Ep. 8 - SAR Provider Injuries & Traveler's Diarrhea Treatment
Jul 28, 2023
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Explore the heightened risks faced by Search and Rescue providers during mountain operations, with revelations from a 20-year study on injury prevalence. Learn about the injury patterns among professionals versus volunteers, and dive into a harrowing tale of traveler's digestive distress. Uncover the symptoms and causes of traveler's diarrhea, especially when venturing into developing nations. Gain insights into treatment options and the careful consideration needed for antibiotics, alongside engaging with the wilderness medicine community for more shared experiences.
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Quick takeaways
Occupational accidents significantly threaten SAR providers, with most injuries occurring during training sessions rather than rescue operations.
Traveler's diarrhea commonly results from bacterial infections, necessitating cautious antibiotic use while promoting symptomatic relief strategies.
Deep dives
Occupational Hazards Among SAR Providers
Occupational accidents pose significant risks for search and rescue (SAR) providers, as evidenced by a comprehensive review of insurance claims from the Italian CNSAS organization. Over a 20-year period, 784 providers were injured in 755 accidents, with 41% occurring during rescue operations and 59% during training sessions. The study highlighted that high-energy falls were the most common cause of trauma, representing 44% of cases, while vehicle-related accidents contributed notably to fatalities—indicating that operations under challenging conditions elevate the risk significantly. Ultimately, the findings suggest that the majority of injuries are non-fatal and occur more frequently during training, underscoring the need for heightened safety measures in such high-risk environments.
Understanding Traveler's Diarrhea
Traveler’s diarrhea is a prevalent issue for individuals returning from journeys to developing countries, affecting a significant percentage of travelers, often resulting in abdominal pain and multiple loose stools. The majority of acute cases stem from self-limiting bacterial infections, with common pathogens including E. coli, Salmonella, and Shigella, while viral infections account for a substantial fraction. Although antibiotics like ciprofloxacin can effectively treat bacterial cases, their use is cautioned against in situations involving blood in stool or fever, due to the risk of complications. As a result, symptomatic treatment methods like loperamide can be recommended, particularly in cases where antibiotics could exacerbate gastrointestinal issues.
Persistent Diarrhea and Its Causes
Diarrhea exceeding 14 days in duration—termed persistent diarrhea—can stem from several underlying issues, including ongoing infections, dysregulation following an initial illness, or an unmasking of chronic gastrointestinal diseases. Notably, parasites such as Giardia are often responsible for longer-lasting symptoms and should be investigated if diarrhea persists beyond two weeks. The decision to use antibiotics in such cases should be approached with caution due to potential complications like malabsorption or secondary infections, including C. difficile. Understanding these dimensions of persistent diarrhea underscores the complexity of gastrointestinal health post-travel and the need for tailored management strategies.
In this two-part episode, I review an article from the Annals of Emergency Medicine "Occupational Accidents Among Search and Rescue Providers During Mountain Rescue Operations and Training Events"