Dr. Christopher Van Tilburg, an expert in emergency and wilderness medicine, discusses the innovative use of ketamine for pain management in challenging outdoor settings. He shares insights on administering ketamine during mountain rescues, comparing it to traditional medications like fentanyl. The conversation dives into dosing strategies, environmental considerations, and the importance of patient monitoring. Dr. Van Tilburg also teases his upcoming book, 'Crisis on Mount Hood,' celebrating a century of mountain rescue stories.
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insights INSIGHT
Immobilization Eases Pain Fast
Immobilizing fractures and packaging the patient provides significant pain relief and eases anxiety in wilderness rescue situations.
Pain control goals include enabling rescuers to move and package patients efficiently and safely.
volunteer_activism ADVICE
Ketamine Over Fentanyl for Wilderness
Carry ketamine and oxycodone for wilderness pain management, but rely mainly on ketamine due to its faster action and safer profile.
Avoid fentanyl because of side effects, DEA restrictions, and challenges with intranasal administration in cold conditions.
volunteer_activism ADVICE
Intramuscular Ketamine Dosing Tips
Administer ketamine intramuscularly at about 1 to 2 mg/kg for pain control in wilderness settings.
Expect peak effect within 5-7 minutes and duration of around 30-40 minutes, and redose as necessary during long extrications.
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Crisis on Mount Hood, Stories from 100 Years of Mountain Rescue
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Ketamine Use in Wilderness Pain Management: An Interview with Dr. Chris Van Tilburg
In this episode of Wilderness Medicine Updates, host Patrick Fink discusses wilderness pain control with guest Dr. Chris Van Tilburg, focusing on the effective use of ketamine. The episode delves into how ketamine serves as a versatile medication for pain management, sedation, and intubation in emergency and wilderness environments.
Dr. Van Tilburg, an expert in wilderness medicine with extensive field experience, shares insights on administering ketamine in challenging rescue scenarios, the limitations and benefits of various medications, and practical considerations for field use. The conversation touches on dose ranges, administration techniques, and patient management during rescues. Additionally, Dr. Van Tilburg talks about his soon-to-be-released book, 'Crisis on Mount Hood: Stories from 100 Years of Mountain Rescue,' celebrating the centennial of the Crag Rats, America's oldest mountain rescue team.
Chapters: 00:00 Welcome and New Year Greetings 00:29 Introducing Today's Guest: Dr. Chris Van Tilburg 03:07 Podcast Shoutouts and Listener Appreciation 03:37 In Conversation with Dr. Chris Van Tilburg 05:58 Challenges of Wilderness Pain Management 09:37 Pain Management Strategies 14:23 Ketamine vs. Other Pain Medications 18:01 Ketamine Dosage and Administration 22:16 Nitty Gritty Tactics: Needle Sizes and Administration 23:02 Intramuscular Injection Sites and Techniques 24:22 Timing and Dosage of Ketamine Administration 25:16 Challenges in Mountain Rescue Situations 27:17 Case Study: Seizure Patient and Ketamine Use 29:18 Considerations for Head Injuries and Ketamine 33:03 Medications in Wilderness Medical Kits 34:02 The Art of Wilderness Medicine 37:54 Protecting Medications in the Field 38:55 Wrapping Up: Upcoming Book and Final Thoughts
As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.
Wilderness Medicine Updates 