December 23rd, 2011 by Paul Auerbach, M.D. in Health Tips
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This is another post derived from a presentation given at the 2011 Annual Summer Meeting of the Wilderness Medical Society. Tracy Cushing, MD, of the University of Colorado School of Medicine gave an excellent presentation on submersion injury—i.e., the dangers of becoming submerged under water. What follows is some of what we learned.
Historically there have been many terms and definitions, such as “drowning,” “near-drowning,” “dry drowning,” and others. Current experts favor the term “submersion injury” as any adverse effect from submersion in water. This commonly causes difficulty breathing, for many reasons. “Immersion syndrome” refers to the situation where there is a lethal heart rhythm during or after a cold-water exposure, usually attributed to stimulation of the vagus nerve, which slows the heart rate. “Shallow water blackout” refers to a person becoming unconscious after hyperventilating prior to attempting a lengthy period of breath-holding underwater.
Drowning is the Read more »
This post, Preventing Drowning And Other Submersion Injuries, was originally published on
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December 20th, 2011 by Paul Auerbach, M.D. in Opinion
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This is another post derived from a presentation given at the 2011 Annual Summer Meeting of the Wilderness Medical Society. Michael Caudell, M.D. from the Medical College of Georgia gave an excellent talk entitled “Scenario-Based Learning in the Wilderness and the Creation of MedWAR.”
MedWAR (Medical Wilderness Adventure Race) is considered a challenge, and takes preparation and skill to complete. Using simulations, participants have to negotiate a series of medical and wilderness challenges. It involves both individual acumen and group dynamics. The MedWAR model is based on critical actions, all of which begin with scene safety, the “ABCs” (airway, breathing, circulation) of a medical resuscitation, and the particular scenario. Victims may be dressed as victims using moulage to simulate injuries, and scene settings are made as realistic as possible. Wilderness medicine is grounded in realism, and laced with improvisation, stress, creativity, and resourcefulness. The MedWAR concept is Read more »
This post, MedWAR Allows Participants To Negotiate A Series Of Medical And Wilderness Challenges, was originally published on
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December 16th, 2011 by Paul Auerbach, M.D. in Uncategorized
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This is another post derived from a presentation given at the 2011 Annual Summer Meeting of the Wilderness Medical Society. Aaron Billin delivered an excellent lecture on search and rescue.
Search and rescue has been defined a few different ways. Two definitions are: “the use of available resources to assist persons or property in potential or actual distress” and “an operation to retrieve persons in distress, provide for their initial medical or other needs, and deliver them to a place of safety.” Search and rescue types are mountain rescue, combat search and rescue, air-sea rescue, urban search and rescue, and ground search and rescue.
Organized search and rescue is the responsibility of national arks, state parks, county sheriffs, state conservation officers, or state police. Most search and rescue missions are carried out by volunteer groups. Ninety percent of all rescues involve Read more »
This post, How Are Medical Personnel Involved In Search And Rescue Missions?, was originally published on
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December 15th, 2011 by Paul Auerbach, M.D. in Health Tips, Opinion
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The 2011 Annual Summer Meeting of the Wilderness Medical Society that was held in Snowmass, Colorado was excellent and provided terrific education for all in attendance. In a series of posts, I’ll highlight some of what we learned.
Brad Bennett gave a wonderful lecture on Tactical Combat Casualty Care (TCCC) for the Wilderness Provider. Military medicine and wilderness medicine share certain common elements: extreme and remote environments, a practice of medicine where definitive care can be hours or days away, difficult patient access, limited medical personnel and equipment, prompt decision making, creative thinking, and improvisation. Medical injuries may overwhelm resources and evacuation may be delayed due to environment conditions and the features of the terrain.
In military situations, Read more »
This post, Treating Combat Injuries And Its Similarities To Wilderness Medicine, was originally published on
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October 13th, 2011 by Paul Auerbach, M.D. in Health Tips, Opinion
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Dr. Robert “Brownie” Schoene, an enormously talented, accomplished, and insightful physician who resides within the bedrock of wilderness medicine, gave a wonderful presentation about the concept of risk at the 2010 annual summer meeting of the Wilderness Medical Society. Risk is inherent in outdoor activities, whether it is part of exploration, adventure, science, or industry. I am going to summarize his approach to the topic, which is among the most important general concepts in the field, and editorialize with some of my thoughts.
When one thinks of risk related to outdoor health, it is about the possibility of suffering harm, damage, or loss. When a person is aware of the possibility of a specific risk, he or she usually weighs the risk against the possible benefits. When you hike on a slippery, snowy trail in early spring, where the trail winds over patches of ice near ledges from which a fall would cause a severe injury, is the experience worth the risk? When you ride a wave on your surfboard when the waves are intimidating and you are outside your comfort zone, is the improvement in performance worth the possibility of a tumble and possible muscle tear or broken bone? Sometimes the answer is easy. When I travel to a third world country, I always run the risk of acquiring infectious diarrhea. The benefits of the mission supersede the discomfort, and I both anticipate the risk and prepare for treatment by carrying oral rehydration supplies and appropriate antibiotics.
I love the quote from Winston Churchill that Dr. Schoene used to illustrate a risk-taker’s approach: Read more »
This post, Understanding Risk Related To Outdoor Health, was originally published on
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