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 symptoms, which included fatigue and emesis progressing to disorientation or seizure. Each was initially transferred to the nearest hospital and ultimately required intensive care. Imaging and laboratory data indicated all 3 patients had hypervolemic hyponatremia. Unlike the well-documented exercise-associated hyponatremia cases commonly occurring in prolonged endurance athletic events, these 3 unique cases of acute hyponatremia were not associated with significant exercise. The cases illustrate the diagnostic and treatment challenges related to acute hyponatremia in an austere setting, and underscore the importance of preventive measures focused on avoidance of overhydration out of concern for dehydration.
journal_name
Wilderness Environ Medjournal_title
Wilderness & environmental medicineauthors
Pearce EA,Myers TM,Hoffman MDdoi
10.1016/j.wem.2014.08.007subject
Has Abstractpub_date
2015-06-01 00:00:00pages
189-95issue
2eissn
1080-6032issn
1545-1534pii
S1080-6032(14)00267-1journal_volume
26pub_type
杂志文章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::Hematotoxic snake bite is a leading cause of mortality in South India. However, it is rare for the emergency physician to encounter a patient with trauma associated with snakebite. Management of such a patient differs substantially from the routine management of either a trauma patient or a snakebite victim. A 59-y-ol...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2020.08.003
更新日期:2020-12-01 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::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:To document changes in body composition and body mass in male and female tree planters. METHODS:Height, mass, skin-fold thickness, and limb girths were measured in 17 male and 5 female tree planters before and after 10 weeks of work. RESULTS:Significant decreases were found in body mass (80.6 +/- 10.7 kg vs...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/pr01-03.1
更新日期:2005-04-01 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::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::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: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:Olfactory function, a cognitive impairment biomarker, was evaluated in mountain ultramarathon (MUM) runners during the Tor des Géants race (332.5 km with an overall altitude gain of 24,000 m; altitude range 330-3296 m above the sea). METHODS:An Odor Identification Test was administered before (T0; n = 53), a...
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
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
doi:10.1016/j.wem.2018.05.001
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to review the patient characteristics and management of 56 cases of high altitude pulmonary edema at the Pheriche Himalayan Rescue Association Medical Aid Post, and to measure the use of medications in addition to descent and oxygen. METHODS:In a retrospective case series, we re...
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:INTRODUCTION:The utility of digital intubation, especially in an austere environment with limited equipment, has been previously described. However, evidence supporting best practices for its technique is limited. We seek to quantify the time to intubation and the rate of successful placement of the tube for digital in...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2018.11.006
更新日期:2019-03-01 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::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: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::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::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
abstract:BACKGROUND:Minimal data exist regarding the activity, membership, training, and medical oversight of search and rescue (SAR) teams. OBJECTIVE:Our objective was to describe these characteristics in the Intermountain West SAR organizations. METHODS:A contact list was generated and electronic surveys were sent to SAR of...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2013.08.002
更新日期:2013-12-01 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::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::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::A 67-year-old woman presented to a community emergency department in Orange County, CA, after she was stung by a scorpion identified as Centruroides limbatus from Central America. She developed local pain and systemic symptoms, including parasthesias, flushing, hypertension, and wheezing. Envenomation by this genus of...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/1080-6032(1999)010[0161:ebtslo]2.3.co;2
更新日期:1999-10-01 00:00:00
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
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the effects of gender and menstrual cycle on the percent of carbohydrate (CHO) utilized during cold water immersion (20 degrees C). Previous research has suggested that males and females utilize CHO differently during submaximal exercise. This study examined whether t...
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
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:BACKGROUND:High altitude pulmonary edema (HAPE) is a potentially deadly disease associated with exposure to altitudes greater than 3000 m. Individuals who have previously experienced HAPE are at a significantly higher risk of recurrence, suggesting an underlying genetic component to HAPE pathogenesis. In a previous nuc...
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::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: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::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