You'll love the way we climb & trek™                                                       

How much is your life worth?

Safety starts with you. If you follow our advice and arrive prepared, you have maximized your chances for a safe Climb. See our "Before you Leave" section.

In Tanzania, our staff is equipped with cell phones and you will be transferred with late model 4WD vehicles and professional drivers.

The day before your Climb, the Climb Leader will give you a safety briefing and inspect your gear.

On the mountain, we are in a class of our own:

	We design our trips using a sensible and gradual approach, using at least 7 days to ascend the mountain.
	Our groups are small - maximum 8 trekkers - to ensure personal attention from the guides.
	Our guides are certified in the 80-hour Wilderness First Responder course (including CPR and and mountain survival skills), and attend yearly recertification courses delivered by NOLS WMI instructors who we fly out to Arusha.
	Our First Aid kit is approved by the Wilderness Medical Institute.
	Our mountain teams use multiple means of communication with each other and KINAPA - such as cell phones and radios.
	A guide or assistant guide will always be at your side.
	You will be safe and warm in our 4-season tents from the best names in the business such as Bibler and Mountain Hardwear. These tents are seen on Everest and K2 and can withstand snowstorms and high wind.
	We are one of very few companies that carry Pulse Oximeters to determine your level of oxygen saturation and pulse rate. These are expensive, highly accurate medical instruments that essentially give a digital readout of your acclimatization rate. NOTE - our policy is not NOT to rely purely on these readouts. This is not an exact science. We've seen healthy climbers with bad reads and vice versa! Our guides are trained to distinguish between mild, moderate and severe AMS. And we use stethoscopes for early High Altitude Pulmonary Edema (HAPE) detection.
	We pack a portable Hyperbaric Chamber on every trek that overnights in the Crater. This expensive, but crucial safety device is used to simulate a lower altitude in rare instances when immediate descent is not feasible.
	We carry oxygen on all routes to improve oxygen saturation of the blood - we don't give oxygen to simply boost your energy! We use it in emergencies only.
	We are the first company carrying AEDs  on our climbs. (Automated External Defibrillators, are devices that look at a person's heart rhythm (through special pads placed on the torso) and can recognize ventricular fibrillation (VF), also known as "sudden cardiac arrest" or SCA. If SCA is present, an AED will advise, and will talk the responder through some very simple steps to defibrillate. AEDs are designed to be used by lay rescuers or "first responders".
	In case of urgent emergencies, Flying Doctors aircraft will evacuate you to Nairobi.
	LOTS of water and food rich in carbohydrates can help to overcome altitude symptoms. We use the very latest in SweetWater and Katadyn filtering technologies. Your water will taste fine!
	When climbing the Western Breach route, please bring a rock climbing helmet in case of rock falls.

Acute Mountain Sickness

Acute mountain sickness (AMS) is an illness that can affect climbers who ascend too rapidly to high altitude (typically above 8,000 feet or 2,400 meters).

Causes: Reduced atmospheric pressure and a lower concentration of oxygen. Symptoms can range from mild to life-threatening. The likelihood and severity of altitude illness is greater with increasing rate of ascent, higher altitude attained, and higher levels of exertion

Who gets it: Approximately 20% of people will develop mild symptoms at altitudes between 6,300 to 9,700 feet.  Above 14,000 feet, a majority of people will experience at least mild symptoms. Symptoms are: headache, tiredness, disturbed sleep, loss of appetite, nausea, dizziness, irritability, some swelling in fingers or face.

Treatment for mild AMS: rest at the same altitude or lower, adequate hydration - 4l or more water per day - to keep urine pale & plentiful. Acetazolamide (Diamox) may be used to stimulate breathing & speed acclimatization or (especially for the sulfa-allergic) to just treat the symptoms while stopping altitude gain and/or to descend. For example, medical treatment of symptoms can include ibuprofen or acetominophen for headache, anti-emetics (for example, promethazine) for nausea, zolpidem for insomnia. All of this presupposes input from your physician.
 

Our guides know that it is very important to check any climber with AMS carefully and regularly. We use pulse-oximeters to test for oxygen saturation. A source of light originates from the oximeter at two wavelengths (650nm and 805nm). The light is partly absorbed by a molecule in our red blood, by amounts which differ depending on whether it is saturated or desaturated with oxygen. By calculating the absorption at the two wavelengths the processor can compute the proportion of red blood which is oxygenated. As one acclimatizes, the heart rate is supposed to decrease as the blood oxygen saturation increases. There are times when one's blood oxygen saturation declines drastically in a short period of time, resulting in disorientation. We monitor closely anyone whose blood oxygen saturation is lower than 80%.

But - oximeter readings are not an exact science. If it was, AMS will be a lot easier to predict. It is not. We use the device mainly to confirm what we may already suspect - that someone is not acclimatizing well.  Our guides (and most porters) know the symptoms VERY well.

Severe AMS: Fluid collects in the lungs (pulmonary edema or HAPE) causing extreme shortness of breath and further decreasing oxygenation. Swelling may also occur in the brain (cerebral edema or HACE), causing confusion, coma, and, if untreated, death.

Above 14,000 feet, approximately 10%  of un-acclimatized people staying at this altitude will develop HAPE and 1.5% will develop HACE. Death from HAPE or HACE is usually due to rapid ascent, failure to take mild AMS seriously and delayed diagnosis of HACE or HAPE.  F&S Kiliwarrior guides are trained to recognize these conditions. 

Symptoms of HAPE: cough with colored sputum, severe breathlessness even at rest, blueness of face, chest pain, severe fatigue, crackles in the lungs on deep in/exhaling, drowsiness, sometimes a mild fever.

Symptoms of HACE: severe headache often worse while lying down, persistent nausea, dizziness and loss of coordination, blurred vision, confusion, drowsiness.

Treatment for severe AMS: immediate descend, controlled oxygen, Diamox, dexamethasone (Decadron) for HACE, nifedipine for HAPE.

If immediate descend is not possible, a portable altitude chamber (PAC) will help alleviate the symptoms until the climber can descend. The Kiliwarriors is one of only a handful of companies that carry a PAC on climbs that overnight in the Crater.

What every climber should know about a PAC:

In very rare cases, it may be unsafe to descend immediately.  Our guides will then recommend the PAC to temporarily alleviate the severe AMS symptoms. The procedure is as follows:

1. Please listen to the guides as they explain the process . They have been trained to use the device properly.

2. You will be placed inside the PAC (see the picture at the top of this page) for at least an hour or more. Do not panic. You guides can see you through the windows and one of them will remain with you the whole time. They will take you out IMMEDIATELY if you get uncomfortable. You can hear them and they can hear you clearly.

3. Before entering the PAC, you will be asked to go to the bathroom. The guides will place a mattress and sleeping bag in the PAC since it may be cold inside. You will also get a sickness bag in case your AMS is causing nausea.

4. Once inside, the zipper will be closed and the team will start the inflation process using a foot pump. You may have to equalize your ears (exhale against your closed nose and lips) during this process.

5. At around 2 pounds per square inch, the PAC simulates a lower altitude and you should start to feel better. Our guides will monitor your progress and after one hour or so, they will slowly deflate the chamber and let you out. During this process you may have to equalize your ears (yawn or swallow).

6. If your severe AMS symptoms persist, the process may be repeated until it is safe to descend.

7. During the descend you will be accompanied by your English-speaking guide or assistant guide - NOT a porter.

Please go here for an in-depth discussion about AMS - http://www.ismmed.org/np_altitude_tutorial.htm