Awesome field guide for any Wilderness Emergency Medical practitioner

Snakes & snake bite in Southern Africa by Johan Marais

Recommended manual for Wilderness Emergency Medicine course in SA

Preparing for REMOTE wilderness expeditions

• Region specific considerations
• climatological
• meteorological
• geographical
• topographical
• geological
• hydrological
• Environmental resources
• Mental preparation
• Organisational including group psychology and sociological considerations
• Time (the resource you cannot negotiate)
• Equipment / expertise / exercise tolerance and physical abilities of team / evacuation plan

Snow blindness

Also known as ultra-violet eye injury. It is a severely painful condition primarily caused by ultra-violet B radiation reflected by snow, and sometimes even water and sand. This is usually a self-limiting problem and can be mitigated by wearing appropriate eye protection.

Causes of shock in the wilderness emergency medicine environment

Liebermeister's Rule and Faget's Sign: Useful clinical guides in the wilderness environment

For every 1 degree Celcius increase in body temperature, the heart rate increases by approximately 10 beats per minute (Liebermeister's Rule), except in situations where there is a relative bradycardia in a patient with a fever (Faget's Sign). This occurs in:

• Yellow fever
• Typhoid
• Tularaemia
• Brucellosis
• Colorado tick fever
• Legionella pneumonia
• Mycoplasma pneumonia
• Drug fever (Beta blockers)(Beta-Faget Sign)

Blood pressure estimates

With lack of appropriate equipment in the field, simple vital sign assessments might become challenging tasks. Estimation of blood pressure in a patient in the wilderness environment is one example. Without sphygomomanometers, the closest clinical assessment one can do is to determine the presence of various pulses. The presence of a radial pulse denotes a systolic BP of at least 80 mmHg. The presence of a femoral pulse implies a systolic BP of at least 70 mmHg. A palpable carotid pulse implies a perfusing systolic BP of at least 60 mmHg. There have been arguments against these estimates as they can be sometimes unreliable. However, in the field without appropriate equipment, these are acceptable.