Wilderness & environmental medicine
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Wilderness Environ Med · Dec 2015
ReviewEthical, Legal, and Administrative Considerations for Preparticipation Evaluation for Wilderness Sports and Adventures.
Preparticipation evaluations (PPEs) are common in team, organized, or traditional sports but not common in wilderness sports or adventures. Regarding ethical, legal, and administrative considerations, the same principles can be used as in traditional sports. ⋯ Additional environmental and personal health issues relative to the wilderness activity should be documented, and referral for further screening should be made as deemed necessary, if unable to be performed by the primary clinician. Travel medicine principles should be incorporated, and recommendations for travel or adventure insurance should be made.
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Wilderness Environ Med · Sep 2015
Case ReportsA Case Study: Rare Lepiota brunneoincarnata Poisoning.
Amatoxin poisoning from the genus Lepiota may have a deadly outcome, although this is not seen as often as it is from the genus Amanita. In this report, we present a patient who was poisoned by a sublethal dose of Lepiota brunneoincarnata mushrooms. The patient was hospitalized 12 hours after eating the mushrooms. ⋯ Using reversed-phase high-performance liquid chromatography analysis, an uptake of approximately 19.9 mg of amatoxin from nearly 30 g of mushrooms was calculated. This consisted of 10.59 mg of α-amanitin, 9.18 mg of β-amanitin, and 0.16 mg of γ-amanitin. In conclusion, we present a patient from Turkey who was poisoned by L. brunneoincarnata mushrooms.
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Wilderness Environ Med · Sep 2015
Comparative StudyComparison of Distal Limb Warming With Fluidotherapy and Warm Water Immersion for Mild Hypothermia Rewarming.
The purpose of the study was to determine the effectiveness of Fluidotherapy rewarming through the distal extremities for mildly hypothermic, vigorously shivering subjects. Fluidotherapy is a dry heat modality in which cellulose particles are suspended by warm air circulation. ⋯ Fluidotherapy was not as effective as warm water for rewarming mildly hypothermic subjects. Although Fluidotherapy is more portable and technically simpler, it provides a lower rate of rewarming that is similar to shivering only. It does help decrease shivering heat production, lowering energy expenditure and cardiac work, and could be considered in a hospital setting, if convenient.
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Wilderness Environ Med · Sep 2015
Which Improvised Tourniquet Windlasses Work Well and Which Ones Won't?
Improvised tourniquets in first aid are recommended when no scientifically designed tourniquet is available. Windlasses for mechanical advantage can be a stick or pencil and can be used singly or multiply in tightening a tourniquet band, but currently there is an absence of empiric knowledge of how well such windlasses work. The purpose of the present study was to determine the performance of improvised tourniquets in their use by the type and number of windlasses to improve tourniquet practice. ⋯ A pair of chopsticks as an improvised tourniquet windlass worked better than pencils or craft sticks.