Lake Louise Rating System (LLSS)
for Altitude Sickness (AMS)

Climbing Kilimanjaro

The Lake Louise rating system (LLSS) was designed to gauge adults for symptoms of acute altitude sickness (AMS). The system uses an assessment questionnaire and a scorecard to work out whether a private has no AMS, mild AMS, or severe AMS. (Note that LLSS doesn’t have a category for moderate AMS.)

While on the mountain, our guides will guide you to perform an assessment twice per day. The guides will use LLSS, alongside pulse oximeter readings and other criteria, to watch your condition on the mountain. LLSS is an objective measure that our staff can use to gauge your health during your climb.

A diagnosis of AMS is predicated on the subsequent conditions:

A rise in mountain altitude within the last 3 or 5 days (a given on Kilimanjaro)
Presence of a headache
Presence of a minimum of one other symptom
A total score of three or more from the questionnaire
Self-Assessment Questionnaire


No headache = 0
Mild headache = 1
Moderate headache = 2
Severe headache = 3
Gastrointestinal symptoms:

None = 0
Poor appetite or nausea = 1
Moderate nausea or vomiting = 2
Severe nausea or vomiting = 3
Fatigue and weakness:

Not tired or weak = 0
Mild fatigue/weakness = 1
Moderate fatigue/weakness = 2
Severe fatigue/weakness = 3
Dizziness and lightheadedness:

Not dizzy = 0
Mild dizziness = 1
Moderate dizziness= 2
Severe dizziness, incapacitating = 3
Difficulty sleeping:

Slept also , as usual, = 0
Did not sleep also as was common = 1
Woke repeatedly, poor sleep = 2
Could not sleep in the least = 3
A total score of three to five indicates mild AMS. A score of 6 or more signifies severe AMS.

The presence of mild AMS is extremely common and doesn’t necessarily mean that you simply will get to descend. On the opposite hand, an assessment of mild AMS doesn’t preclude you from being rotated either. LLSS is one tool, out of the many, that we use to form that determination. Although we might like everyone to the summit, our primary responsibility is to keep you safe

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