Nepal Trekking Emergency Protocols: Complete Guide to Crisis Response

The Himalayas are unforgiving. At high altitude, conditions can deteriorate rapidly, weather can change within minutes, and help can be hours or even days away. Unlike urban emergencies where calling for help brings immediate response, mountain emergencies require self-reliance, proper planning, and systematic protocols that bridge the gap between crisis onset and professional rescue.

This comprehensive guide provides step-by-step emergency protocols for every major crisis scenario you might encounter while trekking in Nepal. From altitude emergencies that require immediate descent to helicopter rescue procedures and insurance claim processes, this guide equips you with the knowledge to respond effectively when seconds count.

Table of Contents

1. Being Prepared Saves Lives
2. Emergency Contact List
3. Altitude Emergency Protocol
4. Injury Response Protocol
5. Helicopter Rescue Procedures
6. Insurance Claims Process
7. Lost or Separated Protocol
8. Weather Emergency Response
9. Communication in Emergencies
10. Medical Evacuation Procedures
11. Embassy Support and Services
12. Survival Strategies if Stranded
13. Post-Emergency Procedures
14. Frequently Asked Questions

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Being Prepared Saves Lives

Emergency preparedness begins long before you set foot on the trail. The difference between a manageable crisis and a tragedy often comes down to preparation completed weeks or months before your trek begins.

The Pre-Trek Emergency Preparation Checklist

Insurance Documentation

• Purchase comprehensive travel insurance with minimum $100,000 medical coverage
• Ensure helicopter evacuation coverage to at least 6,000 meters altitude
• Carry physical copies of your insurance policy and emergency contact numbers
• Store digital copies in cloud storage accessible from any device
• Note your policy number, emergency assistance hotline, and authorization requirements

Medical Preparation

• Visit a travel medicine specialist 4-6 weeks before departure
• Obtain prescriptions for altitude medication (Diamox/Acetazolamide)
• Carry a comprehensive first aid kit appropriate for high-altitude trekking
• Pack any personal medications with doctor's letters explaining their necessity
• Know your blood type and any allergies

Emergency Communication

• Register with your home country's embassy in Kathmandu
• Provide detailed itinerary to family members at home
• Establish check-in schedule and emergency trigger protocols
• Save all emergency numbers in your phone and write them on waterproof paper
• Consider renting a satellite phone or emergency beacon for remote treks

Physical Documents to Carry

• Passport (original and photocopies)
• Insurance policy and emergency card
• Embassy contact information
• Medical history summary with allergies and conditions
• Emergency contact details for next of kin
• Trekking permits and TIMS card

Understanding Mountain Emergencies

Mountain emergencies differ fundamentally from lowland emergencies in several critical ways:

Time and Distance: What takes minutes in a city can take hours in the mountains. Helicopter response depends on weather, daylight, and availability. Ground evacuation can take days.

Self-Reliance: You may need to initiate your own rescue, stabilize injuries, or begin descent before professional help arrives. Waiting passively can be fatal.

Environmental Factors: Altitude, cold, weather, and terrain compound every emergency. A minor injury at sea level becomes life-threatening at 5,000 meters.

Communication Limitations: Cell service is unreliable or nonexistent in many trekking areas. Satellite communication may be your only option.

Resource Scarcity: Advanced medical care exists only in Kathmandu. Trail-side resources are limited to basic first aid and whatever you carry.

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Emergency Contact List

Primary Emergency Numbers

Nepal Police Emergency: 100 (nationwide)

Tourist Police Kathmandu: +977-1-4247041

Nepal Tourism Board Emergency: +977-1-4256909

Himalayan Rescue Association (HRA):

• Main Office Kathmandu: +977-1-4440292
• Altitude Sickness Helpline (24/7): +977-9851054222
• Pheriche Aid Post (Everest): +977-9849866383 (seasonal)
• Manang Aid Post (Annapurna): +977-9846037556 (seasonal)

CIWEC Hospital Kathmandu: +977-1-4424111 (24/7 emergency)

Grande International Hospital: +977-1-5159266

Nepal Ambulance Service: 102

Helicopter Rescue Companies

Simrik Air: +977-1-4464878, +977-9851029129 Fishtail Air: +977-1-4411992 Altitude Air: +977-1-4488299 Manang Air: +977-1-4482515

Embassy Contacts in Kathmandu

United States Embassy

• Address: Maharajgunj, Kathmandu
• Phone: +977-1-4234000
• Emergency (after hours): +977-1-4234000, follow prompts

United Kingdom Embassy

• Address: Lainchaur, Kathmandu
• Phone: +977-1-4237100
• Emergency: +44-20-7008-5000 (UK Foreign Office)

Australian Embassy

• Address: Bansbari, Kathmandu
• Phone: +977-1-4371678
• Emergency: +61-2-6261-3305 (Canberra)

Canadian Embassy

• Phone: +977-1-4441976 (Honorary Consulate)
• Emergency: +1-613-996-8885 (Ottawa)

German Embassy

• Address: Gyaneshwor, Kathmandu
• Phone: +977-1-4412786
• Emergency: +49-30-1817-0 (Berlin)

French Embassy

• Address: Lazimpat, Kathmandu
• Phone: +977-1-4412332
• Emergency: +33-1-43-17-53-53 (Paris)

Trekking Region-Specific Contacts

Everest Region:

• Lukla Health Post: +977-38-540042
• Namche Police Post: +977-38-540011
• Pheriche HRA Aid Post: +977-9849866383 (seasonal)

Annapurna Region:

• Manang HRA Aid Post: +977-9846037556 (seasonal)
• Jomsom Police: +977-69-440011
• Pokhara Hospital: +977-61-520066

Langtang Region:

• Dhunche Police: +977-10-540011
• Syabrubesi Health Post: Local inquiry required

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Altitude Emergency Protocol

Altitude emergencies are the most common serious medical crises on Nepal treks. Understanding the progression from mild Acute Mountain Sickness (AMS) to life-threatening High Altitude Cerebral Edema (HACE) and High Altitude Pulmonary Edema (HAPE) can mean the difference between a minor setback and a fatal outcome.

Recognizing Altitude Illness Severity

Mild AMS (Acute Mountain Sickness)

• Headache (primary symptom)
• Mild fatigue and weakness
• Dizziness or lightheadedness
• Loss of appetite
• Difficulty sleeping
• Nausea without vomiting

Moderate AMS

• Severe headache not relieved by medication
• Persistent nausea and vomiting
• Moderate fatigue affecting normal activity
• Shortness of breath with minimal exertion
• Decreased coordination

Severe AMS / Early HACE (High Altitude Cerebral Edema)

• Severe headache unresponsive to strong painkillers
• Confusion, disorientation, irrational behavior
• Ataxia (loss of coordination—cannot walk straight)
• Extreme fatigue, cannot perform simple tasks
• Changes in consciousness or personality
• Visual disturbances

HACE (Medical Emergency)

• Profound confusion, cannot recognize companions
• Severe ataxia (cannot walk without support)
• Hallucinations
• Unconsciousness or coma
• Without treatment, death within 24 hours

HAPE (High Altitude Pulmonary Edema - Medical Emergency)

• Severe breathlessness at rest
• Wet, gurgling breathing sounds
• Coughing up pink, frothy sputum
• Extreme fatigue and weakness
• Cyanosis (blue lips and fingernails)
• Chest tightness or pain
• Without treatment, death within hours

Step-by-Step Altitude Emergency Response

Step 1: Recognition and Assessment (0-5 minutes)

• Stop all activity immediately
• Assess symptoms using the categories above
• If ataxia is present (cannot walk a straight line), this is SEVERE—act immediately
• If pink frothy sputum or severe breathing difficulty, this is HAPE—act immediately

Step 2: Initial Treatment (5-15 minutes)

• Mild AMS: Rest, hydrate, take Acetazolamide (Diamox) 250mg, take Ibuprofen for headache
• Moderate AMS: Stop ascent, consider descent of 300-500 meters, hydrate, medicate
• Severe AMS/HACE/HAPE: Begin immediate descent—do not wait

Step 3: Descent Protocol for Severe Cases

• Descend minimum 500-1,000 meters as quickly as safely possible
• Continue descent until symptoms significantly improve
• Person should not carry their own pack
• If walking impossible, arrange porter/yak carry or helicopter evacuation
• Do not leave person alone—they may become confused and wander

Step 4: Medication for Severe Cases

• HACE: Dexamethasone 8mg immediately, then 4mg every 6 hours
• HAPE: Nifedipine 20mg (if available), oxygen if available
• Both conditions: Supplemental oxygen significantly improves survival
• Continue descent even while administering medication

Step 5: Evacuation Decision

• If descent on foot is impossible (terrain, weather, patient condition)
• Contact insurance emergency line for helicopter authorization
• Contact HRA helpline for medical guidance: +977-9851054222
• Prepare landing zone if helicopter is coming

Step 6: Post-Crisis Care

• Once at lower altitude and stable, seek medical evaluation
• Do not re-ascend until cleared by medical professional
• Severe cases should evacuate to Kathmandu for full evaluation
• Previous HACE/HAPE significantly increases future risk

Altitude Emergency Prevention

The best emergency response is preventing the emergency from occurring:

• Follow the "climb high, sleep low" principle
• Never increase sleeping altitude by more than 300-500 meters per day above 3,000m
• Build in acclimatization days (rest days at same altitude)
• Stay hydrated—drink 3-4 liters daily at altitude
• Avoid alcohol and sleeping pills, which mask symptoms
• Ascend at your own pace—ignore peer pressure
• Descend at first sign of symptoms not improving

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Injury Response Protocol

Injuries on Nepal treks range from minor blisters to life-threatening trauma. The principles of wilderness first aid apply, modified for high altitude and remote conditions.

Common Trek Injuries and Response

Blisters

• Stop as soon as you feel a hot spot
• Clean area, apply moleskin or blister pad
• If blister has formed, sterilize needle, drain fluid, keep skin intact
• Apply antibiotic ointment and protective dressing
• Prevention: Properly fitted boots, moisture-wicking socks, break in footwear before trek

Sprains and Strains

• Stop immediately, do not "walk it off"
• Apply RICE: Rest, Ice (cold stream water), Compression, Elevation
• Assess severity—can you bear weight?
• Minor sprain: Rest, anti-inflammatory medication, compression bandage, continue cautiously
• Severe sprain (cannot bear weight): May require evacuation or improvised splinting

Fractures

• Do not attempt to move person until injury is stabilized
• Immobilize joint above and below suspected fracture
• Use trekking poles, sleeping pads, or branches as splints
• Pad all splints to prevent pressure sores
• Monitor circulation below injury (pulse, sensation, color)
• Arrange evacuation—walking with a fracture is rarely possible

Cuts and Wounds

• Control bleeding with direct pressure
• Clean wound thoroughly with clean water
• Apply antibiotic ointment
• Close with butterfly bandages or sutures if trained
• Cover with sterile dressing
• Watch for signs of infection (increasing redness, warmth, pus, fever)

Head Injuries

• Any loss of consciousness, even momentary, is serious
• Watch for signs of concussion: headache, nausea, confusion, unequal pupils
• If severe head injury suspected, do not move unless in immediate danger
• Keep neck immobilized if spinal injury possible
• Evacuate for medical evaluation

Wilderness First Aid Principles

The Primary Survey (DRSABCD)

• Danger: Ensure scene is safe for you and patient
• Response: Check if patient responds to voice or touch
• Send for help: Alert others, begin emergency communications
• Airway: Ensure airway is clear and open
• Breathing: Check for normal breathing
• Circulation: Check for pulse and control severe bleeding
• Defibrillation: Not available in wilderness—focus on CPR if needed

When to Evacuate vs. Continue Evacuate if:

• Fractures preventing walking
• Head injuries with loss of consciousness
• Severe altitude illness not responding to descent
• Internal bleeding suspected
• Wounds requiring surgical care
• Symptoms worsening despite treatment

Continue with caution if:

• Minor sprains that allow weight-bearing
• Small cuts that stop bleeding and show no infection
• Mild altitude sickness responding to rest and medication
• Minor gastrointestinal upset

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Helicopter Rescue Procedures

Helicopter rescue in Nepal is a well-established but expensive service. Understanding the process ensures faster response and prevents costly mistakes that could void your insurance.

The Helicopter Rescue Process

Step 1: Decision to Call for Rescue

• Confirm ground evacuation is truly impossible
• Document the medical necessity (guide notes, symptoms list)
• Understand that non-essential helicopter use may not be covered by insurance

Step 2: Contact Insurance Emergency Line FIRST

• Call your insurance company's 24/7 emergency assistance number
• Provide: Policy number, patient name, location, medical situation
• Wait for authorization number before arranging helicopter
• If immediate life threat and cannot reach insurance, proceed with rescue and document everything

Step 3: Arrange Helicopter

• Insurance company may coordinate directly with helicopter operators
• If arranging yourself: Call helicopter companies directly (numbers above)
• Provide: Exact location (GPS coordinates if possible), landing zone description, patient condition, number of people, weather conditions

Step 4: Prepare for Pickup

• Identify flat landing area minimum 30m x 30m
• Clear debris, mark corners with bright fabric or gear
• Keep all people and loose items away from landing zone
• Have patient ready for immediate loading
• Secure all loose items—helicopter downdraft is powerful

Step 5: During Pickup

• Approach helicopter only when pilot signals
• Stay low—rotor blades dip when slowing
• Follow crew instructions exactly
• One person may accompany patient

Helicopter Rescue Costs

Cost Factors:

• Distance from Kathmandu
• Altitude of pickup location (helicopters have altitude limits)
• Weather conditions requiring multiple attempts
• Medical equipment and personnel required
• Urgency and time of day

Weather Limitations

Helicopters cannot fly in:

• Heavy rain or snow
• Strong winds (especially afternoon thermals)
• Low visibility or fog
• Night conditions (no night flying in Nepal mountains)

Best Rescue Window: Early morning, before 10 AM, when winds are calmest

If weather prevents rescue:

• You may need to wait hours or days
• Begin ground evacuation if patient condition allows
• Arrange porter/yak carry to lower, more accessible location
• Keep patient stable with available treatment

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Insurance Claims Process

Filing insurance claims correctly ensures you receive reimbursement for emergency expenses. Poor documentation or procedural errors can result in denied claims.

Step-by-Step Claims Process

During the Emergency

1. Contact insurance emergency line first (before arranging rescue if possible)
2. Get authorization number for any major treatment or evacuation
3. Document everything: dates, times, symptoms, treatments, providers, costs
4. Keep all receipts: helicopters, hospitals, medications, accommodations due to emergency
5. Get itemized bills (not just totals)
6. Request English translations of Nepali documents
7. Take photos of relevant documents and situation

After Returning Home

1. Notify insurance within required timeframe (usually 30-90 days)

2. Gather required documents:

   • Completed claim form
   • Copy of insurance policy
   • Itemized medical bills and receipts
   • Medical reports and diagnosis
   • Proof of payment
   • Flight tickets/boarding passes showing travel dates
   • Police report (if theft or accident)
   • Witness statements if applicable

3. Submit claim via online portal, email, or mail (keep copies of everything)

4. Respond promptly to any requests for additional information

5. Track claim status and follow up if no response within 30 days

Common Claim Denial Reasons and Prevention

Exceeded altitude limits

• Prevention: Verify policy covers to 6,000m minimum before purchase

Pre-existing condition

• Prevention: Disclose all conditions, purchase within 14 days of first trip payment for waiver

No prior authorization

• Prevention: Always call emergency line before arranging evacuation

Insufficient documentation

• Prevention: Keep every receipt, get itemized bills, photograph everything

Excluded activity

• Prevention: Confirm "trekking to [altitude]" is explicitly covered in writing

Late notification

• Prevention: Report claims within 24-72 hours even if documentation incomplete

Appealing Denied Claims

If your claim is denied:

1. Request written explanation citing specific policy language
2. Review policy documents—is their interpretation correct?
3. Gather additional documentation addressing their concerns
4. Write formal appeal with specific policy language supporting your position
5. Escalate to supervisor if initial appeal fails
6. Contact insurance ombudsman in insurer's home country
7. Consider legal consultation for large claims

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Lost or Separated Protocol

Getting lost or separated from your group is disorienting and potentially dangerous. Having a predetermined protocol prevents panic and enables reunion.

Prevention Measures

Before the Trek:

• Agree on reunion points at each day's major landmarks
• Establish what to do if separated: wait at last known location vs. proceed to next checkpoint
• Exchange phone numbers and emergency contacts within group
• Know your guide's phone number and trekking agency emergency contact

During the Trek:

• Stay within sight of group members
• At trail junctions, wait for the group to assemble before proceeding
• If you need to stop (bathroom, photos), inform someone
• Carry whistle for signaling
• Have offline maps downloaded (Maps.me, Gaia GPS)

If You Become Lost

Step 1: STOP (0-5 minutes)

• S - Sit down and stay calm
• T - Think about your situation
• O - Observe your surroundings
• P - Plan your next steps

Step 2: Assess Your Situation (5-15 minutes)

• Do you have shelter, water, food?
• Is weather threatening?
• Do you have communication devices?
• What time is it? How much daylight remains?
• When did you last see the trail or your group?

Step 3: Make Yourself Findable

• Return to last known location if safe and possible
• Use whistle: three blasts is universal distress signal
• Stay in open area visible from above
• Create ground signals with bright gear if helicopter search possible
• Stay on main trail—do not take shortcuts

Step 4: Signal for Help

• Phone: Call guide, trekking agency, emergency services
• Whistle: Three blasts, pause, repeat
• Mirror: Flash toward aircraft or distant people
• Bright clothing or gear: Spread in open area

Step 5: Shelter Decision

• If approaching dark and rescue unlikely before morning
• Find or create shelter (under rock overhang, behind windbreak)
• Conserve energy and body heat
• Stay put unless you are certain of the route to safety

If a Group Member Is Lost

1. Stop immediately when absence is noticed
2. Account for everyone present
3. Return to last confirmed location where all were together
4. Call out and whistle
5. Search nearby in pairs, not alone
6. Set time limit for search (usually 1-2 hours)
7. Report to authorities if not found
8. Mark your location so lost person can find you

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Weather Emergency Response

Himalayan weather can change from clear to life-threatening in minutes. Understanding weather patterns and response protocols is essential for survival.

Recognizing Dangerous Weather

Approaching Storm Signs:

• Rapidly building clouds, especially in afternoon
• Drop in temperature
• Increasing wind
• Change in wind direction
• Dark, anvil-shaped clouds (thunderstorm)
• Sudden barometric pressure drop (if you have altimeter watch)

Avalanche Conditions:

• Heavy recent snowfall (more than 30cm in 24 hours)
• Warming temperatures after snow
• Wind-loaded slopes
• Steep terrain (30-45 degree slopes most dangerous)
• Recent avalanche activity nearby

Whiteout Conditions:

• Cannot distinguish ground from sky
• Complete loss of visual reference
• Can lead to walking off cliffs or into crevasses

Weather Emergency Response Protocols

Thunderstorm/Lightning

1. Descend from exposed ridges and peaks immediately
2. Avoid isolated trees, metal objects, water
3. If caught in open: crouch on balls of feet, minimize ground contact
4. Spread group out (minimum 15 meters apart)
5. Wait 30 minutes after last lightning before continuing
6. Seek shelter in substantial building or low area

Blizzard/Heavy Snow

1. Seek shelter immediately—do not attempt to continue
2. If on trail, return to nearest tea house
3. If no shelter available, create emergency shelter (snow cave, behind rocks)
4. Stay together for warmth
5. Wait for conditions to improve before continuing
6. May need to wait hours or days

Avalanche (If Buried)

1. Create air pocket around face immediately
2. Try to determine which direction is up (let saliva drip)
3. Dig toward surface if you have room
4. Stay calm, conserve air
5. Shout only when you hear searchers nearby

Avalanche (If Searching)

1. Watch where victim was last seen and where they went under
2. Turn off avalanche transceiver to receive mode (if equipped)
3. Search likely burial areas: uphill side of trees/rocks, deposition zones
4. Probe systematically, dig quickly when located
5. Check airway first, begin CPR if needed
6. Treat for hypothermia

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Communication in Emergencies

Reliable communication can mean the difference between timely rescue and tragedy. Understanding your options and their limitations is crucial.

Communication Methods and Limitations

Cell Phones

• Coverage: Intermittent to none in most trekking areas
• Everest region: Coverage at some villages (Namche, Gorak Shep)
• Annapurna region: Some coverage in lower sections
• Limitations: Battery drains faster in cold, signal often unavailable when needed most
• Tip: Enable airplane mode with WiFi to conserve battery, check signal at each village

Satellite Phones

• Coverage: Global (Iridium network recommended for Nepal)
• Cost: Rental $50-100/week plus call charges
• Rental: Available in Kathmandu at trekking shops
• Limitations: Requires clear sky view, expensive, can be heavy
• Best for: Remote treks (Dolpo, Makalu, Kanchenjunga)

Emergency Beacons (PLB/Satellite Messengers)

• Types: Garmin inReach, SPOT, ACR PLB
• Function: Send SOS with GPS coordinates to rescue services
• Coverage: Global satellite coverage
• Cost: Device $300-500, subscription $15-50/month
• Limitations: One-way communication (PLB) or limited messaging (satellite messengers)
• Best for: Any trek, essential for remote areas

WiFi at Tea Houses

• Availability: Most popular trail tea houses have WiFi
• Cost: Free to $3-5 per use
• Reliability: Often slow or unavailable, but useful for non-urgent communication
• Tip: Use for daily check-ins when available, not emergency reliance

Emergency Communication Protocol

1. Pre-trek: Establish check-in schedule with home contact
2. Daily: Check in via available method (WiFi, phone, satellite)
3. If check-in missed: Home contact waits 24 hours, then begins contact attempts
4. If contact fails: Home contact notifies trekking agency and embassy
5. SOS activation: Emergency beacon sends coordinates to international rescue coordination
6. Follow-up: Beacon SOS triggers contact verification attempt before full rescue deployment

The Emergency Contact at Home

Designate someone at home as your emergency contact with following information:

• Your complete itinerary with dates and locations
• Insurance policy details and emergency numbers
• Trekking agency contact information
• Your guide's phone number
• Embassy contact information
• Authorization to make decisions on your behalf if unreachable

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Medical Evacuation Procedures

When injuries or illness exceed what can be treated on the trail, medical evacuation becomes necessary. Understanding the process ensures faster, smoother evacuation.

Ground Evacuation

When to Use Ground Evacuation:

• Patient can walk slowly with assistance
• Helicopter unavailable or weather prevents flying
• Distance to road/airstrip is reasonable
• Injury/illness is stable and not immediately life-threatening

Ground Evacuation Methods:

• Walking with assistance (mild cases)
• Carried on porter's back (traditional method)
• Improvised stretcher (poles with sleeping pads/bags)
• Horse or yak (some trails)
• Vehicle once road is reached

Organizing Ground Evacuation:

1. Assess patient's condition and ability to assist
2. Arrange porters (usually 4-8 needed for stretcher carry)
3. Plan route to nearest road, airstrip, or helicopter-accessible point
4. Inform trekking agency and insurance
5. Arrange vehicle or flight from evacuation point
6. Send someone ahead to prepare for arrival

Helicopter Evacuation

When Helicopter Is Necessary:

• Life-threatening condition requiring immediate hospital care
• Patient cannot walk or be carried safely on ground
• Ground evacuation would take too long given condition
• Remote location where ground evacuation is impractical

Helicopter Evacuation Process (detailed earlier in guide):

1. Contact insurance for authorization
2. Arrange helicopter
3. Prepare landing zone
4. Execute pickup
5. Transport to Kathmandu hospital

Hospital Arrival in Kathmandu

Primary Hospitals for Trekking Emergencies:

CIWEC Hospital

• Location: Lazimpat, Kathmandu
• Phone: +977-1-4424111 (24/7)
• Specialties: Travel medicine, altitude illness, expatriate care
• Notes: English-speaking staff, familiar with trekking injuries

Grande International Hospital

• Location: Dhapasi, Kathmandu
• Phone: +977-1-5159266
• Specialties: Multi-specialty, ICU facilities
• Notes: Modern facility, helicopter landing pad

Nepal International Clinic

• Location: Lal Durbar, Kathmandu
• Phone: +977-1-4434642
• Specialties: Travel medicine, emergency care

What to Expect at Hospital:

1. Emergency triage and assessment
2. Request for insurance information and payment guarantee
3. Diagnostic tests as needed
4. Treatment and stabilization
5. Decision on local care vs. medical evacuation to home country

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Embassy Support and Services

Your embassy can provide crucial support during emergencies, but understanding what they can and cannot do prevents disappointment and wasted time.

What Embassies CAN Do

• Issue emergency travel documents if passport lost or stolen
• Provide list of local doctors, lawyers, interpreters
• Contact family members on your behalf
• Visit you if you are arrested or hospitalized
• Help arrange fund transfers from family
• Assist with repatriation of remains in case of death
• Provide general advice and information
• Advocate on your behalf with local authorities
• Register you for travel advisories and emergency notifications

What Embassies CANNOT Do

• Pay your bills (medical, hotel, helicopter, legal)
• Provide loans (except rare emergencies, must be repaid)
• Get you out of jail or override local laws
• Investigate crimes (that's local police responsibility)
• Provide legal advice or act as lawyers
• Make travel arrangements for you
• Intervene in private disputes
• Provide translation services

When to Contact Your Embassy

• Arrested or detained
• Victim of serious crime
• Lost or stolen passport
• Medical emergency requiring coordination with home country
• Natural disaster or civil unrest evacuation
• Death of a fellow citizen
• Welfare concerns about another citizen

Embassy Registration

Register your travel with your embassy before departure:

• US Citizens: Smart Traveler Enrollment Program (STEP) at step.state.gov
• UK Citizens: Register at gov.uk/foreign-travel-advice
• Australian Citizens: Register at smartraveller.gov.au
• Canadian Citizens: Registration of Canadians Abroad at travel.gc.ca

Registration enables:

• Emergency contact during disasters
• Information about local conditions
• Faster assistance if you need help

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Survival Strategies if Stranded

In worst-case scenarios—weather traps you, rescue is delayed, you're lost—survival skills become essential. These strategies can keep you alive until help arrives.

The Survival Priorities

Order of Priority:

1. Shelter: Protection from elements (hypothermia kills fastest)
2. Water: Can survive days without water, less than a week
3. Fire: For warmth, signaling, water purification, morale
4. Food: Can survive weeks without food (lowest priority)

Emergency Shelter

Natural Shelters:

• Cave or rock overhang
• Dense evergreen trees (creates warmer microclimate)
• Behind large boulder (wind protection)
• Depression in ground (warmer than exposed area)

Improvised Shelters:

• Bivy sack or emergency space blanket (always carry)
• Tarp or poncho lean-to
• Snow cave (if significant snow depth and you know technique)
• Debris hut (leaves, branches over framework)

Shelter Principles:

• Small is warmer—body heat can heat small space
• Insulate from ground—sleeping on cold ground causes hypothermia
• Block wind—even light wind dramatically increases heat loss
• Entrance away from wind direction

Finding and Purifying Water

Water Sources:

• Streams (preferably fast-moving, higher altitude)
• Snow and ice (melt in container, don't eat directly—lowers body temperature)
• Morning dew on grass (collection with cloth)
• Rain collection

Purification (if you have supplies):

• Water purification tablets
• SteriPen UV purifier
• Boiling (1 minute rolling boil minimum)
• Filter pump

Without Supplies:

• Flowing water from high altitude is generally safer
• Still water near habitation is dangerous
• Survival situation—drink questionable water rather than die of dehydration, treat illness later

Staying Warm

Heat Retention:

• Stay dry—wet clothing loses insulation
• Layer clothing, trap air between layers
• Cover head—significant heat loss from head
• Keep moving—generate body heat through activity
• Eat food—digestion generates heat
• Curl up—reduce surface area exposed

Recognizing Hypothermia:

• Shivering (early stage—body trying to generate heat)
• Confusion, slurred speech
• Clumsiness, stumbling
• Drowsiness, desire to sleep
• Paradoxical undressing (severe stage—brain malfunction)
• If someone stops shivering but still cold, this is critical—they need immediate warming

Signaling for Rescue

Visual Signals:

• Bright colored gear spread in open area
• Ground signals: SOS, HELP, or large X made with rocks, gear, or in snow
• Mirror flash toward aircraft
• Fire (smoke by day, flames by night)

Audio Signals:

• Whistle: three blasts, pause, repeat
• Shouting: "HELP" is universally understood
• Banging rocks together rhythmically

Electronic Signals:

• Emergency beacon activation
• Phone calls whenever signal available
• Text messages often go through when calls won't

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Post-Emergency Procedures

After an emergency is resolved, several important steps ensure your health, document the incident, and complete insurance requirements.

Immediate Post-Emergency (First 24-48 Hours)

1. Medical Follow-up

   • Complete medical evaluation even if feeling better
   • Document all diagnoses, treatments, and recommendations
   • Obtain copies of all medical records
   • Get written clearance before resuming activity or flying home

2. Notify Key Parties

   • Insurance company (if not already notified)
   • Family members
   • Trekking agency
   • Embassy (if applicable)

3. Document Everything

   • Photograph all receipts and documents
   • Write detailed account of what happened while memory is fresh
   • Get contact information of witnesses
   • Collect business cards from medical providers

Before Leaving Nepal

1. Gather All Documentation

   • Itemized medical bills with English translation
   • Medical reports and test results
   • Evacuation receipts
   • Police reports (if applicable)
   • Witness statements
   • Photographs of injuries or scene

2. Settle Outstanding Bills

   • Hospital bills (may require payment before discharge)
   • Ensure you have receipts for everything paid
   • Confirm insurance authorization numbers for all major expenses

3. Medical Clearance

   • Obtain clearance to fly (altitude changes can affect recent altitude illness or injuries)
   • Get prescription for any ongoing medications
   • Arrange follow-up care at home

After Returning Home

1. File Insurance Claims (within required timeframe)

   • Complete claim forms accurately
   • Attach all required documentation
   • Keep copies of everything submitted
   • Note submission date and method

2. Medical Follow-up at Home

   • Schedule appointment with primary care physician
   • Provide Nepal medical records
   • Complete any recommended tests or treatments
   • Address any ongoing symptoms

3. Psychological Processing

   • Mountain emergencies can be traumatic
   • Some post-traumatic stress is normal
   • Seek professional support if experiencing persistent anxiety, nightmares, or flashbacks
   • Connect with other trekkers who've had similar experiences

4. Learn and Share

   • Analyze what went wrong and how to prevent it
   • Share experience with trekking community to help others
   • Update your emergency protocols based on lessons learned

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Frequently Asked Questions

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Conclusion

Emergency preparedness is not pessimism—it is the foundation of responsible adventure. The trekkers who return safely from Nepal's mountains year after year are not merely lucky; they are prepared. They carry the right insurance, know the warning signs of altitude illness, understand helicopter rescue procedures, and have practiced emergency protocols before they need them.

The information in this guide could save your life or the life of a fellow trekker. Review it before your trek, carry key reference information with you, and share this knowledge with your trekking companions. In the mountains, we look out for each other.

Remember: The best emergency is the one you prevent. Proper acclimatization, conservative decision-making, appropriate gear, and listening to your body will keep you safe on the vast majority of treks. But when prevention fails, preparation ensures survival.

Trek safely. Trek prepared. Return home with stories to tell.