Abstract：
OBJECTIVE:To measure afterdrop and rewarming in subjects placed in a hypothermia wrap immediately after extrication from 60 minutes of snow burial. METHODS:We measured esophageal core body temperature (Tes) in 6 subjects buried in compacted snow (mean density 39%) for up to 60 minutes at an altitude of 2450 m while breathing with an AvaLung (Black Diamond Equipment, Salt Lake City, UT). Mean snow temperature was -3.5 ± 1.0 °C and mean air temperature was 0 ± 2 °C. Subjects wore a 1-piece Gore-Tex suit over medium weight Capilene underwear with a hood, face mask, goggles, mittens, and boots. After extrication from snow burial subjects were immediately placed in a hypothermia wrap. Tes was measured for an additional 60 minutes as subjects rewarmed by shivering. RESULTS:Tes cooling rate during snow burial was 0.84 ± 0.3 °C/h during a mean burial time of 58 ± 4 minutes. Tes afterdrop (0.77 ± 0.4 °C) occurred 12 ± 8 minutes after extrication from snow burial at a cooling rate of 4.0 ± 0.8 °C/h (P <.001 Tes snow burial vs afterdrop cooling rate). Rewarming rate was 1.1 ± 0.3 °C/h over the subsequent 48 ± 8 minutes (P = 0.045 snow burial cooling vs rewarming rate). CONCLUSION:Afterdrop rate increased about 4-fold as compared to snow burial cooling rate for a transient time period in subjects who were placed immediately into an insulating hypothermia wrap. Spontaneous endogenous rewarming increased core body temperature at a slightly higher rate than it decreased during snow burial. These findings suggest that field rewarming of mildly hypothermic and shivering avalanche burial victims is possible, but they should be insulated quickly to limit significant afterdrop.
journal_name
Wilderness Environ Medjournal_title
Wilderness & environmental medicineauthors
Grissom CK,Harmston CH,McAlpine JC,Radwin MI,Ellington B,Hirshberg EL,Crouch Adoi
10.1016/j.wem.2010.06.007subject
Has Abstractpub_date
2010-09-01 00:00:00pages
229-35issue
3eissn
1080-6032issn
1545-1534pii
S1080-6032(10)00205-Xjournal_volume
21pub_type
杂志文章abstract：:Remote extended expeditions often support scientific research and commercial resource exploration or extraction in hostile environments. Medical support for these expeditions is inherently complex and requires in-depth planning. To be successful, this planning must include substantial input from clinicians with experi...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2013.05.005
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abstract：:We report the case of a patient who presented with respiratory failure, recurrent ventricular fibrillation, ventricular arrhythmias, and hypotension after an intentional ingestion of aconite flowers. Significant ingestion of this plant can produce life-threatening cardio- and neurotoxicity that may require evacuation ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
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abstract：BACKGROUND/OBJECTIVE:We examined the changes in ventilation during sleep at high altitude using the LifeShirt monitoring system on 2 climbers who were attempting to summit Mount Aconcagua (6956 m). METHODS:Prior to the summit attempt, we measured cardiovascular and pulmonary function at 401 m (Rochester, MN) and gathe...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/06-WEME-BR-041R.1
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journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
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abstract：:We describe a patient with missed traumatic pneumothorax due to penetrating neck injury that was presumably caused by a stingray while diving. The barb can result in significant injuries to deep structures and organs despite a deceptively small entrance wound. This case underscores the importance of performing a thoro...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
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journal_title：Wilderness & environmental medicine
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更新日期：2009-04-01 00:00:00
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journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2015.12.009
更新日期：2016-06-01 00:00:00
abstract：INTRODUCTION:Wilderness medicine involves the treatment of individuals in remote, austere environments. Given the high potential for injuries as well as the unique treatment modalities required in wilderness medicine, evidence-based clinical practice guidelines are necessary to provide optimal care. In this study, we i...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2018.02.008
更新日期：2018-09-01 00:00:00
abstract：:There are many tales describing ferocious schools of piranha attacking humans, but there are few scientific data supporting such behavior. The very few documented instances of humans attacked and eaten by piranha schools include 3 that occurred after death by other causes (eg, heart failure and drowning). These predac...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
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更新日期：2003-01-01 00:00:00
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journal_title：Wilderness & environmental medicine
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更新日期：2020-12-01 00:00:00
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journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2015.11.013
更新日期：2016-03-01 00:00:00
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journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
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更新日期：2004-07-01 00:00:00
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journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/06-weme-or-013r.1
更新日期：2007-04-01 00:00:00
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journal_title：Wilderness & environmental medicine
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doi：10.1016/j.wem.2020.04.003
更新日期：2020-09-01 00:00:00
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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
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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：: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
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journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(2000)011[0005:teogam]2.3.co;2
更新日期：2000-04-01 00:00:00
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journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,随机对照试验
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更新日期：2016-03-01 00:00:00
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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
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journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2015.08.001
更新日期：2015-12-01 00:00:00
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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：OBJECTIVE:Planning and providing emergency and primary care for a large transient population of visitors and employees in a national park can be problematic. Furthermore, planning for emergency and primary health care needs of visitors and itinerant workers in a wilderness area national park has not been well documente...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(2000)011[0257:pfaaem]2.3.co;2
更新日期：2000-01-01 00:00:00
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journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2013.05.006
更新日期：2013-12-01 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：:Despite the presence of a number of anecdotal reports in the mountaineering literature, mucociliary dysfunction at high altitude has received little scientific attention. However, the dry, cold, thin air at high altitude has the potential to undermine normal mucociliary function. This seems increasingly likely in moun...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,评审
doi：10.1580/pr36-05.1
更新日期：2006-01-01 00:00:00
abstract：INTRODUCTION:Cricothyroidotomy is an advanced and life-saving technique, but it is also a rare and a difficult procedure. The purpose of the present study was to produce a low-cost simulation model with realistic anatomic features to investigate its effectiveness in developing cricothyroidotomy skills. METHODS:This st...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2020.05.003
更新日期：2020-09-01 00:00:00
abstract：:Two children, ages 2 and 4 years, envenomed by the snake Cerastes vipera are presented. Both children suffered from local pain and swelling of the hand that spread up to the shoulder in the 2-year-old and up to the elbow in the 4-year-old. A hemorrhagic blister was noted on the bitten finger in the younger patient. Ur...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(1995)006[0269:sbbcvi]2.3.co;2
更新日期：1995-08-01 00:00:00
abstract：:Bites by the European adder (Vipera berus) are a rare medical emergency in the UK with 20 to 50% of an estimated 50 to 200 cases per year necessitating treatment with antivenom. We present a case demonstrating both severe systemic and local effects necessitating out of hospital resuscitation, vasopressor support, and ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2018.08.002
更新日期：2019-03-01 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
