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In the Forefront
This issue of Wilderness & Environmental Medicine represents the exciting and vast scope of our field. High altitude, wilderness toxicology, long distance events, hypothermia diagnosis, avalanche ...
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Scott E. McIntosh,
Tracy Cushing,
Linda E. Keyes
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1
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| Editorials |
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Lessons From Dr Strangelove
In the early 1980s, a group of visionary physicians founded a medical organization predicated on the advancement of a singular health issue. This society was not one dedicated to patient care in the w...
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Jay Lemery
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2-4
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A Time Has Come for Wilderness Emergency Medical Service: A New Direction
In this issue of Wilderness & Environmental Medicine, an article by Warden et al provides a timely overview of various specialized operational emergency medical service (EMS) programs that serve i...
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Brad L. Bennett
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5-6
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| Original Research |
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Nifedipine for the Treatment of High Altitude Pulmonary Edema
Objective: The purpose of this study was to assess the risk factors, patient profile, clinical features, and oral nifedipine as a treatment option for a series of 110 patients with high altitude pulmo...
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Rajesh Deshwal,
Mohd Iqbal,
Sidhant Basnet
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7-10
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Background Rates of Acute Mountain Sickness-Like Symptoms at Low Altitude in Adolescents Using Lake Louise Score
Objective: To record the incidence of symptoms consistent with a diagnosis of acute mountain sickness (AMS), using the Lake Louise questionnaire, in adolescents hiking at low altitude. Methods: The st...
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Jon Dallimore,
Jo-ai Foley,
Peter Valentine
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11-14
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Peripheral Arterial Desaturation Is Further Exacerbated by Exercise in Adolescents With Acute Mountain Sickness
Objective: Rapid ascent to altitude can result in the development of high altitude illnesses such as acute mountain sickness (AMS). This study aimed to investigate AMS symptoms in adolescents and stud...
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Sarah A. Major,
Ryan J.K. Hogan,
Elizabeth Yeates,
Chris H.E. Imray
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15-23
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Recombinant Angiotensin-Converting Enzyme 2 Suppresses Pulmonary Vasoconstriction in Acute Hypoxia
Objective: Alveolar hypoxia as a result of high altitude leads to increased pulmonary arterial pressure. The renin-angiotensin system is involved in the regulation of pulmonary arterial pressure throu...
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Axel Kleinsasser,
Iris Pircher,
Benedict Treml,
Martin Schwienbacher,
Manfred Schuster,
Eveline Janzek,
Hans Loibner,
Josef M. Penninger,
Alex Loeckinger
et al.
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24-30
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Physiological Bone Responses in the Fingers After More Than 10 Years of High-Level Sport Climbing: Analysis of Cortical Parameters
Objective: Sports activity can induce bone modeling processes with apposition of new bone and changes in bone morphology. Sport climbing places extreme forces and stress on the hands, especially on th...
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Frederik Hahn,
Matthias Erschbaumer,
Philipp Allenspach,
Kaspar Rufibach,
Andreas Schweizer
et al.
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31-36
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| Operational and Tactical Medicine |
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Medical Direction of Wilderness and Other Operational Emergency Medical Services Programs
Within a healthcare system, operational emergency medical services (EMS) programs provide prehospital emergency care to patients in austere and resource-limited settings. Some of these programs are ad...
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Craig R. Warden,
Michael G. Millin,
Seth C. Hawkins,
Richard N. Bradley
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37-43
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| Case Reports |
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Novel Use of a Hemostatic Dressing in the Management of a Bleeding Leech Bite: A Case Report and Review of the Literature
Persistent bleeding from leech bites is a common occurrence, although little evidence is available to guide management. Detailed here is the case of a 30-year-old American man who presented with two l...
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Preston J. Fedor
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44-48
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Wolf Spider Envenomation
Although wolf spider venom has been implicated in necrotic arachnidism without acceptably documented verification, limited, prospectively collected data demonstrate a lack of cutaneous necrosis. The i...
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Zhanna Livshits,
Benjamin Bernstein,
Louis N. Sorkin,
Silas W. Smith,
Robert S. Hoffman
et al.
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49-50
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Managing Anaphylaxis in a Jungle Environment
Anaphylaxis is a medical emergency requiring prompt action to prevent death from cardio-respiratory collapse. It can be a biphasic, unpredictable, and challenging reaction to deal with even in a hospi...
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Suzy Stokes,
Sean Hudson
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51-55
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| Brief Reports |
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Increasing Creatine Kinase Concentrations at the 161-km Western States Endurance Run
Objective: Very high blood creatine kinase (CK) concentrations have been observed among recent finishers of the 161-km Western States Endurance Run (WSER), and it has been suggested that there is a li...
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Martin D. Hoffman,
Julie L. Ingwerson,
Ian R. Rogers,
Tamara Hew-Butler,
Kristin J. Stuempfle
et al.
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56-60
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Improvised Traction Splints: A Wilderness Medicine Tool or Hindrance?
Objectives: To investigate whether a traction splint made from improvised materials is as efficacious as commercially available devices in terms of traction provided and perceived comfort and stabilit...
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Lori Weichenthal,
Susanne Spano,
Brian Horan,
Jacob Miss
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61-64
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Animal-Related Motorcycle Collisions in North Dakota
20 January 2012
Objective: To study the epidemiology and mortality of animal-motorcycle collisions. Methods: A retrospective study of all motorcycle collisions recorded in the North Dakota Department of Transportatio...
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Patricia S. Bramati,
Lynn F. Heinert,
Lindsey B. Narloch,
Jeff Hostetter,
Javier D. Finkielman
et al.
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65-69
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Homemade Thermometry Instruments in the Field
Objective: Esophageal temperature is the gold standard for in-the-field temperature monitoring in hypothermic victims with cardiac arrest. For practical reasons, some mountain rescue teams use homemad...
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Mathieu Pasquier,
Valentin Rousson,
Grégoire Zen Ruffinen,
Olivier Hugli
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70-74
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| Clinical Images |
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A Rash
A 31-year-old, otherwise healthy woman presented to a clinic in California with a rash on her arm (). Ten days earlier she had traveled by car from Michigan.
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Natacha Chough
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75-76
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| Lessons from History |
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Snow Blindness and Other Eye Problems During the Heroic Age of Antarctic Exploration
During the heroic age of Antarctic exploration, snow blindness was a common problem, but not all the descriptions of it fit the modern view of the disease, and some of the explorers complained of long...
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Henry R. Guly
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77-82
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| Introduction to Wilderness Instructor |
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Wilderness Medicine Within Global Health
Those of us who started teaching first aid and emergency care decades ago have seen the curricula for the courses taught to lay people shrink as the emergency medical services (EMS) system in this cou...
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Steve Donelan
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83
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| Wilderness Instructor |
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Wilderness Medicine Within Global Health: A Strategy for Less Risk and More Reward
In the last several years, healthcare workers and trainees have demonstrated an unprecedented interest in global health and the medical challenges facing developing countries and regions in crisis. Pe...
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Jay Lemery,
Dana Sacco,
Amita Kulkarni,
Liz Francis
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84-88
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| Abstracts of Current Literature |
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The American Journal of Emergency Medicine
This study aimed to evaluate the efficacy of mobile phone networks for remote medical consultations. This experimental study compared the use of mobile phone radiology consultation to hospital worksta...
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89
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Western Journal of Emergency Medicine
This article summaries the current contingency operations and resources for a mass casualty incident (MCI) in Antarctica. The authors cited surveyed literature and past incidents to describe the curre...
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89
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Morbidity and Mortality Weekly Report
This report provided valuable information about the incidence and characteristics of heat illness related to sports and recreation. The Centers for Disease Control (CDC) analyzed data from the Nationa...
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89-90
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Archives of Surgery
This retrospective observational study assessed the effect of tranexamic acid (TXA) in combat injury on total blood product use, thromboembolic complications, and mortality. Tranexamic acid is a lysin...
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90
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Journal of Applied Physiology
The authors of this article investigated the link between vasogenic edema associated with acute mountain sickness (AMS). One contributing factor to the development of vasogenic edema may be the disrup...
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90
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| Wilderness Essay |
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Mountain Clothing and Thermoregulation: A Look Back
At the time humans began exploring the upper reaches of the world's highest mountain ranges in the early 20th century, knowledge about survival in extreme climates was undergoing rapid development. Ea...
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George W. Rodway
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91-94
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| Letters to the Editor |
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Pulse Oximetry After 6-Minute Walk Test and Summit Success on Kilimanjaro
02 December 2011
Kilimanjaro, at 5896 m, is famous both as 1 of the 7 summits and as an accessible trekking peak that can be climbed with minimal experience or technical skill. It is a popular destination for charity ...
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Rob Daniels
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95-96
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Utilizing Avalanche Safety Equipment to Prevent Snow Immersion Asphyxiation Revisited
The final week of 2010 was bittersweet for snowriders. Massive storms pummeled the western mountains in North America with big fat flakes. Skiers and snowboarders flocked to the deep powder snow on ho...
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Christopher Van Tilburg
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96-97
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Surgical Tick Removal
05 December 2011
Tick-borne diseases are increasing in prevalence. Ticks are best removed as soon as possible, because the risk of disease transmission increases significantly after 24 hours of attachment. Furthermore...
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Stylianos Roupakias,
Paraskevi Mitsakou,
Angelos Al Nimer
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97-99
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| Wilderness Images |
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Chortens Before Ama Dablam
19 January 2012
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Luanne Freer
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100
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Burchell's Zebra
19 January 2012
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Peter Kummerfeldt
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101
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