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 Elizabeth River in coastal Virginia. A 55-y-old male presented via ambulance after 5 to 10 d of being "stuck in the mud." He was hypernatremic, with a sodium of 176 mEq·L-1, hypothermic to 34.5°C (94.1°F), and hypotensive at 88/50 mm Hg, with a sodium concentration of 176 mEq·L-1 and an osmolality of 412 mosm·kg-1. He developed pneumonia, with respiratory cultures growing Vibrio parahemolyticus, Klebsiella oxytoca, and Shewanella algae. He had pustules, which grew Aeromonas hydrophilia and Aeromonas caviae. A nasogastric tube was placed. Using suction, 500 mL of coarse sand and gravel was removed from his stomach. Antibiotics and intravenous fluids were given. The patient fully recovered after 3 wk and was discharged to rehabilitation. Exposure to brackish water can present a unique set of infectious and metabolic complications. Initial care should include treatment of metabolic derangements, such as hypovolemia, hypernatremia, and hypothermia, and treatment of infections with antibiotics based on knowledge of the most likely causative organisms.
journal_name
Wilderness Environ Medjournal_title
Wilderness & environmental medicineauthors
Hughey SB,McCoy KL,Mills AEdoi
10.1016/j.wem.2020.04.003subject
Has Abstractpub_date
2020-09-01 00:00:00pages
324-326issue
3eissn
1080-6032issn
1545-1534pii
S1080-6032(20)30069-7journal_volume
31pub_type
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::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: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::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::This article describes 3 incidents in which therapeutic or experimental warming of cold individuals caused first- to third-degree burns to the skin. Mechanisms for these injuries are considered. We conclude that active external rewarming of the trunk of a cold patient in the field can be administered safely and burn r...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2019.06.005
更新日期:2019-12-01 00:00:00
abstract:INTRODUCTION:There are 3 pit viper species in Canada. Limited Canadian literature exists on the epidemiology of venomous snakebites and the treatment patterns with antivenom. This study described the epidemiology, the utilization of antivenom, and estimated expenditures due to forfeited antivenom for pit viper envenoma...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2018.06.005
更新日期:2018-12-01 00:00:00
abstract:INTRODUCTION:Finger growth plate injuries are the most common injury among youth climbers, and the association between these injuries and speed climbing, a mandatory discipline in the 2021 Olympics, has not been examined previously. Our primary purpose was to examine the demographic and training characteristics of adol...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2020.06.008
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:To determine the knowledge, beliefs, and behavior of local residents and visitors to North Queensland who may be at risk of contact with "Irukandji" jellyfish. METHODS:Structured interviews were conducted with 208 ferry passengers (92.9% response) traveling between Magnetic Island and Townsville (19 degrees ...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/1080-6032(2004)015[0004:rkpabo]2.0.co;2
更新日期:2004-04-01 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::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::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: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: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::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: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::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::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:OBJECTIVE:Our intent was to observe the effect of simulated altitude exposure on the intracranial pressure (ICP) of New Zealand white rabbits. It is theorized that the hypoxia of high altitude causes a rise in ICP, which may play a role in the pathogenesis of acute mountain sickness (AMS). Dexamethasone is a medication...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/1080-6032(2003)14[183:baeinz]2.0.co;2
更新日期:2003-10-01 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: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:INTRODUCTION:Clinical and bacteriological features of cobra (Naja) bites are still relatively unknown in Vietnam. This study aimed to characterize the clinical and bacteriological characteristics of local wounds in patients with presumed Naja spp bite, as well as their antibiotic treatment. METHODS:A cross-sectional s...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2020.01.002
更新日期:2020-06-01 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: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::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: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::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:INTRODUCTION:To compare the effectiveness of a molded fleece jacket with that of a standard cervical collar at limiting movement of the cervical spine in 3 different directions. METHODS:This is a prospective study using 24 healthy volunteers to measure cervical flexion/extension, rotation, and lateral flexion with bot...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2019.07.002
更新日期:2019-12-01 00:00:00
abstract::Stingray envenomation is a common occurrence. X-ray evaluation of stingray wounds is an unnecessarily misunderstood diagnostic concept. We present the case of a patient stung by a stingray with a prolonged and complicated course and permanent disability due to a retained barb. The patient had undergone multiple medica...
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: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::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