Sir Chris Bonnington speaks at Expedition and Wilderness Course

We are delighted to announce that Sir Chris Bonington will be delivering the Rupert Bennett Memorial lecture.

Our next Expedition and Wilderness Medicine training courses are in March and May 2010 and we are very excited to have booked the prestigious Plas y Brenin National Mountain Centre, North Wales for the course in May.

EWM supported Indian Ocean rower Sarah Outen’s progress so far

Expedition and Wilderness Medicine has been supporting Sarah Outen’s attempt to row across the Indian Ocean by providing specialist medical training, advice and support. Sarah is now well into her challenge and you can follow her incredible progress via her website – Sarah Outen’s Indian Ocean rowing expedition.

Heat related injuries in extreme desert conditions

Operating in extremely hot conditions creates a unique set of medical risks. In the link is the medical outline – for non medics, regarding those risks from the Namibia Ultra Marathon training guide.

DEHYDRATION
Dehydration is the most common heat related illness – in fact, it is thought that dehydration could be the single greatest threat to the health of an athlete. When training regularly and for long distances, fluid intake should be made a priority. You must drink fluids all day – not just during training. 

Don’t depend on feeling thirsty to tell you when to drink. Thirst is a late response of the body to fluid depletion. Once you feel thirsty, you are already low on fluids. The best indicator of proper fluid levels is urine output and colour. Ample urine that is light coloured to clear shows that the body has plenty of fluid. 

Dark urine means that the body is low on water, and is trying to conserve its supply by hoarding fluid which means that urine becomes more concentrated (thereby darker). 

Dehydration can be the cause of feelings of fatigue or exhaustion – at all times watch out for signs of dehydration and take on water regularly through out the day. 

Runners prepare themselves

Start line near Brandberg

Namibia Ultra Marathon

News just in…Namibia Ultra Marathon completed

We’ve just heard from the Namibia Ultra Marathon race director Steve Clark, that everyone is now back in Swakopmund. Steve said the race was very tough with temperatures getting up to 42 ºc. Winner Darren Roberts was very surprised and shocked to hear he won the race but once it sunk in he was delighted. Tom Adams very nearly caught Darren up at the finish line which made it a nail-biting finish.

Namibia 24-hr Ultra Marathon Results are as follows:

1st Place – Darren Roberts 20hr 28

2nd Place – Tom Adams 20hr 29

3rd Place – Tom Maguire 21 hr 05

4th Place – Emma Rogan 21 hr 27 – First female to complete the Namibia 24-hr Ultra Marathon

5th Place – Jerry Haywood 22 hr 30

6th Place – Nick Tidbull 23 hr 17

7th Place – Nicholas Wright 23 hr 45

8th Place – Helen Skelton 23 hr 50 – BBC Blue Peter Presenter

9th Place – Adrian Crossley, Stuart Moore, Kellie Power & Michael Skakesheff 25 hr 07. These guys all crossed the line together holding hands, they were all just outside the 24 hour deadline but all were allowed to finish.

Dr Amy Hughes will when she’s back write up about the medical situations she was faced with on the race and how people coped with the extreme heat.

Expedition and Wilderness Medicine Director visits South Georgia

Black and White view of South Georgia

In March of this year Mark Hannaford was lucky enough to get a fantastic photographic project down to South Georgia and the South Sandwich Islands with the Scott Polar Research Institute (http://www.spri.cam.ac.uk ) and the South Georgia Heritage Trust (http://www.sght.org ).

Mark tells us about this project, SPRI and the amazing history behind these islands. “Prior to landing I asked a colleague, well known naturalist Dr Peter Cary, if it was realistic to compare South Georgia with the Galapagos Islands and his reply ‘only if you want to downplay South Georgia’. Which surprised me but the islands lived up to and exceeded any expectations that I had.

Essential Healthcare in Ethiopia

Essential Healthcare Amid Dust and Desolation in Southeast Ethiopia by
MSF doctor Anna Greenham who describes work and life in the Somali region of Ethiopia.

“Life in the Somali region of Ethiopia is tough. The rains have failed, food is running out and even the camels are dying of thirst. Add to this a complex armed conflict and you have a recipe for disaster. Nomadic people can’t find water or grazing for their livestock and are forced to travel huge distances to survive. Many have lost everything. Without a livelihood they move to the edge of towns where they live in squalid conditions in very basic shelters, unable to access clean water or food. It is in one of these small rural towns, Wardher, that MSF provides the only reliable health care for a dispersed population of about 40,000 people.

Expedition and Wilderness Medicine partners with the Wilderness Medical Society of America

Wilderness Medical Society Approved Courses

All of Expedition and Wilderness Medicine Courses are approved for credit by the Wilderness Medical Society (WMS) for the Academy of Wilderness Medicine Fellowship Program (FAWM). For more information visit: www.wms.org The Wilderness Medical Society has entered a partnership with Expedition and Wilderness Medicine to offer you an opportunity to earn credits towards the WMS Academy of Wilderness Medicine Fellowship program (FAWM).

This is an exciting postgraduate qualification in Expedition and Wilderness Medicine which is likely to become the gold standard in this field.

What is the FAWM?

The Fellowship in the Academy of Wilderness Medicine is designed for individuals who want to be acknowledged for their professional achievement in Wilderness Medicine, and wish to validate their training for their patients, and clients. This initiative between Expedition and Wilderness Medicine and WMS offers a means to identify those who have achieved a demanding set of requirements. Society members enrol in the Academy and, by completing Expedition and Wilderness Medicine courses, receive credit for specific, identifiable experience, accumulating credit toward becoming a Fellow.

Any current member of the Wilderness Medical Society who successfully completes the requirements will have the distinction of being a registered member of the Academy of Wilderness Medicine and entitled to use the designation Fellow of the Academy of Wilderness Medicine (FAWM) and may reference it on resumes, business cards, and advertisements. The Academy maintains a demanding set of requirements that validates each member’s qualifications in wilderness medicine. C

andidates for the Academy participate in Expedition and Wilderness Medicine Courses and receive credit for the topics covered. When candidates fulfil the requirements of the Core Curriculum and demonstrate other required experience in Wilderness Medicine, they qualify to be reviewed to become members of the Academy with the designation “Fellow of the Academy of Wilderness Medicine.”

To find out more visit the Expedition and Wilderness Medicine website.

Desert Medicine Course BOOK NOW!

We have a few places left on our Desert Medicine Course in Namibia from 19-25  April.  This course was run for the first time last year and proved a fantastic success.  Run by Drs Sean Hudson and Sundeep Dhillon plus a knowledgeable local team this course is ideal for those interested in working in arid or desert environments.

The tutors will develop the skills of the participants through a combination of practical sessions and evening lectures. The days will be spent in the field, learning both the essential medical skills and survival skills which will allow you to be a valuable member of a desert expedition team. Topics covered include, managing animal bites, identifying tropical diseases, heat related illnesses and managing the health of an expedition in the field, travelling in the desert by vehicle and on foot, setting up camp, cooking and lighting fires, managing casualties and evacuating them when needed. And much more. Skills without which a successful medical response is extremely difficult.

Expedition and Wilderness Medicine is chosen to provide backstop support for Pen Hadows latest expedition to the pole

The Catlin Arctic Survey

Pen Hadows latest expedition supported by HRH Prince of Wales is to be supported by the medical resources of Expedition and Wilderness Medicine.

 

The Catlin Arctic Survey Expedition is an international collaboration between polar explorers and some of the world’s foremost scientific bodies. It seeks to resolve one of the most important environmental questions of our time:

How long will the Arctic Ocean’s sea ice cover remain a permanent feature of our planet?

The team will be travelling on foot, hauling sledges from 80°N 140°W, across 1200-km of disintegrating and shifting sea ice, for around 100 days, in temperatures from 0ºC down to -50°C.

Essential data:

Despite the technological advances of the 20th century, we still only have estimates of the thickness of the sea ice cover on the Arctic Ocean. Travelling across the sea ice, the Catlin Arctic Survey team will take precise measurements of its thickness and density. This will enable the programme’s Science Partners to determine, with a greater degree of accuracy, how long the ice cap will remain. Currently, its predicted meltdown date is anywhere between four and a hundred years from now.

Global significance:

The melting of the sea ice will accelerate climate change, sea level rise and habitat loss on a global scale. Its loss is also a powerful indicator of the effects of human activity on our planet’s natural systems and processes. The Survey’s scientific findings will be taken to the national negotiating teams working to replace the Kyoto Protocol agreement at the UN Climate Change Conference of Parties in Copenhagen in December 2009.

Pioneering technology:

The Catlin Arctic Survey has developed and tested a portable, ice-penetrating radar. This will take continuous and detailed measurements of both the snow and ice layers along the 1200 km route.

Ground-breaking satellite communications equipment, developed specifically for this project, will allow the survey team to transmit their unfolding story directly from the ice to a global audience.

 

Mike Grocott Expedition and Wilderness Medicine lecturer speaks to the BBC about the Caudwell Extreme Everest Expedition

Everest trip helps critically ill

Copyright  Michelle Roberts
BBC News health reporter

Dr Grocott and the Caudwell team plan another trek in 2009

The lessons learned by medics from a trip to Everest could help the treatment of critically ill patients.

The team that braved the Himalayan summit to study the body’s responses to extreme adversity has recorded the lowest ever human blood oxygen level.

The results could see treatment plans for some patients with similarly low blood oxygen levels re-evaluated.

The “Caudwell Xtreme Everest” work has been published in the New England Journal of Medicine.

The blood readings established what has long been suspected – that high-altitude climbers have incredibly low levels of oxygen in their blood, which at sea-level would only be seen in patients close to death.

The figures they have got are quite incredible. They are phenomenally low oxygen levels Anaesthetist Dr Andy Tomlinson

The average arterial oxygen level was 3.28 kilopascals or kPa – the lowest was 2.55 kPa.

The normal value in humans is 12-14 kPa and patients with a level below 8 kPa are considered critically ill.

Expedition leader Dr Mike Grocott said: “We rarely see below 6 kPa in our patients.

“Yet our readings were well below this and we were walking and talking and functioning normally.

“This gives us some perspective about what levels of oxygen deprivation people can tolerate.”

He said some critically ill patients may have adapted to the low oxygen levels and may not need the aggressive interventions, such as ventilation, that are currently given to get blood oxygen levels closer to normal ranges.

“All these interventions carry a risk of harm and you have to weigh up the benefits versus potential damage to organs like the lungs.

“Maybe we could be less aggressive in treating some of these patients.”

He said other intensive care researchers were planning to investigate it.

Tolerance limits

Acting as guinea pigs themselves, the London team of medics – five anaesthetists, two GPs and a vascular surgeon – took the first readings of human blood oxygen 8,400m above sea level.

The team climbed with oxygen tanks, then removed their masks 20 minutes prior to testing to give time for their lungs to get used to the low-oxygen atmosphere and to avoid any skewing of the readings.

The team were unable to make the measurement on the summit of Everest as conditions were too severe, with temperatures at -25C and winds above 20 knots.

Having descended a short distance from the summit, the doctors removed their gloves, unzipped their down suits and drew blood from the femoral artery in the groin.

The samples were then carried by Sherpas back down the mountain and analysed within two hours at a science lab set up at the team’s camp at 6,400m.

Based on calculations of the expected level of oxygen in the blood, the Caudwell Xtreme team speculate that accumulation of fluid in the lungs as a result of the high altitude might have contributed to the low oxygen levels.

They hope ongoing research will eventually lead to better treatments for patients with acute respiratory distress syndrome, cystic fibrosis, emphysema, septic shock, “blue baby” syndrome and other critical illnesses.

Dr Andy Tomlinson, an anaesthetist at the City General Hospital in Stoke-on-Trent and a keen climber, said: “The figures they have got are quite incredible. They are phenomenally low oxygen levels.

“There is obviously a difference between critically ill patients and fit and healthy climbers.

“Never the less, there are lessons to be learned for critical care.”

Dr Peter Nightingale of the Royal College of Anaesthetists said: “This may well make doctors re-evaluate their current provision of oxygen and the researchers may well be right that patients can run on lower oxygen levels.

“But we do not know and we need more research.”

Mike Grocott is a Expedition and Wilderness Medicine lecturer and presents on our UK training course – Expedition and Wilderness Medicine UK