Correct Response<\/strong><\/td>\n<\/tr>\n\n| Persistent headache<\/td>\n | Dull to throbbing; present for hours; not fully relieved by rest<\/td>\n | Stop; hydrate; ibuprofen 600 mg or paracetamol 500 mg every 8 hrs; rest; do NOT ascend<\/td>\n<\/tr>\n |
\n| Nausea \/ vomiting<\/td>\n | Upset stomach; loss of appetite; vomiting possible<\/td>\n | Rest; eat light foods; stay hydrated; ondansetron 4 mg if prescribed; rest<\/td>\n<\/tr>\n |
\n| Dizziness<\/td>\n | Unsteadiness; lightheadedness; world seems tilted<\/td>\n | Sit or lie down immediately; hydrate; do not stand suddenly<\/td>\n<\/tr>\n |
\n| Unusual fatigue<\/td>\n | Exhaustion far beyond what physical effort warrants<\/td>\n | Mandatory rest; give body time to adjust; do not push forward<\/td>\n<\/tr>\n |
\n| Poor sleep<\/td>\n | Cannot sleep despite exhaustion; waking repeatedly<\/td>\n | Normal at altitude; rest even without sleeping; Diamox helps with sleep-related AMS<\/td>\n<\/tr>\n |
\n| Breathlessness on exertion<\/td>\n | Short of breath climbing stairs or walking on flat ground<\/td>\n | Slow down significantly; take 15-minute rests every hour; check SpO2<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/span>Stage 2: High-Altitude Cerebral Edema (HACE) \u2014 Serious, Requires Immediate Descent<\/span><\/h3>\nHACE is AMS that has progressed to the brain. Reduced oxygen causes the brain to swell inside the skull \u2014 a life-threatening condition. HACE is the reason no amount of devotion should keep you at altitude if the following signs appear:<\/p>\n \n- Severe headache that does not respond to rest or painkillers<\/li>\n
- Confusion, disorientation, inability to think or speak clearly<\/li>\n
- Stumbling, loss of coordination (ataxia) \u2014 ask the person to walk a straight line; inability to do so is a strong HACE indicator<\/li>\n
- Extreme lethargy \u2014 difficulty staying awake; abnormal drowsiness<\/li>\n
- Vision disturbances \u2014 blurred vision; double vision<\/li>\n<\/ul>\n
Action: <\/strong>IMMEDIATE DESCENT \u2014 do not wait for morning, do not wait to see if it improves at the same altitude. Every 300 metres of descent provides measurable relief. Administer supplemental oxygen at the nearest medical camp while evacuation is arranged. HACE can progress to unconsciousness within hours.<\/p>\n<\/span>Stage 3: High-Altitude Pulmonary Edema (HAPE) \u2014 Most Rapidly Fatal<\/span><\/h3>\nHAPE is fluid accumulation in the lungs caused by altitude-induced pulmonary hypertension. It is the most rapidly fatal form of altitude illness and is responsible for many pilgrimage deaths. Crucially, HAPE can develop independently of AMS \u2014 meaning a person can appear fine one evening and develop life-threatening symptoms overnight.<\/p>\n \n- Persistent dry cough progressing to a wet, gurgling cough<\/li>\n
- Breathlessness at complete rest \u2014 struggling to breathe while simply sitting<\/li>\n
- Crackling or gurgling sounds in the chest (rales) \u2014 fluid in lungs<\/li>\n
- Extreme weakness \u2014 cannot walk even a few steps without stopping<\/li>\n
- Blue lips or fingertips (cyanosis) \u2014 critically low blood oxygen<\/li>\n
- Rapid heart rate at rest; increasing confusion as oxygen drops<\/li>\n<\/ul>\n
Action: <\/strong>MEDICAL EMERGENCY. Contact the Kedarnath medical camp immediately. Administer supplemental oxygen. Request helicopter evacuation \u2014 two air ambulances are on standby at Kedarnath in 2026. Do not give water to drink if wet cough is present (lungs are filling with fluid). Begin descent immediately while awaiting evacuation. Nifedipine (if prescribed by your doctor and in your kit) reduces pulmonary artery pressure and can buy critical time.<\/p>\n\n\n\n\ud83d\udea8 HAPE Warning: HAPE can be more rapidly fatal than HACE. Early warning signs \u2014 a persistent dry cough and slightly greater breathlessness than expected \u2014 are easily dismissed as ‘just tired from the trek.’ Do not dismiss them. A cough that appears at altitude and does not stop with rest is a warning sign. Act early.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/span>SpO2 Readings at Kedarnath: What the Numbers Mean and When to Act<\/span><\/h2>\nA portable pulse oximeter (\u20b9800\u2013\u20b91,500) measures the percentage of haemoglobin in your blood carrying oxygen. At sea level, normal SpO2 is 95\u2013100%. At altitude, it drops. Understanding your readings helps you make real-time safety decisions on the trek.<\/p>\n \n\n\nSpO2 Reading<\/strong><\/td>\nWhat It Means at Kedarnath<\/strong><\/td>\nAction Required<\/strong><\/td>\n<\/tr>\n\n| 95\u2013100%<\/td>\n | Excellent acclimatisation; no concern<\/td>\n | Continue normally; monitor regularly<\/td>\n<\/tr>\n | \n| 90\u201394%<\/td>\n | Mild hypoxia; common at altitude<\/td>\n | Rest; hydrate; do not exert heavily; monitor every 2 hours<\/td>\n<\/tr>\n | \n| 85\u201389%<\/td>\n | Expected range for partially acclimatised pilgrims at 3,583 m<\/td>\n | Rest if symptomatic; watch for AMS signs; avoid exertion<\/td>\n<\/tr>\n | \n| 80\u201384%<\/td>\n | Body is struggling \u2014 significant hypoxia<\/td>\n | Stop trekking; complete rest; seek nearest medical camp; do not ascend<\/td>\n<\/tr>\n | \n| Below 80%<\/td>\n | Dangerous hypoxia \u2014 medical situation<\/td>\n | Supplemental oxygen immediately; contact medical camp; begin descent NOW<\/td>\n<\/tr>\n | \n| Below 75%<\/td>\n | Critical \u2014 risk of organ damage, unconsciousness<\/td>\n | Emergency \u2014 helicopter evacuation; oxygen therapy; do not delay<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n Important: SpO2 alone does not give the full picture. Some pilgrims with SpO2 at 83% feel fine; others with 90% are severely symptomatic. Altitude sickness is diagnosed primarily on symptoms, not numbers alone. A sudden, rapid drop in SpO2 over a few hours is more concerning than a stable low reading. Use the oximeter as one tool alongside how the person actually looks, feels, and behaves.<\/p>\n <\/span>How to Prevent Altitude Sickness at Kedarnath: Proven Steps<\/span><\/h2>\nPrevention at altitude is vastly more effective than treatment. Following the steps below can reduce AMS risk from 30\u201390% to well under 10% for most healthy pilgrims.<\/p>\n <\/span>Step 1: Acclimatise at Guptkashi \u2014 The Single Most Important Step<\/span><\/h3>\nThis one step prevents more altitude illness deaths than any medicine or equipment. The Uttarakhand government specifically recommends spending at least one night at Guptkashi (1,319 m) before ascending to Kedarnath. Ideally, two nights. For helicopter pilgrims \u2014 who gain 2,000+ metres of altitude in 12 minutes \u2014 spending the night before the flight at Guptkashi or Phata is not optional; it is their primary protection against AMS.<\/p>\n \n\n\n| Day<\/strong><\/td>\n | | | | | | |