Wilderness & environmental medicine
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Wilderness Environ Med · Jan 2007
Pattern of injury after rock-climbing falls is not determined by harness type.
Experimental data indicate that when using a sit harness alone, any major fall during rock climbing may cause life-threatening thoraco-lumbar hyperextension trauma or "head down position" during suspension. To clarify the actual influence of the type of harness on the pattern and severity of injury, accidents involving a major fall in a climbing harness were analyzed retrospectively. ⋯ The type of harness does not influence the pattern or severity of injury, and the forces transferred via the harness do not cause a specific harness-induced pathology. We did not find any evidence that hyperextension trauma of the thoraco-lumbar region is an important mechanism of injury in climbers using a sit harness alone. Rock contact during the fall, and not the force transferred through the harness, is the major cause of significant injury in climbing accidents.
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Wilderness Environ Med · Jan 2007
An experimental study of warming intravenous fluid in a cold environment.
Numerous studies support the use of warmed intravenous fluids in hypothermic patients. The most effective method to accomplish this goal in a cold prehospital, wilderness, or combat setting is unknown. We evaluated various methods of warming intravenous fluids for a bolus infusion in a cold remote environment. ⋯ Heating of cold intravenous fluids in a cold environment is possible using either Meal Ready to Eat heat packs or a camping stove. Further study is needed to evaluate the ability of either method to consistently produce an appropriate fluid temperature given various ambient and initial fluid temperatures.
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Wilderness Environ Med · Jan 2007
Case ReportsSyncope, massive aspiration, and sudden death following rattlesnake bite.
Fatalities following rattlesnake bite are rare in the United States, usually occur some hours following the bite, and are generally secondary to direct venom effects. We report a patient with acute syncope and subsequent massive aspiration resulting in airway obstruction and rapid death following a probable Northern Pacific rattlesnake (Crotalus oreganus oreganus) bite.
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Wilderness Environ Med · Jan 2007
Tympanic thermometry is unsuitable as a screening tool for hypothermia after open water swimming.
Mass participation in competitive open water swimming is becoming increasingly popular. The purpose of this study was to determine whether infrared emission detection (IRED) tympanic temperature measurement taken in participants approximately 1 minute following a long-distance open water swimming event is a suitable screening tool for hypothermia. ⋯ Infrared emission detection tympanic thermometry is unsuitable as a screening tool for hypothermia following a prolonged open water swim because it substantially overestimates the incidence and severity of hypothermia in participants.