The previous edition of the WMN gave a detailed review of neuroanatomy, neurophysiology, brain mapping by neuronal activity, neurologic deficits, and the neurological exam. This edition will explore and review the various etiologies of changes in levels of consciousness (LOC), their recognition, emergent treatment, and management in the extended care environment.
When an individual presents with a changing or deteriorating level of consciousness, it can be one of the most disconcerting and challenging aspects of providing emergency care.
In urban emergency care, the standard is to maintain the airway, place the patient in a safe position, give oxygen, transport immediately, and do your best to try to find out why they have a deteriorating level of consciousness. Most likely the patient will not deteriorate much more in the intervening minutes until arrival at the emergency department. This is one of the few areas where there may not be a lot that can be done in the prehospital setting, but early recognition and rapid transport can and will save brain cells.
March/April 2004 ISSN-1059-6518 Volume 17, Number 2
https://www.wildernessmedicinenewsletter.com/wp-content/uploads/2014/10/wmnlogo20151.png00WMN Editorshttps://www.wildernessmedicinenewsletter.com/wp-content/uploads/2014/10/wmnlogo20151.pngWMN Editors2004-03-15 18:40:422017-06-06 07:24:59Change in Level of Consciousness
Every once in a while we are given the gift of getting to know an extraordinary individual. In this case, the individual is Mike Lynn. During a cross-country trek last February Mike found himself benighted in New Hampshire’s White Mountains. As the night grew longer, the temperatures plummeted to –30F. Mike dug in and waited for rescue. Rescue did not come that night. In fact, he ended up spending two nights and one day out in –30F weather. Eventually, Mike was rescued, and since then I have had the delightful opportunity to get to know him as he has progressed through the long recovery process from frostbitten feet.
January/February 2004 ISSN-1059-6518 Volume 17, Number 1
https://www.wildernessmedicinenewsletter.com/wp-content/uploads/2014/10/wmnlogo20151.png00WMN Editorshttps://www.wildernessmedicinenewsletter.com/wp-content/uploads/2014/10/wmnlogo20151.pngWMN Editors2004-01-15 15:51:382011-12-06 15:48:38WHEN JACK FROST BITES One man’s encounter with cold reality
and the interest in endurance sports became part of popular culture, the search for the “magic” potion, supplement, or nutrition bar has created a dizzying number of choices for the athlete and outdoors person who is looking for a way to get the most from themselves either in competition, outdoor adventures, or both. The crossover aspect of fitness and wild pursuits is more prevalent today than ever, and as a result, the desire to blend the two activities has been expressed by a growing number of wilder competitions: wilderness-based stage races, 12- and 24-hour races in wild settings, and the like. Today, the endurance athlete and the long distance hiker, the mountain biker, mountaineer, and backcountry skier/boarder, all begin to share common goals—peak human performance in an increasingly wild environment. Success in these pursuits carries with it the necessity to balance three components: proper hydration, nutrition, and perhaps the most elusive, pacing.
November/December 2003 ISSN-1059-6518 Volume 16 Number 6
https://www.wildernessmedicinenewsletter.com/wp-content/uploads/2014/10/wmnlogo20151.png00WMN Editorshttps://www.wildernessmedicinenewsletter.com/wp-content/uploads/2014/10/wmnlogo20151.pngWMN Editors2003-11-01 18:06:292011-12-06 19:20:28The Performance Triad; The Critical Balance of Hydration, Nutrition, and Pacing
September/October 2003 ISSN-1059-6518 Volume 16 Number 5
PAIN CONTROL IN MUSCULOSKELETAL INJURIES
Frank Hubbell, DO
The pain associated with musculoskeletal injuries is caused by swelling or direct stimulation of pain receptors. Swelling causes distention of tissues thus stimulating stretch pain receptors. Swelling is also an inflammatory response, and with it comes the production of various inflammatory chemical mediators, such as prostaglandin, that directly and indirectly stimulate pain receptors. Pain control can be achieved by several mechanisms: minimizing swelling, preventing the production of prostaglandin, or blocking the nerve receptors responsible for pain.
https://www.wildernessmedicinenewsletter.com/wp-content/uploads/2014/10/wmnlogo20151.png00WMN Editorshttps://www.wildernessmedicinenewsletter.com/wp-content/uploads/2014/10/wmnlogo20151.pngWMN Editors2003-09-12 17:40:582017-06-06 07:24:58PAIN CONTROL IN MUSCULOSKELETAL INJURIES
This is the third and final article in this series on Musculoskeletal Trauma. The first article reviewed injuries to the skull, face, spine, and pelvis. The second reviewed injuries to the extremities. This article will review orthopedic emergencies and dislocations. The material in this series applies directly to providing care in the wilderness or extended care environment beyond the “golden hour.”
September/October 2003 ISSN-1059-6518 Volume 16 Number 5
NEUROLOGY II
/in Level of Consciousness, Neurological/by WMN EditorsThe previous edition of the WMN gave a detailed review of neuroanatomy, neurophysiology, brain mapping by neuronal activity, neurologic deficits, and the neurological exam. This edition will explore and review the various etiologies of changes in levels of consciousness (LOC), their recognition, emergent treatment, and management in the extended care environment.
May/June 2004 ISSN-1059-6518 Volume 17, Number 3
Read more
Change in Level of Consciousness
/in Level of Consciousness, Neurological/by WMN EditorsWhen an individual presents with a changing or deteriorating level of consciousness, it can be one of the most disconcerting and challenging aspects of providing emergency care.
In urban emergency care, the standard is to maintain the airway, place the patient in a safe position, give oxygen, transport immediately, and do your best to try to find out why they have a deteriorating level of consciousness. Most likely the patient will not deteriorate much more in the intervening minutes until arrival at the emergency department. This is one of the few areas where there may not be a lot that can be done in the prehospital setting, but early recognition and rapid transport can and will save brain cells.
March/April 2004 ISSN-1059-6518 Volume 17, Number 2
Read more
WHEN JACK FROST BITES One man’s encounter with cold reality
/in Cold Injuries, Frostbite, Hypothermia/by WMN EditorsEvery once in a while we are given the gift of getting to know an extraordinary individual. In this case, the individual is Mike Lynn. During a cross-country trek last February Mike found himself benighted in New Hampshire’s White Mountains. As the night grew longer, the temperatures plummeted to –30F. Mike dug in and waited for rescue. Rescue did not come that night. In fact, he ended up spending two nights and one day out in –30F weather. Eventually, Mike was rescued, and since then I have had the delightful opportunity to get to know him as he has progressed through the long recovery process from frostbitten feet.
January/February 2004 ISSN-1059-6518 Volume 17, Number 1
Read more
The Performance Triad; The Critical Balance of Hydration, Nutrition, and Pacing
/in Hydration, Nutrition, prevention/by WMN EditorsEver since the running boom of the seventies,
and the interest in endurance sports became part of popular culture, the search for the “magic” potion, supplement, or nutrition bar has created a dizzying number of choices for the athlete and outdoors person who is looking for a way to get the most from themselves either in competition, outdoor adventures, or both. The crossover aspect of fitness and wild pursuits is more prevalent today than ever, and as a result, the desire to blend the two activities has been expressed by a growing number of wilder competitions: wilderness-based stage races, 12- and 24-hour races in wild settings, and the like. Today, the endurance athlete and the long distance hiker, the mountain biker, mountaineer, and backcountry skier/boarder, all begin to share common goals—peak human performance in an increasingly wild environment. Success in these pursuits carries with it the necessity to balance three components: proper hydration, nutrition, and perhaps the most elusive, pacing.
November/December 2003 ISSN-1059-6518 Volume 16 Number 6
Read more
PAIN CONTROL IN MUSCULOSKELETAL INJURIES
/in Medications, NSAIDs, Pain control/by WMN EditorsSeptember/October 2003 ISSN-1059-6518 Volume 16 Number 5
PAIN CONTROL IN MUSCULOSKELETAL INJURIES
Frank Hubbell, DO
The pain associated with musculoskeletal injuries is caused by swelling or direct stimulation of pain receptors. Swelling causes distention of tissues thus stimulating stretch pain receptors. Swelling is also an inflammatory response, and with it comes the production of various inflammatory chemical mediators, such as prostaglandin, that directly and indirectly stimulate pain receptors. Pain control can be achieved by several mechanisms: minimizing swelling, preventing the production of prostaglandin, or blocking the nerve receptors responsible for pain.
Read more
MUSCULOSKELETAL TRAUMA Part 3
/in Dislocations, Musculoskeletal, Orthopedic Emergencies/by WMN EditorsThis is the third and final article in this series on Musculoskeletal Trauma. The first article reviewed injuries to the skull, face, spine, and pelvis. The second reviewed injuries to the extremities. This article will review orthopedic emergencies and dislocations. The material in this series applies directly to providing care in the wilderness or extended care environment beyond the “golden hour.”
September/October 2003 ISSN-1059-6518 Volume 16 Number 5
Read more