Wilderness & environmental medicine
-
Wilderness Environ Med · Jan 2004
Case ReportsUse of the Gamow Bag by EMT-basic park rangers for treatment of high-altitude pulmonary edema and high-altitude cerebral edema.
As part of an emergency medical system protocol, national park service rangers certified at the level of an emergency medical technician-basic (EMT-B) are taught to recognize and treat high-altitude pulmonary edema and high-altitude cerebral edema. In Sequoia and Kings Canyon National Parks, this is done with the assistance of physician on-line medical control as a backup. High-altitude pulmonary edema and high-altitude cerebral edema are both potentially fatal altitude illnesses that can be particularly problematic in the backcountry, where evacuation may be delayed. We report a case of high-altitude pulmonary edema and high-altitude cerebral edema occurring at moderate altitude that was successfully treated by park rangers with the Gamow Bag.
-
Wilderness Environ Med · Jan 2004
Inhibitors of hypoxic pulmonary vasoconstriction prevent high-altitude pulmonary edema in rats.
Rapid ascent to high altitude causes hypoxic pulmonary vasoconstriction (HPV) and leads to high-altitude pulmonary edema (HAPE) in susceptible humans. Vasodilating agents lessen HAPE (as evidenced by radiographic and gas exchange measurements), but data establishing their effectiveness on alveolar protein content and hemorrhage are lacking. This study was designed to assess whether preventing HPV reduces the alveolar-capillary barrier leak characteristic of HAPE. ⋯ The results demonstrate that treatment with NiCl2 or acetazolamide prevents HAPE in rats and are consistent with a role for elevated pulmonary artery pressure in the pathogenesis of HAPE.
-
Wilderness Environ Med · Jan 2004
Review Case ReportsAirway compromise after first rattlesnake envenomation.
The purpose of this report is to describe an unusual presentation of anaphylaxis after first-time rattlesnake envenomation. A patient on a medical toxicology inpatient service is presented who had signs of anaphylaxis, including airway compromise, after first-time rattlesnake envenomation. ⋯ The patient's recovery was prolonged. In conclusion, rattlesnake envenomation may result in rapidly progressive airway compromise, possibly caused by anaphylaxis in patients with previous dermal or gastrointestinal exposure to snake proteins.
-
Wilderness Environ Med · Jan 2004
Epidemiology of wilderness search and rescue in New Hampshire, 1999-2001.
To describe the epidemiology of wilderness search and rescue in a region with easily accessible, heavily used wilderness areas. ⋯ The most prevalent demographic group requiring search-and-rescue efforts in New Hampshire was men aged 30 to 40 years who were hiking and who resided within a 4-hour drive of the area where they encountered difficulty. To decrease the number of people involved in most search and rescue, efforts should be focused on preventing wilderness users from getting lost and preventing lower extremity musculoskeletal injuries. Wilderness deaths may be prevented by focusing attention on cardiac health in wilderness users older than 50 years and on water safety.
-
Wilderness Environ Med · Jan 2004
Biography Historical Article Classical ArticleThe physiology of channel swimmers. 1955.