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Wilderness & Environmental Medicine

Joseph D Forrester, Kenneth Tran, Lakshika Tennakoon, Kristan Staudenmayer
BACKGROUND: Rock climbing and mountaineering are popular outdoor recreational activities. More recently, indoor climbing has become popular, which has increased the number of persons at risk for climbing-related injuries. OBJECTIVE: To assess the morbidity, mortality, and healthcare cost due to climbing-related injury among persons presenting to US emergency departments (ED). METHODS: We performed a retrospective analysis of the 2010 to 2014 National Emergency Department Sample database, a nationally representative sample of all visits to US EDs...
September 18, 2018: Wilderness & Environmental Medicine
Lauren M Kropp, Christopher B Parsley, Omer Lee Burnett
Fire corals (Millepora spp) are the second most common reef-forming organisms and are frequently found in tropical and subtropical waters. Fire corals are not true corals but rather hydrozoans more closely related to jellyfish and sea nettles. Rigidly affixed to the reef and with a branching structure, each fire coral is a colony of numerous individual hydrozoans forming a collective symbiotic organism. It is common for divers to accidentally make contact with fire corals. Fire coral contact is characterized by the immediate onset of burning pain caused by venom discharge from numerous tiny nematocysts located externally on the creature...
September 17, 2018: Wilderness & Environmental Medicine
Ty B Nichols, Alana C Hawley, William R Smith, Albert R Wheeler, Scott E McIntosh
INTRODUCTION: Carrying standard safety gear (beacon, probe, and shovel), planning a route of descent, and recreating with companions can help to mitigate the risk of injury or death resulting from avalanches in the backcountry. The goal of this study was to identify factors associated with performance of these safety practices. METHODS: A convenience sample of backcountry skiers and snowboarders was surveyed in 2016 at the backcountry gates of Jackson Hole Mountain Resort...
September 10, 2018: Wilderness & Environmental Medicine
Hiroki Nagasawa, Kazuhiko Omori, Ikuto Takeuchi, Kei Fujiwara, Hirohisa Uehara, Kei Jitsuiki, Akihiko Kondo, Hiromichi Ohsaka, Kouhei Ishikawa, Youichi Yanagawa
No abstract text is available yet for this article.
September 9, 2018: Wilderness & Environmental Medicine
Buddhika T B Wijerathne, Geetha K Rathnayake, R K Sriyani Dias, Nuwan D Wickramasinghe, Sujeewa P B Thalgaspitiya, Anuruddha H Karunaratne, Suneth B Agampodi
No abstract text is available yet for this article.
August 22, 2018: Wilderness & Environmental Medicine
Alison Sheets, Dale Wang, Spencer Logan, Dale Atkins
INTRODUCTION: A better understanding of the nature of morbidity and mortality in avalanche accidents helps direct both rescue efforts as well as preventive strategies to reduce fatalities. METHODS: We reviewed all avalanche fatalities from the avalanche years beginning in 1994 to 2015 in the state of Colorado, United States, using the database maintained by the Colorado Avalanche Information Center. For each fatality, we obtained the coroner's official determination of cause of death, and autopsy records if one was performed...
June 27, 2018: Wilderness & Environmental Medicine
Pablo Deschepper, Bert Jonckheere, Jasper Matthys
No abstract text is available yet for this article.
September 2018: Wilderness & Environmental Medicine
Alison Matthews
Airway management in the wilderness runs the gamut from basic airway support to endotracheal intubation. Fortunately, direct laryngoscopy is a seldom called upon skill in expedition medicine. However, the medical skills required during a mission or expedition are never truly known in advance. Improvisation during evolving medical events is a mainstay of expedition medicine education and practice. It is unlikely, given constraints of weight and size of expedition medical kits, that a conventional laryngoscope would find its way into a standard "go bag...
September 2018: Wilderness & Environmental Medicine
Michael D Campian, Alexandra E Flis, Masaru Teramoto, Daniel M Cushman
INTRODUCTION: The use of performance enhancing drugs (PEDs) has been reported in several sports. There have been no peer-reviewed articles on the use of PEDs in ultramarathon running. This study was to examine the use of PEDs in ultramarathon running and to identify attitudes and beliefs about the usage of PEDs in the sport. METHODS: An online survey was developed. The survey was distributed to potential participants through Ultrasignup and the Western States Endurance Run Facebook sites...
September 2018: Wilderness & Environmental Medicine
Neal W Pollock
No abstract text is available yet for this article.
September 2018: Wilderness & Environmental Medicine
Linda E Keyes, Beat H Walpoth, Marc Blancher, François Becker
No abstract text is available yet for this article.
September 2018: Wilderness & Environmental Medicine
Matt Wilkes, Eleanor C Heath, Nicholas P Mason
Methoxyflurane is a volatile, fluorinated anesthetic agent with analgesic properties. Although no longer used as an anesthetic due to concerns regarding renal toxicity in high doses, it has enjoyed a resurgence as an inhaled analgesic in prehospital care and in the emergency department. The agent is nonflammable and leads to rapid, titratable analgesia without intravenous access. The Penthrox inhaler device is light, robust, and straightforward to administer. Consequently, it has been proposed as an ideal analgesic for the remote high altitude setting...
September 2018: Wilderness & Environmental Medicine
Francesco Adami, Peter Paganussi, Giovanna Perone, Paola Bera, Giosuè Braga, Carlo Concoreggi
We report the case of a patient who presented with respiratory failure, recurrent ventricular fibrillation, ventricular arrhythmias, and hypotension after an intentional ingestion of aconite flowers. Significant ingestion of this plant can produce life-threatening cardio- and neurotoxicity that may require evacuation from the wilderness to a medical facility capable of advanced treatment and intensive care monitoring.
September 2018: Wilderness & Environmental Medicine
Sudeep Adhikari, Keshav Raj Sigdel, Buddhi Paudyal, Buddha Basnyat
No abstract text is available yet for this article.
September 2018: Wilderness & Environmental Medicine
Robert K Needleman, Isabelle P Neylan, Timothy B Erickson
INTRODUCTION: Recent analyses of data show a warming trend in global average air and sea surface ocean temperatures. The atmosphere and ocean have warmed, the amounts of snow and ice have diminished, the sea level has risen, and the concentrations of greenhouse gases have increased. This article will focus on climate change and projected effects on venomous marine and amphibious creatures with the potential impact on human health. METHODS: Retrospective analysis of environmental, ecological, and medical literature with a focus on climate change, toxinology, and future modeling specific to venomous aquatic and amphibious creatures...
September 2018: Wilderness & Environmental Medicine
Martin Samdal, Helge H Haugland, Cato Fjeldet, Marius Rehn, Mårten Sandberg
INTRODUCTION: Physician-staffed helicopter emergency medical services (HEMS) in Norway are an adjunct to existing search and rescue services. Our aims were to study the epidemiological, operational, and medical aspects of HEMS daylight static rope operations performed in the southeastern part of the country and to examine several quality dimensions that are characteristic of this service. METHODS: We reviewed the static rope operations performed at 3 HEMS bases during a 3-y period and applied a set of quality indicators designed for physician-staffed emergency medical services to evaluate the quality of care...
September 2018: Wilderness & Environmental Medicine
Anne K Lorentzen, Luit Penninga
Greenland is not only the largest island in the world, it is also the least densely populated country on the globe. The majority of Greenland's landmass lies within the Arctic Circle. Weather conditions in Arctic areas can be extreme, thus exposing locals and visitors to a high risk of acquiring frostbite injuries. More than two thirds of Greenland is covered by a permanent ice sheet, and temperatures can drop to below -70°C. In addition, frequent storms, occupational exposure, and alcohol all contribute to an increased risk for frostbite injury...
September 2018: Wilderness & Environmental Medicine
Michael N Ofori, Cindy Carol Bitter
No abstract text is available yet for this article.
September 2018: Wilderness & Environmental Medicine
Gregory D Richardson, Susanne J Spano
INTRODUCTION: One of the most popular destinations in Yosemite National Park is Half Dome. Overcrowding at the turn of the 21st century prompted a restriction of hiker access to cable handrails to the summit without technical rock climbing equipment. Prior epidemiological study of Half Dome deaths is not known to the authors. Our goal was to identify trends among all Half Dome-related fatalities in Yosemite National Park. METHODS: Multimedia sources were searched for deaths involving the cable handrails, subdome, summit, technical climbing, or base jumping...
September 2018: Wilderness & Environmental Medicine
Ken Zafren, Anne Brants, Katie Tabner, Andrew Nyberg, Matiram Pun, Buddha Basnyat, Monika Brodmann Maeder
The Nepal Earthquake of 2015 killed over 8000 people and injured over 20,000 in Nepal. Moments after the earthquake, an avalanche of falling ice came down from above Everest Base Camp (EBC). The air blast created by the avalanche flattened the middle part of EBC, killing 15 people and injuring at least 70. The casualties were initially triaged and treated at EBC and then evacuated by air to Kathmandu for definitive care. There were intermediate stops at the villages of Pheriche and Lukla during which the casualties were offloaded, retriaged, treated, and loaded again for further transport...
June 8, 2018: Wilderness & Environmental Medicine
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