Wilderness & environmental medicine
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Wilderness Environ Med · Jan 2006
Changes in injury patterns and severity in a helicopter air-rescue system over a 6-year period.
To study the influence of current trends in alpine sports on the frequency and types of injuries handled by a helicopter-based emergency medical system (HEMS) in a wilderness mountain region. ⋯ For the HEMS in this study, there has been an increasing number of calls for help from persons involved in outdoor leisure activities. As the number of life-threatening injuries declines, HEMSs more frequently serve as means of rescue rather than as providers of emergency treatment.
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Wilderness Environ Med · Jan 2006
Improvised cricothyrotomy provides reliable airway access in an unembalmed human cadaver model.
Patients with injuries requiring surgical airway management occurring far from medical care might benefit from the availability of a simple, reliable, improvisational method of cricothyrotomy with materials available in a wilderness or prehospital setting. We evaluated an improvised cricothyrotomy device in an experimental, unembalmed human cadaver model. ⋯ Cricothyrotomy is the quickest and most effective method for obtaining airway access when nonsurgical methods of securing the airway are contraindicated or fail. Although frequently described, no improvised airway devices of this type have been tested in a systematic manner. We tested the reliability and utility of cricothyrotomy with a high-flow intravenous spike and drip chamber. Our results suggest that the spike and drip chamber is a plausible means of temporarily establishing airway access in patients with acute airway obstruction in a wilderness or prehospital environment.
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Wilderness Environ Med · Jan 2006
Practice GuidelineThe use of automated external defibrillators and public access defibrillators in the mountains: official guidelines of the international commission for mountain emergency medicine ICAR-MEDCOM.
In this article we propose guidelines for rational use of automated external defibrillators and public access defibrillators in the mountains. In cases of ventricular fibrillation and pulseless ventricular tachycardia, early defibrillation is the most effective therapy. Easy access to mountainous areas permits visitation by persons with high risks for sudden cardiac death, and medical trials show the benefit of exercising in moderate altitude. ⋯ Public access defibrillators should be placed with priority in popular ski areas, in busy mountain huts and restaurants, at mass-participation events, and in remote but often-visited locations that do not have medical coverage. Automated external defibrillators should be available to first-responder groups and mountain-rescue teams. It is important that people know how to perform cardiopulmonary resuscitation and how to use public access defibrillators and automated external defibrillators.
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Wilderness Environ Med · Jan 2006
ReviewVenomous adversaries: a reference to snake identification, field safety, and bite-victim first aid for disaster-response personnel deploying into the hurricane-prone regions of North America.
Each hurricane season, emergency-preparedness deployment teams including but not limited to the Office of Force Readiness and Deployment of the US Public Health Service, Federal Emergency Management Agency, Deployment Medical Assistance Teams, Veterinary Medical Assistance Teams, and the US Army and Air Force National Guard are at risk for deploying into hurricane-stricken areas that harbor indigenous hazards, including those posed by venomous snakes. North America is home to 2 distinct families of venomous snakes: 1) Viperidae, which includes the rattlesnakes, copperheads, and cottonmouths; and 2) Elapidae, in which the only native species are the coral snakes. Although some of these snakes are easily identified, some are not, and many rank among the most feared and misunderstood animals. This article specifically addresses all the native species of venomous snakes that inhabit the hurricane-prone regions of North America and is intended to serve as a reference to snake identification, basic field safety procedures, and the currently recommended first-aid measures for snakebite casualties.
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Allergic contact dermatitis caused by the Toxicodendron (formerly Rhus) species-poison ivy, poison oak, and poison sumac-affects millions of North Americans every year. In certain outdoor occupations, for example, agriculture and forestry, as well as among many outdoor enthusiasts, Toxicodendron dermatitis presents a significant hazard. ⋯ Recent research in prevention is emphasized, and resources to help in the identification of plants are provided in the bibliography. The literature was searched using a MEDLINE query for "Toxicodendron dermatitis", and the identified article bibliographies were searched as well.