Sarah Outen – makes it with a little help from EWM!! The first Britian to row in the India Ocean and the first female ever!

Sarah Outen in a breathtaking achievement and with a little help in terms of support and training from Expedition and Wilderness Medicine has successfully become the first Britian and the first woman ever to row across the Indian Ocean and the youngest woman to solo any ocean- massive congratulations to her from us

A very exciting, record-breaking, and ever so slightly crazy sort of challenge. It involved my little boat, the Indian Ocean and lots of chocolate. April Fools Day 2009 I set out from Western Australia in a bid to become the first woman to row solo across this ocean. 124 days later after 4,000 miles, having eaten all my chocolate, faced storms and mid-ocean capzies , I landed in Mauritius. It was raw and elemental – just as adventure should be.

Find out more about Sarah’s epic row at http://www.sarahouten.co.uk or donate online via JustGiving

Landing at the end of the record breaking row

Landing at the end of the record breaking row

The Life-Line Clinic, Namibia | Job Oppurtunity

Namib Naukluft National Park, NamibiaNamibia 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.

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Expedition and Wilderness Medicine Director visits South Georgia

Black and White view of 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.

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

The Catlin Arctic Survey

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.

 

Expedition Medicines Christmas madness

Expedition Medicine Christmas eNews December 2008

Santa's Church

Santa Church

 

EML’s Christmas Crackers

Christmas is nearly upon us and to help us all beat the credit crunch we have been working hard to secure you some fantastic and EXCLUSIVE discounts.

Not only are we offering discounts on some of our challenge events but we also have suppliers giving us some great offersWe hope you enjoy! Get your copy for Christmas

 

 

Looking for that special medic gift – look no further! 

Get your copy for Christmas‘An invaluable resource for anyone planning a trip in the outdoors, either as part of an expedition or a wilderness adventure’

The climber Andy Cave IFMGA mountain guide, mountaineer, author and conference speaker was even more effusive in his praise;

‘As I was reading this manual I found myself frequently exclaiming “God if only we’d have had this book back then!” I will be keeping it very close to hand on my next adventurous trip I can promise’

Buy or download your copy here.

 

 

 

DISCOUNTS FOR EML CUSTOMERS

DogSled ATD_logo_125w JW IcelandUltra
Across the Divide is delighted to offer the following discounts on the events listed below. We hope to see you soon on an ATD challenge!

JUST WALK
We are offering £10 off the 60km walk and £5 off the 40km walk. Just Walk is a stunning walk over the South Downs allowing you to raise funds for the charity of your choice. There are four distances to choose from, 10km, 20km, 40km or 60km. Sign up now at

ADVENTURE RACES
We are offering £20 off the registration fees on the Namibia & NEW Spanish Ultra Marathons. These events are aimed at those wanting to push themselves to their limits, ideal if you want to raise funds for the charity of your choice and fancy a real challenge! Sign up now at http://www.adventure-racing.org/

OPEN EVENTS
It’s so easy to sign up, choose a challenge, choose a charity, register then start fundraising for the experience of a lifetime! We have an inspirational range of challenges and we are offering £20 off the registration fees for the following Open Events

Exhilarating India Bike Ride 7 – 16 March 2009
Three Cities Bike Ride – London – Brussels – Amsterdam 18 – 22 June 2009
London to Paris Bike Ride 24 – 28 June 2009

 

All offers end midnight 31st December 2008. Discount is taken off the registration fees and can only be used with online bookings.
 

 

 

Hi_Ho
Hi Ho Silver 15% discount
Our neighbours at Hi Ho Silver are offering ATD customers a HUGE 15% saving at their online shop. A beautiful range of silver jewellery and gifts with the additional bonus of a gift chooser and gift wrap. Delve in, discover and buy from their fantastic range. Just enter the code UhwkGqj when at the checkout.
T&Cs: Exclusively redeemable online at www.hihosilver.co.uk. Not valid on sale items, e-vouchers and in conjunction with any other offers. Offer ends on 24th December 2008 at midnight. Promoter: Hi Ho Silver, registered in England No. 5042138.

 

 

 

montane1_

Montane in partnership with The Climber’s Shop 15% off

We have been working with Montane for a number of years now and like us they are passionate about the outdoors. They have performance clothing for any activity from biking to hiking to climbing. They have negotiated for ATD customers a 15% discount with one of their top customers: The Climber’s Shop.
To claim your discount visit the website and enter the code CHONOS at checkout. Offer ends midnight 20th December 2008.

 

 

Lonely Planet, Nomad Travel Store & Trek Hire UK…

 

 

LonelyPlanet
20% off at Lonely Planet
Booked your ATD next trip? Then you might want to grab a copy of the Lonely Planet. They are offering you a 20% discount* off all Lonely Planet guidebooks. So lose yourself in depths of Norway, find yourself trekking in India or unearth some hidden gems on your home turf.To redeem the offer, visit http://shop.lonelyplanet.com load up your basket and enter the promo code:

ATDLP20

*This offer may not be used in conjunction with any other promotion and excludes theme packs, digital products, travel gear and delivery charges. Offer ends 31st March 2009. You must enter the promo code ATDLP20 to redeem the discount.

 

Nomad
15% off at Nomad Travel Store
Nomads have been kitting out travellers with clothing, equipment, books, maps, medical supplies and vaccinations for nearly 20 years.

Prepare for your next ATD adventure with the 15% discount they are offering ATD customers. Visit their online store where you can shop for all your goods for your next ATD trip. The code you need is ATD1000.

The discount does not apply to medical items or the shipping cost of the order (although orders over £75 after discount will have free delivery anyway).

 

Trekhire
up to 15% discount at Trek Hire UK
If you don’t want to buy yourself new kit for your ATD adventure then why not hire? Trek Hire UK can offer you the latest gear at very competitive hire prices, and even better they are offering discounts to ATD customers.

If you spend £50 or more you gain a 10% discount if you spend £200 or more you get a 15% discount (this is great if there is a few of you!).

To redeem this offer just call them on 01306 886333, promotional code is ATDTH20.

 

Profeet & Cotswold Outdoor…..

 

profeet Cotswold_red_logo
Profeet is a new concept in custom fitted footwear such as running shoes and ski boots, providing the ultimate in fit, comfort and performance. Their unique 3D FIt System utilises biomechanical video gait analysis and foot scanning, the creation of custom insoles and the selection of appropriate footwear.They are offering ATD customers up to 25% off – email Julie for more details but hurry only a few vouchers left.

 

Cotswold Outdoor is an outdoor retailer which has been around for over 30 years. They have one of the most comprehensive ranges of outdoor clothing and equipment in the UK. They are offering ATD customers a 15% online discount, simply use the promotional code AF-ATDE-Y8 when the promotional code box appears in your basket.

T&C’s: Exclusions include: Gift Vouchers, Rock Bottom goods (both shown online and carried in store), sale items, previously discounted goods (N D coded items), DVDs and specially ordered goods. (These items will be correctly priced at point of sale). In addition, this offer cannot be used in conjunction with any other affiliation, Cotswold offer or discount. Expires 31st December 2008. Only available online. Once you have added your goods to the shopping basket, please enter the Promotional Code AF-ATDE-Y8 in the promotional code box (not case sensitive but you need to use the hyphens.

Solo across the Indian Ocean

A very exciting, record-breaking, and ever so slightly crazy sort of challenge. It involves a small boat, some oars and over 3,000 miles of Indian Ocean.

Sarah Outen | Row the Indian Ocean

Sarah Outen | Row the Indian Ocean

Expedition Medicine has recently been approached by a great British explorer maybe read ‘eccentric’ in the making, Sarah Outen who plans, in memory of here rather to row single handed across the Indian Ocean in 2009. Sarah has asked us to provide a tailored medical training course designed specifically around her needs which we are happy to do.

But so inspired by her challenge are we that we are also offering ongoing support and provide a regular feature on her progress through our regular Enews – if you don’t receive it yet you can sign up by clicking here, and also via this blog – so watch this space…

…a bit more detail, in Sarah’s own words,

In Spring 2009 I will row solo from Western Australia to Mauritius in a bid to become the first woman, and youngest and fastest person, to make the crossing.

Rowing up to 12 hours a day under a scorching sun, riding 30ft waves, battling winds and currents, sharks, capsizes and shipping traffic, it will be a test of endurance, stamina and my sense of humour. It will be raw and elemental – just as adventure should be.

it’s not all about the records

The venture is dedicated to my lovely Dad, who died suddenly in June 2006. He had suffered terribly with rheumatoid arthritis for as long as I can remember, so in his memory I am fundraising for the Arthritis Research Campaign.

A biologist and outdoor enthusiast, I love the creatures to be found at sea and want to encourage others to appreciate them, too. After all, what we love, we save. My journey will be a green one, as far as possible, and aims to encourage responsible stewardship of our planet, especially of the blue stuff.

 

Row the Indian Ocean

Diving Medicine and training in Oman – Dr Lesley Thomson

Most of my diving has been in cold water. Not just the American definition of cold water, being anything less than 18ºC, but properly cold! UK winter diving of 5-6ºC for example, or Arctic Russia and Antarctic winter diving with sea temperature down to -1.8ºC, together with air temperature down to -20ºC.

Diving in Antarctica

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Expedition Medicine launches a new course on Dartmoor

Expedition Medicine on DartmoorOur highly rated Expedition and Wilderness Medicine Training Course is heading south.

We are really excited about our new course – following the same schedule as our Lakeland course and with many of the same inspirational faculty we have linked up with Dartmoor’s premier training faculty, the Heatree Centre located near Newton Abbot to provide an additional course in May.

We are hoping that will make the travelling time shorter for some of you and reduce to carbon footprint of the courses, we will of course be working with the Woodland Trust as well to identify one of their projects close by which the proceeds of the course will help support.

Expedition and Wilderness Medicine Dartmoor Course

Expedition Medicine

A Case of Splenic Infarction at High altitude in Sickle Cell Trait by Dr Alison Cook

Trekking in Peru 

 

A Case of  Splenic Infarction at High altitude in Sickle Cell Trait

About the author – Dr Alison Cook is a G.P. with a keen interest in expeditions and the medical issues in remote locations.  She has attended the Expedition and Wilderness Medicine course in Keswick and has worked as an expedition medic for Across the Divide Expeditions in locations diverse as Namibia and Peru.  Alison has also worked with Medecins Sans Frontieres (MSF)  in Niger.

In March 2007 an ATD client with undiagnosed sickle cell trait (SCT) suffered a splenic infarction on a high altitude expedition.  Although the phenomenon of splenic infarction in SCT at high altitude is well documented, it is a relatively rare event and therefore a worthwhile case to share amongst expedition medics.

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How do I use a hyperbaric chamber? What are the alternatives?

Hyperbaric Chamber

The concept behind the 3 main portable hyperbaric chambers is they effect a physiological descent by inflating the air impermeable bags above ambient atmospheric pressure. The extent of the descent is dependent on the altitude at which the bag is used and the pressure to which they can be pumped. The patient is placed in the bag lying down (which can be claustrophobic), there is a window for the patient to look through, the fabric of the bag is thick but a conversation can be undertaken. If the patient has difficulty lying flat put the bag on a slope.

Oxygen can be placed inside the bag with the patient. It is worth ensuring the patient has something comfortable to lie on and has a sleeping bag if they get cold. Conversely if its day time the bag needs to be in the shade to avoid ‘boil in a bag’. The bag is zipped up and the bag inflated slowly using a foot pump until the pop-off valve hisses (at around 2 psi). The pressure then has to be maintained by continuing to pump but at a slower rate.

The patient is normally kept in the bag for about an hour, as long as they remain stable in the bag. As pressure increases, the patient needs to be warned to equalise if they are able. It may be worth giving the patient a bag to vomit in if required. Occasionally the zips burst, leading to rapid depressurization and the risk of barotrauma. When reducing the pressure to get the patient out do it slowly, the zip can normally be opened slowly when the side of the bag dimples on pressure.

What are the advantages and disadvantages of this piece of equipment? 

Advantages: Lightweight well tested, robust. All the equipment weighs aproximately 7kg. Fast to use, inexpensive in comparison to the others. 

Disadvantages: Still costs £1500 or so, the zip can breakdown and is the weak point. No carrying handles if you wanted to physiologically and geographically descend simultaneously. 

Who makes hyperbaric chambers?
The Gamow bag is the oldest design. The other bags are the PAC and the Certec. Both as good and lighter.  The Certec uses a different pumping system, which can be tiring. 

Gamow Bag.   The Gamow does not have handles but can be carried on a stretcher if absolutely necessary.   You can read more about Gammow Bags and their inventor, Igor Gamow, scientist, classicist, professor, adventurer, at web.mit.edu/invent. Gamow is the son of the famed physicist George Gamow, a co-author of the Big Bang Theory and the first to propose the genetic code. 

Where can I hire a Gamow Bag?
They can be hired from Expedition and Wilderness Medicine see our Media Support Page for more details.

More About CERTEC Bags.   The present CERTEC hyperbaric chamber is an improved version of a hyperbaric chamber that was originally designed in 1989 by a French and German team.

The color of the new CERTEC hyperbaric chamber is not orange but yellow and blue.

Its design is different from all other pressure bags (Gamow, PAC, etc.) since it is comprised of two bags in one:

An outside envelope made of very strong material (to withstand tension) and good friction (for stability on any surface) , an inside envelope made of polyurethane (for airtightness) 

Advantages of this double envelope design are: 
it is rugged and durable
good protection of the airtight inner envelope 

All air valve systems are doubled for security:
two inflation valves
two automatically opening preset valves (220 mB) 

A very large window allows contact with the person in the bag.

Two full length zippers (inside and outside bags) allow easy in- and egress.

The inflation pressure is 220 mB, corresponding to a virtual descent of about 2500 m (depending on the actual altitude).

Total weight of the CERTEC Hyperbaric Chamber is 4,8 kg (carry bag and pump included).

It comes with a very efficient double effect pump (i.e. that pumps during up and downstroke) has a volume displacement of 3,7 liters for each pump cycle.

Only 4 pump cycles per minute are necessary to keep the CO2 in the bag at acceptable levels.

The price of the CERTEC Hyperbaric Chamber is $2300. It can also be rented. 

Advantages: Higher pressures, though it isn’t known how clinically important/useful this is. The bag is lighter than the Gamow. The double-wall system should provide more durability.

Disadvantages: Similar to the Gamow bag, the Certec is expensive, around $2300. I have not seen the newer Certec bag, and my comments are based on the older orange model. I found the (old) pump to be quite difficult to use as it required bending over at the waist (see photo at top of page); it was very fatiguing. As in the Gamow® Bag, fresh air must be regularly pumped into the bag to prevent CO2 buildup.

More about The PAC® (Portable Altitude Chamber)
Dr. Jim Duff, an experienced climber and expedition physician, has developed a nice alternative to the Gamow® and Certec® bags. The PAC (a coated fabric bag) is about the same size and weight as the Gamow, but more of a mummy shape, so there is more room around the head and shoulders. It also develops a 2 psi pressure, equivalent to the Gamow bag. The PAC is much cheaper than the Gamow bag and is probably the most sturdiest of the three hyperbaric bags on the market.

The main design difference, however, is in the radial zipper at the head end. This opens the whole head end and makes access far easier than either the Gamow or Certec bags. This is especially important with large and/or comatose patients (ask anyone who has tried to stuff such a patient into the Gamow bag!). There is no pressure gauge, instead there is a clear pocket on the inside of the window, so you can insert an altimeter and watch it from outside. 

The external, dangling pressure gauge on the Gamow Bag is vulnerable to wear/damage and subsequent leakage, something avoided in the Certec by having the pressure gauge set flush into the bag. I should note that the presence or absence of a gauge does not affect treatment; the pressure gauge or altimeter is merely a reassurance that the equipment is functional, something that is easy to ascertain in straightforward ways, ie, the bag inflates and the pop-off pressure control valves hiss. 

Note that with the PAC the maximum pressure is limited by the pop-off valves to 2 psi, but you can adjust the valves to a lower pressure to accomodate patients who have trouble clearing their ears. Instructions for using the PAC are printed right on the side of the bag, as is a table showing the equivalent descent at various altitudes, a nice touch. This bag has recently been used in the HRA Pheriche clinic and seems to be durable.

Advantages: The shorter zipper and simplicity of design has resulted in a bag that is far cheaper than the other available alternatives: US$1,200 including delivery almost anywhere in the world. The end-opening design is a major advance in terms of ease of getting patients in and out

Disadvantages: No significant disadvantages.

Web Resources
High Altitude Medicine Guide
Gamov’s entry in Wikipedia
Climbing High

Interview with Igor Gamow
PAC Technology

About the author
Dr. Sean Hudson is a Fellow of the Royal Geographical Society and on the expeditionary advisory board for Summit. Sean has been involved in a wide array of expeditions over the last 18 years. During this time he has trekked across the Darien Gap, The Thar Desert, worked as a trekking guide and Chief Medic for Raleigh International in Namibia and Zimbabwe, a trauma medic in Columbia and ski field doctor in New Zealand. Since 1998 he has worked for Across the Divide Expeditions as medic and expedition medicine advisor, providing medical cover on expeditions in 21 different countries. Dogsledding to Desert trekking in Namibia. In 2002, he and his wife, expedition medic Dr. Caroline Knox, helped to established Expedition and Wilderness Medicine, which seeks to provide comprehensive training for medical professionals working as expedition medical officers in a variety extreme and remote environments.