The Use of Rigid C-Collars

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...

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Cooling for Heat Stroke

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, while...

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Albuterol for HAPE

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 publication for more...

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Thrombolytics in Frostbite Treatment

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...

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Treatment for Drowning

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...

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Venomous Snakebite Treatment

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...

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Narcan Administration

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. This is why narcan administration know-how is (sadly) so...

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