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 austere environments in which medical care is limited and often not available, and patient evacuation to definitive care is often greatly delayed. Rapid recognition and appropriate treatment are essential in the severe form to ensure a positive outcome. Failure in this regard is a recognized cause of event-related fatality. In an effort to produce best practice guidelines for EAH in the austere environment, the Wilderness Medical Society convened an expert panel. The panel was charged with the development of evidence-based guidelines for management of EAH. Recommendations are made regarding the situations when sodium concentration can be assessed in the field and when these values are not known. These recommendations are graded on the basis of the quality of supporting evidence and balance between the benefits and risks/burdens for each parameter according to the methodology stipulated by the American College of Chest Physicians. This is an updated version of the original WMS Practice Guidelines for Treatment of Exercise-Associated Hyponatremia published in Wilderness & Environmental Medicine 2013;24(3):228-240.
journal_name
Wilderness Environ Medjournal_title
Wilderness & environmental medicineauthors
Bennett BL,Hew-Butler T,Hoffman MD,Rogers IR,Rosner MH,Wilderness Medical Society.doi
10.1016/j.wem.2014.08.009subject
Has Abstractpub_date
2014-12-01 00:00:00pages
S30-42issue
4 Suppleissn
1080-6032issn
1545-1534pii
S1080-6032(14)00271-3journal_volume
25pub_type
杂志文章,实务指引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,评审
doi：10.1016/j.wem.2016.11.007
更新日期：2017-06-01 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
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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 purpose of this study was to describe the relative frequency, patterns, and mechanisms of sailing-related injuries in dinghies and keelboats. Data were also collected on risky and risk-averse behaviors of sailors, as well as on sailing-related illnesses. METHODS:A web-based, logic-driven, multiple-choice...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2010.06.006
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abstract：:A tool that can differentiate ischemic stroke from other neurological conditions (eg, hemorrhagic stroke, high-altitude cerebral edema) in the field could enable more rapid thrombolysis when appropriate. The resources (eg, an MRI or CT scanner) to investigate stroke at high altitude may be limited, and hence a portabl...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2010.10.007
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abstract：INTRODUCTION:This study compared 2 commercially available beverages, an oral rehydration solution (ORS; 60.9 mM Na+; 3.4% carbohydrate) and a sports drink (SDS; 18.4 mM Na+; 5.9% carbohydrate), on hydration and metabolism during submaximal exercise in the heat. METHODS:Ten male subjects completed two 90-min exercise t...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2018.01.005
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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
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pub_type： 杂志文章
doi：10.1580/1080-6032(2005)16[198:prouaa]2.0.co;2
更新日期：2005-01-01 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：:A hydatid cyst is a parasitic disease caused by the tapeworm Echinococcus granulosus. It is endemic in many areas, including New Zealand, Australia, and the Mediterranean region. Pulmonary hydatid disease can be diagnosed incidentally in asymptomatic patients or may cause symptoms such as cough, chest pain, dyspnea, f...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/07-WEME-CR-1561.1
更新日期：2008-07-01 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：: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: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：: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：OBJECTIVE:Thermal sensation and the physiological responses of women (follicular phase) exposed to 17 degrees C immersion for 120 minutes were investigated. METHODS:The subjects were divided into 2 groups by percent body fat (low fat [LF] = 21% +/- 2% [mean +/- SD] vs high fat [HF] = 30% +/- 3%). A 2-way analysis of v...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(2000)011[0157:tsasud]2.3.co;2
更新日期：2000-10-01 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：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：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：OBJECTIVE:The main goal was to explore the different toxin properties (proteolytic, hemorrhagic, and neurotoxic) of Leptodeira annulata ashmeadii Duvernoy's gland secretion (DGS). METHODS:To separate and characterize the different proteins present in L. annulata ashmeadii DGS, 20% sodium dodecyl sulfate-polyacrylamide...
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pub_type： 杂志文章
doi：10.1580/1080-6032(2004)015[0082:phanac]2.0.co;2
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：10.1016/j.wem.2017.09.010
更新日期：2018-03-01 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：: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
更新日期：2013-12-01 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:To help the Mountain Rescue Association of Scotland find the best protective mountain rescue casualty bag in cold and windy conditions. The study investigated how 3 different casualty bags (labeled Bag 1, Bag 2, and Bag 3) performed in a cold (-10 degrees C, dry bulb), windy (wind speed 3.0 m x s(-1)) environ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(2002)013[0036:acomrc]2.0.co;2
更新日期：2002-04-01 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：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：: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 ability to control water-borne diseases is critical for soldiers, hikers, and others who may need to drink directly from an outdoor source. Water-borne protozoan parasites that are specifically of concern are Giardia and Cryptosporidium because of their resistance to halogen disinfection. The purpose of this study...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(1997)008[0096:eoiwpt]2.3.co;2
更新日期：1997-05-01 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
