Is the Water Rescue Service in Poland Heading in the Right Direction? Preparing Lifeguards to the Standards of First Aid in Europe
Publication date: June 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 2Author(s): Iwona Tabaczek-Bejster, Jerzy Kiszka, Dorota Ozga (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Enviromedics: The Impact of Climate Change on Human Health, Jay Lemery, Paul Auerbach. Rowman & Littlefield Lanham (2017), USD $28 (hardcover), 214 pages
Publication date: June 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 2Author(s): Timothy B. Erickson (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

ERRATUM in Wilderness Environ Med. 29/1
Publication date: June 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 2Author(s): (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Erratum in Wilderness Environ Med. 29/1
Publication date: June 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 2Author(s): (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Ethics Authorization for Research Reporting
Publication date: June 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 2Author(s): Neal W. Pollock (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Effect of Helmet Use on Traumatic Brain Injuries and Other Head Injuries in Alpine Sport
ConclusionsThis study confirms the effectiveness of helmets in protecting users from head injuries but questions their effects on TBI, especially concussion. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Mount Meru
Publication date: June 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 2Author(s): (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Predictive Factors for Death After Snake Envenomation in Myanmar
ConclusionsPatients who present with these independent predictive factors should be recognized and provided with early appropriate intervention to reduce the mortality rate among adults with snake envenomation in Myanmar. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Snakebites Treated in North Carolina Emergency Departments, October 2013–September 2015
ConclusionsThe current study indicated that snakebites are common injuries treated at NC EDs, with a strong seasonal and geographic component. Additional research is needed to further characterize the circumstances associated with snakebites for the development of preventive measures and public health education. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Comparison of Sports Drink Versus Oral Rehydration Solution During Exercise in the Heat
ConclusionsThese data indicate no difference in fluid retention between ORS or SDS when supplemented during exercise in the heat. This implies that fluid volume, and not drink contents, may be more important when ingested during exercise in a hot environment. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Hospital-Treated Snow Sport Injury in Victoria, Australia: A Summary of 2003–2012
Publication date: June 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 2Author(s): Emma J. Siesmaa, Angela J. Clapperton, Dara TwomeyIntroductionTo determine the incidence rate and changes over time for ice and snow sports injury in Victoria, Australia, from 2003 to 2012 and describe the most common types and causes of these injuries.MethodsRetrospective data from the Victorian Injury Surveillance Unit describing hospital admissions and emergency department presentations were extracted for the 10-year period of 2003 to 2012 for all ice- and snow-related injury. Descriptive injury data and participatio...
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

The Epidemiology and Medical Morbidity of Long-Distance Backpackers on the John Muir Trail in the Sierra Nevada
Publication date: June 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 2Author(s): Susanne J. Spano, Arla G. Hile, Ratnali Jain, Philip R. StalcupIntroductionThe baseline characteristics and medical morbidity of hikers on the 354 km (220 mi) John Muir Trail (JMT) have not been previously reported.MethodsUsing online and on-site recruitment, hikers completing the JMT in 2014 were directed to an online 83-question survey. Pearson correlations, regression models, and descriptive statistics were applied to data, reported as mean±SD (range). Statistical significance was set at P
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Medical Services at an International Summer Camp Event Under Hot and Humid Conditions: Experiences From the 23rd World Scout Jamboree, Japan
ConclusionsOur findings suggest the importance of taking effective countermeasures against heat strain, fatigue, and unsanitary conditions at the WSJ. Medical services staff should take attendees’ age, sex, and period into consideration to prevent heat strain–related diseases during such camps under hot and humid conditions. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Camel Bites: A Case Study with a Summary of Current Epidemiology, Injury Patterns, and Treatment Modalities
Publication date: Available online 5 June 2018Source: Wilderness & Environmental MedicineAuthor(s): Vincent J. Calleo, Patrick O. Curtin, Amy S. BiondichAnimal bites are a major source of morbidity and mortality worldwide. In the United States, the majority of animal bites come from domestic pets, including dogs, cats, and rodents. Camel bites, on the other hand, are exceedingly rare in the United States and are poorly described in the western medical literature. Special considerations must be made when camel bite injuries occur, as they may be therapeutically challenging. Although some clinical features of camel bites...
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

A Light in the Dark: The Discovery of Another Fluorescent Frog in the Costa Rican Rainforests
Publication date: Available online 5 June 2018Source: Wilderness & Environmental MedicineAuthor(s): Pablo Deschepper, Bert Jonckheere, Jasper Matthys (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Death on the Dome: Epidemiology of Recreational Deaths on Half Dome in Yosemite National Park
ConclusionsWe identified 31 Half Dome deaths over 85 y. A minority were attributable to unfavorable weather or unskilled hiking participants. Climber registration could provide dependable denominators for accident incidence statistics. A renewed focus on suicide prevention is warranted. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Case Report: Severe Frostbite in Extreme Altitude Climbers—The Kathmandu Iloprost Experience
Publication date: Available online 8 June 2018Source: Wilderness & Environmental MedicineAuthor(s): Prativa Pandey, Ravi Vadlamudi, Rashila Pradhan, Kishore R. Pandey, Alex Kumar, Peter HackettSevere frostbite occurs frequently at extreme altitude in the Himalayas, often resulting in amputations. Recent advances in treatment of frostbite injuries with either intravenous or intra-arterial tissue plasminogen activator, or with iloprost, have improved outcomes in frostbite injuries, but only if the patient has access to these within 24 to 48 h postinjury, and ideally even sooner. Frostbitten Himalayan climbers are seldom ...
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Wilderness Mass Casualty Incident (MCI): Rescue Chain After Avalanche at Everest Base Camp (EBC) In 2015
We describe the process by which an ad hoc rescue chain evacuated the casualties. We discuss challenges, both medical and nonmedical, what went well, and lessons learned. We make recommendations for disaster planning in the Khumbu (Everest) region, an isolated high altitude roadless area of Nepal. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Right Lower Quadrant Pain After Animal Attack
Publication date: Available online 9 June 2018Source: Wilderness & Environmental MedicineAuthor(s): Michael N. Ofori, Cindy Carol Bitter (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Frostbite—A Case Series From Arctic Greenland
We present 6 cases of frostbite injuries in Greenland, ranging from mild to severe frostbite in both locals and foreign visitors. The cases illustrate some of the known risk factors for frostbite injuries. The etiology, pathophysiology, clinical presentation, and recommended management of frostbite are summarized. Novel treatments for frostbite and frostbite sequelae are discussed in the context of the Greenlandic healthcare system. Furthermore, cultural aspects and reasons for a seemingly low incidence of frostbite injuries in Greenland are explored. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Static Rope Evacuation by Helicopter Emergency Medical Services in Rescue Operations in Southeast Norway
ConclusionsStatic rope operations are rarely performed. The quality indicators suggest that the service is safe, available, and equitable. Its main benefit seems to be evacuation and the maintenance of readiness before rapid transport of the physician to the scene or the patient to the hospital. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Metabolic Demand of Hiking in Wildland Firefighting
The objective of this study was to document characteristics of hiking during wildland firefighter (WLFF) training and wildfire suppression. For the first time, the overall physical demands during wildland firefighting were evaluated in the field using global positioning systems coupled with wireless physiological monitoring and load carriage prediction models.MethodsMale (n=116) and female (n=15) interagency hotshot crew and type II WLFFs on wildfires volunteered for this direct observation study. Participants’ heart rate, internal temperature, speed, and elevation gain were monitored throughout training and during w...
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Nail the Diagnosis
Publication date: Available online 27 June 2018Source: Wilderness & Environmental MedicineAuthor(s): Sudeep Adhikari, Keshav Raj Sigdel, Buddhi Paudyal, Buddha Basnyat (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Environmental and Ecological Effects of Climate Change on Venomous Marine and Amphibious Species in the Wilderness
ConclusionReview of the literature investigating the effect and forecasts of climate change on venomous marine and amphibious creatures has demonstrated that temperature extremes and changes to climatic norms will likely have a dramatic effect on these toxicological organisms. The effects of climate change on these species through temperature alteration and rising coastal waters will influence each species differently and in turn potentially affect commercial industries, travel, tourism, and human health. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Causes of Death Among Avalanche Fatalities in Colorado: A 21-Year Review
ConclusionsAsphyxia was the primary cause of death in avalanche fatalities in Colorado during our study period. The incidence of fatal trauma was 29% and did not correlate with user group demographics or avalanche characteristics. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Self-Reported Use and Attitudes Toward Performance-Enhancing Drugs in Ultramarathon Running
ConclusionPEDs are being used in ultramarathon running. The exact extent of the use of PEDs in ultramarathon running is still unknown and challenging to fully investigate without formal, random testing, which is expensive and technically challenging. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

An Experience of Improvised Laryngoscopy
Publication date: Available online 30 June 2018Source: Wilderness & Environmental MedicineAuthor(s): Alison MatthewsAirway management in the wilderness runs the gamut from basic airway support to endotracheal intubation. Fortunately, direct laryngoscopy is a seldom called upon skill in expedition medicine. However, the medical skills required during a mission or expedition are never truly known in advance. Improvisation during evolving medical events is a mainstay of expedition medicine education and practice. It is unlikely, given constraints of weight and size of expedition medical kits, that a conventional laryngosc...
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Recurrent Ventricular Arrhythmia Caused by Ingestion of Aconitum (Monkshood) Flowers
We report the case of a patient who presented with respiratory failure, recurrent ventricular fibrillation, ventricular arrhythmias, and hypotension after an intentional ingestion of aconite flowers. Significant ingestion of this plant can produce life-threatening cardio- and neurotoxicity that may require evacuation from the wilderness to a medical facility capable of advanced treatment and intensive care monitoring. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 11, 2018 Category: Environmental Health Source Type: research

Cover photo: Wild lupines
Publication date: Available online 10 March 2010Source: Wilderness & Environmental MedicineAuthor(s): Alastair Hodges (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

Relations Between Self-Reported and Linguistic Monitoring Assessments of Affective Experience in an Extreme Environment
ConclusionsFuture research should build on this initial study to further test the links between self-reported affect and emotional states monitored via linguistics. This could help develop methods for monitoring psychological health in extreme environments and support organizational decision making. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

Psychological Attributes of Ultramarathoners
ConclusionsAlthough only a screening, the number of positive screens on the Exercise Addiction Inventory suggests use of screening measures with an ultramarathon running population. Athletes with positive screening tests should be fully evaluated for depression and exercise addiction because this would enable appropriate athlete support and treatment referral. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

Prehospital Emergencies in Illegal Gold Mining Sites in French Guiana
We report the characteristics of, and the medical responses to, medical emergencies in illegal gold mining sites.MethodsWe performed a retrospective study of all medical emergencies reported from illegal gold mining sites to the centralized call office of SAMU 973 from 1998 through 2000 and from 2008 through 2010. According to the national health care system, any medical emergency within the territory is handled by the prehospital emergency medical service (SAMU 973), irrespective of the patients’ legal status. Data were extracted from the SAMU 973 notebook registry (1998–2000) or the SAMU 973 computerized data...
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

Core Content for Wilderness Medicine Training: Development of a Wilderness Medicine Track Within an Emergency Medicine Residency
The objective of this study is to create a longitudinal wilderness medicine curriculum that can be incorporated into an EM residency program. Interest-specific tracks are becoming increasingly common in EM training. We chose this model to develop our curriculum specific to wilderness medicine. Outlined in the article is a 3-year longitudinal course of study that includes a core didactic curriculum and a plan for graduated level of responsibility. The core content is specifically related to the required EM core content for residency training with additions specific to wilderness medicine for the residents who pursue the tra...
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

A Case of Autosplenectomy in Sickle Cell Trait Following an Exposure to High Altitude
Publication date: March 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 1Author(s): Uday Yanamandra, Reena Das, Pankaj Malhotra, Subhash VarmaA 24-year-old man presented with acute abdominal pain upon ascent to moderate altitude (3500 m). An immediate evaluation revealed a splenic infarct, and he was evacuated to sea level. Upon recovery, he was sent back to 3500 m without detailed etiological evaluation, whereupon he experienced recurrent episodes of left-side subcostal pain. Imaging suggested autosplenectomy, and workup revealed a negative thrombophilia profile but was positive for sickle cell trait...
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

Pott’s Disease Resulting in Complete Cervical Vertebral Destruction
We present a case report of a military veteran presenting with neck pain and initially diagnosed with cervical disc disease. The patient’s pain progressed to the point of developing paresthesias in his bilateral upper extremities. Eventually, cervical spine radiographs were obtained that revealed complete cervical vertebral body destruction from spinal tuberculosis. Epidemiology, diagnosis, and treatment of the disorder are discussed. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

Microangiopathic Hemolytic Anemia Following Three Different Species of Hump-Nosed Pit Viper (Genus: Hypnale) Envenoming in Sri Lanka
We report a series of 3 patients who developed MAHA after being bitten by each species of hump-nosed pit viper. The first patient was bitten by H hypnale and developed a severe form of MAHA associated with acute kidney injury and thrombocytopenia falling into the category of thrombotic microangiopathy. The other 2 developed MAHA that resolved without any complications. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

An Effective Treatment in the Austere Environment? A Critical Appraisal into the Use of Intra-Articular Local Anesthetic to Facilitate Reduction in Acute Shoulder Dislocation
The objective of this systematic review of the literature was to determine if intra-articular local anesthetic (IAL) is an effective treatment that could have prehospital application. A methodical search of MEDLINE, PubMed, and EMBASE databases targeted publications from January 1, 1990 until January 1, 2017. Eligible articles compared IAL with other analgesic techniques in patients 16 years or older experiencing acute glenohumeral dislocation. Reduction success, complications, and patient-reported outcome measures underwent comparison. All identified publications originated from the hospital setting. Procedural success ra...
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

Amatoxin-Containing Mushroom Poisonings: Species, Toxidromes, Treatments, and Outcomes
Publication date: March 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 1Author(s): James H. DiazAmatoxins are produced primarily by 3 species of mushrooms: Amanita, Lepiota, and Galerina. Because amatoxin poisonings are increasing, the objective of this review was to identify all amatoxin-containing mushroom species, present a toxidromic approach to earlier diagnoses, and compare the efficacies and outcomes of therapies. To meet these objectives, Internet search engines were queried with keywords to select peer-reviewed scientific articles on amatoxin-containing mushroom poisoning and management. Des...
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

A Puff of Spores
Publication date: March 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 1Author(s): James H. Diaz (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

Common Bite—Bizarre Rash
Publication date: March 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 1Author(s): Simant Singh Thapa, Buddha Basnyat (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

Elevation 3 mm: A Case of a Cardiac Emergency and Rescue on Mount Monadnock
Publication date: March 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 1Author(s): Benjamin J. Church, Nicholas J. Daniel (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

Wilderness First Responder: Are Skills Soon Forgotten?
Publication date: March 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 1Author(s): Alexandra L. Rhue, Beth VanDerveerWilderness first responders are trained to provide competent medical care in wilderness settings or until evacuation for more advanced treatment can be obtained. In light of the isolated environments in which they are called upon to respond to illnesses and injuries, their ability to effectively apply their training is crucial. Despite the responsibility assigned to them, there is an absence of research assessing the skill and knowledge retention of wilderness first responders, creatin...
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

Human–Snake Encounters and Folk Remedies in Nepal
Publication date: March 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 1Author(s): Alok Atreya, Tanuj Kanchan (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

Acetazolamide Use in Ultrarunners at Altitude: Issues with Doping
Publication date: March 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 1Author(s): Suvash Dawadi (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

Mismanagement of Severe Altitude Illness in a Tertiary Hospital in Nepal: A Cautionary Tale
Publication date: March 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 1Author(s): Santosh Baniya, Buddha Basnyat (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

Jellyfish Blooms Causing Mass Envenomations in Aquatic Marathonists: Report of Cases in S and SE Brazil (SW Atlantic Ocean)
Publication date: March 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 1Author(s): Vidal Haddad, André C. Morandini, Lucia E. Rodrigues (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

An Iconic Pit Viper of the Central American Rainforests
Publication date: March 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 1Author(s): Pablo Deschepper, Raf Aerts (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

Journal Shopping and Pruning the Literature
Publication date: March 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 1Author(s): Neal W. Pollock (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

2017 Wilderness & Environmental Medicine Peer Reviewers
Publication date: March 2018Source: Wilderness & Environmental Medicine, Volume 29, Issue 1Author(s): Alicia Byrne (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research

Helicopter Mountain Rescue in Slovenia from 2011 to 2015
ConclusionsA significant number of mountain rescue operations were conducted in Slovenia from 2011 through 2015. Most of these were needed for injured, ill, or deceased persons. A notable number of rescues in 2015 required a helicopter. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 6, 2018 Category: Environmental Health Source Type: research