Wilderness & Environmental Medicine

Jellyfish stings are the most common cause of marine envenomation in humans. Various species of box jellyfish have been identified around Penang Island, Malaysia, and these include multitentacled and four-tentacled box jellyfish (class Cubozoa). The typical syndrome following envenomation from these jellyfish has been poorly documented, posing a greater challenge when managing an unidentified jellyfish sting from Penang Island. We report a case of a 32-y-old man from Penang Island who was stung by an unidentified jellyfish while walking into the sea...

No abstract text is available yet for this article.

INTRODUCTION: There is no published information on the epidemiology of wilderness rescues in California outside of national parks. The objective of this study was to investigate the epidemiology of wilderness search and rescue (SAR) missions in California and identify risk factors for individuals requiring rescue due to accidental injury, illness, or navigation errors in the California wilderness. METHODS: A retrospective review of SAR missions in California from 2018 to 2020 was conducted...

INTRODUCTION: Backcountry skiers and snowboarders are increasingly using avalanche airbags to improve safety. New safety devices can cause risk compensation, the concept in which users take more risks given the larger safety margin provided by the device. This may limit overall benefits. We sought to elucidate attitudes toward risk-taking behaviors and risk compensation in backcountry users relating to avalanche airbags. METHODS: A convenience sample of 144 backcountry skiers and snowboarders was surveyed after a backcountry tour in the Wasatch Mountains of Utah and the Tetons of Wyoming during the winter 2020-21 season...

No abstract text is available yet for this article.

The past few decades of military experience have brought major advances in the prehospital care of patients with trauma. A focus on early hemorrhage control with aggressive use of tourniquets and hemostatic gauze is now generally accepted. This narrative literature review aims to discuss external hemorrhage control and the applicability of military concepts in space exploration. In space, environmental hazards, spacesuit removal, and limited crew training could cause significant time delays in providing initial trauma care...

No abstract text is available yet for this article.

Ciguatera is a common marine, toxin-borne illness caused by the consumption of fish that contain toxins that activate voltage-sensitive sodium channels. The clinical manifestations of ciguatera are typically self-limited, but chronic symptoms may occur in a minority of patients. This report describes a case of ciguatera poisoning with chronic symptoms, including pruritus and paresthesias. A 40-y-old man was diagnosed with ciguatera poisoning after consuming amberjack while vacationing in the US Virgin Islands...

INTRODUCTION: Annually, approximately 250,000 people climb Mount Fuji in Japan. Nonetheless, only few studies have examined the prevalence of falls and related factors on Mount Fuji. METHODS: We conducted a questionnaire survey of 1061 participants (703 men and 358 women) who had climbed Mount Fuji. The following information was collected: age, height, body weight, luggage weight, experience on Mount Fuji, experience on other mountains, presence or absence of a tour guide, single-day climber or overnight-stay lodger, information on the downhill trail (volcanic gravel, long distance, and the risk of falls), presence or absence of trekking poles, shoe type, shoe sole condition, and fatigue feeling...

Systemic symptoms resulting from exposure to members of the Lepidoptera order, such as moths, butterflies, and caterpillars, are known as lepidopterism. Most cases of lepidopterism are mild and result from dermal exposure to urticating hairs; ingestion is less common and generally more medically significant because the hairs may get embedded in the patient's mouth, hypopharynx, or esophagus, leading to dysphagia, drooling, edema, and possible airway obstruction. In previous cases of symptomatic caterpillar ingestion reported in the literature, extensive efforts, including direct laryngoscopy, esophagoscopy, and bronchoscopy, were undertaken to remove these hairs...

Women increasingly participate in outdoor activities in wilderness and remote environments. We performed a literature review to address diagnostic and therapeutic considerations during first-trimester pregnancy for remote multiday travel. Pretrip planning for pregnant patients traveling outside access to advanced medical care should include performing a transvaginal ultrasound to confirm pregnancy location and checking D rhesus status. We discuss the risk of potential travel-related infections and recommended vaccinations prior to departure based on destination...

No abstract text is available yet for this article.

INTRODUCTION: Point-of-care ultrasound (POCUS) is utilized in austere environments because it is lightweight, durable, battery powered, and portable. In austere settings, weight and space constraints are limitations to carrying dedicated ultrasound gel. Few studies have assessed commonly carried liquids as gel alternatives. The study objective was to assess the suitability of common food and personal care products as ultrasound coupling agents compared with that of commercial gel. METHODS: A noninferiority study compared 9 products to commercial gel...

No abstract text is available yet for this article.

Transient acute kidney injury (AKI) following ultraendurance footraces is a common biochemical diagnosis. However, severe AKI requiring renal replacement therapy is uncommon in ultramarathoners. We report 4 runners (3 men; mean age, 44 ± 3 y) who required prolonged (10-42 d) dialysis following the Western States 100 Mile Endurance Run over a 3-y span (0.38% of starters). The maximum ambient temperatures on the race day ranged from 36.6° to 38.3°C. The runners presented to local hospitals 17 to 32 h after running, with laboratories confirming rhabdomyolysis, hyponatremia (mean serum sodium concentration, 127±2 mmol⋅L-1 ), and AKI (mean serum creatinine concentration, 8...

INTRODUCTION: The primary aim of the study was to compare select training and health characteristics between ultramarathon and shorter distance runners participating in a trail race series. METHODS: A questionnaire was sent to all participants who signed up for a trail race series, including distances of 10 km, half marathon, 50 km, 80.5 km (50 mi), and 100 km. There were 59 participants (27 ultramarathoners and 32 half marathon/10-km runners) who completed the questionnaire...

Mediterranean loggerhead sea turtles (Caretta caretta) are very large. During spawning season, they land on the beaches of Turkey and Greece at night, which are frequently visited by humans, and lay their eggs. Typically, they suck feed in deep water. It is uncommon for C caretta, which have strong mouths and jaws, to attack people. We report a case of a 44-y-old female patient who was attacked by a turtle on the Mediterranean beach in September 2020. She was brought to the emergency department, where she was noted to have a deep cut on the thumb and large bruises on the left side of her waist...

INTRODUCTION: Achieving the optimal survival rate for sudden cardiac arrest in mountains is challenging. The odds of surviving are influenced mainly by distance, response time, and organization of the emergency medical system. The aim of this study was to analyze the epidemiology and outcomes of patients with out-of-hospital cardiac arrest in whom cardiopulmonary resuscitation was performed in the Polish Tatra Mountains. METHODS: This was a retrospective analysis of data on sudden cardiac arrest collected from the database of the Tatra Mountain Rescue Service and local emergency medical system from 2001 to 2021...

INTRODUCTION: Little is known about the epidemiology of emergency medical search and rescue incidents globally. The purpose of this study was to describe the epidemiology of emergency medical search and rescue incidents in the North Shore Mountains of Vancouver, British Columbia, Canada. METHODS: This was a retrospective review and descriptive analysis of search and rescue incident reports created by North Shore Rescue over a 25 y period from 1995 to 2019, inclusive...

Scientific writing relies on an extensive array of written and unwritten rules to balance clarity, relevance, and economy. Careful development can strengthen each element of original research manuscripts. Some strategies are straightforward, including general organization and compliance with submission guidelines. Some aspects are more controversial, such as the subtleties of organizational structure, including claims of novelty, and presentation of limitations in the text. Manuscript crafting is usually improved through mindfulness of economy in presentation and objective restraint in interpretations...