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Wilderness Medicine

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1. CRACKCast E182 – Drug Therapy in the Geriatric Patient

, as it will no doubt help you on your next shift. Shownotes – Rosen’s In Perspective The elderly are coming in droves! Drug therapy issues are particularly challenging in older adults because of altered pharmacokinetics and pharmacodynamics compared to younger adults. In addition, they take more medications, have more comorbidities, and are at increased risk for adverse drug effects because of the physiologic changes of aging As a result, medication selection and dosing need to be age-adapted for optimal patient (...) currently divides his time as an EM Physician in Calgary (SHC/FMC) and in Sports Medicine. His interests are in endurance sports, exercise as medicine, and wilderness medical education. When he isn’t outdoors with his family, he's brewing a coffee or dreaming up an adventure….. Latest posts by Chris Lipp ( ) - July 2, 2018 - June 25, 2018 - June 21, 2018 Adam Thomas CRACKCast Co-founder and newly minted FRCPC emergency physician from the University of British Columbia. Currently spending his days

2018 CandiEM

2. CRACKCast E179 – Drug Therapy in Pregnancy

are some “D” drugs Amiodarone All NSAIDS in the 3rd trimester Carbamazepine Paroxetine Sulfonamides Tetracyclines [3] List 5 dangerous medicines to be avoided if breastfeeding Concerns exist for: Amiodarone Chemotherapeutic/antineoplastic agents Chloramphenicol Ergotamine Gold salts Phenindione Radioactive pharmaceuticals Retinoids Tetracyclines (chronic > 3 weeks) Certain psychotropic medications Codeine Pseudoephedrine Copied from: For more resources on this, see: [4] List 4 dangerous antibiotics (...) succinate Ginger Diphenhydramine Dimenhydrinate Metoclopramide Prochlorperazine Ondansetron DO NOT use Codeine Ergotamine This post was uploaded and copyedited by Riley Golby ( ) (Visited 888 times, 1 visits today) Chris Lipp is one of the founding Fathers for CrackCast. He currently divides his time as an EM Physician in Calgary (SHC/FMC) and in Sports Medicine. His interests are in endurance sports, exercise as medicine, and wilderness medical education. When he isn’t outdoors with his family, he's

2018 CandiEM

3. Medical Oversight, Educational Core Content, and Proposed Scopes of Practice of Wilderness EMS Providers: A Joint Project Developed by Wilderness EMS Educators, Medical Directors, and Regulators Using a Delphi Approach. (Abstract)

Medical Oversight, Educational Core Content, and Proposed Scopes of Practice of Wilderness EMS Providers: A Joint Project Developed by Wilderness EMS Educators, Medical Directors, and Regulators Using a Delphi Approach. A disparity exists between the skills needed to manage patients in wilderness EMS environments and the scopes of practice that are traditionally approved by state EMS regulators. In response, the National Association of EMS Physicians Wilderness EMS Committee led a project (...) to define the educational core content supporting scopes of practice of wilderness EMS providers and the conditions when wilderness EMS providers should be required to have medical oversight.Using a Delphi process, a group of experts in wilderness EMS, representing educators, medical directors, and regulators, developed model educational core content. This core content is a foundation for wilderness EMS provider scopes of practice and builds on both the National EMS Education Standards and the National

2017 Prehospital emergency care

4. The effect of wilderness and medical training on injury and altitude preparedness among backcountry hikers in Rocky Mountain National Park (Full text)

The effect of wilderness and medical training on injury and altitude preparedness among backcountry hikers in Rocky Mountain National Park The purpose of this study was to document the correlation between medical and wilderness training with levels of preparedness for acute mountain sickness (AMS), illness, and injury among backcountry hikers.We conducted a cross-sectional, convenience survey in Rocky Mountain National Park in July and August 2015. The study group consisted of 380 hikers who (...) completed a written survey that collected information about demographics, wilderness experience, altitude experience, hiking equipment, communications devices, and trip planning.Factors such as wilderness training (wilderness first aid [WFA], wilderness first responder [WFR], or wilderness emergency medical technician [WEMT]), wilderness experience, and altitude experience all affected hikers' emergency preparedness. Respondents with medical training were more prepared to avoid or respond to AMS (62.3

2018 World journal of emergency medicine PubMed abstract

5. Therapy the Natural Way: A Realist Exploration of the Wilderness Therapy Treatment Process in Adolescent Mental Health Care in Norway. (Abstract)

Therapy the Natural Way: A Realist Exploration of the Wilderness Therapy Treatment Process in Adolescent Mental Health Care in Norway. Wilderness therapy has the potential to meet the specific needs of the current adolescent population by providing a rather unique outdoor group treatment. Wilderness therapy is not a new approach to mental health treatment, but its theoretical basis is not yet clearly delineated, in part because of the diversity found across programs and contexts. This article (...) presents a critical realist exploration of a wilderness therapy program that was recently implemented as part of adolescent mental health services in Southern Norway. In this study, we combine fieldwork and interviews for an in-depth investigation of the treatment process, where the objective was to acquire a deeper understanding of the opportunities that arise in the wilderness therapy setting. The therapeutic mechanisms and influential contextual premises found across the ecological, physical

2018 Qualitative Health Research

6. CRACKCast E164 – Plants, Mushrooms, and Herbal Medications

; Exclusion of other causes Systemic features Liver necrosis Occasional degeneration of skeletal & cardiac muscle fibers Micturition difficulty Muscle: Cramps; Cardiac change This post was uploaded and copy-edited by Andrew Guy (Visited 642 times, 1 visits today) Chris Lipp is one of the founding Fathers for CrackCast. He currently divides his time as an EM Physician in Calgary (SHC/FMC) and in Sports Medicine. His interests are in endurance sports, exercise as medicine, and wilderness medical education (...) ingestion will prove to involve a non–life-threatening substance GI symptoms that onset in more than 6 to 8 hours suggest a potentially life-threatening ingestion, such as the cyclopeptide and gyromitrin groups Use local poison control centers, mycologists, and botanists to help identify serious plants and mushrooms that have been ingested. We recommend digital photography with expert consultation Herbal medications are unregulated and may have inherent toxicity, herb-drug interactions, or contaminants

2018 CandiEM

7. CRACKCast E178 – Co-Morbird Medical Emergencies During Pregnancy

and the first dose of vaccine within 12 hours of birth. Two additional doses of vaccine are administered at a later date. This post was copy-edited and uploaded by Andrew Guy. (Visited 665 times, 1 visits today) Chris Lipp is one of the founding Fathers for CrackCast. He currently divides his time as an EM Physician in Calgary (SHC/FMC) and in Sports Medicine. His interests are in endurance sports, exercise as medicine, and wilderness medical education. When he isn’t outdoors with his family, he's brewing (...) CRACKCast E178 – Co-Morbird Medical Emergencies During Pregnancy CRACKCast E178 - Co-Morbird Medical Emergencies During Pregnancy - CanadiEM CRACKCast E178 – Co-Morbird Medical Emergencies During Pregnancy In by Chris Lipp May 17, 2018 This episode of CRACKCast covers Rosen’s Chapter 178, Co-Morbid Medical Emergencies during Pregnancy. This chapter covers many complicated issues that arise during the care of pregnant patients already suffering from concomitant medical illness, and how to manage

2018 CandiEM

8. CRACKCast E189 – Air Medical Transport

the University of British Columbia. Currently spending his days between a fellowship in critical care and making sure his toddler survives past age 5. - 3 hours ago Latest posts by Adam Thomas ( ) - July 2, 2018 - June 25, 2018 - June 21, 2018 Chris Lipp is one of the founding Fathers for CrackCast. He currently divides his time as an EM Physician in Calgary (SHC/FMC) and in Sports Medicine. His interests are in endurance sports, exercise as medicine, and wilderness medical education. When he isn’t outdoors (...) CRACKCast E189 – Air Medical Transport CRACKCast E189 – Air Medical Transport - CanadiEM CRACKCast E189 – Air Medical Transport In , by Adam Thomas June 25, 2018 This episode of CRACKCast covers Chapter 191 in Rosen’s Emergency Medicine (9th Ed.) – Air Medical Transport. Including a review of clinically relevant physics! Fun stuff! Shownotes – Key concepts Boyle’s law and Dalton’s law have the greatest impact and explain the development of hypoxia and most common altitude-related symptoms

2018 CandiEM

9. CRACKCast E188 – Emergency Medical Service: Overview and Ground Transport

in Calgary (SHC/FMC) and in Sports Medicine. His interests are in endurance sports, exercise as medicine, and wilderness medical education. When he isn’t outdoors with his family, he's brewing a coffee or dreaming up an adventure….. Latest posts by Chris Lipp ( ) - July 2, 2018 - June 25, 2018 - June 21, 2018 Follow CRACKCast Schedule Mondays: CRACKCast Tuesdays: Medical Concepts Wednesdays: Opinion Thursdays: Throwbacks Fridays: National Interest Submit Content Join our community of educators (...) CRACKCast E188 – Emergency Medical Service: Overview and Ground Transport CRACKCast E188 – Emergency Medical Service: Overview and Ground Transport - CanadiEM CRACKCast E188 – Emergency Medical Service: Overview and Ground Transport In , by Adam Thomas June 21, 2018 This episode of CRACKCast covers Chapter 190 of Rosen’s Emergency Medicine(9th Ed.). After listening to this podcast, you will have a more comprehensive understanding of the intricacies of pre-hospital care and be better able

2018 CandiEM

10. Mapping the concept, content and outcome of wilderness therapy for childhood cancer survivors: protocol for a scoping review. (Full text)

wilderness-related therapies for cancer survivors. However, there is no clarity on the role these therapies play in childhood cancer. The current scoping review aims to systematically map the concept, content and outcome of wilderness therapy for childhood cancer survivors.This review will be guided by the Joanna Briggs Institute Reviewers' manual for scoping reviews. A systematic literature search using medical subject headings (MeSH) and text words related to wilderness therapy and childhood cancer (...) for a scoping review that will undertake secondary analysis of data already published in literature and is therefore exempt from medical ethical review. The scoping review will inform understanding of the benefits and risks of wilderness therapy for childhood cancer survivors, their families, practitioners, clinicians and researchers, and will help elucidate the steps necessary for building its evidence base going forward. Results will be published in a peer-reviewed scientific journal.© Author(s

2019 BMJ open PubMed abstract

11. What are constructive anxiety levels in wilderness therapy? An exploratory pilot study. (Abstract)

What are constructive anxiety levels in wilderness therapy? An exploratory pilot study. Participant state anxiety in outdoor therapeutic practices continues to raise many questions. To help inform this important topic we present and discuss the results of an exploratory pilot study on participant day-to-day state anxiety throughout a Norwegian wilderness therapy intervention.Thirty-three adolescents from six groups completed a total of 251 state sections of the State-Trait Anxiety Inventory.On (...) for the outdoor therapy field at large.Copyright © 2019 Elsevier Ltd. All rights reserved.

2019 Complementary Therapies in Clinical Practice

12. Faculty of Prehospital Care, Royal College of Surgeons Edinburgh guidance for medical provision for wilderness medicine (Full text)

Faculty of Prehospital Care, Royal College of Surgeons Edinburgh guidance for medical provision for wilderness medicine To support leaders and those involved in providing medical care on expeditions in wilderness environments, the Faculty of Pre-Hospital Care (FPHC) of The Royal College of Surgeons of Edinburgh convened an expert panel of leading healthcare professionals and expedition providers. The aims of this panel were to: (1) provide guidance to ensure the best possible medical care (...) for wilderness medicine covers elements of primary healthcare, pre-hospital emergency medicine and preventative medicine. Some unique competencies were also identified. Further to this, the panel recommends the use of a matrix and advisory expedition medic competencies relating to the remoteness and medical threat of the expedition. This advice is aimed at all levels of expedition medic, leader and organiser who may be responsible for delivering or managing the delivery of remote medical care

2015 Extreme physiology & medicine PubMed abstract

13. Management of Suspected Opioid Overdose with Naloxone by Emergency Medical Services Personnel

, response to naloxone (e.g., based on Glasgow Coma Scale score), other substances and drugs involved in overdose, or other factors. Studies should supplement use of medical examiner and hospital records to identify outcomes with formal followup assessments, and evaluate outcomes such as linkage to treatment for opioid use disorder and risk of future overdose episodes, in addition to serious adverse outcomes such as death. Conclusions Low-strength evidence suggests that IN naloxone at a dose of 2 mg (...) Management of Suspected Opioid Overdose with Naloxone by Emergency Medical Services Personnel Comparative Effectiveness Review Number 193 Management of Suspected Opioid Overdose with Naloxone by Emergency Medical Services Personnel e Comparative Effectiveness Review Number 193 Management of Suspected Opioid Overdose With Naloxone by Emergency Medical Services Personnel Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane

2017 Effective Health Care Program (AHRQ)

14. FAQ About Medical Student Electives

elective should I take it? By “cool” elective I mean stuff like: NASA elective Wilderness Medical Elective International Electives Toxicology Etc. This is a silly question. Of course you should! These are things that will stick out on your application. I have always found that doing what you love leads you to where you want to be. In addition to the potential opportunities that could result out of doing cool electives like this, they will give you awesome experiences that you will be able to talk about (...) on your interviews. How can I get the electives I want? Unfortunately, the elective-granting policies are a black box. Applying can be one of the most frustrating experiences of medical school. The rise in popularity of EM means that electives are not the easiest to obtain. As of 2017, applications for visiting electives at all English-speaking Canadian faculties of medicine have been standardized through the creation of the AFMC Student Portal. Any visiting electives must be applied for through

2017 CandiEM

15. Assessing the Effectiveness and Value of Drugs for Rare Conditions: A Technical Brief for the ICER Orphan Drug Assessment & Pricing Summit

Therapy: Understanding the Science, Assessing the Evidence, and Paying for Value. Boston, MA: Institute for Clinical & Economic Review; March 2017 2017. 62. McCabe C, Claxton K, Tsuchiya A. Orphan drugs and the NHS: should we value rarity? BMJ (Clinical research ed). 2005;331(7523):1016-1019. 63. Winstone J, Chadda S, Ralston S, Sajosi P. Review and comparison of clinical evidence submitted to support European Medicines Agency market authorization of orphan-designated oncological treatments. Orphanet (...) has been an increase in the price for orphan drugs. As shown in Figure 2, when considering publicly available prices before insurer rebates or discounts, the average annual costs of orphan drugs are five times higher than those of non-orphan medications. ©Institute for Clinical and Economic Review, 2017 2 Figure 2. Average annual costs of orphan and non-orphan drugs. Historically, higher prices for orphan drugs have not been associated with greater barriers to insurance coverage, in part because

2017 California Technology Assessment Forum

16. Mountain medical kits: epidemiology-based recommendations and analysis of medical supplies carried by mountain climbers in Colorado. (Full text)

Mountain medical kits: epidemiology-based recommendations and analysis of medical supplies carried by mountain climbers in Colorado. : To provide medical kit recommendations for short mountain wilderness recreation trips (hiking, trekking, backpacking, mountaineering etc.) based on the epidemiology of injury and illness sustained and best treatment guidelines. Additionally, to compare these recommendations to the medical kit contents of mountain climbers in Colorado.: A primary literature (...) review concerning the epidemiology of injury and illness in mountain wilderness settings was performed. This information and literature on the efficacy of given treatments were used to derive recommendations for an evidence-based medical kit. The contents of 158 medical kits and the most likely demographics to carry them were compiled from surveys obtained from mountain climbers on 11 of Colorado's 14 000-foot peaks.: Musculoskeletal trauma, strains, sprains and skin wounds were the most common

2017 Journal of Travel Medicine PubMed abstract

17. Wilderness Medicine

: Wilderness Medicine , Wilderness Trauma II. Causes Common Wilderness Injury and Illness Athletic injuries (sprains, strains and soft tissue s) Gastrointestinal symptoms ( , , ) Skin Injuries ( s, s, s, , ) Exacerbations of chronic medical conditions (e.g. , ) s or -like illness Serious Wilderness Trauma and serious illness are uncommon s are the most common Severe dehydration is uncommon Environmental injury ( , , , altitude sickness) are surprisingly uncommon III. Management: Trauma Constantly (...) Wilderness Medicine Wilderness Medicine Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Wilderness Medicine Wilderness Medicine Aka

2019 FP Notebook

18. Exploring Mechanisms for Effective Technology-Enhanced Simulation-based Education in Wilderness Medicine: A Systematic Review. (Full text)

Exploring Mechanisms for Effective Technology-Enhanced Simulation-based Education in Wilderness Medicine: A Systematic Review.  Technology-enhanced simulation is well-established in healthcare teaching curricula, including those regarding wilderness medicine. Compellingly, the evidence base for the value of this educational modality to improve learner competencies and patient outcomes are increasing. The aim was to systematically review the characteristics of technology-enhanced simulation (...) presented in the wilderness medicine literature to date. Then, the secondary aim was to explore how this technology has been used and if the use of this technology has been associated with improved learner or patient outcomes. EMBASE and MEDLINE were systematically searched from 1946 to 2014, for articles on the provision of technology-enhanced simulation to teach wilderness medicine. Working independently, the team evaluated the information on the criteria of learners, setting, instructional design

2016 Curēus PubMed abstract

19. Association Between Emergency Medical Service Response Time and Motor Vehicle Crash Mortality in the United States. (Full text)

Association Between Emergency Medical Service Response Time and Motor Vehicle Crash Mortality in the United States. Motor vehicle crashes (MVCs) are a leading public health concern. Emergency medical service (EMS) response time is a modifiable, system-level factor with the potential to influence trauma patient survival. The relationship between EMS response time and MVC mortality is unknown.To measure the association between EMS response times and MVC mortality at the population level across US (...) counties.This population-based study included MVC-related deaths in 2268 US counties, representing an estimated population of 239 464 121 people, from January 1, 2013, through December 31, 2015. Data were analyzed from October 1, 2017, through April 30, 2018.The median EMS response time to MVCs within each county (county response time), derived from data collected by the National Emergency Medical Service Information System.The county rate of MVC-related death, calculated using crash fatality data recorded

2019 JAMA surgery PubMed abstract

20. Prevention of Acute Nausea and Vomiting due to Antineoplastic Medication in Pediatric Cancer Patients

: Additional Literature Search: Dronabinol and Levomepromazine 142 Appendix E: Quality of Evidence and Strength of Recommendation 148 Appendix F: Tables of Included Studies 149 F.1 Summary of studies used to inform recommendation #2a 149 F.1a Highly emetogenic antineoplastic therapy as ranked by POGO Guideline for Classification of the Acute Emetogenic Potential of antineoplastic Medication in Pediatric Cancer Patients 5 Version date: February 28, 2013 F.1b Highly emetogenic antineoplastic therapy (...) as ranked by study investigators where insufficient information available to assign emetogenic risk using the POGO Guideline for Classification of the Acute Emetogenic Potential of antineoplastic Medication in Pediatric Cancer Patients F.2 Summary of studies used to inform recommendation #2b 154 F.2a Moderately emetogenic antineoplastic therapy as ranked by POGO Guideline for Classification of the Acute Emetogenic Potential of antineoplastic Medication in Pediatric Cancer Patients F.2b Moderately

2013 SickKids Supportive Care Guidelines

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