Key messages

• The symptoms of mild to moderate acute mountain sickness can be reduced by graded acclimatization or acetazolamide 500 mg slow release and ameliorated by bed rest and acetazolamide.

• Severe acute mountain sickness and/or high-altitude cerebral edema is treated with oxygen (4-6 l/min) and 4 mg dexamethasone every 6 h with urgent evacuation.

• High-altitude pulmonary edema is treated with oxygen and nifedipine 20 mg every 6 h with urgent evacuation. In the most severe cases dexamethasone 4 mg every 6 h and acetazolamide 250 mg twice daily should be added to nifedipine treatment.

• Repetitive Valsalva maneuvers are performed for barotrauma prophylaxis.

• Emergency treatment of decompression sickness consists of 100 per cent oxygen, fluid replacement, and urgent referral to a hyperbaric chamber.

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