Aside from the coral snake, most of the venomous snakes in North America are pit vipers (rattlesnakes, copperheads, water moccasins, etc.). The good news is that most of these use a common synthetic antivenin to treat all of them. Especially in a wilderness or remote setting (and sadly, even in...
As of recent, the epidemic of opioid overdoses should be familiar to most people. Reports of incidents in wilderness are rare, not entirely zero. Narcan, like the AED, is a valuable skill for both wilderness and emergency medical providers to have. Commonly administered via intranasal spray (2.0 – 4.0 mg...
Drowning is a hypoxic brain issue (requiring supplemental oxygenation administration on scene). The focus on treatment is to reverse hypoxia with A-B-C CPR (not C-A-B). Use rescue breathing and if available, supplemental oxygen. Remove any likely water and vomit from the airway as needed (likely from the stomach). Do not...
Thrombolytics (clot-dissolving medications) have a role in the treatment of severe frostbite in restoring circulation after the injury has been thawed. This hospital based treatment is time sensitive, and the sooner the treatment is started, the better. Patients exhibiting thawed severe frostbite should be evacuated to definitive care as soon...
We no longer suggest the use of albuterol in the treatment of High Altitude Pulmonary Edema (HAPE). Although there are reports of beta-agonist use in HAPE treatment and the risks of use are low, no data support a benefit from albuterol in patients experiencing HAPE. Read the WMS Journal...
Cold water immersion is the gold standard treatment for heat stroke. How much should we worry about inducing hypothermia when we cool heat stroke patients with cold water immersion? This is a classic example of benefit versus risk. The benefit of rapidly cooling heat stroke is clear: it’s life-saving,...
The Journal of Wilderness and Environmental Medicine (WEMJ 2019; 30(4): 412e6) has a study on improvised cervical collars that was conducted by a group at the University of Utah. They used a model soft improvised C-Collar of a rolled up fleece, similar to a common model we use in the...
Syncope (fainting) is a brief loss of postural tone followed by a spontaneous and complete recovery. It is often caused by a decreased blood flow to the brain, usually from low blood pressure. It may be due to severe pain, strong emotion, urination, defecation, vomiting, swallowing, or carotid sinus stimulation....
For decades, orthopedic injuries have been treated using the “RICE” mnemonic; rest, ice, compress, elevate. As there have been many studies done on best practices; many of which from both professional and collegiate athletic programs, new science shows that a drastic change may show significantly greater results. Rest is...
The combination of a non-steroidal anti-inflammatory (NSAID) medication such as Ibuprofen (eg. Advil), when taken together with Acetaminophen (eg. Tylenol), has been demonstrated in a number of studies to provide superior pain control to either drug alone or in combination with an oral narcotic. We concur with the sequence that...