Wilderness Medicine (practice)
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Wilderness Medicine (practice)
Wilderness medicine is a rapidly evolving field and is of increasing importance as more people engage in hiking, climbing, kayaking, and other potentially hazardous activities in the backcountry. The modern definition of wilderness medicine is "medical care delivered in those areas where fixed or transient geographic challenges reduce availability of, or alter requirements for, medical or patient movement resources". A primary focus of the field is the evaluation, prioritization (triage), preliminary treatment of acute injuries or illnesses which occur in those environments and the emergency evacuation of victims. However, back country rescue and wilderness first aid is not the sole activity of wilderness medical professionals, who are also concerned with many additional topics. These include but are not limited to: * Secondary care follow up to first aid in remote settings, such as expeditions * Evaluation of experience and issuance of updated protocols for first response and sec ...
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Stanford University
Stanford University, officially Leland Stanford Junior University, is a private research university in Stanford, California. The campus occupies , among the largest in the United States, and enrolls over 17,000 students. Stanford is considered among the most prestigious universities in the world. Stanford was founded in 1885 by Leland and Jane Stanford in memory of their only child, Leland Stanford Jr., who had died of typhoid fever at age 15 the previous year. Leland Stanford was a U.S. senator and former governor of California who made his fortune as a railroad tycoon. The school admitted its first students on October 1, 1891, as a coeducational and non-denominational institution. Stanford University struggled financially after the death of Leland Stanford in 1893 and again after much of the campus was damaged by the 1906 San Francisco earthquake. Following World War II, provost of Stanford Frederick Terman inspired and supported faculty and graduates' entrepreneu ...
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High Altitude
Altitude or height (also sometimes known as depth) is a distance measurement, usually in the vertical or "up" direction, between a reference datum and a point or object. The exact definition and reference datum varies according to the context (e.g., aviation, geometry, geographical survey, sport, or atmospheric pressure). Although the term ''altitude'' is commonly used to mean the height above sea level of a location, in geography the term elevation is often preferred for this usage. Vertical distance measurements in the "down" direction are commonly referred to as depth. In aviation In aviation, the term altitude can have several meanings, and is always qualified by explicitly adding a modifier (e.g. "true altitude"), or implicitly through the context of the communication. Parties exchanging altitude information must be clear which definition is being used. Aviation altitude is measured using either mean sea level (MSL) or local ground level (above ground level, or ...
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Airway Management
Airway management includes a set of maneuvers and medical procedures performed to prevent and relieve airway obstruction. This ensures an open pathway for gas exchange between a patient's lungs and the atmosphere. This is accomplished by either clearing a previously obstructed airway; or by preventing airway obstruction in cases such as anaphylaxis, the obtunded patient, or medical sedation. Airway obstruction can be caused by the tongue, foreign objects, the tissues of the airway itself, and bodily fluids such as blood and gastric contents ( aspiration). Airway management is commonly divided into two categories: basic and advanced. Basic techniques are generally non-invasive and do not require specialized medical equipment or advanced training. These include head and neck maneuvers to optimize ventilation, abdominal thrusts, and back blows. Advanced techniques require specialized medical training and equipment, and are further categorized anatomically into supraglottic device ...
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Triage
In medicine, triage () is a practice invoked when acute care cannot be provided for lack of resources. The process rations care towards those who are most in need of immediate care, and who benefit most from it. More generally it refers to prioritisation of medical care as a whole. In its acute form it is most often required on the battlefield, during a pandemic, or at peacetime when an accident results in a mass casualty which swamps nearby healthcare facilities' capacity. Triage always follows the modern interpretation of the Hippocratic oath, but otherwise there is plenty of leeway in interpretation, leading to more than one simultaneous idea of its nature. The best settled theories and practical scoring systems used in here come from the area of acute physical trauma in an emergency room setting; a broken bone obviously counts for less than uncontrolled arterial bleeding, apt to lead to death. But no current principle carries too well over to mental health, reproductive heal ...
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Aviation Medicine
Aviation medicine, also called flight medicine or aerospace medicine, is a preventive or occupational medicine in which the patients/subjects are pilots, aircrews, or astronauts. The specialty strives to treat or prevent conditions to which aircrews are particularly susceptible, applies medical knowledge to the human factors in aviation and is thus a critical component of aviation safety. A military practitioner of aviation medicine may be called a flight surgeon and a civilian practitioner is an aviation medical examiner. One of the biggest differences between the military and civilian flight doctors is the military flight surgeon's requirement to log flight hours. Overview Broadly defined, this subdiscipline endeavors to discover and prevent various adverse physiological responses to hostile biologic and physical stresses encountered in the aerospace environment. Problems range from life support measures for astronauts to recognizing an ear block in an infant traveling on an a ...
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Hypothermia
Hypothermia is defined as a body core temperature below in humans. Symptoms depend on the temperature. In mild hypothermia, there is shivering and mental confusion. In moderate hypothermia, shivering stops and confusion increases. In severe hypothermia, there may be hallucinations and paradoxical undressing, in which a person removes their clothing, as well as an increased risk of the heart stopping. Hypothermia has two main types of causes. It classically occurs from exposure to cold weather and cold water immersion. It may also occur from any condition that decreases heat production or increases heat loss. Commonly, this includes alcohol intoxication but may also include low blood sugar, anorexia and advanced age. Body temperature is usually maintained near a constant level of through thermoregulation. Efforts to increase body temperature involve shivering, increased voluntary activity, and putting on warmer clothing. Hypothermia may be diagnosed based on either a person ...
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Dehydration
In physiology, dehydration is a lack of total body water, with an accompanying disruption of metabolic processes. It occurs when free water loss exceeds free water intake, usually due to exercise, disease, or high environmental temperature. Mild dehydration can also be caused by immersion diuresis, which may increase risk of decompression sickness in divers. Most people can tolerate a 3-4% decrease in total body water without difficulty or adverse health effects. A 5-8% decrease can cause fatigue and dizziness. Loss of over ten percent of total body water can cause physical and mental deterioration, accompanied by severe thirst. Death occurs at a loss of between fifteen and twenty-five percent of the body water.Ashcroft F, Life Without Water in Life at the Extremes. Berkeley and Los Angeles, 2000, 134-138. Mild dehydration is characterized by thirst and general discomfort and is usually resolved with oral rehydration. Dehydration can cause hypernatremia (high levels of sodium ...
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Heat Illness
Heat illness is a spectrum of disorders due to increased body temperature. It can be caused by either environmental conditions or by exertion. It includes minor conditions such as heat cramps, heat syncope, and heat exhaustion as well as the more severe condition known as heat stroke. It can affect any or all anatomical systems. Classification A number of heat illnesses exist including: * Heat stroke - Defined by a body temperature of greater than due to environmental heat exposure with lack of thermoregulation. Symptoms include dry skin, rapid, strong pulse and dizziness. * Heat exhaustion - Can be a precursor of heatstroke; the symptoms include heavy sweating, rapid breathing and a fast, weak pulse. * Heat syncope - Fainting or dizziness as a result of overheating. * Heat edema * Heat cramps - Muscle pains that happen during heavy exercise in hot weather. * Heat rash - Skin irritation from excessive sweating. * Heat tetany - Usually results from short periods of stress in int ...
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Toxicology
Toxicology is a scientific discipline, overlapping with biology, chemistry, pharmacology, and medicine, that involves the study of the adverse effects of chemical substances on living organisms and the practice of diagnosing and treating exposures to toxins and toxicants. The relationship between dose and its effects on the exposed organism is of high significance in toxicology. Factors that influence chemical toxicity include the dosage, duration of exposure (whether it is acute or chronic), route of exposure, species, age, sex, and environment. Toxicologists are experts on poisons and poisoning. There is a movement for evidence-based toxicology as part of the larger movement towards evidence-based practices. Toxicology is currently contributing to the field of cancer research, since some toxins can be used as drugs for killing tumor cells. One prime example of this is ribosome-inactivating proteins, tested in the treatment of leukemia. The word ''toxicology'' () is a neocla ...
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Envenomation
Envenomation is the process by which venom is injected by the bite or sting of a venomous animal. Many kinds of animals, including mammals (e.g., the northern short-tailed shrew, ''Blarina brevicauda''), reptiles (e.g., the king cobra), spiders (e.g., black widows), insects (e.g., wasps), and fish (e.g., stone fish) employ venom for hunting and for self-defense. In particular, snakebite envenoming is considered a neglected tropical disease resulting in >100,000 deaths and maiming >400,000 people per year. Mechanisms Some venoms are applied externally, especially to sensitive tissues such as the eyes, but most venoms are administered by piercing the skin of the victim. Venom in the saliva of the Gila monster and some other reptiles enters prey through bites of grooved teeth. More commonly animals have specialized organs such as hollow teeth (fangs) and tubular stingers that penetrate the prey's skin, whereupon muscles attached to the attacker's venom reservoir squirt venom d ...
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Drowning
Drowning is a type of suffocation induced by the submersion of the mouth and nose in a liquid. Most instances of fatal drowning occur alone or in situations where others present are either unaware of the victim's situation or unable to offer assistance. After successful resuscitation, drowning victims may experience breathing problems, vomiting, confusion, or unconsciousness. Occasionally, victims may not begin experiencing these symptoms until several hours after they are rescued. An incident of drowning can also cause further complications for victims due to low body temperature, aspiration of vomit, or acute respiratory distress syndrome (respiratory failure from lung inflammation.). Drowning is more likely to happen when spending extended periods of time near large bodies of water. Risk factors for drowning include alcohol use, drug use, epilepsy, minimal swim training or a complete lack of training, and, in the case of children, a lack of supervision. Common drowning ...
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Lightning
Lightning is a naturally occurring electrostatic discharge during which two electric charge, electrically charged regions, both in the atmosphere or with one on the land, ground, temporarily neutralize themselves, causing the instantaneous release of an average of one Joule, gigajoule of energy. This discharge may produce a wide range of electromagnetic radiation, from heat created by the rapid movement of electrons, to brilliant flashes of visible light in the form of black-body radiation. Lightning causes thunder, a sound from the shock wave which develops as gases in the vicinity of the discharge experience a sudden increase in pressure. Lightning occurs commonly during thunderstorms as well as other types of energetic weather systems, but volcanic lightning can also occur during volcanic eruptions. The three main kinds of lightning are distinguished by where they occur: either inside a single Cumulonimbus cloud, thundercloud (intra-cloud), between two clouds (cloud-to-cl ...
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