Altitude and safety

High mountain treks and expeditions, at altitudes of over 3,000 meters, are not without risks. Lack of oxygen may cause acute mountain sickness (AMS) that can result in cerebral or pulmonary edema in just a few hours.  To avoid this inconvenience that could end in a tragedy, it is important to acclimatize properly… and to have the right information. 

Here is an extract from Ifremmont’s small medical guide concerning altitude:

“Atmospheric pressure drops progressively as you gain altitude. Pressure is twice as low at 5,000 m and three times as low at 8,000 m. This has direct physical consequences on our body. The drop in atmospheric pressure leads to a decrease in oxygen pressure in the ambient air. The greater the drop in oxygen pressure in the air, the less our lungs are able to take in oxygen. This reduces oxygen pressure in the blood, thus affecting physical performance. However, the body can acclimatize provided it is given time to do so. When trekking, recommendations say not to exceed an elevation gain of 500 to 800 m per consecutive night up to 3,000 m, then, beyond this, no more than 300 to 500 m. Hydration triggers and stimulates the renal function. Furthermore, proper hydration ensures better acclimatization.”

The cold, whether in polar or high mountain environments, presents serious risks of hypothermia and frostbite, which could put an end to the expedition. Besides the risk of aftereffects for the participant, this will incur repatriation costs that are often very high due to the isolation of the group. From experience, for people with particularly unfavorable health issues such as Raynaud’s syndrome or other, the “feel-like” temperatures as from which increased vigilance is essential are in the order of -20°C. 

Consequently, before your trek or expedition at high altitude and/or in polar conditions, it is vital to ask yourself the following few questions. Just one “Yes” answer means you must consult a doctor well before your departure date. 

Also note that a medical check-up is recommended in the year before a journey in an isolated environment, particularly for people over 50 and/or people with chronic illnesses.

Participants who have never been at high altitudes can evaluate their likeliness of developing acute mountain sickness by submitting to a “hypoxia test” conducted by a specialist. Consultation of a specialist is also recommended for all people suffering from chronic pathologies that are likely to worsen at high altitudes.

We are partners of the Ifremmont institute in Chamonix, an institute for Training and Research in Mountain Medicine. It was founded by the doctor Emmanuel Cauchy in 2005, who tragically passed away in April 2018. 

Ifremmont is a recognized center in the Mont-Blanc region, for research and training in mountain medicine, ranging from first aid to treatment of mountain sicknesses such as acute mountain sickness (AMS), and for documentation on all aspects of mountain medicine. It is an innovative player in e-health, offering embarked sensors and telemedicine for people practicing mountain and extreme sports.  

Progressively, the institute has naturally transposed its altitude skills to other isolated environments and develops clinical and fundamental research into cold and altitude pathologies and extreme environments.

Several times a year, Ifremmont offers field training for local guides in the Himalayas and the Andes. The guides we recruit for our most challenging treks and expeditions are thus well informed and aware of altitude issues, and trained in the utilization of specific safety gear such as the hyperbaric chamber.  

We propose a number of services in partnership with Ifremmont: medical teleconsultation and personalized medical advice prior to departure, hypoxy tests, medical hotline available on expeditions, and training of our guides and participants in our journeys.

TO KNOW MORE ABOUT IFREMMONT

The participants in most of our expeditions at very high altitudes or in polar environments qualify free of charge for a preventive medical teleconsultation with Ifremmont and for the H24 “SOS AMS” medical assistance service. Both these services are also proposed as options to all our clients for a flat fee of €100. 

Developed exclusively with our Altidoc/Ifremmont partners, we have set up an altitude pre-acclimatization protocol that we propose for our programs at over 7,000 meters when acclimatization time on site is limited or someone has already shown chronic signs of poor acclimatization. It targets those who wish to give themselves the best possible chances of summiting, by ensuring they arrive in tip-top condition at base camp, and can thus prepare favorably for their climbs up to the higher camps.

However, this protocol does not mean we intend to reduce the duration of our expeditions, as proposed by other operators around the globe. This physical and hypoxic preparation is optional and not mandatory, but offers an added advantage for those who feel the need to be supported in this approach.

This protocol in no way guarantees a successful summit and is no replacement for the physical and technical training and the experience that you have accumulated in the course of your previous mountaineering years.

Hypoxic preparation led by the leading experts in the field

This protocol is managed by our Altidoc/Ifremmont/SportAltitude partners, who are among the leading international experts in these areas. It is with them that we propose medical training at high altitudes and in isolated environments, as well as the medical pre-consultations and the H24 medical hotline on expedition. Also, it is with them that many “eight-thousanders”, some of international renown, and successful summiters, chose to carry out their preparation.

Hypoxic preparation protocol

The procedure we have set up is managed remotely with their experts as per an individualized protocol. This enables everyone, wherever they live, to benefit from it. This protocol acts on two main factors:

• hypoxic passive physical preparation (you sleep in an altitude tent) to increase your red blood cells;
• hypoxic active physical preparation (utilization of a mask) to prepare your muscles to work with less oxygen. For those of you living near an altitude training center, you can also do this there (Geneva, Paris, Lyon, Toulouse, etc.), after discussion with the doctor and/or coach.

In both cases, the protocol is the following with the doctors and coaches:

• physical preparation assessment interview, tips for utilizing the hypoxic and training gear (preparation do’s and dont’s);
• definition of the personalized program, week by week up to the day of departure;
• weekly phone follow-up for active physical preparation, twice-monthly for passive physical preparation;
• remote monitoring via physical data captured by your smartwatch and coordinated by SportAltitude for active preparation;
• possibility of sending them a message to specify preparation elements, particularly at the start but also throughout the process;
• possibility of them coordinating with your coach if you have one, to optimize your preparation;

We welcome any questions you may have concerning these protocols that we are only a few in the world to propose.

The physical integrity of our participants during their journey is at the heart of our commitments. In particular, journeys in geopolitically unstable areas and challenging expeditions and treks in isolated or extreme environments call for even greater vigilance on our part in view of the objective dangers incurred. Preparation first, followed by the quality of the guiding and the gear proposed, form the three points in the triangle of a successful expedition. We have developed extensive expertise in this area. 

Geopolitical and health analyses

Craftsmen of travel and independent, not easily affected by passing fads and the psychosis that puts everything in the same sack, we analyze situations case by case, day by day, and stick to on-the-ground reality and its evolution. Our long-established local footing means we can rely on responsible and competent local teams and confidently propose our programs to you. We are totally transparent when explaining our choices.  Our experience and feedback over the last thirty years are proof of the pertinence of our analyses. Whenever you sign up for a journey where the destination is placed in an orange or a red zone (zones considered at risk) by the Ministry of Foreign Affairs, we ask you to confirm that you have read the “advice to travelers” section on their website, to allow us to exchange serenely on the subject. With respect to health hazards, we recommend the Institut Pasteur’s health recommendations for each country.

Preparation, the key to safety

One of the keys to a successful expedition is your physical preparation. A stress test in normoxic conditions, or even in hypoxic conditions if you are planning a trek or an expedition at more than 5,000 meters, and a VO2 Max calculation for particularly challenging expeditions, can be good diagnoses of your physical fitness. A medical check-up with your doctor, and above all with your dentist, should be a mandatory reflex for long and isolated expeditions. The months preceding your departure will allow you to build up your stamina and to strengthen your abdominal muscles by working on core stability if you are to carry heavy loads, etc. We can propose coaches for a remote monitoring of your progression.   

For the most challenging expeditions, we systematically plan a preparatory weekend, during which you will meet the guide and the other participants, in order to get to know one another and envisage the preparation required. More generally, this will be an opportunity to exchange your experiences, specify the list of gear and how to acquire it (purchase or hire), handle key equipment for your safety, and so on. Periodically, our École de l’Aventure courses help prepare you for your expeditions.

Last but not least, our extensive experience in the field has shown us that the issues of nutrition at high altitude and/or in polar environments are essential: weight loss and muscle wasting due to lack of appetite, increase in physical activity, effects specific to hypoxia, etc. After consulting experts, we have developed our own methodology: daily calorie intake, proteins, lipids, vitamins, nutritional and gustatory qualities of lyophilized food… We prepare your expedition based on this methodology, if need be taking your allergies and deficiencies into account.

École de l'Aventure, beginners and advanced training courses 

To help participants in our journeys to become more self-sufficient, responsible and confident, to allow them to benchmark their level in technical activities or to help them build their progression program to achieve a particularly cherished goal, we propose training courses in France and Europe, ranging from a half-day to several days. These courses are organized by leading experts around three themes: knowledge of environments such as high altitude, polar environments, oceans, etc.; command of techniques such as mountaineering, rock climbing, kite skiing, kayaking, etc.; a practical and safety-focused approach to travel photography, first aid, altitude medicine, and other practical issues.   

These courses are led by recognized specialists, instructors and teachers, who will share with you their extensive grassroots experience and their spotlight stories.  

Quality of guiding and gear

Guiding is the other key to your safety once on site. The technical qualities and experience of your guide will make all the difference, particularly when it comes to decision-making. Our guides are experienced and recognized in their field.

Gear is an issue that is vital on expeditions, whether we’re talking of tents, kayaks, pulkas, boots, bindings, etc. We never compromise on the quality of our group gear and equipment. We propose hiring gear from leading equipment suppliers such as Petzl or Valandré for high altitude expeditions, with whom we have a privileged relationship.   

Group safety gear

On some expeditions, your guide will have situation-specific safety gear, one or more satellite phones, in some cases a VHF radio or walkie-talkies, high mountain safety gear, a geolocation tag, etc. For expeditions passing altitudes of more than 5,000 meters, a hyperbaric chamber is provided, as is also a pack containing an oximeter and acute mountain sickness medicine.