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In Response to Implementing Tourniquet Conversion Guidelines for Civilian EMS and Prehospital Organizations by Standifird et al. 针对 Standifird 等人撰写的《民间急救服务和院前组织实施止血带转换指南》。
IF 1.4 4区 医学
Wilderness & Environmental Medicine Pub Date : 2024-09-17 DOI: 10.1177/10806032241281241
David Jerome
{"title":"In Response to Implementing Tourniquet Conversion Guidelines for Civilian EMS and Prehospital Organizations by Standifird et al.","authors":"David Jerome","doi":"10.1177/10806032241281241","DOIUrl":"https://doi.org/10.1177/10806032241281241","url":null,"abstract":"","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299433","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
Creation of an Emergency Care Capacity Assessment Tool for Facilities in Austere Environments. 为环境恶劣的设施创建紧急救护能力评估工具。
IF 1.4 4区 医学
Wilderness & Environmental Medicine Pub Date : 2024-09-12 DOI: 10.1177/10806032241278982
Vijay Christopher Kannan,Geoff Comp,Stephanie Lareau
{"title":"Creation of an Emergency Care Capacity Assessment Tool for Facilities in Austere Environments.","authors":"Vijay Christopher Kannan,Geoff Comp,Stephanie Lareau","doi":"10.1177/10806032241278982","DOIUrl":"https://doi.org/10.1177/10806032241278982","url":null,"abstract":"INTRODUCTIONFacilities in austere environments may consider emergency care beyond their scope. Often patients with high-acuity conditions have no other choice than to present to these facilities. The disconnect between the intent of health systems planners and the reality faced by providers manifests as facilities unable to manage such cases.The Indian Health Service, with a range of stakeholders, developed an emergency care delivery assessment tool for facilities in austere environments, designed to identify deficiencies in facility readiness for emergency care delivery across four areas: 1. Procedural2. Human resources3. Non-pharmacologic material resources4. Pharmacologic material resources.METHODSThe tool's underlying architecture is a resource matrix similar to hospital-based tools, using the \"Facility\" component of the WHO Emergency Care Systems Framework as the Y-axis and undifferentiated presentations taught by the WHO basic emergency care course, advanced trauma life support, and advanced life support in obstetrics as the X-axis. The tool was piloted at a remote frontier clinic.RESULTSWe found 48 deficiencies: 7 procedural, 1 human resources, 31 non-pharmacologic materials, and 9 pharmacologic materials. We aggregated deficiencies by facility function to assess the capacity to perform each. We also aggregated deficiencies by clinical presentation to identify targets for educational interventions.CONCLUSIONWe successfully created a novel emergency care capacity assessment tool for use in austere environments using materials with broad international consensus. The successful pilot found deficiencies across all 4 areas. This tool may be useful in many other remote domestic facilities and rural health posts in low- and middle-income countries.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142204075","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
Catfish Puncture Wound and Retained Spine Management in the ED Setting: A Case Report. 急诊室中的鲶鱼刺伤和脊柱留置治疗：病例报告。
IF 1.4 4区 医学
Wilderness & Environmental Medicine Pub Date : 2024-09-10 DOI: 10.1177/10806032241273505
Spencer J Carbone,Jennifer L Jozefick,Adam P Sigal,Robert H Nordell
{"title":"Catfish Puncture Wound and Retained Spine Management in the ED Setting: A Case Report.","authors":"Spencer J Carbone,Jennifer L Jozefick,Adam P Sigal,Robert H Nordell","doi":"10.1177/10806032241273505","DOIUrl":"https://doi.org/10.1177/10806032241273505","url":null,"abstract":"Fishing is a common recreational activity in the United States, with over 29 million registered fishers. Although not inherently dangerous, commonly seen injuries from fishing include embedded fishhooks and injury from flora and fauna. Emergency department (ED) physicians need a basic understanding of how to treat these less-than-frequent injuries. We present a case report of a patient who presented with a catfish spine lodged in her leg. These spines not only cause puncture wounds but can result in lacerations and venom release as well. Our patient presented 6 hours after the initial injury for spine removal and symptom management. Plain radiographs of the affected extremity demonstrated a 2 cm foreign body consistent with a catfish spine. The wound was expanded, and the spine successfully removed. The patient was discharged on levofloxacin and reported a healing wound without complications nearly 2 weeks after the injury.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142204076","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
Backward and in Heels . . . Mabel Purefoy FitzGerald's Extraordinary Journey to Discovery at High Altitudes. 后退并穿着高跟鞋 . .梅布尔-普尔福伊-菲茨杰拉德在高海拔地区的非凡发现之旅.
IF 1.4 4区 医学
Wilderness & Environmental Medicine Pub Date : 2024-09-02 DOI: 10.1177/10806032241272125
Martha Tissot van Patot
{"title":"Backward and in Heels . . . Mabel Purefoy FitzGerald's Extraordinary Journey to Discovery at High Altitudes.","authors":"Martha Tissot van Patot","doi":"10.1177/10806032241272125","DOIUrl":"https://doi.org/10.1177/10806032241272125","url":null,"abstract":"<p><p>In 1911, Mabel Purefoy FitzGerald (1872-1973) conducted a study in the mountains of Colorado that offered invaluable insights into how the body responds to chronic hypoxia. Researchers awarded the Nobel Prize for Physiology or Medicine 2019 cited her work as critical in unravelling the hypoxia sensing system. The astounding career situation in which FitzGerald found herself while conducting this study offers important insights into the challenges faced by women in science at the turn of the twentieth century. Like Ginger Rogers dancing with Fred Astaire, FitzGerald did the equivalent of everything her male colleagues did, only backward and in high heels. Although it is tempting to believe that such inequities for women are relegated to history, the career challenges faced by 2023 Nobel Laureate Katalin Karikó highlight evidence that the struggle for equality of women in science remains a significant problem.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114038","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
In Reply to Dr Gupta et al. 答复古普塔博士等人
IF 1.4 4区 医学
Wilderness & Environmental Medicine Pub Date : 2024-09-01 Epub Date: 2024-06-05 DOI: 10.1177/10806032241260347
Stefan Cowtan, Jonathon Broughton, Sarvesh Logsetty
{"title":"In Reply to Dr Gupta et al.","authors":"Stefan Cowtan, Jonathon Broughton, Sarvesh Logsetty","doi":"10.1177/10806032241260347","DOIUrl":"10.1177/10806032241260347","url":null,"abstract":"","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248970","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 Qualitative Review of the Air Rescue One Rural Search and Rescue Program in British Columbia, Canada. 加拿大不列颠哥伦比亚省 "空中救援一号 "农村搜救计划定性审查。
IF 1.4 4区 医学
Wilderness & Environmental Medicine Pub Date : 2024-09-01 Epub Date: 2024-06-11 DOI: 10.1177/10806032241258425
Raphael Nowak, Jeremy N Vandekerkhove, Deena D Wasserman
{"title":"A Qualitative Review of the Air Rescue One Rural Search and Rescue Program in British Columbia, Canada.","authors":"Raphael Nowak, Jeremy N Vandekerkhove, Deena D Wasserman","doi":"10.1177/10806032241258425","DOIUrl":"10.1177/10806032241258425","url":null,"abstract":"<p><strong>Introduction: </strong>Rural emergency prehospital care in British Columbia is conducted primarily by the British Columbia Ambulance Services or ground search and rescue volunteers. Since 2014, the volunteer Air Rescue One (AR1) program has provided helicopter emergency winch rescue services to rural British Columbia. The aim of this research was to describe the activity of the AR1 program and to make recommendations to improve future operations.</p><p><strong>Methods: </strong>Data were collected retrospectively from September 2014 to May 2021, and parameters of emergency callout statistics from the organization's standard operating guidelines, rescue reports, and interviews were summarized and reviewed.</p><p><strong>Results: </strong>Of 152 missions within the study period, 105 were medically related rescues involving trauma or cardiac events. Snowmobiling, mountain biking, and hiking were the most common activities requiring rescue. The 38 medical callouts that were not completed by AR1 were reviewed for contributing factors. Response time varied due to the vast service area, but median time from request to takeoff was 55 min (interquartile range 47-69 min), and median on-scene time was 21 min (interquartile range 11-33 min).</p><p><strong>Conclusions: </strong>AR1 provides advanced medical care into British Columbia's remote and difficult-to-access areas, minimizing delays in treatment and risk to patients and responders. Callout procedures should be streamlined enabling efficient AR1 activation. Collection of medical and flight information should be improved with standardized documentation, aiding in internal education and future research into the program's impact on emergency prehospital care. Future directions for improvement of care include the possibility of introducing portable ultrasound technology.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141301923","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 Comprehensive Pathophysiologic, Histologic, and Biochemical Analysis of Buthus paris (C. L. Koch, 1839) Venom. Buthus paris（C. L. Koch，1839 年）毒液的病理生理学、组织学和生化综合分析。
IF 1.4 4区 医学
Wilderness & Environmental Medicine Pub Date : 2024-09-01 Epub Date: 2024-05-07 DOI: 10.1177/10806032241249748
Abdessamad Elmourid, My Abdelmonaim Elhidan, Samia Boussaa, Mehdi Ait Laaradia, Btissam Bouimeja, Omar Amahmid, Mohamed Merzouki, Oulaid Touloun
{"title":"A Comprehensive Pathophysiologic, Histologic, and Biochemical Analysis of <i>Buthus paris</i> (C. L. Koch, 1839) Venom.","authors":"Abdessamad Elmourid, My Abdelmonaim Elhidan, Samia Boussaa, Mehdi Ait Laaradia, Btissam Bouimeja, Omar Amahmid, Mohamed Merzouki, Oulaid Touloun","doi":"10.1177/10806032241249748","DOIUrl":"10.1177/10806032241249748","url":null,"abstract":"<p><strong>Introduction: </strong><i>Buthus</i> species, including <i>B paris</i>, are classified as one of the most dangerous scorpion genera in Morocco, implicated in several cases of human death. Our objective is to characterize, for the first time, the toxicity and histopathologic and biochemical impacts of <i>B paris</i> venom.</p><p><strong>Methods: </strong>We investigated the experimental pathophysiology of <i>B paris</i> venom by examining histologic changes in vital organs (heart, kidneys, liver, and lungs) and assessing biochemical enzymatic markers (alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatine phosphokinase, urea, and creatinine) in mice injected subcutaneously with 2 doses of 400 and 450 mg·kg<sup>-1</sup>.</p><p><strong>Results: </strong>Our results showed that the subcutaneous median lethal dose of <i>B paris</i> venom was around 0.52 mg·kg<sup>-1</sup>. Histologic findings revealed significant tissue damage in the previously mentioned vital organs, confirmed through biochemical analysis indicating impaired heart and liver functions. Additionally, an increase in urea, creatinine, and glucose levels occurred following <i>B paris</i> venom injection.</p><p><strong>Conclusion: </strong>Our findings show that <i>B paris</i> venom exhibits a high level of experimental toxicity. These results highlight the potentially lethal nature of this venom and emphasize the potential medical importance of this species.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877801","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
Wilderness Medical Society Clinical Practice Guidelines for Medical Direction of Search and Rescue Teams. 荒野医学会《搜救队医疗指导临床实践指南》。
IF 1.4 4区 医学
Wilderness & Environmental Medicine Pub Date : 2024-09-01 Epub Date: 2024-05-06 DOI: 10.1177/10806032241249126
Christopher A Davis, Cassie Lowry, Aaron Billin, Linda Laskowski-Jones, Alison Sheets, David Fifer, Seth C Hawkins
{"title":"Wilderness Medical Society Clinical Practice Guidelines for Medical Direction of Search and Rescue Teams.","authors":"Christopher A Davis, Cassie Lowry, Aaron Billin, Linda Laskowski-Jones, Alison Sheets, David Fifer, Seth C Hawkins","doi":"10.1177/10806032241249126","DOIUrl":"10.1177/10806032241249126","url":null,"abstract":"<p><p>The Wilderness Medical Society convened a panel to review available evidence supporting practices for medical direction of search and rescue teams. This panel included of members of the Wilderness Medical Society Search and Rescue Committee, the National Association of EMS Physicians Wilderness Committee, and leadership of the Mountain Rescue Association. Literature about definitions and terminology, epidemiology, currently accepted best practices, and regulatory and legal considerations was reviewed. The panel graded available evidence supporting practices according to the American College of Chest Physicians criteria and then made recommendations based on that evidence. Recommendations were based on the panel's collective clinical experience and judgment when published evidence was lacking.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873088","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
Cold-Induced Vasodilation, Rewarming, and Dexterity Impairment Following Second-Degree Frostbite. 病例报告：二度冻伤后冷引起的血管扩张、复温和灵活性受损。
IF 1.4 4区 医学
Wilderness & Environmental Medicine Pub Date : 2024-09-01 Epub Date: 2024-07-23 DOI: 10.1177/10806032241262986
Rebecca S Weller, Tony Duong, Rebecca J McClintock, Alice LaGoy, Matthew Peterson, Douglas M Jones
{"title":"Cold-Induced Vasodilation, Rewarming, and Dexterity Impairment Following Second-Degree Frostbite.","authors":"Rebecca S Weller, Tony Duong, Rebecca J McClintock, Alice LaGoy, Matthew Peterson, Douglas M Jones","doi":"10.1177/10806032241262986","DOIUrl":"10.1177/10806032241262986","url":null,"abstract":"<p><p>Frostbite, a severe cold injury resulting from exposure to subfreezing temperatures, damages the skin and underlying tissues of the affected area and ranges in severity from first to fourth degree. This case report investigates the impact of second-degree frostbite suffered by a marine during winter training on cold-induced vasodilation (CIVD). Comparisons of CIVD before and after the injury revealed significant alterations in CIVD responses. CIVD, a physiological mechanism characterized by blood vessel dilation in response to cold exposure, plays a crucial role in operating in cold-weather environments and enhancing dexterity. The marine exhibited prolonged CIVD onset time, lower finger temperatures, increased pain sensations, and diminished dexterity after the frostbite injury during follow-up CIVD testing. The findings suggest that the frostbite-induced damage possibly compromised the microvascular function, contributing to the observed changes in CIVD. The marine reported persistent cold sensitivity and difficulty in maintaining hand warmth when assessed postinjury. This case underscores the potential long-term consequences of frostbite on CIVD and manual dexterity, emphasizing the importance of understanding these physiological changes for individuals engaged in cold-weather activities, particularly for military and occupational personnel.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753147","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
Severe Hyperthermia in Mountaineering: Coincidence of Heat Stroke and Infection. 登山运动中的严重高热：中暑和感染的并发症。
IF 1.4 4区 医学
Wilderness & Environmental Medicine Pub Date : 2024-09-01 Epub Date: 2024-06-05 DOI: 10.1177/10806032241258333
Tobias Huber, Alexander Egger, Stefan Heschl
{"title":"Severe Hyperthermia in Mountaineering: Coincidence of Heat Stroke and Infection.","authors":"Tobias Huber, Alexander Egger, Stefan Heschl","doi":"10.1177/10806032241258333","DOIUrl":"10.1177/10806032241258333","url":null,"abstract":"<p><p>Heat illness is a condition that is sometimes seen in those undertaking physical activities. This case report focuses on a female hiker who developed heat stroke during a trek in the Dachstein region of Upper Austria. The patient's presentation was initially unclear and could only be confirmed by the use of a thermometer. This had a significant impact on the medical decision-making process during a complex rescue operation.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248972","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
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