Hamlet Tours

Hamlet Tours

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What is Altitude Sickness?

A mixture (syndrome) of problems like headache, nausea, shortness of breath, tiredness encountered at high altitude i.e. above 3000 meter.

Cause / Factor of Altitude Sickness

  1. less oxygen
  2. low pressure i.e. barometric pressure
  3. rapid ascent
  4. possibly dehydration
  5. hypothermia etc..


Type of Altitude Sickness

  1. AMS: – Acute Mountain Sickness
  2. HAPE: – High Altitude Pulmonary Edema
  3. HACE: – High Altitude Cerebral Edema


Symptoms of Altitude Sickness

  1. Acute mountain sickness – ams mild symptoms feel like hangover / not feeling well
  2. Headache
  3. Fatigue/tiredness
  4. Nausea
  5. Shortness of breath
  6. Loss of appetite
  7. Sleep disturbance
  8. Dizziness
  9. High altitude pulmonary edema (water in the lung) – hape
  10. Increasing shortness of breath at rest
  11. Severe cough- dry /productive
  12. Very tired – unusual fatigue while walking
  13. High pulse rate i.e. 110
  14. Blueness of face, lip, finger nails – that means inability to transport oxygen into the blood
  15. It can happen after 2 nights of arrival in the altitude.
  16. High altitude cerebral edema (water in the head) – hace


Severe Symptoms of Altitude Sickness

  1. Severe headache
  2. Vomiting
  3. Walking like a drunk (ataxia)
  4. Mental confusion/altered mental status
  5. Irritable – does not want to be bothered by other people.
  6. Unconsciousness or coma.
  7. Test: tandem walking test, hell to toe step. fall off from the line


Decision Making

Find out the problem i.e. at altitude assumes all problems are altitude sickness unless proven otherwise. if it is altitude problem with mild symptoms, stay at the same altitude until the symptoms gone. e.g. take an aspirin, try to go up but listen to your body. if symptoms are worsening, go down.



  1. Acclimatization – after 1000m.
  2. Ascent, stay one more night for acclimatization.
  3. Do not make rapid ascent; don’t go to fast too high.
  4. No alcohol, sleeping pills and smoking.
  5. Drink more fluid 3-4 liter day clean water – boiled or treated/tea/coffee/soup/juice etc.
  6. Do not carry heavy packs; 10-12 kegs is ok.
  7. Climb higher sleep lower.
  8. Over 3000m, only 400m. ascent a day.
  9. Do not travel alone.


Golden Rules

  1. Awareness of altitude illness.
  2. If you have mild symptoms, do not go higher, take aspirin
  3. If you have worsening symptoms, go down.
  4. Never leave your team member behind unattended either trekker or porter.



  1. Descent is the best medicine; do not wait for the helicopter.
  2. Medicine
  3. Oxygen
  4. Diamox – for ams- 125 mg. before dinner – for sleeping problem if feeling suffocated.
  5. Nafedipine for hape
  6. Steroids/dexamethasone for hace.
  7. Hyperbaric bag – gamow bag

Please note: Travel Insurance is compulsory for booking any of Excursion Nepal tours: trekking and mountaineering.

There is whole lot of Insurance companies providing you travel Insurance service over the Internet that you can choose form according to your convenience. But you need to strictly be aware of the fact that the policy the insurance company provides should cover the process of giving you the service of Helicopter rescue from the mountains in case of Altitude Sickness or other accidents during your trip.
For more details on insurance and some of our suggestions on Insurance companies, please go through the links below:

For Canadians and Americans:


For Australians and New Zealanders


For British

http://www.thebmc.co.uk (British Mountaineering Council)
http://www.essentialtravel.co.uk (Select Grade 4 cover – Sport Cover)

For Europe


For South-Africa


This is the basic list to cover the more common ailments that affect trekkers. Climbing groups, expeditions and trekkers going to isolated areas will need a more comprehensive kit.

  1. Sphygmomanometer (Blood pressure Instrument)
  2. Syringes (20 ml, 10 ml)
  3. Hot water bottle
  4. Pen and writing pad
  5. Stethoscope
  6. Thermometer
  7. Matchbox
  8. Splints
  9. Scissors
  10. Tongue blades
  11. Pen light
  12. Cervical collar
  13. Bandage and Dressings:
  14. Sterile gauge pads (large and small)
  15. Band aids
  16. Triangular Bandages
  17. Elastic Bandages (3, 4 and 6 inches)
  18. Adhesive Tapes
  19. Eye pads
  20. Cotton roll (large and small)
  21. Q-tips
  22. Safety pins
  23. Medications


For Pain

  1. Paracetamol (500mgs tablet and 125 mgs in 5 ml syrup)
  2. Aspirin (300mgs tablets)


For Allergy

  1. Avil (25 mgs tablet)
  2. Benadryl Syrup
  3. Trexyl – (60mgs tablet, 30 mgs in 5 ml syrup)


For Infections

  1. Eye: Neosporin Ophthalmic Cream
  2. Throat and Lung: Amoxicillin (125mg per 5 ml syrup, 250 mgs and 500 mgs tablets)
  3. For Abdomen: Metronidazole(200mgs, 400mgs tablets) Tinidazole (500 mgs tablets)

For Open Wounds

  1. Cloxacillion and Cephalexin(125 mgs in 5 ml 250 mgs and 500 mgs tablets)
  2. For urinary infections
  3. Narfloxacin (200 mgs, 400 mgs tablets)



  1. Betadine (Solution and cream)
  2. Miconazole Cream (for fungal infection)
  3. Silver sulphadiazine(for burn injury)

A visa is necessary to enter Nepal (except for Indians) and can be obtained for the following duration from any Royal Nepalese Embassy or Consulate or at the entry points in Nepal. (You could easily obtain Nepal visa at your arrival in Tribhuwan International airport –TIA)

Following types of tourist visas may be obtained 

Type of Visa Visa Valid for Fee
Multiple Entry 15 Days US$ 25/-
Multiple Entry 30 days US$ 40 /-
Multiple Entry 90 days US$ 100/-

Important Information

1. Once the visa is issued, it will not be amended, revalidated and visa fees will not be refunded.

2. Personal cheques and credit cards are not accepted for visa fees.

3. Visitors may also obtain tourist visa at major arrival points in Nepal including Tribhuwan International Airport     (TIA), Kathmandu. Requirements at arrival: 2 PP size photos, complete prescribed visa form available at entry     point.

4. Visa fees effective from 12 February 2009

5. Children under the age of 10 shall be issued visit visa free of cost.

6. A visa year covers a period from 1 January to 31 December each year.


Entry validity:

Six months from the date of issue. The validity of visa dates is counted from the date of arrival in Nepal.



A passport valid for at least 6 more months is required. Make a photocopy of your passport and keep it with you, leaving your passport in Kathmandu.


The Requirements

  1. Valid passport.(with a validity of a minimum period of six months)
  2. Application Form (Download application form for diplomatic/official/tourist visa)
  3. Two passport size picture
  4. Visa fees in cash


Entry Points to Nepal

  1. Tribhuvan International Airport, Kathmandu
  2. Kakarvitta, Jhapa (Eastern Nepal)
  3. Birganj, Parsa (Central Nepal)
  4. Kodari, Sindhupalchowk (Northern Border)
  5. Belhiya, Bhairahawa (Rupandehi, Western Nepal)
  6. Jamuna, Nepalgunj (Banke, Mid Western Nepal)
  7. Mohana, Dhangadhi (Kailali, Far Western Nepal)
  8. Gaddachauki, Mahendranagar (Kanchanpur, Far Western Nepal)



Tourist Visa Fees

  1. Multiple entry 30 days US$ 40 or equivalent convertible currency
  2. Multiple entry 90 days US$ 100 or equivalent convertible currency
  3. Visa for SAARC countriesFree visa for 30 days available for tourists of SAARC countries.
  4. Visa for Indian citizens: Indian nationals do not require visa to enter into Nepal but getting to Nepal by air/overland they have to show their passport or any identity card issued by Indian government, at the entry point to Nepal. The children under 10 years no need to show any identification.


Tourist Visa Extension

Visa extension fee for 15 days or less is US $ 30 or equivalent convertible currency and visa extension fee for more than 15 days is US$ 2 per day Tourist visa can be extended for a maximum period of 150 days in a single visa year (January – December).


Transit Visa

Foreigners, who have entered in Nepal to stay for a night in Nepal and willing to use Nepal’s Air port to visit another country with plane ticket or foreigners, traveling in the accidentally force landed plane for any circumstances shall be issued transit visa for one day by the paying 5 US $ or equivalent convertible currency.


General Information

  1. No foreigner is entitled to enter into and stay in the Kingdom of Nepal without valid visa.
  2. Tourist entry visa can be obtained for the following duration from Nepalese Embassy or consulate or other mission offices or immigration offices located on entry points in Nepal.
  3. Once the visa is issued, it will not be amended, re-validated and visa fees will not be refunded.
  4. Personal cheque and credit cards are not accepted at any entry point of Nepal.
  5. Living in Nepal without passport or a valid visa is a punishable offense.
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