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Emergency Medical Training for the Commercial Fishing Industry: An Expanded Role for Wilderness Medicine
This article describes the conception, implementation, and evaluation of a wilderness medicine–based first aid class for the commercial fishing industry. Commercial fishing is a dangerous occupation in the United States. Currently, commercial fishermen often only have access to basic first aid classes. Because of its focus on austere environments, hazardous conditions, and distance from definitive medical care—hallmarks of commercial fisheries—wilderness medicine offers a more appropriate approach to decreasing morbidity and mortality in the industry. A 2-d, 16-h pilot wilderness medicine course for commercial fisher...
Source: Wilderness and Environmental Medicine - July 12, 2019 Category: Environmental Health Source Type: research

Risk of Death and Major Injury from Natural Winter Hazards in Helicopter and Snowcat Skiing in Canada
ConclusionWe recommend the design of an industry-wide incident and near-miss reporting system to support evidence-based improvements of safety practices. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 12, 2019 Category: Environmental Health Source Type: research

Pediatric High Altitude Cerebral Edema in the Nepal Himalayas
We report on 2 cases of suspected HACE in 2 patients, aged 12 and 16 y, who presented to the Manang Himalayan Rescue Association clinic at 3500 m. The 16-y-old patient presented with severe headache, vomiting, and ataxia after rapid ascent to 3800 m. The 12-y-old patient presented with severe headache, vomiting, visual disturbances, and ataxia at 4500 m, which began to resolve with descent to the clinic at 3500 m. Our cases suggest that HACE can occur in children and adolescents. Because there are no specific guidelines for treatment of acute mountain sickness or HACE in patients under the age of 18 y, we recommend treatme...
Source: Wilderness and Environmental Medicine - July 12, 2019 Category: Environmental Health Source Type: research

The Seven Continents Marathon Club
Publication date: Available online 9 July 2019Source: Wilderness & Environmental MedicineAuthor(s): (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 9, 2019 Category: Environmental Health Source Type: research

DNA from Tooth Embedded in Man's Foot Resolves Quarter-Century-Old Shark Bite Mystery
Publication date: Available online 1 July 2019Source: Wilderness & Environmental MedicineAuthor(s): Lei Yang, John S.S. Denton, Shannon Corrigan, Tyler B.T. Bowling, Gavin J.P. Naylor (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - July 2, 2019 Category: Environmental Health Source Type: research

Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness: 2019 Update
Publication date: Available online 24 June 2019Source: Wilderness & Environmental MedicineAuthor(s): Andrew M. Luks, Paul S. Auerbach, Luanne Freer, Colin K. Grissom, Linda E. Keyes, Scott E. McIntosh, George W. Rodway, Robert B. Schoene, Ken Zafren, Peter H. HackettTo provide guidance to clinicians about best preventive and therapeutic practices, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for prevention and treatment of acute mountain sickness, high altitude cerebral edema, and high altitude pulmonary edema. Recommendations are graded based on the quality of supporti...
Source: Wilderness and Environmental Medicine - June 25, 2019 Category: Environmental Health Source Type: research

Recovery of Heart Rate Variability After Exercise Under Hot Conditions: The Effect of Relative Humidity
ConclusionsStress score and sympathetic/parasympathetic ratio seem to be the best HRV predictors of internal load. Although there are no differences in HRV during recovery at the same time points in both conditions, the recovery is slower after exercise in HH than in HD. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - June 25, 2019 Category: Environmental Health Source Type: research

Cougar (Puma concolor) Injury in the United States
ConclusionsCougar attacks are uncommon but can be fatal. Attacks commonly affect children and young adults, although all age groups are at risk of attack and death. Most attacks occur during the daytime in the summer and fall. As development and recreational activities put humans in closer contact with cougars, establishing validated public health messaging is critical to minimize injurious encounters. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - June 25, 2019 Category: Environmental Health Source Type: research

In Response to Reduced Acetazolamide Dose for AMS by McIntosh et al
Publication date: Available online 25 June 2019Source: Wilderness & Environmental MedicineAuthor(s): Robert Bennett (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - June 25, 2019 Category: Environmental Health Source Type: research

High Altitude Deterioration: A Historical Essay
Publication date: Available online 20 June 2019Source: Wilderness & Environmental MedicineAuthor(s): Harvey V. LankfordThis wilderness essay about high altitude deterioration will explore the historical mountaineering and medical literature with a limited discussion of physiology. The writings of mountaineers and physician-mountaineers provide an evocative supporting narrative to illustrate one of the problems of living at altitude. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - June 21, 2019 Category: Environmental Health Source Type: research

Friction Blister by Climbing Harness: A Case Report
Publication date: Available online 20 June 2019Source: Wilderness & Environmental MedicineAuthor(s): Subarna Adhikari, Suvash Dawadi, Jenisha UpadhyayAn experienced 24-y-old climber on Mount Everest presented to the Base Camp medical clinic with a friction blister on his right flank. The blister was filled with clear fluid and was located about 3 cm posterior and 3 cm superior to the highest point of the right iliac crest, the site where a climbing harness would support the climber while hanging. A diagnosis of friction blister caused by a climbing harness used while traversing between Camp 2 and Camp 3 of Mount Everest wa...
Source: Wilderness and Environmental Medicine - June 21, 2019 Category: Environmental Health Source Type: research

Successful Management of Two Patients with Intracranial Hemorrhage due to Carpet Viper (Echis ocellatus) Envenomation in a Limited-Resource Environment
We present 2 cases of E ocellatus envenomation with intracranial hemorrhage seen at a rural hospital in Bembèrèkè, Benin, and describe the successful management of these patients in a limited-resource setting. In one case the patient was treated with an ineffective Indian-made antivenom before evaluation by the authors and continued to deteriorate until she was treated with effective antivenom 10 d after the bite. In both cases lumbar puncture was performed for diagnostic or therapeutic purposes with good effect, and both patients made full recoveries without sequelae. These cases demonstrate the remarkable ability of h...
Source: Wilderness and Environmental Medicine - June 21, 2019 Category: Environmental Health Source Type: research

Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Heat Illness: 2019 Update
We present a review of the classifications, pathophysiology, and evidence-based guidelines for planning and preventive measures, as well as best practice recommendations for both field- and hospital-based therapeutic management of heat illness. These recommendations are graded based on the quality of supporting evidence and balance the benefits and risks or burdens for each modality. This is an updated version of the original Wilderness Medical Society Practice Guidelines for the Treatment and Prevention of Heat-Related Illness published in 2013. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - June 18, 2019 Category: Environmental Health Source Type: research

The Reliability of Noninvasive Blood Pressure Measurement through Layers of Autumn/Winter Clothing: a Prospective Study
ConclusionsOur findings confirm that it is possible to perform reliable NIBP measurements over 2 and 3 layers of autumn/winter clothing. Measuring NIBP with a clothed arm does not show clinical or statistically significant differences in comparison with measurements performed on the bare arm. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - June 18, 2019 Category: Environmental Health Source Type: research

Catfish Bite Case Report
Publication date: Available online 18 June 2019Source: Wilderness & Environmental MedicineAuthor(s): Lawrence LeBlondAlthough catfish are found worldwide and commonly consumed in the southern United States, fatal infections from catfish are rare. Edwardsiella tarda is a bacterium known to cause gastrointestinal distress most commonly, but extraintestinal infections are a rarely considered danger for those acquiring, preparing, and consuming aquatic animals. Susceptible to all gram-negative active antibiotics, it is easily treated except in immunocompromised hosts, such as those with malignancy, diabetes, and hepatic dysfun...
Source: Wilderness and Environmental Medicine - June 18, 2019 Category: Environmental Health Source Type: research