Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Frostbite: 2019 Update
We present a review of pertinent pathophysiology. We then discuss primary and secondary prevention measures and therapeutic management. Recommendations are made regarding each treatment and its role in management. These recommendations are graded on the basis of the quality of supporting evidence and balance between the benefits and risks or burdens for each modality according to methodology stipulated by the American College of Chest Physicians. This is an updated version of the guidelines published in 2014. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 18, 2019 Category: Environmental Health Source Type: research

Emergency Medical Training for the Commercial Fishing Industry: An Expanded Role for Wilderness Medicine
This article describes the conception, implementation, and evaluation of a wilderness medicine–based first aid class for the commercial fishing industry. Commercial fishing is a dangerous occupation in the United States. Currently, commercial fishermen often only have access to basic first aid classes. Because of its focus on austere environments, hazardous conditions, and distance from definitive medical care—hallmarks of commercial fisheries—wilderness medicine offers a more appropriate approach to decreasing morbidity and mortality in the industry. A 2-d, 16-h pilot wilderness medicine course for comme...
Source: Wilderness and Environmental Medicine - July 12, 2019 Category: Environmental Health Source Type: research

Risk of Death and Major Injury from Natural Winter Hazards in Helicopter and Snowcat Skiing in Canada
ConclusionWe recommend the design of an industry-wide incident and near-miss reporting system to support evidence-based improvements of safety practices. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 12, 2019 Category: Environmental Health Source Type: research

Pediatric High Altitude Cerebral Edema in the Nepal Himalayas
We report on 2 cases of suspected HACE in 2 patients, aged 12 and 16 y, who presented to the Manang Himalayan Rescue Association clinic at 3500 m. The 16-y-old patient presented with severe headache, vomiting, and ataxia after rapid ascent to 3800 m. The 12-y-old patient presented with severe headache, vomiting, visual disturbances, and ataxia at 4500 m, which began to resolve with descent to the clinic at 3500 m. Our cases suggest that HACE can occur in children and adolescents. Because there are no specific guidelines for treatment of acute mountain sickness or HACE in patients under the age of 18 y, we recommend treatme...
Source: Wilderness and Environmental Medicine - July 12, 2019 Category: Environmental Health Source Type: research

The Seven Continents Marathon Club
Publication date: Available online 9 July 2019Source: Wilderness & Environmental MedicineAuthor(s): (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 9, 2019 Category: Environmental Health Source Type: research

DNA from Tooth Embedded in Man's Foot Resolves Quarter-Century-Old Shark Bite Mystery
Publication date: Available online 1 July 2019Source: Wilderness & Environmental MedicineAuthor(s): Lei Yang, John S.S. Denton, Shannon Corrigan, Tyler B.T. Bowling, Gavin J.P. Naylor (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 3, 2019 Category: Environmental Health Source Type: research

Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness: 2019 Update
Publication date: Available online 24 June 2019Source: Wilderness & Environmental MedicineAuthor(s): Andrew M. Luks, Paul S. Auerbach, Luanne Freer, Colin K. Grissom, Linda E. Keyes, Scott E. McIntosh, George W. Rodway, Robert B. Schoene, Ken Zafren, Peter H. HackettTo provide guidance to clinicians about best preventive and therapeutic practices, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for prevention and treatment of acute mountain sickness, high altitude cerebral edema, and high altitude pulmonary edema. Recommendations are graded based on the quality of supp...
Source: Wilderness and Environmental Medicine - June 25, 2019 Category: Environmental Health Source Type: research

Recovery of Heart Rate Variability After Exercise Under Hot Conditions: The Effect of Relative Humidity
ConclusionsStress score and sympathetic/parasympathetic ratio seem to be the best HRV predictors of internal load. Although there are no differences in HRV during recovery at the same time points in both conditions, the recovery is slower after exercise in HH than in HD. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - June 25, 2019 Category: Environmental Health Source Type: research

Cougar (Puma concolor) Injury in the United States
Publication date: Available online 25 June 2019Source: Wilderness & Environmental MedicineAuthor(s): Yoyo Y. Wang, Thomas G. Weiser, Joseph D. ForresterIntroductionHuman encounters with the cougar (Puma concolor) are rare in the United States but may be fatal.MethodsWe performed a retrospective analysis of cougar attacks in the United States. We asked Fish and Wildlife Department officials from the 16 states in which cougars are known to live to identify all verified cougar attacks recorded in state history. Variables describing the human victim, cougar, and conditions surrounding the attack were recorded. The Fisher e...
Source: Wilderness and Environmental Medicine - June 25, 2019 Category: Environmental Health Source Type: research

In Response to Reduced Acetazolamide Dose for AMS by McIntosh et al
Publication date: Available online 25 June 2019Source: Wilderness & Environmental MedicineAuthor(s): Robert Bennett (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - June 25, 2019 Category: Environmental Health Source Type: research

High Altitude Deterioration: A Historical Essay
Publication date: Available online 20 June 2019Source: Wilderness & Environmental MedicineAuthor(s): Harvey V. LankfordThis wilderness essay about high altitude deterioration will explore the historical mountaineering and medical literature with a limited discussion of physiology. The writings of mountaineers and physician-mountaineers provide an evocative supporting narrative to illustrate one of the problems of living at altitude. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - June 21, 2019 Category: Environmental Health Source Type: research

Friction Blister by Climbing Harness: A Case Report
Publication date: Available online 20 June 2019Source: Wilderness & Environmental MedicineAuthor(s): Subarna Adhikari, Suvash Dawadi, Jenisha UpadhyayAn experienced 24-y-old climber on Mount Everest presented to the Base Camp medical clinic with a friction blister on his right flank. The blister was filled with clear fluid and was located about 3 cm posterior and 3 cm superior to the highest point of the right iliac crest, the site where a climbing harness would support the climber while hanging. A diagnosis of friction blister caused by a climbing harness used while traversing between Camp 2 and Camp 3 of Mount Everes...
Source: Wilderness and Environmental Medicine - June 21, 2019 Category: Environmental Health Source Type: research

Successful Management of Two Patients with Intracranial Hemorrhage due to Carpet Viper (Echis ocellatus) Envenomation in a Limited-Resource Environment
We present 2 cases of E ocellatus envenomation with intracranial hemorrhage seen at a rural hospital in Bembèrèkè, Benin, and describe the successful management of these patients in a limited-resource setting. In one case the patient was treated with an ineffective Indian-made antivenom before evaluation by the authors and continued to deteriorate until she was treated with effective antivenom 10 d after the bite. In both cases lumbar puncture was performed for diagnostic or therapeutic purposes with good effect, and both patients made full recoveries without sequelae. These cases demonstrate the remar...
Source: Wilderness and Environmental Medicine - June 21, 2019 Category: Environmental Health Source Type: research

Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Heat Illness: 2019 Update
We present a review of the classifications, pathophysiology, and evidence-based guidelines for planning and preventive measures, as well as best practice recommendations for both field- and hospital-based therapeutic management of heat illness. These recommendations are graded based on the quality of supporting evidence and balance the benefits and risks or burdens for each modality. This is an updated version of the original Wilderness Medical Society Practice Guidelines for the Treatment and Prevention of Heat-Related Illness published in 2013. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - June 18, 2019 Category: Environmental Health Source Type: research

The Reliability of Noninvasive Blood Pressure Measurement through Layers of Autumn/Winter Clothing: a Prospective Study
ConclusionsOur findings confirm that it is possible to perform reliable NIBP measurements over 2 and 3 layers of autumn/winter clothing. Measuring NIBP with a clothed arm does not show clinical or statistically significant differences in comparison with measurements performed on the bare arm. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - June 18, 2019 Category: Environmental Health Source Type: research

Catfish Bite Case Report
Publication date: Available online 18 June 2019Source: Wilderness & Environmental MedicineAuthor(s): Lawrence LeBlondAlthough catfish are found worldwide and commonly consumed in the southern United States, fatal infections from catfish are rare. Edwardsiella tarda is a bacterium known to cause gastrointestinal distress most commonly, but extraintestinal infections are a rarely considered danger for those acquiring, preparing, and consuming aquatic animals. Susceptible to all gram-negative active antibiotics, it is easily treated except in immunocompromised hosts, such as those with malignancy, diabetes, and hepatic dy...
Source: Wilderness and Environmental Medicine - June 18, 2019 Category: Environmental Health Source Type: research

An Occupational Health Survey of British Mountain Guides Operating Internationally
ConclusionsMusculoskeletal problems are the main occupational health problems experienced by the study group. New findings include a low but important prevalence of ultraviolet radiation–associated conditions. One in 3 guides have experienced significant psychological trauma, and one quarter of these had symptoms of PTSD. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - June 15, 2019 Category: Environmental Health Source Type: research

Cold Water Immersion Syndrome and Whitewater Recreation Fatalities
Publication date: Available online 6 June 2019Source: Wilderness & Environmental MedicineAuthor(s): David J. Farstad, Julie A. DunnSudden death during whitewater recreation often occurs through understandable mechanisms such as underwater entrapment or trauma, but poorly defined events are common, particularly in colder water. These uncharacterized tragedies are frequently called flush drownings by whitewater enthusiasts. We believe the condition referred to as cold water immersion syndrome may be responsible for some of these deaths. Given this assumption, the physiologic alterations contributing to cold water immersi...
Source: Wilderness and Environmental Medicine - June 7, 2019 Category: Environmental Health Source Type: research

Using an Unmanned Aircraft System (Drone) to Conduct a Complex High Altitude Search and Rescue Operation: a Case Study
Publication date: Available online 4 June 2019Source: Wilderness & Environmental MedicineAuthor(s): Jake N. McRae, Christopher J. Gay, Brandon M. Nielsen, Andrew P. HuntUnmanned aircraft systems, also known as unmanned aerial vehicles or drones, are becoming increasingly common consumer products; their potential applications to search and rescue operations are becoming ever more apparent. A consumer drone was used to locate a mountaineer after he and his climbing partner were separated while summiting Broad Peak in the Karakoram Mountains of northeastern Pakistan, the world's 12th highest summit. The use of a commercia...
Source: Wilderness and Environmental Medicine - June 4, 2019 Category: Environmental Health Source Type: research

ERRATUM in Wilderness Environ Med. 30/1
Publication date: Available online 4 June 2019Source: Wilderness & Environmental MedicineAuthor(s): (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - June 4, 2019 Category: Environmental Health Source Type: research

Challenges of Remote Medical Care in South Sudan: Centipede Bites
This report aims to add to the local literature; because of decades of internal conflict and poor infrastructure, reporting of health data from South Sudan is severely lacking. Further investigation into the pharmacological variation and activity of toxic peptides in centipede venom is recommended. As it stands, this case provides additional information on potential effects of centipede envenomation that should be useful to any healthcare providers preparing for the delivery of remote medical care throughout the Great Upper Nile region. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - June 1, 2019 Category: Environmental Health Source Type: research

Human Responses to 5 Heated Hypothermia Wrap Systems in a Cold Environment
Publication date: Available online 2 May 2019Source: Wilderness & Environmental MedicineAuthor(s): Ramesh Dutta, Kartik Kulkarni, Alan M. Steinman, Phillip F. Gardiner, Gerren K. McDonald, Gordon G. GiesbrechtIntroductionWe compared the effectiveness of 5 heated hypothermia wrap systems.MethodsPhysiologic and subjective responses were determined in 5 normothermic subjects (1 female) for 5 heated hypothermia wraps (with vapor barrier and chemical heat sources) during 60 min of exposure to a temperature of −22°C. The 5 systems were 1) user-assembled; 2) Doctor Down Rescue Wrap; 3) Hypothermia Prevention and Man...
Source: Wilderness and Environmental Medicine - May 4, 2019 Category: Environmental Health Source Type: research

Chemical Heat Packs as an Intervention to Prolong Ultrasound Battery Runtime
Publication date: Available online 2 May 2019Source: Wilderness & Environmental MedicineAuthor(s): Steven Roy, Ryck K. Schielke, Daniel Haffey, Heather CoombsIntroductionPoint-of-care ultrasonography is a burgeoning field of practice and study. Although point-of-care ultrasonography has started to penetrate the field of wilderness medicine, its use in cold environments is often limited by poor battery performance. In the current study, we investigated the effect of chemical foot warmers on battery runtime of handheld ultrasound machines in cold weather.MethodsThis prospective study used a balanced, crossover randomizat...
Source: Wilderness and Environmental Medicine - May 4, 2019 Category: Environmental Health Source Type: research

Environmental Deaths in the Northern Territory of Australia, 2003–2018
ConclusionsThe Northern Territory has a challenging environment that is hot, humid, remote, and isolated. Circumstantial information and thorough police investigations are essential in the medicolegal investigation of environmental deaths. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - April 28, 2019 Category: Environmental Health Source Type: research

In Reply to Drs McAnaney and Ganti
Publication date: Available online 24 April 2019Source: Wilderness & Environmental MedicineAuthor(s): Joseph A. Sol, Joseph W. Domitrovich, Brent C. Ruby, Steven E. Gaskill, Charles L. Dumke (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - April 25, 2019 Category: Environmental Health Source Type: research

The Evolution to Prospective Research in Wilderness Medicine
Publication date: Available online 22 April 2019Source: Wilderness & Environmental MedicineAuthor(s): Neal W. Pollock (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - April 23, 2019 Category: Environmental Health Source Type: research

Introduction to Mountain Rescue Casualty Care and the Undergraduate Medical Elective
Publication date: Available online 22 April 2019Source: Wilderness & Environmental MedicineAuthor(s): Steve Donelan (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - April 23, 2019 Category: Environmental Health Source Type: research

Challenges of Remote Medical Care in South Sudan: Centipede Stings
This report aims to add to the local literature; because of decades of internal conflict and poor infrastructure, reporting of health data from South Sudan is severely lacking. Further investigation into the pharmacological variation and activity of toxic peptides in centipede venom is recommended. As it stands, this case provides additional information on potential effects of centipede envenomation that should be useful to any healthcare providers preparing for the delivery of remote medical care throughout the Great Upper Nile region. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - April 19, 2019 Category: Environmental Health Source Type: research

Ayoloco: One of Mexico's Surviving Glaciers
Publication date: Available online 19 April 2019Source: Wilderness & Environmental MedicineAuthor(s): Rodrigo Ville-Benavides (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - April 19, 2019 Category: Environmental Health Source Type: research

Taking the Edge out of High-Risk Selfies in Adventure Tourists
Publication date: Available online 17 April 2019Source: Wilderness & Environmental MedicineAuthor(s): Gerard T. Flaherty, Michael Smith (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - April 18, 2019 Category: Environmental Health Source Type: research

Cause of Death in Utah Avalanche Fatalities, 2006–2007 through 2017–2018 Winter Seasons
ConclusionsAsphyxia continues to be the most prevalent killer in avalanche burial. Patterns of ongoing avalanche deaths continue to suggest that rapid recovery and techniques that prolong survival while buried may decrease fatality rates. Trauma is a significant factor in many avalanche fatalities. Education and technologies focused on reducing traumatic injuries such as improved education in techniques for avalanche risk avoidance and/or use of avalanche airbags may further decrease fatality rates. Snowmobilers represent an increasing percentage of Utah avalanche deaths and now make up the majority of victims; increased e...
Source: Wilderness and Environmental Medicine - April 18, 2019 Category: Environmental Health Source Type: research

BASE Jumping Injuries Presenting to Emergency Departments in the United States: an Assessment of Morbidity, Emergency Department, and Inpatient Costs
Publication date: Available online 16 April 2019Source: Wilderness & Environmental MedicineAuthor(s): Joseph D. Forrester, Kirbi Yelorda, Lakshika Tennakoon, David A. Spain, Kristan StaudenmayerBackgroundBASE (building, antenna, span, earth) jumping involves jumping from fixed objects with specialized parachutes. BASE jumping is associated with less aerodynamic control and flight stability than skydiving because of the lower altitude of jumps. Injuries and fatalities are often attributed to bad landings and object collision.MethodsWe performed a retrospective analysis of the 2010–2014 National Emergency Departmen...
Source: Wilderness and Environmental Medicine - April 17, 2019 Category: Environmental Health Source Type: research

South African Marine Envenomations and Poisonings as Managed Telephonically by the Tygerberg Poisons Information Centre: A 20-Year Retrospective Review
ConclusionThe proportion of marine-related toxicology cases was low. Telephonic consultations by healthcare professionals relating to poisoning were generally of a serious nature. The data can be used to drive public health awareness campaigns. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - April 13, 2019 Category: Environmental Health Source Type: research

Search and Rescue and Remote Medical Evacuation in a Norwegian Setting: Comparison of Two Systems
Publication date: Available online 12 April 2019Source: Wilderness & Environmental MedicineAuthor(s): Bjørn O. Reid, Helge Haugland, Marius Rehn, Oddvar Uleberg, Andreas J. KrügerIntroductionHelicopter emergency medical services (HEMS) contribute to and complement other specialized search and rescue (SAR) services. Conversely, traditional SAR services perform medical evacuation (medevac), depending on crew, training, medical equipment, and procedures for interdisciplinary cooperation. We aim to describe and compare SAR and remote medevac mission characteristics in a military SAR helicopter system to a civil...
Source: Wilderness and Environmental Medicine - April 13, 2019 Category: Environmental Health Source Type: research

Ski-Everest (8848 m) Expedition: Digit Skin Temperature Responses to Cold Immersion May Reflect Susceptibility to Cold Injury
ConclusionsThe attenuated CIVD response of the case alpinist may reflect a previously unrecognized enhanced susceptibility to frostbite. In addition to the poor vasomotor response observed in the injured toes, he also exhibited a poor vasomotor response in his noninjured fingers. The results of the present study indicate that a test of vasomotor activity during thermal stress may identify individuals predisposed to cold injury. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - April 10, 2019 Category: Environmental Health Source Type: research

Accuracy of Estimated Creatinine in Multistage Ultramarathon Runners
Publication date: Available online 11 March 2019Source: Wilderness & Environmental MedicineAuthor(s): Colin E. Little, Grant S. Lipman, Daniel Migliaccio, David S. Young, Brian J. KrabakIntroductionUltramarathon running is increasing in popularity worldwide, as is the growing body of research on these athletes. Multiple studies have examined acute kidney injury through estimated baseline creatinine (Cr) and glomerular filtration rate (GFR). Values are estimated through an age-based formula of GFR and the modification of diet in renal disease (MDRD) equation. However, the accuracy of this practice in a cohort of healthy...
Source: Wilderness and Environmental Medicine - March 12, 2019 Category: Environmental Health Source Type: research

Rock Climbing Injuries Treated in US Emergency Departments, 2008–2016
ConclusionsThis study reports continued increase in annual numbers of climbing injuries. Whether this is based on a higher injury rate or on a higher number of climbers overall cannot be stated with certainty because no denominator is presented to estimate the injury rate among climbers. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 9, 2019 Category: Environmental Health Source Type: research

Mountain Rescue Casualty Care and the Undergraduate Medical Elective
This article reports a condensed mountain rescue casualty care course designed for medical students by a mountain rescue team. The course was offered as part of a student-selected module during phase 3A at the University of Sheffield Medical School. Within the module, students also learned the relevant biomedical sciences and clinical skills to construct their knowledge of mountain rescue casualty care. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 8, 2019 Category: Environmental Health Source Type: research

Successful Summit of Two 8000 m Peaks After Recent High Altitude Pulmonary Edema
We present a case of a 52-y-old male climber who was diagnosed with high altitude pulmonary edema during the 2018 Everest spring climbing season, descended to low altitude for 9 d, received treatment, and returned to continue climbing with a very rapid ascent rate. Despite a very recent history of high altitude pulmonary edema and not using pharmacologic prophylaxis over a very rapid reascent profile, the climber successfully summited Mt. Everest (8848 m) and Lhotse (8516 m) without any problems. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 8, 2019 Category: Environmental Health Source Type: research

Impact of a Half Dome Cable Permitting Process on Search and Rescue Activity, Hiker Mortality Rates, and Operational Costs Above Little Yosemite Valley
ConclusionsSAR incidents, victims, fatalities, or costs above LYV did not decrease after cable handrail permitting. Parkwide SAR activity decreased during the same intervals. This strongly suggests that overcrowding is not the key factor influencing safety on Half Dome. This discordant trend warrants close observation over 5 to 10 y. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 5, 2019 Category: Environmental Health Source Type: research

Successful Field Rewarming of a Patient with Apparent Moderate Hypothermia Using a Hypothermia Wrap and a Chemical Heat Blanket
We present a case in which a hypothermia wrap and the CHB from a Hypothermia Prevention and Management Kit were used successfully to rewarm a patient with apparent moderate hypothermia in the field. We are unaware of previous reports of successful field rewarming of a patient with moderate hypothermia. We believe the use of the CHB in conjunction with a hypothermia wrap made field rewarming possible. We recommend that a CHB, along with the components of a hypothermia wrap, be carried by search and rescue teams when a hypothermic patient might be encountered. Although there were no documented core temperatures, we believe t...
Source: Wilderness and Environmental Medicine - February 27, 2019 Category: Environmental Health Source Type: research

Epidemiology of Cardiac Events During Prehospital Care in Mountain Rescues Conducted in Aragón
ConclusionsAragón mountain rescues show an increase in patient age in recent years. The most common medical case among rescued individuals with heart conditions was a hiker over the age of 50 y with cardiovascular risk factors, inferior infarction, and occurrence at an altitude above 2000 m. Based on our observations, appropriate training should be undertaken, especially by older hikers, who may also benefit from cardiac screening, and rescue vehicles/personnel and mountain huts should be equipped with semiautomatic external defibrillators. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 6, 2019 Category: Environmental Health Source Type: research

Retrospective Documentation of a Confirmed White-Lipped Green Pit Viper (Trimeresurus albolabris Gray, 1842) Bite in the South-Central Hills of Nepal
We report a case (managed with several non-evidence-based interventions) of noticeable coagulopathic envenomation due to confirmed T albolabris bite in Nepal. This is the first known reported case of such a bite in Nepal. This case highlights the urgent need to improve diagnosis, monitoring, and supportive care for bite victims and to study the effectiveness of Thai pit viper antivenoms for the treatment of T albolabris envenomations. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 6, 2019 Category: Environmental Health Source Type: research

Efficacy of Head and Torso Rewarming Using a Human Model for Severe Hypothermia
Publication date: Available online 6 February 2019Source: Wilderness & Environmental MedicineAuthor(s): Kartik Kulkarni, Erik Hildahl, Ramesh Dutta, Sandra C. Webber, Steven Passmore, Gerren K McDonald, Gordon G. GiesbrechtIntroductionTo evaluate the rewarming effectiveness of a similar amount of heat (from a charcoal heater) applied to either the head or torso in a human model for severe hypothermia in which shivering is pharmacologically inhibited in mildly hypothermic subjects.MethodsSix male subjects were cooled on 3 different occasions, each in 8°C water for 60 min, or to a lowest core temperature of 35°C....
Source: Wilderness and Environmental Medicine - February 6, 2019 Category: Environmental Health Source Type: research

Sea Ice Floes in the Weddell Sea
Publication date: Available online 4 February 2019Source: Wilderness & Environmental MedicineAuthor(s): (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 5, 2019 Category: Environmental Health Source Type: research

In Response to Metabolic Demand of Hiking in Wildland Firefighting by Sol et al
Publication date: Available online 4 February 2019Source: Wilderness & Environmental MedicineAuthor(s): Cara McAnaney, Arun Ganti (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 5, 2019 Category: Environmental Health Source Type: research

Camp Fire Smoke Sunset
Publication date: Available online 5 February 2019Source: Wilderness & Environmental MedicineAuthor(s): (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 5, 2019 Category: Environmental Health Source Type: research

Expired Drugs in the Remote Environment
ConclusionsThe results suggest that the studied drugs may be stable beyond expiry, even when not maintained in strictly temperature-controlled conditions. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 2, 2019 Category: Environmental Health Source Type: research

One Foot After Another—Fungal Foot Issues in Expedition Adventure Racing
We present a case with characteristic clinical manifestations, including the “sandpaper symptom.” There is limited literature exploring infectious foot complaints in expedition adventure racers. Beyond this case report, more research is needed to better understand incidence rates, risk factors, diagnostic measures, treatment, and prevention options. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 2, 2019 Category: Environmental Health Source Type: research

Rejection Under Peer Review
Publication date: Available online 1 February 2019Source: Wilderness & Environmental MedicineAuthor(s): Neal W. Pollock (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 1, 2019 Category: Environmental Health Source Type: research