#29: Solar Water Disinfection, Hypothermia, Mountain Rescue, and Marine Medicine
Mar 15, 2023
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Gordon Giesbrecht, an authority in wilderness medicine, discusses thrilling and practical topics. He shares a gripping hypothermia case handled with innovative techniques. The conversation dives into solar water disinfection, showcasing how sunlight can purify water even at high altitudes. Giesbrecht also explores the challenges of mountain rescue operations and highlights essential training for volunteers. Additionally, he navigates marine medicine, covering risks from shark bites and microbial threats, urging a confident, informed approach to nature.
The podcast highlights the critical role of the NACA score in assessing injury severity during wilderness search and rescue operations.
Detailed exploration of resuscitation techniques for a hypothermic patient showcases innovative methods and improvisation in challenging medical scenarios.
Solar water disinfection (SODIS) proves to be an effective and low-cost technique for purifying water in resource-limited environments.
Deep dives
NACA Score and Its Significance
The NACA score is a critical parameter used to assess the severity of injuries in wilderness medicine, having been developed in the 1950s in the United States. It provides a standardized framework to characterize injury severity, particularly helpful in search and rescue operations. The score ranges from minor injuries to lethal conditions, allowing medical professionals to prioritize care and resources effectively. Its implementation ensures that responders can evaluate a patient's condition quickly, streamlining rescue and medical interventions.
Cold Weather Rescue Challenges
A case study highlighted the complexities involved in resuscitating a hypothermic patient found unconscious in her car during a winter cold spell. Despite challenges in warming the patient and restoring normal heart rhythms, advanced techniques such as eCPR and dual sequential defibrillation were discussed in detail. The struggle to manage equipment limitations, including temperature probes and intravenous access, emphasized the necessity for improvisation within emergency medical practices. Ultimately, innovative methods led to successful warming and stabilization of the patient.
Solar Water Disinfection (SODIS)
Solar water disinfection, known as SODIS, is a low-cost and effective method for purifying water using sunlight, particularly in resource-limited environments. Research indicated that exposing water in clear plastic bottles to sunlight effectively inactivated E. coli, demonstrating its utility beyond previously established altitudes. Increased UV exposure at higher elevations also enabled faster microbial inactivation, affirming the technique's adaptability. The discussion emphasized SODIS as a vital solution in humanitarian healthcare and wilderness medicine scenarios where traditional disinfection methods are unavailable.
Search and Rescue Insights from North Shore Rescue
The North Shore Rescue group in Vancouver has documented over 25 years of search and rescue data, revealing a growing demand for emergency medical services in wilderness settings. A significant portion of these incidents involves medical emergencies, highlighting the need for trained medical volunteers capable of handling advanced cases such as cardiac arrests in rugged terrains. Insights into case severity using the NACA score provided valuable data for understanding the challenges faced during rescues. The research also pointed to the potential for improving medical training and public awareness to enhance rescue outcomes.
Marine Animal Injuries and Treatment
The discussion on marine injuries focused on effective management strategies for bites from various sea creatures, particularly sharks and stingrays. Pre-hospital treatment recommendations included hot water immersion to alleviate pain and aid in wound healing. While concerns over the risk of bacteria such as Vibrio were raised, preventative measures like avoiding shiny accessories in fish-inhabited waters were emphasized. The conversation highlighted the rarity of such incidents while providing guidance for immediate care and proper imaging techniques for embedded spines or teeth.
#29: Solar Water Disinfection, Hypothermia, Mountain Rescue, and Marine Medicine
Mar 2023
Wilderness & Environmental Medicine journal online: www.wemjournal.org
Questions/comments/feedback and/or interest in participating? Send an email to: WMPodcast@wms.org
Part 1: Hypothermia Case
Darryl shares a recent hypothermia case handled at a tertiary care hospital using wilderness medicine techniques.
Gordon Giesbrecht podcast: https://soundcloud.com/wildernessmedicinepodcast/wem-podcast-march-2019
NEJM article: https://www.nejm.org/doi/full/10.1056/NEJMoa2207304
Part 2: Journal Club
Title: Evaluation of Escherichia coli Inactivation at High Altitudes Using Solar Water Disinfection
Authors: Kylie Van Hoesen, MD; William Mundo, MD, MPH; Savannah Mierau, BA; Camille J. Hochheimer, PhD; Lucas Eggers, BS; Steven Shaw, MS; Brian C. Russo, PhD; Elaine Reno, MD
Link to article: https://www.wemjournal.org/article/S1080-6032(22)00197-1/fulltext
CME Available: https://wms.org/members
Part 2: Mountain Rescue
Link to article: https://www.wemjournal.org/article/S1080-6032(22)00213-7/fulltext
Part 3: Marine Medicine
Link to article: https://www.wemjournal.org/article/S1080-6032(22)00196-X/fulltext
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