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  Subjects -> ENVIRONMENTAL STUDIES (Total: 768 journals)
    - ENVIRONMENTAL STUDIES (704 journals)
    - POLLUTION (22 journals)
    - TOXICOLOGY AND ENVIRONMENTAL SAFETY (33 journals)
    - WASTE MANAGEMENT (9 journals)

ENVIRONMENTAL STUDIES (704 journals)            First | 1 2 3 4 5 6 7 8     

Materials for Renewable and Sustainable Energy     Open Access   (Followers: 8)
Mathematical and Computational Forestry & Natural-Resource Sciences     Free  
Mathematical Population Studies: An International Journal of Mathematical Demography     Hybrid Journal   (Followers: 2)
Medieval Sermon Studies     Hybrid Journal   (Followers: 5)
Medio Ambiente y Urbanizacion     Full-text available via subscription  
Membranes     Open Access   (Followers: 4)
Michigan Journal of Sustainability     Open Access  
Midwest Studies In Philosophy     Hybrid Journal   (Followers: 10)
Mine Water and the Environment     Hybrid Journal   (Followers: 6)
Mitigation and Adaptation Strategies for Global Change     Hybrid Journal   (Followers: 12)
Modern Asian Studies     Hybrid Journal   (Followers: 4)
Modern Cartography Series     Full-text available via subscription   (Followers: 6)
Mountain Research and Development     Open Access   (Followers: 3)
Multequina     Open Access  
Mutation Research/Fundamental and Molecular Mechanisms of Mutagenesis     Hybrid Journal   (Followers: 2)
Mutation Research/Genetic Toxicology and Environmental Mutagenesis     Hybrid Journal   (Followers: 8)
Nativa     Open Access  
Natur und Recht     Hybrid Journal   (Followers: 5)
Natural Areas Journal     Full-text available via subscription   (Followers: 7)
Natural Hazards     Hybrid Journal   (Followers: 179)
Natural Resources     Open Access  
Natural Resources and Environmental Issues     Open Access   (Followers: 5)
Nature and Culture     Full-text available via subscription   (Followers: 9)
NeuroToxicology     Hybrid Journal   (Followers: 1)
Neurotoxicology and Teratology     Hybrid Journal   (Followers: 2)
NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy     Full-text available via subscription   (Followers: 6)
New Zealand Journal of Environmental Law     Full-text available via subscription   (Followers: 3)
NJAS - Wageningen Journal of Life Sciences     Full-text available via subscription   (Followers: 1)
Noise Notes     Full-text available via subscription   (Followers: 3)
Novos Cadernos NAEA     Open Access  
Observatorio Medioambiental     Open Access  
Occupational and Environmental Medicine     Full-text available via subscription   (Followers: 8)
Ocean Acidification     Open Access  
Oecologia     Hybrid Journal   (Followers: 24)
Oikos     Hybrid Journal   (Followers: 29)
Open Journal of Ecology     Open Access   (Followers: 10)
Open Journal of Marine Science     Open Access   (Followers: 6)
Open Journal of Modern Hydrology     Open Access   (Followers: 1)
Our Nature     Open Access   (Followers: 2)
Oxford Journal of Legal Studies     Hybrid Journal   (Followers: 16)
Pace Environmental Law Review     Open Access   (Followers: 4)
Packaging, Transport, Storage and Security of Radioactive Material     Hybrid Journal   (Followers: 2)
Palaeobiodiversity and Palaeoenvironments     Hybrid Journal   (Followers: 3)
Papers on Global Change IGBP     Open Access   (Followers: 1)
Particle and Fibre Toxicology     Open Access   (Followers: 3)
Pastos y Forrajes     Open Access  
Pesquisa em Educação Ambiental     Open Access  
Pharmacology & Therapeutics     Hybrid Journal   (Followers: 5)
Pharmacology Biochemistry and Behavior     Hybrid Journal   (Followers: 1)
Philosophical Studies     Hybrid Journal   (Followers: 7)
Physio-Géo     Open Access   (Followers: 2)
Pittsburgh Journal of Environmental and Public Health Law     Open Access   (Followers: 1)
Planet     Open Access  
Planning & Environmental Law: Issues and decisions that impact the built and natural environments     Hybrid Journal   (Followers: 6)
Plant Ecology & Diversity     Partially Free   (Followers: 10)
Plant Knowledge Journal     Open Access   (Followers: 2)
Plant, Cell & Environment     Hybrid Journal   (Followers: 4)
Polar Journal     Hybrid Journal   (Followers: 1)
Policy Studies     Hybrid Journal   (Followers: 7)
Policy Studies Journal     Hybrid Journal   (Followers: 5)
Polish Polar Research     Open Access   (Followers: 4)
Political Studies     Hybrid Journal   (Followers: 22)
Political Studies Review     Hybrid Journal   (Followers: 14)
Population and Environment     Hybrid Journal   (Followers: 6)
Population Ecology     Hybrid Journal   (Followers: 9)
Population Studies: A Journal of Demography     Hybrid Journal   (Followers: 4)
Postcolonial Studies     Hybrid Journal   (Followers: 5)
Practice Periodical of Hazardous, Toxic, and Radioactive Waste Management     Full-text available via subscription   (Followers: 3)
Presence Teleoperators & Virtual Environments     Hybrid Journal   (Followers: 1)
Presidential Studies Quarterly     Hybrid Journal   (Followers: 3)
Procedia Environmental Sciences     Open Access   (Followers: 2)
Proceedings of ICE, Waste and Resource Management     Hybrid Journal   (Followers: 3)
Proceedings of the Institution of Mechanical Engineers Part M: Journal of Engineering for the Maritime Environment     Hybrid Journal   (Followers: 1)
Proceedings of the International Academy of Ecology and Environmental Sciences     Open Access   (Followers: 4)
Process Safety and Environmental Protection     Hybrid Journal   (Followers: 3)
Progress in Industrial Ecology, An International Journal     Hybrid Journal   (Followers: 4)
Psychological Assessment     Full-text available via subscription   (Followers: 5)
Public Money & Management     Hybrid Journal   (Followers: 4)
Public Works Management & Policy     Hybrid Journal   (Followers: 5)
Qatar Foundation Annual Research Forum Proceedings     Open Access   (Followers: 3)
Radioactivity in the Environment     Full-text available via subscription   (Followers: 4)
Regional Environmental Change     Hybrid Journal   (Followers: 3)
Regional Studies     Hybrid Journal   (Followers: 6)
Religious Studies     Hybrid Journal   (Followers: 10)
RELP - Renewable Energy Law and Policy     Full-text available via subscription   (Followers: 4)
Remediation Journal     Hybrid Journal   (Followers: 5)
Remote Sensing Letters     Hybrid Journal   (Followers: 8)
Renaissance Studies     Hybrid Journal   (Followers: 13)
Rendiconti Lincei     Hybrid Journal  
Renewable Energy Focus     Full-text available via subscription   (Followers: 7)
Research & Reviews : Journal of Ecology     Full-text available via subscription  
Research and Practice for Persons with Severe Disabilities     Full-text available via subscription   (Followers: 3)
Research Journal of Environmental Sciences     Open Access   (Followers: 1)
Research Journal of Environmental Toxicology     Open Access   (Followers: 2)
ReSource     Full-text available via subscription  
Resources     Open Access  
Resources, Conservation and Recycling     Hybrid Journal   (Followers: 9)
Reuse/Recycle Newsletter     Hybrid Journal   (Followers: 2)
Review of English Studies     Hybrid Journal   (Followers: 7)
Review of Environmental Economics and Policy     Hybrid Journal   (Followers: 7)

  First | 1 2 3 4 5 6 7 8     

Journal Cover Wilderness & Environmental Medicine
   [5 followers]  Follow    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
     ISSN (Print) 1080-6032
     Published by Elsevier Homepage  [2563 journals]
  • BMJ Open Physiological Variables Associated with the Development of Acute
           Mountain Sickness at the South Pole
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2




      PubDate: 2014-06-18T22:46:29Z
       
  • Scandinavian Journal Of Medicine And Science In Sports
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2




      PubDate: 2014-06-18T22:46:29Z
       
  • Regarding the Wilderness Medical Society Practice Guidelines for
           Heat-Related Illness
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2
      Author(s): Martin D. Hoffman , Tamara Hew-Butler , Martin Schwellnus



      PubDate: 2014-06-18T22:46:29Z
       
  • The Importance of Keeping Cool: Reply Regarding the Wilderness Medical
           Society Practice Guidelines for the Prevention and Treatment of
           Heat-Related Illness
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2
      Author(s): Grant S. Lipman , Kurt P. Eifling , Mark A. Ellis , Flavio G. Gaudio , Edward M. Otten , Colin K. Grissom



      PubDate: 2014-06-18T22:46:29Z
       
  • Everest: The First Ascent. How a Champion of Science Helped to Conquer the
           Mountain Harriet Tuckey Guilford, CT; Lyons Press: 2013 402 pages
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2
      Author(s): Harvey V. Lankford



      PubDate: 2014-06-18T22:46:29Z
       
  • High Altitude Medicine & Biology Mountaineering Fatalities on
           Aconcagua: 2001–2012
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2




      PubDate: 2014-06-18T22:46:29Z
       
  • European Journal Of Sport Science The Influence of Wearing Compression
           Stockings on Performance Indicators and Physiological Responses Following
           a Prolonged Trail Running Exercise
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2




      PubDate: 2014-06-18T22:46:29Z
       
  • Antimicobial Agents And Chemotherapy Efficacy of an Experimental
           Azithromycin Cream for Prophylaxis of Tick-Transmitted Lyme Disease
           Spirochete Infection in a Murine Model
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2




      PubDate: 2014-06-18T22:46:29Z
       
  • Human Attacks by Large Felid Carnivores in Captivity and in the Wild
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2
      Author(s): Suzanne M. Shepherd , Angela Mills , William H. Shoff
      Whereas those who live in the native ranges of the large feline carnivores are well aware of the risks of cat and human encounters, North Americans and Europeans are increasingly exposed to exotic animals through travel, ecotourism, leisure pursuits in rural areas, occupational exposure, zoo and animal park visits, wild habitat encroachment at the urban-wildlands interface, and contact with exotic pets. In encounters during which persons have been severely injured, lapses in animal management protocols, lack of appropriate adult supervision, and intoxication have been reported. Unlike common domestic pets that have lived in close association with humans for thousands of years, no matter where individual large felines may have been raised, they remain wild carnivores with strong prey-drive and territorial instincts. The emergency management of large felid attacks is similar to that of other major trauma: stabilization; management of significant orthopedic, neurologic, vascular, and soft tissue injuries; antibiotic coverage provided for the number of organisms that inhabit their mouths and the potential for tetanus and rabies; and early management in survivors of likely posttraumatic stress disorder. We must actively explore responsible measures globally that can be taken to ensure biologically appropriate, ethical, safe, and sustainable conservation of these large carnivores in both their natural habitats and captivity.


      PubDate: 2014-06-18T22:46:29Z
       
  • Wilderness and Adventure Travel With Underlying Asthma
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2
      Author(s): Daniel Doan , Andrew M. Luks
      Given the high prevalence of asthma, it is likely that providers working in a pretravel setting will be asked to provide guidance for asthma patients about how to manage their disease before and during wilderness or adventure travel, while providers working in the field setting may need to address asthma-related issues that arise during such excursions. This review aims to provide information to assist providers facing these issues. Relevant literature was identified through the MEDLINE database using a key word search of the English-language literature from 1980 to 2013 using the term “asthma” cross-referenced with “adventure travel,” “trekking,” “exercise,” “exercise-induced bronchoconstriction,” “high-altitude,” “scuba,” and “diving.” We review data on the frequency of worsening asthma control during wilderness or adventure travel and discuss the unique aspects of wilderness travel that may affect asthma patients in the field. We then provide a general approach to evaluation and management of asthma before and during a planned sojourn and address 2 particular situations, activities at high altitude and scuba diving, which pose unique risks to asthma patients and warrant additional attention. Although wilderness and adventure travel should be avoided in individuals with poorly controlled disease or worsening control at the time of a planned trip, individuals with well-controlled asthma who undergo appropriate pretravel assessment and planning can safely engage in a wide range of wilderness and adventure-related activities.


      PubDate: 2014-06-18T22:46:29Z
       
  • Long-Term Complications of Rattlesnake Bites: A Telephone Survey From
           Central California
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2
      Author(s): Susanne J. Spano , Rais Vohra , Fernando Macias
      Objective The purpose of this institutional review board-approved, cross-sectional study was to identify residual symptoms and signs of envenomation reported by snakebite survivors via a telephone survey. Methods Victims of rattlesnake bite who were treated at a single hospital center during a 10-year period were contacted through a telephone survey. Study subjects were included through a diagnosis-based retrospective chart review of snakebite victims, and excluded if they did not receive rattlesnake antivenom. Data collection was done using a standardized form that included sections about residual, recurrent, or new pain, weakness, paresthesias, or other limitations of the bitten limb. Results We identified 46 snakebite cases including 5 of 46 “dry” bites. The remaining cases (41 of 46) all received Crofab. Interviews were completed for 31% of these patients (13 of 41), and the remainder were lost to follow-up. Most bites occurred in men (12 cases, 92% males) and on the arms (9 cases, 69%). Six of the 13 respondents (46%) reported residual symptoms from the bite. Persistent symptoms described included localized pain at the bite site (3 cases), numbness or paresthesias (2 cases), abnormal skin peeling and discoloration at the bite site (2 cases), and persistent weakness of the bitten extremity (1 case). Among patients reporting persistent symptoms, the bite-to-survey interval ranged from 7 months to 12 years, with a median interval of 4 years. Conclusions Our study population demonstrated a notable incidence (43%) of self-reported persistent symptoms related to their rattlesnake bites, although the overall level of disability from these injuries seems low.


      PubDate: 2014-06-18T22:46:29Z
       
  • Catastrophic Acute Ischemic Stroke After Crotalidae Polyvalent Immune Fab
           (Ovine)-Treated Rattlesnake Envenomation
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2
      Author(s): Sean P. Bush , Graham G. Mooy , Tammy H. Phan
      We report 2 cases of catastrophic ischemic stroke after Crotalidae polyvalent immune Fab (ovine)-treated rattlesnake envenomation, 1 fatal and the other resulting in significant permanent disability. It is possible these serious adverse events may have been related to venom factor(s), an interaction between venom and antivenom, occult patient blood dyscrasia, or to random unrelated events. We present the rationale for each possibility, and submit the experiences to elicit alternate postulation and communication of similar presentations.


      PubDate: 2014-06-18T22:46:29Z
       
  • Mechanical Chest Compressions in an Avalanche Victim With Cardiac Arrest:
           An Option for Extreme Mountain Rescue Operations
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2
      Author(s): Urs Pietsch , Volker Lischke , Christine Pietsch , Karl-Heinz Kopp
      Mountain rescue operations often present helicopter emergency medical service crews with unique challenges. One of the most challenging problems is the prehospital care of cardiac arrest patients during evacuation and transport. In this paper we outline a case in which we successfully performed a cardiopulmonary resuscitation of an avalanche victim. A mechanical chest-compression device proved to be a good way of minimizing hands-off time and providing high-quality chest compressions while the patient was evacuated from the site of the accident.


      PubDate: 2014-06-18T22:46:29Z
       
  • Survival of a Patient With Tetanus in Bhutan Using a Magnesium Infusion
           Managed Only by Clinical Signs
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2
      Author(s): Kuenza P. Wangmo , Margie Teng , Richard Henker , Stephen Kinnear , Jampel Tshering , Nancy E. Wang
      Tetanus is a life-threatening disease that continues to have a high prevalence in developing countries. Severe muscle spasms often require patients to receive tracheostomy, high-dose sedatives, and sometimes prolonged neuromuscular blockade. Magnesium sulfate (MgSO4) infusion has great promise as an adjunct treatment for severe tetanus, as it may allow clinicians to decrease the dose of other sedative medications. Although the mechanism of action of MgSO4 is not well understood, it appears to attenuate both the muscle spasms and autonomic instability associated with severe tetanus infections. However, MgSO4 infusions are often managed based on serial measurements of serum magnesium levels and other laboratory tests such as arterial blood gases, which can be difficult to obtain in resource-poor settings. We describe a case of severe tetanus in Bhutan managed through the use of magnesium infusion titrated solely to physical examination findings.


      PubDate: 2014-06-18T22:46:29Z
       
  • From Matterhorn to Mt Everest: Empowering Rescuers and Improving Medical
           Care in Nepal
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2
      Author(s): Monika M. Brodmann Maeder , Buddha Basnyat , N. Stuart Harris
      This article describes a private initiative in which professional Swiss rescuers, based at the foot of the Matterhorn, trained Nepalese colleagues in advanced high altitude helicopter rescue and medical care techniques. What started as a limited program focused on mountain safety has rapidly developed into a comprehensive project to improve rescue and medical care in the Mt Everest area for both foreign travelers and the local Nepalese people.


      PubDate: 2014-06-18T22:46:29Z
       
  • They Had Me in Stitches: A Grand Canyon River Guide’s Case Report
           and a Review of Wilderness Wound Management Literature
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2
      Author(s): Susanne J. Spano , Brad Dimock
      We present a case of failed conservative management of a traumatic wound sustained in a wilderness setting. The patient was initially treated with a povidone-iodine scrub, suture closure, and expectant management by 2 physicians who were paying clients on a multiday river rafting expedition. Empiric antibiotic coverage and irrigation of the dehisced wound were initiated several days after initial treatment. The patient arranged his own evacuation 8 days after injury. Hospitalization, intravenous (IV) antibiotics, and surgical debridement with wound vacuum placement led to a full recovery. This case presents several common wound care pitfalls. The sequelae to these pitfalls are more dramatic in a wilderness setting and underscore the importance of early aggressive management and considering prompt evacuation when treating wounds sustained in the wilderness.


      PubDate: 2014-06-18T22:46:29Z
       
  • Risk Determinants of Acute Mountain Sickness in Trekkers in the Nepali
           Himalaya: a 24-Year Follow-Up
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2
      Author(s): Marion McDevitt , Scott E. McIntosh , George Rodway , Jitsupa Peelay , Doug L. Adams , Bengt Kayser
      Objective Exposure to altitude may lead to acute mountain sickness (AMS) in nonacclimatized individuals. We surveyed AMS prevalence and potential risk factors in trekkers crossing a 5400-m pass in Nepal and compared the results with those of 2 similar studies conducted 12 and 24 years earlier. Methods In April 2010, 500 surveys were distributed to English-speaking trekkers at 3500 m on their way to 5400 m, of which 332 (66%) surveys were returned complete. Acute mountain sickness was quantified with the Lake Louise Scoring System (LLSS, cutoff ≥3 and ≥5) and the Environmental Statistical Questionnaire III AMS-C score (ESQ-III, cutoff ≥0.7). We surveyed demographics, body mass index (BMI), smoking habit, rate of ascent, awareness of AMS, and acetazolamide use. Results Prevalence of AMS was 22%, 23%, and 48% (ESQ-III ≥0.7, LLSS ≥5, and LLSS ≥3, respectively) lower when compared with earlier studies. Risk factors for AMS were younger age, female sex, higher BMI, and smoking habit. Forty-two percent had elementary knowledge about the risk and prevention of AMS. Forty-four percent used acetazolamide. Trekkers took longer to climb from 3500 to 5400 m than in earlier studies. Conclusions Prevalence of AMS continued to decline over a period of 24 years, likely as a result of slower ascent and increased use of acetazolamide. The AMS risk factors of younger age, female sex, and high BMI are consistent with prior studies. Awareness of risk and prevention of AMS remains low, indicating an opportunity to better educate trekkers and potentially further reduce AMS prevalence.


      PubDate: 2014-06-18T22:46:29Z
       
  • Wilderness Search Strategy and Tactics
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2
      Author(s): Ken Phillips , Maura J. Longden , Bil Vandergraff , William R. Smith , David C. Weber , Scott E. McIntosh , Albert R. Wheeler III
      Reports of overdue persons are common for search and rescue personnel. Search incidents for missing persons are conducted following established industry standard practices, which are continuously refined through experience and the analysis of previous search operations. Throughout this process, elements of uncertainty exist, and the knowledge and experience of the searchers and search managers may influence the outcome significantly. A sound knowledge of current search tactics will help search and rescue medical providers function more effectively during search operations. Initial actions during a search incident include 3 primary tasks that must be accomplished on any search: investigation, containment, and then hasty search efforts. Concurrent with these initial actions are the establishment of the search area and a formal US National Incident Management System incident command system. That is essential for an efficient operation and will lay the groundwork for expanding the operation past the initial operational period. The goal of applying these standard search management practices is to allow searchers to maximize their efforts, reduce some of the inherent uncertainty, and most importantly, place searchers in a position to detect the missing person.


      PubDate: 2014-06-18T22:46:29Z
       
  • Seek Challenge
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2
      Author(s): Scott E. McIntosh , Tracy Cushing , Linda E. Keyes



      PubDate: 2014-06-18T22:46:29Z
       
  • Use of the Visual Range of Detection to Estimate Effective Sweep Width for
           
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2
      Author(s): Robert J. Koester , Kenneth B. Chiacchia , Charles R. Twardy , Donald C. Cooper , John R. Frost , R. Quincy Robe
      Objective Standard-of-practice search management requires that the probability of detection (POD) be determined for each search resource after a task. To calculate the POD, a detection index (W) is obtained by field experiments. Because of the complexities of the land environment, search planners need a way to estimate the value of W without conducting formal experiments. We demonstrate a robust empirical correlation between detection range (Rd) and W, and argue that Rd may reliably be used as a quick field estimate for W. Methods We obtained the average maximum detection range (AMDR), Rd, and W values from 10 detection experiments conducted throughout North America. We measured the correlation between Rd and W, and tested whether the apparent relationship between W and Rd was statistically significant. Results On average we found W ≈ 1.645 × Rd with a strong correlation (R 2 = .827). The high-visibility class had W ≈ 1.773 × Rd (also R 2 = .867), the medium-visibility class had W ≈ 1.556 × Rd (R 2 = .560), and the low-visibility had a correction factor of 1.135 (R 2 = .319) for Rd to W. Using analysis of variance and post hoc testing, only the high- and low-visibility classes were significantly different from each other (P < .01). We also found a high correlation between the AMDR and Rd (R 2 = .9974). Conclusions Although additional experiments are required for the medium- and low-visibility search objects and in the dry-domain ecoregion, we suggest search planners use the following correction factors to convert field-measured Rd to an estimate of the effective sweep width (W): high-visibility W = 1.8 × Rd; medium-visibility W = 1.6 × Rd; and low-visibility W = 1.1 × Rd.


      PubDate: 2014-06-18T22:46:29Z
       
  • Spine Immobilization Algorithm Revisited
    • Abstract: Publication date: Available online 6 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Paul Nicolazzo



      PubDate: 2014-06-18T22:46:29Z
       
  • Novel Method for Reducing Temperature of i-STAT1 Analyzer in Extreme
           Environments
    • Abstract: Publication date: Available online 3 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Jeremy Joslin , Joshua Mularella , Susan Schreffler , DO Jennifer Kruse



      PubDate: 2014-06-18T22:46:29Z
       
  • Reply to: Novel Anticoagulants Should NOT Be Recommended for High-Risk
           Activity
    • Abstract: Publication date: Available online 2 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Seth C. Hawkins , Michael J. Caudell , Thomas Deloughery , William Murray



      PubDate: 2014-06-18T22:46:29Z
       
  • The Impact of an Ultramarathon on Hormonal and Biochemical Parameters in
           Men
    • Abstract: Publication date: Available online 13 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Brian R. Kupchak , William J. Kraemer , Martin D. Hoffman , Stephen D. Phinney , Jeff S. Volek
      Objective To examine circulating hormonal responses in men competing in the Western States Endurance Run (WSER, June 23 to 24, 2012): a 161-km trail run that starts in Squaw Valley, CA, and concludes in Auburn, CA. Methods We examined 12 men who completed the WSER. Blood samples were obtained the morning before the race, immediately postrace (IP), and 1 (D1) and 2 (D2) days after the conclusion of the WSER. The hypothalamic-pituitary-testicular (HPT) axis was assessed by measuring testosterone and luteinizing hormone (LH). We also examined sex hormone-binding globulin (SHBG) and cortisol. Biochemical and muscle damage markers were also measured. Results Relative to prerace, there were significant (P ≤ .05) decreases in testosterone, LH, and SHBG, whereas cortisol showed a significantly marked elevation at IP. Testosterone, LH, SHBG, and cortisol remained significantly different from prerace at D1. Additionally, the testosterone to cortisol (T:C) ratio, a marker of anabolism, was decreased at IP and D1. Serum total protein, albumin, and globulin significantly decreased at IP, and remained decreased at D1 and D2. Bilirubin increased significantly IP and D1, whereas alkaline phosphatase decreased at D1 and D2. Creatine kinase, myoglobin, aspartate aminotransferase, and alanine aminotransferase increased at IP, and continued to be significantly elevated at D1 and D2. Conclusions Training for and completing the WSER produced a significant suppression in the HPT axis as seen by decreased levels of testosterone and LH. Additionally, running the WSER continued to influence endocrine function until 2 days after the race. Furthermore, the stress caused by the WSER produced severe muscle damage.


      PubDate: 2014-06-18T22:46:29Z
       
  • In Reply to Spine Protection in the Austere Environment
    • Abstract: Publication date: Available online 13 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Robert Quinn , Jason Williams , Brad Bennett , Gregory Stiller , Arthur Islas , Seth McCord



      PubDate: 2014-06-18T22:46:29Z
       
  • Incidence and Characteristics of Snakebite Envenomations in the New York
           State Between 2000 and 2010
    • Abstract: Publication date: Available online 16 May 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Jeremy D. Joslin , Jeanna M. Marraffa , Harinder Singh , Joshua Mularella
      Objective We sought to evaluate the incidence of reported venomous snakebites in the state of New York between 2000 and 2010. Methods Data were collected retrospectively from the National Poison Data System (NPDS) and then reviewed for species identification and clinical outcome while using proxy measures to determine incidence of envenomation. Results From 2000 to 2010 there were 473 snakebites reported to the 5 Poison Control Centers in the state of New York. Venomous snakes accounted for 14.2% (67 of 473) of these bites. Only 35 bites (7%) required antivenom. The median age of those bitten by a venomous snake was 33. Most victims were male. Conclusions Although not rare, venomous snakebites do not occur commonly in New York State, with a mean of just 7 bites per year; fortunately most snakebites reported are from nonvenomous snakes. Yet even nonvenomous bites have the potential to cause moderately severe outcomes. Medical providers in the state should be aware of their management.


      PubDate: 2014-06-18T22:46:29Z
       
  • A Pilot Study of Solar Water Disinfection in the Wilderness Setting
    • Abstract: Publication date: Available online 16 May 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Christopher M. Tedeschi , Christopher Barsi , Shane E. Peterson , Kevin M. Carey
      Objective Solar disinfection of water has been shown to be an effective treatment method in the developing world, but not specifically in a wilderness or survival setting. The current study sought to evaluate the technique using materials typically available in a wilderness or backcountry environment. Methods Untreated surface water from a stream in rural Costa Rica was disinfected using the solar disinfection (SODIS) method, using both standard containers as well as containers and materials more readily available to a wilderness traveler. Results Posttreatment samples using polyethylene terephthalate (PET) bottles, as well as Nalgene and Platypus water containers, showed similarly decreased levels of Escherichia coli and total coliforms. Conclusions The SODIS technique may be applicable in the wilderness setting using tools commonly available in the backcountry. In this limited trial, specific types of containers common in wilderness settings demonstrated similar performance to the standard containers. With further study, solar disinfection in appropriate conditions may be included as a viable treatment option for wilderness water disinfection.


      PubDate: 2014-06-18T22:46:29Z
       
  • Atraumatic Splenic Rupture After Coagulopathy Owing to a Snakebite
    • Abstract: Publication date: Available online 29 May 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Changwoo Kang , Dong Hoon Kim , Seong Chun Kim , Dong Seob Kim , Chi-Young Jeong
      Among the many complications that may follow envenomation by some species of venomous snakes, coagulopathy is common and well known. However, hemoperitoneum induced by coagulopathy after a snakebite is rare. Atraumatic spontaneous splenic rupture is also an uncommon and life-threatening condition. Here, we report a case of presumptive envenomation by Gloydius spp. that resulted in atraumatic splenic rupture as a probable manifestation of coagulopathy, which has not been previously reported.


      PubDate: 2014-06-18T22:46:29Z
       
  • The Incidence of Acute Mountain Sickness Among Passengers Traveling Across
           the Tibetan Plateau by Train
    • Abstract: Publication date: Available online 29 May 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Yong Wang , Hong Jiang , Xinying Xue , Lei Pan , Lina Jia , Yongjie Huang , Jin Qian , Xiaoyong Ma



      PubDate: 2014-06-18T22:46:29Z
       
  • Grant S.LipmanMDThe Wilderness First Aid Handbook2013Sky Horse
           PublishingNew York, NYUS $14.95, 120 pages, soft cover
    • Abstract: Publication date: Available online 17 May 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Gabriel Cade



      PubDate: 2014-06-18T22:46:29Z
       
  • Diana L.De StefanoEncounters in Avalanche Country: A History of Survival
           in the Mountain West, 1820–19202013University of Washington
           PressSeattle, WA, USAUS$34.95, 171 pages, hardcover
    • Abstract: Publication date: Available online 29 May 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Christopher Van Tilburg



      PubDate: 2014-06-18T22:46:29Z
       
  • Doppler Detection in Ama Divers of Japan
    • Abstract: Publication date: Available online 29 May 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Frédéric Lemaître , Kiyotaka Kohshi , Hideki Tamaki , Kasuo Nakayasu , Mesanori Harada , Masanobu Okayama , Yuka Satou , Michiko Hoshiko , Tatsuya Ishitake , Guillaume Costalat , Bernard Gardette
      Objective Symptoms consistent with neurological decompression sickness (DCS) in commercial breath-hold (Ama) divers has been reported from a few districts of Japan. The aim of this study was to detect circulating intravascular bubbles after repetitive breath-hold diving in a local area where DCS has been reported in Ama divers. Methods The participants were 12 partially assisted (descent using weights) male Ama divers. The equipment (AQUALAB system) consisted of continuous-wave Doppler with a 5-MHz frequency, and the Doppler probe was placed in the precordial site with the ultrasonic wave directed into the pulmonary infundibulum. We carried out continuous monitoring for 10 minutes at the end of the series of repetitive dives, and the recordings were made on numerical tracks and graded in a blind manner by 2 experienced investigators, according to the Spencer Doppler code. Results Depths and number of dives were 8 to 20 m and 75 to 131 times. Mean diving duration and surface interval were 64 ± 12 seconds and 48 ± 8 seconds, respectively (mean ± SD). We detected the lowest grade of intravascular bubbles (Spencer’s grade I) in an Ama diver whose mean surface interval was only 35.2 ± 6.2 seconds. His mean descending, bottom, and ascending times were 10.4 ± 1.6 seconds, 39.2 ± 8 seconds, and 18.2 ± 3.0 seconds, respectively, over the course of 99 dives. Conclusions Intravascular bubbles may be formed after repetitive breath-hold dives with short surface intervals or after a long breath-holding session in Ama divers. Symptoms consistent with neurological accidents in repetitive breath-hold diving may be caused in part by the intravascular presence of bubbles, indicating the need for safety procedures.


      PubDate: 2014-06-18T22:46:29Z
       
  • Marooned
    • Abstract: Publication date: June 2014
      Source:Wilderness & Environmental Medicine, Volume 25, Issue 2
      Author(s): Tom Edward Mallinson



      PubDate: 2014-06-18T22:46:29Z
       
  • In Reply to Symptomatic Hypotonic Hyponatremia Presenting at High Altitude
    • Abstract: Publication date: Available online 29 May 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Susanne J. Spano , Zacharia Reagle , Timothy Evans



      PubDate: 2014-06-18T22:46:29Z
       
  • Exercise Limitation of Acetazolamide at Altitude (3459 m)
    • Abstract: Publication date: Available online 13 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Arthur R. Bradwell , Stephen D. Myers , Maggie Beazley , Kimberly Ashdown , Nick G. Harris , Susie B. Bradwell , Jamie Goodhart , Chris H. Imray , Yashvi Wimalasena , Mark E. Edsell , Kyle T.S. Pattinson , Alex D. Wright , Stephen J. Harris
      Objective To assess the effect of acetazolamide (Az) on exercise performance during early acclimatization to altitude. Methods Az (250 mg twice daily) or placebo was administered for 3 days in a double-blind, randomized manner followed by a rapid ascent to 3459 m in the Italian Alps. Twenty healthy adults (age range, 18–67 years) were tested at 60% of sea-level peak power output for 15 minutes on a bicycle ergometer after 16 to 27 hours of altitude exposure. Exercise performance was measured in relation to peripheral oxygen saturations measured from pulse oximetry (Spo 2), Lake Louise acute mountain sickness (AMS) score, and perceived difficulty. Results At altitude, resting Spo 2 was higher in the Az group compared with placebo (P < .001). The highest AMS scores were in 4 of the placebo individuals with the lowest resting Spo 2 (P < .05). During the exercise test, Spo 2 fell in all but 1 subject (P < .001) and was reduced more in the Az group (P < .01). Four Az and 1 placebo subject were unable to complete the exercise test; 4 of these 5 had the largest fall in Spo 2. The perception of exercise difficulty was higher in the Az subjects compared with those taking the placebo (P < .01). There was an age relationship with exercise limitation; 4 of the 9 older than 50 years failed to complete the test whereas only 1 of 11 younger than 50 years failed, and there were no failures in the 6 younger than 30 years (P < .05). Conclusions In this study group, and despite higher resting Spo 2, Az may have compromised exercise at 3459 m altitude during early acclimatization, particularly in older subjects.


      PubDate: 2014-06-18T22:46:29Z
       
  • An Unprovoked Attack by a Blue Shark Prionace glauca (Chondrichthyes:
           Carcharhinidae) on a Spear Fisherman in Terceira Island, Azores, Northeast
           Atlantic
    • Abstract: Publication date: Available online 13 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): João Pedro Barreiros , Otto B.F. Gadig , Vidal Haddad Jr.



      PubDate: 2014-06-18T22:46:29Z
       
  • Wilderness Medical Society Practice Guidelines for Basic Wound Management
           in the Austere Environment
    • Abstract: Publication date: Available online 13 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Robert H. Quinn , Ian Wedmore , Eric Johnson , Arthur Islas , Anne Anglim , Ken Zafren , Cindy Bitter , Vicki Mazzorana
      In an effort to produce best-practice guidelines for wound management in the austere environment, the Wilderness Medical Society convened an expert panel charged with the development of evidence-based guidelines for the management of wounds sustained in an austere (dangerous or compromised) environment. Recommendations are made about several parameters related to wound management. These recommendations are graded based on the quality of supporting evidence and the balance between the benefits and risks or burdens for each parameter according to the methodology stipulated by the American College of Chest Physicians.


      PubDate: 2014-06-18T22:46:29Z
       
  • Spine Protection in the Austere Environment
    • Abstract: Publication date: Available online 13 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Ken Zafren , William R. Smith , David E. Johnson , Tim Kovacs



      PubDate: 2014-06-18T22:46:29Z
       
  • Sleeping in Moderate Hypoxia at Home for Prevention of Acute Mountain
           Sickness (AMS): A Placebo-Controlled, Randomized Double-Blind Study
    • Abstract: Publication date: Available online 13 June 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Christoph Dehnert , Astrid Böhm , Igor Grigoriev , Elmar Menold , Peter Bärtsch
      Objective Acclimatization at natural altitude effectively prevents acute mountain sickness (AMS). It is, however, unknown whether prevention of AMS is also possible by only sleeping in normobaric hypoxia. Methods In a placebo-controlled, double-blind study 76 healthy unacclimatized male subjects, aged 18 to 50 years, slept for 14 consecutive nights at either a fractional inspired oxygen (Fio 2) of 0.14 to 0.15 (average target altitude 3043 m; treatment group) or 0.209 (control group). Four days later, AMS scores and incidence of AMS were assessed during a 20-hour exposure in normobaric hypoxia at Fio 2 = 0.12 (equivalent to 4500 m). Results Because of technical problems with the nitrogen generators, target altitude was not achieved in the tents and only 21 of 37 subjects slept at an average altitude considered sufficient for acclimatization (>2200 m; average, 2600 m). Therefore, in a subgroup analysis these subjects were compared with the 21 subjects of the control group with the lowest sleeping altitude. This analysis showed a significantly lower AMS-C score (0.38; 95% CI, 0.21 to 0.54) vs 1.10; 95% CI, 0.57 to 1.62; P = .04) and lower Lake Louise Score (3.1; 95% CI, 2.2 to 4.1 vs 5.1; 95% CI, 3.6 to 6.6; P = .07) for the treatment subgroup. The incidence of AMS defined as an AMS-C score greater than 0.70 was also significantly lower (14% vs 52%; P < .01). Conclusions Sleeping 14 consecutive nights in normobaric hypoxia (equivalent to 2600 m) reduced symptoms and incidence of AMS 4 days later on exposure to 4500 m.


      PubDate: 2014-06-18T22:46:29Z
       
  • Personality Characteristics in a Population of Mountain Climbers
    • Abstract: Publication date: Available online 2 April 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Erik Monasterio , Yassar A. Alamri , Omer Mei-Dan
      Objective Mountaineering and mountain-related sports are growing in popularity and are associated with significant risk of injury. There is a perception that mountaineers possess unique personality characteristics that attract them to the sport. We aim to determine whether there are any identifiable differences between the personality characteristics of experienced mountaineers and a normal control population and to determine whether there is an association between specific personality traits and risk of injury. Methods Questionnaires were utilized to obtain data on demographics, accidents, and personality characteristics from a population of experienced mountaineers. The Temperament and Character Inventory (TCI) was used, and the results were compared with normative data from age-matched controls. Results Forty-seven mountaineers from 8 different countries enrolled in the study. The mean age was 33 years, and 44 (90%) had been mountaineering for more than 5 years. Twenty-three climbers (49%) had been involved in a total of 33 accidents. Mountaineers scored higher on novelty seeking (P < .05) and self-directedness (P < .05) and lower on harm avoidance (P < .001) and self-transcendence (P < .001). There was a significant association between the character measure of cooperativeness and the total number (−.33, P < .05) and severity (−.475, P < .05) of accidents. Conclusions Mountaineering is associated with significant risk of injury. Wide variation in the scores of personality traits suggests that there is not a tightly defined personality profile among mountaineers. Scores on cooperativeness may assist in determining risk of injury in mountaineers.


      PubDate: 2014-04-29T12:47:14Z
       
  • Symptomatic Hypotonic Hyponatremia Presenting at High Altitude
    • Abstract: Publication date: Available online 24 April 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Martin D. Hoffman , Robert H. Weiss



      PubDate: 2014-04-29T12:47:14Z
       
  • Novel Anticoagulants Should NOT Be Recommended for High-Risk Activity
    • Abstract: Publication date: Available online 13 April 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Michael A. Darracq , Megann Young



      PubDate: 2014-04-29T12:47:14Z
       
  • Maximum Water Temperature Limit in Open-Water Swimming Events
    • Abstract: Publication date: Available online 13 March 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Filippo Macaluso , Rosario Barone , Ashwin W. Isaacs , Felicia Farina , Giuseppe Morici , Valentina Di Felice



      PubDate: 2014-04-29T12:47:14Z
       
  • Poly-l-Arginine Topical Lotion Tested in a Mouse Model for Frostbite
           Injury
    • Abstract: Publication date: Available online 13 March 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Lauren J. Auerbach , Brittney K. DeClerk , C. Garrison Fathman , Geoffrey C. Gurtner , Paul S. Auerbach
      Background Frostbite injury occurs when exposure to cold results in frozen tissue. We recently reported a novel mouse model for frostbite injury to be used in screening potentially therapeutic drugs and other modalities. Objective We used the mouse skin frostbite model to evaluate the effect of poly-l-arginine contained in lotion (PAL) applied topically to involved skin. Methods Sixty mice were studied in a randomized, double-blind method. Standardized 2.9-cm-diameter circles were tattooed on the mouse dorsum. Magnets snap frozen in dry ice (–78.5°C) were used to create a frostbite injury on skin within the circle as a continuous 5-minute freeze. Mice were treated with prefreeze placebo, postthaw placebo, combined prefreeze and postthaw placebo, prefreeze with PAL, postthaw with PAL, or combined prefreeze and postthaw with PAL. Appearance, healing rate, tissue loss, and histology were recorded until the wounds were healed. Results Application of PAL before inducing frostbite injury resulted in decreased tissue loss as compared with other treatment conditions. Conclusions Applying PAL topically to frostbitten mouse skin caused decreased tissue loss. Poly-l-arginine should be studied further to determine whether it is a beneficial therapeutic modality for frostbite injury.


      PubDate: 2014-04-29T12:47:14Z
       
  • Acute Mountain Sickness Is Not Repeatable Across Two 12-Hour Normobaric
           Hypoxia Exposures
    • Abstract: Publication date: Available online 13 March 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Martin J. MacInnis , Sarah Koch , Kristin E. MacLeod , Eric A. Carter , Radha Jain , Michael S. Koehle , Jim L. Rupert
      Objective The purposes of this experiment were to determine the repeatability of acute mountain sickness (AMS), AMS symptoms, and physiological responses across 2 identical hypoxic exposures. Methods Subjects (n = 25) spent 3 nights at simulated altitude in a normobaric hypoxia chamber: twice at a partial pressure of inspired oxygen (PIO2 ) of 90mmHg (4000 m equivalent; “hypoxia”) and once at a PIO2 of 132 mmHg (1000 m equivalent; “sham”) with 14 or more days between exposures. The following variables were measured at hours 0 and 12 of each exposure: AMS severity (ie, Lake Louise score [LLS]), AMS incidence (LLS ≥3), heart rate, oxygen saturation, blood pressure, and the fraction of exhaled nitric oxide. Oxygen saturation and heart rate were also measured while subjects slept. Results The incidence of AMS was not statistically different between the 2 exposures (84% vs 56%, P > .05), but the severity of AMS (ie, LLS) was significantly lower on the second hypoxic exposure (mean [SD], 3.1 [1.8]) relative to the first hypoxic exposure (4.8 [2.3]; P < .001). Headache was the only AMS symptom to have a significantly greater severity on both hypoxic exposures (relative to the sham exposure, P < .05). Physiological variables were moderately to strongly repeatable (intraclass correlation range 0.39 to 0.86) but were not associated with AMS susceptibility (P > .05). Conclusions The LLS was not repeatable across 2 identical hypoxic exposures. Increased familiarity with the environment (not acclimation) could explain the reduced AMS severity on the second hypoxic exposure. Headache was the most reliable AMS symptom.


      PubDate: 2014-04-29T12:47:14Z
       
  • Heat-Related Illness: Time To Update Our Lexicon
    • Abstract: Publication date: Available online 13 March 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Jeremy Joslin , Joshua Mularella , Robert Worthing



      PubDate: 2014-04-29T12:47:14Z
       
  • Keeping a Broad Perspective: Reply Regarding the Wilderness Medical
           Society Practice Guidelines for the Prevention and Treatment of
           Heat-Related Illness
    • Abstract: Publication date: Available online 20 March 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Grant S. Lipman , Kurt P. Eifling , Mark A. Ellis , Flavio G. Gaudio , Edward M. Otten , Colin K. Grissom



      PubDate: 2014-04-29T12:47:14Z
       
  • Kenneth V.IsersonImprovised Medicine: Providing Care in Extreme
           Environments1st Edition2012McGraw-Hill ProfessionalNew York, NYUS $56.00,
           578 pages, paperback
    • Abstract: Publication date: Available online 15 March 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Aaron D. Campbell



      PubDate: 2014-04-29T12:47:14Z
       
  • CAVES as an Environment for Astronaut Training
    • Abstract: Publication date: Available online 13 March 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Giacomo Strapazzon , Luca Pilo , Loredana Bessone , Michael R. Barratt



      PubDate: 2014-04-29T12:47:14Z
       
  • Evaluation of Fluid Bolus Administration Rates Using Ruggedized Field
           Intravenous Systems
    • Abstract: Publication date: Available online 13 March 2014
      Source:Wilderness & Environmental Medicine
      Author(s): Theodore R. Morgan
      Objective The purpose of this study was to evaluate 2 ruggedized field intravenous (IV) systems currently in use by US military medics and to determine their effect on fluid bolus administration rates. Methods A series of 500 mL fluid boluses consisting of either Lactated Ringer’s solution or Hextend were delivered to 2 artificial intravenous training arms using a standard 18G catheter (control) and 2 separate ruggedized field IV systems. Fluid boluses were delivered under both gravity force and pressure infusion (constant 300 mm Hg), and total bolus times were recorded. Results Using Lactated Ringer’s solution, the standard IV system took a mean time of 9:33 minutes (95% CI: 9:13–9:54) to deliver a 500 mL fluid bolus whereas the 2 ruggedized field systems took mean times of 14:50 minutes (95% CI: 14:00–15:40) and 12:20 minutes (95% CI: 11:54–12:45). Using Hextend, the mean bolus time for the control system was 24:39 minutes (95% CI: 22:47–26:32). The 2 ruggedized field systems required an average of 49:32 minutes (95% CI: 48:07–50:58) and 39:46 minutes (95% CI: 37:30–42:01) to deliver an equivalent bolus. Pressure infusion significantly increased flow rate in all systems. Conclusions Ruggedized field IV systems can significantly delay fluid bolus rates. In instances where ruggedized field systems are deemed necessary, pressure infusion devices should be considered to overcome the constrictive effects of the ruggedized system.


      PubDate: 2014-04-29T12:47:14Z
       
 
 
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