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Pelvic Ring Fracture During a Professional Surfing Event at the Banzai Pipeline
We present a case of a 32-y-old male professional surfer who sustained an isolated pelvic ring fracture after wiping out on a large wave and striking the ocean floor during a world championship tour surfing competition in Hawaii. The surfer was rescued by the water patrol lifeguards, evaluated by onsite medical staff, and stabilized for transfer and subsequent surgical management. As surfing and surfing competitions become increasingly popular, medical staff and event organizers must be aware of the possibility for severe, life-threatening injuries during surfing events. Although infrequent, staff must be prepared to mana...
Source: Wilderness and Environmental Medicine - January 17, 2020 Category: Environmental Health Source Type: research

Thrombotic Microangiopathy following Hypnale zara (Hump-Nosed Pit Viper) Envenoming: The First Known Case Report from Sri Lanka
Publication date: Available online 20 December 2019Source: Wilderness & Environmental MedicineAuthor(s): Rathnayaka Mudiyanselage M.K. Namal Rathnayaka, P.E. Anusha Nishanthi Ranathunga, Senanayake A.M. KularatneA 65-y-old previously healthy farmer developed thrombotic microangiopathy (TMA) comprising the triad of acute kidney injury, microangiopathic haemolysis, and thrombocytopenia after a proven Hypnale zara (hump-nosed pit viper) bite. He developed coagulopathy, which was treated with fresh frozen plasma, and underwent 8 cycles of hemodialysis. He is being followed up in the nephrology clinic for acute kidney injury. T...
Source: Wilderness and Environmental Medicine - December 21, 2019 Category: Environmental Health Source Type: research

Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness: 2019 Update
Publication date: December 2019Source: Wilderness & Environmental Medicine, Volume 30, Issue 4, SupplementAuthor(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 qua...
Source: Wilderness and Environmental Medicine - December 14, 2019 Category: Environmental Health Source Type: research

Wilderness Medical Society Clinical 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 - December 14, 2019 Category: Environmental Health Source Type: research

Wilderness Medical Society Clinical 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 - December 14, 2019 Category: Environmental Health Source Type: research

Venous Pooling in Suspension Syndrome Assessed with Ultrasound
ConclusionsFree hanging in a harness leads to rapid venous pooling in the lower limbs. The most important measure to prevent suspension syndrome might be constant movement of the legs. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - December 14, 2019 Category: Environmental Health Source Type: research

In Response to Estimating Creatinine in Ultramarathon Runners by Little et al
Publication date: December 2019Source: Wilderness & Environmental Medicine, Volume 30, Issue 4Author(s): Wojciech Wołyniec, Renke Marcin, Wojciech Ratkowski (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - December 12, 2019 Category: Environmental Health Source Type: research

The Brazil’s Lancehead (Bothops brazili): An Uncommon Pit Viper of the Amazonia
Publication date: Available online 5 December 2019Source: Wilderness & Environmental MedicineAuthor(s): Paulo Sérgio Bernarde, Marllus Rafael Negreiros de Almeida (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - December 6, 2019 Category: Environmental Health Source Type: research

The Disease Ecology, Epidemiology, Clinical Manifestations, and Management of Emerging Cryptococcus gattii Complex Infections
Publication date: Available online 6 December 2019Source: Wilderness & Environmental MedicineAuthor(s): James H. DiazCryptococcus neoformans, a soil-dwelling fungus found worldwide, can cause cryptococcosis, an opportunistic fungal infection of the lungs and central nervous system. One former member of the C neoformans complex, Cryptococcus gattii, has caused meningitis in immunosuppressed and immunocompetent persons in endemic regions in Africa and Asia. Between 1999 and 2004, C gattii caused outbreaks of human cryptococcosis in unexpected, nonendemic, nontropical regions on Vancouver Island, Canada, and throughout the US...
Source: Wilderness and Environmental Medicine - December 6, 2019 Category: Environmental Health Source Type: research

Wilderness Medical Society Clinical Practice Guidelines for Spinal Cord Protection
Publication date: Available online 25 November 2019Source: Wilderness & Environmental MedicineAuthor(s): Seth C. Hawkins, Jason Williams, Brad L. Bennett, Arthur Islas, Dietrich Whitfield Kayser, Robert QuinnThe Wilderness Medical Society reconvened an expert panel to update best practice guidelines for spinal cord protection during trauma management. This panel, with membership updated in 2018, was charged with the development of evidence-based guidelines for management of the injured or potentially injured spine in wilderness environments. Recommendations are made regarding several parameters related to spinal cord prote...
Source: Wilderness and Environmental Medicine - November 26, 2019 Category: Environmental Health Source Type: research

Wilderness Medical Society Clinical Practice Guidelines for Diabetes Management
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 routine and urgent therapeutic management of diabetes and glycemic complications. These recommendations are graded based on the quality of supporting evidence and balance between the benefits and risks or burdens for each recommendation. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - November 19, 2019 Category: Environmental Health Source Type: research

Wilderness Medical Society Clinical Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia: 2019 Update
Publication date: Available online 15 November 2019Source: Wilderness & Environmental MedicineAuthor(s): Jennifer Dow, Gordon G. Giesbrecht, Daniel F. Danzl, Hermann Brugger, Emily B. Sagalyn, Beat Walpoth, Paul S. Auerbach, Scott E. McIntosh, Mária Némethy, Marion McDevitt, Robert B. Schoene, George W. Rodway, Peter H. Hackett, Ken Zafren, Brad L. Bennett, Colin K. GrissomTo provide guidance to clinicians, the Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for the out-of-hospital evaluation and treatment of victims of accidental hypothermia. The guidelines present the main diagn...
Source: Wilderness and Environmental Medicine - November 16, 2019 Category: Environmental Health Source Type: research

ERRATUM in Wilderness Environ Med. 29/3
Publication date: Available online 13 November 2019Source: Wilderness & Environmental MedicineAuthor(s): (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - November 13, 2019 Category: Environmental Health Source Type: research

Improvised vs Standard Cervical Collar to Restrict Spine Movement in the Backcountry Environment
ConclusionsOur small study demonstrated that mountain travelers and rescuers may be able to use an improvised fleece jacket collar in place of a standard collar if spine trauma is suspected after a backcountry accident. Further research should examine different types of improvised collars, their ability to remain in place over extended evacuations, and when to apply collars to backcountry patients. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - November 7, 2019 Category: Environmental Health Source Type: research

BASE Jumping Fatalities Between 2007 and 2017: Main Causes of Fatal Events and Recommendations for Safety
ConclusionsBASE jump practice has undergone radical transformations in the last 10 y, especially linked to the mountain environment and the use of wingsuits. These factors were linked to most fatal events. Key recommendations are basic practical measures, such as ground preparation and equipment checks, and deep technical and personal knowledge that involves regular engagement and significant introspection. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - November 6, 2019 Category: Environmental Health Source Type: research