Abstract：
:Puerto Rico (PR) is home to 10 indigenous species of snake. Alsophis portorricensis has traditionally been considered harmless. In 1961, Hageman classified A portorricensis as somewhere between "venomous" and "nonvenomous." In 1966, Heatwole and Banuchi reported the only case found in the literature of a "venomous" bite from Alsophis portorricensis. Only 6 cases of snakebite were reported to the PR Department of Health from 1998 to 2007; ecchymosis, swelling, and abnormal vital signs were noted in all of the cases. In 5 of these 6 cases, the captured snake was, in fact, identified as Alsophis portorricensis of the Colubridae family; in the remaining case, the description strongly suggests that it was the same species as the others. All bites were inflicted on fingers, which were presented for evaluation from 2 to 24 hours after the event. All documented cases report that the bite lasted from 1 to 4 minutes. All of the victims presented with localized pain and ecchymosis. Localized edema extended from the hand to the elbow in 4 cases, and up to the shoulder in 2 cases. All patients were treated symptomatically, observed at the Emergency Department (ED), and discharged home within 24 hours after the ED evaluation. All patients reported the resolution of symptoms within 1 week. Traditionally, PR has not been associated with any dangerous species of snake. These cases show that the second most abundant snake on the island can inflict a venomous bite, with local and systemic symptoms that warrant adequate preparation by the medical community.
journal_name
Wilderness Environ Medjournal_title
Wilderness & environmental medicineauthors
García-Gubern C,Bello R,Rivera V,Rocafort A,Colon-Rolon L,Acosta-Tapia Hdoi
10.1016/j.wem.2010.07.001subject
Has Abstractpub_date
2010-12-01 00:00:00pages
353-6issue
4eissn
1080-6032issn
1545-1534pii
S1080-6032(10)00244-9journal_volume
21pub_type
杂志文章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：: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
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:This study was designed to evaluate the effectiveness of a new protocol implemented to standardize snakebite management in Iran. METHODS:In this study, 27 patients treated according to the new protocol in 2012 (P+) were compared with 22 patients treated according to the previous modality in the year before i...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2014.09.011
更新日期：2015-06-01 00:00:00
abstract：:Avalanches are one of the major threats to life in high-mountain terrain and account every year for approximately 150 accidents causing injury or death in the United States alone. Every year avalanches cause significant property damages and a death toll of approximately 15 people in the United States. The specific cha...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(1997)008[0101:gsrusc]2.3.co;2
更新日期：1997-05-01 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：:Exposure to and consumption of brackish water are associated with an elevated risk of infection, hypernatremia, and hypothermia. Minimal data exist to support the diagnosis and treatment of patients with long-term brackish water exposure. We present a case of a patient who spent 5 to 10 d semisubmerged in the Elizabet...
journal_title：Wilderness & environmental medicine
pub_type：
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.2013.11.007
更新日期：2014-06-01 00:00:00
abstract：OBJECTIVE:The incidence of fatal closed head injury (CHI) and nonfatal CHI causing an altered level of consciousness in avalanche victims is unknown. The purpose of this study was to assess the incidence and potential significance of CHI in avalanche-related deaths. METHODS:The records of the state medical examiner an...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(2001)012[0244:atachi]2.0.co;2
更新日期：2001-01-01 00:00:00
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journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2019.10.008
更新日期：2020-03-01 00:00:00
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journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2012.07.004
更新日期：2013-03-01 00:00:00
abstract：BACKGROUND:Skiing and snowboarding are popular activities that involve high kinetic energies, often at altitude, and injuries are common. As a portable imaging modality, ultrasound may be a useful adjunct for mountainside clinics. This review briefly discusses skier and snowboarder injury profiles and focuses on the ro...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,评审
doi：10.1016/j.wem.2012.03.012
更新日期：2012-09-01 00:00:00
abstract：:We present 3 cases of severe hyponatremia occurring on a commercially guided river rafting trip on the Colorado River in Grand Canyon National Park. All 3 women appeared to have been overhydrating because of concern about dehydration and required evacuation within 24 hours of each other after the staggered onset of sy...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2014.08.007
更新日期：2015-06-01 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
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journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2009.12.020
更新日期：2010-03-01 00:00:00
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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
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journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.wem.2012.03.007
更新日期：2012-09-01 00:00:00
abstract：:Although catfish are found worldwide and commonly consumed in the southern United States, fatal infections from catfish are rare. Edwardsiella tarda is a bacterium known to cause gastrointestinal distress most commonly, but extraintestinal infections are a rarely considered danger for those acquiring, preparing, and c...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2019.04.004
更新日期：2019-09-01 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
doi：10.1580/1080-6032(2003)14[249:paohis]2.0.co;2
更新日期：2003-01-01 00:00:00
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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
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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：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
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journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2013.05.005
更新日期：2013-12-01 00:00:00
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journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2015.03.006
更新日期：2015-09-01 00:00:00
abstract：:As part of an emergency medical system protocol, national park service rangers certified at the level of an emergency medical technician-basic (EMT-B) are taught to recognize and treat high-altitude pulmonary edema and high-altitude cerebral edema. In Sequoia and Kings Canyon National Parks, this is done with the assi...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(2004)15[198:uotgbb]2.0.co;2
更新日期：2004-10-01 00:00:00
abstract：:Anaphylaxis is a medical emergency requiring prompt action to prevent death from cardio-respiratory collapse. It can be a biphasic, unpredictable, and challenging reaction to deal with even in a hospital environment. The wilderness environments afforded by expeditions, remote health posts, and military exercises pose ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2011.12.002
更新日期：2012-03-01 00:00:00
abstract：OBJECTIVE:Avalanches pose a life-threatening risk to participants of outdoor winter activities. Determining the causes of death in avalanche fatalities can aid rescue and resuscitation strategies and hopefully improve survival. METHODS:The study population included all avalanche fatalities in Utah from the 1989-90 to ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/07-WEME-OR-092R1.1
更新日期：2007-01-01 00:00:00
abstract：:Combat operations necessitate bold thought and afford the opportunity to rapidly evolve and improve trauma care. The development and maturation of Tactical Combat Casualty Care (TCCC) is an important example of a critical process improvement strategy that reduced mortality in high-threat combat-related trauma. The Com...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,评审
doi：10.1016/j.wem.2016.11.008
更新日期：2017-06-01 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：: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
