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Wilderness Medicine

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87 papers 0 to 25 followers
https://www.readbyqxmd.com/read/27206845/retrospective-analysis-of-616-air-rescue-trauma-cases-related-to-the-practice-of-extreme-sports
#1
Gaël Gosteli, Bertrand Yersin, Cédric Mabire, Mathieu Pasquier, Roland Albrecht, Pierre-Nicolas Carron
INTRODUCTION: Extreme sports (ESs) are increasingly popular, and accidents due to ESs sometimes require helicopter emergency medical services (HEMSs). Little is known about their epidemiology, severity, specific injuries and required rescue operations. AIM: Our aims were to perform an epidemiological analysis, to identify specific injuries and to describe the characteristic of prehospital procedures in ES accidents requiring HEMSs. METHODS: This is a retrospective study, reviewing all rescue missions dedicated to ESs provided by HEMS REGA Lausanne, from 1 January 1998 to 31 December 2008...
July 2016: Injury
https://www.readbyqxmd.com/read/26948556/primary-care-in-extreme-environments-medical-clinic-utilization-at-antarctic-stations-2013-2014
#2
James M Pattarini, Jullian R Scarborough, V Lee Sombito, Scott E Parazynski
OBJECTIVES: The unique challenges posed by the Antarctic environment include both physiological and psychological stressors to the individual as well as the limited onsite medical capabilities available to address them. This report compares medical clinic utilization among 3 US Antarctic stations to identify differences in diagnostic frequency and utilization of clinic resources under current medical prescreening regimes for summer and winter seasons. METHODS: Clinic data from 3 Antarctic locations (McMurdo Station, Amundsen-Scott South Pole Station, and Palmer Station) for the 2013-2014 Antarctic year were reviewed for patient encounter frequency by season, and provider-assigned visit diagnostic category...
March 2016: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/26585073/orbital-compartment-syndrome-alternative-tools-to-perform-a-lateral-canthotomy-and-cantholysis
#3
Kenneth V Iserson, Zelda Luke-Blyden, Scott Clemans
Orbital compartment syndrome acutely threatens vision. Lateral canthotomy and cantholysis ameliorate the compartment syndrome and, to save a patient's vision, must be performed in a timely manner. This requires appropriate tools. In resource-poor settings, the straight hemostat and iris scissors that are generally used for this procedure may be unavailable. In such situations, safe alternatives include using a multitool in place of a hemostat and a #11 scalpel blade instead of the iris scissors. As when using hemostats of varying sizes, the pressure applied to the multitool must be carefully modulated...
March 2016: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/26948558/a-new-proposal-for-management-of-severe-frostbite-in-the-austere-environment
#4
Emmanuel Cauchy, Christopher B Davis, Mathieu Pasquier, Eric F Meyer, Peter H Hackett
Despite advances in outdoor clothing and medical management of frostbite, individuals still experience catastrophic amputations. This is a particular risk for those in austere environments, due to resource limitations and delayed definitive treatment. The emerging best therapies for severe frostbite are thrombolytics and iloprost. However, they must be started within 24 hours after rewarming for recombinant tissue plasminogen activator (rt-PA) and within 48 hours for iloprost. Evacuation of individuals experiencing frostbite from remote environments within 24 to 48 hours is often impossible...
March 2016: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/26433731/wilderness-medical-society-practice-guidelines-for-the-treatment-of-pitviper-envenomations-in-the-united-states-and-canada
#5
Nicholas C Kanaan, Jeremiah Ray, Matthew Stewart, Katie W Russell, Matthew Fuller, Sean P Bush, E Martin Caravati, Michael D Cardwell, Robert L Norris, Scott A Weinstein
No abstract text is available yet for this article.
December 2015: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/26747703/should-aed-devices-be-routinely-included-in-wilderness-medical-kits
#6
EDITORIAL
Jeremy D Joslin, Amy Sue Biondich
No abstract text is available yet for this article.
March 2016: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/26141918/lyme-disease-what-the-wilderness-provider-needs-to-know
#7
REVIEW
Joseph D Forrester, J Priyanka Vakkalanka, Christopher P Holstege, Paul S Mead
Lyme disease is a multisystem tickborne illness caused by the spirochete Borrelia burgdorferi and is the most common vectorborne disease in the United States. Prognosis after initiation of appropriate antibiotic therapy is typically good if treated early. Wilderness providers caring for patients who live in or travel to high-incidence Lyme disease areas should be aware of the basic biology, epidemiology, clinical manifestations, and treatment of Lyme disease.
December 2015: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/26165581/a-novel-method-to-decontaminate-surgical-instruments-for-operational-and-austere-environments
#8
Randy W Knox, Samandra T Demons, Cord W Cunningham
OBJECTIVE: The purpose of this investigation was to test a field-expedient, cost-effective method to decontaminate, sterilize, and package surgical instruments in an operational (combat) or austere environment using chlorhexidine sponges, ultraviolet C (UVC) light, and commercially available vacuum sealing. METHODS: This was a bench study of 4 experimental groups and 1 control group of 120 surgical instruments. Experimental groups were inoculated with a 10(6) concentration of common wound bacteria...
December 2015: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/22441084/peripheral-arterial-desaturation-is-further-exacerbated-by-exercise-in-adolescents-with-acute-mountain-sickness
#9
Sarah A Major, Ryan J K Hogan, Elizabeth Yeates, Chris H E Imray
OBJECTIVE: Rapid ascent to altitude can result in the development of high altitude illnesses such as acute mountain sickness (AMS). This study aimed to investigate AMS symptoms in adolescents and study basic cardiopulmonary measurements at altitude. METHODS: Thirty-eight adolescents aged 16 to 19 years flew to 3500 m from 215 m and continued over a 23-day period to ascend to a maximum altitude of 5200 m. Each member of the expedition completed a Lake Louise Self-Assessment Questionnaire (LLSAQ) on a daily basis, and AMS was defined as a score of ≥ 3, with an associated headache...
March 2012: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/20591380/adverse-encounters-with-alligators-in-the-united-states-an-update
#10
REVIEW
Ricky L Langley
OBJECTIVE: Severe injuries and fatalities can occur from an alligator attack. Encounters with alligators appear to be increasing in the United States. This review provides information from alligator attacks reported in the United States as well as infections that may occur after an alligator bite. METHODS: Telephone interviews were conducted with state wildlife offices in all Southern states in order to collect information on the number of alligator bites, nuisance calls, and the estimated alligator population of each state...
June 2010: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/22656662/hyponatremia-in-an-85-year-old-hiker-when-depletion-plus-dilution-produces-delirium
#11
Clark Coler, Martin D Hoffman, Gary Towle, Tamara Hew-Butler
We report a case of critical exercise-associated hyponatremia in an 85-year-old man, an experienced hiker, during an overnight trek through Yosemite National Park. His medical history was significant for mild renal insufficiency, diastolic dysfunction, and pulmonary hypertension. He was taking a thiazide diuretic (hydrochlorothiazide), without a prior history of an electrolyte imbalance. The hiker drank a modest amount of fluid (3 liters) and urinated only once during the 9-hour descent, from a starting elevation of approximately 3000 meters, before the sudden onset of delirium occurred...
June 2012: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/23062322/predictive-value-of-basal-exhaled-nitric-oxide-and-carbon-monoxide-for-acute-mountain-sickness
#12
Haiyan You, Xiaoxiao Li, Tao Pei, Qingyuan Huang, Fuyu Liu, Yuqi Gao
OBJECTIVE: The purpose of this study was to examine the relationship between acute mountain sickness (AMS) and the fraction of exhaled nitric oxide (Fe(NO)) and carbon monoxide (Fe(CO)) before ascent to high altitude and to evaluate their predictive value for AMS. METHODS: A total of 314 healthy young male recruits were voluntarily enrolled. Before ascent to an elevation of 4300 m, their Fe(NO) and Fe(CO) values, demographic factors, drinking and smoking history, vital capacity, and forced vital capacity were obtained...
December 2012: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/22727678/rock-climbing-rescues-causes-injuries-and-trends-in-boulder-county-colorado
#13
Daniel A Lack, Alison L Sheets, Jacob M Entin, David C Christenson
OBJECTIVE: To describe rates and patterns of rock climbing rescue incidents, morbidity and mortality in Boulder County, CO. METHODS: Rocky Mountain Rescue Group incident reports from 1998 to 2011 were reviewed to provide a 14-year statistical account of rock climbing incidents. RESULTS: Rock climbing rescues in Boulder accounted for 428 of a total of 2198 (19.5%) mountain and wilderness rescue victims. Most rock climbing victims were male (78%), and 46% of victims were between the ages of 20 and 29 years; most rock climbing incidents occurred on weekend days (median time of 3:30 pm) during the spring, summer, and autumn...
September 2012: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/20591370/search-and-rescue-activity-on-denali-1990-to-2008
#14
Scott E McIntosh, Aaron Brillhart, Jennifer Dow, Colin K Grissom
OBJECTIVE: To describe search and rescue activity performed by the National Park Service (NPS) on Denali, the highest point in North America. METHODS: A retrospective review was performed of all search and rescue (SAR) operations by the NPS from 1990 to 2008. Descriptive analysis was used to describe these cases as well as chi-square and logistic regression analysis to determine which mountaineers were more likely to require a rescue. RESULTS: During the study period, 1...
June 2010: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/22000548/conduit-vessel-blood-flow-during-the-trek-to-mount-everest-base-camp
#15
Valerie Dumais, Patrice Nault, Alexander Tsertsvadze, Thomas L Forbes
OBJECTIVE: Hemodynamic changes in response to the hypoxic environment of high altitude are vascular bed-specific. The aim of the present study was to investigate diameter and blood flow changes in conduit vessels in response to hypobaric hypoxia. METHODS: Eleven healthy subjects ascending Mount Everest to base camp participated in this study. Vessel diameter and blood velocity for brachial, carotid, common femoral, superficial femoral, and deep femoral arteries were measured by portable Doppler ultrasound...
December 2011: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/21962045/a-comparison-of-the-incidence-and-understanding-of-altitude-illness-between-porters-and-trekkers-in-the-solu-khumbu-region-of-nepal
#16
Lauren Newcomb, Chhewang Sherpa, Annabel Nickol, Jeremy Windsor
OBJECTIVE: Altitude illness can occur in anyone who ascends to high altitude. Better understanding of altitude illness is associated with a lower incidence of acute mountain sickness (AMS). The purpose of this study is to compare, for the first time, the incidence and understanding of altitude illness between foreign trekkers and indigenous porters in Nepal. METHODS: Interviews and questionnaires were completed at the International Porter Protection Group Rescue Post at Machermo (4470 m)...
September 2011: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/20832700/spontaneous-endogenous-core-temperature-rewarming-after-cooling-due-to-snow-burial
#17
Colin K Grissom, Chris H Harmston, John C McAlpine, Martin I Radwin, Brad Ellington, Ellie L Hirshberg, Andre Crouch
OBJECTIVE: To measure afterdrop and rewarming in subjects placed in a hypothermia wrap immediately after extrication from 60 minutes of snow burial. METHODS: We measured esophageal core body temperature (Tes) in 6 subjects buried in compacted snow (mean density 39%) for up to 60 minutes at an altitude of 2450 m while breathing with an AvaLung (Black Diamond Equipment, Salt Lake City, UT). Mean snow temperature was -3.5 ± 1.0 °C and mean air temperature was 0 ± 2 °C...
September 2010: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/21664559/infectious-diseases-associated-with-caves
#18
Ricardo Pereira Igreja
In recent times, caving has become increasingly popular, with almost 2 million people visiting national park caves each year in the United States. Although the 2 million tourist visits are extremely low risk, smaller numbers of sport cavers are at risk for some high risk conditions, and expedition cavers are at risk for some obscure infections. Infectious diseases like histoplasmosis, rabies, leptospirosis, and tick-borne relapsing fever may be transmitted by the underground fauna. To reduce the risk of illness or injury while caving, knowledge of potential risks before engaging in this activity is important...
June 2011: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/19737041/skiing-and-snowboarding-head-injuries-in-2-areas-of-the-united-states
#19
Mark W Greve, David J Young, Andrew L Goss, Linda C Degutis
OBJECTIVE: To explore the use of helmets in skiers and snowboarders injured at ski runs and terrain parks in Colorado and the northeast United States and to examine differences in head injury severity in terrain parks as compared to ski runs. METHODS: This was a retrospective cohort study. We reviewed emergency department medical records of injured skiers at 9 medical facilities in Colorado, New York, and Vermont to examine the frequency of helmet use, type of terrain on which injuries occurred, and effect of injury event type and helmet use on change in mental status...
2009: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/21907600/the-effects-of-high-and-low-dose-aspirin-on-thermoregulation-during-and-after-acute-cold-exposure
#20
RANDOMIZED CONTROLLED TRIAL
Leigh K Murray, Ronald Otterstetter, Matthew D Muller, Ellen L Glickman
OBJECTIVE: To explore the effect of aspirin on the thermoregulatory responses of men during exposure to 12°C air (acute cold exposure) for a period of 120 minutes and recovery in 25°C air (rewarming) for 120 minutes. METHODS: Seven male subjects (26.1 ± 2.4 yr) underwent pre-experimental testing to determine peak VO(2) and body composition. Participants underwent 3 trials in which they ingested the following for 1 week prior to each experimental trial: a capsule filled with cellulose (placebo), 81 mg · day(-1) of aspirin (low-dose aspirin), or 650 mg · day(-1) of aspirin (high-dose aspirin)...
December 2011: Wilderness & Environmental Medicine
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