Facing Emergencies at high altitude treks

Trekking at high altitudes in the Himalayas is a rewarding and an unforgettable experience. However, it is important to keep your safety in mind, just like we do. Weather conditions, altitude gain, fitness and other factors can make or mar your experience. You, as an adult, need to be equally responsible for your own wellbeing as we are and act maturely in adverse conditions.

You’ve to understand that treks are away from cities and medical help is not always easily available. So, if you are heading for an adventurous trekking trip, stick to certain trekking guidelines and tips. Following these simple tips will help make the trek more fun and experiential for you as well as your fellow trekkers.

These tips and guidelines cater useful and requisite information about your fitness training, packing and health precautions to be taken before and during the trek.

Preparations before the trek 
1) Enhance your fitness levels. Eg: Run 5km in 30 minutes, walk, cycle, stretch. Remember, walking at high altitudes is not as easy and comfortable as in the vicinity of your home.
2) Increase your lung capacity. Do cardio exercises. This will help in breathing comfortably at high altitudes. (Note: We mean ‘do’ not ‘overdo’)
3) Read about your own trek – the itinerary, past trekkers’ experiences, connect with fellow trekkers via our FB group TREK THE HIMALAYAS

Instructions before the trek 
Medical fitness check up: Be serious and transparent about this check up. Visit a reliable medical practitioner and do a genuine check up. Be frank about your recent health conditions, past trekking experiences and other ailments.  Getting a medical certificate from a distant uncle (in exchange of home-made achaar!) is a dangerous idea.

[box]Medical fitness check up should include:

  • Chronic diseases: Diabetes, asthma, epilepsy, heart diseases etc.
  • Blood pressure: Resting heart rate of less 100 beats/min
  • History of attitude related illnesses
  • Drug allergies
  • Fitness level and overall health condition should be good. [/box]

Emergency number:  Another serious number. Share the number of that person who will genuinely respond in case of emergency.

What to pack: Bright colours are preferable, since they are easy to spot in greyish landscapes of the mountains. Prefer comfort over style. (Your social media friends will be more interested in the landscape than your outfits for sure.)
Keep warm clothes in ample amount. The climate on mountain keeps fluctuating. You will need warm clothes at height to save yourself from the chills. A raincoat is also crucial. Without proper and comfortable clothing, you cannot enjoy trekking.

Footwear: Always wear well-fitted trekking shoes while trekking. Uncomfortable pair of shoes can hurt your feet and can lead to serious foot injuries while trekking.

During trek: 

  1. Stay hydrated. Drink sufficient amount of water at regular intervals  (Minimum 4 litres a day is essential)
  2. Diet on the mountain is critical. A high liquid and carbohydrate content is preferred. Never skip your meal even if your appetite is low.
  3. Walk slowly but steadily.
  4. At the base camp: DO NOT SLEEP. Take a walk around the site. (You’re in the Himalayas, remember.  Capture and cherish all that you can)
  5. Do not smoke or drink alcohol.
  6. Do not have any medication such as sleeping pills while you are at high altitude. They could make any symptoms of altitude sickness worse. Before having any medicine, inform the Trek Leader.
  7. Importantly, in case of any discomfort, inform the Trek Leader. They cannot guess something like headache till you inform them.
  8. Help your fellow trekkers and motivate them to cope with altitude. Do not let them hide anything from the Trek Leader.
  9. The decision taken by the Trek Leader will be final.

In case of emergency :

From a simple slip causing bruises, sprains, or fractures to AMS, any illness can mar the whole experience. Our guides are well trained for necessary first aid and other high altitude problems like mild AMS. They always carry the first aid kit during the trek. However we still recommend you to bring your personal first aid kit as well.

Safety measures from TTH 

Every batch carries the following kit:

  1. Basic medical kit including Dimox and Dexamethzone  for Acute Mountain Sickness
  2. Portable Oxygen cylinder
  3. Stretcher
  4. Portable Altitude Chamber: For treks higher than 16,000 feet

Rescue plans alternatives: 

  1. In case of emergencies, when a trekker has severe illness, even at lower altitudes, we arrange to walk back with stretcher to the nearest road and then transfer to a nearest hospital in an ambulance (108) .
  2. Helicopter rescue: In extreme cases, we try our best to arrange for helicopter rescue. If we get enough support from the authorities from Uttarakhand and Himanchal Pradesh.

[box]AMS – Acute Mountain Sickness

What is AMS?

Acute mountain sickness (AMS) is the most common and mildest form of altitude sickness. AMS is most likely to affect if you ascend quickly – especially at a rate of more than 500m per day – or if you don’t allow yourself time to get used to the height (acclimatise).

Symptoms of altitude sickness

You may notice symptoms of altitude sickness about 6 to 24 hours after you’ve arrived at an area of high altitude depending on your speed of ascent.


  • Have a headache
  • feel tired
  • feel sick or vomit
  • lose your appetite
  • feel dizzy
  • have difficulty sleeping

Why does it occur?

Trekking in high altitude Himalayas is at lower pressures and lower oxygen levels. A few individuals cannot withstand this change which leads to AMS. There is no difference in gender or age.

How to control AMS?


Speak up: Inform the Trek Leader of any fatigue, dizziness or headache.
Do not downplay on your symptoms.

Descend: If your symptoms get worse, the best thing you can do is Descend to a lower base-camp as instructed by the Trek Leader. There are some medications that can help ease your symptoms and treat complications, but only descending will deal with the cause.

If AMS is not controlled

AMS in more severe form can lead to fluid build-up in the lungs (HAPE) and in the brain (HACE) which usually affect at extreme altitude.[/box]


It’s fine to get AMS. It’s not fine to let it turn fatal.

It’s stupidity to ascend even if you have mild AMS symptoms. [/box]

Written By:- Rakesh Pant