Crotalus oreganus concolor: Envenomation Case with Venom Analysis and a Diagnostic Conundrum of Myoneurologic Symptoms
Publication date: Available online 12 March 2020Source: Wilderness & Environmental MedicineAuthor(s): Daniel E. Keyler, Vinay Saini, Mark O’Shea, Jeff Gee, Cara F. Smith, Stephen P. Mackessy (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 13, 2020 Category: Environmental Health Source Type: research

Canadian Armed Forces Brigade Medical Station
Publication date: Available online 12 March 2020Source: Wilderness & Environmental MedicineAuthor(s): David Jerome (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 13, 2020 Category: Environmental Health Source Type: research

The Disease Ecology, Epidemiology, Clinical Manifestations, and Management of Trichinellosis Linked to Consumption of Wild Animal Meat
Publication date: Available online 10 March 2020Source: Wilderness & Environmental MedicineAuthor(s): James H. Diaz, Rebecca J. Warren, Marissa J. Oster (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 11, 2020 Category: Environmental Health Source Type: research

In Response to Cardiac Events in Mountain Rescues in Aragón by Martínez-Caballero et al
Publication date: March 2020Source: Wilderness & Environmental Medicine, Volume 31, Issue 1Author(s): Iñigo Soteras, Peter Paal, Marc Ayala, Francesc Carmona, Enric Subirats, Giacomo Strapazzon (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - March 10, 2020 Category: Environmental Health Source Type: research

2019 Wilderness & Environmental Medicine Peer Reviewers
Publication date: Available online 12 February 2020Source: Wilderness & Environmental MedicineAuthor(s): (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 14, 2020 Category: Environmental Health Source Type: research

Flush Drowning as a Cause of Whitewater Deaths
ConclusionsFlush drownings appear to occur more frequently in older persons. Although hypothetical, the relative increase in flush drowning in the Rocky Mountains might partly be the result of colder water temperatures. If the cause of flush drowning is better understood, safety in whitewater recreation may be improved. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 13, 2020 Category: Environmental Health Source Type: research

Prospective Double-Blinded Randomized Field-Based Clinical Trial of Metoclopramide and Ibuprofen for the Treatment of High Altitude Headache and Acute Mountain Sickness
ConclusionsMetoclopramide and ibuprofen may be effective alternative treatment options in HAH and AMS, especially for those patients who additionally report nausea. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 13, 2020 Category: Environmental Health Source Type: research

Cardiovascular Disease and Triathlon-Related Deaths in the United Kingdom
ConclusionsCardiovascular disease was found to be the most common cause of TRD. Further research is needed to determine the underlying cardiac pathology that triggers TRDs. With this information it may be possible to develop screening tools that can prevent similar fatalities from occurring in the future. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 11, 2020 Category: Environmental Health Source Type: research

Managing Bias in Research
Publication date: Available online 7 February 2020Source: Wilderness & Environmental MedicineAuthor(s): Neal W. Pollock (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 8, 2020 Category: Environmental Health Source Type: research

Implementing Wilderness Medicine Training for Undergraduate Medical Students in the UK
Publication date: Available online 7 February 2020Source: Wilderness & Environmental MedicineAuthor(s): Jonathan Schulz, Jake Warrington, Conal Maguire, Thomas Georgi, Russell HearnThe UK General Medical Councils’ approved curricula share only 3 topics with the Fellowship in the Academy of Wilderness Medicine core curriculum, suggesting an underrepresentation of wilderness medicine (WM) in medical education. We developed a 5-mo course to address the gaps between these curricula to run in parallel with the conventional curriculum. Our 71-h course is composed of lectures and practical exercises. We set out to evalu...
Source: Wilderness and Environmental Medicine - February 8, 2020 Category: Environmental Health Source Type: research

Critical Separation Versus Effective Sweep Width: Bridging the Old and New Search-and-Rescue Worlds
ConclusionsCritical separation is a simple, quick way to array searchers in the field. The current study suggests that the value of critical separation in producing the 50% target POD will depend on the whether the search object used for the critical separation determination has a similar detectability/W to the actual target of the search effort. Still, the results from a critical separation determination may offer more predictability and reliability than the common practice of POD estimation by team leaders. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 8, 2020 Category: Environmental Health Source Type: research

Reduction of Arterial Oxygen Saturation Among Rescuers During Cardiopulmonary Resuscitation in a Hypobaric Hypoxic Environment
Publication date: Available online 7 February 2020Source: Wilderness & Environmental MedicineAuthor(s): Takashi Suto, Shigeru Saito, Masaru Tobe, Masafumi Kanamoto, Yusuke MatsuiWe experienced a case involving prolonged cardiopulmonary resuscitation (CPR) during cardiac arrest on Mt. Fuji (3776 m), demanding lengthy exertion by the rescuers performing CPR. Considering the effects of exertion on the rescuers, we examined their percutaneous arterial oxygen saturation during simulated CPR and compared the effects of compression-only and conventional CPR at 3700 m above sea level. The effects of CPR on the physical conditi...
Source: Wilderness and Environmental Medicine - February 8, 2020 Category: Environmental Health Source Type: research

Medicine in Extreme Environments: A New Medical Student Elective Class for Wilderness, Aerospace, Hyperbaric, Exercise, and Combat Medicine
Publication date: Available online 7 February 2020Source: Wilderness & Environmental MedicineAuthor(s): Gautam Babu, Bradley D. Upchurch, William H. Young, Benjamin D. LevineWe developed an elective course titled Medicine in Extreme Environments (MEE) at the University of Texas Southwestern Medical Center for first- and second-year medical students. This course covered physiology, research, clinical practice, and career guidance regarding the fields of wilderness, space, hyperbaric, combat, and exercise medicine. The primary aim was to generate interest in and awareness of these seldom covered fields of medicine by exp...
Source: Wilderness and Environmental Medicine - February 8, 2020 Category: Environmental Health Source Type: research

Pain Is Inevitable But Suffering Is Optional: Relationship of Pain Coping Strategies to Performance in Multistage Ultramarathon Runners
Publication date: Available online 7 February 2020Source: Wilderness & Environmental MedicineAuthor(s): Kevin N. Alschuler, Brian J. Krabak, Anna L. Kratz, Mark P. Jensen, Dave Pomeranz, Patrick Burns, Joshua Bautz, Claire Nordeen, Crystal Irwin, Grant S. LipmanIntroductionUltramarathon runners commonly endure musculoskeletal pain during endurance events. However, the effect of pain coping skills on performance has not been examined.MethodsA prospective observational study during three 250 km (155 mi), 6 stage ultramarathons was conducted. Finish line surveys were completed after each of the four 40 km (25 mi) and one ...
Source: Wilderness and Environmental Medicine - February 8, 2020 Category: Environmental Health Source Type: research

Wilderness Medical Society Clinical Practice Guidelines for the Management of Exercise-Associated Hyponatremia: 2019 Update
Publication date: Available online 8 February 2020Source: Wilderness & Environmental MedicineAuthor(s): Brad L. Bennett, Tamara Hew-Butler, Mitchell H. Rosner, Thomas Myers, Grant S. Lipman (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 8, 2020 Category: Environmental Health Source Type: research

Exercise in Thermal Inversions: PM2.5 Air Pollution Effects on Pulmonary Function and Aerobic Performance
ConclusionsNeither run time nor pulmonary function of healthy adults were adversely affected by an acute bout of exercise in elevated ambient PM2.5, equivalent to yellow or orange on the air quality index. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - February 7, 2020 Category: Environmental Health Source Type: research

Periorbital Edema Mimicking an Allergic Reaction After Black Widow Envenomation
Publication date: Available online 31 January 2020Source: Wilderness & Environmental MedicineAuthor(s): Meghan B. Spyres, Ayrn D. O’Connor (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - January 31, 2020 Category: Environmental Health Source Type: research

Tolio: Foot Rot in Grand Canyon River Runners
In this report we describe common skin conditions affecting the feet of river runners on the Colorado River in Grand Canyon National Park. These conditions are frequently referred to by river runners with a catchall term, “tolio.” Several skin disorders have been identified as components of tolio, with the most prevalent currently being pitted keratolysis. We present a case of pitted keratolysis in a river guide occurring during a multiday river trip, where treatment can be difficult. Prevention is often more important. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - January 31, 2020 Category: Environmental Health Source Type: research

Powassan Virus in a Hunter Returning from a Trip in the Adirondack Park
We present the case of a 56-y-old man who presented to our hospital with symptoms of confusion, altered behavior, and headache. The patient developed fever and status epilepticus despite supportive care and required endotracheal intubation. Six days before presentation, the patient had returned from a hunting trip in the Adirondack region of New York State. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - January 30, 2020 Category: Environmental Health Source Type: research

In Reply to Drs Lawson and Newman
Publication date: Available online 27 January 2020Source: Wilderness & Environmental MedicineAuthor(s): Susanne J. Spano, John A. Seymer, Desiree H. Crane, Paul S. Auerbach (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - January 29, 2020 Category: Environmental Health Source Type: research

Bruce C. Paton, MD: August 28, 1925 to November 4, 2019
Publication date: Available online 27 January 2020Source: Wilderness & Environmental MedicineAuthor(s): Howard Backer (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - January 29, 2020 Category: Environmental Health Source Type: research

In Response to Impact of Half Dome Cable Permitting by Spano et al
Publication date: Available online 23 January 2020Source: Wilderness & Environmental MedicineAuthor(s): Steven R. Lawson, Peter Newman (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - January 24, 2020 Category: Environmental Health Source Type: research

Penetrating Thoracic Injury and Fatal Aortic Transection From the Barb of a Stingray
We present a case of a 62-y-old diver who was pierced in the chest by the barb of a stingray while transferring the animal to another tank as part of his work in a public aquarium. He was rescued immediately from the tank but was found to be in cardiac arrest. Bystander cardiopulmonary resuscitation was promptly initiated by his colleagues. He was rapidly evacuated to the nearest emergency department, where he was noted to be in pulseless electrical activity. A single puncture wound was noted over the right second intercostal space, with the spine of the stingray still impaled in the chest. Trauma surgeons were activated p...
Source: Wilderness and Environmental Medicine - January 24, 2020 Category: Environmental Health Source Type: research

In Response to Cardiac Events in Mountain Rescues in Aragón by Martínez-Caballero et al
Publication date: Available online 22 January 2020Source: Wilderness & Environmental MedicineAuthor(s): Iñigo Soteras, Peter Paal, Marc Ayala, Francesc Carmona, Enric Subirats, Giacomo Strapazzon (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - January 23, 2020 Category: Environmental Health Source Type: research

In Reply to Dr Soteras et al
Publication date: Available online 22 January 2020Source: Wilderness & Environmental MedicineAuthor(s): Carmen M. Martínez-Caballero, Eva Sierra Quintana (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - January 23, 2020 Category: Environmental Health Source Type: research

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 ...
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 injur...
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...
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 7, 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 th...
Source: Wilderness and Environmental Medicine - December 7, 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 p...
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 presen...
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

Family Medicine Patient and Physician Attitudes Toward Climate Change and Health in Wisconsin
ConclusionsPatients and physicians are concerned about climate change and its health implications. Patient data reveals that physicians are highly trusted but underutilized sources. However, physicians are unsure of their role in addressing this topic. Thus, a large opportunity exists for family physicians to educate patients on the emerging issue of climate change and health. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - November 6, 2019 Category: Environmental Health Source Type: research

Age and Sex Are Strongly Correlated to the Rate and Type of Mountain Injuries Requiring Search and Rescue Missions
Publication date: Available online 5 November 2019Source: Wilderness & Environmental MedicineAuthor(s): Jaroslaw Amarowicz, Anna Kumorek, Kamila BoczonIntroductionBecause of the growing popularity of mountain tourism, the number of injuries related to mountain activities has increased rapidly. The regional volunteer search and rescue team (Tatra mountain rescue team [MRT], Poland) anticipates future increases in injuries and accidents.MethodsAn analysis was performed on Tatra MRT incident reports for the years 2012 through 2013. These reports include information on the mechanism of injury, weather conditions, and demog...
Source: Wilderness and Environmental Medicine - November 6, 2019 Category: Environmental Health Source Type: research

Presumed Copperhead Snakebite and Antivenom Administration in the Third Trimester
Publication date: Available online 5 November 2019Source: Wilderness & Environmental MedicineAuthor(s): Jessica Yano, Matthew Zerden, Benjamin GermanSnake envenomation during pregnancy is an uncommon emergency with several potential complications associated with the poisoning and its treatment. This case discusses a 27-y-old gravida 3, para 1102 (3 total pregnancies, 1 term birth, 1 premature birth, 0 abortions, 2 living births, twins) at 36 wk gestation who was bitten by a presumed Agkistrodon contortrix (copperhead snake). She had worsening pain and swelling in the right lower limb. Crotalidae polyvalent immune Fab w...
Source: Wilderness and Environmental Medicine - November 6, 2019 Category: Environmental Health Source Type: research

Fresh Low Titer O Whole Blood Transfusion in the Austere Medical Environment
Publication date: Available online 3 November 2019Source: Wilderness & Environmental MedicineAuthor(s): Alison Matthews, Steven G. Schauer, Andrew D. FischerMassive hemorrhage is an immediate threat to life. The military developed the Tactical Combat Casualty Care guidelines to address the management of acute trauma, including administration of blood products. The guidelines have been expanded to include low titer O whole blood, which is in limited use by the military. This proposal describes how the transfusion of fresh whole blood might be applied to the remote civilian environment. In doing so, this life-saving inte...
Source: Wilderness and Environmental Medicine - November 4, 2019 Category: Environmental Health Source Type: research

Clinical Findings Associated with Ornithodoros brasiliensis Tick Parasitism in Travelers, Southern Brazil
We report a series of clinical cases associated with parasitism by the Ornithodoros brasiliensis tick in a group of travelers in the Caxias do Sul municipality, Southern Brazil. These cases draw attention to underdiagnosed noninfectious syndromes caused by ticks with restricted local distributions. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - November 2, 2019 Category: Environmental Health Source Type: research

Heightened Immune Response to Presumed Loxosceles reclusa Envenomation
Publication date: Available online 2 November 2019Source: Wilderness & Environmental MedicineAuthor(s): Kristin M. Schmid, Matthew R. Treaster, Christopher Barrios, Chenchen Zhang, Anthony J. ScalzoLoxoscelism is a systemic inflammatory reaction in response to a brown recluse spider bite (BRSB). In this case we describe a patient with a heightened inflammatory response to a presumed BRSB, with Coomb’s positive hemolysis, cytoplasmic antineutrophil cytoplasmic antibody (cANCA) vasculitis, and features of hemophagocytic lymphohistiocytosis (HLH). A 24-y-old female presented with sudden pain and swelling to her lowe...
Source: Wilderness and Environmental Medicine - November 2, 2019 Category: Environmental Health Source Type: research

Sources for Altitude Illness Information for Trekkers in the Himalayas
Publication date: Available online 28 October 2019Source: Wilderness & Environmental MedicineAuthor(s): Brian M. Strickland, Nicholas C. KanaanAbstractIntroductionEducational materials are important tools in the prevention of altitude illness among individuals traveling to high altitude destinations. Travelers obtain information about altitude illness from many different educational resources. Our objective was to determine which educational resources for altitude illness prevention were used by trekkers on the Everest Base Camp trek and Annapurna Circuit. We also sought to compare which resources were used by individu...
Source: Wilderness and Environmental Medicine - October 29, 2019 Category: Environmental Health Source Type: research

An Introduction From the Co-Chairs of the Wilderness Medical Society Clinical Practice Guidelines Committee
Publication date: Available online 28 October 2019Source: Wilderness & Environmental MedicineAuthor(s): Christopher Davis, Michael Caudell, Tracy Cushing (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - October 29, 2019 Category: Environmental Health Source Type: research

Emergency Airways After Himalayan Black Bear Attacks in Bhutan
ConclusionsThe use of highly trained HEMS critical care retrieval teams may improve outcomes in critically injured patients who require time-critical airway management in remote areas. Countries such as Bhutan with populations far from emergency and critical care might benefit from the establishment of HEMS critical care retrieval services. HEMS teams providing care while retrieving patients from austere environments should be expert in emergency airway management. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - October 29, 2019 Category: Environmental Health Source Type: research

Intestinal Evisceration in Children From the Bite of the Domestic Pig, Sus scrofa domesticus: A Report of Two Cases
We report 2 separate cases of children managed at our institution who sustained abdominal injuries after attack by domestic pigs in rural Zimbabwe. Both incidents occurred at home in remote rural areas with long prehospital transport times. Initial resuscitative interventions were performed in both cases in the prehospital setting and at poorly resourced peripheral hospitals before referral. Prophylactic antibiotics were also given in both cases. Laparotomy was performed for both patients. Reduction of eviscerated bowel, exploratory laparotomy, and peritoneal lavage were performed with closure of the abdominal wounds. No s...
Source: Wilderness and Environmental Medicine - October 29, 2019 Category: Environmental Health Source Type: research