Wilderness & environmental medicine
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Wilderness Environ Med · Jan 2009
Polygraphy of sleep at altitudes between 5300 m and 7500 m during an expedition to Mt. Everest (MedEx 2006).
Sleep at extreme altitudes is characterized by the repetitive occurrence of central apneas that in some cases may lead to a marked decrease in arterial oxygen saturation. During the Ludwig Maximilians University Expedition to Mt. Everest (MedEx 2006), nocturnal polygraphic recordings were made at different altitudes and included the first recordings ever made at 7500 m, which were completed on 8 separate occasions during the expedition. ⋯ These data correlate well compared with those obtained in hypobaric chamber studies and show that regardless of physiologic adjustment to low oxygen conditions at Base Camp altitude, during the final summit attempt oxygen saturation drops further to 55% and even less. Thus recordings of nocturnal oxygen saturation at Camp 3 (7500 m) on Everest, where the night is spent before the summit attempt, may help to show the actual efficiency of hypoxic ventilatory response and to detect the individual hypoxic tolerance to altitudes above 8000 m.
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Wilderness Environ Med · Jan 2009
Letter Case ReportsFrostbite injury related to chlorethane application.
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Wilderness Environ Med · Jan 2009
Comparative StudyComparison of a SAM splint-molded cervical collar with a Philadelphia cervical collar.
To compare the effectiveness of a SAM splint molded into a cervical collar with that of a Philadelphia cervical collar at limiting movement of the cervical spine in 5 different movements. ⋯ The results of this study suggest that the SAM splint, when molded into a cervical collar, is as effective as the Philadelphia collar at limiting movement of the cervical spine.
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To analyze the nature of surfing injuries in Cornwall in order to identify trends and inform clinical management. ⋯ Surfing injuries were most common in young adult men. Most injuries presenting to the ED were minor/moderate injuries and did not require hospital admission. The overall pattern of injuries was similar to those found in studies from other countries where surfing is popular; however, there was a higher-than-expected incidence of shoulder dislocation. The trends identified in this study could be used to inform education focused on prevention of the most common injuries. Increased use of protective headwear should be considered.
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Wilderness Environ Med · Jan 2009
Field management of displaced ankle fractures: techniques for successful reduction.
Ankle fracture/dislocations are generally low-energy injuries most commonly seen in older adults. Prompt reduction is indicated when evacuation to definitive care would be prolonged or neurovascular compromise to the foot is suspected. Reduction restores neurovascular integrity, realigns joint contact surfaces, reduces pain, and decreases soft-tissue edema. ⋯ Improvised Quigley's traction can be built in a wilderness setting using available clothing. After successful reduction, fractured ankles should be adequately stabilized and the affected extremity should be kept nonweight bearing. The hematoma block and improvised Quigley's traction are valuable skills for the wilderness medical provider and may facilitate a successful and relatively pain-free reduction of dislocated ankle fractures in a wilderness setting.