Wilderness & environmental medicine
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Wilderness Environ Med · Dec 2014
Evaluation of a simulation training program for uncomplicated fishhook removal.
The aim of this study was to evaluate the effectiveness of a fishhook removal simulation workshop using investigator-developed diagrams, practice models, and a teaching video. ⋯ This study is the first to describe a simulation training program for uncomplicated fishhook removal, and to experimentally evaluate physician learning and preferences for fishhook removal techniques. After a brief educational session, physicians could effectively use all techniques except needle cover. Simple retrograde was the overall preferred technique.
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Wilderness Environ Med · Dec 2014
Practice GuidelineWilderness Medical Society practice guidelines for the treatment of acute pain in remote environments: 2014 update.
The Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for the management of pain in austere environments. Recommendations are graded on the basis of the quality of supporting evidence as defined by criteria put forth by the American College of Chest Physicians. This is an updated version of the original WMS Practice Guidelines for the Treatment of Acute Pain in Remote Environments published in Wilderness & Environmental Medicine 2014;25(1):41-49.
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Wilderness Environ Med · Dec 2014
Practice GuidelineWilderness Medical Society practice guidelines for the out-of-hospital evaluation and treatment of accidental hypothermia: 2014 update.
To provide guidance to clinicians, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for the out-of-hospital evaluation and treatment of victims of accidental hypothermia. The guidelines present the main diagnostic and therapeutic modalities and provide recommendations for the management of hypothermic patients. ⋯ The guidelines also provide suggested general approaches to the evaluation and treatment of accidental hypothermia that incorporate specific recommendations. This is an updated version of the original Wilderness Medical Society Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia published in Wilderness & Environmental Medicine 2014;25(4):425-445.
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Wilderness Environ Med · Dec 2014
High-intensity intermittent exercise increases pulmonary interstitial edema at altitude but not at simulated altitude.
Ascent to high altitude leads to a reduction in ambient pressure and a subsequent fall in available oxygen. The resulting hypoxia can lead to elevated pulmonary artery (PA) pressure, capillary stress, and an increase in interstitial fluid. This fluid can be assessed on lung ultrasound (LUS) by the presence of B-lines. We undertook a chamber and field study to assess the impact of high-intensity exercise in hypoxia on the development of pulmonary interstitial edema in healthy lowlanders. ⋯ HIIE led to an increase in B-lines at altitude after subacute exposure but not during acute exposure at equivalent simulated altitude. This may indicate pulmonary interstitial edema.
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Wilderness Environ Med · Dec 2014
New Zealand land search and rescue operations: an analysis of medical and traumatic conditions.
The aim of this study was to describe the range and types of medical and traumatic conditions encountered in land search and rescue operations in New Zealand. ⋯ Search and rescue personnel are exposed to a broad range of medical and traumatic conditions. In New Zealand, they include preexisting cognitive impairment that results in persons lost in urban environments. Notwithstanding this, many subjects will also need to be managed in remote, resource-limited environments for extended periods. First aid training and field equipment should reflect these demands.