Action
Review Lake Louise AMS score (see Table 3, page 5)
Decision
What is the patient’s Lake Louise score?
Background
High altitude illness (HAI) can develop from several hours to up to 5 days after ascent to a given altitude. Symptoms most commonly develop 6 to 12 hours after arrival at altitude. The clinical features and presentation of illness can vary widely in individuals. There have been several standardized scoring systems to aid clinicians and researchers in determining the likelihood of HAI. Based on literature review, the simplest and most widely cited guidelines are the revised 2018 Lake Louise AMS score as well as the 1992 Lake Louise consensus on HACE and HAPE. The guidelines were developed based upon the consensus of study evidence and discussions among a group of leading altitude experts initially undertaken at the 1991 International Hypoxia Symposium and then revised in 2018.
According to the Lake Louise AMS score (see Table 3), if an individual has at least 1 point for headache and at least 3 total points, without neurological findings, with an altitude exposure of at least 6 hours, then AMS is suggested. A total score from 3 to 5 would be considered mild, 6 to 9 as moderate, and 10 to 12 as severe. The greatest limitation in using this scoring system is in identifying patients without complaint of a headache in whom AMS is present. The authors of the score do stipulate that it is geared more toward investigational research and should not be used by clinicians to diagnose or manage HAI. Nonetheless, it seems plausible that the application of this score could be useful as a quick starting point in stratifying the severity of disease and help provide guidance for subsequent interventions.
