Wilderness & Environmental Medicine最新文献_第5页

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":"70 1","pages":"10806032241278982"},"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

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

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 Buthus paris (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":"Introduction: Buthus species, including B paris, 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 B paris venom.Methods: We investigated the experimental pathophysiology of B paris 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-1.Results: Our results showed that the subcutaneous median lethal dose of B paris venom was around 0.52 mg·kg-1. 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 B paris venom injection.Conclusion: Our findings show that B paris 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.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"271-277"},"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

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

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":"Introduction: 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.Methods: 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.Results: 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).Conclusions: 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.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"287-294"},"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

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

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":"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.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"351-355"},"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

Corrigendum 2 to "Russula subnigricans Poisoning Causes Severe Rhabdomyolysis That Could be Misdiagnosed as Non-ST Segment Elevation Myocardial Infarction". Russula subnigricans 中毒导致严重横纹肌溶解，可能被误诊为非 ST 段抬高型心肌梗死》的更正 2。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-09-01 Epub Date: 2024-05-27 DOI: 10.1177/10806032241259468

引用次数: 0

Corrigendum to "Prevention and Treatment of Nonfreezing Cold Injuries and Warm Water Immersion Tissue Injuries: A Supplement to the Wilderness Medical Society Clinical Practice Guidelines". 非冰冻冷伤和温水浸泡组织损伤的预防和治疗：荒野医学会临床实践指南》补编。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-09-01 Epub Date: 2024-05-05 DOI: 10.1177/10806032241253558

引用次数: 0