Hiking and Altitude sickness on Mauna Kea, Hawaii

Summary

How to hike Mauna Kea, Hawaii
Mountain climbers may be at risk of altitude sickness during ascent.
Altitude sickness occurs when a person ascends too quickly, preventing the body from adequately adjusting to lower oxygen levels and changes in air pressure.
Symptoms of altitude sickness include headaches, vomiting, insomnia, and impaired performance and coordination.
In severe cases, fluid may accumulate in the lungs, brain, or both, posing a life-threatening risk.
First aid measures include immediate descent, medication, and administering oxygen from a portable container.

Stargazing on Mauna Kea

Our stargazing locations range from 6,500 to 9,000 feet (1,980 to 2,740 meters) in altitude, depending on cloud conditions. These areas are generally safe for stargazing, and our tours involve minimal hiking. While most of the following information may not be directly relevant to our tours, it’s valuable knowledge for anyone planning to ascend high-altitude mountains.

Hiking on Mauna Kea

Ascending Mauna Kea’s summit (13,803 feet / 4,207 meters) is a challenging yet rewarding experience, offering breathtaking views and a unique high-altitude environment. However, due to the extreme elevation, hikers should be prepared for rapid weather changes, reduced oxygen levels, and potential altitude sickness. Proper acclimatization, hydration, and pacing are essential for a safe and enjoyable hike.

Be sure to stop at the Onizuka Astronomy Center and consult with the support staff before beginning your hike to the summit of Mauna Kea. They can provide valuable information on safety, weather conditions, and altitude acclimatization to ensure a safer and more informed ascent.

Mountain climbers are at risk of developing altitude sickness, also known as mountain sickness, which can be harmful or even fatal if ignored. This condition arises when the body ascends too rapidly, preventing it from properly adjusting to lower oxygen levels and changes in air pressure. The result is hypobaric hypoxia, a state where insufficient oxygen reaches the body’s tissues.

In severe cases, fluid can accumulate in the lungs, brain, or both, leading to life-threatening complications. While altitude illness is rare at intermediate elevations (1,500–2,500 meters), it becomes a greater concern above 2,000 meters, typically developing after at least four hours at that height. Once climbers ascend beyond 2,500 meters, symptoms such as headaches and vomiting may occur.

Interestingly, men are more susceptible to altitude sickness than women, though the reason remains unknown. Physical fitness does not provide immunity, nor does a history of symptom-free climbs guarantee protection in the future. The only reliable prevention method is a gradual ascent, allowing the body sufficient time to acclimate.

The Mauna Kea trail is a demanding 13-mile round-trip hike near Hilo, taking about 9 hours to complete. Offering stunning views of Mauna Loa and the Pacific, it requires proper gear and preparation for high-altitude conditions above 12,000 feet. Altitude sickness is a risk, so bring plenty of water and be ready to turn back if necessary. Dogs are not allowed.

Start at the visitor center, self-register, and access the steep, six-mile trail a short distance up the road. The path is rugged, with loose cinder and lava, requiring self-reliance. Near 13,000 feet, it joins a paved service road for an easier return.

Symptoms of Altitude Sickness

Early Signs of Altitude Sickness May Include:

Headache
Fatigue or sluggishness
Decreased physical performance
Impaired coordination
Difficulty sleeping (insomnia)
Loss of appetite
Lightheadedness or dizziness
Nausea
Vomiting

Severe Altitude Sickness

Severe altitude sickness primarily manifests in two critical conditions: High-Altitude Pulmonary Edema (HAPE)—fluid accumulation in the lungs—and High-Altitude Cerebral Edema (HACE)—fluid buildup in the brain. These conditions often occur together, posing a life-threatening risk. If HAPE progresses, excessive fluid in the lungs can lead to suffocation.

Symptoms of Severe Altitude Sickness:

Shortness of breath, even at rest
Rapid or irregular heartbeat (palpitations)
Bluish tint to the skin and nails due to oxygen deprivation (cyanosis)
Persistent cough, often producing frothy or pink-tinged sputum from lung damage
Confusion or irrational behavior, including denial of symptoms
Difficulty maintaining balance, sitting up, or walking in a straight line

Immediate descent and medical intervention are crucial to prevent life-threatening complications.

Prevent Altitude Sickness

The most effective way to prevent altitude sickness is to ascend gradually. Once above 3,000 meters (9,800 feet), limit your ascent to 300 meters (1,000 feet) per day, and take an additional rest and acclimatization day for every 1,000-meter (3,300-foot) gain. Obviously this is not possible when hiking to the top of Mauna Kea in one day.

Additional Strategies for Prevention:

Consult your doctor before your trip for personalized advice and recommendations.
Dietary adjustments: Some climbers believe a high-carbohydrate diet before trekking may help reduce the risk.
Be prepared: Pack essential first aid supplies, including necessary medications.
Medications for prevention: Acetazolamide has been proven effective in aiding acclimatization, especially if flying directly to high altitudes. Some climbers have also used salmeterol inhalers and Viagra-like drugs to reduce lung fluid buildup.
Use treatment medications cautiously: Drugs like nifedipine and dexamethasone should be reserved for treating mild altitude sickness rather than prevention, as they may mask early warning signs.
Travel with experienced guides who understand high-altitude risks.
Stay hydrated: You may require up to seven liters of water per day at high altitudes.
Avoid smoking and alcohol, as both can worsen oxygen deprivation.
Do not use sleeping pills, as they depress the central nervous system and can exacerbate hypoxia (low oxygen levels).
Know your personal risk: If you have experienced altitude sickness before, you are more susceptible to it in the future.

Following these precautions can significantly reduce the likelihood of developing altitude sickness and improve your chances of a safe, enjoyable climb.

First Aid for Altitude Sickness

Using the buddy system is essential, as individuals experiencing altitude sickness often fail to recognize their own symptoms and may resist descending despite worsening conditions.

First Aid Measures:

Stop ascending immediately. Set up camp and allow time for symptoms to subside, which may take a few days.
Avoid alcohol and smoking, as both can worsen oxygen deprivation.
Provide pain relief with aspirin or paracetamol in standard recommended doses.
Encourage deep breathing every few minutes to help reduce carbon dioxide buildup in the bloodstream.
Administer dexamethasone in the recommended dosage to alleviate symptoms.
For severe cases, descend immediately—aim for a drop of 500 to 1,000 meters (1,600 to 3,300 feet).
Use diuretic medications to reduce the risk of fluid buildup in the lungs and brain.
Administer supplemental oxygen from a portable oxygen tank if available.

Early intervention is crucial to prevent serious complications. If symptoms persist or worsen, rapid descent and medical attention are the best course of action.

Hyperbaric Oxygen Therapy for Altitude Sickness

Hyperbaric oxygen therapy involves the use of specially designed pressurized chambers or rooms capable of delivering up to 100% pure oxygen, compared to the 21% oxygen found in air at sea level.

This treatment method rapidly increases oxygen levels in the body, helping to alleviate symptoms of altitude sickness. Portable oxygen cylinders allow for oxygen administration through a facemask or hood, offering a practical solution for climbers in remote areas.

However, oxygen therapy and altitude sickness medications should never be used as a way to continue ascending once symptoms have appeared, as doing so can lead to fatal consequences. Descent remains the safest and most effective treatment.

Where to Seek Help for Altitude Sickness

Consult your doctor for medical advice and treatment options before or after experiencing altitude sickness.

Key Points to Remember

Mountain climbers are susceptible to altitude sickness.
Rapid ascent increases risk, as the body needs time to adapt to lower oxygen levels and changes in air pressure.
Common symptoms include headaches, vomiting, insomnia, and impaired coordination and performance.
Severe cases can be life-threatening, with fluid potentially accumulating in the lungs, brain, or both.
First aid measures include immediate descent, appropriate medications, and oxygen therapy using a portable oxygen container.

Sources and References

Hyperbaric Oxygen Therapy – Hyperbaric Medicine Unit, Royal Adelaide Hospital, South Australia.
Dawka S, Barthakur R (2008) – Altitude Sickness: A Review, Journal of Gandaki Medical College, Vol. 1, No. 1.
Schommer K, Bärtsch P (2011) – Basic Medical Advice for Travelers to High Altitudes, Deutsches Ärzteblatt International, Vol. 108, No. 49, pp. 839–848. [More information here.]
Centers for Disease Control and Prevention (USA) – Altitude Illness.

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Hiking and Altitude sickness on Mauna Kea, Hawaii