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Understanding Risk Related To Outdoor Health

Dr. Robert “Brownie” Schoene, an enormously talented, accomplished, and insightful physician who resides within the bedrock of wilderness medicine, gave a wonderful presentation about the concept of risk at the 2010 annual summer meeting of the Wilderness Medical Society. Risk is inherent in outdoor activities, whether it is part of exploration, adventure, science, or industry. I am going to summarize his approach to the topic, which is among the most important general concepts in the field, and editorialize with some of my thoughts.

When one thinks of risk related to outdoor health, it is about the possibility of suffering harm, damage, or loss. When a person is aware of the possibility of a specific risk, he or she usually weighs the risk against the possible benefits. When you hike on a slippery, snowy trail in early spring, where the trail winds over patches of ice near ledges from which a fall would cause a severe injury, is the experience worth the risk? When you ride a wave on your surfboard when the waves are intimidating and you are outside your comfort zone, is the improvement in performance worth the possibility of a tumble and possible muscle tear or broken bone? Sometimes the answer is easy. When I travel to a third world country, I always run the risk of acquiring infectious diarrhea. The benefits of the mission supersede the discomfort, and I both anticipate the risk and prepare for treatment by carrying oral rehydration supplies and appropriate antibiotics.

I love the quote from Winston Churchill that Dr. Schoene used to illustrate a risk-taker’s approach: Read more »

This post, Understanding Risk Related To Outdoor Health, was originally published on Healthine.com by Paul Auerbach, M.D..

Handling One’s Emotions In A Survival Situation

Perhaps the greatest thrill in attending a summer meeting of the Wilderness Medical Society (WMS) is listening to new, enthusiastic and exciting speakers. They bring new insights and opinions to numerous topics and discussions, which is an essential part of the educational process. This past summer, at the 2010 Annual Meeting of the WMS held in Snowmass, Colorado, Dr. Drew Watters from the Indiana University School of Medicine approached the audience with his observations about neurobiology and survival. It was an innovative approach to a very common topic within wilderness medicine. How does one account for and handle emotions in a time of stress, including the most stressful situation of all—namely, a survival situation? When is it better to think, rather than to react? The objectives of his presentation were to understand to a certain extent survival, the anatomy of thought and perception, the neurobiology of emotions, behavior, emotive and cognitive decisions, and implementation of interventions in situations dominated by emotion.

Anyone who has practiced wilderness medicine knows that bad things happen, sometimes despite the best preparations and intentions. People make bad decisions that can too often be characterized as dumb. If they follow with more bad decisions, the situation Read more »

This post, Handling One’s Emotions In A Survival Situation, was originally published on Healthine.com by Paul Auerbach, M.D..

Wilderness Medical Society Publishes Prevention And Treatment Tips For Altitude Sickness

Led by Andrew Luks MD and his colleagues, the Wilderness Medical Society has published Consensus Guidelines for the Prevention and Treatment of Acute Altitude Illness (Wild Environ Med 2010:21;146-155). These guidelines are intended to provide clinicians about best evidence-based practices, and were derived from the deliberations of an expert panel, of which I was a member. The disorders considered were acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE). The guidelines present the main prophylactic and therapeutic modalities for each disorder and provide recommendations for their roles in disorder management. The guidelines also provide suggested approaches to prevention and management of each disorder that incorporate the recommendations.

In outline format, here is what can be found in these Guidelines: Read more »

This post, Wilderness Medical Society Publishes Prevention And Treatment Tips For Altitude Sickness, was originally published on Healthine.com by Paul Auerbach, M.D..

What You Need To Know About Snakebites

Eastern coral snake Eastern coral snake, photo courtesy of Norman Benton, CC-BY-SA 3.0

The Wilderness Medical Society held its annual meeting at Snowmass last summer July 23-28, 2010. There were numerous terrific educational sessions. In a series of posts, I am going to highlight some of what we learned from the presenters.

Jonathan Allen gave a presentation on venomous snakebite management. Here are some facts to remember:

Snakebite Statistics

Approximately 15 percent of the 3,000 snake species worldwide are dangerous to humans. There are annually 400,000 to 2,000,000 envenomations from snakebite worldwide, with 20,000 to 100,000 deaths. In the U.S., there is at least one species of venomous snake in every state except Alaska, Maine, and Hawaii. There are approximately 20 venomous species, including pit vipers and coral snakes, and an estimated 6,000 to 7,000 venomous snakebites each year, including six to 10 deaths. Perhaps only 20 percent of bites are reported.

Deaths from snakebites typically Read more »

This post, What You Need To Know About Snakebites, was originally published on Healthine.com by Paul Auerbach, M.D..

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