Expedition & Wilderness Medicine » Expedition Medicine

New Diving and Marine Medicine location – Maldives, Indian Ocean.

Mark Hannaford — Mon, 30 Nov 2009 14:00:54 +0000

Diving Medicine Training Course in the Maldives

Diving and Marine Medicine Training Course – Indian Ocean

3 – 9 OCTOBER 2010 ABOARD THE LIVEABOARD MV ARI QUEEN, THE MALDIVES

Expedition Medicine are very excited at being able to offer an inspirational course for all those medical professionals responsible for clients or expedition team members in a diving or marine environment.

This is a 6 day course, aiming to give participants an understanding of conditions likely to occur whilst working as a doctor on a diving expedition. Topics covered will include pre-expedition medicals, diving-related illness, marine envenomation, emergency treatments and casevac plans. Practical sessions include boat handling, search & rescue and underwater communications. There will be at least 2 dives a day, including a night dive and hopefully a visit to the hyperbaric chamber on Kuramathi Island – the largest facility in the Maldives. At the end of the week, participants should feel confident to act as medical officer on a diving expedition, or in any UK diving medical practice. Read the ‘What to Expect’ section below to get more of an idea of what the course entails.

MINIMUM COURSE REQUIREMENTS
All participants are expected to at least have a PADI Open Water qualification (or equivalent) with a minimum of 10 dives. Ideally participants should have PADI Advance Open Water qualification (or equivalent) as we will be doing some current diving. Conditions are dependent on dive sites, currents and times of year. If your qualification is not recent we recommend you complete at least 2 or 3 refresher dives before the course so that you get the most out of the fantastic diving the Maldives offers.
If the group is mixed, the dives will be split into 2 groups, so that each group is diving to its own ability.
PARTICIPANTS MUST BRING WITH THEM THEIR DIVE QUALIFICATION CERTIFICATES AND LOG BOOKS AS PROOF OF DIVING QUALIFICATIONS.

The Diving And Marine Medicine Course is accredited for FAWM points but we are waiting for confirmation of these as the Diving medicine course has moved to a new location.

Volunteering in Zambia

Mark Hannaford — Fri, 24 Jul 2009 12:26:37 +0000

Life In Luangwa , Zambia

“Doctor Emergency”! I had seen the blood spattered wheelbarrow parked on the veranda that served as the waiting room and now the sign of the shuffling flip flops told me I was about to meet its occupant. He entered the room uncertainly, supported between his two inebriated friends. The blood soaked tea towel adorning his head giving a big clue as to his presenting complaint. Removal revealed a 7inch gash across his forehead down to the skull. His helpful friends informed me it had been inflicted by an axe, two nights ago, in a fight and they excitedly asked me to examine his leg which had been stabbed by a spear.

Welcome to life in Luangwa or more accurately the Kakumbi Rural Health Centre. I have just returned from my second three month stint as the South Luangwa Safaris Association Medical Fund doctor. The post provides the unique opportunity for doctors to practice in a developing country whilst enjoying some Western style comforts. South Luangwa is a place where two worlds collide. It is situated in the Eastern province of Zambia, one of the countries poorest provinces in one of the world’s poorest countries. It hosts some of the worlds most exclusive safari holidays and draws tourists from around the globe. The medical fund was formed by the safari lodges as a way of importing expatriate doctors to provide medical services for the staff and guests of the lodges whilst securing access to a doctor for the local population. Kakumbi Rural Health Centre is the only clinic in Zambia to have a doctor working in it.

Work at the clinic is challenging. There is a language barrier, a cultural gulf and very basic facilities. There is no access to investigations and so most diagnosis are made on clinical grounds. A limited number of drugs and dressings are available but supply is often interrupted. The local hospital is over an hours drive away along a very poor quality, heavily potholed road. It is manned by two doctors and has microbiology, some blood testing facilities, an x ray machine and an ultra sound scanner. There is no ambulance service and patients are responsible for finding and paying for their own transport.

The health needs of the local population are huge. HIV/Aids is rife and both it and its complications often present during surgery. Diseases now confined to the history books of the Western world make not uncommon appearances. I saw cases of Tuberculosis, Syphilis and Rheumatic Fever during my three months visit. Other more unusual cases include snake bites, crocodile attack and foot trauma due to entanglement in a bicycle wheel. Trauma is a frequent occurrence in the community: children fall in open fires; builders fall off roofs; fishermen get hooks in their eyes and people assault each other. My stay spanned the wet season and in early March the number of confirmed cases of malaria started to rise. By month end it became evident that a full blown epidemic was likely and by mid April we ran out of malaria rapid diagnostic test kits and Co-Artem, the first line drug treatment. A week later supplies of quinine were down to less than 10 adult doses. On most days the clinic resembled a hospital and resources and staff were stretched to the limit. Sadly deaths started to occur as more severe complications such as cerebral malaria started to appear in young children.

The doctor is constantly on-call for the safari lodges but the workload is carefully managed and fitted around work at the clinic. After hours call outs are minimal and luckily I did not have to deal with any major emergencies on this trip. Zambia lacks medical facilities of a standard suitable for most tourists and therefore any problems arising either have to be dealt with by the doctor or medivacced to South Africa. Thankfully most visits to the lodges for guests are for minor problems; diarrhoea, lost tablets etc but serious medical problems and major trauma have occurred in the past. There aren’t however many places in the world where when returning from a “ home visit” you can come across a sleepy pride of lions snoozing on the road or giraffe gracefully grazing in the bushes.

Life in Luangwa is far from all doom and gloom. The valley is stunningly beautiful and the National Park is alive with wildlife both big and small. The doctor has very graciously been granted free access to the park and after a testing day at work there is nothing better than spending a few hours unwinding with a cold beer watching elephants frolic in a mud bath or a spectacular African sunset across a Hippo filled lagoon. There is plenty of opportunity to really get to know and understand the wildlife of the area and local guides and residents are more than happy to help you make the most of the experience.

I have thoroughly enjoyed both of my visits to the South Luangwa valley. I have immensely enjoyed working alongside the local staff and have learned a lot from the nurses. I have re-honed my clinical skills and revelled in the freedom of the autonomy of working in a very different health system. “Life in Luangwa” gives you a fascinating insight into the challenges that face rural Sub Saharan Africa in the 21st Centaury and I would highly recommend the experience to any doctor who is looking for a clinical challenge: who is willing to adapt to an unfamiliar environment and who has the relevant skills and experience to be able to feel comfortable in such a remote but awesomely beautiful place.

Dr Rhona Whiston May 2009

Desert Medicine Traininng Course in Namibia

Expedition and Wilderness Medical Training Courses for medical professionals

The Life-Line Clinic, Namibia | Job Oppurtunity

Mark Hannaford — Fri, 24 Jul 2009 12:20:58 +0000

Namibia Medical volunteer
This challenging programme offers you a unique opportunity to work at a small, rural Bushman clinic in Africa and make a difference to the lives of those in most need.
N/a’an ku sê is a unique and special place in the heart of Namibia which is committed to conserving wildlife and improving the lives of the Bushman community. Live your African dream and help make a difference by volunteering at our Lifeline Clinic.

About N/a’an ku sê’s Lifeline Clinic
• Bushman are treated as third class citizens and live in extreme poverty
• Adult onset diabetes, cardiovascular disease and cancer are sharply increasing in Bushmen and alcoholism has become prevalent
• Many Bushman children suffer from malnutrition, disease, discrimination and abuse

The N/a’an ku sê Lifeline Clinic was set up in 2003 to address the needs of the rural indigenous communities in Epukiro, a remote part of Namibia. The demand for a basic but comprehensive health service became apparent to medical professionals working in the area when they witnessed the tragic and unnecessary death of a young child due to the failure of ambulance service and hospital staff, largely due to the fact that the child was a Bushman. This vital service relies upon the time and dedication of volunteers and donations from supporters to continue to run and serve the communities in need.

About the role
• Improving Health: The clinic is dedicated to the health and welfare of the Bushman community.
• Making a real difference: The clinic has treated nearly 3000 patients over the past year.
• Free treatments: Over 2200 (72%) of the patients were Bushman who were treated for free.

The clinic aims to help marginalized local people and provide accessible affordable primary healthcare to those living in the area. By joining this project you will experience the harsh realities faced by Africa’s Bushmen communities and have the chance to make a difference to their lives. You will be immersed in the health and development programme while providing care to patients living in extreme poverty.

During your time at the Lifeline Clinic you will work with Sister Anna and assistant Natalia seeing and treating patients from the local Bushman and Herero community. Your daily schedule will be varied and you will carry out duties such as making and recording medical observations, keeping medical records, monitoring the progress of pregnant women, helping with wound dressings and working in the pharmacy. You will also visit an outer community or farm to do general health check ups and any treatments as required.
As part of your time at the clinic you will undertake an assignment such as looking into drivers of disease such as alcoholism to find out more about the health needs of this marginalized society.

You will also assist with community projects such as planting and cultivating vegetable gardens to help encourage good nutrition. You will spend time with the local Bushman community to understand how they live as well as going on a walk with them to look for bush food or medical plants.

You can also choose to experience the rare and exciting opportunity to work and care for the animals of Africa, assisting in their rehabilitation as part of our wildlife volunteering program.

Take part now! To take part in this project or find out more please email bookingsnaankuse@iway.na or visit www.ecotourism-namibia.com.

Make a donation –We rely on voluntary donations and the time and support of volunteers such as you to continue to help the Bushman people in need. If you are interested in supporting the clinic and the patients who need our help please email donationsnaankuse@iway.na to find out how you can help. We urgently need funding to continue to run this service, buy medicines and pay for our one full time Nurse who runs the clinic.

Experience your African dream at N/a’an ku sê
N/a’an ku sê is a unique and special place in the heart of Namibia which is committed to conserving wildlife and improving the lives of the Bushman community. Live your African dream and help make a difference by taking part on one of our exciting and rewarding volunteer programmes:

Volunteer at our Lifeline Clinic – located in a remote part of Namibia, this vital clinic is dedicated to the health & welfare of the Bushman community. By volunteering at the clinic, you will be immersed in the health and development programme while providing care to patients living in extreme poverty.
Contact: bookingsnaankuse@iway.na

Volunteer with wildlife – you can choose to combine your time at the clinic with the rare and exciting opportunity to work and care for the animals of Africa, assisting in their rehabilitation as part of our wildlife volunteering program.
Contact: bookingsnaankuse@iway.na

Experience our Lodge – start or finish your trip to Namibia with a stay at our beautiful lodge in the heart of Namibia’s bush land. Here, you can enjoy sumptuous meals, take a dip in our beautiful pool, experience unforgettable carnivore feeding tours and enjoy magnificent African sunsets.
Contact: naankuselodge@iway.na

Make a donation – sadly N/a’an ku sê does not receive any government funding and we rely solely on voluntary donations and the time of our volunteers to keep our vital projects running. By adopting an animal, sponsoring a child or treating a patient you can ensure we can continue to make a difference in the lives of the people and animals who need it most.
Contact: donationsnaankuse@iway.na

Making a difference
By visiting our unique lodge, volunteering at one of our projects or making a donation you can make a real difference to the animals and people we strive to help. All profits from our Lodge and volunteering activities go directly to benefit our work with wildlife conservation, our Lifeline Clinic for Bushman in Epukiro and the people from the Bushman community we employ.

Take part now by emailing bookingsnaankuse@iway.na or visit www.ecotourism-nambia.com to find out more about the work of N/a’an ku sê.

Desert Medicine training course – Namibia

Expedition and Wilderness Medicine training courses

Essential Healthcare in Ethiopia

Mark Hannaford — Fri, 24 Jul 2009 12:10:33 +0000

Essential Healthcare Amid Dust and Desolation in Southeast Ethiopia
MSF doctor Anna Greenham 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.

Wardher town is a dusty, bleak place. Most people live in tin roofed shacks or mud huts. There are only dirt roads, no running water and electricity only works for a few hours a day. There is a market but hardly any fresh food is available.

You would probably be shocked if I gave you a tour of our clinic. Things are very basic. Crowds of anxious patients wait outside on benches for consultations. Some have walked for days to reach us. Many have tried traditional therapies first and only access the clinic when they are critically sick. The sickest patients are referred to our inpatient department where two large tents with mats on the floor function as wards. It may look chaotic but it is amazing what we can achieve with so little. As well as primary and secondary health care we support a TB program, feed around 100 malnourished children, provide routine antenatal care, vaccinations and even mobile clinics to isolated villages. By training local staff we hope to leave something behind when MSF eventually leaves the area.

Most of the children are dying from simple illnesses- diarrhea, chest infections, preventable childhood illnesses such as measles and malnutrition. We use IV fluids, antibiotics and nutritional support to nurse these children back to health. Amazingly, most of our patients do recover, despite the limitations of what we have to offer. Some are not so lucky. It is so sad watching a baby die from pneumonia, when in a more advanced setting they would easily survive. The nearest proper hospital is 2 days drive away so this is rarely an option.

When I am not volunteering as a medical doctor for MSF I work as a General Practitioner in the NE of England. Next time anyone complains about the National Health Service there I suggest they put themselves in the shoes of a typical nomad like Fatima*, who walked for 4 days with no food or water to reach the clinic with her 4 month old baby. She was so exhausted that her breast milk had dried up. Her baby weighed only 2.5kg and was close to death. We were able to admit them both to our inpatient ward and the child is slowly improving with intensive nutritional support. She is one of the lucky ones. Many others are not strong enough to make the journey.

Work can be very frustrating. I am so busy during the day that I never have time to finish anything properly! I juggle ward rounds, reviewing complicated cases in our out patient department, admitting emergency cases, doing minor surgery in our small dressing room and assisting difficult deliveries. Add to this training local staff, sorting out human resource problems and trying to chase goats out of my ward, I hardly know whether I am coming or going. It can also be stressful living and working in an area of armed conflict, with severe restrictions on any form of social life.

Despite all the difficulties and challenges, I do love my work. It is so satisfying seeing critically sick children recover, when without the efforts of the MSF team they would certainly perish. MSF is not only providing health care, our presence in Wardher also gives hope to what is a very neglected population”.

Note
MSF has delivered vital healthcare to communities in the Somali region of Ethiopia, on and off as necessary and where possible, since the 1990’s; where the population struggle to survive amid numerous challenges, not least an ongoing conflict between governmental and rebel forces.

*False name to protect anonymity

Expedition and Wilderness Medical Training courses for medical professionals.

Sir Chris Bonnington speaks at Expedition and Wilderness Course

Mark Hannaford — Tue, 30 Jun 2009 09:33:21 +0000

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

Mark Hannaford — Sun, 07 Jun 2009 23:02:28 +0000

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.

Expedition and Wilderness Medicine Director visits South Georgia

Mark Hannaford — Mon, 23 Mar 2009 20:04:10 +0000

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.

Firstly however where is South Georgia? Lying about three days sailing to the east of the Falkland Islands the territory is a collection of remote and inhospitable islands, consisting of the largest island of South Georgia which measures approximately 106 miles by 18 miles and a chain of smaller islands known as the South Sandwich Islands lying about 400 miles to the south-east. The island was first sighted in 1675 by a London merchant called Anthony de la Roché and later by Captain James Cook during his remarkable journey who circumnavigated the island and then landed to claim for the crown naming it ‘the Isle of Georgia’ in honor of King George III.

Commercially the islands came to prominence in the early 1900’s when a number of large whaling stations where constructed by Norwegian companies to exploit the extremely rich waters, the stations where extremely successful and at one stage over 40,000 whales where being killed in the Southern Ocean, a large proportion being processed at South Georgia’s whaling stations. It is remarkable that the whale population has been able to survive at all with this rate of slaughter and a testament to how rich these oceans can potentially be in marine life if whaling is banned completely.

South Georgia is also closely associated with Sir Ernest Shackleton and his remarkable feat of leadership. After his ship the Endurance was crushed by ice in the Weddell Sea on October 1915 he led his 28 crew members in three small boats to the remote Elephant Island where they set up an extremely inhospitable base camp. Then Shackleton and five companions, including New Zealander Captain Frank Worsley the master of the Endurance, set sail in one of the small boats, the James Caird, on one of history’s epic journey to get help from Norwegians on South Georgia. In a miraculous feat of seamanship Worsley navigated the James Caird across the stormiest seas in the world under the constant threat of capsizing and hardly a clear view of the storm clad skies with which to get a sextant fix. Arriving at the glacier ridden cliffs of South Georgia fifteen days later they were forced to stand offshore for a further frustrating day whilst they waited for hurricane force winds to batter the island. The next day the storm, which had sunk a 500 ton steamer nearby, had abated and they were able to land on the uninhabited south shore. Rather than risk another sea journey Shackleton decided to cross the island on foot without a map or any local knowledge of the terrain, travelling with just Worsley and fellow Irishman Thomas Crean he trekked across glaciers and mountains to stagger a day and half later in the whaling station of Stromness. British explorer Duncan Carse retracing their footsteps in 1955 wrote ‘I do not know how they did it, except that they had to, three men of the heroic age of Antarctic exploration with 50 feet of rope between them, and a carpenter’s adze’. In 1922 Shackleton returned to South Georgia on his last expedition where he suffered a massive heart attack and died on the 5^th of January.

In honor of him his crew erected a memorial on King Edward Point near Grytviken and then set sail for England with his body onboard. However, upon reaching Montevideo, Leonard Hussey a veteran from the Imperial Trans-Antarctic Expedition received a telex from Emily Shackleton, the ‘bosses’ wife requesting that they return to South Georgia and bury her husband there. Shackleton is buried in the graveyard at Grytviken. Shackleton’s doctor wrote ‘think this is as “the Boss” would have had it himself, standing lonely in an island far from civilization, surrounded by stormy tempestuous seas, and in the vicinity of one of his greatest exploits.’ The islands most recently came to the worlds notice during the Falklands conflict when a group of Argentineans, posing as scrap metal merchants, occupied the abandoned whaling station at Leith Harbor on South Georgia. On 3^rd April the Argentine troops attacked and occupied Grytviken. The islands where recaptured on the 25^th April as a result of Operation Paraquet.

The work for the Scott Polar Research Institute (SPRI) revolved around getting some high quality images of Grytviken and its natural surroundings and for the South Georgia Heritage Trust (SGHT) some imagery of their remarkable museum located in the former whaling manager house at Grytviken for a new brochure (http://sgmuseum.gs/mediawiki/index.php/South_Georgia_Museum ). Whilst past the main breeding period the beaches of the island where covered with the massive belching stinky bulk of Elephant Seals and frustratingly aggressive Fur Seal pups attempting to already assert the mastery of their particular stretch of beach. A peek out of my window at King Edward Point I was able to watch a colony of King Penguins move towards the sea and Antarctic Terns fishing offshore all highlighted by the backdrop of the dramatic glacial clad peaks of the Allardyce Range and Mount Paget. There are few places that are quite as stunningly sublimely beautiful as South Georgia, mans hold on the island is tenuous at best reliant upon regular boat resupplies from Port Stanley but nature hold is remarkable by in tenacity and abundance.

With six days to complete the task and the weather not always working with me the hospitality and assistance of the staff at the British Antarctic Survey base at King Edward Point helped me capture what I think isn’t too bad a collection – visit the Across the Divide blog to judge for yourself (http://mark1066.wordpress.com/ ).

Help support SPRI. Across the Divide has been connected with SPRI for a number of years running an annual charity dog sledding adventures in the Arctic which helps raise invaluable funds for the Institute – if you would like to help and even just journey in the High Arctic with a dog team for company then why not sign up for next years dogsledding challenge here http://www.acrossthedivide.com/openEvents/charityopen.asp

Thanks to:

MV Discovery operated by Voyages of Discovery (http://www.voyagesofdiscovery.com ) for giving me a lift down to South Georgia.

The British Antarctic Survery (http://www.antarctica.ac.uk ) who accommodated Mark, at their base at Grytviken where his project was based.

Linblad Expeditions (http://www.expeditions.com ), based in New York, who picked me up by their new flagship expedition ship the National Geographic Explorer and given a lift in to Cape Town. The whole trip relied on a great deal of help from other people and organisations for which I am very grateful.

: Relics of a whaling industry – looking out over Cumberland Bay

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

Mark Hannaford — Wed, 11 Feb 2009 18:52:25 +0000

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.

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

Mark Hannaford — Thu, 08 Jan 2009 08:30:29 +0000

Everest trip helps critically ill

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

Jungle Medicine course – Costa Rica

Mark Hannaford — Wed, 17 Dec 2008 01:34:41 +0000

Course director Dr Sean Hudson writing about the Jungle Medicine Training Course in Costa Rica

Back in Costa Rica again and the jungle didn’t fail to provide the perfect environment for the course. As one would expect, it was hot, wet and full of interesting fauna and flora. I never fail to be impressed by the beauty of the jungle, but by god it can be hard sometimes. Its one of the few places I visit that can be so harsh then so comfortable. The moment you start to feel comfortable in the jungle is that Nirvana moment.

It took a while coming this trip because of the heavy rain but we eventually made it. Mike, Ceri, Mark and Martin again excelled themselves and the addition of our new herpetologist bringing snakes into camp was great. The best new addition to the course this year was however the HENNESSEY HAMMOCK, it is without a doubt the best bit of expedition equipment I have come across. 18 people in the jungle in some of wettest conditions I have experienced and everyone was dry, or if they weren’t they didn’t let on. Quite incredible.

Other than the medic feeling a little queasy on the river, everyone escaped injury and illness. Other than the EL developing drucunculiasis that is! but he’s got to have something to winge about. Back next year and I’m looking forward to it already.

Find out more about Expedition and Wilderness Medicine and about the Jungle Medicine Training Course in particular