Wilderness & environmental medicine
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Wilderness Environ Med · Jan 2001
Mountaineering accidents in the European Alps: have the numbers increased in recent years?
Media reports convey the impression that the incidence of fatal accidents in the European Alps has increased. Because more specific data are lacking, we analyzed available data from the mountain rescue services in Germany, Austria, southern Tirol, Zermatt/Switzerland, and Chamonix/France from 1987 until 1997. ⋯ Even taking into account the varying definitions of "mountain accident" used in these countries, available data from the analyzed areas of the European Alps do not demonstrate a drastic increase in the number of fatalities. In the future, data concerning mountain accidents in the European Alps should be monitored according to standard definitions and stored by the International Commission for Alpine Rescue.
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Wilderness Environ Med · Jan 2001
Retrospective study of 70 cases of severe frostbite lesions: a proposed new classification scheme.
Previous frostbite classifications were mainly based on retrospective diagnosis and, most of the time, could not be used to predict the final outcome of the lesions and especially the probability of an amputation and its level. The aim of this study was to suggest a new classification at day 0 based mainly on the topography of the lesions and on early bone scan results, which are more convenient and accurate in predicting the final outcome of frostbites. ⋯ Based on these clinical results and on the results of bone scans (previously validated), a new classification of frostbite severity at day 0 is proposed. Four degrees of severity are defined: first degree, leading to recovery; second degree, leading to soft tissue amputation; third degree, leading to bone amputation, and fourth degree, leading to large amputation with systemic effects.
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Wilderness Environ Med · Jan 2001
Letter Case ReportsSeizures at high altitude in a patient on antiseizure medications.
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This article considers several issues regarding cold stress, development of hypothermia, and prehospital care of the hypothermic patient. Advice is given on the use of clinical impressions and functional characteristics to determine the level of hypothermia. ⋯ Circum-rescue collapse is the dramatic worsening condition of the patient just before, during, or after rescue from cold stress. After rescue, the treatment priorities are to arrest the fall in core temperature, establish a steady, safe rewarming rate while maintaining the stability of the cardiorespiratory system, and provide sufficient physiological support.