20 SUMMER 12

Volume 29, Number 3

Everest Expedition 2012 Q&A with Dr. Charles Clarke Best Wilderness Medicine Books 6th World Congress Program Schedule! WHAT'S INSIDE

Wilderness Matters Arthur (Tony) Islas, MD, FAWM...... 4 INSIDE Everest Expedition 2012: A Gutsy Trek Nancy Pietroski, PharmD...... 6 Wilderness Medicine A quarterly magazine published by the Best Wilderness Medicine Books: A Reading List Wilderness Medical Society Seth C. Hawkins, MD, FAWM...... 8 The Wilderness Medical Society makes Everest Expedition no representations regarding the legal 2012 Q&A with Dr. Charles Clarke or medical information provided by the Sam Schimelpfenig, MD...... 10 individual authors in Wilderness Medicine magazine. Be Careful Out There: Poison Oak, Ivy, Sumac The goals of Wilderness Medicine 6 SFC Theodore Morgan...... 12 magazine are to: 1. Provide timely information regarding Reach Out-Community Education: Top 10 Topics Wilderness Medical Society news and Q&A with Dr. activities. Debra Stoner, MD, FAWM...... 14 Charles Clarke 2. Provide a forum for exchange of ideas and knowledge regarding wilderness, Great Gear for Work and Play: Deep in the Editor’s Pack environmental, and travel medicine. 3. Disseminate wilderness medicine Christopher Van Tilburg, MD, FAWM...... 16 information to the wilderness, 8 outdoor, and travel community. Trail Mix: Nutrition for Adventurers—Top 10 Best Backcountry Foods Wilderness Medicine (ISSN 1073- Mary Ryan, MS, RD, CD...... 18 502X) is published online quarterly in Best Wilderness January, April, July, and October by the Wilderness Medical Society, 2150 South Medicine Books Footprints for Kids: Top 10 Outdoor Activities for Kids 1300 East, Suite 500, Salt Lake City, Debra Stoner, MD, FAWM...... 20 Utah, 84106. Submit request to reprint Wilderness Medicine in whole or in part to copyright.com. In Memoriam—James A. Wilkerson, III, MD, FAWM 10 ...... 21 ©2012 Wilderness Medical Society. All rights reserved. To Be Or Not To Be “Certified” in Wilderness Medicine Debra Stoner, MD, FAWM...... 22 WMS Editorial Office & 6th World Congress Advertising Sales Jonna Barry Program Schedule! Tactical Combat Casualty Care Guidelines Updated 1505 N Royer St Brad Bennett, PhD, EMT, FAWM...... 23 Colorado Springs, CO 80907 Tel: (719) 330-7523 Fax: (801) 705-1483 Committee Roll Call...... 23 Email submissions to [email protected] 29 Photo by Paul Morrison. Cliff Notes Design & layout: Ali Arastu...... 26 CoPilot Creative 301 E Pikes Peak Ave Colorado Springs, CO 80903 Photo by Steve Rogers. 6th World Congress Program Schedule...... 29 copilotcreative.com Cover photo: Descending to Vignettes Hut, day 6 of Haute Route ski tour, Penniene Alps, near Swiss-Italian border by Christopher Van Tilburg. WILDERNESS MEDICINE // Summer 2012 3 WILDERNESS MATTERS Arthur A. (Tony) Islas MD, MPH, CAQ – Sports Medicine, FAWM, President WMS EditorIAL STAFF

Christopher Van Tilburg, Thank You MD, FAWM Editor-in-Chief I’d like to thank all of those who have helped run the WMS machinery these past two years. First thanks to the office staff, Loren Jonna Barry Greenway, Teri Howell, Jim Ingwersen Managing Editor and Jonna Barry, who help to create the “Society” much more than any of us in the administration do. I am grateful for all the extra time and energy they spend on societal Seth C. Hawkins, MD, FAWM issues. Thanks, guys! Senior Editor

I’d also like to thank those members who served on the board during the past two Debra Stoner, years. I’m always inspired to see the amount MD, FAWM Associate Editor I write this, my last edition of Wilderness Matters, just of time and energy that people give towards the WMS. Thank you all for supporting the having completed the Everest WMS Base Camp trek, WMS and making my job much easier. Larry E. Johnson, and I am still a little jet lagged. My mind is still swirling MD, PhD with that mixture of mountains and culture that is Lastly, I’d like to thank the executive Assistant Editor Nepal. However, out of this haze I’m keenly aware that committee, the working group of the board: my time as president of the WMS is just about up, and Colin Grissom, Jay Lemery, Brad Bennett I have a few things to say before I step down. and Eric Johnson. I trust these individuals implicitly and cannot put into words how Contributing Editors The Society grateful I am for their commitment and Nancy Pietroski, First and foremost, I feel that I am leaving the reigns of the Society camaraderie over the last two years. Thank PharmD in better shape than when I took them over. Financially, we are you, my brothers. Upcoming on the upswing and are able to cover our bases now without Conferences cutting into our savings. This change is mostly due to an increase Moving Forward wms.org/conferences Sam Schimelpfenig, in membership. I challenged the Society two years ago that by As I step down at Whistler, I am excited about MD the Whistler World Congress in July 2012, my goal was 3,000 the future of the WMS under the leadership February 2-9, 2013 members. I’m happy to report we have 3,033 members today and of Jay Lemery. Jay is a dynamic and innovative MedSail: Medicine for Mariners, our membership is continuing to rise. leader and will be a great president for the British Virgin Islands Society. He’s a unique combination of an Lynn Yonge, MD, FAWM Why are we increasing in membership? We are offering more to academic thinker and an approachable, down- February 14-20, 2013 our members. We now have two additional learning programs to-earth guy. The Society is lucky to have him. Winter Wilderness & Mountain creating quite a buzz: beyond the Fellowship we have the Diploma I wish Jay all the best and will be happy to Medicine Conference, Canyons of Mountain Medicine and the Masters Fellow Program. In continue serving the Society as immediate Resort, Park City, Utah addition, we have offered more educational opportunities both past president during his presidency. Editors Emeritus online and at our meetings. Case in point, our year 2011-2012 July 11-17, 2013 Edward Geehr, MD 1984-1986 Howard Backer, MD 1986-1991 has been the busiest year in recent WMS history. We started with Whistler! 30th Annual Summer Conference Eric A. Weiss, MD 1991-1994 our Snowmass Annual Meeting in July 2011, hosted a Desert Lastly I’m looking forward to Whistler! The on Wilderness Medicine and Karl Neumann, MD 1994-2002 Meeting in Tucson in November, held our winter Park City international meetings are always some of the Annual Meeting, Beaver Run meeting in February, put on the Everest Base Camp CME treks best for stirring lectures and exchanging ideas Resort, Breckenridge, Colorado April and May 2012 and now ending with the Whistler World on wilderness medicine topics. In addition, the Congress in July. I firmly believe that if you give our members facilities are top notch and the mountains are October 30-November 3, 2013 new opportunities to learn and grow within the WMS, the just beautiful. I hope to see as many members Environmental Change & Human membership as a whole will grow as well. Our newest membership as possible and spend some time hiking and Health, Dauphin Island Sea Lab, initiative is to call our soon-to-be-expired members, as well as exploring the British Columbia mountains! Dauphin Island, Alabama our lapsed members, and remind them to renew so they don’t Come with me if you get a chance! miss any issues of the Journal or any of our terrific conferences. I believe this has helped to increase our membership, which has In Peace, helped stabilize and strengthen the Society. Tony

4 WILDERNESS MEDICINE // Summer 2012 Photos by Nancy Pietroski. Everest Then, I bonked. Imagine what the odiferous mélange of burning kerosene, frying soybean oil, smoking yak dung, and shared toilets does to an already depleted appetite. As it happens, my husband, Dave Smith, had developed a URI a couple of days before and was getting increasingly exhausted. After the Gorak Shep hike, he had an oxygen saturation of Expedition 57% and faint rales in his left lung. He was put on oxygen overnight, and we both descended to Pheriche with our guide Min, grateful for an atmosphere slightly more saturated with rich air. The only thing I was able to eat with 2012:Nancy Pietroski, PharmD gusto for a few days after we descended were Pringles potato A Gutsy Trek chips, which were available in every lodge, teahouse, and little stand along the trail. I hope the locals his is not the story of a reaching the final destination of Everest Base Camp (EBC) with the first of have not adopted this unhealthy snack, and it is a staple that exists solely Tthree groups of the WMS “Everest Expedition 2012” trekkers. Instead, it’s a tale of how, despite for the diet of international trekkers! your best physical preparation, your body can betray you and things can go not as planned. Although disappointed not having made it to EBC, the consolation in Pheriche were views of the stunning Ama Dablam. Once on the mend, I saw patients with the docs in the HRA clinic. Ailments ranged from Eleven of us in the WMS-Peak Promotion group with On the fourth day, gastrointestinal disaster struck me. On common Nepali respiratory crud to HACE and HAPE cases that needed leader Dr. Scott McIntosh, four Sherpa guides, assorted the hot, steep, dusty trail – teeming with trains of zopkios to be evacuated by helicopter: every chopper that landed generated porters, and zopkios (a yak-cow hybrid), departed loaded with pounds of poop, hundreds of trekkers’ boots, much local excitement. kaleidoscopic, but fumey Kathmandu, anxious to escape blooming rhododendron pollen – I was suddenly gripped the “Kathmandu Cough” and the frenetic nonstop tooting by Nepalese tourista. I staggered up the trail to Tengboche When the group rejoined us a couple of days later, they were exhausted of car and motorcycle horns, where locals race frantically (3860 m, 12738 ft), while the lead guide, Tendi, ran up and in need of a shower, but had exciting tales to tell: two days and but purposefully. The night before we left, the majority of ahead to rummage in the first aid kit for Cipro. Thus began nights at EBC visiting Everest ER (everester.com); meeting Dr. Luanne the trekkers on the trip had enrolled in Scott’s acetazolamide a grueling bacteriologic warfare in my gut which grindingly Freer and the WMS Everest summit team; attending the last of the CME study (randomized to 125 mg BID vs. the lower dose of ate away at my appetite and increased the risk for AMS. lectures; observing a puja ceremony; climbing the icefall (the Camp II 62.5 mg BID) and received the first of a series of CME group); eating the best high altitude pancakes for breakfast in the cook lectures: most aptly on Acute Mountain Sickness. The next day, we made it from Tengboche to Pheriche tent; and the sheer craziness of the over 1000-person base camp. (4240m, 13992 ft), and the Himalayan Rescue Association

After the breathtakingly short landing at the Lukla airport clinic (www.himalayanrescue.org). After a rest day, we were We then put in two very exhausting days descending (and ascending) (2840m, 9372 ft), we embarked upon a standard Everest joined by Maria, one of the clinic docs, as we trudged up all the way from Pheriche to Namche Bazaar, where we met the second Base Camp trek, fueling our lusty appetites with repasts in to Loboche (4910 m, 16203 ft), then on to desolate Gorek WMS trek group led by Tony Islas. Then from Namche to Lukla we tea houses and lodges of Phakding (2610 m, 8613 ft) and Shep (5140 m, 16962 ft). For days, I had been plying myself wound our way through the lush and oxygen-rich district of Bengkar Namche Bazaar (3440 m, 11352 ft). We feasted on momos with a concoction of acetaminophen for hangover-severe (2630 m, 8679 ft). (like dumplings), fried noodles and “veg,” and mac ‘n’ headaches, antibiotics, antispasmodics, antiemetics, Pepto- cheese Nepali-style. At night, we passed around the pulse Bismol, and electrolyte solution. But I was still nauseated and We all recovered in the now delightfully chaotic Kathmandu and were oximeter with appetizers. anorexic. We made the slow plod to the peak of Kala Patthar never left unattended by the Peak Promotion guides even as they readied (5550 m, 18315 ft), and the day and panoramic vistas were for other treks including the third WMS group led by Paul Auerbach. achingly beautiful. We could see the gravelly village of EBC Our family and friends loved following our progress on the blog and it’s at the base of the Khumbu Ice Fall and perfect mesmerizing a wonderful memento of a momentous trip in a magnificent land. views of Everest, Lhotse, Nuptse, and Pumori.

6 WILDERNESS MEDICINE // Summer 2012 Every issue, this magazine presents book reviews been written yesterday, especially in the description of the of recent publications. This issue we would like divergence of rescue teams and the outdoor communities to take a step back and profile the cream of the they serve, and the increasing absence of a sense of self- reliance in “victims.” crop – the best wilderness medicine books of the past decades. These volumes are must-reads for Wilderness Medicine. wilderness medicine novices, unexpected gems for Emergency Medicine Clinics of North America veterans, and worthy reads for seasoned experts. 2004;22(2). Sholl JM, Rathlev NK, Olshaker JS, eds. This There are so many great books, we will continue to quiet installment in the EM Clinics of NA series is often expand this list in future issues, describing the best overlooked, but manages to simultaneously offer up-to- of the best. What would make your top list? date introductions to standard wilderness medicine topics while also offering groundbreaking discussions of topics previously lacking academic attention. Russell’s discussion Wilderness Medicine 6th ed. in this text of “Wilderness EMS Systems” is a landmark Auerbach PS, ed. Philadelphia: Elsevier Mosby, 2012. essay, and remains one of the few academic writings Now in its 6th edition, the revered definitive wilderness addressing WEMS systems analysis. Wilderness Medicine Books: medicine textbook remains the broadest and most well- The Best recognized text on the subject. What other wilderness Handbook on Drowning. Bierens JJLM, a Reading List (Volume I) • Seth C. Hawkins, MD medicine text covers “Space Medicine” or “Global Crimes, Incarceration and Quarantine?” Auerbach’s work tackles ed. Berlin: topics both familiar and esoteric, to build a remarkably Springer-Verlag, 2006. No other wilderness medicine deep and broad vision of the state of the art in wilderness topic receives such an exhaustive, international, single medicine. text treatment. A “congress book” generated by the Board of Governors of the Maatschappij tot Redding van Mountain Rescue Doctor: Wilderness Drenkelingen (founded in 1767), this text represents the worldwide state of the art in drowning management, as Medicine in the Extremes of Nature. defined by the First World Congress on Drowning held Van Tilburg C. New York: St. Martin’s Press, 2007. This is a in the Netherlands in 2002. Not only is this a must-read remarkable book. From one of wilderness medicine’s most for those interested in watersports medicine and rescue, it prolific and gifted writers, it offers an honest dissection also serves as a model for truly international collaboration of the benefits and challenges of pursuing a career as a and consensus establishment in other wilderness medicine wilderness medicine physician. It is requisite reading for subdisciplines. any student who feels the pull to design a physician lifestyle around Wilderness EMS and rescue activities. Into the Unknown: The Remarkable Life Wilderness Search and Rescue. of Hans Kraus. Schwartz SEB. New York: iUniverse, 2005. Schwartz’s book is a fairly straightforward biography Setnicka TJ. Boston: Appalachian Mountain Club of one of the most remarkable figures in the outdoor (AMC), 1980. Over 30 years ago, Setnicka and his team medical world. Kraus worked in an era barely predating wrote “We have attempted a kind of ‘Rescue Guide for formal wilderness medicine, and a few generations later has the Compleat Idiot.’” This text predicted the outdating of been inexplicably forgotten. A legendary rock climber, he the gear it described “in the near future,” and hoped that served as John F. Kennedy’s private back doctor, and Time at some point thereafter SAR groups would be put out of Magazine considered him among the greatest doctors ever. business by a lack of demand for their services. Instead, This book produces new documentation on Kennedy’s the book remains remarkably relevant, unparalleled in death, and how the wilderness-inspired recommendations its comprehensive coverage, and SAR services are more from Kraus (which Kennedy was allegedly days away in demand than ever. For the most part, the techniques from adopting) might have saved Kennedy’s life in Dallas. it describes are still extremely functional. What’s more, This climber-doctor established transformative changes to its philosophical call to arms regarding philosophical, orthopedic and post-injury practice, proposed sweeping legislative and cultural challenges to SAR could have changes to the physical fitness and public health programs

WILDERNESS MEDICINE // Summer 2012 9 What have been your most memorable experiences? Regrettably, but it is inevitable, the more memorable experiences have been when someone died. It is an extremely difficult situation, and you learn a lot about yourself and other members on the team by how everyone responds to that incident. When the & extreme event happens, one often finds oneself totally unprepared, but as the medical leader of a trip you need to think about what to do if the with Dr. Charles Clarke unthinkable actually happens. What advice would you give to the newer members of Sam Schimelpfenig, MD the WMS? Wilderness medicine is a wonderful way to combine the Continued from page 9 daily practice of medicine with something that is uniquely Q Neurologist A and mountaineer Dr. Charles Clarke rewarding. Being able to provide care to people in need longstanding interest in expeditions to remote areas and when you are least expecting it is an immensely satisfying high altitudes and has run an international information personal experience. I would advise members to get as much across the country in the 1950s, while simultaneously service for altitude medical problems and cold injury since experience as they can and if the opportunity ever presents putting up climbing first ascents throughout Europe 1982. Based in United Kingdom, he was elected President itself to be part of an expedition to take full advantage of it – and the United States and playing the leading role in of the British Mountaineering Council in 2006 and is a you never know what the adventure will bring! establishing the Shawangunks as the iconic climbing longtime member of the Wilderness Medical Society. Dr. site it is today. This biography serves as a reminder that Clarke is the keynote speaker for the WMS 6th World What advice would you give to anyone planning on wilderness medicine practitioners are uniquely positioned Congress in July. Recently, we had a few minutes to catch mountaineering or trekking at high altitude? to influence public health, public policy and medical up with him between expeditions to discuss risk, rescues, I remind these folks that the environment they are entering practice in their subspecialties, while still pursuing their and medicine. is inherently dangerous, and they MUST (but can’t) be recreational passions. prepared for everything – it’s serious stuff. Despite the best Dr. Charles Clarke, physician, author and mountaineer. As technology in medicine continues to advance, what preparation, altitude illness is still unpredictable. There is a Medicine for Mountaineering & Other invention has had the most impact in definite risk of morbidity and mortality the higher up one Wilderness Activities 6th ed. Wilderness Medicine? goes. In addition to the usual advice on things to do to help Wilkerson JA, ed. Seattle: Mountaineers Books, 2010. The mobile phone has been the greatest advancement. It prevent altitude illness, I think it is important for them to As a newly minted Wilderness EMT in the early 90s, gives rescuers the ability to consult with experts long before truly understand the risk that they are taking when they this was my go-to book. It was first published in 1967, the patient arrives at a medical facility. It also allows those head to these extremes of our environment. substantially predating Auerbach’s more academic who are injured to summon help almost immediately if textbook. Wilkerson admirably kept it up to date with needed instead of the former situation where someone What is your opinion regarding helicopters rescues at frequent updates, the most recent being in 2010. The text potentially traveled for days just to get in touch with the high altitude, in places like the Himalayas? originated in the mountaineering community, but proved outside world. Wilderness medicine has always been a I don’t see any reason why helicopters shouldn’t be used in so functional for other environments that the clumsy but unique specialty because providers have to use their clinical situations where it is appropriate to use them. The problem more accurate “& Other Activities” title expansion was skills and judgment, as well as the materials on hand to is when they are used in a situation that doesn’t require their added a few editions ago. This textbook is simultaneously treat patients, without being able to rely on the diagnostic use. Every rescue scenario generally involves some level of risk a landmark mountaineering medicine classic in its 1967 testing available in a hospital setting. But even with some for the rescuer, so you have to take that into account when edition and a cutting edge universal wilderness medicine of the newer inventions being carried on expeditions, deciding on the best approach to a situation. Helicopters are text in its 2010 edition. We acknowledge the late Dr. wilderness medicine providers are still practicing “old- used in other parts of the world with great success, and as Wilkerson, a wilderness medicine leader and icon, in fashioned medicine,” which is one of the most rewarding long as their use is regulated in some way, I think it will be a these pages. aspects of this field. great tool to have available in the Himalayas.

10 WILDERNESS MEDICINE // Summer 2012 WILDERNESS MEDICINE // Summer 2012 11 Identification “brushed” on the patient as he or she unknowingly walks by “Leaves of three, let them be” the offending plant. This “streaked” distribution of the rash This venerated rhyme has long served as a primary tool is often a major consideration in diagnosis. in the identification and avoidance of the toxicodendron species. While it serves to remind us of the three leaflet For minor rashes apply soothing lotions, such as calamine, configuration of poison ivy plants, this verse unfortunately to ameliorate itching. If initiated prior to vesicle formation, falls short in the identification of the other two major topical steroid preparations can be used to reduce symptoms. offenders. It lacks the specificity to target poison oak, with Topical antihistamine preparations should be avoided, as its 3-5 leaflets, and it is completely confounded by the 7-13 they will have no leaflet configuration of effect on the cell poison sumac. mediated allergic reaction and they Consider a less-known “Leaves of three, have the harmful verse, “berries white, potential of poison sight,” which let them be inducing skin refers to the small “ sensitization. clusters of berry-like fruit that can be found at the junction of the leaf stem and plant body. Green in the summer For more severe outbreaks, typically found in highly sensitized months and turning to off-white in the fall, this fruit is individuals or those exposed to large quantities of urushiol, found on all three plant varieties, and therefore serves as consider systemic corticosteroid therapies such as an oral Poison Oak, Ivy and Sumac an important tool in the identification of toxicodendron regimen tapered over 14-21 days, or a single intramuscular species. injection of a long-acting steroid such as triamcinolone acetonide. This treatment has potential benefit in the austere This infamous trio of the toxicodendron species of plants Treatment or travel setting, where complex oral dosing regiments can is certainly well known to those of us who make a habit be impractical. of venturing into the wilderness. Most of us have at some After urushiol exposure, immediate treatment involves attempts to decontaminate skin by removing urushiol resin Regardless of the severity of the outbreak basic medical point experienced the intensely pruritic, weeping rash before it can be absorbed and initiate a reaction. A mere 10 principles still apply. The affected area should be kept of toxicodendron dermatitis that results from coming in minutes after exposure 50% of surface urushiol has been clean and efforts should be taken to maintain skin integrity contact with the resin urushiol, found in all three of these absorbed into the skin, and by 30 minutes all of the resin and prevent excoriation from overzealous scratching. As plants. Urushiol induced rashes can vary in severity from has been absorbed and it can no longer be rinsed off. A always, and especially in the wilderness setting, the affected variety of commercial products are available, but the most area should be closely monitored for the development of minor nuisance to debilitating condition, making their widely recommended technique simply involves using a secondary infection. prevention and treatment an important consideration to gentle cold water rinse, with or without a mild soap. SFC Theodore Morgan is a Special Forces medic and instructor at the Joint Special anyone planning an excursion into the woods. Operations Medical Training Center at Fort Bragg, NC. He is a graduate of Western Delayed treatment occurs after an urushiol rash develops. Carolina University’s Emergency Medical Care program with a concentration in Typically the toxicodendron dermatitis rash develops about wilderness medicine.

two days post exposure, but this time can vary from as little Recommended Reading as five hours to as long as two weeks. Common features Gladman, A.C. Toxicodendron Dermatitis: Poison Ivy, Oak, and Sumac. Wilderness include intense pruritis, erythema and vesicle formation. Environ Medicine. 2006; 17:120-8. The latter two signs often appear in a characteristic linear or streaked manner, resulting from the urushiol being

WILDERNESS MEDICINE // Summer 2012 13 5. Trauma. Rappel into this topic with a discussion on head, chest, abdomen and spine injuries. Grab a few colleagues and smear on the moulage for a realistic scenario. Fortify people with the knowledge of when to call for help Top 10 and what to do while they wait. 6. Cold Injury. Approach this topic from a prevention Topics viewpoint, then pop into treatment. Pitch the warning about thaw and refreeze damage along with deleterious Embrace the philosophy of community education effects of alcohol. with Senior Editor Deb Stoner. Grab one of these ten topics to anchor your enthusiasm and teach in 7. Heat Illness. Rock-on with this great topic to present your community. Like a great climb it will leave in the weeks ahead of local adventure races, triathlons or you breathless.—Ed. any extreme sport venue. Navigate through the spectrum of illness by describing a scenario and asking the audience for treatment options. Participation is key to engaging them and anchoring the information.

8. Travel-Associated Diseases. Angle into the Community Education discussion by first asking the audience to share a Debra Stoner, MD, FAWM 1. Clothing and Gear. Pack up your favorite threads “Montezuma revenge story”…any bad case of the squirts is and gear into a daypack. Pull out each item and discuss how sure to “loosen” up the group. Discuss water purification, the right stuff can make the difference between survival disease prevention and treatment. Include CDC references and death. Pull a participant up front and demonstrate the for specific destinations. layering technique for clothing. Keep them a step ahead and review correct footwear for kids and adults. 9. Animal Encounters. Betaflash into this topic with lots of pictures. These lectures draw crowds of all ages. Matching 2. Bites and Stings. Research critters that fly, slither and the behavior to the animal and human, outline precautions, crawl in your locality, then talk to a local entomologist to self-protection during an attack and first aid. put a buzz in your knowledge. Got Scouts…kids love this topic. Fling a few fake snakes and insects around the room 10. Lightning Injury. Bolt into lightening pathophysiology to get their attention. Then allay their fears by reviewing and injury prevention because knowing the why and how chemical, physical and behavioral protection measures. minimizes injury. Strike up the enthusiasm with a learning exercise: at the end of the lecture hold up a large cardboard 3. Wounds, Burns and Lacerations. Tear apart your thunder cloud, give the kids paper raindrops, turn on a first aid kit and repack it with the group. Banish the myth thunder audio and descend on the group asking people to of buttering burns by introducing modern burn treatments. tell one thing they learned during the lecture. Review basics of wound care and when to get professional help. If you like the idea of teaching in your community, visit the WMS Trading Post wms/tradingpost. Many of these topics 4. Contusions, Sprains and Fractures. Immobilize can be purchased as ready-to-teach PowerPoint presentations your participants…literally. Use a volunteer to demonstrate under Educational Products. Known as the Community splinting after discussing sprains versus fractures. Anchor Education Lecture Series (CELS), the lectures are scaled their knowledge; set up stations for practice with make shift down for presentation to the general public. So gear up, step splints such as pack stays and sticks. No need for a rescue out and ascend into the world of community education.

Photo by Debra Stoner team if you teach them the basics and self-extrication.

WILDERNESS MEDICINE // Summer 2012 15 My Haute Route kit: squeezing a Trading in my Avalung for an 4:30 AM, Tilly Jane Sno-Park, Mount weight less, take less: traveling light, 7-days of ski mountianeering gear into airbag pack. Hood Oregon: not the time or place to Verettes, Haiti Great a 36-liter pack. rely on lesser gear. 1 Unbelievable how light and durable gear is nowadays. 6 I’m not a big fan of cramped quarters in bivy sacks For a recent Haute Route ski mountaineering or potato-chip thin pads. I do like high R values for tour, I took the uberlight aluminum and barebones comfort and warmth! My quiver for sleeping: Cocoon trifecta from Black Diamond including Neve Pro Silk Mummy Liner, Mountain Hardwear Phantom Crampons, Raven Ultra Ice Axe, and Couloir Harness 15-degree down sleeping bag, Thermarest Pro-lite pad, for Work and Play (blackdiamondequipment.com). A far cry from my Nemo Obi1 solo tent, and Sierra Designs Anteres 3 tent Gear: 20-year-old steel. (I wouldn’t even think of having anything for a crew. The theme here: warm, light, quality and minimal Christopher Van Tilburg, MD but Dynafit Vertical ST binders on my skis.) accessories.

2 For years I’ve used an artificial airpocket backpack 7 Best invention ever: LED headlamps. Light, bright and Deep in the Editor’s Pack to delay asphyxiation if caught in an avalanche. But long lasting, the Petzl Tikka 2 is the ticket for basic use finally, advanced European technology is obtainable in or try the multibeam Pixa 3 for all-nighters. I’ve been writing about, testing and helping North America. I made the switch to the Backcountry Access Float 38 for mountain rescue and ski mountaineering, the 8 develop gear for two decades. If you’ve followed The backcountry coffee conundrum is finally resolved avalanche airbag which helps prevent burials—it’s the most with Starbucks Via instant shots. Sure, it’s corporate. Great Gear, you know I focus on gear for general affordable backcountryaccess.com( ). For non-skimo trips, But no filter, no grounds, no mess and no bad taste. outdoor use. However it must pass the rigors of I dislike over-accessorized packs so my go-to is the simple, working outside for us mountain docs and nurses, sleek, fast-packing Osprey Falcon 44. 9 Are white gas stoves tools of the past? The MSR ski patrollers, river guides, military medics and Pocket Rocket is compact, light and simple to fire up research scientists. So I’ll unhitch my pack and 3 Let’s face it, clothing is so good nowadays you can foul weather. Get the tiny canisters for an alpine ascent of empty it on these pages. Here are my favorite tools often survive the unexpected night out without a tent. Mount Shasta and you’ll have enough fuel for melting snow I love the Mammut Nordwand hardshell jacket with Sweetwater for work and play. and sipping morning coffee. Don’t forget a Gore-Tex Proshell. It’s light, weatherproof, and a medium Platypus—how did we survive without hydration bags? The fits like a medium. Just to plug softshell/puffy craze, I have 1-liter bag works for an extra container in camp and fits in my third pair of Mammut mountain pants, the latest is my ski coat pocket when skiing inbounds in Chile with my athletic-fit Fiamma pant. Don’t forget a puffy jacket with kids. a hood—bulky insulation of down, like the Patagonia Down Jacket or light, compressible Primaloft polyester 10 Yea, I still am a minimalist. The single most important hoody from Wild Things (mammut.ch, Patagonia.com, parts of my medical kit: tape. I like Johnson and wildthingsgear.com). Johnson waterproof first aid tape and 3M Coflex cohesive self-adhering wrap. Add in some benzoin, wound 4 A long way from the waffle stompers we had as kids, closure strips and AAA meds (antibiotic, anti-anaphylactic, trail shoes are the best all-purpose footwear. From a analgesic), and you’ve got the essentials. 2-hour mountain rescue mission to a 4-day trek of the Inca Trail, the North Face 105 Ultramarathon and the La So, skinny down your pack with this lightweight, compact, Sportiva Wildcat GTX are built for foul weather and trail durable gear; take less and weigh adventure for work or play. speed.

5 On two recent trips to Haiti, I tested water purification systems. But, for weight weenies, you can’t beat Katadyn’s MicroPur chlorine dioxide tablets:

Cramponing up the Col du Chardonnay, skiing from France to Switzerland, no room Photos byTilburg. Christopher for Van extra weight. ultralight, ultracompact, and inexpensive total disinfection.

WILDERNESS MEDICINE // Summer 2012 17 Trail These staples, like peanut butter and jerky, have found their however, potassium is just below 75%, so choosing some Nutrition for Adventurers way into backpacks for a long time. But many variations of high potassium dried fruits or dried starchy vegetables like Mary Ryan, MS, RD, CD these foods have evolved that can enhance the nutritional potatoes or sweet potatoes could boost it. Fat, protein and value while pleasing your palate. Modern trail mixes go way fiber slightly exceed general recommendations, which vary beyond “GORP” (Good Ole’ Raisins & Peanuts) featuring based on personal build and activity. The fats provided here Mix: dried berries and tropical fruits. Tuna, salmon and chicken are largely beneficial poly- and mono-unsaturated varieties come in convenient lightweight foil packets providing high from nuts that are also a tasty, concentrated source of energy quality protein and the fish omega-3 fatty acids. Although and provide a wide array of important micronutrients. backcountry purists eschew “energy bars,” they can be a Choosing a variety of foods during the course of your trip will Sample convenient, lightweight and a potentially nutritious snack likely provide enough of what you need overall, and ideally Backcountry for a long day on the trail. it will average out to 100% over the course of several days. Top 10 Menu If in doubt you can take along a multivitamin supplement. Best Backcountry Foods This is adequate calories, carbohydrates, and more than Breakfast: half of the RDI (recommended daily intake) for vitamins Mary Ryan ([email protected]) is a nutrition instructor at Bastyr University, Stoke the stove, sharpen your Swiss Army Seattle, Washington. She has a private nutrition practice, “Beyond Broccoli,” and is the ¾ c. (dry) Rolled oats and minerals for an average 130-pound active woman. The author of the book NOLS Backcountry Nutrition: Easting Beyond the Basics. knife, and get ready for some mouth watering ˚ 1 Tbs. Peanut butter electrolytes sodium, magnesium and calcium are adequate; wilderness meals. Balancing palatability, ˚ ˚ ¼ c. (total) Dried availability, perishability, convenience, pack cranberries & bananas weight, space, and, of course, nutrition ˚ 1/3 c. Powdered milk we’ve come up with the top 10 backcountry 1 pkt. Hot cocoa foods. These foods are versatile enough to ˚ be used as meals or snacks. Many of the Trail snacks/lunch items on our list have been part of our throughout the day: backcountry repertoire for decades with ˚ 1 oz. Jerky modern variations to improve nutritional 1/3 c. Trail mix content, variety, taste and convenience. ˚ ˚ ½ c. different combos of dried fruit & nuts (to So join us for a chow-down mix things up) backcountry style: ˚ 1 Energy bar 1. Peanut butter or other nut/seed butters ˚ 3 scoops sports drink 2. Jerky made from beef, turkey, bison, mixed with water (plus fish, tofu or tempeh lots of plain water in 3. Trail mix: any combination of dried fruits between!) and nuts/seeds 4. oats, any type of instant, rolled, Muesli, Dinner: or granola ˚ 1½ oz. salmon (from 5. Tuna, salmon or chicken in those handy foil packet) foil packets ˚ ¼ c. Sundried 6. Angel hair pasta or couscous, tomatoes whole wheat ˚ 1½ c. Whole wheat 7. Pesto paste angel hair pasta 8. Chocolate, any type, yum! (cooked) 9. “Energy” or granola bars ˚ 2 Tbs. Pesto sauce 10. Beverages such as coffee, tea, hot ˚ 12 oz. Mint herbal tea chocolate, powdered sports drink or ˚ 1.3 oz. Dark powdered milk chocolate bar

WILDERNESS MEDICINE // Summer 2012 19 Footprints:

In Memoriam

James A. Wilkerson III, MD, succumbed after a brief illness Friday, April 13, 2012. Our longtime friend and colleague, Jim UnpluG was one of the earliest members of the Society and certainly one of its most the Kids! ardent supporters. He served on the Board 7. Ride the trails. of Directors for six years and as Chair of Debra Stoner, MD, FAWM Mountain biking builds strength and balance the Continuing Education Committee skills and is fun for the whole crew. Pop off a wheel for fourteen years. As an Editorial Board and have everyone practice changing a tire. Check member of and Reviews Section Editor out the Rails-to-Trails Conservancy 20,000 plus for Wilderness & Environmental Medicine, miles in the USA www.railstotrails.org Jim was our resident expert on rabies and ticks. A request to give a talk on rabies at a wilderness medicine conference led to his interest in that 8. Go rock climb. No matter the age or subject. Paul Auerbach, coeditor with Oswald Oelz of the Journal, at Top 10 season, scrambling up stone improves agility that time known as the Journal of Wilderness Medicine, invited him to Outdoor Activities for Children and hand-eye coordination. First, learn the basics write a review article on rabies for the Journal. That 1995 review led together from a professional instructor at an indoor to Jim’s chapters on rabies in the fifth and sixth editions of Auerbach’s gym or climbing wall. Then hit your local crag to Wilderness Medicine. boulder or top rope. Over the years, you’ve had lots of tips on getting the grommets into the forests, Jim became interested in wilderness medicine in 1960 when he read an rivers, mountains of the world. Here’s the best picks from 9. Snorkel and dive. Jump in and account in Accidents in North American Mountaineering that he thought get wet along your local coastline, lake or sounded like an unconscious person’s airway had not been kept open Senior Editor Deb Stoner.—Ed. even the pool. Better, take lessons as a family. Take during evacuation. Knowledge about such care was not widespread at time to teach the buddy system and water safety. that time. That led to Jim writing an article on airway maintenance for Plan a family vacation to the coast to peer into the Summit Magazine. That article attracted some interest and promoted the underwater world. idea of a book on wilderness medicine to inform wilderness adventurers Explore your backyard or 4. Backpack. about preventing injuries and carrying out rescues. Jim contacted a a park. Take the plunge, pick a short trail and set up a tent. 10. Volunteer vacations. Swing a number of individuals such as Charles Houston, Herb Hultgren, and Looking for a great introduction to the outdoors for Scout out a loop trail to keep it interesting. Get braver, stay pick, dig in with a shovel and get your hands Tom Hornbein, and together they put together the first edition of toddlers, jump in by plotting a short hike around the yard a few nights, and take day hikes from your base camp. Stir dirty by building or repairing a trail. Sweating it out Medicine for Mountaineering, published in 1967, with a sixth edition or your local park. Pretend you’re a deer looking for a the pot: everyone can help cook. together teaches kids the value of giving back to their published in 2010. The book is cited in this issue ofWilderness Medicine stream or take an insect picture book and help your junior community. Celebrate National Trails Day each year as one of the “best wilderness medicine texts” in the history of the ranger find a spider, butterfly or ant. 5. Go geocaching. in June. Check out the American Hiking Society’s discipline. Take older kids on a high-tech outdoor treasure hunt website www.americanhiking.org/volunteer- 2. Visit a local state park. game and teach valuable GPS skills. Find hidden objects or vacations Jim’s interests in wilderness medicine expanded with work on that book. State parks have short and long hiking trails, ideal containers in one of many different caches, for all levels of The Mountaineers Books suggested he write book on cold injuries, for beginners and experienced family treks. Give everyone skill. Check out: www.geocaching.com Give them the outdoors, and, in the words of A.A. which led to the 1986 book Hypothermia and Cold Injuries with Cam a map and orientate your young hiker to map reading Milne, you will have left them with a piece of yourself: Bangs and John Hayward. Twenty years later Gordon Giesbrecht and skills. Check out the nature center or just go fly a kite. 6. Power up a paddle. “If ever there is tomorrow when we’re not together… Jim together completed a second edition. Even small children can sit in a canoe, kayak or there is something you must always remember. You 3. Car camp. rowboat and begin to learn to paddle. For older kids, make are braver than you believe, stronger than you seem, Jim shared his adventures with his wife Sam and their large and close Pile the gear in, jump in the car, and spend a few them stroke! Opportunities abound to educate them on and smarter than you think. But the most important family. He was a mountaineer, whitewater rafter, backpacker, scuba diver, nights in your closest campground. You’ll still have a big water, sun and insect safety. thing is, even if we’re apart…I’ll always be with you.” and skier. He received his medical degree from John Hopkins in 1958, metal security blanket for comfort. Hide the matches completed a Fellowship at the Ronald Regan UCLA Medical Center in and teach kids to use a fire-igniting tool to practice fire 1965, and had a successful pathology practice in Merced, California, building and safety…with supervision! until retiring to Park City, Utah several years ago.

WILDERNESS MEDICINE // Summer 2012 21 Committee Roll Call

If you are interested in getting involved, joining a committee is a great place to start. Some are quite active and need help. Others meet a few times a Tactical Combat year to advise the board of directors on certain issues. Here’s a list of the main committees and Debra Stoner, MD, FAWM Casualty Care their contacts. Make sure you look them up at Whistler. –Ed. Answers to your questions concerning wilderness certification course appropriate for MD, PhD, PA, Guidelines Updated medicine course curriculums: what is appropriate for NP, RN, Paramedic, EMT or medical professionals in Brad Bennett, PhD, EMT, FAWM Awards Committee. your level of training, institutions that provide the training who have an interest in wilderness medicine. Chair, Ken Zafren, MD, FAWM training and where to take the course. Certification, CME credits are achieved and certification lasts four The Awards Committee of the Wilderness Medical Society has in most courses, only “confirms” you took the course years. awls.org one main purpose: “to recognize individuals or groups for their and does not imply expertise or licensing. The courses The updated Tactical Combat Casualty Care contribution to wilderness medicine.” We have a lot of fun doing listed below represent only a few of the many available Fellow of the Academy of Wilderness Medicine Guidelines and supporting curriculum have this once a year. Awards include the Founders Award, the Dian programs. (FAWM): This is a fellowship program offered by the now been posted on the Military Health Simpkins Service Award, the Research Award, the Education WMS Academy of Wilderness Medicine to all levels of System (MHS) web site. This updated Award, the Warren Bowman Associate Member Award, the Wilderness First Responder (WFR): This is a course wilderness professionals. Members of the WMS may material reflects the latest changes to the Auerbach Award, and the Blair Erb World Congress Award. The geared to non-medical professionals and designed to complete the FAWM curriculum by accumulating a TCCC Guidelines recommended by the awards are bestowed at the banquet during the Annual Meeting meet the needs of wilderness guides, expedition leaders, minimum of 100 total credits from required and elective Defense Health Board in August of 2011. of the Society. Nominations are accepted from members of the and outdoor instructors. The course, taught over nine topics. wms.org/fawm Society at any time. The current members of the committee days, includes certification in adult & child CPR and These changes include: are: Paul Auerbach, Blair Erb (Chairman Emeritus), Bill AED. Masters Fellow Degree: The Master’s Fellow degree 1) the use of tranexamic acid to help Forgey, Tony Islas, Eric Johnson, Jay Lemery, and Ken Zafren wildmedcenter.com/wilderness-first-responder.html program is an advanced, post-FAWM certification improve survival in casualties who are in, ([email protected]) remotemedicine.ie/WEFR.html offered by WMS and created to denote individuals or at risk for, hemorrhagic shock; who have completed an advanced program in a specific 2) the use of the Combat Ready Clamp Education Committee. Advanced Wilderness First Aid/Essential Wilderness sub-discipline of wilderness medicine. wms.org/fawm/ to control junctional hemorrhage when Chair, Michael J. Caudell, MD, FACEP, FAWM First Aid (AWFA/EWFA): These certification courses masters.asp tourniquets and Combat Gauze are not The Education Committee continues to work toward are offered as a 90-hour or 50-hour course designed effective; and producing quality products and services to further wilderness for non-medical professionals such as outdoor Diploma in Mountain Medicine (DiMM): This is 3) medicine education. Products are available in the Trading Post educators, guides or trip leaders. They cover the basics an internationally recognized course certifying that the bilateral needle decompression for (wms.org/tradingpost). wildernessfirstaid.ca participant has undergone rigorous wilderness medicine casualties with torso trauma or training and testing. Designed as continuing wilderness polytrauma who suffer a cardiopulmonary Teaching Simulations, Volume I, are case-based PowerPoint Wilderness Emergency Medical Technician education for doctors, nurses, and paramedics who work arrest prior to arriving at a medical vignettes designed to simulate a realistic and interactive (W-EMT): This certification course is aimed at in or aspire to work in austere mountain environments. treatment facility. learning experience. Continuously striving for licensed EMTs, either basic, intermediate, or paramedic WMS is partnering with the University of Utah and improvement, StevenRoy and Jim Shuler have been with patient care experience. Other licensed health University of Colorado to introduce this advanced TCCC-related guidelines and curriculum working on a revision of the current product format, professional can attend and receive a completion card program in the USA. wms.org/education/dimm. materials are located on the MHS website: health.mil/Education_And_Training/ while Michael Caudell and Jim Shuler edit and prepare in lieu of a certificate.wildernessmedicine.com TCCC.aspx Volume II. Check the Conference Calendar at wms.org/ Advanced Wilderness Life Support/Wilderness conferences/calendar.aspx for additional providers, The National Association of Emergency Medical Technicians will A Community Education Lecture Series, developed by Deb Advanced Life Support (WALS/AWLS): This is a dates and locations. soon have these materials posted on the Prehospital Trauma Life Support section of their website at: Stoner, is a teaching aid for those reaching out to the nonmedical naemt.org/education/PHTLS/TCCC.aspx audiences.

22 WILDERNESS MEDICINE // Summer 2012 WILDERNESS MEDICINE // Summer 2012 23 Committee Roll Call Continued

The development of a Speaker’s Bureau is in the works, Mobile Bay Estuarium is across the street and the renowned Committee members continue to work in settings around of the Committee and the many other contributors to spearheaded by Chris McStay. The committee has initiated Audubon Bird Sanctuary is contiguous to Sea Lab property. the globe, providing healthcare in post-earthquake Haiti, these publications. The Committee is comprised of editors- a Student Outreach program which will include a mentor as well as throughout Africa and Asia. We are proud to have in-chief, associate and section editors and contributing resource list for interest groups as well as resources and President-elect, Jay Lemery, MD, FAWM made contributed to the development of this year’s second pre- editors of the four publications. Practice Guidelines, now guidance for those mentors. The annual Student Elective, environmental dialogue the cornerstone of his two-year conference focused on disaster and humanitarian response. being published in WEM journal, has spun off into its own with Liz Edelstein and Tom Kessler on-site, also continues term. The Environmental Council will assist the organization We are currently working to create a forum in which to committee, with its first meeting being held in this July in to thrive, having held another successful course in in developing a speaker list and environmental themed share international volunteer and practice opportunities Whistler (see below.) Townsend, Tennessee. A revision of the syllabus is being activities. among WMS members, thus allowing members easier performed under the guidance of Liz Edelstein. Visit access to meaningful international activities. If you are The Publications Committee meets annually at the summer wms.org/education/elective.asp for more information. Carlton Heine, MD, PhD, FAWM, will assume the role of interested in participating in this committee, you may meeting to review annual reports from the staff and the committee chair at the 2012 World Congress. Email Carl at contact me a [email protected]. publisher and discuss projects and initiatives. Any WMS In response to students meeting resistance in wilderness [email protected]. member who is interested in contributing as a writer, editor, medicine training from their home institution, the Membership Committee. peer reviewer or in any other capacity should contact the committee created a task force under the direction of Kiran Fellowship, Academy of Chair, Aaron Billin, MD, FAWM Committee Chair, Mel Otten at [email protected] Pandit to develop a standard curriculum and “guidelines” Wilderness Medicine. The WMS Membership Committee is responsible for and the staff liaison Jonna Barry [email protected] . for medical student electives. Chair, Brad Bennett, PhD, EMT, FAWM advising the Board of Directors on issues such as new The Fellowship program in the Academy of Wilderness members, retention, membership fees, and membership Practice Guidelines Committee. new committee As an additional resource, thanks to Vicki Mazzorana and Medicine continues to excel. Currently, we have 54 new benefits. The Membership Committee meets annually Chair, Colin K. Grissom, MD, FAWM Cindy Bitter, a WMS Members On-Line Photo Library Fellows since the 2011 Convocation Ceremony at the WMS at the WMS summer meeting and conducts business The purpose of the Wilderness Medical Society Practice (wms.org/members) has been established for members’ Annual Meeting in Snowmass last year. We expect that up throughout the year by email. The Membership Committee Guidelines Committee is to support publication of practice use in educational endeavors and in promoting wilderness to two dozen additional Fellow candidates will meet their currently includes 13 individuals from both the WMS guidelines, sponsored by the Wilderness Medical Society medicine. Members can also contribute photos. requirements for the Convocation Ceremony at the World Board of Directors and the WMS general membership: (WMS), in the peer-reviewed and indexed literature. The Congress of Wilderness Medicine. As of April 2012, we have Benjamin Lischner, Bryan Simon, Christopher Czaplicki, premise is that dissemination of important knowledge and If you are interesting in becoming involved in any 1004 Fellow candidates in the Academy and a total of 261 Craig Hart, Denise Edwards, Gabe Goesch, Ken Adams, improvement of care for patients with wilderness medicine- of these projects, or have a new idea that you would Fellows. Kyle Brown, Matt Cushing, Michael Arnett, Patrick related illness or injury is promoted by publication of peer- like to develop, please contact Michael Caudell at Linnenbank, Bob Quinn, and Aaron Billin. We have most reviewed guidelines in the medical literature. As a result [email protected]. In 2012, the Academy Advisory Committee has approved recently been discussing an option for WMS members to of this initiative several WMS Practice Guidelines have three new Master’s Fellow candidates. Their selected program spread the cost of a life membership out over a period of been published in Wilderness & Environmental Medicine: Environmental Committee. of study includes focused education and research in the areas time. For more information or to become involved, email administration of epinephrine for anaphylaxis (2010), Chair, Lynne Yonge, MD, FAWM of altitude illness, anaphylaxis and wilderness EMS medical [email protected]. prevention and treatment of high altitude illness (2010), The WMS will hold its first environmental conference direction. Loren Greenway received the first Master Fellow and prevention and treatment of frostbite (2011). Future October 30-November 5, 2013 at Dauphin Island Sea for Dive Medicine in 2011. For additional interest in the Publications Committee. guidelines underway include lightning injuries, heat illness, Lab, Alabama. With a focus on the human health effects Master’s Fellow Program see: wms.org/fawm/masters.asp. Chair, Mel Otten, MD, FAWM wound care, hypothermia, and eye injuries in the wilderness. of environmental degradation, topics will include the The Publications Committee oversees the various The eventual goal is to publish a collection of WMS Practice role of news media in environmental conservation, green International Committee. educational, research and human interest publications of the Guidelines in a supplement of Wilderness & Environmental buildings using LEED guidelines, biodiversity and historic Chair, Chris Tedeschi, MD, FAWM Society. The members can see the fruits of this committee’s Medicine that will be peer-reviewed, indexed, and available and medicinal plants. Nearby Coast Guard facilities will WMS members practice wilderness medicine on seven labor several times a year. Wilderness & Environmental worldwide. The WMS Practice Guidelines Committee will provide training on marine search and rescue techniques. continents and dozens of countries—as expedition Medicine Journal, Wilderness Medical Society Practice have a general meeting in Whistler at the WMS World Speakers include Pulitzer Prize-winning biologist E.O. physicians, researchers and teachers, volunteers, disaster Guidelines (now incorporated into the Journal), Wilderness Congress in 2012 on Sunday, July 15 at 5:00 pm., Westin Wilson, and the EPA’s Paul Anastas, widely known as the responders and humanitarian relief workers. The Medicine Magazine, and the Educational Presentation Emerald BC. WMS members interested in the process of father of “Green Chemistry.” International Committee serves as a forum for members (PowerPoint) Series for medical professionals, are products writing practice guidelines are invited to attend. In addition, interested in making connections between WM activities of the Committee. The WMS publications are second to we will discuss collaboration with International Society of The Dauphin Island Sea Lab is situated within short around the globe. none in quality and educational value. The huge amount Mountain Medicine. ([email protected]). walking distance of 3 major tourist attractions. Civil War of effort that goes into managing, writing, editing, era Fort Gaines lies adjacent to the Sea Lab campus. The producing and marketing reflects the expertise and energy

24 WILDERNESS MEDICINE // Summer 2012 WILDERNESS MEDICINE // Summer 2012 25 CLIFF NOTES CARSTENSZ PYRAMID C.M.E. 17 Hours of AMA/PRA Category 1 Credits & 17 Hours of FAWM Credits

August 17, to September 6, 2013 Cliff Notes This is a great time for us to see how to help Ali Arastu, MSIII, Student your school’s student interest group do more, Representative and plug into various student committees Keck School of Medicine, University of to be more involved. In the student sector Southern California of WMS, we have several committees that all serve to help students and their school’s I am stoked to have a great group of students interest groups to be more involved including at Whistler for our summer conference. If our Student Interest Group and Student you are interested in volunteering at a future Education committees and the Wilderness WMS conference, please shoot me an email Medicine magazine quarterly column. These at [email protected] and introduce committees are essential to keeping the yourself at Whistler. Also, the students will student body connected not only with each have a gorgeous condo. The exact price other, but also with up-to-date information yet will depend on how many students we regarding educational and other student- have sprawled out in sleeping bags; but it specific opportunities. If you would like to will definitely be far, far cheaper than any be involved with any of these committees, hotel room. have any questions at all, or simply want to talk wilderness medicine, do not hesitate to contact me.

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the Wilderness Medical Society and Andes Mountain Guides. The Wilderness Medical Society is accredited by the ACCME to provide continuing medical education for physicians. The Wilderness Medical Society designates this educational activity for a maximum of 17 AMA PRA Category 1 Credits TM. Each physician should only claim credit commensurate with the extent of their participation in the activity. ACONCAGUA C.M.E. 17 Hours of AMA/PRA Category 1 Credits & 17 Hours of FAWM Credits November January 16, to February 4, 2013 1-3, 2012 Sun Valley Idaho

The BEST Continuing Education Trip: For hands-on training and the latest knowledge to effectively respond to medical emergencies in remote areas? Accredited by the BEST Taught by the BEST Guided by the BEST Don’t miss the best conference of it’s kind in the Western US! Wilderness Medical Society Dr. Rachel Anderson Andes Mountain Guides www.AndesMountainGuides.com/cme This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the Wilderness www.ski-mtn-trauma.com Medical Society and Andes Mountain Guides. The Wilderness Medical Society is accredited by the ACCME to provide continuing medical education for physicians. The Wilderness Medical Society designates this educational activity for a maximum of 17 AMA PRA Category 1 Credits TM. Each physician should only claim credit commensurate with the extent of their participation in the activity.

26 WILDERNESS MEDICINE // Summer 2012 WILDERNESS MEDICINE // Summer 2012 27 board of directors

2012 WMS BOARD COMMITTEES ADMINISTRATIVE OFFICE OF DIRECTORS Academy of Wilderness Medicine Director Loren Greenway, PhD, FAWM, CEO Brad L. Bennett, PhD, WEMT, FAWM [email protected] Executive Board Awards Committee Chair Teri Howell, Administrative Director Arthur (Tony) Islas, MD, FAWM, Ken Zafren, MD, FAWM [email protected] President Continuing Medical Education Chair Wilderness Medical Society Jay Lemery, MD, FAWM, Hill McBrayer, MD, FAWM 2150 South 1300 East, Suite 500 President-Elect, Treasurer, Conference Chair Conference Committee Chair Salt Lake City, UT 84106 Colin Grissom, MD, FAWM, Jay Lemery, MD, FAWM Email: [email protected] Past President Education Committee Chair Tel: 801-990-2988 Brad Bennett, PhD, FAWM, Michael Caudell, MD, FAWM Fax: 801-990-4640 Secretary, Director of the Academy of Finance and Audit Wilderness Medicine Jay Lemery, MD, FAWM Jim Ingwersen, IT Director Loren Greenway, PhD, MFAWM, CEO, Disaster Medicine Committee Chair Email: [email protected] Associate Director of the Academy of Joy Crook, MD Tel: 719-492-2200 Wilderness Medicine Environmental Council Chair Lynn Yonge, MD, FAWM Jonna Barry, Managing Editor Members at-Large International Medicine Committee Chair Email: [email protected] Ali Arastu, Student Representative Chris Tedeschi, MD, FAWM Tel: 719-330-7523 Whistler, British Columbia, Canada Aaron R. Billin, MD, FAWM Membership Committee Chair Tracy Cushing, MD, FAWM Aaron Billin, MD, FAWM July 13-17, 2012 Lance Ferguson, MD, FAWM Nominations Committee Chair Marion McDevitt, DO, FAWM Colin Grissom, MD, FAWM Scott E. McIntosh, MD, FAWM Publications Chair Learn from the experts. Chris McStay, MD, FAWM Edward (Mel) Otten, MD, FAWM Robert H. Quinn, MD, FAWM Research Council Chair How to protect yourself. George W. Rodway, APRN, PhD, FAWM Thomas Deloughery, MD, FAWM What to tell your patients. Greg Stiller, MD, FAWM Student Services Chair Sara Squyres, PA-C, MPAS, FAWM Ali Arastu, MS3 Web Development Chair Jim Ingwersen Welcome to the 6th World Congress on Wilderness Medicine.

Whether you are a first-time attendee or a long-time supporter of the Wilderness Medical Society, the World Congress will provide an excellent opportunity to sharpen your skills, deepen your knowledge of wilderness medicine,

and network with kindred spirits. In addition to our core Photo by Chad Chomlack. program, we are offering four preconference programs: Certify in Wilderness Medicine Mountain and Expedition Medicine (DiMM), Disaster and Humanitarian Medicine, Marine Medicine, and Advanced Learn treatments for the most common wilderness injuries and illnesses Wilderness Life Support. This year’s conference is packed full Manage live scenarios while earning CME and FAWM credits of workshops, hands-on experiences, and activities that are sure to keep you busy, informed and entertained for the next Available to all medical professionals (PA’s, MD’s, DO’s, RN’s, PN’s, EMT’s and Paramedics) 5 days. Photo by Steve Rogers.

2012 AWLS Certification Courses Keep this program handy! It contains your day-to-day program and activities. Whistler, BC / Mt. Hood, OR / Queenstown, New Zealand / New River Gorge, WV Jackson, WY / Mount Snow, VT / Boulder, CO / Zion Park, UT

Combining your profession ™ REGISTER NOW University of Utah with your passion Photo by Michael Allen www.awls.org / 1-866-830-3394 School of Medicine

28 WILDERNESS MEDICINE // Summer 2012 INFORMATION Program Schedule PRE-CONFERENCE: Subject to change, please check daily schedules at registration desk. Disaster and Humanitarian Response Continued NOTE: Registration for any of the Pre-Conference programs does not include registration to the Main 4:30-5:30 Special Needs Populations in SAR and Westin - Conference. Separate registration is required to at- PRE-CONFERENCE: Dive Medicine Disaster - Robin Stutman Nordic tend the Main Conference. Westin Nordic Friday, July 13 We request that you wear your badges during all 6:00 - 7:00 am CONTINENTAL BREAKFAST Hilton - Workshops: (included in Disaster Pre-Conf. Registration): conference activities. 6:00 - 7:45 REGISTRATION Mt. Currie South 1:30 - 3:30 Field Orthopedics - Sam Baker, Bob Quinn Hilton - 7:45 - 8:00 Welcome and Introductions (12-021-2)* Overview of diagnosis and Diamond Your registration includes a syllabus on a thumb-drive 8:00 - 8:45 Dive and Marine Medicine - management of orthopedic conditions in Head Andy Pennardt (01-002-.75)* austere environments including external that contains the lectures. Each lecture handout has fixators, hemorrhage control, field amputa- 8:45 - 9:30 Computer Use in Diving - tions and compartment syndrome. been converted to a PDF format. The WMS uses elec- Eric Johnson (01-028-.75) tronic media whenever possible. Please practice the 3 Field Anesthesia - Alison Matthews, John Hilton - 9:30 - 9:45 BREAK Hermann (12-003-2)* Landmark and US Sutcliffe A Rs (reduce, reuse and recycle) by returning your name 9:45 - 10:30 Dive Accident Prevention - guided regional anesthesia. badge holder to us at the end of the conference. Nick Bird (01-012-.75) Security & Bug Out Kit - Nick Williams Hilton - 10:30 - 11:15 WMS Dive Accident Experience - (11-021-2) Risk mitigation in the field with Sutcliffe B All of the plenary sessions and small group sessions Loren Greenway (01-017-.75) development of security plan for Whistler 11:15 - 12:00 Decompression Illness, DAN Data - environs, preparation for unexpected are included in your registration fee. Workshops Nick Bird (01-026-.75) departure. require additional fee as indicated in the program. Field Water Purification - Howard Backer Hilton -

Saturday, July 14 (08-005-2)* Discussion pros/cons and dem- Black Tusk Banquet, Awards Ceremony, and Special Guest onstration of water purification methods Speaker: July 16, 6 pm - 8 pm. Come mingle with 7:00 - 8:00 CONTINENTAL BREAKFAST Hilton - including filters, UV, chemical purification Mt. Currie and boiling. like-minded colleagues and enjoy dinner and a cash 8:00 - 8:45 Seafood Toxidromes - Ian Wedmore (09- 027-.75)* South 3:30 - 5:30 Field Orthopedics - Sam Baker, Bob Quinn Hilton - bar. Dr. Clarke has been climbing since the late 1950s, 8:45 - 9:30 Marine Animal Attacks - Paul Auerbach (12-021-2)* Diamond and his program is titled Himalayan Journeys. His in- (01-006-.75) Overview of diagnosis and manage- Head ment of orthopedic conditions in austere terests are exploration of remote areas – in the Indian 9:30 - 9:45 BREAK environments including external fixators, and Nepalese Himalaya, western China and eastern 9:45 - 10:30 Top Ten Most Important Papers in Hyper- hemorrhage control, field amputations and Tibet, altitude medicine and Tibetan medicine. He baric Medicine - Eric Johnson (01-005-.75) compartment syndrome. is a neurologist in London and the principal editor of 10:30 - 11:15 Advances in Dive Equipment - Loren Field Anesthesia - Alison Matthews, John Hilton - Greenway Hermann (12-003-2)* Landmark and US Sutcliffe A Neurology: A Queen Square Textbook (2009). (01-028-.75) guided regional anesthesia. 11:15 - 12:00 Panel Discussion Ultrasound in Disaster - Teresa Wu (05- Hilton - CME Credits/Evaluation: The Wilderness Medical 031-2) Use of US in disaster with focus on Sutcliffe B Society (WMS) is accredited by the Accreditation intraperitoneal hemorrhage, pneumothorax PRE-CONFERENCE: detection, maternal-fetal applications, and Council for Continuing Medical Education to provide Disaster and Humanitarian Response foreign bodies. continuing medical education for physicians. The Friday, July 13 Field Water Purification -Howard Backer Hilton - WMS designates this educational activity for a maxi- (08-005-2)* Discussion pros/cons and dem- Black Tusk mum of 45.75 AMA PRA Category 1 Credits™. Each 6:00 - 7:00 am CONTINENTAL BREAKFAST/ Westin - onstration of water purification methods REGISTRATION Emerald C including filters, UV, chemical purification physician should only claim credit commensurate with 7:00 - 7:45 Pre-Travel Preparation - Michael Callahan and boiling. the extent of their participation in the activity. (11-012-.75)

7:45 - 8:30 What Skills Do I Need? - Kiran Pandit Saturday, July 14 (11-020-.75) To receive your certificate for CME credit, please visit 8:30 - 9:30 Epidemiology of Illness and Injury After 6:00 - 7:00 am CONTINENTAL BREAKFAST Westin - Disaster - Emerald C the conference support page at WMS.ORG. Com- 7:00 - 7:45 Field Experience - Buddha Basnyat Michael Callahan (11-001-1)* (11-028-.75) plete and submit the evaluation. Once you have 9:30 - 9:45 BREAK 7:45 - 8:45 Media Coverage of Global Health done this, the link for the CME worksheet for this con- 9:45 - 10:45 Bioterrorism - Jim Geiling (11-003-1)* Emergencies -Chris Tedeschi (11-023-1) ference will appear. Complete and submit the form 10:45 - 11:30 Security - Nick Williams (11-021-.75) A survey of how digital and broadcast and you will be presented with your certificate! media approach global health emergen- 11:30 - 12:30 Disaster Orthopedics - Bob Quinn (12- cies, geared to first-line responders and pm 021-1)* those who communicate with the media in FAWM Credits: Claim your FAWM on the “My FAWM 12:30 - 1:30 LUNCH (on your own) the field. Credits” page on WMS.ORG 8:45 - 9:30 ICS: Your Role in Effective Disaster Re- Small Group Sessions: sponse - Robin Stutman (06-003-.75) All WMS faculty have signed Conflict of Interest 3:30 - 4:30 Go Bag - Tracy Cushing (05-013-1)* Westin - 9:30 - 9:45 BREAK Callaghan disclosure statements. It is the policy of the Wilder- 9:45 - 10:45 Field Triage - Jim Geiling (11-028-1) Communications - Gordon Worley Westin - ness Medical Society to disclose real or apparent (06-023-1) Pros and cons of different com- Nordic 10:45 - 11:45 Tropical Medicine for Volunteers conflicts of interest of faculty members related to the munication strategies, including ham radio, - Buddha Basnyat (02-017-1)* content of their presentation to participants to help walkie-talkies, text, social media and email 11:45 - 12:30 pm Disaster Team Development with the opportunity for participants to trial - Paul Auerbach (11-027-.75) the participants form their own judgment about the a few models. 12:30 - 1:30 LUNCH (on your own) presentation. Accordingly, the Wilderness Medi- 4:30-5:30 Ditch Medicine - Dominique Davenport Westin - Callaghan 1:30 - 3:30 Workshops or Small Group Sessions cal Society has determined there are no conflicts to (see next page) report associated with this conference. Post-Incident Stress - Brenda Tiernan Westin - (12-022-1)* Post Incident Stress learning Alpine DE 3:30 - 4:30 How to Get Involved - Panel Discussion, objectives 1) be aware of risk factors for PIS Paul Auerbach - Moderator (11-012-1) Whistler Village Activities: The best source for Whis- 2) recognize early signs of PIS in self and team members 3) learn effective strategies tler Village activity information is online at for coping with PIS. whistler.com/activities/summer. All of the available

Photo by Mike Crane summer activities are listed there. *Denotes FAWM core topic. WILDERNESS MEDICINE // Summer 2012 31 PRE-CONFERENCE: Saturday, July 14 MAIN CONFERENCE Continued Wilderness Simulation - John Lisso- Westin - way, Grant Lipman (12-018-3) Simulation Alpine BCD Disaster and Humanitarian Response Continued 7:00 - 8:00 am CONTINENTAL BREAKFAST Hilton - medicine has become a well accepted 8:00 - 9:00 Nutrition and Food Planning - Cheakamus Small Group Sessions: teaching modality in most major medical centers. Perhaps it’s time to bring hi fidelity Ryan Paterson (09-011-1)* 1:00 - 5:00 Panel: Exercise-Associated Hyponatremia Westin - Small Group Sessions: simulation into austere environments? This 9:00 - 10:00 Legal - Scott McIntosh, Chris Davis (EAH) in the Backcountry - Brad Bennett, Emerald A workshop will explore the possibilities. 1:30 - 2:30 Interacting with the Media - Chris Tedes- Hilton - (12-052-1)* Ian Rogers, Martin Hoffman, Tamara Hew- chi (11-023-1) A focused discussion on how Sutcliffe A 10:00 - 10:15 BREAK Butler (07-017-3.75) An international panel practitioners can engage the media to tell will present an overview of the historical Activities: their stories, with analysis of some recent 10:15 -11:15 Stress - David Keitz (12-034-1) (1980-present; background; incidence; examples and controversies. pathophysiology; international consensus 12:00 - 1:00 pm WMS Student Reception Westin - 11:15 am - Meet your Local SAR: Incident command, Foyer 12:15 pm theory, structure - Bruce Brink (06-003-1) reports for management and prevention of Post Incident Stress - Brenda Tiernan Hilton - EAH, which occurs primarily in endurance (12-022-1)* Post Incident Stress learning Sutcliffe B 5:00 - 6:00 WMS Practice Guidelines Committee Westin - 12:15 - 1:30 LUNCH (on your own) athletes world-wide. Panel members will Meeting Emerald BC objectives 1) be aware of risk factors for PIS discuss how their evidence-based research 2) recognize early signs of PIS in self and 1:30 - 4:30 Improvised Rescue Techniques - Dave 6:00 - 7:30 Fellow Convocation Hilton - Mt. Weber (06-013-3) leading to effective prevention guidelines team members 3) learn effective strategies with a reduction in incident rates in endur- Currie for coping with PIS. ance events before EAH was accepted Ballroom 2:30 - 3:30 Communications - Gordon Worley - Hilton - PRE-CONFERENCE: Advanced Wilderness Life Support in the U.S. prior to 2003. This panel will 7:30 - 8:30 Unexpected Journeys, Military, Moun- Westin - (06-023-1) Pros and cons of different com- Sutcliffe A present the evidence which lead to two tain, Diving, Jungle and Desert Adven- Emerald BC munication strategies, including ham radio, Friday, July 13 (2005 and 2007) published international tures - Sundeep Dhillon walkie-talkies, text, social media and email concensus reports with the leading patho- 1:00 - 5:30 pm Advanced Wilderness Life Support ($335) Westin - physiology theories, treatment methods with the opportunity for participants to trial AWLS Faculty Emerald A a few models. and case presentations for moderate and Monday, July 16 severe EAH. Go Bag - Tracy Cushing (05-013-1)* Hilton - 6:45 - 7:30 CONTINENTAL BREAKFAST Westin - Sutcliffe B Saturday, July 14 1:00-1:20 Introductions, EAH history - 7:15 - 8:00 Research Presentations Emerald BC Ditch Medicine - Dominique Davenport Westin - 7:30 am - Advanced Wilderness Life Support Westin Bennett Callaghan 5:00 pm (continued) AWLS Faculty Alpine DE 1:20-2:05 Pathophysiology of EAH - Hew- 8:00 - 8:45 Cold Water Diving - Karen Van Hoesen Westin - Butler (01-036-.75) Emerald BC 2:05-2:50 Epidemiology, risk factors and 8:45 - 9:30 Hypothermia - Gordon Giesbrecht (09- Workshops (included in Disaster Pre-Conf. Registration): MAIN CONFERENCE prevention of EAH - Rogers 019-.75)* 1:30 - 3:30 Field Triage - Jim Geiling, Vicki Mazzorana Saturday, July 14 2:50-3:05 Break 9:30 - 10:15 Temperature Regulation and Heat Stress (11-028-2) Practice triage techniques with Westin - 3:05-3:50 Clinical features and field man- - Bob Kenefik (09-009-.75)* discussion of triage categories and optimal Alpine A 4:00 - 6:00 pm REGISTRATION Westin - agement of EAH - Hoffman use of available resources. Foyer 10:15 - 10:30 BREAK 3:50-4:35 Case studies in EAH - Panel 10:30 - 11:15 SAR in European Alps - Bruno Durrer (06- Security & Bug Out Kit - Nick Williams 6:00 - 6:30 State of the Wilderness Medical Society Westin - 4:35-4:55 Panel Q&A - Panel (11-021-2) Risk mitigation in the field with - Tony Islas Emerald BC 001-.75)* Westin - 4:55-5:00 Closing Comments - Bennett development of security plan for Whistler Alpine B 6:30 - 8:00 President’s Welcome Reception 11:15 - 12:00 Military Medical Problems in Afghanistan environs, preparation for unexpected Lessons from on High - Brownie Schoene 1:00 - 3:00 Healthy Aging - Preventive and Rehab Westin - - Bob Kenefik (12-048-.75) departure. Medicine – Jolie Bookspan (07-018-2) Nordic Fast paced workshop to learn sports 12:00 - 12:45 Wilderness Wound Management - Eric Ultrasound in Disaster - Teresa Wu (05- Johnson (12-012-.75)* 031-2) Use of US in disaster with focus on Sunday, July 15 medicine techniques to spot and prevent intraperitoneal hemorrhage, pneumothorax Westin - musculoskeletal injuries and syndromes 12:45 - 1:30 LUNCH (on your own) detection, maternal-fetal applications, and Nordic 6:45-7:30 am REGISTRATION Westin - mistaken for aging. foreign bodies. Foyer 3:00 - 5:00 Wilderness Dental Care - Eric Johnson (04- CONTINENTAL BREAKFAST Westin - 001-2)* Practitioners will learn techniques Small Group Sessions: 7:30 - 7:45 Opening Remarks - George Rodway Emerald BC for prevention, diagnosis, and treatment 1:30 - 2:30 Sports Medicine for the Wilderness - Westin - PRE-CONFERENCE: Diploma in Mountain Medicine of dental emergencies in austere environ- Tony Islas (07-018-1) Basic musculoskeletal Alpine AB 7:45 - 8:30 Fever in the Traveler - Buddha Basnyat ments. Learn what to bring and when/how medicine for wilderness medicine prac- Friday, July 13 (02-034-.75)* to intervene on some of the more com- titioners oriented towards muscular and 6:00 - 7:00 am CONTINENTAL BREAKFAST/ Hilton - 8:30 - 9:15 Recent Advances in Patients at Altitude - monly encountered oral maladies. tendonopathy issues that can be addressed REGISTRATION Cheakamus Peter Hackett (03-007-.75)* on the trail. 7:00 - 7:20 History of the Diploma in Mountain 9:15 - 10:00 Neurological Problems at Extreme Alti- Workshops ($75): 2:30 - 3:30 Myths, Facts and State of the Art in Wa- Medicine - David Hillebrandt tude - Charlie Clarke (03-018-.75) ter Treatment - Carl Weil (08-005-1)* 1:00 - 4:00 Patient Packaging and Transport - Dave Hilton - Learn what works, what doesn’t and why. 7:20 - 8:20 Epidemiology of Mountain Accidents - 10:00 - 10:15 BREAK Weber, Jennifer Dow (06-008-3)* At the Sutcliffe Scott McIntosh (03-013-1) Bring your own device and possibly learn a 10:15 - 11:00 Search and Rescue in Alaska with the foundation of wilderness medicine is new piece of information about it. Numer- 8:20 - 9:00 Weather - George Rodway, Jennifer Dow National Park Service - Jennifer Dow extended patient care. This workshop will ous devices have been received by the (05-002-.75) (06-001-.75)* focus beyond the initial patient assessment lecturer for your review and sample use in process and challenge the participants to 9:00 - 10:00 Submersion - Tracy Cushing (09-004-1)* class. Treatment samples will be available 11:00 - 12:00 Panel Discussion: Decision Making in Alti- consider the next steps in ensuring a safe to all attending. Mr. Weil has visited with 10:00 - 10:15 BREAK tude Illness - Colin Grissom, Peter Hackett, evacuation. The majority of the allotted most of the major manufacturers in the field Brownie Schoene, Charlie Clarke, Buddha time will be spent practicing techniques to in his effort to stay current with water treat- 10:15 am Pre-existing Medical Conditions - Peter Basnyat (03-002-1)* mitigate risks for both patients and rescu- -12:15 pm Hackett (03-007-2)* ment and to share only the latest with you. 12:00 - 1:00 LUNCH (on your own) ers. Participants are asked to bring the 12:15 - 1:30 LUNCH (on your own) gear they typically carry on day trips. 3:30 - 4:30 How to Build a Medical Kit - WEMSI Faculty (Jel Coward, Matt Ladbrook, Peter 1:30 - 4:30 Navigation Workshop - WEMSI Faculty Navigation - WEMSI Faculty (Jel Cow- Hilton - Harvey) (05-026-1)* Lifetime wilderness (Jel Coward) (05-015-3)* ard, Matt Ladbrook, Peter Harvey, Joe Cheakamus medical providers share their tricks of the O’Gorman, Rebecca Lindley) (05-015-3)* trade for designing your medical kit. From A practical workshop on navigation in the high temperature expeditions in Africa to wilderness led by an international team of the winter mountains of British Columbia. experienced mountain navigators. This will What to carry and when. How to carry it. include how to read a map, map and com- Storage. Planning for larger groups. Re- pass theory and practice, GPS pearls and cording. Legal issues .....and more. pitfalls, navigating in in low visibility, route planning....and more.... Bring a compass and GPS if you have them! Workshops ($75): 1:30 - 4:30 Survival Techniques - Todd Miner (05-001- Westin - 3)* Stay found and stay alive. Preparation Callaghan is the key to survival. This workshop will explore practical techniques for sustaining life in harsh environments to assist you in returning alive.

*Denotes FAWM core topic. WILDERNESS MEDICINE // Summer 2012 33 MAIN CONFERENCE Continued Small Group Sessions: 1:30 - 2:30 Avalanche Survival and Rescue - Bruno Westin - Academy of Wilderness Medicine™ 2012 Fellows Durrer (06-002-1) This small group will Emerald A Wilderness Photography - Greg Hren Westin - explore the various techniques and devices A professional photographer will enlighten Nordic for avalanche survival and rescue. Learn 6th Fellow Convocation Jason Barter Gemma Lewis you with his tips and tricks for capturing how to survive the slide and rescue others. Aaron Birch Ronald Ligon and preserving the best images from your Sunday, July 15, 6:00-7:30 pm Anna Michaela Black Grant Lipman travels. 2:30 - 3:30 Research and Publication - How and Why? - Scott McIntosh, George Rodway The Hilton, Mt. Currie Ballroom Daniel Boyd Anil Menon SAR Helicopter Demonstration (Free) - Offsite (14-010-1) Why is research and publica- Catherine Chamberlin Keith Murray Bruce Brink (06-017-3) This aerial demon- tion important to Wilderness Medicine? Dinesh Deonarain Mária Némethy stration (weather permitting) and static What does it take to get started? A primer The Wilderness Medical Society and the Academy of Wilderness display of helicopter SAR procedures and on these subjects for those interested in Medicine congratulate the 2012 inductees to the Academy. Sundeep Dhillon Robert O’Reilly equipment by local British Columbia teams research in austere environments (and the Jeffrey Donnelly Gina Ortiz will give insight into operational needs of dissemination of their findings). Brendon Drew Jacqueline Percy high-volume mountain rescue squads. 3:30 - 4:30 Expedition Medicine: What to Know and The Fellow of the Academy of Wilderness Medicine (FAWM) certificate Joel Ehler Spencer Peterson Surgical Airway in the Austere Environ- Westin - What to Ask - David Townes (04-002-1)* presented to each inductee identifies those who have achieved a Mark Ellis Tamim Qaum ment: Myths and Realities - Brad Bennett Alpine CDE In this session, pre-expedition planning Virgil Figueroa Steven Rogge (12-017-3)* The attendee will gain an ap- including personnel, supplies and equip- demanding set of requirements validating their training and experience preciation of the challenge of performing a ment, what to anticipate and what to do in Wilderness Medicine for the assurances of patients, clients, and the Katrin Finsnes Emily Sagalyn surgical airway in an austere environment. during the expedition and controversies in Kelly Gillespie Matthew Steward Although a rare event, this workshop will expedition medicine will be discussed. public at large. Laura Griebling Richard Trierweiler be based on lessons learned from the Martin Hoffman David Udall battlefield as conducted in the most chal- Lawrence LeBlond Eric Widra lenging environment. What works and what Workshops ($75): doesn’t? Case presentations will be used Sonny Lee Patricia Zishka to reinforce the critical essentials of surgical 1:30 - 4:30 Traumatology Skills Carousel - WEMSI Westin - Tyson Lehman airway training - airway anatomy, tools, Faculty (Jel Coward, Matt Ladbrook, Peter Alpine AB procedure steps, simulation models, all Harvey, Joe O’Gorman) (12-001-3)* A presented in a standardized format that will ‘round robin’ of those important skills for be key when a decision is made to conduct dealing with trauma in the wilderness. A this procedure in an emergent situation in ‘hands-on’, high exposure revolving work- the backcountry. shop run by wilderness “folks who ‘do’” in 2012 WMS Awards their everyday lives. Improvised Rescue Techniques - Dave Westin - Activities: Weber, Jennifer Dow (06-013-3) This Alpine CDE Ball USA/WMS Award Education Award Research Award Blair Erb World Congress 2008 Luanne Freer, MD 1994 Doug Gentile, MD 1994 Peter Hackett, MD International Award 8:00 - 11:00 am WMS Board Meeting Westin - workshop will take a critical look at the gear Glacier that should be considered for personal 2009 Seth Hawkins, MD 1995 Howard Donner, MD 1995 Murray P. Hamlet, DVM 1995 Franz Berghold, MD backcountry excursions in order to best 2010 Jay Lemery, MD 1996 Paul S. Auerbach, MD 1996 David Shlim, MD 1999 Bruno Durrer, MD 6:00 - 8:00 pm Awards Banquet, Evening Speaker: Westin - prepare for an unplanned patient evacua- Himalayan Journeys - Charlie Clarke Emerald tion. Ample time will be spent practicing 1997 William Forgey, MD 1997 Wayne Askew, PhD 2003 Urs Wiget, MD, and Peter ABC various rescue options utilizing improvised WMS Ice Ax Award 1998 Phillip Bertram, MD and 1998 Benjamin Levine, MD Hackett, MD gear and systems. Participants are asked 2012 Andrew Luks, MD Steve Donelan 1999 Gordon G. Giesbrecht, PhD 2007 Jim Milledge, MD, and to bring the gear they typically carry on day 1999 karl Neumann, MD 2000 Robert Roach, PhD Robert B. Schoene, MD Tuesday, July 17 trips. Paul S. Auerbach Award 2000 Edward Otten, MD 2001 Ellen L. Glickman, PhD 2012 Buddha Basnyat, MD; 6:45 - 7:30 am CONTINENTAL BREAKFAST Westin - 1:30 - 5:30 Ultrasound Workshop - Colin Grissom, Jay Westin - 2000 James Wilkerson III, MD 2001 James A. Litch, MD 2002 Colin Grissom, MD Gordon Giesbrecht, PhD; 7:30 - 8:15 Modified Immediate Trauma Manage- Emerald BC Gupta, Matthew Cushing (05-031-4) Nordic Ultrasound is an emerging techonology 2001 Warren D. Bowman, MD 2002 James Liffrig, MD 2003 Erik Swenson, MD David Warrell, DM, DSc, ment for the Wilderness - Ian Rogers 2002 Peter Hackett, MD 2003 ken Zafren, MD 2004 Robert B. Schoene, MD FRCP (12-013-.75) that is used in the acute care setting to assist in diagnosis of cardiac, chest, and 2003 Bruce Paton, MD 2004 Rob Hilvers, MD 2005 Sean P. Bush 8:15 - 9:00 The Intersection of Wilderness Medicine abdominal pathology. Portable ultrasound 2004 Colin Grissom, MD 2005 Robert L. Norris, MD 2006 None Wilderness & Environmental and International Medical Relief - machines are currently available, some of Paul Auerbach (11-019-.75) which are very compact. These ultrasound 2005 Gordon G. Giesbrecht, PhD 2006 None 2007 Robert L. Norris, MD, and Medicine Journal Awards 2006 Robert B. Schoene, MD 2007 Peter Kummerfeldt Ian Simpson, MD 9:00 - 9:45 Wilderness Ophthalmology - machines are being employed in the pre- Lance Ferguson (12-005-.75)* hospital setting, rural or remote medical 2007 Luanne Freer, MD 2008 Thomas Kessler, MD 2008 Mary Ann Cooper, MD 2010 Peer Reviewer facilities, as well as in emergency depart- 2008 Howard Backer, MD 2009 Brad L. Bennett, PhD 2009 Buddha Basnyat, MD Recognition Awards: 9:45 - 10:00 BREAK ments. Ultrasound is an ideal diagnostic 2009 Edward (Mel) Otten, MD 2010 Debra Stoner, MD 2010 Thomas Deloughery, MD Linda Keyes, MD, Neal Pollock, MD 10:00 - 10:45 Research Presentations modality that can be used in austere and wilderness environments. This half day 2010 Frank K. Butler, Jr., MD, 2011 Elizabeth Edelstein, MD 2011 Scott McIntosh, MD George Rodway, PhD 10:45 - 11:30 Morality, Ethics and Personal Dilemmas workshop will include didactic lectures and Capt., MC USN (Ret) 2012 Linda Keyes, MD 2012 Hermann Brugger, MD Jeremy Windsor, MBChB in Mountain Medicine - David Hillebrandt hands on training in basic chest, cardiac, 2011 Eric L. Johnson, MD Ken Zafren, MD and abdominal ultrasound. 11:30 - 12:15 pm Third World Travelers Case Studies - 2012 David Shlim, MD Founders Award Dian Simpkins Service Award Buddha Basnyat (02-017-.75)* 1994 Warren Bowman, MD 1994 Bruce Paton, MD 2011 Peer Reviewer 12:15 - 12:30 Closing Remarks - George Rodway Warren D. Bowman Award 1995 Herbert Hultgren, MD 1995 Blair Erb, MD Recognition Awards: 12:30 - 1:30 LUNCH (on your own) 2000 Buck Tilton 1996 Robert Schoene, MD 1996 Edward Geehr, MD Howard Backer, MD, MPH 2001 Tod D. Schimelpfenig, EMT 1997 Peter Hackett, MD 1997 Dian Simpkins Colin Grissom, MD. 2002 Linda B. Lindsey, RN 1998 kenneth Kizer, MD 1998 Howard D. Backer, MD Scott A. Weinstein, MD, PhD 2003 George Rodway, PhD, CRNP 1999 Joseph Serra, MD 1999 William A. Robinson, MD 2004 Peter Kummerfeldt 2000 Edward Geehr, MD and 2000 James Bagian, MD and Eric Outstanding Contributor Award: 2005 Sheryl Olsen, RN Charles S. Houston, MD Johnson, MD James A. Wilkerson III, MD 2006 None 2001 Paul S. Auerbach, MD and 2001 Benjamin I. Rosner, PhD 2007 Sara Squyres, PA-C Murray P. Hamlet, DVM 2002 Matthew Russell, MD 2013 Peer Reviewer 2008 Tod D. Schimelpfenig, EMT 2002 William Robinson, MD 2003 oswald Oelz, MD Recognition Awards: 2009 Charles Shimanski 2003 Blair D. Erb, MD 2004 ken Zafren, MD Edward J. “Mel” Otten, MD 2010 C. Denise Edwards, Lt. Col., 2004 William W. Forgey, MD 2005 Tom Kessler, MD Vidal Haddad, Jr., MD, PhD USAF 2005 Howard D. Backer, MD 2006 Jonna Barry Michael Cardwell, BS 2011 Gordon Worley, RN, CFRN, 2006 James R. Liffrig, MD 2007 Christopher Van Tilburg, MD EMT-P 2007 Luanne Freer, MD 2008 James Wilkerson III, MD 2012 Todd Miner, PhD 2008 Bruce Paton, MD 2009 Jim Ingwersen 2009 Eric L. Johnson, MD 2010 Teri Howell 2010 Thomas Kessler, MD 2011 Reuben “Hill” McBrayer, MD 2011 Robert L. Norris, MD 2012 Michael Caudell, MD 2012 ken Zafren, MD

WILDERNESS MEDICINE // Summer 2012 35 Combining Your Profession With Your Passion™

The Wilderness Medical Society’s 2013 CME Conferences Exciting destinations for learning, earning CME, and outdoor adventure

MedSail: Medicine for WMS 30th Anniversary Mariners & Safety at Sea & Wilderness Medicine February 2-9, 2013 Conference The Moorings, British Virgin Islands July 11-17, 2013 Beaver Run Resort, Breckenridge, Colorado Winter Wilderness & Mountain Medicine Conference Environmental Change February 14-20, 2013 & Human Health Canyons, Park City, Utah October 30-November 3, 2013 Dauphin Island Sea Lab, Dauphin Island, Alabama

To view all activities for WMS Partners, see Partner/Affiliate Events at wms.org/conferences/calendar.aspx. Note: all items are listed as a community service and are not necessarily CME/ WMS.ORG/conferences or call FAWM approved. To determine if an activity is eligible for FAWM 801.990.2988 for up-to-date info credits, please see eligible activities at wms.org/fawm