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A Case Report of a Bite From the Nile Crocodile (Crocodylus niloticus) Managed with Regional Anesthesia
We report a case of an adult male who presented with a large lower extremity wound after a crocodile bite. The patient was managed with initial debridement and irrigation and serial wound care entirely under regional anesthesia at the bedside. The patient did not develop wound infection, eventually receiving a skin graft with good functional outcomes. Regional anesthesia techniques are increasingly being used in the trauma setting, and their versatility allows for their use in multiple settings, by practitioners with limited experience and in resource-limited environments. No specific guidelines exist for performance of ne...
Source: Wilderness and Environmental Medicine - October 23, 2019 Category: Environmental Health Source Type: research

Time Course of Hoist Operations by the Search and Rescue Helicopter Service in Southeast Norway
ConclusionsHoist rescue was performed in 10% (148) of the SAR operations. New information about hoist extrication time intervals can improve rescue helicopter dispatch accuracy. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - October 23, 2019 Category: Environmental Health Source Type: research

Endemic North American Plants as Potentially Suitable Agents for Wound Cleaning Under Resource Scarce Conditions
ConclusionsThese data suggest that both St. John’s wort and white oak are potential candidates for infection prophylaxis and therapy in austere wilderness scenarios, with St. John’s wort being the more potent agent. White oak may be more logistically feasible because the larger surface area of a white oak tree allows for harvesting a larger quantity of bark compared to the smaller surface area of the St. John’s wort plant. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - October 18, 2019 Category: Environmental Health Source Type: research

Risk of Burns During Active External Rewarming for Accidental Hypothermia
This article describes 3 incidents in which therapeutic or experimental warming of cold individuals caused first- to third-degree burns to the skin. Mechanisms for these injuries are considered. We conclude that active external rewarming of the trunk of a cold patient in the field can be administered safely and burn risk reduced if 1) manufacturer instructions are followed; 2) insulation is placed between the skin the and heat source; and 3) caregivers make regular efforts to observe heated skin for possible pending burn injury. Direct inspection is mandatory for the skin of areas that are on top of a heat source when the ...
Source: Wilderness and Environmental Medicine - September 29, 2019 Category: Environmental Health Source Type: research

Characteristics and Motivating Factors of Attendees of a Regional Student-Run Wilderness Medicine Conference
Publication date: Available online 28 September 2019Source: Wilderness & Environmental MedicineAuthor(s): Christina M. Stuart, Kailey C. Tindle, Lara L. PhillipsDespite recent growth, opportunities for preclinical medical students to engage with the field of wilderness medicine remain geographically, financially, and logistically limited. Attendees of the 2018 Mid-Atlantic Student Wilderness Medicine Conference were invited to complete a post hoc web-based survey after the event. Results of the survey were analyzed to determine the demographic characteristics and motivating factors for attendance, as well as perceived conf...
Source: Wilderness and Environmental Medicine - September 29, 2019 Category: Environmental Health Source Type: research

Photoperiod Impact on a Sailor’s Sleep-Wake Rhythm and Core Body Temperature in Polar Environment
ConclusionsOur study observed that during a polar sailing expedition, many circadian disruptions appeared as free-running rhythms or dissociation between sleep and Tc rhythm. Future studies will evaluate effects of these disruptions and their probable association with accident risks. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - September 10, 2019 Category: Environmental Health Source Type: research

Assessing the Validity of Bioelectrical Impedance and Skinfold Calipers for Measuring Body Composition in NOLS Backcountry Hikers
ConclusionsThis study shows that the skinfold caliper and the Tanita scale give measurements comparable to the less readily available and more costly Bod Pod measurement in backcountry expedition participants. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - September 7, 2019 Category: Environmental Health Source Type: research

Dermatological Progression of a Probable Box Jellyfish Sting
Publication date: Available online 30 August 2019Source: Wilderness & Environmental MedicineAuthor(s): Paul S. Auerbach, Deepak Gupta, Karen Van Hoesen, Adriana ZavalaThis case report describes the typical features of the dermatological progression of a patient stung by a (probable) box jellyfish. The purpose is to guide clinicians and patients to an understanding of what to expect after such a sting using the clinical narrative and unique sequential photographs of the injury. With knowledgeable consultation from experienced physicians and meticulous care, this envenomation healed without the need for skin grafting. (Sourc...
Source: Wilderness and Environmental Medicine - August 31, 2019 Category: Environmental Health Source Type: research

Arthropod Bites and Stings Treated in Emergency Departments: Recent Trends and Correlates
ConclusionsThese results provide updated surveillance on the prevalence and correlates of arthropod bites and stings in the US population. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - August 10, 2019 Category: Environmental Health Source Type: research

In Reply to Dr Bennett
Publication date: Available online 8 August 2019Source: Wilderness & Environmental MedicineAuthor(s): Scott E. McIntosh, Mika Hemphill, Marion C. McDevitt, Tsering Yangzom Gurung, Mukhiya Ghale, Jonathan R. Knott, Ghan Bahadur Thapa, Buddha Basnyat, Jennifer Dow, David C. Weber, Colin K. Grissom, The RADICAL author team (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - August 10, 2019 Category: Environmental Health Source Type: research

In Response to Estimating Creatinine in Ultramarathon Runners by Little et al
Publication date: Available online 9 August 2019Source: Wilderness & Environmental MedicineAuthor(s): Wojciech Wołyniec, Renke Marcin, Wojciech Ratkowski (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - August 10, 2019 Category: Environmental Health Source Type: research

The Insignificance of Significance in Scientific Reporting
Publication date: Available online 7 August 2019Source: Wilderness & Environmental MedicineAuthor(s): Neal W. Pollock (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - August 7, 2019 Category: Environmental Health Source Type: research

Evaluation of Scorpion Envenomation by Tityus trivittatus in Adults: An Analysis of Variables Related to Severity of Clinical Presentation
ConclusionsOur study exposed factors associated with moderate presentations of scorpion envenomation and proposes the option of conservative treatment for affected adults. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 25, 2019 Category: Environmental Health Source Type: research

The Significance of a Cooperative Medical System for Treating Decompression Illness on the Izu Peninsula in Japan
ConclusionsThis retrospective study revealed simultaneity between the introduction of the yearly meetings and a reduced duration of the HEMS staff's activity at either the scene or the first aid hospital. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 22, 2019 Category: Environmental Health Source Type: research

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