Wilderness & environmental medicine
-
Wilderness Environ Med · Sep 2014
Incidence and characteristics of snakebite envenomations in the New York state between 2000 and 2010.
We sought to evaluate the incidence of reported venomous snakebites in the state of New York between 2000 and 2010. ⋯ Although not rare, venomous snakebites do not occur commonly in New York State, with a mean of just 7 bites per year; fortunately most snakebites reported are from nonvenomous snakes. Yet even nonvenomous bites have the potential to cause moderately severe outcomes. Medical providers in the state should be aware of their management.
-
Wilderness Environ Med · Sep 2014
Case ReportsAtraumatic splenic rupture after coagulopathy owing to a snakebite.
Among the many complications that may follow envenomation by some species of venomous snakes, coagulopathy is common and well known. However, hemoperitoneum induced by coagulopathy after a snakebite is rare. Atraumatic spontaneous splenic rupture is also an uncommon and life-threatening condition. Here, we report a case of presumptive envenomation by Gloydius spp. that resulted in atraumatic splenic rupture as a probable manifestation of coagulopathy, which has not been previously reported.
-
Wilderness Environ Med · Sep 2014
Randomized Controlled TrialExercise limitation of acetazolamide at altitude (3459 m).
To assess the effect of acetazolamide (Az) on exercise performance during early acclimatization to altitude. ⋯ In this study group, and despite higher resting Spo2, Az may have compromised exercise at 3459 m altitude during early acclimatization, particularly in older subjects.
-
Wilderness Environ Med · Sep 2014
Practice GuidelineWilderness Medical Society practice guidelines for basic wound management in the austere environment.
In an effort to produce best-practice guidelines for wound management in the austere environment, the Wilderness Medical Society convened an expert panel charged with the development of evidence-based guidelines for the management of wounds sustained in an austere (dangerous or compromised) environment. Recommendations are made about several parameters related to wound management. These recommendations are graded based on the quality of supporting evidence and the balance between the benefits and risks or burdens for each parameter according to the methodology stipulated by the American College of Chest Physicians.