Wilderness & environmental medicine
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To describe the general characteristics and epidemiology of search and rescue (SAR) in Yosemite National Park (YNP) and identify possible areas for intervention directed at reduction in use of these services. ⋯ Day-hikers in and around Yosemite Valley use a large portion of SAR services, with lower extremity injuries and dehydration/hypovolemia/hunger the most common reasons. It seems reasonable to direct future intervention to prevention of these commonly identified problems in this particular population of Park visitors.
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Wilderness Environ Med · Jan 2007
Ventilatory responses to hypoxia and high altitude during sleep in Aconcagua climbers.
We examined the changes in ventilation during sleep at high altitude using the LifeShirt monitoring system on 2 climbers who were attempting to summit Mount Aconcagua (6956 m). ⋯ Interestingly, the changes in ventilatory response during simulated altitude and at comparable altitude on Aconcagua during the summit attempt were similar, suggesting reductions in FiO(2), rather than in pressure, alter this response.
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Wilderness Environ Med · Jan 2007
Randomized Controlled TrialPerformance characteristics of the second-generation remote emergency medical oxygen closed-circuit rebreather.
Closed-circuit oxygen rebreathers may provide high concentrations of oxygen at extremely low flow rates appropriate for field use with limited oxygen supplies. The performance of the preproduction, second-generation remote emergency medical oxygen (REMO(2)) system developed for Divers Alert Network was evaluated. ⋯ The second-generation REMO(2) was well tolerated by healthy subjects during 8-hour laboratory evaluation trials. The device provided high mean inspired oxygen fractions at low mean oxygen flow rates, relatively modest mean maximal inspired and expired pressures, and excellent scrubber canister duration. Further evaluation of field performance with a patient population is warranted.
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Traumatic brain injury (TBI) is an important cause of morbidity and mortality in skiing and snowboarding. Although previous studies have advocated the use of a helmet to reduce the incidence of TBI, only a minority of skiers and snowboarders wear helmets. The low use of helmets may be partially due to controversy regarding their effectiveness in a high-speed crash. The protective effect of a ski helmet is diminished at the high speeds a skier or snowboarder can potentially obtain on an open slope. However, ski areas have undergone significant changes in the past decade. Many skiers and snowboarders frequent nontraditional terrain such as gladed areas and terrain parks. Since these areas contain numerous physical obstacles, we hypothesized that skiers and snowboarders would traverse these areas at speeds slow enough to expect a significant protective effect from a helmet. ⋯ Skiers and snowboarders navigate nontraditional terrain at speeds slower than on open slopes. At the observed velocities, a helmet would be expected to provide significant help in diminishing the occurrence of TBI. Medical authorities should advocate the use of helmets as an important component of an overall strategy to reduce the incidence of TBI associated with skiing and snowboarding.
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Wilderness Environ Med · Jan 2007
Pattern of injury after rock-climbing falls is not determined by harness type.
Experimental data indicate that when using a sit harness alone, any major fall during rock climbing may cause life-threatening thoraco-lumbar hyperextension trauma or "head down position" during suspension. To clarify the actual influence of the type of harness on the pattern and severity of injury, accidents involving a major fall in a climbing harness were analyzed retrospectively. ⋯ The type of harness does not influence the pattern or severity of injury, and the forces transferred via the harness do not cause a specific harness-induced pathology. We did not find any evidence that hyperextension trauma of the thoraco-lumbar region is an important mechanism of injury in climbers using a sit harness alone. Rock contact during the fall, and not the force transferred through the harness, is the major cause of significant injury in climbing accidents.