Home Page: Wilderness Environmental Medicine

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WebSite: http://www.wemjournal.org

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If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. You will then receive an email that contains a secure link for resetting your passwordEmail*If the address matches a valid account an email will be sent to __email__ with instructions for resetting your passwordCancel WEM Clinical Practice Guidelines - 2019 Update The WMS is pleased to publish an update to our clinical practice guidelines. To read the updates, please check the issue. WEM Live! WEM Live! Need a convenient way to digest the latest and greatest articles published in Wilderness Environmental Medicine?Our podcast, Wilderness Environmental Medicine Live!, features primary authors from some of the articles from our latest issue to walk you through their work and help you to understand what they found. (CME available.) We want you to learn … and enjoy doing it!Listen now!iTunesSoundcloud WEM and The Journal of Special Operations Medicine (JSOM) are pleased to announce a shared science program. This opportunity is made possible through a reciprocal partnership between the journals. More WEM in the News When absolute certainty may not be possible: Criteria for determination of death by mountain rescue teamsRead the articleRead the press release [PDF]Patients with exercise-related hyponatremia advised to "drink to thirst"Read the articleRead the press release [PDF]Wilderness Medical Society issues important new clinical practice guidelinesRead the supplementRead the press release [PDF]Unique report details the dermatological progression and effective treatment of a severe jellyfish stingRead the articleRead the press release [PDF]Restricted permit-only access to Yosemite National Park’s Half Dome summit, anticipated to improve hiker safety, did notRead the articleRead the press release [PDF] About WEM Wilderness Environmental Medicine (WEM), the official journal of the Wilderness Medical Society, is a peer-reviewed international journal devoted to original scientific and technical contributions on the practice of medicine defined by isolation, extreme natural environments, and limited access to medical help and equipment. Sampling of topics covered: high altitude and climbing; hypothermia and cold-induced injuries; drowning and near-drowning; hazardous plants, reptiles, insects, and marine animals; animal attacks; search and rescue, etc.More Deaths resulting from animal attacks in the United StatesRicky L. Langley, William E. MorrowDOI: https://doi.org/10.1580/1080-6032(1997)008[0008:DRFAAI]2.3.CO;2Vol. 8, Issue 1, p8 16PreviewPDFxThe objective of this study was to elucidate the etiology and frequency of deaths in the United States from encounters with animals. The number of deaths from venomous and nonvenomous animals is reported annually to the US Department of Health and Human Services and published in Vital Statistics of the United States. This study is a survey of all animal-related fatalities listed as E-codes 905–906 reported in the Vital Statistics of the United States from 1979 through 1990. Data were extracted uniformly from the annual reports and analyzed using descriptive statistics.Effect of a face mask on respiratory water loss during sleep in cold conditionsAlan E. Rosen, Jonathan M. RosenDOI: https://doi.org/10.1580/1080-6032(1995)006[0189:EOAFMO]2.3.CO;2Vol. 6, Issue 2, p189 195PreviewPDFxThe purpose of this study was to test the hypothesis that a heat-and-moisture-retaining mask would result in a significant decrease in respiratory water loss among healthy subjects sleeping in a cold environment. The study was done in a backyard near a tertiary-care center during winter nights with ambient temperatures of less than 0°C. Subjects were 10 healthy volunteers, 8 males and 2 females, aged 23–40 years, with a mean of 30.9 years. In a crossover design study, subjects slept alone in mountaineering tents on two nights (8 h each night) using sleeping bags and ground insulation.Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness: 2019 UpdateAndrew M. Luks, Paul S. Auerbach, Luanne Freer, Colin K. Grissom, Linda E. Keyes, Scott E. McIntosh, George W. Rodway, Robert B. Schoene, Ken Zafren, Peter H. HackettDOI: https://doi.org/10.1016/j.wem.2019.04.006Vol. 30, Issue 4, S3 S18PreviewFull-Text HTMLPDFSupplemental MaterialsxTo provide guidance to clinicians about best preventive and therapeutic practices, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for prevention and treatment of acute mountain sickness, high altitude cerebral edema, and high altitude pulmonary edema. Recommendations are graded based on the quality of supporting evidence and the balance between the benefits and risks/burdens according to criteria put forth by the American College of Chest Physicians.Wilderness Medical Society Clinical Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia: 2019 UpdateJennifer Dow, Gordon G. Giesbrecht, Daniel F. Danzl, Hermann Brugger, Emily B. Sagalyn, Beat Walpoth, Paul S. Auerbach, Scott E. McIntosh, Mária Némethy, Marion McDevitt, Robert B. Schoene, George W. Rodway, Peter H. Hackett, Ken Zafren, Brad L. Bennett, Colin K. GrissomDOI: https://doi.org/10.1016/j.wem.2019.10.002Vol. 30, Issue 4, S47 S69PreviewFull-Text HTMLPDFSupplemental MaterialsxTo provide guidance to clinicians, the Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for the out-of-hospital evaluation and treatment of victims of accidental hypothermia. The guidelines present the main diagnostic and therapeutic modalities and provide recommendations for the management of hypothermic patients. The panel graded the recommendations based on the quality of supporting evidence and a balance between benefits and risks/burdens according to the criteria published by the American College of Chest Physicians.Carabid beetle invasion of the ear in OmanDeepa Bhargava, Reginald VictorDOI: https://doi.org/10.1580/1080-6032(1999)010[0157:CBIOTE]2.3.CO;2Vol. 10, Issue 3, p157 160PreviewPDFxTwo cases of human ear invasion by a predaceous beetle, Crasydactylus punctatus Guerin (Coleoptera; Carabidae), are reported from the Sultanate of Oman. The first case was that of a 35-year old woman who suffered a severe otologic injury caused by the biting and chewing of the external auditory canal and the tympanic membrane. The beetle then entered the middle ear and caused sensorineural hearing loss. The second case involved a 22-year-old male from whose ear a specimen of the same species was successfully removed after it was immobilized with 10% lidocaine spray. Rhabdomyolysis and Multisystem Organ Failure Due to Fulminant Ehrlichiosis InfectionAlex C. Overmiller, Cindy C. BitterDOI: https://doi.org/10.1016/j.wem.2021.01.009Publication stage: In Press Corrected ProofPreviewFull-Text HTMLPDFxA previously healthy 51-y-old male presented to his local emergency department with subjective fevers, myalgias, dyspnea, and generalized weakness that had been progressive for several weeks. He was initially diagnosed with bilateral pneumonia, septic shock, and rhabdomyolysis requiring transfer to a tertiary care facility. He was treated for sepsis with broad-spectrum antibiotics, steroids, and a fluid bolus before transfer. Once he arrived at the tertiary care facility, he developed respiratory failure requiring intubation and ventilatory support.Acute Bilateral Fixed Mydriasis Caused by Lupini Bean IntoxicationCorinne Lahoud, Najib-Georges Hanna, Alexandre Jalkh, Georges AzarDOI: https://doi.org/10.1016/j.wem.2021.01.003Publication stage: In Press Corrected ProofPreviewFull-Text HTMLPDFxLupini beans are legume seeds of the genus Lupinus, consumed in many parts of the world. The main species are Lupinus mutabilis, Lupius angustifolius, and Lupinus albus. The latter is commonly eaten as a snack in Mediterranean countries. The beans are very rich in alkaloids, which give them a bitter taste. One of these alkaloids was shown to cause anticholinergic effects. Lupini beans, if inadequately prepared, can cause toxicity manifesting as an anticholinergic syndrome. We present the case of a 50-y-old woman who presented with bilateral mydriasis, mouth dryness, and anxiety.Possible Indirect Adverse Effects to the Eyes in Skiers Wearing HelmetsMilorad LetićDOI: https://doi.org/10.1016/j.wem.2020.12.008Publication stage: In Press Corrected ProofPreviewFull-Text HTMLPDFxUse of helmets among skiers started to increase some 20 y ago, becoming mandatory for children under 16 y old in Austria in 2009.1 Today, 86% of skiers wear helmets.2 Helmet use has reduced the risk of head injuries by 35%.3 Widespread use of helmets implies thorough study of the possible adverse effects of wearing helmets that could offset their protective effects. Helmet use does not increase the risk of neck or cervical spine injury or the risk of compensation behavior.4 However, the 2 groups of head injuries, traumatic brain injury and other types of head injuries, are not equally prevented by ski helmets, and the number of traumatic brain injuries is not reduced to the same extent as the number of other types of head injuries.Marine Penetrating Injury to the Shoulder of Uncertain OriginJoshua Briotti, Joseph Yohan Jayamaha, Angus KeoghDOI: https://doi.org/10.1016/j.wem.2021.01.012Publication stage: In Press Corrected ProofPreviewFull-Text HTMLPDFxPenetrating injuries from marine animals are rare events; however, published case reports have detailed critical injuries including death occurring as a result of such incidents. We present a case of a marine penetrating injury to the right posterolateral shoulder of a 10-y-old boy. The patient underwent open surgical debridement and a course of oral antibiotics before returning to normal function. Clinicians should have an appreciation of various clinical patterns of marine penetrating wounds, the need for prompt imaging to exclude foreign bodies, and appropriate antibiotics to cover gram-negative bacteria and Vibrio species, which are commonly found in marine-related injuries.Methoxyflurane May Be a Suitable Analgesic for Extreme Prehospital ConditionsFrédéric Bussienne, Thomas ReynaudDOI: https://doi.org/10.1016/j.wem.2021.01.007Publication stage: In Press Corrected ProofPreviewFull-Text HTMLPDFxMethoxyflurane (MEOF) is a fluorinated hydrocarbon anesthetic that was introduced to the market by Abbott Laboratories as Penthrane in the early 1960s. MEOF was found to have analgesic properties at subanesthetic doses. A disposable inhaler was developed for self-administration of MEOF for pain relief in minor surgical procedures and obstetrics in the late 1960s. In 1966, the first report of postoperative nephrotoxicity associated with MEOF emerged. Although MEOF has been withdrawn for use as an anesthetic agent, low-dose MEOF delivered via a handheld inhaler has continued to be in wide use in Australia and New Zealand since 1975. Access this journal on ScienceDirect Visit ScienceDirect to see if you have access via your institution. WEM Member Access WMS Members log in here to obtain access to the current volume year and issue. For more information on how to gain access, please click here. We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the Cookie Preference Center for this site.

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