A person is said to be acclimatized to high elevations when he can effectively perform physically and mentally. The acclimatization process begins immediately upon arrival at the higher elevation. If the change in elevation is large and abrupt, some soldiers can suffer from acute mountain sickness (AMS), high-altitude pulmonary edema (HAPE), or high-altitude cerebral edema (HACE). Disappearance of the symptoms of acute mountain sickness (from four to seven days) does not indicate complete acclimatization. The process of adjustment continues for weeks or months. The altitude at which complete acclimatization is possible is not a set point but for most soldiers with proper ascent, nutrition and physical activity it is about 14,000 feet.
a. Immediately upon arrival at high elevations, only minimal physical work can be performed because of physiological changes. The incidence and severity of AMS
symptoms vary with initial altitude, the rate of ascent, and the level of exertion and individual susceptibility. Ten to twenty percent of soldiers who ascend rapidly (in less than 24 hours) to altitudes up to 6,000 feet experience some mild symptoms. Rapid ascent to 10,000 feet causes mild symptoms in 75 percent of personnel. Rapid ascent to elevations of 12,000 to 14,000 feet will result in moderate symptoms in over 50 percent of the soldiers and 12 to 18 percent may have severe symptoms. Rapid ascent to 17,500 feet causes severe, incapacitating symptoms in almost all individuals. Vigorous activity during ascent or within the first 24 hours after ascent will increase both the incidence and severity of symptoms. Some of the behavioral effects that will be encountered in unacclimatized personnel include:
• Increased errors in performing simple mental tasks.
• Decreased ability for sustained concentration.
• Deterioration of memory.
• Decreased vigilance or lethargy.
• Increased irritability in some individuals.
• Impairment of night vision and some constriction in peripheral vision (up to 30 percent at 6,000 feet).
• Sleep disturbances.
• Irregular breathing.
b. Judgment and self-evaluation are impaired the same as a person who is intoxicated. During the first few days at a high altitude, leaders have extreme difficulty in maintaining a coordinated, operational unit. The roughness of the terrain and the harshness and variability of the weather add to the problems of unacclimatized personnel. Although strong motivation may succeed in overcoming some of the physical handicaps imposed by the environment, the total impact still results in errors of judgment. When a soldier cannot walk a straight line and has a loss of balance, or he suffers from an incapacitating headache, he should be evacuated to a lower altitude (a descent of at least 1,000 feet for at least 24 hours).
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