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BASE Jumping Injuries Presenting to Emergency Departments in the United States: an Assessment of Morbidity, Emergency Department, and Inpatient Costs
ConclusionsAlthough deemed one of the most dangerous extreme sports, many patients with BASE injuries surviving to arrival at definitive medical care do not require inpatient admission. (Source: Wilderness and Environmental Medicine)
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
ConclusionsBoth SAR and HEMS services perform SAR and remote medevac missions extensively and mission profiles vary. (Source: Wilderness and Environmental Medicine)
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
ConclusionsEstimated values of GFR and Cr by standard age-based values and MDRD equation were significantly inaccurate, which would overinflate the incidence of acute kidney injury. Future studies should devise a new model for estimation of baseline Cr that is validated in this population. (Source: Wilderness and Environmental Medicine)
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 7, 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
ConclusionsIn our study, head and torso warming had the same core rewarming rates when shivering was pharmacologically inhibited in mildly hypothermic subjects. Therefore, in nonshivering cold subjects, head warming is a viable alternative if torso warming is contraindicated (eg, when performing cardiopulmonary resuscitation or working on open chest wounds). (Source: Wilderness and Environmental Medicine)
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