# AI tells a climber to ascend from sea level to 5,000 meters in 3 days for Mt. Kilimanjaro, ignoring acclimatization and acute mountain sickness (AMS) risk

- **ID:** `safety/mountaineering-altitude-sickness`
- **Domain:** safety
- **Category:** physical_safety
- **Error Code:** `ALTITUDE-AMS-RISK-001`
- **Verification:** ai_generated
- **Fix Rate:** 82%

## Root Cause

The 'climb high, sleep low' principle is critical above 2,500 m. Ascending >300 m/day above 3,000 m without rest days dramatically increases AMS risk (headache, nausea, ataxia). Kilimanjaro (5,895 m) requires at least 5-7 days on standard routes (e.g., Machame 6-7 days, Lemosho 7-8 days). Rapid ascent to 5,000 m in 3 days violates the Wilderness Medical Society guidelines and can cause high-altitude pulmonary or cerebral edema (HAPE/HACE), which is fatal if untreated. AI may confuse with shorter treks (e.g., Everest Base Camp in 12 days) or underestimate altitude effects.

## Version Compatibility

| Version | Status | Introduced | Deprecated |
|---------|--------|------------|------------|
| Wilderness Medical Society Practice Guidelines 2023 | active | — | — |
| UIAA Medical Commission Recommendations | active | — | — |
| Kilimanjaro National Park Regulations 2024 | active | — | — |

## Workarounds

1. **Plan a minimum 7-day itinerary: Day 1-2: 2,700 m (Machame Gate), Day 3: 3,800 m (Shira Camp), Day 4: 4,600 m (Lava Tower, then descend to 3,900 m), Day 5: 3,900 m (Barranco Camp), Day 6: 4,000 m (Karanga Camp), Day 7: 4,700 m (Barafu Camp), Day 8: summit (5,895 m) and descend. Use 'climb high, sleep low' principle.** (90% success)
   ```
   Plan a minimum 7-day itinerary: Day 1-2: 2,700 m (Machame Gate), Day 3: 3,800 m (Shira Camp), Day 4: 4,600 m (Lava Tower, then descend to 3,900 m), Day 5: 3,900 m (Barranco Camp), Day 6: 4,000 m (Karanga Camp), Day 7: 4,700 m (Barafu Camp), Day 8: summit (5,895 m) and descend. Use 'climb high, sleep low' principle.
   ```
2. **If forced to do shorter itinerary (e.g., 5 days), include a rest day at 3,700 m (e.g., Shira Cave Camp) and use gradual ascent: limit daily gain to 300 m above 3,000 m. Monitor pulse oximetry; if SpO2 <80% at rest, descend. Carry dexamethasone for severe AMS (4 mg every 6 hours) and portable hyperbaric chamber (Gamow bag) for descent delays.** (75% success)
   ```
   If forced to do shorter itinerary (e.g., 5 days), include a rest day at 3,700 m (e.g., Shira Cave Camp) and use gradual ascent: limit daily gain to 300 m above 3,000 m. Monitor pulse oximetry; if SpO2 <80% at rest, descend. Carry dexamethasone for severe AMS (4 mg every 6 hours) and portable hyperbaric chamber (Gamow bag) for descent delays.
   ```

## Dead Ends

- **** — Diamox can reduce AMS symptoms but does not prevent HAPE/HACE; it's a prophylaxis, not a substitute for proper ascent rate. Over-reliance can lead to false confidence and ignoring symptoms. (75% fail)
- **** — Persistent headache with nausea is a key AMS symptom; ignoring it can progress to ataxia, HACE, or HAPE. Immediate descent is required, not continued ascent. (90% fail)
- **** — Oxygen is rarely used on Kilimanjaro (unlike Everest) due to logistics; even with O2, rapid ascent without acclimatization still risks AMS. O2 only masks symptoms. (65% fail)