Wilderness & environmental medicine
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Avalanche airbag backpacks have been shown to be effective at reducing avalanche mortality. However, they are yet to be considered standard avalanche safety equipment, which has long consisted of a transceiver, a shovel, and a probe. This is despite data showing that airbags reduce mortality by decreasing the likelihood of burial. ⋯ Moreover, the literature suggests airbags reduce mortality at a rate similar to transceivers. For those who work, volunteer, and recreate in avalanche terrain, airbags should be considered standard safety equipment. However, multiple barriers exist for universal adoption, including cost, size, weight, training burden, availability, risk tolerance, and lack of community support and recommendations from professional societies and associations.
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Wilderness Environ Med · Dec 2020
ReviewDetermination of Death in Mountain Rescue: Recommendations of the International Commission for Mountain Emergency Medicine (ICAR MedCom).
Determination of death requires specific knowledge, training, and experience in most cases. It can be particularly difficult when external conditions, such as objective hazards in mountains, prevent close physical examination of an apparently lifeless person, or when examination cannot be accomplished by an authorized person. Guidelines exist, but proper use can be difficult. ⋯ Only clear criteria such as decapitation or detruncation should be used to determine death from a distance or by laypersons who are not medically trained. To present criteria that allow for accurate determination of death in mountain rescue situations, the International Commission for Mountain Emergency Medicine convened a panel of mountain rescue doctors and a forensic pathologist. These recommendations are based on a nonsystematic review of the literature including articles on determination of death and related topics.
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Wilderness Environ Med · Dec 2019
Practice GuidelineWilderness Medical Society Clinical Practice Guidelines for Spinal Cord Protection.
The 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. ⋯ Key recommendations include the concept that interventions should be goal oriented (spinal cord/column protection in the context of overall patient and provider safety) rather than technique oriented (immobilization). This evidence-based, goal-oriented approach does not support the immobilization of suspected spinal injuries via rigid collars or backboards.
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Wilderness Environ Med · Dec 2019
Time Course of Hoist Operations by the Search and Rescue Helicopter Service in Southeast Norway.
Optimal dispatch of emergency medical services relies on accurate time estimates of the various prehospital stages. Hoist rescue work time intervals performed by the search and rescue (SAR) helicopter service in Norway have not been studied to date. We aimed to describe the epidemiologic, operational, and medical aspects of the SAR service in southeast Norway. To complement the prehospital timeline, we performed simulated hoist operations. ⋯ Hoist rescue was performed in 10% (n=148) of the SAR operations. New information about hoist extrication time intervals can improve rescue helicopter dispatch accuracy.
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Wilderness Environ Med · Dec 2019
Age and Sex Are Strongly Correlated to the Rate and Type of Mountain Injuries Requiring Search and Rescue Missions.
Because 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. ⋯ Sex and age are associated with the mechanisms and severity of injuries in the mountain environment. They should be considered in the development of appropriate prevention and response programs. Further studies are needed to confirm the results.