Wilderness & environmental medicine
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The objective of this study was to compare patterns of injury found in traditional rock climbing with those found in sport climbing. A questionnaire was administered to rock climbers by mail, in person, and via the World Wide Web. Injuries that occurred while rope-protected climbing on rock were analyzed regarding the anatomical location and the mechanism and activity at the time of injury. ⋯ Most injuries occurred while leading and involved the upper extremity, especially the fingers. Falling was the predominant mechanism of injury on traditional climbs, and stress over a joint while attempting a difficult move was the most common mechanism on sport climbs. Potential for injury prevention lies in teaching climbers to recognize the limitations of the fingers as weight-bearing structures.
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Wilderness Environ Med · Jan 1998
Partitioned weight loss and body composition changes during a mountaineering expedition: a field study.
Weight loss and changes in body composition are recognized phenomena associated with high-altitude mountaineering expeditions. Attempts to partition the weight loss between fat mass (FM) and fat-free mass (FFM) have been inconclusive. Therefore, five male subjects, average age 40.0 +/- 5.5 years, were studied prior to, during, and following a 21-day expedition between 2200 m and 4300 m on Mt. ⋯ The three methods used to partition the weight loss between FM and FFM did not agree: 77% FM vs 23% FFM by densitometry, 25% FM vs 75% FFM by skinfolds, and 38% FM vs 62% FFM by MRI. Energy intake (3640 +/- 1250 kcal/day) was negatively correlated (Pearson r > 0.88(2) tail) with losses in weight (r = -0.89), skinfolds (r = -0.93), and girths (r = -0.88), ie the greater the intake the less the decline. Therefore, insufficient energy intake appeared primarily responsible for the weight loss and changes in body composition during the expedition.
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High-altitude illness encompasses a spectrum of disorders related to the hypoxia experienced by individuals at elevation. Altitude-related illness has been well described in the United States, but there are no studies published in the medical literature looking at the occurrence of high-altitude illness within the US National Parks system. The purpose of this study is to describe the incidence, treatment, and outcomes of visitors to Sequoia and Kings Canyon National Parks who presented to emergency medical services (EMS) personnel with signs and symptoms consistent with high-altitude illness. ⋯ We conclude that altitude-related illness does occur in Sequoia and Kings Canyon National Parks and, although high-altitude illness accounts for only 4% of EMS contacts, caring for these patients uses a significant amount of national park resources. We suggest continued training of emergency medical technicians and park medics in the recognition and treatment of these disorders. We also support education of hikers to reduce or prevent the morbidity associated with altitude-related illness.
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Wilderness Environ Med · Jan 1998
Case Reports"Puss caterpillar" envenomation: a report from North Carolina.
A 41-year-old white man with no specific past medical history presented to the Emergency Department on October 13, 1997, following what he described as a "caterpillar bite." The insect was subsequently identified as a "puss caterpillar" (Megalopyge opercularis). The patient experienced immediate excruciating pain that radiated throughout his left arm and gradually spread to the left chest area. ⋯ The patient was subsequently admitted for observation and released several days later. Viewed in the context of previous clinical reports, this case highlights the broad range of clinical symptoms that can result from the puss caterpillar sting.