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Altitude Sickness

What would happen to you if you were taken immediately to the summit of Mt. Everest? The answer is you would pass out, and likely die within minutes. So why, then, can people summit Everest without oxygen? The answer to this lies in the understanding of oxygen, pressure, and your body’s ability to acclimatize over time. In general, the percent of oxygen in the air stays the same with altitude, however, the partial pressure of the oxygen in the air mixture decreases. Although overly simplistic, this means that as we gain altitude, the molecules of oxygen are more spread out and our body’s ventilation systems do not work as well. Over time, our body can adapt to lower pressure and therefore someone who is properly acclimatized can withstand much higher altitudes than someone who is not.

Acute Mountain Sickness (AMS) is the term used to describe illness related to altitude. Unfortunately, the symptoms of AMS are similar to many other illnesses. However, crews and individuals that live at lower elevations (usually below 4,000 feet) and are working and sleeping above 6,500 feet are at risk for AMS. It is rare to experience AMS below 8,000 feet, however, about 50% of people will experience at least a mild form of AMS above 10,000 feet. AMS should be considered if an individual:

  1. Recently traveled to a higher elevation (generally above 8,000 feet) AND
  2. Has a headache AND
  3. Has other symptoms including:
    1. Dizziness or lightheadedness
    2. Fatigue or weakness
    3. Nausea/vomiting/anorexia
    4. Insomnia

The most severe types of altitude related illness are a consequence of fluid buildup and swelling in either the brain or the lungs. These conditions are called high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE). With HAPE, individuals experience AMS in addition to coughing and severe shortness of breath. With HACE, individuals experience AMS in addition to confusion, seizures, and other mental status changes.

Prevention of AMS, HACE, and HAPE is done by slowly acceding to altitude over several days; working high and sleeping low; and good nutrition and hydration.

Treatment of AMS ranges depending on severity. For mild symptoms, generally rest and hydration with some moderate decent in altitude for one or two days will allow for complete recovery and the ability to continue to work at altitude. For significant AMS, HACE, or HAPE, immediate decent, and evacuation is necessary.

Other examples include:

  • High altitude cerebral edema (HACE) is a severe and potentially fatal condition associated with high altitude illness that is often thought of as a late or end-stage AMS.
  • High altitude pulmonary edema (HAPE) is a severe form of high altitude illness that, if left untreated, can lead to mortality in 50 percent of affected individuals. It occurs secondary to hypoxia and is a form of noncardiogenic pulmonary edema. It is characterized by fatigue, dyspnea, and a dry cough with exertion.

Discussion Questions:

Where on this fire, your home unit or areas in the country might you or  your crew be at risk for developing AMS? What should you do to prevent/prepare? What should you do if symptoms develop?

References:

Category
Firefighter Health and First Aid

6MFS Suggestion Form


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NWCG Latest Announcements

2025/2026 Leadership Campaign Quarter 2 Now Available!

Date: February 13, 2026
Questions? 
Please contact: Leadership Committee

NWCG is excited to announce that the Quarter Two materials for the 2025/2026 Wildland Fire Leadership Campaign are now available! This annual initiative invites all leadership and wildland fire management students to engage with essential skills and knowledge needed to lead effectively in dynamic environments.

This quarter focuses on Leadership Level 2: New Leader (Conveying Intent). Conveying intent is a crucial leadership competency in the high-risk, dynamic environment of wildland firefighting. Months 4 - 6 will concentrate on how successfully conveying intent enhances situational awareness, promotes shared understanding, and empowers firefighters to exercise initiative and adapt to changing conditions.

References:

2025/2026 NWCG Leadership Campaign - Leadership Levels

Wildland Fire Leadership Development Program

Leadership Committee

Opportunity to Serve the Wildland Fire Community as an IPTM SME!

Date: February 10, 2026
Questions? 
Please contact: NWCG SME Specialist

NWCG is seeking experienced wildland firefighters and support personnel to serve as Subject Matter Experts (SMEs) for the Incident Performance and Training Modernization (IPTM) initiative. The intent of IPTM is to transition NWCG’s training and qualification system to a performance-based model through updated position descriptions, Incident Position Standards, Next Generation Position Task Books (Next Gen PTBs), and updates to training where needed.

NWCG is currently recruiting SMEs for the following positions:

  • Aircraft Timekeeper (ATIM)
  • Compensation/Claims Unit Leader (COMP)
  • Cost Unit Leader (COST)
  • Crew Representative (CREP)
  • Deck Coordinator (DECK)
  • Fire Effects Monitor (FEMO)
  • Field Observer (FOBS)
  • Geographic Information System Specialist (GISS)
  • Ordering Manager (ORDM)
  • Receiving/Distribution Manager (RCDM)
  • Staging Area Manager (STAM)

Projects begin April/May 2026 and require 15–20 hours per month for 6–8 months, including a five-day workshop in Boise, Idaho this May. Apply by February 27, 2026, at the link below and review the attached document for details.

References:

NWCG SME Interest Sign-up

IPTM Subject Matter Expert Duties and Expectations Document

Incident Performance and Training Modernization (IPTM)

NEW! M-280, Resource Advisor, Fireline (Instructor-Led) Course Available Now

Date: January 29, 2026
Questions? 
Please contact: Resource Advisor Subcommittee

NWCG is pleased to announce the new M-280, Resource Advisor, Fireline (Instructor-Led) course is now available. This training supports individuals working towards Resource Advisor, Fireline (REAF) incident qualifications.

M-280, Resource Advisor, Fireline (Instructor-Led) training prepares students to serve as a Resource Advisor, Fireline (REAF) as defined in NWCG Incident Position Standards for Resource Advisor, Fireline, PMS 350-112. This course presents scenarios that reflect the diverse challenges a REAF may encounter during an incident. Through these scenarios, participants gain hands-on experience and an understanding of REAF responsibilities in a controlled learning environment.

References:

Resource Advisor, Fireline Position Page

NWCG Position Standards for Resource Advisor, Fireline, PMS 350-112

M-280, Resource Advisor, Fireline (Instructor-Led)

Wildland Fire Learning Portal

2026 Updates to the NWCG Standards for Wildland Fire Position Qualifications, PMS 310-1

Date: January 23, 2026
Questions? 
Please contact: Incident and Position Standards Committee

The Incident and Position Standards Committee has updated the NWCG Standards for Wildland Fire Position Qualifications, PMS 310-1.

These updates address changes to incident position names and requirements for qualification, training, and experience. Updates related to the implementation of Complex Incident Management (CIM) and Incident Performance Training Modernization (IPTM) are also included.

The NWCG Wildland Fire Position Qualification Flowchart, PMS 308 has also been updated to reflect the recent changes.

References:

NWCG Standards for Wildland Fire Position Qualifications, PMS 310-1

NWCG Wildland Fire Position Qualification Flowchart, PMS 308

IPSC Memo 26-01: January 2026 Updates to the NWCG Standards for Wildland Fire Positions Qualifications, PMS 310-1