Wilderness & environmental medicine
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Wilderness Environ Med · Sep 2012
Rock climbing rescues: causes, injuries, and trends in Boulder County, Colorado.
To describe rates and patterns of rock climbing rescue incidents, morbidity and mortality in Boulder County, CO. ⋯ The occurrence of rock climbing-related rescue victims comprised one fifth of all rescue victims in Boulder County. A large fraction of incidents and fatalities resulted from unroped climbing. Incidents of lost or uninjured stranded climbers and belay incidents account for more than half of victims, which can likely be prevented by gaining appropriate experience, seeking local information, and applying some simple safety measures for control of rope belays.
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Caving is a demanding sport practiced throughout the world. Currently, there are no collective data analyzing injury mechanism or type in these austere environments. This study is a retrospective analysis of caving incidents documented by the National Speleological Society (NSS)-American Caving Accidents (ACA) annual publication. ⋯ The majority of injuries were not life threatening; however, over the course of 28 years there were 81 documented fatalities. Similar to other studies of wilderness injuries, fractures, soft tissue injuries, and lacerations were prominent in this study. In general, the overall precipitating event leading to injuries is falling, leading to orthopedic trauma. To better prepare cave rescue teams we have attempted to describe the characteristics of caving injuries in the United States.
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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.