Wilderness & Environmental Medicine最新文献_第3页

Emergency Medical Care Provided by North Shore Rescue Advanced Medical Providers. 由北岸救援队高级医疗服务提供者提供紧急医疗服务。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-12-01 Epub Date: 2024-09-27 DOI: 10.1177/10806032241282963

Foster T Wynne, Matthew Turnock, Michael Crickmer, Alec H Ritchie

{"title":"Emergency Medical Care Provided by North Shore Rescue Advanced Medical Providers.","authors":"Foster T Wynne, Matthew Turnock, Michael Crickmer, Alec H Ritchie","doi":"10.1177/10806032241282963","DOIUrl":"10.1177/10806032241282963","url":null,"abstract":"Introduction: The North Shore Rescue (NSR) Advanced Medical Provider (AMP) program is composed of physicians and nurses based in North Vancouver who attend high acuity medical search and rescue (SAR) callouts in British Columbia, Canada. This study aimed to analyze the medical care provided by AMPs with appropriate comparisons to non-AMP callouts.Methods: A retrospective review of all NSR callouts from January 1, 2018, to December 31, 2022, was conducted. The analysis included AMP involvement, rescue logistics, subject demographics, activity, primary cause, provisional diagnosis, treatments, medical decision-making, and extraction means. National Advisory Committee for Aeronautics (NACA) scores were assigned by physicians to evaluate medical acuity as well as under-triage and over-triage.Results: Of the 767 NSR callouts over the 5-year span, 283 (37%) were medical, and of these, 35% (n = 99) involved AMPs. Seventy-five percent of AMP rescues involved traumatic injuries, and 31% involved nontraumatic medical illnesses. The mean NACA score for AMP callouts was significantly higher than non-AMP callouts (3.1 ± 1.3 vs 1.9 ± 1.3, p < .00001). Medications were administered in 40% of AMP rescues, procedures were performed in 54%, and 37% involved advanced medical decision-making. Over-triage occurred in 33% of AMP callouts, with under-triage in 10%.Conclusions: The AMP program provides a useful service when advanced medical care in wilderness environments is needed. AMPs coordinate appropriate medical response and ensure safe, comfortable, and efficient transport to definitive care. The NSR AMP program may act as a model for the development of similar programs by other SAR teams.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Identification of Factors Associated with Both Frequency and Severity of Deer-Related Motorcycle Crashes. 确定与鹿有关的摩托车碰撞事故的频率和严重程度的相关因素。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-11-06 DOI: 10.1177/10806032241291771

David P Betten, Benjamin M Goulding, Phillip J Kostka, William D Corser, Kristen N Owen

{"title":"Identification of Factors Associated with Both Frequency and Severity of Deer-Related Motorcycle Crashes.","authors":"David P Betten, Benjamin M Goulding, Phillip J Kostka, William D Corser, Kristen N Owen","doi":"10.1177/10806032241291771","DOIUrl":"https://doi.org/10.1177/10806032241291771","url":null,"abstract":"Introduction: Motorcyclists are particularly vulnerable to injury when encountering large animals such as deer in the roadway. The frequency of these events, factors associated with their occurrence, and the extent of injuries sustained from such crashes are not yet well described.Methods: A review of 10 years (2012-2021) of statewide motorcycle crash reports from a single state with a large deer population was performed to ascertain the frequency of deer-associated motorcycle crashes. Environmental and roadway conditions, as well as motorcyclist age, gender, and helmet usage, were identified to determine if associations exist with the severity of injuries sustained.Results: Statewide, 8.5% of reported motorcycle crashes involved deer. Excluding the two most densely populated counties, this rose to 10.7%, with 24.1% of crashes occurring during non-daylight hours being deer related. Factors associated with increased frequency of more severe injury and death included not wearing a helmet, female gender, and rural county crash location. Death and severe injuries were reported in more than twice as many riders who were unhelmeted compared to those wearing helmets (36.1 vs 16.6%; p < 0.01).Conclusion: In a single midwestern state, deer represent a significant danger to motorcyclists, especially in rural settings during non-daylight hours. A cautious approach to riding during this time, utilizing available safety precautions to minimize risk of severe injury and death, and further exploration of viable interventions to reduce the likelihood of these occurrences should be considered.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Biopsychosocial Health Considerations for Astronauts in Long-Duration Spaceflight: A Narrative Review. 长期太空飞行中宇航员的生物心理社会健康考虑因素：叙述性评论。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-10-29 DOI: 10.1177/10806032241289106

Bradley N Barbour, Karolina Twardowska, Nicolò Favero, Payam Ghoddousi, Peter Hodkinson

{"title":"Biopsychosocial Health Considerations for Astronauts in Long-Duration Spaceflight: A Narrative Review.","authors":"Bradley N Barbour, Karolina Twardowska, Nicolò Favero, Payam Ghoddousi, Peter Hodkinson","doi":"10.1177/10806032241289106","DOIUrl":"10.1177/10806032241289106","url":null,"abstract":"Long-duration spaceflights beyond low-Earth orbit, including missions to the Moon and Mars, pose significant health risks. Although biomedical approaches commonly appear in the literature, considering psychological and social factors alongside physiologic health offers a more holistic approach to astronaut care. Integrating the biopsychosocial (BPS) framework into medical planning addresses complex spaceflight challenges and aids in developing mitigation strategies. This review examined health risks associated with long-duration spaceflight within a BPS framework. Sources included governmental space agencies, academic textbooks, and relevant publications from multiple databases. Considering the National Aeronautics and Space Administration's Human Research Program's 5 main hazards, a conceptual model was developed to highlight the multifactorial BPS effects of spaceflight. In space, astronauts face unique environments and biological adaptations, including fluid shift, plasma volume loss, bone density loss, and muscle atrophy. Noise and the absence of natural light disrupt circadian rhythms, causing sleep disturbances and fatigue, which affect physical and mental health. Studies on crews in isolated and confined extreme environments reveal psychosocial challenges, including impaired mood and cognition, interpersonal tension, and miscommunication. International collaboration in spaceflight introduces differences in communication, problem solving, and social customs due to diverse cultural backgrounds. Upcoming long-distance missions likely will amplify these challenges. This review emphasizes BPS health considerations in long-duration spaceflight. It highlights the interplay among psychological, social, and biological factors, advocating for multidisciplinary teams and a holistic approach to astronaut health and mission planning and the potential added value of BPS perspectives in considering countermeasures.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tube Tip in Pharynx (TTIP) Ventilation-a Simple Rescue Technique in Limited Resource Settings. 咽部置管通气（TTIP）--资源有限环境中的简单抢救技术。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-10-26 DOI: 10.1177/10806032241291525

Sandra Ellefsen, Anja B Stubager, Michael S Kristensen

引用次数: 0

Wilderness Medicine Curricula in US Multidisciplinary Training Courses. 美国多学科培训课程中的野外医学课程。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-10-26 DOI: 10.1177/10806032241289315

Maria Holstrom-Mercader, Avram Flamm

{"title":"Wilderness Medicine Curricula in US Multidisciplinary Training Courses.","authors":"Maria Holstrom-Mercader, Avram Flamm","doi":"10.1177/10806032241289315","DOIUrl":"https://doi.org/10.1177/10806032241289315","url":null,"abstract":"Introduction: Wilderness medicine (WM) is the study of medicine in austere environments. There are several US multidisciplinary courses that teach WM to people from varying medical backgrounds. However, WM topics are covered to different extents. This study's purpose was to compare WM components among US multidisciplinary training courses.Methods: The American College of Emergency Physicians WM fellowship curriculum's 19 components and the Fellowship of the Academy of Wilderness Medicine's 12 core and 16 elective competencies and their credits were used as two control lists. Curricula from 10 US multidisciplinary courses were analyzed for WM components. Using descriptive analysis, each course curriculum was compared with the controls.Results: This study examines WM components in 10 courses. The greatest number of American College of Emergency Physicians WM fellowship topics (14 of 19) was covered by the Paramedic course and the fewest number (4 of 19) by the Tactical Combat Casualty Care-Combat Lifesaver course. The greatest number of Fellowship of the Academy of Wilderness Medicine core credits (56) was offered by the Paramedic course and the fewest number (24) by the Tactical Combat Casualty Care-Medical Personnel course. The greatest number of Fellowship of the Academy of Wilderness Medicine elective credits (83) was offered by the Paramedic course and the fewest number (25) by the Tactical Combat Casualty Care-Combat Lifesaver course.Conclusion: This research analyzed WM components in US multidisciplinary courses and demonstrated that each covers WM topics to varying extents. This shows an opportunity for these courses to expand their WM education within their scope. It also demonstrates competencies offered by different courses for interested trainees.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Operational Stress Injuries in Disaster Responders: A Framework for Supporting Mental Health in Climate Crisis. 救灾人员的操作压力伤害：气候危机中的心理健康支持框架》。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-10-21 DOI: 10.1177/10806032241287210

William Mundo, Terry O'Connor, Laura McGladrey

引用次数: 0

A Case of Couching: Portable Ultrasound Screening Increases Quality of Care in Cataract Outreach Camp. 沙发案例：便携式超声波筛查提高了白内障外展营的护理质量。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-10-16 DOI: 10.1177/10806032241289107

Alec Bernard, Kathryn Flaharty, Sampson Makpayiln, Boateng Wiafe, Geoff Tabin, In-Hei Hahn

引用次数: 0

The Influence of Climate Change on Vector-Borne Diseases in a Wilderness Medicine Context. 气候变化对荒野医学背景下病媒传播疾病的影响。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-10-14 DOI: 10.1177/10806032241283704

Jonas E Mertens

{"title":"The Influence of Climate Change on Vector-Borne Diseases in a Wilderness Medicine Context.","authors":"Jonas E Mertens","doi":"10.1177/10806032241283704","DOIUrl":"https://doi.org/10.1177/10806032241283704","url":null,"abstract":"The imminent climate crisis has been labeled as the biggest health threat humanity must deal with. Vector-borne disease distribution and transmission as well as the population at risk are influenced to a great degree by environmental and climactic factors affecting both the vectors themselves and the causative pathogens. Paired with an increase in worldwide travel, urbanization, and globalization, along with population displacements and migration, elucidating the effects of anthropogenic climate change on these illnesses is therefore of the essence to stave off potential negative sequelae. Outcomes on different vector-borne diseases will be diverse, but for many of them, these developments will result in a distribution shift or expansion with the possibility of (re-)introduction of vector and pathogen species in previously nonendemic areas. The consequence will be a growing likelihood for novel human, vector, and pathogen interactions with an increased risk for infection, morbidity, and mortality. Wilderness medicine professionals commonly work in close relationship to the natural environment and therefore will experience these alterations most strongly in their practice. Hence, this article attempts to bring awareness to the subject at hand in a wilderness medicine context, with a focus on malaria, the most burdensome of arthropod-borne diseases. For prevention of the potentially dire consequences on human health induced by climate change, concerted and intensified efforts to reduce the burning of fossil fuels and thus greenhouse gas emissions will be imperative on a global scale.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Review of Climate-Driven Threats to Recreational Water Users in Hawaii. 气候对夏威夷休闲用水者的威胁综述。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-10-14 DOI: 10.1177/10806032241286486

Elizabeth M Kiefer, Diana Felton

引用次数: 0

Space Radiology: Emerging Nonsonographic Medical Imaging Techniques and the Potential Applications for Human Spaceflight. 太空放射学：新兴的 Nonsonographic 医学成像技术及其在载人航天飞行中的潜在应用。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-10-03 DOI: 10.1177/10806032241283380

Michael Pohlen

{"title":"Space Radiology: Emerging Nonsonographic Medical Imaging Techniques and the Potential Applications for Human Spaceflight.","authors":"Michael Pohlen","doi":"10.1177/10806032241283380","DOIUrl":"https://doi.org/10.1177/10806032241283380","url":null,"abstract":"Space medicine is a multidisciplinary field that requires the integration of medical imaging techniques and expertise in diagnosing and treating a wide range of acute and chronic conditions to maintain astronaut health. Medical imaging within this domain has been viewed historically through the lens of inflight point-of-care ultrasound and predominantly research uses of cross-sectional imaging before and after flight. However, space radiology, a subfield defined here as the applications of imaging before, during, and after spaceflight, will grow to necessitate the involvement of more advanced imaging techniques and subspecialist expertise as missions increase in length and complexity. While the performance of imaging in spaceflight is limited by equipment mass and volume, power supply, radiation exposure, communication delays, and personnel training, recent developments in nonsonographic modalities have opened the door to their potential for in-mission use. Additionally, improved exam protocols and scanner technology in combination with artificial intelligence algorithms have greatly advanced the utility of possible pre- and postflight studies. This article reviews the past and present of space radiology and discusses possible use cases, knowledge gaps, and future research directions for radiography, fluoroscopy, computed tomography, and magnetic resonance imaging within space medicine, including both the performance of new exam types for new indications and the increased extraction of information from exams already routinely obtained. Through thoughtfully augmenting the use of these tools, medical mission risk may be reduced substantially through preflight screening, inflight diagnosis and management, and inflight and postflight surveillance.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0