Wilderness medicine

doi:10.5847/wjem.j.issn.1920-8642.2014.01.001

Abstract

Abstract:

BACKGROUND: Human activity in wilderness areas has increased globally in recent decades, leading to increased risk of injury and illness. Wilderness medicine has developed in response to both need and interest.
METHODS: The field of wilderness medicine encompasses many areas of interest. Some focus on special circumstances (such as avalanches) while others have a broader scope (such as trauma care). Several core areas of key interest within wilderness medicine are discussed in this study.
RESULTS: Wilderness medicine is characterized by remote and improvised care of patients with routine or exotic illnesses or trauma, limited resources and manpower, and delayed evacuation to definitive care. Wilderness medicine is developing rapidly and draws from the breadth of medical and surgical subspecialties as well as the technical fields of mountaineering, climbing, and diving. Research, epidemiology, and evidence-based guidelines are evolving. A hallmark of this field is injury prevention and risk mitigation. The range of topics encompasses high-altitude cerebral edema, decompression sickness, snake envenomation, lightning injury, extremity trauma, and gastroenteritis. Several professional societies, academic fellowships, and training organizations offer education and resources for laypeople and health care professionals.
CONCLUSIONS: The future of wilderness medicine is unfolding on multiple fronts: education, research, training, technology, communications, and environment. Although wilderness medicine research is technically difficult to perform, it is essential to deepening our understanding of the contribution of specific techniques in achieving improvements in clinical outcomes.

Key words: Wilderness medicine, High-altitude sickness, Dive medicine, Envenomation, Trauma, Hyperthermia, Hypothermia, Frostbite, Avalanche, Combat injuries, Search and rescue, Travel medicine, Disaster medicine

Douglas G. Sward, Brad L. Bennett. Wilderness medicine[J]. World Journal of Emergency Medicine, 2014, 5(1): 5-15.

Figures/Tables 1

Table 1

Grants offered by the Wilderness Medical Society in Support of Health Research in Wilderness Medicine (www.wms.org/research).

Grants
Charles S. Houston Award
Audience
Medical students
Article by recent recipients
• Fischer MD, Willmann G, Schatz A, Schommer K, Zhour A, Zrenner E, Bartz-Schmidt KU, Gekeler F. Structural and functional changes of the human macula during acute exposure to high altitude. PLoS One 2012; 7: e36155.
Research-in-Training Award
Audience
Residents and fellows of accredited graduate medical education programs or PhD candidates
Articles by recent recipients
• Graves JM, Whitehill JM, Stream JO, Vavilala, MS, Rivara FP. Emergency department-reported head injuries from skiing and snowboarding among children and adolescents, 1996-2010. Inj Prev, March 19, 2013 [Epub ahead of print].
• Muller MD, Mast JL, Patel H, Sinoway LI. Cardiac mechanics are impaired during fatiguing exercise and cold pressor test in healthy older adults. J Appl Physiol 2013; 114: 186-194.
• Muller MD, Gao Z, Mast JL, Blaha CA, Drew RC, Leuenberger UA, Sinoway LI. Aging attenuates the coronary blood flow response to cold air breathing and isometric handgrip in healthy humans. Am J Physiol Heart Circ Physiol 2012; 302: 1737-1746.
Herbert N. Hultgren Award
Audience
Members of the Wilderness Medical Society
Article by recent recipients
• Chang CY, Trehan I, Wang RJ, Thakwalakwa C, Maleta K, Deitchler M, Manary MJ. Children successfully treated for moderate acute malnutrition remain at risk for malnutrition and death in the subsequent year after recovery. J Nutr 2013; 143: 215-220.
Peter Hackett-Paul Auerbach Research Grant
Audience
Young investigators, physicians or non-physicians, with projects that will improve wilderness medicine practice
WMS Adventure Travel Research Grant
Audience
Investigators conducting field research associated with the WMS Adventure Travel Experiences

Table 1

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