Tips for successful travel in high altitude

No matter how exciting the travel is to the high altitude, it is always challenging and is never free of troubles. We have hundreds of stories of people loosing lives in mountains due to lack of preparation and making very minor and stupid mistakes in high altitude.

The summit/trek success depends on few very important things which should be followed properly and I recommend you to follow these as a “standard set of checklist” before you start your high altitude travel.


              Well organized pre-planned trip is the backbone of a successful trip to the high altitude and this is applicable from beginners to technical mountain summiteer. Pre-planning includes the following sets of planning:

  1. Appropriateness of travel destination:
    1. First and the foremost, make sure if the destination you choose is appropriate based on your physical fitness, past medical history and previous experience. If you are planning your first high altitude trek then it is better to have a short hikes in high altitude (2,500 meters -3,500 meters) to experience how it feels like to be in thin air.
  • Planning of itinerary:
    • A slow and gradual ascent profile is the key to successful acclimatization. Never ascent more than 500 meters of sleeping altitude per day and take a rest day after ascent of >1000 meters.
  • Health insurance plan:
    • Make sure the insurance plan covers all possible events during the travel. Check with your insurance company in advance and talk to them to make sure the policy covers altitude illnesses and other travel related illnesses.
  • Check weather forecast:
    • These days it is possible to check in advance the weather forecast. Prepare for the possible unexpected environmental changes and pack accordingly. Unexpected snow, rain, snowstorm, lightning, etc causes unexpected consequences if you are unprepared. So, preparation for possible unexpected events is vital for trouble free travel.
  • Medical Kit:
    • Make sure you have enough medical supplies for basic first aid. You can costumize your kit based on your expertise and experience/training. However, I recommend you to have following medications/items before you embark on your trip:
      •  Crepe bandages
      •  Gauze pieces/pads and band aids
      •  Betadine/antiseptics
      •  Ointments for burn, allergies and antimicrobials
      •  Painkillers (paracetamol, ibuprofen, aspirin, etc)
      •  Anti-emetics
      •  Acetazolamide

We can prepare you the first aid kit based on your need/demand and get it delivered at your doorsteps.

Get checked out:

              Before you start your trip to high altitude please get yourself checked up with your GP/Primary Care Physician. In fact, it is mandatory for people with pre-existing medical problems and follow doctor’s recommendations.

              You can book an appointment for pre-travel consultation here.

Get Fit:

              Physical fitness is not the predictor of altitude illness but it is important to be fit to endure in the high altitude. If you are physically fit then you have better chances of being more resilient and not get other injuries and illness.

              You can prepare physically by doing regular physical exercises like running, walking long distances, swimming, biking, weight training, etc.

Get Educated:              

Proper knowledge about altitude illnesses & its prevention, terrain, weather & topography, local culture, food, religion, clothing, foot wares and basic first aid is very important in making the trip successful. Experts agree that knowledgeable travelers are more likely to be safe and healthy.

Safe travels and stay safe!

Dr. Santosh Baniya, MD (June, 2022)

Level of difficulty in expedition

Trek/Expedition difficulty levels:

There is no specific classification on level/grades of difficulties for an expedition or trek. Please follow the following “Level of difficulty” which is prepared based on my experience and extensive literature reviews.

  • Level 1:
    • Fitness level: Low fitness level/regular daily activities
    • Technicality: No technical skills required
    • Total duration of trip: 3-7 days
    • Duration of hike/trek: 3-5 hours/day
    • Altitude: Below 3,000 meters
    • Terrain: Well-maintained path with frequent exposure with locals/villages
    • Past experience: Not required
    • Accommodation: Tea house/lodges/hotels
  • Level 2:
    • Fitness level: Medium/1-2 days of cardio exercise/week
    • Technicality: No technical skills required
    • Total duration of trip: 7-14 days
    • Duration of hike/trek: 4-6 hours/day
    • Altitude: 3,000-5,000 meters
    • Terrain: Steep hills, usually rough trails, occasional encounter with horses/mules with less frequent exposure with locals/villages
    • Past experience: Previous hiking, camping or level 1 trekking experience required
    • Accommodation: Tea house/lodges with camping (optional)
  • Level 3:
    • Fitness level: Good/3-4 days of cardio exercise/fitness training per week
    • Technicality: Basic skills on crampons, knots and ice axe required
    • Total duration of trip: 12-21 days
    • Duration of hike/trek: 5-8 hours/day
    • Altitude: 3,000-5,500 meters
    • Type of trail: Steep hills, mostly rough trails, a couple of passes, exposure with snow & glacier, occasional exposure with locals/villages
    • Past experience: Previous exposure to high altitude trekking required
    • Accommodation: Tea house/lodges plus camping (mostly)/semi-expedition style
  • Level 4:
    • Fitness level: Good and above average/Regular daily exercise
    • Technicality: Efficient with crampons, ropes, knots and ice axe
    • Total duration of trip: 2-4 weeks
    • Duration of hike/trek: 5-8 hours/day
    • Altitude: 5,000-6,000 meters
    • Type of trail: Steep hills, rough trails, high passes, glacier and snow crossing and rare exposure with other people
    • Past experience: Previous level 3 trekking experience required
    • Accommodation: Mostly camping/expedition style

Dr. Santosh Baniya, MD (April, 2022)

Calculating oxygen capacity of cylinder and it’s lifespan

Supplementing oxygen through the oxygen cylinder either to thrive in extreme altitudes (>8,000 meters) to ascent peak or to treat hypoxia related illnesses is a very common practice. This has been in practice since decades. But, every time someone decides to use the oxygen cylinder, s/he faces the most difficult questions;

  1. How much oxygen is there in the cylinder? And,
  2. How long will it last?

Cylinder size and total oxygen capacity:

The oxygen capacity of the cylinder depends on the size of the cylinder and here is the common type of cylinder size and its capacity:

Cylinder sizeDEFGJ
Oxygen capacity (Liters)340680136034006800
Water capacity (Liters)2.3L4.7L17L39L47.2L

To calculate the oxygen capacity of any type of oxygen cylinder the formula is:

Cylinder Capacity (Liters) = Water capacity × 144

Longevity of the cylinder/Duration of oxygen supply:

              This depends on the flow rate, cylinder (tank) pressure, residual pressure and conversion factor of different cylinder size. And, this can be calculated using the following formula:

Time to runout a cylinder = (Cylinder pressure in PSI – 200) × Cylinder conversion factor ÷ Flow rate (Liter/min)

Residual pressure = 200 (constant)

Cylinder pressure = measured in the pressure gauze attached to the cylinder

Flow rate = desired flow rate adjusted in the flow meter

Cylinder sizeCylinder conversion factor

Cylinder conversion factor = depends on size of cylinder


Please calculate the time to rundown the oxygen cylinder (F-size) at given pressure and flow rate:

Gauze pressure = 2,000 psi

Residual pressure = 200 psi

Flow rate = 5 liter/min

Time duration = (2000-200) × 0.68 ÷ 5  

                      = 244.8 minutes or 4.08 hours

Safely used the oxygen delivery devices!

Dr. Santosh Baniya, MD (July, 2022)