Wilderness medical emergency

wilderness medical emergency is a medical emergency that takes place in a wilderness or remote setting at least 60 minutes away from definitive care ( hospital , clinic, etc.). Such an emergency can require specialized skills, treatment techniques, and knowledge in order to manage the patient for an extended period of time before and during evacuation. [1]

Types

Injury and illnesses

  • Arthropod bites and stings
  • Appendicitis (leading to folk peritonitis “what if” for long distance sailing)
  • Ballistic trauma (gunshot wound when hunting)
  • Eye injuries (such as from branches)
  • Flail chest with ice climbing and snowclimbing falls
  • Hyperthermia ( heat stroke or sunstroke )
    • Malignant hyperthermia
  • Hypothermia
  • Frostbite
  • poisoning
    • Food poisoning associated with warm weather expeditions
    • Venomous animal cock
    • Botanical from mushrooms or “wild greens”
  • Severe burn (forest fire)
  • Spreading wound infection
  • Suspected spinal injury from falling, falling rock, ice
  • Traumatic brain injury from falls, falling rock, ice

Infections

  • Lyme disease infection
  • Malaria infection associated with expeditions
  • Necrotizing Fasciitis
  • Rabies infection
  • Salmonella poisoning associated with expeditions

Neurologic

  • Subdural hematoma , associated with rockfall , icefall , falls while climbing, sledding crashes with rocks, mountain bike crashes

Respiratory

  • Altitude sickness
  • Asphyxia
  • Drowning
  • Inhalation Smoke (related to Forest fire )
  • Pneumothorax
  • Pulmonary edema associated with high altitude ( HAPE )
  • Respiratory Arrest associated with neurotoxic cocks

Shock

  • Anaphylaxis associated with stings
  • Hypovolemic shock (due to hemorrhage ) associated with climbing falls, kayak crashes, etc.
  • Septic shock

Mass-casualty incidents

A Casualty Attack Mass (MCI) is a situation in which the number or severity of casualties overwhelmed the medical services provider. Wilderness MCIs may include blizzards , earthquakes , avalanches , landslides , floods and forest fire , but they need to be natural disasters. Mass casualties have also been caused by human error in parts of climbers or explorers, with or without complications from inclement weather. [2] In mass casualty incidents, emergency service providers must prioritize their patients using a process called triage in order to make the most of their limited resources.

Response

Extrication and evacuation

Main article: Wilderness emergency response

Transporting an injured person out of the wilderness can be a difficult exercise requiring considerable manpower. [3] [4] It is advised that the person does not have enough experience with an injured party. [3]

Golden Hour

In emergency medicine , some advocates assert That There is a golden hour qui Refers to a time period lasting from A Few minutes to Several hours Following traumatic injury being white sustained by a casualty, During qui there is The Highest likelihood That prompt medical treatment will prevent prevention death . [5] While most medical professionals agree that the delay is in doubt, it is unlikely that they will not be able to do so. Dr. Bryan Bledsoe, an outspoken critic of the golden hour and other EMS “myths” like critical incident stress managementIt is important to remember that it is important to remember critical medical issues. [6]

Responder Certifications

First aid

Wilderness first aid (WFA) is the specific discipline of first aid where it relates to care in remote areas, where emergency medical services will be difficult to obtain or take a long time to arrive.

Locating the victim and assessing the situation is often difficult. citation needed ] Specialists in white water rescue , mountain rescue , mine disaster and other fields are often employed. In Some cases, emergency extrication procedures at incidents Such As automobile accidents are required before assessment is possible. Only once the location of the victim has been determined, can the ordinary first aidprocess begin. The evaluation of the process has been refined through a long process of evaluation.

Certification

Wilderness First Aid is a relatively new field compared to regular or ‘urban’ first aid. For this reason, there are a number of boards and societies qui-have-been FORMED in recent years to attempt to suit les normalized standards for wilderness first aid certification and wilderness medicine in general. Currently, there are no national standards for wilderness medicine, but one of the most popularly tested curricula is the “National Practice Guidelines for Wilderness Emergency Care” published by the Wilderness Medical Society in 2010. [7]

The American Red Cross First Aid Wilderness & Remote (r.2010) certification is valid for 2 years. [8]

In Canada the first WFA races were taught in the mid-1980s and the first organization was adopted by the Wilderness First Aid and Safety Association of BC (defunct since 1998). [9]

As of 2014, all official BSA high adventure programs (Such As PhilmontThe American Heart Association, Emergency Care and Safety Institute, American Heart Association, American Heart Association, and the American Red Cross Society. (ECSI), or American Safety & Health Institute (ASHI). At least one person must be certified in both WFA and CPR for all backpacking and camping activities where a Tour Plan must be filed. The preferred course is the American Red Cross Wilderness and Remote First Aid, which is a sixteen-hour course designed to help in situations where help is not readily available. Several hours may be required to reach a remote location after a message is delivered to the nearest staffed camp. First aid and CPR training will result in proper care and attention. Participants must present current certification cards to verify this requirement.[10] [ full quote needed ]

First responders

A Wilderness First Responder (72- to 80-hour race) certification is both a higher certification than a Wilderness First Aid Gold (16- to 20-hour race) certification, and may also be used to upgrade an Emergency Medical Technician to a Wilderness Emergency Medical Technician . Outdoor Emergency Care is a National Ski Patrol Certification, but it does not fully meet the requirements for a WFR certification. [11]

Training and certification organizations

Main article: Wilderness medicine

A number of fellowships are available for emergency medical services including emergency medical services , hospice and palliative care, research, undersea and hyperbaric medicine, sports medicine, ultrasound, pediatric emergency medicine, emergency medicine, wilderness medicine, toxicology, and Critical Care Medicine. [12]

  • Wilderness Medicine Institute (WMI) of NOLS
  • Wilderness Medicine Outfitters (WMO)
  • Stonehearth Open Learning Opportunities (SOLO)
  • True North Wilderness Survival School – http://www.ExploreTrueNorth.com
  • The Center for Wilderness Safety (CWS)
  • American Red Cross – http://www.redcross.org/
  • American Safety & Health Institute (ASHI) – http://www.hsi.com/ashi
  • Longleaf Wilderness Medicine – http://www.longleafmedical.com/ (LWM)
  • Survival Training School of California- http://www.californiasurvivaltraining.com

See also

  • Certified first responder
  • Emergency medical services (EMS)
  • First aid
  • List of medical emergencies
  • List of wilderness medical emergencies
  • Medic
  • Medical emergency
  • National Ski Patrol (NSP)
  • Oxygen first aid
  • Paramedic
  • Ski patrol
  • Street medic
  • triage
  • Wilderness Medical Emergency Technician (W-EMT)

References

  1. Jump up^ “Wilderness Medicine” . Farlex . Retrieved 1 February 2017 .
  2. Jump up^http://www.thecityedition.com/2012/First_Aid.html#mass[ full citation needed ]
  3. ^ Jump up to:b Wilkerson, James (2001). “Evacuation” . Medicine for mountaineering & other wilderness activities . pp. 25-7. ISBN  978-0-89886-799-2 .
  4. Jump up^ Keller, William (2001). “Transporting the Injured” . Keller’s Outdoor Survival Guide: How to Prevail When Lost, Stranded, or Injured in the Wilderness . p. 88. ISBN  978-1-57223-266-2 .
  5. Jump up^ American College of Surgeons (2008). Atls Advanced Trauma Life Support Program for Doctors . Bitter College of Surgeons. ISBN  978-1-880696-31-6 . [ page needed ]
  6. Jump up^ Bledsoe, BE (2002). “The Golden Hour: fact or fiction?” Emergency Medical Services . 31 (6): 105. PMID  12078402 .
  7. Jump up^ McIntosh, SE; Opacic, M; Freer, L; and. al. (2014). “Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Frostbite: 2014 update”. Wilderness Environ Med . Elsevier Inc. 25 (4): 43-54. PMID  25498262 . doi : 10.1016 / j.wem.2014.09.001 .
  8. Jump up^ “Wilderness and Sports” . Red Cross . Retrieved 31 January 2017 .
  9. Jump up^ [1]St. John Ambulance Wilderness First Aid Provides a race[ not in citation Given ] Archived2011-07-20 at theWayback Machine.
  10. Jump up^ http://www.bsawfa.com/who-requires-wfa.html
  11. Jump up^ Hawkins, Seth C. (2012). “The Relationship Between Ski Patrol and Emergency Medical Services Systems”. Wilderness & Environmental Medicine . 23 (2): 106-11. PMID  22656654 . doi : 10.1016 / j.wem.2012.03.008 .
  12. Jump up^ “Subspecialty Certification” . ABEM . Retrieved June 29, 2011 .