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 experience in remote, emergency, and prehospital medicine and from personnel familiar with the proposed working environment. Using the guidelines discussed in this paper will help ensure that planners consider all necessary, medically relevant elements before launching an extended remote expedition. The 10 key elements of a workable remote healthcare system are to: 1. Optimize workers’ fitness. 2. Anticipate treatable problems. 3. Stock appropriate medications. 4. Provide appropriate equipment. 5. Provide adequate logistical support. 6. Provide adequate medical communications. 7. Know the environmental limitations on patient access and evacuation. 8. Use qualified providers. 9. Arrange for knowledgeable and timely consultations. 10. Establish and distribute rational administrative rules. Planners using these guidelines may better be able to generate a strategy that optimizes the participants' health benefits, the expedition's productivity, and the expedition sponsor's cost savings.
journal_name
Wilderness Environ Medjournal_title
Wilderness & environmental medicineauthors
Iserson KVdoi
10.1016/j.wem.2013.05.005subject
Has Abstractpub_date
2013-12-01 00:00:00pages
366-77issue
4eissn
1080-6032issn
1545-1534pii
S1080-6032(13)00149-Xjournal_volume
24pub_type
杂志文章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：OBJECTIVE:Antarctic expeditioners face extremes of environmental conditions along with isolation which affect normal human activity at a polar station. Diets of polar expeditioners consist of products that have been kept in storage for more than a year. Processing and preservation adversely affect the nutritive value o...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/06-WEME-OR-004R3.1
更新日期：2007-01-01 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：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 ultraso...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/08-WEME-BR-228R2.1
更新日期：2009-10-01 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
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
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
更新日期：2007-07-01 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：INTRODUCTION:Seasonal migration of people in search of Yarsagumba fungus creates a population of collectors that faces hardship and health risks in austere high-altitude settings. METHODS:In 2016, our 4-person team performed a 2-day health-needs survey of people collecting Yarsagumba fungus near the village of Yak Kha...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2017.04.007
更新日期：2017-09-01 00:00:00
abstract：OBJECTIVE:Cuzco, Peru, is host to a dangerous mix of high altitude and rapid access from low elevation, which results in a high prevalence of acute mountain sickness (AMS). Thus, it is important that travelers entering Cuzco understand the basics of AMS. To this end, we assessed travelers' awareness of AMS, especially ...
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
abstract：INTRODUCTION:Grand Canyon National Park has seen an increase in visitors traversing the canyon from rim to rim (R2R) in a single day. R2R hikers travel over 33.8 km (21 mi) over 3300 m (11,000 ft) of elevation change and endure large temperature changes. Grand Canyon emergency medical service providers provide emergenc...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2018.08.001
更新日期：2019-03-01 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：OBJECTIVE:The purpose of this study was to examine the retention of wilderness first aid (WFA) knowledge, self-efficacy beliefs, and skills over time in a sample of WFA course participants. METHODS:Seventy-two open enrollment (volunteer) WFA course participants were assessed at 4 months, 8 months, or 12 months after t...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2012.04.005
更新日期：2012-09-01 00:00:00
abstract：OBJECTIVE:To describe injuries and illnesses treated during an expedition-length adventure race and combine the results with those from previous studies to identify common patterns of injury and illness during these events. METHODS:The 2003 Subaru Primal Quest Expedition Length Adventure Race was held in Lake Tahoe, C...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/pr29-05
更新日期：2006-10-01 00:00:00
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" bi...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2010.07.001
更新日期：2010-12-01 00:00:00
abstract：:Pig bite injuries are an infrequently described consequence of human-animal conflict. The domestic pig is thought to be a placid animal not given to unprovoked aggression. We report 2 separate cases of children managed at our institution who sustained abdominal injuries after attack by domestic pigs in rural Zimbabwe....
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2019.08.002
更新日期：2019-12-01 00:00:00
abstract：:Crocodilians represent one of the oldest constant animal lineages on the planet, in no small part due to their formidable array of predatory adaptations. As both human and crocodilian populations expand, they increasingly encroach on each others' territories, bringing morbidity and mortality to both populations. In th...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,评审
doi：10.1580/1080-6032(2005)16[143:CAIAAA]2.0.CO;2
更新日期：2005-10-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to test the hypothesis that polymorphisms in the endothelial PAS domain protein 1 (EPAS1) gene are associated with the susceptibility to high altitude pulmonary edema (HAPE) in Han Chinese. METHODS:This study enrolled 153 HAPE patients (HAPE-p), matched with Han Chinese resistan...
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：:Despite recent growth, opportunities for preclinical medical students to engage with the field of wilderness medicine remain geographically, financially, and logistically limited. Attendees of the 2018 Mid-Atlantic Student Wilderness Medicine Conference were invited to complete a post hoc web-based survey after the ev...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2019.06.009
更新日期：2019-12-01 00:00:00
abstract：OBJECTIVE:The purposes of this experiment were to determine the repeatability of acute mountain sickness (AMS), AMS symptoms, and physiological responses across 2 identical hypoxic exposures. METHODS:Subjects (n = 25) spent 3 nights at simulated altitude in a normobaric hypoxia chamber: twice at a partial pressure of ...
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：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：OBJECTIVE:The study aimed to examine the physiological responses to acute normobaric hypoxia during an intermittent walking protocol. METHODS:Twelve active healthy male participants completed a 125-minute test that involved rest and walking (50% VO(2max)) during normoxic (20.93%O(2)) and 2 hypoxic conditions (14%O(2) ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,随机对照试验
doi：10.1580/07-WEME-OR-143.1
更新日期：2008-01-01 00:00:00
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：OBJECTIVE:To explore the effect of aspirin on the thermoregulatory responses of men during exposure to 12°C air (acute cold exposure) for a period of 120 minutes and recovery in 25°C air (rewarming) for 120 minutes. METHODS:Seven male subjects (26.1 ± 2.4 yr) underwent pre-experimental testing to determine peak VO(2) ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.wem.2011.06.007
更新日期：2011-12-01 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：:The purpose of this case study is to examine the physiological/behavioral factors leading up to heat exhaustion in a male wildland firefighter during wildland fire suppression. The participant (24 years old, 173 cm, 70 kg, and 3 years firefighting experience) experienced heat exhaustion following 7 hours of high ambie...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2011.01.008
更新日期：2011-06-01 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：:Flying snakes (Genus Chrysopelea) are a group of ophisthoglyphous colubrids in South and South East Asia known for gliding in the air. Of the five species of flying snakes, Sri Lankan flying snake, Chrysopelea taprobanica, is endemic to Sri Lanka. Authenticated bites and the venom characteristics of this uncommon snak...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2013.01.008
更新日期：2013-09-01 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
abstract：:Anaphylaxis is a severe, life-threatening, multisystem hypersensitivity reaction that can rapidly progress to hypotension and airway compromise. Successful management of anaphylaxis has been documented with the use of prescription intramuscular epinephrine pens that require only minimal training for safe use. The prio...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2016.02.005
更新日期：2016-06-01 00:00:00
