Hypothermia Evidence, Afterdrop, and Guidelines
Publication date: Available online 1 April 2015 Source:Wilderness & Environmental Medicine Author(s): Ken Zafren , Gordon G. Giesbrecht , Daniel F. Danzl , Hermann Brugger , Emily B. Sagalyn , Beat Walpoth , Eric A. Weiss , Paul S. Auerbach , Scott E. McIntosh , Mária Némethy , Marion McDevitt , Jennifer Dow , Robert B. Schoene , George W. Rodway , Peter H. Hackett , Brad L. Bennett , Colin K. Grissom (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - April 10, 2015 Category: Environmental Health Source Type: research

Field Ultrasound Evaluation of Central Volume Status and Acute Mountain Sickness
Conclusions Ultrasonography is a useful tool in the assessment of intravascular volume at altitude. In this sample, we found ultrasonographic evidence that subjects with AMS have a higher intravascular volume than asymptomatic individuals. These data support the hypothesis that individuals with AMS have decreased altitude-related diuresis compared with asymptomatic individuals. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - April 10, 2015 Category: Environmental Health Source Type: research

A Pain in the Neck
Publication date: Available online 7 April 2015 Source:Wilderness & Environmental Medicine Author(s): Pranawa Koirala , Seth Wolpin , Pratibha Phuyal , Buddha Basnyat , Ken Zafren (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - April 8, 2015 Category: Environmental Health Source Type: research

In Reply to Hypothermia Evidence, Afterdrop, and Guidelines
Publication date: Available online 1 April 2015 Source:Wilderness & Environmental Medicine Author(s): Ken Zafren , Gordon G. Giesbrecht , Daniel F. Danzl , Hermann Brugger , Emily B. Sagalyn , Beat Walpoth , Eric A. Weiss , Paul S. Auerbach , Scott E. McIntosh , Mária Némethy , Marion McDevitt , Jennifer Dow , Robert B. Schoene , George W. Rodway , Peter H. Hackett , Brad L. Bennett , Colin K. Grissom (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - April 3, 2015 Category: Environmental Health Source Type: research

Reduction of Acute Shoulder Dislocations in a Remote Environment: A Prospective Multicenter Observational Study
Conclusions The reduction method presented in the present study is an effective method for the reduction of acute shoulder luxations in remote places. Our data suggest that this method could be applied for safe and effective reduction of shoulder dislocation. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 30, 2015 Category: Environmental Health Source Type: research

Hypothermia Evidence, Afterdrop, and Practical Experience
Publication date: Available online 29 March 2015 Source:Wilderness & Environmental Medicine Author(s): Douglas Brown , John Ellerton , Peter Paal , Jeff Boyd (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 30, 2015 Category: Environmental Health Source Type: research

Femoral Traction Splints in Mountain Rescue Prehospital Care: To Use or Not to Use? That Is the Question
Conclusions Femur fractures are rare within mountain rescue. Traction splints may be no more effective than other methods of splinting in prehospital care. We failed to identify evidence that supports the hypothesis that traction splints reduce morbidity or mortality. We advocate the use of a femoral traction splints but recognize that other splints may also be appropriate in this environment. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 26, 2015 Category: Environmental Health Source Type: research

Cardiovascular and Perceptual Responses to an Ultraendurance Channel Swim: A Case Study
Publication date: Available online 24 March 2015 Source:Wilderness & Environmental Medicine Author(s): Daniel A. Judelson , James R. Bagley , Jennifer M. Schumacher , Lenny D. Wiersma Ultraendurance open water swimming presents unique physiological challenges. This case study aimed to describe cardiovascular and perceptual responses during a successful solo channel swim. Investigators followed a female swimmer’s Catalina Channel (32.2 km) crossing, monitoring water temperature (Twater) and air temperature (Tair), distance remaining (DR), average velocity, and heart rate (HRswim) at regular intervals. Every ...
Source: Wilderness and Environmental Medicine - March 26, 2015 Category: Environmental Health Source Type: research

Adirondack Park Incidents: A Retrospective Review of Search and Rescue Reports From 2008 and 2009
Conclusions This study portrays the initial demographics of SAR efforts in Adirondack Park. It will aid in educating people on preparing for wilderness activities, as well as tailoring SAR resources to the demographics of injury and illness within the park. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 20, 2015 Category: Environmental Health Source Type: research

Cerebral Hemodynamics at Altitude: Effects of Hyperventilation and Acclimatization on Cerebral Blood Flow and Oxygenation
Conclusions An intensification of the normal cerebral hypocapnic vasoconstrictive response occurred after partial acclimatization in the setting of divergent peripheral and cerebral oxygenation. This may help explain why hyperventilation fails to improve cerebral oxygenation after partial acclimatization as it does after initial ascent. The use of DCS is feasible at altitude and provides a direct measure of CBF indices with high temporal resolution. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 19, 2015 Category: Environmental Health Source Type: research

EPAS1 Gene Polymorphisms Are Associated With High Altitude Polycythemia in Tibetans at the Qinghai-Tibetan Plateau
Conclusions Compared with normal Tibetans, Tibetans with HAPC are maladapted and have a different haplotype in EPAS1 SNPs rs12619696, rs13419896, and rs4953354. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 17, 2015 Category: Environmental Health Source Type: research

In Response to Wilderness Search Strategy and Tactics, by Phillips et al
Publication date: Available online 16 March 2015 Source:Wilderness & Environmental Medicine Author(s): Donald C. Cooper , John R. Frost (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 17, 2015 Category: Environmental Health Source Type: research

Management of a Pediatric Snake Envenomation After Presentation With a Tight Tourniquet
We describe an illustrative case of pediatric snake envenomation presenting with a tightly wound tourniquet. A 10-year-old boy presented after a snake bite to the right calf. A tourniquet was in place just below the right knee. The species of snake was unknown. The patient was hemodynamically stable, but the entirety of the right leg distal to the tourniquet was discolored. Over concern for a potential venom bolus effect upon tourniquet removal, the decision was made to start a crotaline Fab antivenom infusion and gradually loosen the tourniquet. The patient tolerated the infusion and removal of the tourniquet without sign...
Source: Wilderness and Environmental Medicine - March 17, 2015 Category: Environmental Health Source Type: research

Improvised Method for Increasing the Temperature of an i-STAT Analyzer and Cartridge in Cold Environments
Publication date: Available online 13 March 2015 Source:Wilderness & Environmental Medicine Author(s): David Radler , Matthew Wetschler , Mark Christensen , Grant S. Lipman (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 14, 2015 Category: Environmental Health Source Type: research

Cardiovascular Demands of Deer Retrieval Methods
Conclusions The results of this study suggest towing a deer with a shoulder harness results in significant reductions in CV demand and lower perceived exertion compared with traditional deer dragging techniques. Deer hunters who are deconditioned or have CV risk factors are strongly encouraged to consider deer retrieval methods utilizing a shoulder harness and tow rope to mitigate the increased demands commonly found with traditional retrieval methods. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 13, 2015 Category: Environmental Health Source Type: research

Negative Predictive Value of Excluding an Embedded Snake Foreign Body by Ultrasonography
Conclusion Bedside ultrasonography performed by an EM physician is a feasible option to rule out embedded foreign bodies after a snake bite if imaging is warranted. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 13, 2015 Category: Environmental Health Source Type: research

How Not to Train Your Dragon: A Case of a Komodo Dragon Bite
We describe the case of a zookeeper who was bitten by a Komodo dragon, with a resultant mallet finger. We further discuss the various potential mechanisms of Komodo dragon lethality, including sepsis and venom deposition theories that are useful in guiding management. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 13, 2015 Category: Environmental Health Source Type: research

A Case Study: Rare Lepiota brunneoincarnata Poisoning
In conclusion, we present a patient from Turkey who was poisoned by L. brunneoincarnata mushrooms. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 13, 2015 Category: Environmental Health Source Type: research

The Epidemiology of Caving Fatalities in the United States
Publication date: Available online 12 March 2015 Source:Wilderness & Environmental Medicine Author(s): Alejandro C. Stella , J. Priyanka Vakkalanka , Christopher P. Holstege , Nathan P. Charlton (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 13, 2015 Category: Environmental Health Source Type: research

Prediction of Physiological Responses and Performance at Altitude Using the 6-Minute Walk Test in Normoxia and Hypoxia
Conclusions The 6MWT is a simple, time-efficient tool for predicting physiological responses to simulated and actual altitude, which are comparable. The 6MWT is effective at monitoring elements of acclimatization to moderate altitude. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 13, 2015 Category: Environmental Health Source Type: research

High Altitude Cerebral Edema—Serial MRI Findings
Publication date: Available online 12 March 2015 Source:Wilderness & Environmental Medicine Author(s): Ivaturi Venkata Nagesh , Gopinath Manoj , Madan Gurdarshdeep (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 13, 2015 Category: Environmental Health Source Type: research

Novel Application of Chemical Cold Packs for Treatment of Exercise-Induced Hyperthermia: A Randomized Controlled Trial
Conclusions Application of CCP to glabrous skin surfaces was more effective for treating exercise-induced heat stress than the traditional CCP cooling intervention. This novel cooling technique may be beneficial as an adjunctive treatment for heat-related illness in the prehospital environment. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 13, 2015 Category: Environmental Health Source Type: research

Electronic Tablet Augmented Simulation: A Pilot Study
Publication date: Available online 12 March 2015 Source:Wilderness & Environmental Medicine Author(s): Shane Peterson , Martin Musi , Jonathan L. Bar , Christopher Tedeschi (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 13, 2015 Category: Environmental Health Source Type: research

Electromagnetic Interference From Electronic Devices Used in the Management of Type 1 Diabetes Can Impair the Performance of an Avalanche Transceiver in Search Mode
Conclusions Electromagnetic interference produced by some diabetes devices when held within 30 cm of a searching avalanche transceiver can impair the ability to locate a signal. Such interference could significantly compromise the outcome of a companion rescue scenario. Further investigation using other pumps and rtCGMS devices is required to evaluate all available diabetes electronics. Meantime, all electronic diabetes devices including rtCGMS and insulin pumps should not be used within 30 cm of an avalanche transceiver. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 13, 2015 Category: Environmental Health Source Type: research

Which Improvised Tourniquet Windlasses Work Well and Which Ones Won’t?
Conclusions A pair of chopsticks as an improvised tourniquet windlass worked better than pencils or craft sticks. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 13, 2015 Category: Environmental Health Source Type: research

Work Patterns Dictate Energy Demands and Thermal Strain During Wildland Firefighting
Conclusions Wildland firefighters do not induce consistently high cardiovascular and thermal strain while completing arduous work in a hot environment despite fairly high chest skin temperatures. The total energy expenditure in the current study suggests job demands are similar to those of 15 years ago, while the increased water turnover may reflect a change in drinking habits. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 13, 2015 Category: Environmental Health Source Type: research

Rebound Coagulopathy in Patients With Snakebite Presenting With Marked Initial Coagulopathy
Conclusions We recommend periodic monitoring of patients with increased INR, decreased fibrinogen, and decreased platelet count. Patients should be monitored for 10 to 14 days after envenomation to identify asymptomatic rebound coagulopathy. Prompt readministration of FabAV appears to correct the coagulopathy. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 8, 2015 Category: Environmental Health Source Type: research

An Introduction to Wilderness Emergency Medical Services Medical Director Course
Publication date: Available online 7 March 2015 Source:Wilderness & Environmental Medicine Author(s): Steve Donelan (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 8, 2015 Category: Environmental Health Source Type: research

Tough Beginnings on Galapagos, Baby Blue Footed Booby
Publication date: Available online 7 March 2015 Source:Wilderness & Environmental Medicine Author(s): Jon Conard (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 8, 2015 Category: Environmental Health Source Type: research

Finger and Toe Temperature Responses to Cold After Freezing Cold Injury in Elite Alpinists
Conclusions Even after FCI that requires digit amputation, there is no evidence of different tissue rates of rewarming between the injured and uninjured fingers or toes of elite alpinists. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 7, 2015 Category: Environmental Health Source Type: research

Deriving Effective Sweep Width for Air-scent Dog Teams
Conclusions The ESW methodology is applicable to air-scent dog teams, potentially allowing search managers to make decisions in applying resources operationally, as well as improving accuracy of planning calculations. In addition, the methods described appear to be capable, given more widely representative data, of making valid statistical comparisons between different search modalities and weather and other factors. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 7, 2015 Category: Environmental Health Source Type: research

Near-Fatal Outcome From Absence of Information About Exercise-Associated Hyponatremia in a Wilderness Medicine Field Guidebook
Publication date: Available online 6 March 2015 Source:Wilderness & Environmental Medicine Author(s): Martin D. Hoffman , Thomas M. Myers (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 7, 2015 Category: Environmental Health Source Type: research

Blisters: The Enemy of The Feet
Publication date: Available online 4 March 2015 Source:Wilderness & Environmental Medicine Author(s): Grant S. Lipman , Bernd V. Scheer (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 6, 2015 Category: Environmental Health Source Type: research

Complex Alpine Extrication: Case Report of Mountain and Speleological Rescue Cooperation
This report describes a unique case of recovery in an austere environment that involved explosives. In June 2012, a 52-year-old man ascended a cliff tower in the Eastern Alps, Italy. A landslide occurred, and a boulder crushed the climber against a large stone located farther down the cliff, causing compression of the lower limbs and the pelvis with consequent severe musculoskeletal trauma. The National Alpine and Cave Rescue Unit (NACRU) arrived and proceeded with stabilization of the injured climber, which took 6 hours and involved a difficult extrication supported by the Cave Rescue division of NACRU. Unfortunately, dur...
Source: Wilderness and Environmental Medicine - March 6, 2015 Category: Environmental Health Source Type: research

Smoking Increases the Risk of Acute Mountain Sickness
Conclusions In workers newly hired to work at high altitude, smoking increases the likelihood of AMS, but this effect appears to be operative only among those with less physically demanding work duties. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 6, 2015 Category: Environmental Health Source Type: research

Genome-wide analyses of Tibetan Athletes
Publication date: March 2015 Source:Wilderness & Environmental Medicine, Volume 26, Issue 1 Author(s): Basangzhuoma , Xiujuan Shao , Changqing Zeng (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 21, 2015 Category: Environmental Health Source Type: research

Polyerythrocythemia and Adaptation to High Altitude
Publication date: March 2015 Source:Wilderness & Environmental Medicine, Volume 26, Issue 1 Author(s): Gustavo Zubieta-Castillo Sr , Gustavo Zubieta-Calleja Jr (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 21, 2015 Category: Environmental Health Source Type: research

Hypoxia and Cancer
Publication date: March 2015 Source:Wilderness & Environmental Medicine, Volume 26, Issue 1 Author(s): Govind Babu (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 21, 2015 Category: Environmental Health Source Type: research

Cardiorespiratory Coupling in Health and Disease: From Bench and Wilderness to the Bedside
Publication date: March 2015 Source:Wilderness & Environmental Medicine, Volume 26, Issue 1 Author(s): Jan Marino-Ramirez (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 21, 2015 Category: Environmental Health Source Type: research

How the Central Nervous System Copes With Hypoxic Challenges
Publication date: March 2015 Source:Wilderness & Environmental Medicine, Volume 26, Issue 1 Author(s): Jan Marino-Ramirez (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 21, 2015 Category: Environmental Health Source Type: research

Surviving Birth at Any Altitude
Publication date: March 2015 Source:Wilderness & Environmental Medicine, Volume 26, Issue 1 Author(s): Alexandra Heath (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 21, 2015 Category: Environmental Health Source Type: research

Use of Intermittent Hypoxia Training (IHT) in Cardiology: Principles and Practices
Publication date: March 2015 Source:Wilderness & Environmental Medicine, Volume 26, Issue 1 Author(s): Tatiana Serebrovska , Valery B. Shatilo (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 21, 2015 Category: Environmental Health Source Type: research

Endogenous Antioxidants and Three Paradoxes of Hypoxic Preconditioning
Publication date: March 2015 Source:Wilderness & Environmental Medicine, Volume 26, Issue 1 Author(s): Sergei A. Stroev , Mikhail O. Samoilov , Ekaterina I. Tyulkova , Tatiana S. Glushchenko (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 21, 2015 Category: Environmental Health Source Type: research

Measurable and Quantifiable Uncertainties at High Altitude Condition
Publication date: March 2015 Source:Wilderness & Environmental Medicine, Volume 26, Issue 1 Author(s): Thuppil Venkatesh (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 21, 2015 Category: Environmental Health Source Type: research

Tolerance to Hypoxia: A High Altitude Paradox
Publication date: March 2015 Source:Wilderness & Environmental Medicine, Volume 26, Issue 1 Author(s): Gustavo Zubieta-Calleja Jr , Gustavo Zubieta-Castillo Sr (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 21, 2015 Category: Environmental Health Source Type: research

Kenneth V.IsersonMDThe Global Healthcare Volunteer’s Handbook: What You Need to Know Before You Go2014Galen PressTucson, AZUS $28.95, 340 pages, paperback
Publication date: March 2015 Source:Wilderness & Environmental Medicine, Volume 26, Issue 1 Author(s): Aaron D. Campbell (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 21, 2015 Category: Environmental Health Source Type: research

Concussions: A Succinct Clinical Picture
Publication date: March 2015 Source:Wilderness & Environmental Medicine, Volume 26, Issue 1 Author(s): Kenneth V. Iseerson (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 21, 2015 Category: Environmental Health Source Type: research

Flying for CME—A Big Carbon Footprint
Publication date: March 2015 Source:Wilderness & Environmental Medicine, Volume 26, Issue 1 Author(s): Nathan M. Hemmer (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 21, 2015 Category: Environmental Health Source Type: research

The Economic Impact of a Medical Adventure Race
Publication date: March 2015 Source:Wilderness & Environmental Medicine, Volume 26, Issue 1 Author(s): David Ledrick , Michael Omori , Michael Caudell (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 21, 2015 Category: Environmental Health Source Type: research

Krait Envenomation Disguised as Heat Exhaustion in a Wilderness Setting
Publication date: March 2015 Source:Wilderness & Environmental Medicine, Volume 26, Issue 1 Author(s): Rajesh Deshwal , Vaibhav Gupta (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 21, 2015 Category: Environmental Health Source Type: research