Wilderness & environmental medicine
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Wilderness Environ Med · Jan 2009
Skiing and snowboarding head injuries in 2 areas of the United States.
To explore the use of helmets in skiers and snowboarders injured at ski runs and terrain parks in Colorado and the northeast United States and to examine differences in head injury severity in terrain parks as compared to ski runs. ⋯ There is an increased risk of head injury, regardless of helmet use, at terrain parks as compared to ski runs, and helmets were notably protective in collisions with fixed objects. Regional differences in injury events were noted in that there were more fall-related head injuries and a higher incidence of collisions with fixed objects in the Northeast compared to Colorado.
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The prevalence of airflow obstruction in recreational self-contained underwater breathing apparatus (SCUBA) divers is unknown. Since airflow obstruction is a relative contraindication for diving, we conducted a study to determine its prevalence and magnitude in a cohort of recreational divers in Saba, Netherlands Antilles. ⋯ The prevalence of airflow obstruction was 6% to 15% by report and 12% by spirometry, approximating the combined prevalence of asthma and chronic obstructive pulmonary disease in the general population. Study limitations include possible self-selection and low enrollment rate. Prospective lung function testing can be conducted at remote sites using nonmedical personnel as "testers." This study could guide future investigations to determine if asthma is a risk factor for decompression illness.
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To identify search and rescue (SAR) trends in US National Park Service (NPS) units. ⋯ Without the presence of NPS personnel responding to SAR incidents, 1 in 5 (20%) of those requesting SAR assistance would be a fatality. Future research and the development of any prevention efforts should focus on the 5 NPS units where 50% of all SAR incidents are occurring.
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Wilderness Environ Med · Jan 2009
Comparison of commercially available disposable chemical hand and foot warmers.
Small chemical hand and foot warmers are used by many winter sport athletes and other outdoor enthusiasts. The purpose of this study was to characterize the thermal behaviors of 14 commercially available hand and foot warmers. ⋯ Although there is a paucity of research information on these types of warmers, this experiment showed that some of the devices exceeded packaging claims while others fell short; that the thermal behavior over time of the devices was variable; and that there appears to be a simple but strong relationship between the mass of the devices and the duration of their heat production.
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Mountaineers face a variety of health risks at altitude including pulmonary edema; portable ultrasound may be used to diagnose high altitude pulmonary edema. This report tests the functionality of electronic equipment in a hypobaric test environment and the ability of remotely guided nonexperts to use ultrasound to evaluate respiratory status on Mt Everest. ⋯ The tested ultrasound devices functioned nominally in cold, hypobaric conditions; acute changes in lung fluid content were noted in these conditions despite normoxia. We successfully used a satellite telemedical connection with a remote expert to guide thoracic ultrasound examinations at Advanced Base Camp on Mt Everest. Coupling portable ultrasound with remote expert guidance telemedicine provides a robust diagnostic capability in austere locations.