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The podcast for medical providers at the edges, bringing you digestible updates at the growing edge of Wilderness Medicine, Wilderness EMS, Search and Rescue, and more.
20 Episodes
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In episode 17 of Wilderness Medicine Updates, host Patrick Fink delves into the ICAR resuscitation algorithm for buried avalanche victims. The episode reviews the physiology of avalanche burial and discusses critical determinants of survival, such as duration of burial, airway patency, signs of life, and lethal injuries. The Basic Life Support (BLS) and Advanced Life Support (ALS) algorithms are explained in detail, with a focus on the practical application for both amateur and professional r...
In this episode, I share an intense story of dealing with a suprise medical condition during a backcountry hut trip in Colorado. I walk through the diagnostic process, treatment options, and the importance of preparation for stays in remote places. Essential medications and tools needed for handling such emergencies in remote settings are discussed, along with advice on how to prepare for future expeditions.My articles on The-High-Route.comThe Hut Medication CardChapters: 00:00 Introduct...
This episode, I look at a study from the Eurac research group on rates of airway occlusion in critically buried avalanche victims. Eurac looked at this critical feature of avalanche resuscitation triage as it both affects the way we treat buried avalanche victims, and it helps us to better understand whether technologies like the black diamond Avalung (retired) and the Safeback SBX can help us survive longer under the snow if buried. Full study text HEREThe High Route article on the Safeback ...
Today, we discuss updates in the WMS guidelines regarding the protection of patients with suspected spinal injuries.The Wilderness Medicine Society Clinical Practice Guidelines are all open-access, and you can find links to all of these guidelines on the right sidebar of this page.The education in this episode is based on the:Wilderness Medical Society Clinical Practice Guidelines for Spinal Cord Protection: 2024 UpdateIf you've never seen a vacuum mattress before, this video (2:10) gives a g...
This episode is a repost of an interview that was first posted on The High Route Podcast. Hosted by the editor of The-High-Route.com, Jason Albert, we discuss my background in wilderness medicine, and then move on to discuss the research that support my argument and assertion that the avalanche airbag backpack should be standard equipment for backcountry skiers, snowboarders, snowmobilers, and anyone who regularly works or recreates in avalanche terrain. Check out The-High-Route.com for aweso...
This is part 1 of a multi-part series on the resuscitation of critically buried avalanche victims. In this episode we learn the physiology that we need to understand the resuscitation algorithm. To learn the necessary biology, we follow a rider as they are carried in an avalanche, subjected to traumatic injury, and are then buried and begin to asphyxiate and cool. The background of this episode is useful to understand why:-Cardiac arrest from trauma is usually unsalvageable;-Arrest due t...
Episode 11 brings you my conversation with Michael Buchanan is a flight paramedic and senior firefighter / paramedic at the West Valley City Fire Department. He is the founder and operation of Mountain Medical Academy, a passion-driven backcountry medical care education company. We discuss the medical care of avalanche victims which Michael has made accessible to recreational skiers and riders who don't have a medical background. Other topics that we discuss include:-Finger sweeps...
In this episode, I discuss the article "Arterial Occlusion Effectiveness of Space Blanket-Improvised Tourniquets for the Remote Setting". In this short blast I get into the meat of this article, and though the authors would tell you that space blankets aren't ready for primetime, I have some thoughts on the matter. In the podcast, I mistakenly say that you need to be a WMS member to access this article, but you don't! It's available open access here:https://www.wemjournal.org/article/S1080-60...
In this episode Dr BZ is back to talk about his experience deploying with the Federal Emergency Management Agency (FEMA) Urban Search and Rescue Task Force (USAR). Dr BZ just returned from a deployment with FEMA USAR to Lahaina, HI, where he served as a team physician supporting rescue and recovery efforts there.We touch on:-Training and gear-Deployments and schedule-Compensation-The care of canines-How you can get involved, and more!Get in touch with Patrick: Send me a text.As always, thanks...
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" https://doi.org/10.1016/j.annemergmed.2022.12.015In the second half, we review the treatment of diarrhea in the returning traveler.Get in touch with Patrick: Send me a text.As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. Connect with us by email at wil...
In this second Fast Push, you get a riff on a great article from JEMS entitled "Safety is Third, Not First, and We All Know It Should Be" by Christopher Davis MD et al.Apologies to all who got V1.0-- something weird happened in post that made me sound like a chipmunk. I might be a medical professional, but I'm no AV specialist. Summary:1. Get the Job Done2. Have Fun3. Safety ThirdGet in touch with Patrick: Send me a text.As always, thanks for listening to Wilderness Medicine Updates, hos...
In this episode I go deep on the health effects of wildfire smoke, answering some key questions that are relevant to recreational athletes, outdoors professionals, wildland firefighters, and industrial athletes alike:Why is wildfire smoke harmful?Is there a safe level of exposure?Can we trust the EPA's guideline levels? (Spoiler: no)Does the benefit of exercise outweigh the damage of smoke exposure?If you have to be outside, how can you limit harms?And more. Get ready for a trip down nerd lan...
In this inaugural interview episode I have the pleasure of grilling Dr. Brant-Zawadzki about operating an urban EMS system at a wilderness boundary.We talk about:- Improvising outside the protocol- Interfacing with SAR, rangers, and road workers- How response kit and expectations are changed beyond the pavement- What a fellowship in Wilderness Medicine can do for you careerAnd more!Show Links:EMS Fellowship, U of UWilderness Fellowship, U of UUnified Fire AuthorityBecome world class by combin...
In this episode we review the available evidence, and the pros and cons, of using mechanical CPR devices like the LUCAS or Autopulse for ski patrol and mountain rescue applications. Episode links:CPR With a Lucas Device - An example video from EMS trainingViglino et. al. - Outcomes of On-Hill Cardiac Arrests - More saves, probably because of younger patients, bystander CPR, shockable rhythms, and shorter time to defib.WMS Guidelines on the Care of Avalanche Victims - Recommends LUCAS use for ...
In this episode we discuss the HOPE score, a tool that improves our ability to select the severely hypothermic patients who can benefit from warming with extracorporeal life support (ECLS). We begin the with the case of Tayyab Jafar, a young man who was successfully resuscitated from severe hypothermia with both cardiopulmonary bypass and ECMO, but not without incident. We then discuss the derivation and validation studies for the HOPE score. You can calculate and use the HOPE score at ...
For today, a new format, the Fast Push: Quick updates that you need to know sooner rather than later.This fast push tackles the growing issue of avalanche beacon interference. To see the source post and useful graphics, check out this link to the Utah Avalanche Center:https://utahavalanchecenter.org/blog/74828TL:DR-Electronics, magnets, heated/foil line clothes near your beacon are bad. -They need to be at least 20cm away from your transmitting beacon, and 50 cm away when you're performi...
Methoxyflurane: inhaled gas of the past and prehospital analgesic of the future? Only if we’re talking about ‘the future’ in North America. Used in Australian EMS for almost half a century, this safe and effective medication is only now starting to get the attention that it deserves outside of the down-under.Today’s paper:Trimmel, H., Egger, A., Doppler, R. et al. Usability and effectiveness of inhaled methoxyflurane for prehospital analgesia - a prospective, observational study. BMC Emerg Me...
Today we look at IV acetaminophen vs IV NSAID vs topical lidocaine vs placebo for treatment of pain due to scorpion stings, with some bonus learning on tramadol.Turgut K, Yavuz E, Gülaçtı U, Aydın İ, Sönmez C, Aktaş N, Arslan E. Comparison of Intravenous Paracetamol, Dexketoprofen Trometamol, or Topical Lidocaine Use for Pain Relief in Scorpion Stings: A Placebo-Controlled, Randomized Study. Wilderness Environ Med. 2022 Dec;33(4):379-385. doi: 10.1016/j.wem.2022.08.002. Epub 2022 Oct 11. PMID...
Is intranasal fentanyl safe and effective for the treatment of acute severe pain on the ski hill?Lynch TV, Callas PW, Peterson TD, Schlein SM. Intranasal Fentanyl for On-the-Hill Analgesia by Ski Patrol. Wilderness Environ Med. 2022 Sep;33(3):296-303. doi: 10.1016/j.wem.2022.05.003. Epub 2022 Jul 16. PMID: 35851192.DOI: 10.1016/j.wem.2022.05.003Get in touch with Patrick: Send me a text.As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. Connect with...
Welcome to Wilderness Medicine Updates! This podcast, new for 2023, delivers brief reviews of research in wilderness medicine, SAR, disaster/austere medicine, and wilderness EMS to help you stay current and provide the best care to patients in challenging environments. Get in touch with Patrick: Send me a text.As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. Connect with us by email at wildernessmedicineupdates@gmail.com.You can pay us ...
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