Field Guide to Wilderness Medicine

Knots

Practice Before You Really Need To Use Them. Terminology The most practical way to select a knot is to first evaluate what role that knot is expected to perform. The following knots are addressed based on function: Stopper knot—a knot…

Survival

The term survival means “to continue to live or exist” and implies the presence of adverse conditions that make this more difficult. Survival scenarios frequently accompany wilderness medical events. Cold Weather Survival Shelter Anyone who spends time in the wilderness…

Aeromedical Transport

Because aeromedical transport involves medical care delivered in a hostile environment, the patient and crew are at risk for injury or death in the event of a mishap. Flight crew training must emphasize safety. A helicopter mountain rescue operation is…

Improvised Litters and Carries

Scene Size-Up To select the best method for bringing a patient to definitive care, the rescuer must make a realistic assessment of several factors: Scene safety is the initial priority. The necessary evaluation, called the scene size-up ( Box 57.1…

Search and Rescue

This chapter addresses broad concepts of wilderness search and rescue (SAR); responders should evaluate their circumstances and seek specific training for the types of incidents they may encounter. Not all rescuers need to be trained to the most advanced levels…

Aquatic Skin Disorders

Among the disorders acquired in water that affect the skin are various dermatoses, cutaneous larva migrans, infections, sensitivity to diving equipment, pseudomonal folliculitis, and otitis externa. Disorders Sargassum Algal Dermatitis Signs and Symptoms Skin erythema, urticarial papular pruritus Treatment 1.…

Seafood Toxidromes

Toxidromes associated with seafood that may be encountered in the wilderness are ciguatera fish poisoning, clupeotoxin fish poisoning, scombroid fish poisoning, tetrodotoxin fish poisoning, paralytic shellfish poisoning (PSP), diarrhetic shellfish poisoning, Vibrio fish poisoning, anisakiasis, domoic acid intoxication, gempylotoxism, botulism,…

Envenomation by Marine Life

Interactions with various forms of marine life can result in stings and puncture wounds that lead to envenomation or anaphylactic reactions. Anaphylaxis For signs, symptoms, and treatment of anaphylactic reactions, see Chapter 26 . Reaction to Sponges Sponges (see Plate…

Injuries From Nonvenomous Aquatic Animals

Sharks, barracuda, moray eels, needlefish, and coral present typical dangers of wounds and infections to persons venturing into the ocean. The injuries range from bites or stings to cuts, impalements, and abrasions. General Treatment Wound Management 1. If the bill…

Scuba Diving–Related Disorders

Disorders related to scuba diving include those caused by environmental exposure (see Chapters 3 and 50 ), dysbarism, nitrogen narcosis, contaminated breathing gas, decompression sickness (DCS), and hazardous marine life (see Chapters 52 and 53 ; Box 51.1 ). Box…