Abstract：
OBJECTIVE:Mountaineers face a variety of health risks at altitude including pulmonary edema; portable ultrasound may be used to diagnose high altitude pulmonary edema. This report tests the functionality of electronic equipment in a hypobaric test environment and the ability of remotely guided nonexperts to use ultrasound to evaluate respiratory status on Mt Everest. METHODS:Two ultrasound devices and associated video equipment were tested in a cooled (4 degrees C-5 degrees C) hypobaric chamber to 27000 feet (8230 m) before travel to Mt Everest. The ultrasound system was connected via satellite phone to a video streaming device and portable computer to stream video through the Internet for remote guidance of a novice user by an expert. Pulmonary interstitial fluid was quantified by the presence of "comet tail" artifacts. RESULTS:There was no notable degradation in equipment performance in cold, hypobaric conditions; ultrasound confirmation of increased comet tails was noted in the chamber despite oxygen supplementation and the very brief exposure. Two pulmonary surveys of asymptomatic participants were completed by novice operators within 25 minutes on Mt Everest. The remote expert was able to guide and identify comet tails suggestive of intermediate pulmonary interstitial fluid. Image quality was excellent. CONCLUSIONS:The tested ultrasound devices functioned nominally in cold, hypobaric conditions; acute changes in lung fluid content were noted in these conditions despite normoxia. We successfully used a satellite telemedical connection with a remote expert to guide thoracic ultrasound examinations at Advanced Base Camp on Mt Everest. Coupling portable ultrasound with remote expert guidance telemedicine provides a robust diagnostic capability in austere locations.
journal_name
Wilderness Environ Medjournal_title
Wilderness & environmental medicineauthors
Otto C,Hamilton DR,Levine BD,Hare C,Sargsyan AE,Altshuler P,Dulchavsky SAdoi
10.1580/08-WEME-BR-228R2.1subject
Has Abstractpub_date
2009-10-01 00:00:00pages
283-9issue
3eissn
1080-6032issn
1545-1534pii
1080-6032-20-3-283journal_volume
20pub_type
杂志文章abstract：OBJECTIVE:To analyze the nature of surfing injuries in Cornwall in order to identify trends and inform clinical management. METHODS:The details of patients presenting (with injuries sustained while surfboard/bodyboard riding) to the Emergency Department (ED) of the Royal Cornwall Hospital, Truro (UK), from September 2...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032-020.004.0335
更新日期：2009-01-01 00:00:00
abstract：:Three groups of five men each were dehydrated overnight in the heat (115 degrees F) on two occasions (D1 and D2) to approximately 5.5% of their starting body weight. During the 3-week period between D1 and D2, one group (AC) was acclimatized to heat and physically conditioned, the second group (C) was physically condi...
journal_title：Wilderness & environmental medicine
pub_type： 传,古典文章,历史文章,杂志文章
doi：10.1580/1080-6032(2000)011[0204:wpadeo]2.3.co;2
更新日期：2000-10-01 00:00:00
abstract：INTRODUCTION:Depending on their theatre of operation, French soldiers may potentially be exposed to scorpion stings and snakebites. Following the recommendations of a French military health service (FMHS) technical committee for envenomation, the FMHS provides antivenoms appropriate to each deployment. This work aimed ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2020.01.006
更新日期：2020-06-01 00:00:00
abstract：OBJECTIVE:We aimed to ascertain risk factors for acute mountain sickness (AMS) in miners exposed to chronic intermittent high altitude conditions. METHODS:All new hires (2009-2012) for mine employment (4000 m above sea level) were followed up for 12 months after first ascent. Demographics, physiologic data, and cigare...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2014.10.006
更新日期：2015-06-01 00:00:00
abstract：OBJECTIVES:This study sought to create a model for testing topical treatment of jellyfish stings. It sought to determine which treatments 1) stimulate/inhibit nematocyst discharge; 2) decrease pain; and 3) decrease skin inflammation; it also sought to discover whether there is a clinical correlation between stimulated ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.wem.2015.10.008
更新日期：2016-03-01 00:00:00
abstract：OBJECTIVE:Winter sports continue to be a popular form of recreation, but few studies have focused on serious injuries. The objectives of this study were to evaluate the major morbidity associated with downhill skiing, snowboarding, and sledding and to determine the incidence of serious injuries sustained while downhill...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(2002)013[0245:ssasii]2.0.co;2
更新日期：2002-01-01 00:00:00
abstract：:High-altitude pulmonary edema (HAPE) is a well-recognized disease entity in trekkers to the Nepal Himalayas. We present the case of a patient who had clinical features consistent with HAPE but did not descend the mountain on time, which contributed to his death. The important factors of the diagnosis, the descent, and...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(2000)011[0099:atroph]2.3.co;2
更新日期：2000-07-01 00:00:00
abstract：:The lowest recorded core temperature from which a person with accidental hypothermia has survived neurologically intact is 11.8°C in a 2-y-old boy. The lowest recorded temperature from which an adult has been resuscitated neurologically intact is 13.7°C in a 29-y-old woman. The lowest core temperature with survival fr...
journal_title：Wilderness & environmental medicine
pub_type： 历史文章,杂志文章
doi：10.1016/j.wem.2020.02.003
更新日期：2020-09-01 00:00:00
abstract：INTRODUCTION:Most recreational whitewater fatalities are caused by fixed underwater entrapment or by "flush drowning," an obscure term frequently associated with high-volume rivers, continuous rapids, cold water, and a lack of prolonged underwater entrapment. Although entrapment drowning is typically associated with su...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2019.09.006
更新日期：2020-03-01 00:00:00
abstract：:Recent studies in normal participants have shown that right to left shunt blood vessels in the lung open up during exercise. We describe the first field study to investigate this phenomenon at altitude. This study aimed to assess the effect of altitude and partial acclimatization on inducible right to left shunting at...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/07-WEME-BR-162.1
更新日期：2008-10-01 00:00:00
abstract：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 tre...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2016.03.001
更新日期：2016-09-01 00:00:00
abstract：OBJECTIVE:The aim of this study was to describe the range and types of medical and traumatic conditions encountered in land search and rescue operations in New Zealand. METHODS:Twenty months (May 2010 to December 2011) of land search and rescue operations were analyzed. Data on medical and traumatic conditions were ex...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2014.05.003
更新日期：2014-12-01 00:00:00
abstract：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 ra...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2014.03.013
更新日期：2014-09-01 00:00:00
abstract：:We experienced a case involving prolonged cardiopulmonary resuscitation (CPR) during cardiac arrest on Mt. Fuji (3776 m), demanding lengthy exertion by the rescuers performing CPR. Considering the effects of exertion on the rescuers, we examined their percutaneous arterial oxygen saturation during simulated CPR and co...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2019.10.008
更新日期：2020-03-01 00:00:00
abstract：:High-altitude pulmonary edema (HAPE) is a recognized risk of rapid ascent to high altitude. Since the recognition of this entity more than 30 years ago, most pulmonary deaths at high altitude have been attributed to HAPE. However, as the bodies can almost never be recovered for postmortem examination, rare diagnoses t...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(1995)006[0220:pepaha]2.3.co;2
更新日期：1995-05-01 00:00:00
abstract：OBJECTIVE:To describe search and rescue activity performed by the National Park Service (NPS) on Denali, the highest point in North America. METHODS:A retrospective review was performed of all search and rescue (SAR) operations by the NPS from 1990 to 2008. Descriptive analysis was used to describe these cases as well...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2009.12.024
更新日期：2010-06-01 00:00:00
abstract：:We report the case of a previously healthy 32-year-old man presenting with severe headache on 2 separate expeditions to Cho Oyu (8201 m). No brain imaging was performed after the first expedition. On the second expedition, thrombosis of the superior sagittal sinus was detected. Investigations for hypercoagulable state...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/pr19-04.1
更新日期：2006-07-01 00:00:00
abstract：:We report a case of survival of a completely buried avalanche victim after being located with the radar-based RECCO Rescue System. In the winter of 2015, 2 off-piste skiers were completely buried in an avalanche near the secured ski area in Baqueira Beret, Spain. The first victim was located with the RECCO Rescue Syst...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2016.02.004
更新日期：2016-06-01 00:00:00
abstract：:During historic, as well as more recent, conflicts, most combat casualties who die from their injuries do so in the prehospital setting. Although many of the injuries incurred by these casualties are nonsurvivable, a number of injuries are still potentially survivable. Of those injuries that are potentially survivable...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,评审
doi：10.1016/j.wem.2016.11.007
更新日期：2017-06-01 00:00:00
abstract：:The use of tranexamic acid (TXA) in the treatment of trauma patients was relatively unexplored until the landmark Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage-2 (CRASH-2) trial in 2010 demonstrated a reduction in mortality with the use of TXA. Although this trial was a randomized, double-bl...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,评审
doi：10.1016/j.wem.2016.12.006
更新日期：2017-06-01 00:00:00
abstract：INTRODUCTION:North Carolina (NC) is home to more than 30 species of indigenous venomous and nonvenomous snakes. Snakebites can cause debilitating and potentially fatal injuries. However, there is a lack of current information available describing the incidence of snakebites in NC. Therefore, we performed this study of ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2018.01.004
更新日期：2018-06-01 00:00:00
abstract：:Treating skin disorders in wilderness settings is often challenging. In this report we describe common skin conditions affecting the feet of river runners on the Colorado River in Grand Canyon National Park. These conditions are frequently referred to by river runners with a catchall term, "tolio." Several skin disord...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2019.09.003
更新日期：2020-03-01 00:00:00
abstract：OBJECTIVE:Severe injuries and fatalities can occur from an alligator attack. Encounters with alligators appear to be increasing in the United States. This review provides information from alligator attacks reported in the United States as well as infections that may occur after an alligator bite. METHODS:Telephone int...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,评审
doi：10.1016/j.wem.2010.02.002
更新日期：2010-06-01 00:00:00
abstract：INTRODUCTION:A clinical course ranging from mild local findings to life-threatening systemic findings may occur after scorpion stings. The purpose of this study was to identify priority markers indicating scorpion sting-related cardiac involvement. METHODS:Our study was performed between July 2014, and September 2015 ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2018.06.013
更新日期：2018-12-01 00:00:00
abstract：:Fatalities secondary to inhalation of volcanic gases in the United States have rarely been reported. We report the deaths of 3 ski patrol members at a popular California ski resort. After a snowstorm, ski patrol members were fencing off a well-known volcanic fumarole when the snow around the vent collapsed. Two member...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/08-WEME-CR-199.1
更新日期：2009-04-01 00:00:00
abstract：:A 74-year-old previously healthy woman was bitten by a hump-nosed pit viper (Hypnale hypnale) at dusk causing incoagulable blood lasting for 6 days. Further, she developed ecchymoses over her forearms, upper arms, hands, and lower back on day 4 after the snakebite, and microangiopathic hemolytic anemia (MAHA). Feature...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2017.05.005
更新日期：2017-09-01 00:00:00
abstract：OBJECTIVE:Our objective was to determine the incidence of acute mountain sickness (AMS) and the cardiorespiratory responses, in children and their parents, after rapid ascent to 3500 m. The sample population was composed of children and their parents who ascended within 24 hours from Arica (sea level) to Putre (3500 m)...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/06-WEME-BR-084.1
更新日期：2008-01-01 00:00:00
abstract：:Risk of injury in cold environments is related to a combination of athlete preparedness, preexisting medical conditions, and the body's physiologic response to environmental factors, including ambient temperature, windchill, and wetness. The goal of this section is to decrease the risk of hypothermia, frostbite, and n...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2015.09.006
更新日期：2015-12-01 00:00:00
abstract：INTRODUCTION:Finger growth plate injuries are the most common injury among youth climbers, and the association between these injuries and speed climbing, a mandatory discipline in the 2021 Olympics, has not been examined previously. Our primary purpose was to examine the demographic and training characteristics of adol...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2020.06.008
更新日期：2020-12-01 00:00:00
abstract：:Exercise-associated hyponatremia (EAH) is defined by a serum or plasma sodium concentration below the normal reference range of 135 mmol/L that occurs during or up to 24 hours after prolonged physical activity. It is reported to occur in individual physical activities or during organized endurance events conducted in ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,实务指引
doi：10.1016/j.wem.2014.08.009
更新日期：2014-12-01 00:00:00
