Lake Louise Questionnaire for the Symptoms of Acute Mountain Sickness: Difference between revisions
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==== Acute Mountain Sickness ==== | ==== Acute Mountain Sickness ==== | ||
Acute Mountain Sickness (AMS) is the most common acute altitude illness that can occur in unacclimatized individuals at altitudes >2500m. Risks factors include, rate of ascent, altitude of ascent, and individual physical characteristics. <ref>Roach Robert C, Hackett Peter H, Olez Oswald, Bartsch Peter, Luks Andrew M, MacInnis Martin J, Baillie J Kenneth, The Lake Louise AMS Score Consensus Committee. Lake Louise Acute Mountain Sickness Score. High Altitude Medicine & Biology. 2018:19(1):4-6. </ref> | Acute Mountain Sickness (AMS) is the most common acute altitude illness that can occur in unacclimatized individuals at altitudes >2500m. Risks factors include, rate of ascent, altitude of ascent, and individual physical characteristics. <ref name=":0">Roach Robert C, Hackett Peter H, Olez Oswald, Bartsch Peter, Luks Andrew M, MacInnis Martin J, Baillie J Kenneth, The Lake Louise AMS Score Consensus Committee. Lake Louise Acute Mountain Sickness Score. High Altitude Medicine & Biology. 2018:19(1):4-6. </ref> | ||
AMS must not be interchanged with high-altitude cerebral edema (HACE). It is not a neurological condition, and is known to be self-limited. Contrarily, HACE may occur between 24-72 hours after ascent, has characteristics of an altered mental state and/or ataxia. It usually occurs in conjunction with AMS or high-altitude pulmonary edema, and would be characterized as a medical emergency. | AMS must not be interchanged with high-altitude cerebral edema (HACE). It is not a neurological condition, and is known to be self-limited. Contrarily, HACE may occur between 24-72 hours after ascent, has characteristics of an altered mental state and/or ataxia. It usually occurs in conjunction with AMS or high-altitude pulmonary edema, and would be characterized as a medical emergency. <ref name=":0" /> | ||
==== Introduction to the Lake Louise Acute Mountain Sickness scale ==== | ==== Introduction to the Lake Louise Acute Mountain Sickness scale ==== | ||
The Lake Louise Acute Mountain Sickness (AMS) scale was first developed in 1991. It is a very useful scale to help diagnose and score the severity of AMS. | The Lake Louise Acute Mountain Sickness (AMS) scale was first developed in 1991. It is a very useful scale to help diagnose and score the severity of AMS. <ref name=":0" /> | ||
The symptoms measured on the initial test included, | The symptoms measured on the initial test included, <ref name=":0" /> | ||
* Headache | * Headache | ||
| Line 29: | Line 29: | ||
<nowiki>*</nowiki>the double words are for general feelings and descriptions | <nowiki>*</nowiki>the double words are for general feelings and descriptions | ||
These were rated with an intensity level of 0-3. A score that is ≥3, with a headache, was indicative of AMS. | These were rated with an intensity level of 0-3. A score that is ≥3, with a headache, was indicative of AMS. <ref name=":0" /> | ||
Of the five symptoms assessed for AMS, disturbed sleep is the most likely symptom to occur due to altitude hypoxia. However, this symptom was seen to be poorly related to the other symptoms, and AMS. It was questioned if sleep disturbance was a symptom of AMS or an effect of hypoxia. Considering this fact, a revised scoring system does not include disturbed sleep as a symptom. Comparing daytime vs. night time effects of altitude was also a factor. | Of the five symptoms assessed for AMS, disturbed sleep is the most likely symptom to occur due to altitude hypoxia. However, this symptom was seen to be poorly related to the other symptoms, and AMS. It was questioned if sleep disturbance was a symptom of AMS or an effect of hypoxia. Considering this fact, a revised scoring system does not include disturbed sleep as a symptom. Comparing daytime vs. night time effects of altitude was also a factor. <ref name=":0" /> | ||
== About the Test == | == About the Test == | ||
Since the 'sleep disturbance' symptom was removed, a scoring of ≥3 from the four symptoms, including a headache, is indicative of AMS. | Since the 'sleep disturbance' symptom was removed, a scoring of ≥3 from the four symptoms, including a headache, is indicative of AMS. <ref name=":0" /> | ||
If someone wanted a more detailed scoring system, they could categorize intensity values as: | If someone wanted a more detailed scoring system, they could categorize intensity values as: <ref name=":0" /> | ||
* 3-5 points as Mild | * 3-5 points as Mild | ||
| Line 42: | Line 42: | ||
* 10-12 points as Severe | * 10-12 points as Severe | ||
Despite symptoms being able to develop within 6 hours of ascent to altitude, it is recommended that the score be assessed subsequent to 6 hours, to bypass any symptoms of travel or effects of acute hypoxia via vagal responses. <ref name=":0" /> | |||
== Characteristics of the Test - (What it looks like) == | |||
The AMS Clinical Functional Score can be used if someone wanted to assess the effect of AMS symptoms on overall health, function, and performance. <ref name=":0" /> | |||
The scoring system looks like the following: <ref name=":0" /> | |||
<u>2018 Lake Louise Acute Mountain Sickness Score</u> | |||
<u>Headache</u> | |||
* 0 - None at all | |||
* 1 - A mild headache | |||
* 2 - Moderate headache | |||
* 3 - Severe headache, incapacitating | |||
<u>Gastrointestinal Symptoms</u> | |||
* 0 - Good appetite | |||
* 1 - Poor appetite or nausea | |||
* 2 - Moderate nausea or vomiting | |||
* 3 - Severe nausea and vomiting, incapacitating | |||
<u>Fatigue and/weakness</u> | |||
* 0 - Not tired or weak | |||
* 1 - Mild fatigue/weakness | |||
* 2 - Moderate fatigue/weakness | |||
* 3 - Sever fatigue/weakness, incapacitating | |||
<u>Dizziness/light-headedness</u> | |||
* 0 - No dizziness/light-headedness | |||
* 1 - Mild dizziness/light-headedness | |||
* 2 - Moderate dizziness/light-headedness | |||
* 3 - Severe dizziness/light-headedness | |||
<u>AMS Clinical Functional Score</u> - Overall, if you had AMS symptoms, how did they affect your activities? | |||
* 0 - Not at all | |||
* 1 - Symptoms present, but did not force any change in activity or itinerary | |||
* 2 - My symptoms forced me to stop the ascent or to go down on my own power | |||
* 3 - Had to be evacuated to a lower altitude | |||
=== How to Conduct the Test === | === How to Conduct the Test === | ||
This test is only to be conducted by investigators, and <u>not</u> Clinicians, Professional Outdoor Guides, and general Individuals, for the diagnosis and management of AMS. | This test is only to be conducted by investigators, and <u>not</u> Clinicians, Professional Outdoor Guides, and general Individuals, for the diagnosis and management of AMS. <ref name=":0" /> | ||
The Lake Louise AMS score can be administered as: | The Lake Louise AMS score can be administered as: <ref name=":0" /> | ||
* A self-report tool | * A self-report tool | ||
| Line 60: | Line 100: | ||
=== What the Results Mean === | === What the Results Mean === | ||
The total AMS score would be the sum of scores for each of the <u>four</u> symptoms, listed again: | The total AMS score would be the sum of scores for each of the <u>four</u> symptoms, listed again: <ref name=":0" /> | ||
* Headache | * Headache | ||
| Line 69: | Line 109: | ||
To be categorized as having AMS, one would need to have atleast 1 point for a headache, and ≥3 points in total. | To be categorized as having AMS, one would need to have atleast 1 point for a headache, and ≥3 points in total. | ||
<nowiki>*</nowiki>For research purposes, the AMS score must include a headache, while for clinical purposes a headache may not need to be included for categorizing AMS. | <nowiki>*</nowiki>For research purposes, the AMS score must include a headache, while for clinical purposes a headache may not need to be included for categorizing AMS. <ref name=":0" /> | ||
<nowiki>*</nowiki>A severe headache of 3 point, with no other AMS symptoms, would be categorized as AMS. | <nowiki>*</nowiki>A severe headache of 3 point, with no other AMS symptoms, would be categorized as AMS. <ref name=":0" /> | ||
== Resources == | == Resources == | ||
Revision as of 08:36, 8 June 2022
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Introduction[edit | edit source]
Acute Mountain Sickness[edit | edit source]
Acute Mountain Sickness (AMS) is the most common acute altitude illness that can occur in unacclimatized individuals at altitudes >2500m. Risks factors include, rate of ascent, altitude of ascent, and individual physical characteristics. [1]
AMS must not be interchanged with high-altitude cerebral edema (HACE). It is not a neurological condition, and is known to be self-limited. Contrarily, HACE may occur between 24-72 hours after ascent, has characteristics of an altered mental state and/or ataxia. It usually occurs in conjunction with AMS or high-altitude pulmonary edema, and would be characterized as a medical emergency. [1]
Introduction to the Lake Louise Acute Mountain Sickness scale[edit | edit source]
The Lake Louise Acute Mountain Sickness (AMS) scale was first developed in 1991. It is a very useful scale to help diagnose and score the severity of AMS. [1]
The symptoms measured on the initial test included, [1]
- Headache
- Gastrointestinal Upset
- Fatigue/Weakness
- Dizziness/Light-Headedness
- Sleep Disturbance
*the double words are for general feelings and descriptions
These were rated with an intensity level of 0-3. A score that is ≥3, with a headache, was indicative of AMS. [1]
Of the five symptoms assessed for AMS, disturbed sleep is the most likely symptom to occur due to altitude hypoxia. However, this symptom was seen to be poorly related to the other symptoms, and AMS. It was questioned if sleep disturbance was a symptom of AMS or an effect of hypoxia. Considering this fact, a revised scoring system does not include disturbed sleep as a symptom. Comparing daytime vs. night time effects of altitude was also a factor. [1]
About the Test[edit | edit source]
Since the 'sleep disturbance' symptom was removed, a scoring of ≥3 from the four symptoms, including a headache, is indicative of AMS. [1]
If someone wanted a more detailed scoring system, they could categorize intensity values as: [1]
- 3-5 points as Mild
- 6-9 points as Moderate
- 10-12 points as Severe
Despite symptoms being able to develop within 6 hours of ascent to altitude, it is recommended that the score be assessed subsequent to 6 hours, to bypass any symptoms of travel or effects of acute hypoxia via vagal responses. [1]
Characteristics of the Test - (What it looks like)[edit | edit source]
The AMS Clinical Functional Score can be used if someone wanted to assess the effect of AMS symptoms on overall health, function, and performance. [1]
The scoring system looks like the following: [1]
2018 Lake Louise Acute Mountain Sickness Score
Headache
- 0 - None at all
- 1 - A mild headache
- 2 - Moderate headache
- 3 - Severe headache, incapacitating
Gastrointestinal Symptoms
- 0 - Good appetite
- 1 - Poor appetite or nausea
- 2 - Moderate nausea or vomiting
- 3 - Severe nausea and vomiting, incapacitating
Fatigue and/weakness
- 0 - Not tired or weak
- 1 - Mild fatigue/weakness
- 2 - Moderate fatigue/weakness
- 3 - Sever fatigue/weakness, incapacitating
Dizziness/light-headedness
- 0 - No dizziness/light-headedness
- 1 - Mild dizziness/light-headedness
- 2 - Moderate dizziness/light-headedness
- 3 - Severe dizziness/light-headedness
AMS Clinical Functional Score - Overall, if you had AMS symptoms, how did they affect your activities?
- 0 - Not at all
- 1 - Symptoms present, but did not force any change in activity or itinerary
- 2 - My symptoms forced me to stop the ascent or to go down on my own power
- 3 - Had to be evacuated to a lower altitude
How to Conduct the Test[edit | edit source]
This test is only to be conducted by investigators, and not Clinicians, Professional Outdoor Guides, and general Individuals, for the diagnosis and management of AMS. [1]
The Lake Louise AMS score can be administered as: [1]
- A self-report tool
- Completed with researcher asking about the symptoms
- Individual filling in the score, and researcher reading it back to the individual
What the Results Mean[edit | edit source]
The total AMS score would be the sum of scores for each of the four symptoms, listed again: [1]
- Headache
- Nausea/Vomiting
- Fatigue
- Dizziness/Light-Headedness
To be categorized as having AMS, one would need to have atleast 1 point for a headache, and ≥3 points in total.
*For research purposes, the AMS score must include a headache, while for clinical purposes a headache may not need to be included for categorizing AMS. [1]
*A severe headache of 3 point, with no other AMS symptoms, would be categorized as AMS. [1]
Resources[edit | edit source]
- bulleted list
- x
or
- numbered list
- x
References[edit | edit source]
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 Roach Robert C, Hackett Peter H, Olez Oswald, Bartsch Peter, Luks Andrew M, MacInnis Martin J, Baillie J Kenneth, The Lake Louise AMS Score Consensus Committee. Lake Louise Acute Mountain Sickness Score. High Altitude Medicine & Biology. 2018:19(1):4-6.
