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Wilderness Medicine Podcast
#35: Walking Cold Patients
Sep 24, 2024
In this insightful discussion, Dr. Mike Green, an expert in emergency medicine and mountain rescue, delves into the complexities of managing mildly hypothermic patients in wilderness settings. He highlights the surprising benefits of ambulating such patients during rescues, redefining traditional protocols. The conversation also covers the innovative use of CPAP masks for improving oxygenation at high altitudes and the vital role of medical directors in search and rescue operations, emphasizing effective communication and continuous education in wilderness practices.
01:03:27
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Quick takeaways
- The debate over the treatment of mildly hypothermic patients highlights contrasting guidelines from the Wilderness Medical Society and the International Commission for Alpine Rescue.
- Recent studies demonstrate that mobilizing alert mildly hypothermic patients to safety may not result in adverse outcomes, challenging conventional treatment approaches.
Deep dives
Walking Mildly Hypothermic Patients: Guidelines and Controversies
Current guidelines regarding the treatment of mildly hypothermic patients have generated debate within the medical community. The Wilderness Medical Society (WMS) guidelines state that patients with mild hypothermia should be insulated and calorically replenished without walking or standing for 30 minutes. In contrast, the International Commission for Alpine Rescue (ICAR) suggests that awake and alert patients may begin mobilization if it aids their rescue. This divergence in recommendations stems from differing interpretations of the potential risks associated with after drop, which can occur when a hypothermic patient is relocated.
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