Wilderness Medicine

A

• Accidental Hypothermia - Staging and Active Rewarming

  Use Swiss staging by core temperature and mental status; prioritize gentle handling, airway and ventilation with warmed oxygen, and active internal rewarming for moderate to severe cases.
• Avalanche Burial - Resuscitation and Hypothermia

  Scene safety and transceiver search, rapid extrication, airway clearance, and CPR when indicated; consider prolonged resuscitation in hypothermic arrest and transport to extracorporeal capable center.

E

• Exertional Heat Stroke - Cold Water Immersion First

  Core temperature over 40 C with CNS dysfunction requires immediate whole body cold water immersion when feasible; cool first, then transport while managing airway and electrolytes.

F

• Frostbite - Field Rewarming and tPA Considerations

  Rapidly rewarm in warm water when refreezing risk is controlled; give analgesia and aloe, avoid rubbing, and consider thrombolysis and imaging in severe cases at specialty centers.

H

• High Altitude Illness - AMS HACE HAPE Management

  Recognize spectrum from AMS to HACE and HAPE; stop ascent, give oxygen and acetazolamide or dexamethasone as indicated, and descend for severe illness.

L

• Lightning Injury - Triage and Resuscitation

  Reverse triage applies: treat those in respiratory arrest first with immediate ventilations; evaluate for cardiac arrhythmias, burns, tympanic rupture, and neurologic deficits.

M

• Marine Envenomation - Jellyfish Sting Care with Vinegar and Hot Water

  Inactivate nematocysts with vinegar for select species, remove tentacles carefully, and use hot water immersion for pain; avoid freshwater rinsing that can trigger discharge.

N

• Nonfatal Drowning - Airway and Ventilation Algorithm

  Prioritize airway and ventilation with spinal precautions when indicated; give oxygen, consider CPAP or intubation for hypoxia, and observe for delayed pulmonary edema.

S

• Snakebite Pit Viper - First Aid and Antivenom

  Keep patient calm, immobilize the limb at heart level, avoid incision or suction, and transport for assessment and antivenom when indicated; monitor for coagulopathy and compartment syndrome.

W

• Wilderness Anaphylaxis - Epinephrine Field Management

  Recognize rapidly with skin, respiratory, or circulatory compromise; give intramuscular epinephrine in the lateral thigh promptly, repeat as needed, and evacuate after stabilization.