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  Subjects -> ENVIRONMENTAL STUDIES (Total: 752 journals)
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ENVIRONMENTAL STUDIES (679 journals)

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Journal Cover Wilderness & Environmental Medicine
  [SJR: 0.49]   [H-I: 29]   [3 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1080-6032
   Published by Elsevier Homepage  [3039 journals]
  • Promoting Resilience among Veterans Using Wilderness Therapy
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Shauna Joye, Zachary Dietrich


      PubDate: 2016-09-03T07:28:12Z
       
  • Ambulatory Blood Pressure Monitoring Reveals Increased Sleeping Blood
           Pressure in Hypertensive Individuals at High Altitude
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): David S. Young, Linda E. Keyes, Luke F. Mather, Charles Duke, Nirajam Rejmi, Benoit M. Phelan, Sushil Pant, Jennifer M. Starling, Matthew K. McElwee, Devlin Cole, Theodore McConnell, Purshotam Paudel, Douglas Sallade, Allison L. Sheets, David R. Twillman, Buddha Basynat


      PubDate: 2016-09-03T07:28:12Z
       
  • The Effect of Riociguat on Gas Exchange, Exercise Performance, and
           Pulmonary Artery Pressure During Acute Altitude Exposure
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Jon Andrews, Stefanie Martina, Michael Natoli, Nicole Harlan, Luke Neilans, Miguel Alvarez Villela, John Freiberger, Aaron Walker, Ishwori Dhakal, Richard Moon


      PubDate: 2016-09-03T07:28:12Z
       
  • The Influence of Snow Density on O2 and CO2 Levels in Subjects Breathing
           into an Artificial Airpocket
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Giacomo Strapazzon, Kai Schenk, Peter Paal, Markus Falk, Tomas Dal Cappello, Katharina Grassegger, Sandro Malacrida, Hannes Gatterer, Lukas Riess, Benjamin Zweifel, Jürg Schweizer, Hermann Brugger


      PubDate: 2016-09-03T07:28:12Z
       
  • A Novel Cooling Method and Comparison of Active Rewarming of Mild
           Hypothermia
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Mark L. Christensen, Grant S. Lipman, Dennis A. Grahn, Kate Shea, Joseph Einhorn, Craig Heller


      PubDate: 2016-09-03T07:28:12Z
       
  • Down to the Wire? Ventilation during Intubated Stretcher Helicopter
           Winching
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): John D. Hollott


      PubDate: 2016-09-03T07:28:12Z
       
  • Prehospital Interventions during Mass Casualty Events in Afghanistan: A
           Case Series
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Steven G. Schauer, Derek Brown, Michael D. April, Erica Simon, Joseph Maddry, Robert Carter, Robert Delorenzo


      PubDate: 2016-09-03T07:28:12Z
       
  • Core Content for Wilderness Medicine Training: Development of a Wilderness
           Medicine Track within an Emergency Medicine Residency
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Jonathan Drew, Nicole Battaglioli, Walter A. Schrading


      PubDate: 2016-09-03T07:28:12Z
       
  • Prospective Double-Blinded Randomized Field-Based Clinical Trial of
           
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Hillary R. Irons, Renee N. Salas, Salman F. Bhai, N. Stuart Harris


      PubDate: 2016-09-03T07:28:12Z
       
  • Survey of Hand and Upper-Extremity Injuries among Rock Climbers
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Clayton E. Nelson, Ghazi M. Rayan, Dustin I. Judd, Kai Ding, Julie A. Stoner


      PubDate: 2016-09-03T07:28:12Z
       
  • Performance Matters: Training Tools to Improve Medical Team Disaster
           Performance in Austere Environments
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Lancer A. Scott, Kemp Anderson, Janelle Sourbeer, Layne Madden, Diann Krywko, Evert Eriksson, Dan Fisher


      PubDate: 2016-09-03T07:28:12Z
       
  • Thermoregulation During Extended Exercise in the Heat: Comparisons of
           Fluid Volume and Temperature
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Walter S. Hailes, John S. Cuddy, Kyle Cochrane, Brent C. Ruby
      Objective This study aimed to determine the physiological and thermoregulatory responses of individuals exercising in the heat (US military red flag conditions, wet-bulb globe temperature 31.5–32.2ºC) while consuming varied volumes of ambient temperature water and ice slurry. Methods Participants (N = 12) walked on a treadmill for 3 hours at approximately 40% peak aerobic capacity in a hot environment while consuming ambient temperature (35.5°C) water (W), ice slurry (0°C, two-thirds shaved ice and one-third water) at a ratio of 2 g·kg-1 body mass every 10 minutes (FS), and reduced volume ice slurry as described at a rate of 1 g·kg-1 body mass every 10 minutes (HS). Trials were completed at least 14 days apart, in a randomized, repeated measures design. Results Percent body weight loss was higher during the HS trial (1.8 ± 0.01%) compared with FS (0.5 ± 0.01%; P < .001) and W (0.6 ± 0.01%; P < .001). Mean rectal temperature at 3 hours was lower during FS (37.8 ± 0.7°C) compared with HS (38.1 ± 0.8°C) and W (38.2 ± 0.8°C) (P = .04 vs HS, and P = .005 vs W, main effect for trial). No differences were found in rectal temperature between HS and W. Heart rate was lower at the end of the third hour during FS (141 ± 10 beats/min) compared with HS (157 ± 19 beats/min) and W (154 ± 18 beats/min) (P = .001 and P = .007, respectively, time × trial interaction). There were no differences in heart rate between HS and W. Conclusions The temperature of consumed fluids may be as important as the volume for the management of thermoregulation and other physiological responses for extended work in hot environments.

      PubDate: 2016-09-03T07:28:12Z
       
  • Telesound: Can Real-Time Video Streaming of Ultrasound Imaging from Remote
           Locations Yield An Accurate Diagnosis?
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Rachel E. Whitney, Antonio Riera, Lei Chen


      PubDate: 2016-09-03T07:28:12Z
       
  • CPR in Whitewater Drowning Victims: Is It Possible To Perform Adequate
           Chest Compressions Through a Personal Flotation Device (PFD)?
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Scott McCorvey, Erin Lurie, Robert D'Zio, Michael Caudell


      PubDate: 2016-09-03T07:28:12Z
       
  • Lightning Accidents in the Austrian Alps 2006 to 2014—A
           Retrospective Study
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Michael Lanthaler, Mathias Ströhle, Andreas Würtele, Hans Ebner, Peter Paal


      PubDate: 2016-09-03T07:28:12Z
       
  • Trauma Training for Journalists: Developing and Implementing an
           Intercultural Medical Curriculum for Journalists Working in Regions of
           Conflict
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): David S. Young, Michael Puntis


      PubDate: 2016-09-03T07:28:12Z
       
  • Relationship of Blood Pressure and Hypertension to Acute Mountain Sickness
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Jennifer Starling, Linda Keyes, Sushil Patel, Nirajam Regmi, Devlin Cole, Charles Duke, Luke Mather, Theodore McConnell, Matthew McElwee, Purshotam Paudel, Benoit Phelan, Douglas Sallade, Alison Sheets, David Twillmann, David Young, Buddha Basnyat


      PubDate: 2016-09-03T07:28:12Z
       
  • Harness Suspension Stress, Narrowing the Focus
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): James Marc Beverly, Jenna M.B. White, Erin Renee Beverly, Trisha A. McLain, Jeremy McCormick, Micah Zuhl, Jason Dale Williams, Christine M. Mermier


      PubDate: 2016-09-03T07:28:12Z
       
  • Crotalus horridus horridus Venom-Induced Thrombocytopenia:
           Characterization of Venom after Binding of Crotalidae Polyvalent Immune
           Fab Antivenom
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Laura Bechtel, Seth Althoff, Christopher Holstege


      PubDate: 2016-09-03T07:28:12Z
       
  • Exercise in Inversions: A Pilot Study of PM2.5 Air Pollution Effects on
           Pulmonary Function and Aerobic Performance
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Dale Wagner


      PubDate: 2016-09-03T07:28:12Z
       
  • Accuracy of Acute Kidney Injury Measurements in Multistage Ultramarathon
           Runners
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Colin Little, Grant Lipman, Daniel Migliaccio, David Young, Brian Krabak


      PubDate: 2016-09-03T07:28:12Z
       
  • Blood Pressure and High Altitude: An Observational Cohort Study of
           Hypertensive and Nonhypertensive Himalayan Trekkers in Nepal
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): T. Douglas Sallade, Linda E. Keyes, Jennifer Starling, Sushil Pant, Alison Sheets, David Young, David Twillman, Nirajan Regmi, Benoit Phelan, Purshotam Paudel, Matthew McElwee, Theodore McConell, Luke Mather, Charles Duke, Devlin Cole, Buddha Basnyat


      PubDate: 2016-09-03T07:28:12Z
       
  • Search and Rescue (SAR) and Fatalities in Mount Rainier National Park
           (MORA) 2010-2015: Location and Altitude Data May Enhance SAR Training and
           Preventative Search and Rescue (PSAR)
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Brian Scheele


      PubDate: 2016-09-03T07:28:12Z
       
  • Epidemiology of Mountain Climbing Injuries Presenting to Emergency
           Departments in the United States from 2012 to 2014
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Benjamin Nicholson, Jacob Kallenberg, Jolion McGreevy


      PubDate: 2016-09-03T07:28:12Z
       
  • Epidemiology of Scuba Diving-Related Injuries Presenting to the Emergency
           Department Between 2012 and 2014
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Benjamin Nicholson, Jolion McGreevy


      PubDate: 2016-09-03T07:28:12Z
       
  • Phase 3 Efficacy and Safety Results of Sufentanil Sublingual 30 mcg Tablet
           for Management of Acute Traumatic Pain in Emergency Medicine
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): James Miner, Harold Minkowitz, Zubaid Rafique, Karen DiDonato, Pamela Palmer


      PubDate: 2016-09-03T07:28:12Z
       
  • An Assessment of Diarrhea among Long-Distance Backpackers in the Sierra
           Nevada
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Derek Meyer, Amber Costantino, Susanne Spano


      PubDate: 2016-09-03T07:28:12Z
       
  • Iloprost With and Without rt-PA: Treatment of 131 Cases of Severe
           Frostbite
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Emmanuel Cauchy, Eric Chetaille, Emmanuel Pham, Hugo Nespoulet, Pascal Zellner, François Becker, Peter Hackett


      PubDate: 2016-09-03T07:28:12Z
       
  • Metal Accumulation in Horseshoe Crab (Limulus polyphemus) Eggs, Embryos,
           and Larvae From Potentially Contaminated Public Beaches
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Aaron Bakker, Jessica Dutton, Nicholas Santangelo


      PubDate: 2016-09-03T07:28:12Z
       
  • The Benefits of Wilderness Programs for Cancer Patients and Survivors: A
           Literature Review
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): S. Terez Malka, Tyler Warmack


      PubDate: 2016-09-03T07:28:12Z
       
  • Canyoneering-related Search and Rescue in Zion National Park from
           2005-2015
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Heather Beasley, Scott McIntosh


      PubDate: 2016-09-03T07:28:12Z
       
  • Direct Measurement of Intracranial Pressure in Hypobaric Hypoxia:
           Implications for Acute Mountain Sickness
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Justin Lawley, Louis Whitworth, Benjamin Levine


      PubDate: 2016-09-03T07:28:12Z
       
  • A Review of Search and Rescue Operations in Slovenia
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Nicholas Walter, Mija Gasperin, Janina Golob Deeb, George Deeb


      PubDate: 2016-09-03T07:28:12Z
       
  • How Effective Is a Dental Skills Workshop in Improving the Knowledge and
           Confidence of Medical Students and Residents in Management of Dental
           Emergencies?
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Nicholas Walter, Janina Golob Deeb, Amber Johnson, George Deeb, Mikhail Bondarew


      PubDate: 2016-09-03T07:28:12Z
       
  • Battlefield Analgesia and Adherence to TCCC Guidelines: A Quality
           Assurance Analysis
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Steven Schauer, Andrew Fisher, Michael April, Cord Cunningham, James Aden, Jessie Fernandez, Robert Carter, Robert Delorenzo, Derek Brown


      PubDate: 2016-09-03T07:28:12Z
       
  • Medical Problems of Casualties and Rescuers in the 2014 Volcanic Eruption
           in Japan
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Kazue Oshiro, Yuji Watanabe, Tomikazu Muarakami


      PubDate: 2016-09-03T07:28:12Z
       
  • Burial Duration and Airpocket Explain Avalanche Survival Patterns in
           Austria
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Emily Procter, Giacomo Strapazzon, Tomas Dal Cappello, Andreas Würtele, Andreas Renner, Benjamin Zweifel, Markus Falk, Hermann Brugger


      PubDate: 2016-09-03T07:28:12Z
       
  • Medical and Logistical Challenges of the Longest Cave Rescue: A Case
           Report
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Thomas-Michael Schneider, Rino Bregani, Rok Stopar, Jakob Krammer, Martin Göksu, Natalie Müller, Michael Petermeyer, Johannes Schiffer, Hermann Brugger, Antonella Santini, Luca Pilo, Giacomo Strapazzon


      PubDate: 2016-09-03T07:28:12Z
       
  • Peer Review and Wilderness &amp; Environmental Medicine
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Neal W. Pollock


      PubDate: 2016-09-03T07:28:12Z
       
  • Point-of-use Unit Based on Gravity Ultrafiltration Removes Waterborne
           Gastrointestinal Pathogens from Untreated Water Sources in Rural
           Communities
    • Abstract: Publication date: September 2016
      Source:Wilderness & Environmental Medicine, Volume 27, Issue 3
      Author(s): Cristóbal Chaidez, Juan R. Ibarra-Rodríguez, José Benigno Valdez-Torres, Marcela Soto, Charles P. Gerba, Nohelia Castro-del Campo
      Objective In developing countries, rural communities often face the lack of potable water infrastructure and must rely on untreated sources for drinking, which are often contaminated with waterborne pathogens. The use of home water treatment devices is seen as one means of reducing the risk of exposure to waterborne pathogens. The aim of this study was to evaluate the microbiological and physicochemical performance of a simple in-home point-of-use device based on gravity ultrafiltration through an ultrafilter membrane. Methods Twenty-five randomly selected households from 2 rural communities in Culiacán, Mexico, were enrolled. Water samples were collected before and after treatment and during storage for a period of 8 weeks. Heterotrophic bacteria, total coliforms, fecal coliforms, Escherichia coli, and Giardia spp were quantified, as well as various physicochemical parameters. Results All of the untreated water samples contained high levels of indicator bacteria, but none were detected in the treated water fulfilling the requirements set by the Mexican Norm (NOM-127-SSA1-1994) and the World Health Organization guidelines for drinking water. However, indicator bacteria (fecal coliforms and E coli) were detected in every sample from water stored 24 hours after treatment. Conclusion This study demonstrated that point-of-use filters using gravity-fed ultrafilters are a low-cost, effective water treatment technology for water of poor microbial quality. However, further identification of the sources and mechanisms by which water is contaminated when stored after treatment will help with designing and implementing better strategies for keeping water safe for domestic use.

      PubDate: 2016-09-03T07:28:12Z
       
  • Association of Cognitive Performance with Time at Altitude, Sleep Quality,
           and Acute Mountain Sickness Symptoms
    • Abstract: Publication date: Available online 22 July 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Amine N. Issa, Nicole M. Herman, Robert J. Wentz, Bryan J. Taylor, Doug C. Summerfield, Bruce D. Johnson
      Objective It is well documented that cognitive performance may be altered with ascent to altitude, but the association of various cognitive performance tests with symptoms of acute mountain sickness (AMS) is not well understood. Our objective was to assess and compare cognitive performance during a high-altitude expedition using several tests and to report the association of each test with AMS, headache, and quality of sleep. Methods During an expedition to Mount Everest, 3 cognitive tests (Stroop, Trail Making, and the real-time cognitive assessment tool, an in-house developed motor accuracy test) were used along with a questionnaire to assess health and AMS. Eight team members were assessed pre-expedition, postexpedition, and at several time points during the expedition. Results There were no significant differences (P >.05) found among scores taken at 3 time points at base camp and the postexpedition scores for all 3 tests. Changes in the Stroop test scores were significantly associated with the odds of AMS (P <.05). The logistic regression results show that the percent change from baseline for Stroop score (β = −5.637; P = .032) and Stroop attempts (β = −5.269; P = .049) are significantly associated with the odds of meeting the criteria for AMS. Conclusions No significant changes were found in overall cognitive performance at altitude, but a significant relationship was found between symptoms of AMS and performance in certain cognitive tests. This research shows the need for more investigation of objective physiologic assessments to associate with self-perceived metrics of AMS to gauge effect on cognitive performance.

      PubDate: 2016-07-29T04:34:32Z
       
  • Improvising a Posterior Nasal Pack with Equipment in a Basic First Aid Kit
    • Abstract: Publication date: Available online 26 July 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Allison K. Royer, Mark C. Royer
      Posterior epistaxis is a serious condition that can be difficult to treat in a wilderness setting. The initial standard of care involves packing the affected nostril with a 7 to 9 cm nasal pack to tamponade the bleed. These packs are often unavailable outside of the emergency or operating room. This study set out to determine whether a posterior nasal pack could be constructed from the supplies present in a basic first aid kit in order to control massive nasal hemorrhage in a wilderness setting. A basic first aid kit was utilized to construct a posterior nasal pack that was inserted into an anatomical model and visibly compared with the Rapid Rhino (Posterior, 7.5 cm; Smith & Nephew, Austin, TX) nasal packing. The shape, size, and anatomical areas of compression (ie, into nasopharynx and posterior aspect of inferior turbinate) of this pack was similar to the commercially available posterior nasal pack. Placement in an anatomical model appears to provide similar compression as the commercially available posterior pack. This technique may provide short-term hemorrhage control in cases of serious posterior nasal hemorrhage where standard treatment options are not available.

      PubDate: 2016-07-29T04:34:32Z
       
  • Significant Traumatic Intracranial Hemorrhage in the Setting of Massive
           Bee Venom–Induced Coagulopathy: A Case Report
    • Abstract: Publication date: Available online 15 July 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Kelsey Stack, Lindsey Pryor
      Bees and wasps of the Hymenoptera order are encountered on a daily basis throughout the world. Some encounters prove harmless, while others can have significant morbidity and mortality. Hymenoptera venom is thought to contain an enzyme that can cleave phospholipids and cause significant coagulation abnormalities. This toxin and others can lead to reactions ranging from local inflammation to anaphylaxis. We report a single case of a previously healthy man who presented to the emergency department with altered mental status and anaphylaxis after a massive honeybee envenomation that caused a fall from standing resulting in significant head injury. He was found to have significant coagulopathy and subdural bleeding that progressed to near brain herniation requiring emergent decompression. Trauma can easily occur to individuals escaping swarms of hymenoptera. Closer attention must be paid to potential bleeding sources in these patients and in patients with massive bee envenomation.

      PubDate: 2016-07-23T04:23:32Z
       
  • Ocular Jellyfish Stings: Report of 2 Cases and Literature Review
    • Abstract: Publication date: Available online 18 July 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Chen Mao, Chien-Chin Hsu, Kuo-Tai Chen
      An ocular jellyfish sting is an ophthalmic emergency and is rarely reported in the medical literature. With the evolution of aquatic activities and entertainment in recent decades, we anticipate that more patients with ocular jellyfish stings may be taken to the emergency department. However, most physicians are unaware of the typical presentations, suitable treatments, prognosis, and possible complications of ocular jellyfish stings. We reported 2 cases with ocular jellyfish stings and collected cases series from literature review. The most common clinical features of ocular jellyfish stings were pain, conjunctival injection, corneal lesion, and photophobia. All patients who sustained ocular stings did so during aquatic activities, and the best management at the scene was proper analgesics and copious irrigation of affected eyes with seawater or saline. The ocular lesions were treated with topical cycloplegics, topical steroids, topical antibiotics, topical antihistamines, and removal of nematocysts. The prognosis was good, and all patients recovered without any permanent sequelae. However, symptoms in some patients may last longer than 1 week. Reported complications included iritis, increased intraocular pressures, mydriasis, decreased accommodation, and peripheral anterior synechiae.

      PubDate: 2016-07-23T04:23:32Z
       
  • Inducing Therapeutic Hypothermia in Cardiac Arrest Caused by Lightning
           Strike
    • Abstract: Publication date: Available online 21 July 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Dane Scantling, Brian Frank, Mathew E. Pontell, Sandra Medinilla
      Only limited clinical scenarios are grounds for induction of therapeutic hypothermia. Its use in traumatic cardiac arrests, including those from lightning strikes, is not well studied. Nonshockable cardiac arrest rhythms have only recently been included in resuscitation guidelines. We report a case of full neurological recovery with therapeutic hypothermia after a lightning-induced pulseless electrical activity cardiac arrest in an 18-year-old woman. We also review the important pathophysiology of lightning-induced cardiac arrest and neurologic sequelae, elaborate upon the mechanism of therapeutic hypothermia, and add case-based evidence in favor of the use of targeted temperature management in lightning-induced cardiac arrest.

      PubDate: 2016-07-23T04:23:32Z
       
  • Electrocardiographic Responses to Deer Hunting in Men and Women
    • Abstract: Publication date: Available online 7 July 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Steven D. Verba, Brock T. Jensen, Jeffrey S. Lynn
      Objective Deer hunting includes various stimuli resulting in augmented sympathetic activity, increased heart rate (HR) response, and rhythm changes. Collectively, these superimposed stresses may increase an individual’s risk for cardiovascular events. We undertook this study to evaluate HR and rhythm responses in multiple phases of deer hunting in men and women with and without cardiovascular disease (CVD). Methods Nineteen participants age 38.3 ± 13.8 years (mean ± SD) with body mass index 29.2 ± 6.9 kg/m2 followed their normal hunting routine. HR and rhythm were recorded continuously during the hunt using a small leadless electrocardiogram (ECG) patch monitor. Results Data were collected on 13 of 19 hunters while hiking. Three hunters recorded HR ≥85% of their age-predicted heart rate maximum (HRmax) for 1 to 2 minutes. Arrhythmias were detected in both participants with CVD and in 8 without CVD. Recorded rhythms included premature atrial, junctional, and ventricular complexes. Six hunters climbed a tree stand; 3 of them recorded HR ≥85% HRmax with sustained elevated HR response for 2 to 3 minutes with premature junctional contractions. Four of 19 participants dragged deer carcasses. During the drag, 1 male hunter recorded an HR of 91% HRmax, and another male hunter without CVD recorded an exercise-induced ischemic ECG. Fifteen of 19 hunters experienced “buck fever” (acute extreme excitation), with 7 reaching ≥85% HRmax for up to 1 minute. Ventricular bigeminy and trigeminy and ventricular couplets were observed in 1 subject during buck fever. Conclusions Men and women with and without CVD recorded substantial increases in HR and clinically relevant arrhythmias while deer hunting.

      PubDate: 2016-07-11T03:54:39Z
       
  • Pathophysiologic Determination of Frostbite Under High Altitude
           Environment Simulation in Sprague-Dawley Rats
    • Abstract: Publication date: Available online 7 July 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Jie Hu, Hua Li, Xiliang Geng, Lin Jiao, Hongping Song, Lin Lou, Mingke Jiao
      Objectives Pathophysiologic changes of frostbite have been postulated but rarely understood, especially the changes caused by chilly high altitude environment. Therefore, we investigated the pathophysiologic changes of high altitude frostbite (HAF) caused by cold and hypoxia. Methods Forty Sprague-Dawley rats were randomly divided into 5 equal groups, namely, control, superficial HAF (S-HAF), partial-thickness HAF (PT-HAF), full-thickness HAF (FT-HAF), and partial-thickness normal frostbite (PT-NF) groups. The S-HAF, PT-HAF, and FT-HAF groups were fed under hypobaric hypoxic conditions simulating an altitude of 5000 m. Then, the PT-NF, S-HAF, PT-HAF, and FT-HAF models were constructed by controlling the duration of the direct freezing by liquid nitrogen. Animal vital signs were measured after the operation, and histopathologic changes were observed after routine hematoxylin and eosin staining. In addition, the microcirculation of frostbite tissues was monitored and compared by contrast ultrasonography during wound healing. Results The S-HAF, PT-HAF, and FT-HAF groups showed significant differences in the microcirculatory and histopathologic changes in the various tissue layers (P < .05). In addition, combined cold and hypoxia caused more damage to frostbite tissue than pure cold. The circulation recovery of HAF models was significantly slower relative to NF models (P < .05). Conclusions A safe and reproducible HAF model was proposed. More important, pathophysiologic determination of HAF provided the foundation and potential for developing novel and effective frostbite therapies.

      PubDate: 2016-07-11T03:54:39Z
       
  • Epidemiology of Feature-Specific Injuries Sustained by Skiers in a Snow
           Park
    • Abstract: Publication date: Available online 7 July 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Luis Carús, María Escorihuela
      Objective The objective of the present case series study was to analyze injury types and injured anatomic locations resulting from skiing in snow park (SP) features and to determine potential risk factors for ski injuries in an SP. Methods The study was conducted during the 2013–2014 winter season in the SP of a major winter resort located in the Spanish Pyrenees. Cases involved skiers who experienced feature-related injuries in the SP. A total of 113 cases met the inclusion criteria. Logistic regression was used to calculate the odds of injury types and injury to anatomic locations on aerial versus nonaerial features. Results The overall injury rate was 0.9 per 1000 skier runs. The proportion of injuries was higher for aerials (1.18% of uses) than for nonaerials (0.66% of uses). Results revealed that the upper extremities were the most commonly injured body region, and sprains/strains/dislocations and fractures were the most common injury type. Conclusions The most commonly injured anatomic location on nonaerial features was the face, while on aerial features it was the head. A higher proportion of fractures was observed on aerial features, while a higher proportion of sprains/strains/dislocations was observed on nonaerial features. Prevention strategies to reduce injury risk include SP redesign, safety and communication policies, instruction on technical skills, and promotion of the use of protective equipment.

      PubDate: 2016-07-11T03:54:39Z
       
  • Myopic Changes in a Climber after Taking Acetazolamide and the Use of
           Corrective Lenses to Temporize Symptoms: A Case Report from Mount
           Kilimanjaro
    • Abstract: Publication date: Available online 5 July 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Adam D. Hill
      When performing detailed tasks related to climbing or hiking, accurate vision is important for safety. Acetazolamide is a medication commonly used to prevent acute mountain sickness, but it has an uncommon side effect of transient myopia. Reports of this side effect are mainly associated with its use in obstetrics, where it is often prescribed in higher doses than used in acute mountain sickness prophylaxis. We describe the case of a climber taking low-dose acetazolamide who developed transient myopia. We further describe potential mechanisms of this rare side effect as well as a novel approach of field management utilizing possible materials at hand.

      PubDate: 2016-07-06T02:12:41Z
       
  • HEMS in Alpine Rescue for Pediatric Emergencies
    • Abstract: Publication date: Available online 1 July 2016
      Source:Wilderness & Environmental Medicine
      Author(s): Stefan Taubenböck, Wolfgang Lederer, Marc Kaufmann, Gunnar Kroesen
      Objective The objective of this study was to describe the pediatric emergencies encountered by the Christophorus-1 helicopter emergency medical service (HEMS) during a period of 2 years. Methods Emergency treatment of pediatric casualties by HEMS was evaluated at a helicopter base. Children up to 14 years who were treated by HEMS emergency physicians from Christophorus-1 during primary missions in the alpine region were retrospectively enrolled. Results Of the 1314 HEMS operations conducted during a 2-year investigation period, pediatric emergencies accounted for 114 (8.7%). Trauma was the most common emergency indication (91.3%) in alpine areas, and 77.5% of the indications were related to skiing and snowboarding; 11.3% of the prehospital pediatric emergencies were classified as life-threatening. Interventions on site were rendered in 46.3% of cases. Mean and SD intervals for approach were 11.0 ± 3.0 minutes; for treatment, 14.0 ± 6.0 minutes; and for transport, 8.0 ± 4.0 minutes. Intervals on site were significantly longer whenever it was necessary to search for an interim landing place (P < .001) or perform rope extrication (P < .001). Aggravating environmental conditions such as low temperature (78.8%), rocky terrain (18.8%), or precipitation (12.5%) were common. Conclusions Rapid procedures are preferred to sustained on-scene treatment, particularly when surrounding conditions are hostile. HEMS emergency physicians attempt to keep on-site intervals short and treatment and monitoring to the essential to minimize delay in rescue.

      PubDate: 2016-07-06T02:12:41Z
       
 
 
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