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Rescue Death
Rescue death (or reflow syndrome) is a hypothesized fatal condition that can occur after blood pools in a part of the body for a prolonged period such as during suspension trauma. There are several proposed mechanisms for this phenomenon. One mechanism suggests that toxins build up in the pooled blood, and problems arise when this toxin-rich, oxygen-poor blood returns to the body when the patient is allowed to lie down. Another mechanism suggests that the sudden increase in preload causes acute heart failure. Although often discussed in lay publications on suspension trauma, several studies systematically reviewing the medical literature have concluded that there is no evidence of this phenomenon. Treatment In the past, preventing a patient from lying down following suspension trauma or any other situation where blood had pooled in the legs for an extended period of time was thought to be important; instead, it was recommended that a patient should be placed in a seated position so ...
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Suspension Trauma
Suspension trauma, also known as orthostatic shock while suspended, harness hang syndrome (HHS), suspension syndrome, or orthostatic intolerance, is an effect which occurs when the human body is held upright without any movement for a period of time. If the person is strapped into a harness or tied to an upright object they will eventually suffer the central ischaemic response (commonly known as fainting). Fainting while remaining vertical increases the risk of death from cerebral hypoxia. Since there is no evidence that these effects are specifically due to trauma, or caused by the harness itself, climbing medicine authorities have argued against the terminology of suspension trauma or harness hang syndrome and instead termed this simply "suspension syndrome".Hawkins SC, Simon RB, Beissinger JP, Simon D. Vertical Aid: Essential Wilderness Medicine for Climbers, Trekkers, and Mountaineers. New York: The Countryman Press, 2017. People at risk of suspension trauma include people u ...
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Preload (cardiology)
In cardiac physiology, preload is the amount of sarcomere stretch experienced by cardiac muscle cells, called cardiomyocytes, at the end of ventricular filling during diastole. Preload is directly related to ventricular filling. As the relaxed ventricle fills during diastole, the walls are stretched and the length of sarcomeres increases. Sarcomere length can be approximated by the volume of the ventricle because each shape has a conserved surface-area-to-volume ratio. This is useful clinically because measuring the sarcomere length is destructive to heart tissue. It requires cutting out a piece of cardiac muscle to look at the sarcomeres under a microscope. It is currently not possible to directly measure preload in the beating heart of a living animal. Preload is estimated from end-diastolic ventricular pressure and is measured in millimeters of mercury (mmHg). Estimating preload Though not exactly equivalent to the strict definition of ''preload,'' end-diastolic volume is ...
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Heart Failure
Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome, a group of signs and symptoms caused by an impairment of the heart's blood pumping function. Symptoms typically include shortness of breath, excessive fatigue, and leg swelling. The shortness of breath may occur with exertion or while lying down, and may wake people up during the night. Chest pain, including angina, is not usually caused by heart failure, but may occur if the heart failure was caused by a heart attack. The severity of the heart failure is measured by the severity of symptoms during exercise. Other conditions that may have symptoms similar to heart failure include obesity, kidney failure, liver disease, anemia, and thyroid disease. Common causes of heart failure include coronary artery disease, heart attack, high blood pressure, atrial fibrillation, valvular heart disease, excessive alcohol consumption, infection, and cardiomyopathy. These cause heart failure by altering ...
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First Aid
First aid is the first and immediate assistance given to any person with either a minor or serious illness or injury, with care provided to preserve life, prevent the condition from worsening, or to promote recovery. It includes initial intervention in a serious condition prior to professional medical help being available, such as performing cardiopulmonary resuscitation (CPR) while waiting for an ambulance, as well as the complete treatment of minor conditions, such as applying a plaster to a cut. First aid is generally performed by someone with basic medical training. Mental health first aid is an extension of the concept of first aid to cover mental health, while psychological first aid is used as early treatment of people who are at risk for developing PTSD. Conflict First Aid, focused on preservation and recovery of an individual's social or relationship well-being, is being piloted in Canada. There are many situations that may require first aid, and many countries hav ...
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Supine Position
The supine position ( or ) means lying horizontally with the face and torso facing up, as opposed to the prone position, which is face down. When used in surgical procedures, it grants access to the peritoneal, thoracic and pericardial regions; as well as the head, neck and extremities. Using anatomical terms of location, the dorsal side is down, and the ventral side is up, when supine. Semi-supine In scientific literature "semi-supine" commonly refers to positions where the upper body is tilted (at 45° or variations) and not completely horizontal. Relation to sudden infant death syndrome The decline in death due to sudden infant death syndrome (SIDS) is said to be attributable to having babies sleep in the supine position. The realization that infants sleeping face down, or in a prone position, had an increased mortality rate re-emerged into medical awareness at the end of the 1980s when two researchers, Susan Beal in Australia and Gus De Jonge in the Netherlands, indep ...
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Suspension Trauma
Suspension trauma, also known as orthostatic shock while suspended, harness hang syndrome (HHS), suspension syndrome, or orthostatic intolerance, is an effect which occurs when the human body is held upright without any movement for a period of time. If the person is strapped into a harness or tied to an upright object they will eventually suffer the central ischaemic response (commonly known as fainting). Fainting while remaining vertical increases the risk of death from cerebral hypoxia. Since there is no evidence that these effects are specifically due to trauma, or caused by the harness itself, climbing medicine authorities have argued against the terminology of suspension trauma or harness hang syndrome and instead termed this simply "suspension syndrome".Hawkins SC, Simon RB, Beissinger JP, Simon D. Vertical Aid: Essential Wilderness Medicine for Climbers, Trekkers, and Mountaineers. New York: The Countryman Press, 2017. People at risk of suspension trauma include people u ...
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Reperfusion Injury
Reperfusion injury, sometimes called ischemia-reperfusion injury (IRI) or reoxygenation injury, is the tissue damage caused when blood supply returns to tissue ('' re-'' + '' perfusion'') after a period of ischemia or lack of oxygen (anoxia or hypoxia). The absence of oxygen and nutrients from blood during the ischemic period creates a condition in which the restoration of circulation results in inflammation and oxidative damage through the induction of oxidative stress rather than (or along with) restoration of normal function. Reperfusion injury is distinct from cerebral hyperperfusion syndrome (sometimes called "Reperfusion syndrome"), a state of abnormal cerebral vasodilation. Mechanisms Reperfusion of ischemic tissues is often associated with microvascular injury, particularly due to increased permeability of capillaries and arterioles that lead to an increase of diffusion and fluid filtration across the tissues. Activated endothelial cells produce more reactive oxygen sp ...
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