{"title":"Rescue operations in the Swiss Alps in 1990 and 1991","authors":"Bruno Durrer MD","doi":"10.1580/0953-9859-4.4.363","DOIUrl":"10.1580/0953-9859-4.4.363","url":null,"abstract":"<div><p>Every year in the Swiss Alps, there are approximately 3000 accidents. Over 90% of victims (1990/1991: <em>n</em> <!-->=<!--> <!-->3500–3800) are rescued by helicopter. In approximately 20% of accidents, a helicopter winch mission is necessary (1990/1991: <em>n</em> <!-->=<!--> <!-->600–700 rescued persons). Swiss Air Rescue (REGA) is responsible for two thirds of all rescues in the off-road areas (1990/1991: <em>n</em> <!-->=<!--> <!-->1958/2321 persons). All REGA rescue missions are registered according to medical (National advisory committee for aeronautics (NACA)) and topographical index. Over two thirds of all winch operations take place in accessible, and one third in difficult accessible sites of accidents. Of these, 2% are extremely difficult rescues, e.g. upon the north faces of the Eiger or the Matterhorn. Over 75% of all winch-rescued persons were rated NACA III–VII, where medical assistance is considered to be necessary at the site of accident. The assignment of experienced emergency doctors, trained in alpine techniques, improves the quality of preclinical treatment even in difficult sites, although clinical demands are not always completely practicable in the field and the possibilities of treatment are often limited by adverse climate and/or topography. An efficient medical-assisted helicopter rescue service has an important impact on the survival chances following alpine sport accidents.</p></div>","PeriodicalId":81742,"journal":{"name":"Journal of wilderness medicine","volume":"4 4","pages":"Pages 363-373"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1580/0953-9859-4.4.363","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67122901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Marine microbiology of Rocas Alijos","authors":"J. Thomas Millington MD, Peggt Wilhelm CLT","doi":"10.1580/0953-9859-4.4.384","DOIUrl":"10.1580/0953-9859-4.4.384","url":null,"abstract":"<div><p>Cordell Expeditions conducted a research journey to Rocas Alijos in 1990 to perform numerous scientific projects at this remote site. As one of the projects, bacteriological cultures were obtained from multiple marine sources, and the bacteria recovered were identified. Antibiotic sensitivities were performed, and the results were compared with previous reports from coastal waters.</p></div>","PeriodicalId":81742,"journal":{"name":"Journal of wilderness medicine","volume":"4 4","pages":"Pages 384-390"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1580/0953-9859-4.4.384","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67122724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Travel related diseases: injury and infectious disease prevention","authors":"Stephen W. Hargarten MD, MPH","doi":"10.1580/0953-9859-4.4.464","DOIUrl":"10.1580/0953-9859-4.4.464","url":null,"abstract":"","PeriodicalId":81742,"journal":{"name":"Journal of wilderness medicine","volume":"4 4","pages":"Pages 464-465"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1580/0953-9859-4.4.464","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67122498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mountaineering emergencies on Denali","authors":"Clare Lattimore MS","doi":"10.1580/0953-9859-4.4.358","DOIUrl":"10.1580/0953-9859-4.4.358","url":null,"abstract":"<div><p>Rescue records of 98 mountaineering emergencies were reviewed to evaluate the risks of climbing North America's highest peak, Denali (6187 m). During a 10 year study period (1978–87) there were 126 search and rescue subjects, including 28 deaths (fatality rate = 4.3 per 1000 climbers; case fatality rate = 22.2%). Increased risk was significant at higher elevations (<em>p</em> <!--><<!--> <!-->0.01), on technically difficult climbing routes (<em>p</em> <!--><<!--> <!-->0.001), and for European and Asian climbers (<em>p</em> <!--><<!--> <!-->0.001). Hazard is inherent to climbing; while prevention of mountaineering injuries is the ideal, development of skilled rescue and medical services is also essential.</p></div>","PeriodicalId":81742,"journal":{"name":"Journal of wilderness medicine","volume":"4 4","pages":"Pages 358-362"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1580/0953-9859-4.4.358","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67122738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Responsibility in the wilderness","authors":"Peter Caldwell MD","doi":"10.1580/0953-9859-4.4.345","DOIUrl":"10.1580/0953-9859-4.4.345","url":null,"abstract":"","PeriodicalId":81742,"journal":{"name":"Journal of wilderness medicine","volume":"4 4","pages":"Pages 345-347"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1580/0953-9859-4.4.345","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"94798256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Wilderness related musculoskeletal injury: role of bone scintigraphy","authors":"Liston Orr MD, Andrew Taylor Jr MD","doi":"10.1580/0953-9859-4.4.407","DOIUrl":"10.1580/0953-9859-4.4.407","url":null,"abstract":"<div><p>Musculoskeletal pain is a common sequela of wilderness related activities. X-ray analysis of persistent musculoskeletal pain often reveals no specific etiology. Nuclear medicine bone scintigraphy has the ability to detect several types of abnormalities which can be missed by plain film techniques. These abnormalities include: 1) stress fracture, 2) enthesopathy, 3) occult fracture. Scintigraphic diagnosis of these injuries can lead to proper and timely treatment while a negative bone scan can effectively rule out osseous injury.</p></div>","PeriodicalId":81742,"journal":{"name":"Journal of wilderness medicine","volume":"4 4","pages":"Pages 407-411"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1580/0953-9859-4.4.407","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67122806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Howard D. Backer MD, FACEP , Ellen Shopes RN, MSN, CCRN , Sherrie L. Collins EMT-P
{"title":"Hyponatremia in recreational hikers in Grand Canyon National Park","authors":"Howard D. Backer MD, FACEP , Ellen Shopes RN, MSN, CCRN , Sherrie L. Collins EMT-P","doi":"10.1580/0953-9859-4.4.391","DOIUrl":"10.1580/0953-9859-4.4.391","url":null,"abstract":"<div><p>Symptomatic hyponatremia has been reported in athletes participating in marathon and ultra-marathon events. We report four cases of symptomatic hyponatremia in hikers in the Grand Canyon. These are the first cases reported in recreational hikers in a wilderness setting. The overall fluid status of these patients is not well defined. In most instances this probably represents dilutional hyponatremia from sweat loss replaced with plain water. Recreational wilderness participants may require electrolyte replacement similar to endurance athletes.</p></div>","PeriodicalId":81742,"journal":{"name":"Journal of wilderness medicine","volume":"4 4","pages":"Pages 391-406"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1580/0953-9859-4.4.391","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67122786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Migraine with aura at high altitude","authors":"Gerhard Jenzer MD, Peter Bärtsch MD","doi":"10.1580/0953-9859-4.4.412","DOIUrl":"10.1580/0953-9859-4.4.412","url":null,"abstract":"<div><p>Detailed investigations after the second attack of a right-sided hemisymptomatology during high altitude mountaineering in an otherwise healthy man pointed to the diagnosis of migraine with aura (MA). Whereas the occurrence óf acute mountain sickness (AMS) and/or high altitude cerebral edema (HACE) and the possibility of a transient ischemic attack (TIA) or stroke should be considered as priorities, the diagnosis of MA should not be neglected.</p></div>","PeriodicalId":81742,"journal":{"name":"Journal of wilderness medicine","volume":"4 4","pages":"Pages 412-415"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1580/0953-9859-4.4.412","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67122858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Stethoscope and sphygmomanometer use on a trek in the Himalayas","authors":"","doi":"10.1580/0953-9859-4.4.461","DOIUrl":"https://doi.org/10.1580/0953-9859-4.4.461","url":null,"abstract":"","PeriodicalId":81742,"journal":{"name":"Journal of wilderness medicine","volume":"4 4","pages":"Pages 461-462"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1580/0953-9859-4.4.461","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137282500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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