Wilderness & environmental medicine
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Over the last decade, a proliferation of interest has emerged in the area of avalanche survival, yielding both an improved understanding of the pathophysiology of death after avalanche burial and technological advances in the development of survival equipment. The dismal survival statistics born out of the modern era of winter recreation unmistakably reveal that elapsed time and depth of burial are the most critical variables of survival and the focus of newer survival devices on the market. Although blunt trauma may kill up to one third of avalanche victims, early asphyxiation is the predominant mechanism of death, and hypothermia is rare. ⋯ The ABS, which forces the wearer to the surface of the avalanche debris by inverse segregation to help prevent burial, has been in use in Europe for the last 10 years with an impressive track record. Finally, the Avalanche Ball is a visual locator device in the form of a spring-loaded ball attached to a tether, which is released from a fanny pack by a rip cord. Despite the excitement surrounding these novel technologies, avalanche avoidance through knowledge and conservative judgment will always be the mainstay of avalanche survival, never to be replaced by any device.
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Wilderness Environ Med · Jan 2002
Skiing, snowboarding, and sledding injuries in a northwestern state.
Winter sports continue to be a popular form of recreation, but few studies have focused on serious injuries. The objectives of this study were to evaluate the major morbidity associated with downhill skiing, snowboarding, and sledding and to determine the incidence of serious injuries sustained while downhill skiing and snowboarding. ⋯ Serious snow sports injuries are rare but potentially debilitating. Head injuries account for the majority of deaths and functional impairment.
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Accidental hypothermia due to environmental exposure is a common condition encountered in the wilderness setting. I report a case of hypothermia that occurred in New Hampshire to a 42-year-old, poorly prepared mountaineer. He presented with ataxia, impaired judgment, oliguria, and slight confusion, suggestive of mild to moderate hypothermia. ⋯ The signs, symptoms, and progression of hypothermia are reviewed, and treatment options are discussed, with an emphasis on management of hypothermia in the wilderness setting. Additionally, more complicated treatment modalities are canvassed, as these are of use to rescue teams and expeditions. Current controversies regarding the treatment of hypothermia, resuscitation efforts, and potential complications are also mentioned.
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Wilderness Environ Med · Jan 2002
An analysis of marine animal injuries presenting to emergency departments in Victoria, Australia.
To describe the epidemiology of marine animal injury in Victoria, Australia, in order to identify risk factors and recommend prevention strategies. ⋯ Marine animal injury is seasonal but rarely serious. Vigilance is required when handling fish, and protective gloves, footwear, and clothing are recommended where appropriate. Clinicians should consider retained foreign bodies in penetrating injuries. Warnings are recommended when jellyfish are most prevalent.