Jungle Medicine Course Videos – Costa Rica

We have been really lucky to have been sent some great videos of the Jungle Medicine Course in Costa Rica hosted by Expedition and Wilderness Medicine.

The BBC and Expedition and Wilderness Medicine

Helen Skelton completes the Namibia ultra marathon

Helen Skelton completes the Namibia ultra marathon

Expedition and Wilderness Medicine have once again been called upon to help BBC’s Blue Peter program. After Helen Skelton, one of the loveliest presenters we have ever had the pleasure of working with, completed Across the Divide’s  Namibia Ultra Marathon, considered by many to be the hardest desert marathon in the world and for which EWM medics provided support, she is now heading off down the Amazon and Expedition and Wilderness Medicine and Across the Divide and  were called upon to provide medical support.

Expedition and Wilderness Medicine who provide remote medical support for film crews and media companies have been busy preparing Helen for the rigours of her next adventure and expedition doctors Dr Sean Hudson and Lucy Dickinson have been busy in the BBC centre running scenarios and doing on site training.    Dr Dickinson has the pleasure of accompanying the Blue Peter expedition but rumours have it is she is more excited about the prospect of gaining an elusive Blue Peter badge than exploring one of the world’s greatest natural wonders!!

In true BBC fashion it was all filmed for prosperity and will appear on next weeks Blue Peters shows on Tuesday 19th of January and Wednesday the 20th.

Cervical collar or SAM splint in a pre-hospital wilderness environment – Dr Sean Hudson reviews

For some time there has been a debate about the value of cervical collars in the pre-hospital wilderness environment. A recent article has lent weight to the ‘don’t take collars on expedition’ protagonists.

The recent journal of Wilderness and Environmental Medicine: Vol. 20, No. 2, pp. 166–168 compares a molded SAM splint as a collar with the traditional philadelphia collar.

The SAM splint was simply wrapped and molded around the C spine. and degrees of movement of the C spine were tested in all planes.

They found no significant difference in the ability of the 2 collars at limiting movement of the cervical spine. Podolsky and colleagues, in a prior study, found that the Philadelphia collar is as effective as numerous other collars available for cervical spine immobilization.

None of these devices has the broad range of uses that can be performed by a SAM splint (in addition to limiting movement of the cervical spine) The ability to carry one universal device for so many different medical conditions is one of the advantages of the SAM splint. This study helps to validate the practice of using a SAM splint as a universal splint for environments with limited medical supplies.

For more information on Expedition and Wilderness Medicine visit www.expeditionmedicine.co.uk.

Wilderness Medicine resources and training courses.

Dr Sean Hudson reviews a journal article on exercise-associated hyponatraemia

 Trawling through the medical journals, as I do!

I found an interesting article and consensus on the pathophysiology and treatment of hyponatraemia. Exercise-Associated Hyponatremia: Overzealous Fluid Consumption, Wilderness and Environmental Medicine: Vol. 20, No. 2, pp. 139–143.

The medical profession is certainly engaging with this increasingly prevalent condition. This particular article approaches the condition from a wilderness perspective and hence is more appropriate for expedition medical professionals. In essence Exercise-associated hyponatremia is hyponatremia occurring during or up to 24 hours after prolonged exertion. In its more severe form, it manifests as cerebral and pulmonary edema. There have now been multiple reports of its occurring in a wilderness setting.

It can now be considered the most important medical problem of endurance exercise. The Second International Exercise-Associated Hyponatremia Consensus Conference gives an up-to-date account of the nature and management of this disease. This article reviews key information from this conference and its statement. There is clear evidence that the primary cause of exercise-associated hyponatremia is fluid consumption in excess of that required to replace insensible losses.

This is usually further complicated by the presence of inappropriate arginine vasopressin secretion, which decreases the ability to renally excrete the excess fluid consumed. Women, those of low body weight, and those taking nonsteroidal anti-inflammatory drugs are particularly at risk. When able to be biochemically diagnosed, severe exercise-associated hyponatremia is treated with hypertonic saline.

In a wilderness setting, the key preventative intervention is moderate fluid consumption based on perceived need (“ad libitum”) and not on a rigid rule.

Expedition and Wilderness Medical Training Courses for Medical Professionals

Expedition and Wilderness Medicine support for Commonwealth Championship for Mountain Running and Ultra Distance.

Expedition and Wilderness Medicine

Expedition and Wilderness Medicine

Expedition & Wilderness Medicine  are to provide the medical cover for the Commonwealth Championship for Mountain Running and Ultra Distance. The events will run over four days in September 2009, and Keswick has been chosen as the venue.

Expedition & Wilderness Medicine Director, Dr Sean Hudson is acting as the Medical Director for the event and overseeing the medical care for the many international and local competitors who will be involved in a number high profile races. In conjunction with Across the Divide they will be managing the medical logistics and communication for the event.

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A participant’s write up – Polar Medicine Training Course February 2008

Polar Medicine Training Course | Norway

The setting for this year’s polar medicine training course was Alta, a small settlement, 72 degrees north and well within the arctic circle. A place with a deserted high street where you would be lucky to see one other passer by every 15 minutes, easily explained by a temperature at least ten degrees below freezing and a good foot of snow on the ground.

Base camp was a 40 km drive along icy roads to a picturesque mountain lodge by the name of Ongajoksetra. At the higher altitude the temperature was that much lower and if a wind was blowing, temperatures as low as minus fifty could be achieved. We were introduced to the Scandinavian team who would teach us methods of navigation across such tough terrain in harsh conditions and also to the Expedition Medicine team who would teach us polar medicine in a series of lectures and practical sessions both in the classroom and in the field. One more group I must not forget to mention is the team of fifty sled dogs who would provide another mode of transport across the snow.

Dr Claire Roche, Polar MedicineMy first day involved skidooing up a mountain demonstrating the importance of protective clothing, navigation aids and preparation for travel in severe blizzards with visibility of approximately two metres, sudden drops in temperature and rapid weather changes. I realised that without our trustworthy guide, Espen Ottem, we could become hopelessly lost in such conditions where you would be unable to survive more than a couple of hours at most. Our dog sledding guide, Pre-Thore was the perfect example of this as he told us of the time where inadequate preparation resulted in frostbite, blackening of his fingertips but fortunately no amputation. This story made me somewhat paranoid about the daily pain and numbness in my hands and feet when outside in the cold for prolonged periods. A “buddy system” was paramount to preventing frostnip. Simply by having that small exposed area of skin, pointed out to you to cover up

Dr Leslie Thomson, a consultant anaesthetist who had first – hand experience of polar medicine after spending several years in Antarctica taking part in the British Antarctic Survey gave an excellent lecture on hypothermia, bringing home how hypothermia is not just a condition seen near the poles but also in the Saturday night party goer who collapses under the stars, the homeless and the elderly. We were taught how to treat by various re-warming methods and when to commence C.P.R in the hypothermic patient sending home the message of not pronouncing death until warm and dead in certain individuals. This information was demonstrated by the story of Dr Anna Bagenholm , a 29 year old doctor who fell into icy water whilst skiing in Northern Sweden, immersed for approximately an hour, her body temperature was 13.7 degrees centigrade. C.P.R continued for three and a half hours alongside re-warming techniques such as bypass, bladder / stomach / peritoneal lavage and warm intravenous fluids. She survived to become the person with the lowest body temperature ever to survive.

Expedition and Wilderness Medicine obviously feel that first- hand experience is the best way of teaching and as a result each member of the group had to undergo cold water immersion. Prior to undertaking this challenge we were kindly taught about the cardiac arrhythmias that can be induced by the shock of entering the water, the short term cold water gasp reflex increasing the chance of aspiration and swimmers failure! One by one we stepped up to an ice hole in our thermal underwear and in the more daring members of the group a little less! to swim across icy water. I can confidently say that was the coldest I had ever been. As if several knives had been plunged into my body, breath taking and inducing chest pain, I swam across water of ridiculously low temperature to attempt getting out of the hole using my ski poles

Of our nights spent in the field we were taught how to construct snow holes. Five hours later our own little home with two double beds, stove, cupboards and shelves for our candles was constructed. It was as comfortable as it could be on a mountain side with winds blowing outside dropping the temperature to twenty below. I was amazed that the snow hole was so warm at five degrees compared to the outside however a slight air of nervousness was in the back of my mind as my avalanche detector slowly flashed in the corner and a rope attached to a spade inside connected our holes to other holes in case of us having to be dug out. The course perfectly demonstrated how to survive in such conditions

In summary the course prepared 25 everyday doctors to be able to traverse the polar landscape, recognise and competently treat local cold injury and hypothermia as well as to be safe expedition medics capable of caring for their groups and evacuating when required. To spend a week in such a location gave me the upmost respect for those who live in these regions and cross the landscape as part of everyday life, as well as a great respect for the land. In a day and age of global warming and melting of the polar ice caps it becomes paramount to look after our environment, to take only photographs and to leave only footprints.

Dr Claire Roche, Clinical Fellow in Emergency Medicine Countess of Chester Hospital.  See the BMJ article.

The next expedition medicine course will be in Desert Medicine Course which will be held in Namibia, August 17th -23rd 2008.

To see the full range of Expedition and Wilderness Medicine Training Courses see here.

Desert Medicine Training Course | Namibia

New Expedition Medicine training course dates

New September dates for UK Expedition Medicine Course in the Lakes

We are happy to announce the dates for our autumn Expedition Medicine course in the Lake District for the 9-12 September 2008 to be held at our training centre at the Barrow House Youth Hostel, Borrowdale, Keswick, Cumbria.

Find out more about the course at the UK expedition medicine training page here

Visit our Expedition Medicine photo gallery here to see more or download an course application form here, but hurry the places are strictly limited.