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-old man was bitten by a snake, after which he lost consciousness, fell, and sustained facial trauma. He was rushed to the emergency department within 30 min and was discovered to have ongoing oromaxillofacial bleeding. His respiratory distress and gasping respirations warranted orotracheal intubation and ventilation. He was treated with anti-snake venom and underwent viscoelastometry-guided transfusion to correct coagulopathy. Hemostasis was achieved after administration of tranexamic acid and bilateral posterior nasal packing. Imaging studies revealed craniomaxillofacial trauma with intracranial hemorrhage. He underwent a delayed mandibular repair. Judicious, guided fluid management, adequate nutrition, and prompt weaning off the ventilator allowed early discharge of the patient from the hospital. The minimal weakness present in his left lower limb at the time of discharge had improved by the time of follow-up. This report shows the utility of early and rapid anti-snake venom in envenomated victims with coagulopathy. The role of cryoprecipitate, tranexamic acid, and viscoelastometric testing needs further exploration in specific hematotoxic snakebites.
journal_name
Wilderness Environ Medjournal_title
Wilderness & environmental medicineauthors
Abraham SV,Hakkeem B,Mathew D,Rafi AM,Poomali A,Thomas J,Kassyap CKdoi
10.1016/j.wem.2020.08.003subject
Has Abstractpub_date
2020-12-01 00:00:00pages
470-481issue
4eissn
1080-6032issn
1545-1534pii
S1080-6032(20)30134-4journal_volume
31pub_type
杂志文章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：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：: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：: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：: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：:Anaphylaxis is a medical emergency requiring prompt action to prevent death from cardio-respiratory collapse. It can be a biphasic, unpredictable, and challenging reaction to deal with even in a hospital environment. The wilderness environments afforded by expeditions, remote health posts, and military exercises pose ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2011.12.002
更新日期：2012-03-01 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：OBJECTIVE:Winter sports continue to be a popular form of recreation, but few studies have focused on serious injuries. The objectives of this study were to evaluate the major morbidity associated with downhill skiing, snowboarding, and sledding and to determine the incidence of serious injuries sustained while downhill...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/1080-6032(2002)013[0245:ssasii]2.0.co;2
更新日期：2002-01-01 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：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：OBJECTIVE:This study was designed to evaluate the effectiveness of a new protocol implemented to standardize snakebite management in Iran. METHODS:In this study, 27 patients treated according to the new protocol in 2012 (P+) were compared with 22 patients treated according to the previous modality in the year before i...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2014.09.011
更新日期：2015-06-01 00:00:00
abstract：OBJECTIVE:Physical stress (exercise and/or environmental) activates the sympathetic-adrenal-medullary (SAM) and hypothalamic-pituitary-adrenocortical (HPA) axes. The combination of ultraendurance exercise in the cold presents a unique summated stress to the body. The purpose of this study was to assess the stress hormo...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2009.12.020
更新日期：2010-03-01 00:00:00
abstract：OBJECTIVE:Scorpionism is an endemic public health problem in Jordan encountered by health providers in all parts of the country. This study updates epidemiological data on scorpion sting encounters in Jordan. METHODS:Data on scorpion sting encounters were obtained from government and military hospitals around the coun...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2017.05.003
更新日期：2017-09-01 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：INTRODUCTION:Depending on their theatre of operation, French soldiers may potentially be exposed to scorpion stings and snakebites. Following the recommendations of a French military health service (FMHS) technical committee for envenomation, the FMHS provides antivenoms appropriate to each deployment. This work aimed ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1016/j.wem.2020.01.006
更新日期：2020-06-01 00:00:00
abstract：:The Wilderness Medical Society convened a panel to review available evidence supporting practices for the prevention and acute management of drowning in out-of-hospital and emergency medical care settings. Literature about definition and terminology, epidemiology, rescue, resuscitation, acute clinical management, disp...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,实务指引
doi：10.1016/j.wem.2015.12.019
更新日期：2016-06-01 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：: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：: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：: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: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：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：: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：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：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:Little is known about health care provider interest, knowledge, and beliefs regarding the health effects of human-induced environmental degradation (HIED). A survey was created and distributed to better characterize health provider beliefs about the adverse health effects of HIED. METHODS:An invitation to pa...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章
doi：10.1580/08-WEME-OR-222R1.1
更新日期：2009-10-01 00:00:00
abstract：OBJECTIVES:This study sought to create a model for testing topical treatment of jellyfish stings. It sought to determine which treatments 1) stimulate/inhibit nematocyst discharge; 2) decrease pain; and 3) decrease skin inflammation; it also sought to discover whether there is a clinical correlation between stimulated ...
journal_title：Wilderness & environmental medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.wem.2015.10.008
更新日期：2016-03-01 00:00:00
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：: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：: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
