Wilderness & environmental medicine
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Wilderness Environ Med · Jun 2012
Comparative StudyPrehospital medical care and the National Ski Patrol: how does outdoor emergency care compare to traditional EMS training?
The purpose of this study was to identify the differences between the educational curricula, skill sets, and funds of knowledge required for certification as an Outdoor Emergency Care Technician (OEC-T), Emergency Medical Technician (EMT), and Emergency Medical Responder (EMR). ⋯ The OEC-T curriculum includes a skill set and fund of knowledge that exceeds those of the EMR program, but does not include all the knowledge needed for an EMT program. The OEC-T program prepares out-of-hospital providers to care for patients in the wilderness, with special emphasis on snowsports pathology. The EMT program places a greater emphasis on medical disease and emergency medication administration. These differences should be considered when determining staffing requirements for agencies caring for patients with snowsports pathology.
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Wilderness Environ Med · Jun 2012
Effects of cardiopulmonary resuscitation at high altitudes on the physical condition of untrained and unacclimatized rescuers.
The authors experienced a case of prolonged cardiopulmonary resuscitation (CPR) on Mount Fuji (3776 m) that demanded strenuous work by the rescuers. The objective of this study was to provide information regarding the physiologic effects on the rescuers of performing CPR at moderate altitude. ⋯ Prolonged CPR at high altitude exerts a significant physical effect upon the condition of rescuers. A role for mechanical devices should be considered wherever possible.
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Wilderness Environ Med · Jun 2012
Black widow spider envenomation, a rare cause of Horner's syndrome.
Horner's syndrome involves a triad of eyelid ptosis, miosis, and facial anhidrosis that results from disruption of the oculosympathetic pathway. Acquired Horner's syndrome is associated with a variety of medical conditions including Pancoast tumor and carotid dissection. ⋯ We hypothesize that late sequelae of black widow spider envenomation secondary to autonomic nerve injury or retrograde axonal transport after mechanical inoculation may have led to an acquired defect in the oculosympathetic pathway resulting in a Horner's syndrome. This case introduces a rare cause of Horner's syndrome and highlights the importance of environmental exposures in the evaluation of these patients.