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 intubation using different approaches and assistance devices. METHODS:Using a manikin, digital intubation was performed with an endotracheal tube alone, with an endotracheal tube and a 14-French stylet, or with a gum-elastic bougie. All 3 techniques were performed in a crossover fashion at the manikin's side and head. Three trials per technique and position were performed. Outcomes measured were the time to intubation and the successful placement of the tube. RESULTS:A total of 72 timed trials were performed. A significant difference did not exist between practitioners being positioned at the head vs side in terms of time or successful placement rate. There was no difference between the time to intubation in the tube-only and stylet-assisted groups, but the bougie-assisted group was significantly slower than the others. The stylet-assisted technique was significantly more successful than the other 2 techniques. CONCLUSIONS:In a manikin model, stylet-assisted digital intubation was the most successful technique tested and allowed intubation to be accomplished just as quickly as with an endotracheal tube alone. Bougie-assisted digital intubation was slower and may not be as helpful as when it is used as an adjunct with direct laryngoscopy. Further research is needed to determine the utility of these adjuncts on live subjects.
journal_name
Wilderness Environ Medjournal_title
Wilderness & environmental medicineauthors
Juergens AL 2nd,Odom BW,Ren CE,Meyers KEdoi
10.1016/j.wem.2018.11.006subject
Has Abstractpub_date
2019-03-01 00:00:00pages
52-55issue
1eissn
1080-6032issn
1545-1534pii
S1080-6032(18)30212-6journal_volume
30pub_type
杂志文章abstract：INTRODUCTION:The Kham Tibetans are one of several Tibetan ethnic subgroups living in the Kham area of China. Because studies on the high-altitude adaptation of the Kham people are scant, the main aim of this study is to investigate whether the response to hypoxia, especially polycythemia status, in the Kham Tibetans is...
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:Heat-related illness is a common disease with significant morbidity and mortality. Despite no proven efficacy, application of chemical cold packs (CCP) to the skin overlying the large vessels of the neck, groin, and axillae is a traditional recommended cooling modality. The study objective was to compare the ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.wem.2014.11.006
更新日期：2015-06-01 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：:The use of tranexamic acid (TXA) in the treatment of trauma patients was relatively unexplored until the landmark Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage-2 (CRASH-2) trial in 2010 demonstrated a reduction in mortality with the use of TXA. Although this trial was a randomized, double-bl...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,评审
doi：10.1016/j.wem.2016.12.006
更新日期：2017-06-01 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：: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：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:Helicopters are commonly used in search and rescue operations, and accidents have occurred during helicopter search and rescue (HSAR) missions. The purposes of this study were to investigate whether the HSAR accident rate in the United States could be determined and whether any common contributing factors or ...
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
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：: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:Our objective was to determine the incidence of acute mountain sickness (AMS) and the cardiorespiratory responses, in children and their parents, after rapid ascent to 3500 m. The sample population was composed of children and their parents who ascended within 24 hours from Arica (sea level) to Putre (3500 m)...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/06-WEME-BR-084.1
更新日期：2008-01-01 00:00:00
abstract：:Teaching emergency procedural skills in a wilderness setting can be logistically challenging. To teach these skills as part of a wilderness medicine elective for medical students, we designed an outdoor simulation session with low-fidelity models. The session involved 6 stations in which procedural skills were taught ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2013.11.001
更新日期：2014-03-01 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
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：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：: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 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：OBJECTIVE:To compare altitude responses of 2 ultraendurance athletes and 2 nonathletes during a 2-week expedition on Denali (Mount McKinley). METHODS:The severity of acute mountain sickness (AMS) symptoms (Lake Louise AMS guidelines) and pulmonary function parameters (forced vital capacity, forced expiratory volume in...
journal_title：Wilderness & environmental medicine
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：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：OBJECTIVE:To describe the epidemiology of injuries sustained during the 2009 season at Whistler Mountain Bike Park. METHODS:A retrospective chart review was performed of injured bike park cyclists presenting to the Whistler Health Clinic between May 16 and October 12, 2009. RESULTS:Of 898 cases, 86% were male (median...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2012.02.002
更新日期：2012-06-01 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:The objective of this study was to describe the pediatric emergencies encountered by the Christophorus-1 helicopter emergency medical service (HEMS) during a period of 2 years. METHODS:Emergency treatment of pediatric casualties by HEMS was evaluated at a helicopter base. Children up to 14 years who were tre...
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
abstract：OBJECTIVE:Portable electronic devices play an important role in the management of type 1 diabetes mellitus. Electromagnetic interference from electronic devices has been shown to impair the function of an avalanche transceiver in search mode (but not in transmitting mode). This study investigates the influence of elect...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2014.12.016
更新日期：2015-06-01 00:00:00
abstract：:Treating skin disorders in wilderness settings is often challenging. In this report we describe common skin conditions affecting the feet of river runners on the Colorado River in Grand Canyon National Park. These conditions are frequently referred to by river runners with a catchall term, "tolio." Several skin disord...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2019.09.003
更新日期：2020-03-01 00:00:00
abstract：:This case report describes the use of a hydration bladder as an improvised air splint for a left forearm fracture in an austere environment. The literature regarding the use of air splints in the prehospital and wilderness environments is scarce, and it does not appear that this technique has been previously described...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2018.10.008
更新日期：2019-03-01 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：:We experienced a case involving prolonged cardiopulmonary resuscitation (CPR) during cardiac arrest on Mt. Fuji (3776 m), demanding lengthy exertion by the rescuers performing CPR. Considering the effects of exertion on the rescuers, we examined their percutaneous arterial oxygen saturation during simulated CPR and co...
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
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：:The case of a 42-y-old rock climber who sustained a complete, isolated rupture of the short head of the biceps brachii muscle after falling onto his upper arm while bouldering is presented. This is the first description of this rare injury after a climbing accident. Moreover, there is no definitive consensus on whethe...
journal_title：Wilderness & environmental medicine
pub_type：
doi：10.1016/j.wem.2020.04.006
更新日期：2020-09-01 00:00:00
abstract：:We describe a case report of a subject suffering high-altitude cerebral and pulmonary edema successfully treated with low flow rates of supplemental oxygen administered with a breathing system designed to conserve oxygen supplies at high altitude. ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/pr08-04.1
更新日期：2005-07-01 00:00:00
