Wilderness & environmental medicine
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Wilderness Environ Med · Sep 2013
Acute injury risk and severity in indoor climbing-a prospective analysis of 515,337 indoor climbing wall visits in 5 years.
Rock climbing's popularity continues to rise, with people of all ages regularly participating in the sport. Climbing literature suggests climbers get injured mostly in their upper extremities. Most studies on climbing injury analysis are conducted retrospectively, with all the inherent problems of a retrospective setup (no exact time collection, biased injury perception, etc). Prospective data are still missing. ⋯ This was the first study to accurately record time spent indoor climbing digitally and evaluate the acute injuries prospectively in a large cohort. There were few injuries sustained, suggesting indoor climbing has a low risk of acute injury per 1000 hours of participation. The injuries were of minor to moderate injury severity, and no fatalities occurred. Several injuries could have been avoided, and further injury-prevention concepts should be developed.
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Wilderness Environ Med · Sep 2013
Case ReportsFirst authenticated case of Sri Lankan flying snake (Chrysopelea taprobanica) bite.
Flying snakes (Genus Chrysopelea) are a group of ophisthoglyphous colubrids in South and South East Asia known for gliding in the air. Of the five species of flying snakes, Sri Lankan flying snake, Chrysopelea taprobanica, is endemic to Sri Lanka. Authenticated bites and the venom characteristics of this uncommon snake remain unknown. We report the first authenticated case of C taprobanica bite, in which a 45-year-old woman had signs of mild local envenoming after the bite, with no evidence of systemic envenoming.
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This study assessed the utility of lifeguard rescue data for providing information on person and situation factors to inform surf bather drowning prevention research. ⋯ Although rescues are proportional to water exposure, frequencies are also influenced by situation and person factors. Bathers at relatively high risk of rescue are hypothesized to be overrepresented in amenable sea and weather conditions, and poor patient condition on rescue may be associated with exposure to a preexisting health condition.
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Wilderness Environ Med · Jun 2013
Comparative StudyMeasuring arterial oxygenation in a high altitude field environment: comparing portable pulse oximetry with blood gas analysis.
High altitude environments present unique medical treatment challenges. Medical providers often use small portable pulse oximetry devices to help guide their clinical decision making. A significant body of high altitude research is based on the use of these devices to monitor hypoxia, yet there is a paucity of evidence that these devices are accurate in these environments. We studied whether these devices perform accurately and reliably under true mountain conditions. ⋯ Based on the results of this study, results of the newer portable pulse oximeters appear to be closely correlated to that of the ABG measurements when tested in true mountain conditions.
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Increased intracranial pressure (ICP) may contribute to acute mountain sickness (AMS). Measuring optic nerve sheath diameter (ONSD) by ultrasound (US) is a noninvasive technique to detect elevated ICP, and increased ONSD has been associated with AMS. We hypothesized that ONSD would increase with acute, rapid ascent to 4300 m and that increased ONSD would be associated with symptoms of AMS. We further hypothesized that treatment with oxygen at 4300 m would reduce symptoms and ONSD. ⋯ In this controlled study, mean ONSD increased in subjects with AMS at high altitude. However, individual variation was high, and most ONSD values were below the clinical threshold for raised ICP. Observed differences were small, of questionable clinical importance, and within the range of precision of the US machine. Overall, our data do not support a role for increased ICP in mild to moderate AMS.