Physical Address

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Serious lung disorders

Asthma Asthma is a hyperresponsive disease of the airways and lungs that involves episodes of coughing, shortness of breath, wheezing, and increased secretions in the bronchi. Generally, most people will know that they are prone to asthma attacks; however, a first-time episode might occur during an allergic reaction, on exertion or exposure to cold, or as a result of emotional stress. In most cases, the mechanism…

Chest injury

Broken ribs Direct force applied to the chest wall can break ribs, causing pain with deep breathing, coughing, or sneezing. An injury to the ribs can damage the underlying structures causing bruising or collapse of a lung (pneumothorax). If the right lower ribs are broken, be alert to the possibility of a bruised or cracked liver, which lies directly below; if the left lower ribs are…

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 tied at the end of a rope to keep something from slipping off the rope (e.g., figure 8 knot) End-of-line knot—a knot used to form a…

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 should practice construction of emergency survival shelters. In a cold environment, a shelter becomes an extension of the microclimate of still, warm air created from body…

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 a high-risk endeavor for the pilot and crew, as well as for the patient. Dangerous mistakes are easy to make around working helicopters. Therefore, aeromedical transport…

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 ), involves a (usually hasty) determination of whether the patient, rescuer, or both are immediately threatened by the environment or situation. Box 57.1 Scene Size-Up Factors…

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 of wilderness operations, and individuals should always operate within the limits of their experience and training. Before attempting to respond to any rescue incident, responsible persons…

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. Promptly wash with soap and water to remove toxins. 2. Treat a mild to moderate reaction with antihistamines and a topical medium-potency corticosteroid preparation ( Table…

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, and Pfiesteria syndrome. Ciguatera Fish Poisoning Ciguatera fish toxins are carried by more than 400 species of bottom-feeding reef fishes. The most frequently affected fish are…

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 36 ) are stationary animals that attach to the sea floor or coral beds. Embedded in their connective tissue matrices are spicules of silicon dioxide or…

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 or spine of an animal is seen to be lodged in the patient and has penetrated deeply into the chest, abdomen, neck, femoral region, or popliteal…

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 51.1 Medical Problems of Scuba Divers Problems Related to Environmental Exposure Motion sickness Drowning Hypothermia Heat illness Sunburn Phototoxic and photoallergic reactions Irritant and other dermatitis…

Membrane Transport

Cellular Transport: Passive and Active Mechanisms Ions and solutes move through several different types of carrier proteins and channels that allow solute movement through the plasma membrane in several different ways. The carriers and channels include: ▪ Ion channels and pores that allow diffusion of solutes between compartments. ▪ Uniporters , which are membrane transport proteins that recognize specific molecules, such as fructose. ▪ Symporters that…

The Cell and Fluid Homeostasis

Cell Structure and Organization Organisms evolved from single cells floating in the primordial sea ( Fig. 1.1 ). A key to appreciating how multicellular organisms exist is through understanding how the single cells maintained their internal fluid environment when exposed directly to the outside environment, with the only barrier being a semipermeable membrane. Nutrients from the “sea” entered the cell, diffusing down their concentration gradients through…

The Physiology of Aging

Biomedical science paid surprisingly little attention to a remarkable change in human biology during the 20th century—the marked increase of human life expectancy N62-1 in developed nations. Life expectancy is the projected mean length of life of those born in a given calendar year (e.g., 1984)—or those of a particular age (e.g., 30 years)—computed from the mortality characteristics of the entire population in a particular year…

Environmental Physiology

The earth and its atmosphere provide environments that are compatible with an extraordinary number of diverse life forms, each adapted to its particular ecological niche. However, not all the earth's surface is equally friendly for human survival, let alone comfort and function. Mountain climbers and deep-sea divers know the profound effects of barometric pressure (P b ) on human physiology, and astronauts quickly learn how the…

Exercise Physiology and Sports Science

Physical exercise is often the greatest stress that the body encounters in the course of daily life. Skeletal muscle typically accounts for 30% to 50% of the total body mass. Thus, with each bout of muscular activity, the body must make rapid, integrated adjustments at the level of cells and organ systems—and must tune these adjustments over time. The subdiscipline of exercise physiology and sports science…