Wilderness medicine (practice)

Wilderness medicine, providing "vital emergency care in remote settings"[1] is a rapidly evolving field and is of increasing importance as more people engage in hiking, climbing, kayaking and other potentially hazardous activities in the backcountry.[2] A primary focus of the field is the evaluation, prioritization (triage), preliminary treatment of acute injuries or illnesses which occur in those environments and the emergency evacuation of victims. However, back country rescue and wilderness first aid is not the sole activity of wilderness medical professionals, who are also concerned with many additional topics. These include but are not limited to:

  • secondary care follow up to first aid in remote settings, such as expeditions
  • evaluation of experience and issuance of updated protocols for first response and secondary care
  • the prevention of wilderness medical emergencies
  • epidemiological studies
  • public policy advisement to wilderness planning agencies, and issuance of guidelines to disaster planning agencies[3] professional guides and amateur back country enthusiast organizations[1]

Scope

Wilderness medicine is a varied sub-specialty, encompassing skills and knowledge from many other specialties.

Diving and hyperbaric medicine

  • Physics and physiology of depth
  • Dive medicine
  • Dysbarisms and barotrauma

Tropical and travel medicine

High-altitude and mountaineering medicine

Expedition medicine

  • Basic field dentistry
  • Expedition planning, pre- and post-expedition responsibilities

Survival, field craft and equipment

Casualty extrication by road
  • Survival techniques and equipment
  • Water procurement
  • Food procurement
  • Hiking and trekking
  • Foot gear and care of the feet
  • Clothing selection for wilderness survival
  • Land navigation

Safety, rescue and evacuation

Preventive medicine, field sanitation and hygiene

  • Field sanitation and hygiene measures
  • Vector control and barriers
  • Water purification methods

General environmental medicine

Using the sky as a lightbox

Improvised medicine

  • Improvised field wound management
  • Improvisational medical techniques in the wilderness

Disaster and humanitarian assistance

  • Triage
  • Field hospital provision
  • Malnutrition therapy

Wilderness emergencies and trauma management

  • Pre-hospital patient assessment
  • Pain management in the wilderness setting
  • Emergency airway management
  • Psychological response to injury and stress
  • Management of trauma and injuries

Epidemiology

The Center for Disease Control in the U.S., and its corresponding agencies in other nations, also monitor pathogen vectors in conjunction with local departments of health, such as Lyme disease, plague and typhus which may be carried by small mammals in a back country or wilderness context.[4]

Austere environments interdisciplinary interface

Insights from the field of Military Combat Tactical Care (TCCC) interact with wilderness medical practice and protocol development. Moreover, new products and technologies tested in combat are adopted by wilderness medical personnel and vice versa.[5]

See also

References

  1. 1 2 Eric A. Weiss. A Comprehensive Guide to Wilderness & Travel Medicine Book.
  2. http://emed.stanford.edu/fellowships/wilderness.html
  3. "Preparation through education is less costly than learning through tragedy" - Max Mayfield, Director National Hurricane Center
  4. http://www2c.cdc.gov/podcasts/media/pdf/EID_7-09_Sylvatic_Typhus.pdf
  5. Will Smith M.D. "Taking Combat Medicine to the EMS and Wilderness Settings". Retrieved February 11, 2010.
  6. "Wilderness Medical Society". wms.org. Retrieved 2018-09-05.
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