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Wilderness & Environmental Medicine

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https://www.readbyqxmd.com/read/28506514/a-novel-cooling-method-and-comparison-of-active-rewarming-of-mildly-hypothermic-subjects
#1
Mark L Christensen, Grant S Lipman, Dennis A Grahn, Kate M Shea, Joseph Einhorn, H Craig Heller
OBJECTIVE: To compare the effectiveness of arteriovenous anastomosis (AVA) vs heated intravenous fluid (IVF) rewarming in hypothermic subjects. Additionally, we sought to develop a novel method of hypothermia induction. METHODS: Eight subjects underwent 3 cooling trials each to a mean core temperature of 34.8±0.6 (32.7 to 36.3°C) by 14°C water immersion for 30 minutes, followed by walking on a treadmill for 5 minutes. Core temperatures (Δtes) and rates of cooling (°C/h) were measured...
May 11, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28501413/managing-traumatic-brain-injury-translating-military-guidelines-to-the-wilderness
#2
REVIEW
Edward J Otten, Warren C Dorlac
Traumatic brain injury (TBI) is a common injury on the battlefield. Much of what medics do to manage these injuries on the battlefield can be translated to other austere environments, such as wilderness or disaster settings. The recognition and diagnosis of TBI can be difficult even in the hospital, but basic understanding of how to define a TBI and prevent secondary injuries can be accomplished with relatively few resources and little training. This article outlines what a TBI is and how to manage it in the field...
May 10, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28501412/sudden-death-in-a-diver-a-diagnostic-conundrum
#3
Scott Dougherty, Maziar Khorsandi, Myra Adelbai, Vipin Zamvar, James Francis
We discuss the case of an experienced diver who ran out of air during his final ascent while scuba diving. He lost consciousness rapidly after surfacing and despite immediate cardiopulmonary resuscitation, could not be revived. On arrival at the emergency department he was noted to have copious amounts of blood in his upper airway and had developed extensive subcutaneous emphysema. Large amounts of air were observed in the central circulation following a postmortem computerized tomography scan as well as pneumomediastinum, a small right-sided hemothorax, and extensive subcutaneous emphysema...
May 10, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28483391/interfang-distances-of-rattlesnakes-sexual-interspecific-and-body-size-related-variation-and-implications-for-snakebite-research-and-management
#4
William K Hayes, Aaron G Corbit, Michael D Cardwell, Shelton S Herbert
OBJECTIVES: Snakebite severity corresponds to size of snake because the amount of venom a snake injects is positively associated with snake size. Because fang marks are often present on snakebite patients, we tested whether the relationship between snake length and distance between fang puncture wounds can be generalized for rattlesnakes of genus Crotalus. METHODS: We measured 2 interfang distances from 79 rattlesnakes of both sexes, 5 species, and varying body length: 1) distance between fang bases in anesthetized snakes, and 2) distance between fang punctures in a membrane-covered beaker bitten defensively...
May 5, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28483390/bruno-ernst-durrer-md-january-14-1953-to-december-5-2016
#5
EDITORIAL
(no author information available yet)
No abstract text is available yet for this article.
May 5, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28483389/battlefield-trauma-induced-hypothermia-transitioning-the-preferred-method-of-casualty-rewarming
#6
REVIEW
Brad L Bennett, John B Holcomb
For centuries, cold and wet weather has affected military combat operations leading to tremendous loss of manpower caused by cold-weather-related injuries including trench foot, frostbite, and hypothermia. The initial battlefield management of hypothermia in military personnel had not advanced significantly following many wars and conflicts until 2006. The aim of this review is to: 1) provide an overview of trauma-induced hypothermia (TIH); 2) highlight the Department of Defense strategy for the implementation of a hypothermia clinical management program for battlefield (prehospital) casualties; 3) highlight the research and development of the Hypothermia Prevention and Management Kit (HPMK) as the preferred field rewarming system for battlefield TIH; and 4) emphasize how the HPMK can be easily transitioned to the civilian sector for active rewarming of both accidental and TIH patients...
May 5, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28479001/prophylactic-acetaminophen-or-ibuprofen-result-in-equivalent-acute-mountain-sickness-incidence-at-high-altitude-a-prospective-randomized-trial
#7
Nicholas C Kanaan, Alicia L Peterson, Matiram Pun, Peter S Holck, Jennifer Starling, Bikash Basyal, Thomas F Freeman, Jessica R Gehner, Linda Keyes, Dana R Levin, Catherine J O'Leary, Katherine E Stuart, Ghan B Thapa, Aditya Tiwari, Jared L Velgersdyk, Ken Zafren, Buddha Basnyat
OBJECTIVE: Recent trials have demonstrated the usefulness of ibuprofen in the prevention of acute mountain sickness (AMS), yet the proposed anti-inflammatory mechanism remains unconfirmed. Acetaminophen and ibuprofen were tested for AMS prevention. We hypothesized that a greater clinical effect would be seen from ibuprofen due to its anti-inflammatory effects compared with acetaminophen's mechanism of possible symptom reduction by predominantly mediating nociception in the brain. METHODS: A double-blind, randomized trial was conducted testing acetaminophen vs ibuprofen for the prevention of AMS...
May 4, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28479000/research-and-research-communication
#8
EDITORIAL
Neal W Pollock
No abstract text is available yet for this article.
May 4, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28478999/integration-of-tactical-ems-in-the-national-park-service
#9
REVIEW
William Will R Smith
The National Park Service (NPS) has domestic responsibility for emergency medical services (EMS) in remote and sometimes tactical situations in 417 units covering over 34 million hectares (84 million acres). The crossover between conflicting patient care priorities and complex medical decision making in the tactical, technical, and wilderness/remote environments often has many similarities. Patient care in these diverse locations, when compared with military settings, has slightly different variables but often similar corresponding risks to the patients and providers...
May 4, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28455202/don-t-kick-the-coral
#10
Peter J Ceponis, Rebecca Cable, Lindell K Weaver
No abstract text is available yet for this article.
April 25, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28455201/erratum-in-wilderness-environ-med-2016
#11
(no author information available yet)
No abstract text is available yet for this article.
April 25, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28455200/traumatic-pneumothorax-associated-with-penetrating-neck-injury-caused-by-a-stingray-a-case-report
#12
Toshinao Suzuki, Toshihiko Takada, Junmei Fudoji
We describe a patient with missed traumatic pneumothorax due to penetrating neck injury that was presumably caused by a stingray while diving. The barb can result in significant injuries to deep structures and organs despite a deceptively small entrance wound. This case underscores the importance of performing a thorough examination and having a high suspicion of distant injury in patients with penetrating neck injuries.
April 25, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28455199/upper-body-compression-garment-physiological-effects-while-cycling-in-a-hot-environment
#13
Iker Leoz-Abaurrea, Roberto Aguado-Jiménez
OBJECTIVE: The purpose of the present study was to investigate the effects of an upper body compression garment (UBCG) on physiologic and perceptual responses while cycling in a hot environment. METHODS: Twenty recreational road cyclists were pair-matched for age, anthropometric data, and fitness level (V̇O2max) and randomly assigned to a control (CON) group (n=10) of cyclists who wore a conventional t-shirt or to a group (n=10) of cyclists who wore UBCG. Test session consisted of cycling at a fixed load (~50% V̇O2max) for 30 minutes at an ambient temperature of ~40ºC (39...
April 25, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28455198/residence-at-moderate-versus-low-altitude-is-effective-at-maintaining-higher-oxygen-saturation-during-exercise-and-reducing-acute-mountain-sickness-following-fast-ascent-to-4559-m
#14
Eva Bernardi, Luca Pomidori, Davide Cavallari, Gaia Mandolesi, Annalisa Cogo
OBJECTIVE: To continuously monitor oxygen saturation (SpO2) by pulse oximeter and assess the development of acute mountain sickness (AMS) using the Lake Louise Score (LLS) during ascent from 1154 to 4559 m in 2 groups of subjects: 10 moderate-altitude residents (MAR; ≥1000-≤2500 m) and 34 low-altitude residents (LAR). MAR are reported to have a lower incidence of AMS during ascent to higher altitudes compared with LAR. Whether this is related to higher SpO2 is still open to debate...
April 25, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28434757/unusual-kissing-lesions-lessons-from-rural-tanzania
#15
Samantha J Moore, Harriet J Blundell
No abstract text is available yet for this article.
April 20, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28433364/belts-evaluated-as-limb-tourniquets-belt-study-comparing-trouser-supporters-used-as-medical-devices-in-a-manikin-model-of-wound-bleeding
#16
Blake W Bequette, John F Kragh, James K Aden, Michael A Dubick
OBJECTIVE: The purpose of the present study is to compare several models of commercially designed belts as used as a tourniquet. METHODS: In the Belts Evaluated as Limb Tourniquets (BELT) study, an experiment was designed to test the effectiveness of pants belts as nonimprovised medical devices to control hemorrhage in a manikin. Models of belts included Tourni-belt, Tourniquet Belt, ParaBelt, and Battle Buddy. Data collected included effectiveness, time to stop bleeding, total time of application, pressure, blood loss, and composite results (score count of good results; composite outcome good if every component was good)...
April 19, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28431827/first-described-envenomation-by-centruroides-pococki-scorpion-in-the-french-caribbean-island-guadeloupe
#17
LETTER
Corinne Schmitt, Romain Torrents, Nicolas Simon, Luc de Haro
No abstract text is available yet for this article.
April 18, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28431826/the-dallol-volcano
#18
Raf Aerts, Eva J J November
No abstract text is available yet for this article.
April 18, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28392170/translating-tactical-combat-casualty-care-lessons-learned-to-the-high-threat-civilian-setting-tactical-emergency-casualty-care-and-the-hartford-consensus
#19
REVIEW
David W Callaway
Combat operations necessitate bold thought and afford the opportunity to rapidly evolve and improve trauma care. The development and maturation of Tactical Combat Casualty Care (TCCC) is an important example of a critical process improvement strategy that reduced mortality in high-threat combat-related trauma. The Committee for Tactical Emergency Casualty Care (C-TECC) adapted the lessons of TCCC to the civilian high-threat environment and provided important all-hazards response principles for austere, dynamic, and resource-limited environments...
April 6, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28385365/texas-bull-nettle-cnidoscolus-texanus-exposures-reported-to-texas-poison-centers
#20
Mathias B Forrester
OBJECTIVE: Texas bull nettle (Cnidoscolus texanus) is covered in bristly hairs similar to stinging nettle. Contact with the plant may result in intense dermal pain, burning, itching, cellulitis, and allergic reaction. This study characterizes C texanus exposures reported to a large state-wide poison center system. METHODS: Cases were C texanus exposures reported to Texas poison centers during 2000-2015. The distribution of cases was determined for patient demographics, exposure circumstances, and patient outcome...
April 3, 2017: Wilderness & Environmental Medicine
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