure to go downstairs if the symptoms get worse
3. If you feel unwell for no reason, consider it mountain sickness.

Proper acclimatization

Primary weapon against high altitudes —correct acclimatization. You cannot force events, the body must have time to adapt.

At altitudes above 3500 m, you should not gain altitude too quickly. It is advisable to climb about 500 m per day, get plenty of rest and give the body time to adjust. Every 2 days after the crossing it is better to stop for a day. Enjoy the surrounding views and practice alpine training.

If you are not going on a solo hike, you should consider individual characteristics other participants.

It is advisable not to travel to high altitudes beyond a short time(helicopter, plane). However, this is not always possible. For example, you have to immediately fly to an altitude of 3000 m while trekking in Peru. If you get to a height in this way, you should spend 1-2 days at it without going higher.

It is very good to adhere to the rule of climbers - "walk high - sleep low". It is advisable to gain some altitude during the day, spend some time there, while receiving physical activity. For the night, go down a little lower (300 meters). We get a gear pattern of movement in the mountains.

Medicines for mountain sickness

Pharmacological drugs to relieve/relieve symptoms of mountain sickness:

1. Diakarb(acetazolamide or diamox) is a diuretic drug that prevents swelling. It has many side effects and cannot be used as a prophylactic. Acetazolamide can cause seizures because it leaches potassium from the body. Should be taken together with drugs containing potassium and magnesium, for example: panangin or asparkam.
2. Dexamethasone- relieves symptoms of altitude sickness, but does not promote acclimatization in any way. It has many side effects and is recommended for use only by those who cannot tolerate acetazolamide. You can take it a few hours before climbing.
3. Any vasodilator (to lower blood pressure) with the lowest side effects(but not a dietary supplement).

For prevention Ginkgo biloba extract (vasodilator), antioxidants (tocopherol, ascorbic acid and lipoic acid), riboxin for cardiac support, coca leaves (available in the Andes) or preparations containing the extract are often used.

Remember that at high altitudes you should always listen to yourself and if you feel very unwell, immediately go down.

Altitude test.
Mountain sickness and other dangers when climbing.

Weather conditions and route conditions are the two main concerns of experienced high mountain climbers. It is better not to start climbing in bad weather or with a bad forecast. The majority of those who died on the slopes of the mountain were those who simply lost the right path in conditions of lack of visibility. Presence or absence of plots bare ice on the route determines its technical complexity. In good conditions, sometimes you can even get by without cats. But when a belt of “bottle” ice appears in winter, or more often in spring, even outstanding ice climbers get excited. Organizing insurance over a long section seems like too much time. Therefore, they walk very, very carefully, but without insurance. One wrong move and... Fly to the end of the slope. Fortunately, there is almost never ice in the summer.
If you are lucky in these two positions, then climbing Elbrus may not be difficult for you at all. But no matter how lucky you are, you will certainly encounter one problem. This is your body's reaction to changes in external conditions. To altitude, to solar radiation, to cold, to other unfavorable factors. For most climbers, this becomes a test of their altitude tolerance.

For a long time, scientists and climbers have encountered in the mountains the phenomenon of decreased performance of the body. Scientifically speaking, there is a sharp increase or rather a breakdown in the cardiovascular activity, respiratory, digestive and nervous systems, especially in the first days of staying at altitude. In many cases, this led to the development of acute mountain sickness, when there was a direct threat to human life. At the same time, the higher the climbers climbed into the mountains, the more unfavorable symptoms appeared. At the same time, the local residents who accompanied the climbers reacted much more calmly to changes in climatic factors. On the one hand, this indicated the individual nature of the reaction to height. On the other hand, it led to conclusions about the possibility of adaptation to unfavorable factors.

Practice has led to conclusions about the need for preliminary acclimatization, carried out in a certain sequence. It usually involves a gradual climb to altitude with a descent at night to lower altitudes. As always, there is theory and there is practice.
Theoretically, we recommend climbing Elbrus after at least 7-10 days of active walking at lower altitudes. But in practice, people often go climbing 4-5 days after arriving in the mountains. What can we do, our behavior is determined by social conditions. Constant shortage time is the cost of the modern lifestyle.

Here's what science says about the adverse factors of high altitudes.

1. Temperature. With increasing altitude, the average annual air temperature gradually decreases by 0.5 °C for every 100 m, and in different seasons of the year and in different geographical areas it decreases differently: in winter it is slower than in summer, amounting to 0.4 °C and 0, respectively. 6°C. In the Caucasus, the average decrease in temperature in summer is 6.3-6.8° per 1 vertical kilometer, but in practice it can be up to 10 degrees.

2. Air humidity. Humidity is the amount of water vapor in the air. Since the pressure of saturated water vapor is determined only by air temperature, in mountainous areas where the temperature is low, the partial pressure of water vapor is also low. Already at an altitude of 2000 m, air humidity is half that at sea level, and at high mountain altitudes the air becomes almost “dry”. This circumstance increases the loss of fluid by the body not only through evaporation from the surface of the skin, but also through the lungs during hyperventilation. Hence the importance of ensuring adequate drinking regime in the mountains, because Dehydration of the body reduces performance.

3. Solar radiation. At mountain heights, the intensity of the radiant energy of the sun increases greatly due to the great dryness and transparency of the atmosphere and its lower density. When rising to an altitude of 3000 m, the total solar radiation increases by an average of 10% for every 1000 m. The greatest changes are found in ultraviolet radiation: its intensity increases by an average of 3-4% for every 100 m of elevation. The body is affected by both visible (light) and invisible (infrared and the most biologically active ultraviolet) sun rays. In moderate doses it can be beneficial to the body. However, excessive exposure to sunlight can lead to burns, sunstroke, cardiovascular and nervous disorders, exacerbation of chronic inflammatory processes. As you gain altitude, the increased biological effectiveness of ultraviolet radiation can cause skin erythema and keratitis (inflammation of the cornea of ​​the eyes). Creams, masks, glasses are mandatory things for climbers on Elbrus. Although there are people who can easily do without it. Their skin is of a different type.

4. Atmospheric pressure. As altitude increases, atmospheric pressure drops, while the concentration of oxygen, as well as the percentage of other gases within the atmosphere, remain constant. Compared to sea level, atmospheric pressure at an altitude of 3000 m is lower by 31% and at an altitude of 4000 m - by 39%, and at the same altitudes it increases from high to low latitudes and in the warm period it is usually higher than in the cold . The drop in atmospheric pressure is closely related to main reason mountain sickness, lack of oxygen. In scientific language this is called a decrease in the partial pressure of oxygen. The experimental results show that at an altitude of 3000 m the amount of O2 in the inhaled air decreases by one third and at an altitude of 4000 m by half. All this leads to undersaturation of hemoglobin with oxygen, an insufficient amount of it enters the tissues and a phenomenon called hypoxia develops. This is actually the body’s reaction to this phenomenon.

Preparing for the ascent. Training. Sometimes you can hear stories about how a person does not train and calmly goes on high-altitude climbs better than “regular” athletes. Well, legends can be retold and retold. In any case, leading an unsportsmanlike lifestyle, not training your body, is a path that we do not welcome. For a successful climb to Elbrus, what is important, first of all, is endurance, the readiness of the heart, lungs and muscles for long-term work. Skiing and long-distance running are the best training tools. On the other hand, you should pay attention to the opposite point. Athletes in peak condition are often very vulnerable to infectious diseases. Therefore, we recommend that for people who have mastered large volumes of training, reduce the load about a week before leaving for the mountains. And avoid competitions with maximum effort at this time. In addition, the body must accumulate fat reserves.

Collection. Equipment. Many people take all kinds of gatherings lightly and even try to boast about their sloppiness. Mountaineering should make such people more organized. Here, every item taken or not taken can cost your life, not only to you, but also to your fellow climbers. It is imperative to prepare yourself for thorough preparation and selection of equipment. Make a list and practice each item in advance, including medications. Do not hesitate to contact the organizers with questions about the selection of equipment and medical support for the ascent.

Nutrition during preparation. It is recommended to prepare yourself the way athletes prepare for a responsible start. The last week before departure there should be a lot of food, it should be varied with a lot of carbohydrates. It is recommended to take a course vitamin complexes. Their choice is great and recommending something specific means advertising. These should be multivitamins and they should be taken strictly according to the doses indicated in the accompanying papers. Or better yet, on the recommendation of your personal doctor.

In the mountains, a period of acclimatization. First days. Don't worry ahead of time. A normal healthy body must demonstrate its response to changing conditions. You should not panic if immediately upon arriving in the mountains you feel unwell, dizzy, lack of appetite, etc. Each person's reaction is unique. But in general healthy person We can recommend not to interfere with your body’s ability to adapt to new stressful conditions. In theory, the body should draw the right conclusions on its own. How can you stop him? First of all, you should avoid taking a lot of medications, let your head hurt a little, let the nausea go away on its own. It is not recommended to overeat and drink large quantities of alcoholic beverages during acclimatization. Leave this for the final part of the expedition, and in the first days you can limit yourself to 50-100 grams, which can help relieve tension. You should continue the course of taking multivitamins that you started on the plain. The body will need many different chemical elements in order to cope with the upcoming test.

Nutrition during the acclimatization period.
During this period, due to changes in the functioning of the body, there may be disruptions in appetite. You should not force anything to eat. Eat what you want. It is advisable to eat a lot of varied and natural foods. However, it should be remembered that the basis of the diet under hypoxic conditions should be carbohydrates. The most easily digestible carbohydrate is sugar. In addition, it has a positive effect on protein and fat metabolism, which changes in high altitude conditions. Daily requirement in sugar during ascent increases to 200-250 g. It is recommended that each participant in ascent to heights consume ascorbic acid with glucose. It is advisable that at all exits the flasks contain tea with sugar and lemon or ascorbic acid.

Just before the ascent. Sleeping mode. Due to the lack of oxygen, for many people, sleep in the first nights at altitudes of 3500 - 4200 meters turns into torture. And before climbing, it is advisable to get a good night's sleep during the day. It is recommended to have a hearty lunch and go to bed immediately after lunch. The exit is carried out in the middle of the night, by which time you need to feel completely rested. Prepare everything you need in advance, especially equipment. Health protection equipment: glasses, preferably spare ones, a mask against cold and wind, a special protective cream for the face with protection factor 15, special lipstick cream, individual medications. As a rule, the group has a person responsible for the public first aid kit, most often this is a guide-leader. However, accessing it during ascent is not always convenient. So, we recommend having with you: aspirin, ascorbic acid and throat lozenges, such as Minton.

Biostimulants. If on acclimatization days it is better to avoid medications, then on the day of ascent this recommendation does not apply so strictly. You must be 100% ready and give it your all on this particular day. Of course, if you have a severe headache, you should immediately stop climbing. But if the pain is minor, it should be relieved by taking appropriate tablets. We recommend having with you previously tested means of increasing performance, which can roughly be classified as biostimulants. For example, tinctures of ginseng, eleutherococcus, lemongrass, drugs such as Pantolex. However, it should be taken into account that there is no such remedy yet that could significantly increase the body’s performance at long time. More strong tablets, which increase performance and have a short-term effect, should be kept as NI in the general first aid kit. You should rely, first of all, on your will, on your ability to endure and endure.

Water mode. Great importance for high-altitude acclimatization, prevention of mountain sickness and preservation of performance, has proper organization water and drinking regime. Water plays an important role in the physiological processes of the body. It makes up 65-70% of body weight (40-50 l). A person's need for water under normal conditions is 2.5 liters. At altitude it must be brought to 3.5-4.5 liters, which will fully ensure physiological needs body. Water exchange closely related to minerals, especially to the metabolism of sodium chloride and potassium chloride. At the same time, water and drinking deficiency is also added to hypoxia.

Sometimes they talk about the dangers of indiscriminate intake of water while climbing. However, this may only apply to easy mountain hikes that follow trails past numerous streams. On a mountain, when you can only consume the water you carry with you, there simply cannot be an excess amount. It is necessary to consume liquid in the form of hot tea with sugar and possibly other additives. To keep the tea hot, you need to have a thermos as much as possible. good quality. Unfortunately, even expensive thermoses do not always pass muster. Test it before heading to the mountains. Regarding your drinking regimen, you can only give the following advice. In the morning, before going out, drink a little more tea than you want. And calculate the contents of the thermos so that it is enough for descent. It is at the end of the working day that a sip of tea can make a huge difference in energizing and maintaining much-needed alertness to danger.

Acute mountain sickness. It cannot be allowed. This condition develops on Elbrus mainly in irresponsible people. You need to carefully monitor your body and don’t be shy to stop climbing and turn back before the disease takes over. acute stage. During the ascent, the guide or leader must carefully monitor the condition of his comrades. The appearance of symptoms of latent or mild forms of mountain sickness requires an immediate reduction in physical activity and pace of movement, increased rest periods, and drinking plenty of fluids. It is recommended to take ascorbic acid (0.1 g). For headaches, it is better to use aspirin.

For severe mountain sickness and moderate severity it is necessary to abandon the climb, urgently and quickly reduce the altitude. This is the most effective medicine. In this case, if possible, the patient should be deprived of a backpack and heavy clothing. The most important remedy may become artificial oxygen. However, so far its use on Elbrus is limited to isolated experiments. Perhaps the patient should be given a diuretic, preferably dicarb, and acute cases You can give furosemide. Other simple drugs are aspirin and ascorbic acid. Stimulants can be caffeine or, better yet, nootropil. Of the new drugs recommended by German researchers as a preventive measure for pulmonary edema caused by mountain sickness, these are Nifedipin and Salmeperol (an asthma medicine).

Latest research on altitude sickness. About three years ago, the whole world went around a sensational message about the use as prophylactic famous medicine a little from another area - Viagra. It is believed that this is a miracle drug that blocks some enzymes and dramatically improves peripheral blood circulation. Including in the lung area. Later it turned out that this message was not limited to a single loud sensation for the press. And Viagra has become part of the means that many Everest climbers take with them. Moreover, this is a dual-use product.
Last year, a large medical experiment was carried out on the slopes of Monterosa in the Alps. 22 climbers acted as test subjects. The main result was proof of the practical uselessness of use as a prophylactic agent. hormonal drugs based on cortisone. The popular drug dexamethasone, which in the film “Vertical Limit” climbers carried with them in suitcases, was recognized by experts as “at least pointless to use.”

According to the largest expert on medical support for climbing Everest, American Professor Peter Hackett, in the coming years we can expect a breakthrough in research regarding altitude sickness. The process of the body’s reaction to the unfavorable factors of high altitude is determined by the activity of such complex mechanism like the brain. The medicine of the near future will deal with the impact on it. We will allow ourselves to improvise a little on this topic. Indeed, the main thing in mountaineering is in the head and in the heart. This is the ability to perceive the beauty and grandeur of nature, love for the mountains. If this is not the case, then it is better to give up mountaineering. And if you have this, then you will find the strength to cope with your own ailments.