Wilderness Medicine Updates Wed, 09 Sep 2026 22:07:09 -0600 https://wildernessmedicineupdates.buzzsprout.com en-us © 2026 Wilderness Medicine Updates yes a2c85110-79fd-5145-8b76-56d45a930b1e Patrick Fink, MD episodic false The podcast for medical providers at the edges, bringing you digestible updates at the growing edge of Wilderness Medicine, Wilderness EMS, Search and Rescue, and more. 

]]> Buzzsprout (https://www.buzzsprout.com) wilderness medicine, wilderness ems, search and rescue, SAR, disaster medicine, austere medicine, Patrick Fink, MD https://storage.buzzsprout.com/rciozp1kp49p9ppcba0or27j34xn?.jpg Wilderness Medicine Updates https://wildernessmedicineupdates.buzzsprout.com Patrick Fink MD, FAWM Ep. 34 - Icy Hot, a case of Heat Illness with Dr. Gavin Clark and Dr. Nick Daniel Ep. 34 - Icy Hot, a case of Heat Illness with Dr. Gavin Clark and Dr. Nick Daniel Dr. Patrick Fink interviews Dr. Nick Daniel and Dr. Gavin Clark about an in-hospital case of exertional heat stroke in a mid-20s runner who collapsed just before the finish of an October New England half marathon in 45°F weather. EMS treated presumed SVT with adenosine, but in the ED the patient was hypotensive, profoundly diaphoretic, and altered; an oral temperature was normal while a rectal core temperature was 105.5°F, highlighting that peripheral temps can’t rule out heat stroke. 

We discuss rapid “cool first” management using ice packs, misting, and fans to reach 102°F within ~30 minutes, compare cooling methods (cold-water immersion, tarp-assisted oscillation, Quantico method, frozen sheets), review labs showing lactate 9 and AKI, explain sepsis-like physiology via gut hypoperfusion, and note possible risk contribution from recent COVID and acute Lyme IgM positivity. 

Links:
Ep. 33 - Heat Illness Fundamentals

Ep. 27 - Thermoregulation: The Physics and Physiology of Body Temperature Regulation

Clark G, Kocen S, Daniel N. Icy Hot: A Case of Unexpected Heat Illness. Wilderness Environ Med. 2026 Jun 16:10806032261458332. doi: 10.1177/10806032261458332. Epub ahead of print. PMID: 42300334.

Eifling KP, Gaudio FG, Dumke C, et al. Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Heat Illness: 2024 Update. Wilderness & Environmental Medicine. 2024;35(1_suppl):112S-127S. doi:10.1177/10806032241227924

Chapters:

00:00 Show Intro and Guests
02:43 Meet the Doctors
03:48 Race Day Collapse Setup
04:47 Finish Line Differential
06:48 EMS Report and History
08:55 Core Temp Surprise
11:25 Field Temp Takeaways
13:38 Rapid Cooling in ED
15:36 Cooling Rates and Goals
16:28 Immersion and Alternatives
18:17 Tarp and Body Bag Hacks
19:32 Quantico and Frozen Sheets
21:10 Field Cooling Methods
21:48 Lab Workup Red Flags
23:23 Lactate Nine Explained
24:21 Heatstroke Sepsis Pathway
26:40 Hidden Factors COVID Ticks
29:09 Fever Versus Hyperthermia
31:27 Prehospital Takeaways
35:00 Race Day Kit Checklist
36:35 Cool First Transport Later
37:29 Outcome And Wrap Up
39:46 Podcast Closing Notes

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Dr. Patrick Fink interviews Dr. Nick Daniel and Dr. Gavin Clark about an in-hospital case of exertional heat stroke in a mid-20s runner who collapsed just before the finish of an October New England half marathon in 45°F weather. EMS treated presumed SVT with adenosine, but in the ED the patient was hypotensive, profoundly diaphoretic, and altered; an oral temperature was normal while a rectal core temperature was 105.5°F, highlighting that peripheral temps can’t rule out heat stroke. 

We discuss rapid “cool first” management using ice packs, misting, and fans to reach 102°F within ~30 minutes, compare cooling methods (cold-water immersion, tarp-assisted oscillation, Quantico method, frozen sheets), review labs showing lactate 9 and AKI, explain sepsis-like physiology via gut hypoperfusion, and note possible risk contribution from recent COVID and acute Lyme IgM positivity. 

Links:
Ep. 33 - Heat Illness Fundamentals

Ep. 27 - Thermoregulation: The Physics and Physiology of Body Temperature Regulation

Clark G, Kocen S, Daniel N. Icy Hot: A Case of Unexpected Heat Illness. Wilderness Environ Med. 2026 Jun 16:10806032261458332. doi: 10.1177/10806032261458332. Epub ahead of print. PMID: 42300334.

Eifling KP, Gaudio FG, Dumke C, et al. Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Heat Illness: 2024 Update. Wilderness & Environmental Medicine. 2024;35(1_suppl):112S-127S. doi:10.1177/10806032241227924

Chapters:

00:00 Show Intro and Guests
02:43 Meet the Doctors
03:48 Race Day Collapse Setup
04:47 Finish Line Differential
06:48 EMS Report and History
08:55 Core Temp Surprise
11:25 Field Temp Takeaways
13:38 Rapid Cooling in ED
15:36 Cooling Rates and Goals
16:28 Immersion and Alternatives
18:17 Tarp and Body Bag Hacks
19:32 Quantico and Frozen Sheets
21:10 Field Cooling Methods
21:48 Lab Workup Red Flags
23:23 Lactate Nine Explained
24:21 Heatstroke Sepsis Pathway
26:40 Hidden Factors COVID Ticks
29:09 Fever Versus Hyperthermia
31:27 Prehospital Takeaways
35:00 Race Day Kit Checklist
36:35 Cool First Transport Later
37:29 Outcome And Wrap Up
39:46 Podcast Closing Notes

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-19783075 Wed, 09 Sep 2026 22:00:00 -0600 2554 heat illness, event medicine, heat stroke, exertional heat stroke, wilderness medicine, austere medicine, heat exhaustion, resuscitation 34 full false Fast Push #5 - TCCC Tourniquet Update Fast Push #5 - TCCC Tourniquet Update Forty to seventy-five percent of tourniquets placed in the field are never actually needed. In Ukraine, tourniquets left on too long during delayed evacuations have cost people limbs that the original wound never would have.

This fast push covers the new May 2026 TCCC Guidelines update and two CoTCCC training briefs on tourniquets, built around lessons from prolonged evacuations in the Russo-Ukrainian war. Topics: telling truly life-threatening bleeding from bleeding that just looks bad, the case of an 11.5-hour tourniquet that cost an arm, reassessment moving from a medic-only skill to something every responder needs, the six options at reassessment (remove, convert, reposition, tighten, add a second, leave alone), how to convert a tourniquet, and what changes once one's been on past six hours.

Takeaway: applying a tourniquet is the easy part. Knowing what to do with it for the next several hours is what actually saves the limb.

References:

Committee on Tactical Combat Casualty Care. TCCC Guidelines, 01 May 2026. https://deployedmedicine.com/tccc Full guidelines PDF: https://learning-media.allogy.com/api/v1/pdf/18ccfdfc-a076-47e9-8a34-376efdd81b43/contents

Butler F, Holcomb J, Dorlac W. TCCC Quick-Look: What Kind of Bleeding Requires a Tourniquet? 19 May 2026. https://www.aast.org/static/dadfd895-d295-4a5d-9f45f8d92940991c/TCCC-260521-TCCC-Quick-Look-Who-Needs-a-Tourniquet.pdf

Koch EJ, Andersen M, Barbee GA, et al. Standardizing Tourniquet Reassessment and Conversion Across TCCC Tiers: TCCC Guidelines Proposed Change 25-2. J Spec Oper Med. 2026;26(1):M4V1-O3Y7. This is the peer-reviewed paper behind the Tourniquet Reassessment Quick-Look. https://jsomonline.org/product/standardizing-tourniquet-reassessment-and-conversion-across-tccc-tiers-tccc-guidelines-proposed-change-25-2/ PubMed: https://pubmed.ncbi.nlm.nih.gov/41818038/

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Forty to seventy-five percent of tourniquets placed in the field are never actually needed. In Ukraine, tourniquets left on too long during delayed evacuations have cost people limbs that the original wound never would have.

This fast push covers the new May 2026 TCCC Guidelines update and two CoTCCC training briefs on tourniquets, built around lessons from prolonged evacuations in the Russo-Ukrainian war. Topics: telling truly life-threatening bleeding from bleeding that just looks bad, the case of an 11.5-hour tourniquet that cost an arm, reassessment moving from a medic-only skill to something every responder needs, the six options at reassessment (remove, convert, reposition, tighten, add a second, leave alone), how to convert a tourniquet, and what changes once one's been on past six hours.

Takeaway: applying a tourniquet is the easy part. Knowing what to do with it for the next several hours is what actually saves the limb.

References:

Committee on Tactical Combat Casualty Care. TCCC Guidelines, 01 May 2026. https://deployedmedicine.com/tccc Full guidelines PDF: https://learning-media.allogy.com/api/v1/pdf/18ccfdfc-a076-47e9-8a34-376efdd81b43/contents

Butler F, Holcomb J, Dorlac W. TCCC Quick-Look: What Kind of Bleeding Requires a Tourniquet? 19 May 2026. https://www.aast.org/static/dadfd895-d295-4a5d-9f45f8d92940991c/TCCC-260521-TCCC-Quick-Look-Who-Needs-a-Tourniquet.pdf

Koch EJ, Andersen M, Barbee GA, et al. Standardizing Tourniquet Reassessment and Conversion Across TCCC Tiers: TCCC Guidelines Proposed Change 25-2. J Spec Oper Med. 2026;26(1):M4V1-O3Y7. This is the peer-reviewed paper behind the Tourniquet Reassessment Quick-Look. https://jsomonline.org/product/standardizing-tourniquet-reassessment-and-conversion-across-tccc-tiers-tccc-guidelines-proposed-change-25-2/ PubMed: https://pubmed.ncbi.nlm.nih.gov/41818038/

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink, MD Buzzsprout-19697358 Mon, 24 Aug 2026 20:00:00 -0600 1169 tourniquet, TCCC, tactical combat casualty care, tourniquet guidelines, tourniquet reassessment bonus false Ep. 33 - Heat Illness Fundamentals: Recognize the Spectrum, Cool First, Transport Second Ep. 33 - Heat Illness Fundamentals: Recognize the Spectrum, Cool First, Transport Second Dr. Patrick Fink reviews the spectrum of heat illness using 2024 Wilderness Medical Society guidelines, covering recognition, physiology, field treatment, and key mimics. He distinguishes heat edema, heat cramps (salt-depletion vs exercise-associated), heat syncope and exercise-associated collapse, and defines heat exhaustion by preserved mental status versus heat stroke by altered mental status in a heat context, warning not to wait for a temperature threshold. He explains heat stroke pathophysiology as direct thermal injury plus a sepsis-like inflammatory cascade from gut hypoperfusion and barrier failure, emphasizing “heat × time” and a 30-minute cooling window. Core management is “cool first, transport second,” with cold water immersion as gold standard and improvised “tarp taco” alternatives; stop cooling around 38.3–38.8°C, avoid antipyretics and dantrolene, and use fluids only as support. He highlights exercise-associated hyponatremia as a dangerous mimic requiring hypertonic saline, and discusses disposition, including possible field release after full recovery within two hours for healthy exertional cases.

Links

Episode 27: Thermoregulation: The Physics and Physiology of Body Temperature Regulation

Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Heat Illness: 2024 Update

Chapters

00:00 Heatstroke Trail Scenario
01:02 Episode Roadmap
03:34 Thermoregulation Basics
06:43 Mild Heat Illness
11:21 Heat Exhaustion Line
13:32 Heat Stroke Recognition
17:18 Why Heatstroke Kills
22:37 Cool First Transport Second
24:51 Cold Water Immersion
27:31 Improvised Field Cooling
28:28 Myths Meds and Fluids
33:56 Hyponatremia Mimic
36:57 Disposition and Transport
39:38 Gear and Preparation
41:05 Key Takeaways Wrap Up

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Dr. Patrick Fink reviews the spectrum of heat illness using 2024 Wilderness Medical Society guidelines, covering recognition, physiology, field treatment, and key mimics. He distinguishes heat edema, heat cramps (salt-depletion vs exercise-associated), heat syncope and exercise-associated collapse, and defines heat exhaustion by preserved mental status versus heat stroke by altered mental status in a heat context, warning not to wait for a temperature threshold. He explains heat stroke pathophysiology as direct thermal injury plus a sepsis-like inflammatory cascade from gut hypoperfusion and barrier failure, emphasizing “heat × time” and a 30-minute cooling window. Core management is “cool first, transport second,” with cold water immersion as gold standard and improvised “tarp taco” alternatives; stop cooling around 38.3–38.8°C, avoid antipyretics and dantrolene, and use fluids only as support. He highlights exercise-associated hyponatremia as a dangerous mimic requiring hypertonic saline, and discusses disposition, including possible field release after full recovery within two hours for healthy exertional cases.

Links

Episode 27: Thermoregulation: The Physics and Physiology of Body Temperature Regulation

Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Heat Illness: 2024 Update

Chapters

00:00 Heatstroke Trail Scenario
01:02 Episode Roadmap
03:34 Thermoregulation Basics
06:43 Mild Heat Illness
11:21 Heat Exhaustion Line
13:32 Heat Stroke Recognition
17:18 Why Heatstroke Kills
22:37 Cool First Transport Second
24:51 Cold Water Immersion
27:31 Improvised Field Cooling
28:28 Myths Meds and Fluids
33:56 Hyponatremia Mimic
36:57 Disposition and Transport
39:38 Gear and Preparation
41:05 Key Takeaways Wrap Up

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-19577210 Thu, 30 Jul 2026 13:00:00 -0600 2660 heat illness, heat edema, heat cramps, heat exhaustion, classical heat stroke, exertional heat stroke, heat stroke, field treatment, wilderness medicine, event medicine 33 full false Fast Push #4: Expired Resuscitation Medications Fast Push #4: Expired Resuscitation Medications That EpiPen in your kit expired eighteen months ago. Anaphylaxis is happening. Do you use it?

This episode digs into a 2025 systematic review from the American Red Cross Scientific Advisory Council that asked a question most of us have quietly wondered about: do expired resuscitation medications still work? We walk through the evidence on the four drugs that matter most in the field — albuterol, aspirin, epinephrine, and naloxone — and what the science actually says when in-date meds aren't an option.

In this episode:

  • Why the expiration date is a manufacturer's guarantee, not a tombstone — and what it actually measures
  • The honest limitation behind all 17 studies: this is bench chemistry, not human outcomes
  • Albuterol holding 98% potency 20–30 years out, and why the inhaler's valve is the real weak link
  • The aspirin asterisk: solid for years, but down to under 12% active drug at 28–40 years
  • Epinephrine that's gone a little brown — discolored doesn't mean toxic, it means weaker
  • The nornaloxone question, and why decades-old naloxone still isn't dangerous
  • Sterility, storage, and the dashboard-baked-pen problem the studies couldn't answer
  • Where the ethics land: doing something with a probably-weakened drug vs. doing nothing

The takeaway: Carry in-date meds. Rotate your stock. Store them cool and dark. But throw out the binary — in a real emergency with no alternative, that expired pen very likely still has most of its fight left.

The mountain doesn't check expiration dates. Neither does anaphylaxis.

Reference: Charlton N, Berry DC, Kannan V, Yee R, Carlson JN, Orkin AM. "The use of expired resuscitation medications for life-threatening first aid conditions: a systematic search and narrative review." Resuscitation Plus. 2025;26:101110. Open access (CC BY).

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> That EpiPen in your kit expired eighteen months ago. Anaphylaxis is happening. Do you use it?

This episode digs into a 2025 systematic review from the American Red Cross Scientific Advisory Council that asked a question most of us have quietly wondered about: do expired resuscitation medications still work? We walk through the evidence on the four drugs that matter most in the field — albuterol, aspirin, epinephrine, and naloxone — and what the science actually says when in-date meds aren't an option.

In this episode:

  • Why the expiration date is a manufacturer's guarantee, not a tombstone — and what it actually measures
  • The honest limitation behind all 17 studies: this is bench chemistry, not human outcomes
  • Albuterol holding 98% potency 20–30 years out, and why the inhaler's valve is the real weak link
  • The aspirin asterisk: solid for years, but down to under 12% active drug at 28–40 years
  • Epinephrine that's gone a little brown — discolored doesn't mean toxic, it means weaker
  • The nornaloxone question, and why decades-old naloxone still isn't dangerous
  • Sterility, storage, and the dashboard-baked-pen problem the studies couldn't answer
  • Where the ethics land: doing something with a probably-weakened drug vs. doing nothing

The takeaway: Carry in-date meds. Rotate your stock. Store them cool and dark. But throw out the binary — in a real emergency with no alternative, that expired pen very likely still has most of its fight left.

The mountain doesn't check expiration dates. Neither does anaphylaxis.

Reference: Charlton N, Berry DC, Kannan V, Yee R, Carlson JN, Orkin AM. "The use of expired resuscitation medications for life-threatening first aid conditions: a systematic search and narrative review." Resuscitation Plus. 2025;26:101110. Open access (CC BY).

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-19285967 Tue, 02 Jun 2026 21:00:00 -0600 743 expired medications, resuscitation medications, wilderness medicine bonus false Ep. 32 - Airway Fundamentals for Austere Settings Ep. 32 - Airway Fundamentals for Austere Settings Prehospital Airway Fundamentals for BLS: Positioning, Pocket Mask, NPA/OPA, BVM, and LMA

Dr. Patrick Fink presents a BLS-focused airway fundamentals episode for prehospital and wilderness/SAR responders, emphasizing an ingrained, stepwise approach to stave off respiratory badness. 

Links:

Airway Fundamentals Video

Intersurgical iGel LMA

Chapters:
00:00 Airway Basics Overview
01:52 Questions And Upcoming Episodes
04:04 Scenario Mountain Biker
05:33 Airway Positioning Jaw Thrust
09:42 Pocket Mask Ventilations
13:24 Nasal Airway NPA
17:53 Oral Airway OPA
22:22 Putting It All Together
24:26 Oxygen And Bag Valve Mask
29:03 PEEP Valve Tips
30:29 Laryngeal Mask Airway
35:52 Full Airway Algorithm Walkthrough
38:39 What I Carry In My Kit
39:39 Practice And Mental Rehearsal
42:17 Wrap Up And Support The Show

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Prehospital Airway Fundamentals for BLS: Positioning, Pocket Mask, NPA/OPA, BVM, and LMA

Dr. Patrick Fink presents a BLS-focused airway fundamentals episode for prehospital and wilderness/SAR responders, emphasizing an ingrained, stepwise approach to stave off respiratory badness. 

Links:

Airway Fundamentals Video

Intersurgical iGel LMA

Chapters:
00:00 Airway Basics Overview
01:52 Questions And Upcoming Episodes
04:04 Scenario Mountain Biker
05:33 Airway Positioning Jaw Thrust
09:42 Pocket Mask Ventilations
13:24 Nasal Airway NPA
17:53 Oral Airway OPA
22:22 Putting It All Together
24:26 Oxygen And Bag Valve Mask
29:03 PEEP Valve Tips
30:29 Laryngeal Mask Airway
35:52 Full Airway Algorithm Walkthrough
38:39 What I Carry In My Kit
39:39 Practice And Mental Rehearsal
42:17 Wrap Up And Support The Show

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-19203722 Tue, 19 May 2026 11:00:00 -0600 2655 airway management, BLS airway, austere airway, wilderness medicine, austere medicine, 32 full false Ep. 31: Hypothermia Basics Ep. 31: Hypothermia Basics In this episode, Dr. Patrick Fink reviews accidental hypothermia for wilderness providers, building on Ep. 27 Thermoregulation, explaining physiologic changes as core temperature falls  and why accurate core temperatures are difficult to obtain in the field. 

We learn the modified Swiss staging system (0–4) based on signs and symptoms and outlines field management: 

- 0 cold stress (shelter, dry/insulate, warm calories; avoid alcohol), 

- 1 mild hypothermia (ataxia/fine motor impairment; passive plus active external rewarming with a hypothermia wrap and heat near axilla/groin; frequent reassessment), 

- 2 moderate hypothermia (confusion/lethargy; active external rewarming, evaluate hypoglycemia, gentle handling and no exertion to avoid afterdrop, cardiac monitoring, expedite evacuation), 

- 3 severe hypothermia (unresponsive with vital signs; airway/ventilation support, extremely gentle transport)

- 4 hypothermic cardiac arrest (60-second pulse check, CPR, limited shocks under 30°C, withhold epinephrine/amiodarone under 30°C, consider intermittent CPR per protocol, and note potassium’s role in termination decisions). 

We also briefly contrasts slow non-extracorporeal warming with ECMO/cardiopulmonary bypass, previewing a future episode on advanced care and the HOPE score

Links

Episode 27: Thermoregulation

WMS 2019 Accidental Hypothermia Guideline

AHA Hypothermia Guidelines

European Resuscitation Council Hypothermia Algorithm

Chapters:

00:00 Welcome and Overview
00:48 Hypothermia Basics
01:12 Cooling Physiology
04:06 Severe Effects and Arrhythmias
06:38 Field Temp Challenges
07:41 Swiss Staging Intro
08:35 Stage 0 Cold Stress
11:40 Stage 1 Mild Hypothermia
16:04 Stage 2 Moderate Hypothermia
20:44 Afterdrop and Handling
22:54 Stage 3 Severe Hypothermia
27:00 Stage 4 Cardiac Arrest
27:57 CPR Shocks and Drugs
37:01 Advanced Rewarming ECMO
43:26 Key Takeaways Summary
46:57 Wrap Up and Support



As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> In this episode, Dr. Patrick Fink reviews accidental hypothermia for wilderness providers, building on Ep. 27 Thermoregulation, explaining physiologic changes as core temperature falls  and why accurate core temperatures are difficult to obtain in the field. 

We learn the modified Swiss staging system (0–4) based on signs and symptoms and outlines field management: 

- 0 cold stress (shelter, dry/insulate, warm calories; avoid alcohol), 

- 1 mild hypothermia (ataxia/fine motor impairment; passive plus active external rewarming with a hypothermia wrap and heat near axilla/groin; frequent reassessment), 

- 2 moderate hypothermia (confusion/lethargy; active external rewarming, evaluate hypoglycemia, gentle handling and no exertion to avoid afterdrop, cardiac monitoring, expedite evacuation), 

- 3 severe hypothermia (unresponsive with vital signs; airway/ventilation support, extremely gentle transport)

- 4 hypothermic cardiac arrest (60-second pulse check, CPR, limited shocks under 30°C, withhold epinephrine/amiodarone under 30°C, consider intermittent CPR per protocol, and note potassium’s role in termination decisions). 

We also briefly contrasts slow non-extracorporeal warming with ECMO/cardiopulmonary bypass, previewing a future episode on advanced care and the HOPE score

Links

Episode 27: Thermoregulation

WMS 2019 Accidental Hypothermia Guideline

AHA Hypothermia Guidelines

European Resuscitation Council Hypothermia Algorithm

Chapters:

00:00 Welcome and Overview
00:48 Hypothermia Basics
01:12 Cooling Physiology
04:06 Severe Effects and Arrhythmias
06:38 Field Temp Challenges
07:41 Swiss Staging Intro
08:35 Stage 0 Cold Stress
11:40 Stage 1 Mild Hypothermia
16:04 Stage 2 Moderate Hypothermia
20:44 Afterdrop and Handling
22:54 Stage 3 Severe Hypothermia
27:00 Stage 4 Cardiac Arrest
27:57 CPR Shocks and Drugs
37:01 Advanced Rewarming ECMO
43:26 Key Takeaways Summary
46:57 Wrap Up and Support



As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-18832608 Wed, 11 Mar 2026 21:00:00 -0600 2974 hypothermia, accidental hypothermia, hypothermic cardiac arrest, hypothermia resuscitation, wilderness medicine, austere medicine, global health, disaster medicine 31 full false Ep. 30 - Rethinking Spinal Immobilization: EMS Evidence Update Ep. 30 - Rethinking Spinal Immobilization: EMS Evidence Update Reevaluating Spinal Motion Restriction: Evidence Update

In this episode of Wilderness Medicine Updates, host Dr. Patrick Fink delves into the evolving guidelines and practices concerning spinal motion restriction. Drawing from historical dogma and modern research, Patrick explores the inefficacies and potential harms of traditional spinal immobilization tools like rigid spine boards and cervical collars. Instead, he advocates for more flexible, evidence-based approaches such as using well-padded surfaces and coaching patients to minimize their own motion. Key points from a comprehensive literature review by the National Association of EMS Physicians and other authoritative bodies are discussed, highlighting the shift from immobilization to motion restriction and its practical implications. Listeners are urged to stay updated with current evidence and consult medical directors before altering their practices.

Links

Ep. 14 - Spinal Immobilization Guidelines Update

2018 ACEP/NAEMSP Sminal Motion Restriction Position Statement

Prehospital Trauma Compendium: Prehospital Management of Spinal Cord Injuries - A NAEMSP Comprehensive Review and Analysis of the Literature


Chapters

00:00 Introduction to Wilderness Medicine Updates

00:42 Historical Perspective on Spinal Immobilization

01:44 Transition to Spinal Motion Restriction

03:30 Review of Recent Literature

05:40 Key Findings on Spinal Motion and Neurological Outcomes

09:30 Effectiveness of Backboards and Cervical Collars

12:10 Potential Harms of Immobilization Tools

16:38 Practical Recommendations and Future Directions

21:48 Conclusion and Final Thoughts


As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Reevaluating Spinal Motion Restriction: Evidence Update

In this episode of Wilderness Medicine Updates, host Dr. Patrick Fink delves into the evolving guidelines and practices concerning spinal motion restriction. Drawing from historical dogma and modern research, Patrick explores the inefficacies and potential harms of traditional spinal immobilization tools like rigid spine boards and cervical collars. Instead, he advocates for more flexible, evidence-based approaches such as using well-padded surfaces and coaching patients to minimize their own motion. Key points from a comprehensive literature review by the National Association of EMS Physicians and other authoritative bodies are discussed, highlighting the shift from immobilization to motion restriction and its practical implications. Listeners are urged to stay updated with current evidence and consult medical directors before altering their practices.

Links

Ep. 14 - Spinal Immobilization Guidelines Update

2018 ACEP/NAEMSP Sminal Motion Restriction Position Statement

Prehospital Trauma Compendium: Prehospital Management of Spinal Cord Injuries - A NAEMSP Comprehensive Review and Analysis of the Literature


Chapters

00:00 Introduction to Wilderness Medicine Updates

00:42 Historical Perspective on Spinal Immobilization

01:44 Transition to Spinal Motion Restriction

03:30 Review of Recent Literature

05:40 Key Findings on Spinal Motion and Neurological Outcomes

09:30 Effectiveness of Backboards and Cervical Collars

12:10 Potential Harms of Immobilization Tools

16:38 Practical Recommendations and Future Directions

21:48 Conclusion and Final Thoughts


As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-18650569 Mon, 09 Feb 2026 11:00:00 -0700 1373 spinal motion restriction, spinal immobilization, wilderness medicine, search and rescue, ski patrol, austere medicine, 30 full false Ep. 29 - Wilderness Orthopedics with Dr. Chris Healy Ep. 29 - Wilderness Orthopedics with Dr. Chris Healy Wilderness Orthopedics: Managing Trauma in Remote Environments with Dr. Chris Healy

In this episode of Wilderness Medicine Updates, host Dr. Patrick Fink tackles orthopedic injuries in the wilderness with Dr. Chris Healy, an orthopedic surgeon and outdoor enthusiast. They explore the management of long bone fractures, traction for femur, pelvic binders, and the nuances of treating injuries in limited-resource environments. The episode covers strategies for handling common injuries like shoulder dislocations, tibia fractures, knee injuries, and how to prioritize care. They also emphasize the importance of timely evacuation and when and how to safely attempt reductions in the field.

Links:

Donate to the Tina Biddle Memorial Scholarship

Sulcus sign / Squaring of the shoulder

Chapters:

00:00 Introduction and Episode Overview
01:36 Tribute to Tina Biddle
04:09 Meet Dr. Chris Healy
05:11 Ski Patrol Background and Pre-Hospital Care
08:12 Approaching Orthopedic Injuries in the Field
17:50 Managing Tibia and Fibula Fractures
21:40 Understanding Compartment Syndrome
27:50 Femur Fractures and Traction Splinting
36:57 Pelvic Fractures: Identification and Management
38:41 Understanding Pelvic Fractures and Binders
39:53 The Role of Pelvic Binders in Pre-Hospital Care
41:11 Challenges with Pelvic Binders in the Field
43:15 Proper Placement of Pelvic Binders
46:36 Field Management of Shoulder Dislocations
50:43 Techniques for Reducing Shoulder Dislocations
54:17 Managing Upper Extremity Injuries
57:51 Handling Knee Injuries in the Field
01:00:37 Patella vs. Knee Dislocations
01:08:06 Evacuation Priorities for Knee Dislocations
01:10:53 Common Issues in Pre-Hospital Orthopedic Care
01:15:36 Final Thoughts and Listener Engagement

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Wilderness Orthopedics: Managing Trauma in Remote Environments with Dr. Chris Healy

In this episode of Wilderness Medicine Updates, host Dr. Patrick Fink tackles orthopedic injuries in the wilderness with Dr. Chris Healy, an orthopedic surgeon and outdoor enthusiast. They explore the management of long bone fractures, traction for femur, pelvic binders, and the nuances of treating injuries in limited-resource environments. The episode covers strategies for handling common injuries like shoulder dislocations, tibia fractures, knee injuries, and how to prioritize care. They also emphasize the importance of timely evacuation and when and how to safely attempt reductions in the field.

Links:

Donate to the Tina Biddle Memorial Scholarship

Sulcus sign / Squaring of the shoulder

Chapters:

00:00 Introduction and Episode Overview
01:36 Tribute to Tina Biddle
04:09 Meet Dr. Chris Healy
05:11 Ski Patrol Background and Pre-Hospital Care
08:12 Approaching Orthopedic Injuries in the Field
17:50 Managing Tibia and Fibula Fractures
21:40 Understanding Compartment Syndrome
27:50 Femur Fractures and Traction Splinting
36:57 Pelvic Fractures: Identification and Management
38:41 Understanding Pelvic Fractures and Binders
39:53 The Role of Pelvic Binders in Pre-Hospital Care
41:11 Challenges with Pelvic Binders in the Field
43:15 Proper Placement of Pelvic Binders
46:36 Field Management of Shoulder Dislocations
50:43 Techniques for Reducing Shoulder Dislocations
54:17 Managing Upper Extremity Injuries
57:51 Handling Knee Injuries in the Field
01:00:37 Patella vs. Knee Dislocations
01:08:06 Evacuation Priorities for Knee Dislocations
01:10:53 Common Issues in Pre-Hospital Orthopedic Care
01:15:36 Final Thoughts and Listener Engagement

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-18525548 Sun, 18 Jan 2026 14:00:00 -0700 4691 orthopedics, fracture, dislocation, wilderness medicine, wilderness orthopedics, compartment syndrome, SAR ortho, ski patrol ortho 29 full false Ep. 28 - Laura McGladrey, Responder Alliance, and Stress Injury: How to Get Back to Green and Save Living While Saving Lives. Ep. 28 - Laura McGladrey, Responder Alliance, and Stress Injury: How to Get Back to Green and Save Living While Saving Lives. Understanding Stress Injuries in First Line Responders with Laura McGladrey

This episode of Wilderness Medicine Updates, hosted by Patrick Fink, features a conversation with Laura McGladrey, founder of the Responder Alliance. They discuss the critical issue of stress injuries among first line responders, including professional ski patrollers, healthcare workers, and rescue team members. Through personal stories and expert insights, Laura explains the concept of stress injuries, how they develop, and the importance of early detection and mitigation. The episode highlights the need for both individual and organizational strategies to support resilience and manage stress. Listeners are introduced to practical tools, cultural shifts, and personal anecdotes to help maintain a long, healthy, and fulfilling career in high-stress environments.

Links

Responder Alliance Home Page
Access all that the organization has to offer.

Responder Alliance: Resource Hub
Easy access to critical tools and offerings.

The Stress Continuum
See the visual continuum that we discuss on the show.

Scholarships: Responder Alliance Foundation
Apply for aid for an individual or team training.

Make a Donation to Responder Alliance Foundation!
Join me in making a tax-deductible donation to support the valuable work of the Responder Alliance and bring this work to those who need it, regardless of cost.

Chapters
00:00 Introduction and Guest Welcome
02:11 Laura's Background and Work
06:00 Understanding Stress Injuries
10:02 Responder Alliance Mission and Challenges
20:55 Critical Incident Stress Management
30:49 Empowering First Responders
32:13 Daily Investments in Resilience
37:26 Recognizing and Managing Stress
38:14 Organizational Support for Stress Management
39:45 Building Resilient Teams
46:12 Learning from Resilient Leaders
52:42 Resources for Stress Mitigation
57:54 Conclusion and Final Thoughts

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Understanding Stress Injuries in First Line Responders with Laura McGladrey

This episode of Wilderness Medicine Updates, hosted by Patrick Fink, features a conversation with Laura McGladrey, founder of the Responder Alliance. They discuss the critical issue of stress injuries among first line responders, including professional ski patrollers, healthcare workers, and rescue team members. Through personal stories and expert insights, Laura explains the concept of stress injuries, how they develop, and the importance of early detection and mitigation. The episode highlights the need for both individual and organizational strategies to support resilience and manage stress. Listeners are introduced to practical tools, cultural shifts, and personal anecdotes to help maintain a long, healthy, and fulfilling career in high-stress environments.

Links

Responder Alliance Home Page
Access all that the organization has to offer.

Responder Alliance: Resource Hub
Easy access to critical tools and offerings.

The Stress Continuum
See the visual continuum that we discuss on the show.

Scholarships: Responder Alliance Foundation
Apply for aid for an individual or team training.

Make a Donation to Responder Alliance Foundation!
Join me in making a tax-deductible donation to support the valuable work of the Responder Alliance and bring this work to those who need it, regardless of cost.

Chapters
00:00 Introduction and Guest Welcome
02:11 Laura's Background and Work
06:00 Understanding Stress Injuries
10:02 Responder Alliance Mission and Challenges
20:55 Critical Incident Stress Management
30:49 Empowering First Responders
32:13 Daily Investments in Resilience
37:26 Recognizing and Managing Stress
38:14 Organizational Support for Stress Management
39:45 Building Resilient Teams
46:12 Learning from Resilient Leaders
52:42 Resources for Stress Mitigation
57:54 Conclusion and Final Thoughts

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink Buzzsprout-18192155 Fri, 14 Nov 2025 14:00:00 -0700 3573 full false Ep. 27 - Thermoregulation: The Physics and Physiology of Body Temperature Regulation Ep. 27 - Thermoregulation: The Physics and Physiology of Body Temperature Regulation In this episode of Wilderness Medicine Updates, host Patrick Fink delves into the topic of thermoregulation, explaining how our bodies regulate temperature in response to environmental changes. Listeners will learn about methods of heat exchange (conduction, convection, radiation, and evaporation), how to measure core temperature, and the body's physiological responses—such as shivering, sweating, and blood flow control. 

The episode also touches on the effects of age, metabolic stressors, and pregnancy on thermoregulation, as well as the importance of understanding these principles in the context of treating conditions like hypothermia and heat-related illnesses.

00:00 Introduction and Episode Overview
01:29 Importance of Thermoregulation
03:12 Human Thermoregulation Mechanisms
04:20 Measuring Core Temperature
07:55 Heat Exchange Methods
14:52 Behavioral and Physiological Responses
24:48 Sex and Age Differences in Thermoregulation
27:14 Conclusion and Next Steps

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> In this episode of Wilderness Medicine Updates, host Patrick Fink delves into the topic of thermoregulation, explaining how our bodies regulate temperature in response to environmental changes. Listeners will learn about methods of heat exchange (conduction, convection, radiation, and evaporation), how to measure core temperature, and the body's physiological responses—such as shivering, sweating, and blood flow control. 

The episode also touches on the effects of age, metabolic stressors, and pregnancy on thermoregulation, as well as the importance of understanding these principles in the context of treating conditions like hypothermia and heat-related illnesses.

00:00 Introduction and Episode Overview
01:29 Importance of Thermoregulation
03:12 Human Thermoregulation Mechanisms
04:20 Measuring Core Temperature
07:55 Heat Exchange Methods
14:52 Behavioral and Physiological Responses
24:48 Sex and Age Differences in Thermoregulation
27:14 Conclusion and Next Steps

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-18135076 Tue, 04 Nov 2025 16:00:00 -0700 1920 thermoregulation, hyperthermia, hypothermia, 27 full false Fast Push #3: Safeback SBX for Avalanche Asphyxia Prevention Fast Push #3: Safeback SBX for Avalanche Asphyxia Prevention In this episode of Wilderness Medicine Updates, host Patrick Fink delves into groundbreaking technology designed to improve safety during avalanche events. The focus is on SafeBack SBX, a Norwegian-developed device that supplies air to users buried in avalanches, potentially extending survival time. Patrick reviews new research published in the Journal of the American Medical Association, which demonstrates significant efficacy in delaying hypoxia during simulated avalanche burials. The episode provides an in-depth analysis of SafeBack SBX, its mechanisms, study results, and its comparative and complementary role alongside existing safety technologies like airbags. Concluding with potential applications and limitations, Patrick aids listeners in deciding whether SafeBack SBX is a worthy addition to their avalanche safety gear.

Links

Eisendle F, Roveri G, Rauch S, et al. Respiratory Gas Shifts to Delay Asphyxiation in Critical Avalanche Burial: A Randomized Clinical Trial. JAMA. Published online October 08, 2025. doi:10.1001/jama.2025.16837

Articles I've written about Safeback:

Suffocation or Survival: A Crucial Factor in Avalanche Burials

Avalanche Safety: Assessing the Safeback SBX System

First Look: Safeback SBX Avalanche Safety System

Chapters
00:31 Overview of SafeBack SBX Technology
02:55 Importance of SafeBack in Avalanche Safety
05:40 Details of the SafeBack Study
07:53 Study Results and Analysis
11:07 Implications and Future Directions
15:50 Conclusion and Final Thoughts



As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> In this episode of Wilderness Medicine Updates, host Patrick Fink delves into groundbreaking technology designed to improve safety during avalanche events. The focus is on SafeBack SBX, a Norwegian-developed device that supplies air to users buried in avalanches, potentially extending survival time. Patrick reviews new research published in the Journal of the American Medical Association, which demonstrates significant efficacy in delaying hypoxia during simulated avalanche burials. The episode provides an in-depth analysis of SafeBack SBX, its mechanisms, study results, and its comparative and complementary role alongside existing safety technologies like airbags. Concluding with potential applications and limitations, Patrick aids listeners in deciding whether SafeBack SBX is a worthy addition to their avalanche safety gear.

Links

Eisendle F, Roveri G, Rauch S, et al. Respiratory Gas Shifts to Delay Asphyxiation in Critical Avalanche Burial: A Randomized Clinical Trial. JAMA. Published online October 08, 2025. doi:10.1001/jama.2025.16837

Articles I've written about Safeback:

Suffocation or Survival: A Crucial Factor in Avalanche Burials

Avalanche Safety: Assessing the Safeback SBX System

First Look: Safeback SBX Avalanche Safety System

Chapters
00:31 Overview of SafeBack SBX Technology
02:55 Importance of SafeBack in Avalanche Safety
05:40 Details of the SafeBack Study
07:53 Study Results and Analysis
11:07 Implications and Future Directions
15:50 Conclusion and Final Thoughts



As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-17986493 Fri, 10 Oct 2025 11:00:00 -0600 1079 safeback, safeback sbx, avalanche related asphyxia, avalanche accidents full false Ep. 26 - Physical Training for Mountain Rescue Professionals with Rob Shaul of Mountain Tactical Institute Ep. 26 - Physical Training for Mountain Rescue Professionals with Rob Shaul of Mountain Tactical Institute On this episode of Wilderness Medicine Updates, host Patrick Fink shifts focus from the science and literature of wilderness medicine to practical fitness tips for search and rescue personnel, ski patrollers, and outdoor rescuers. Patrick interviews Rob Shaw, founder and head coach of the Mountain Tactical Institute, about his specialized training programs for various types of mountain athletes, including those in industrial and tactical roles. They discuss the nuances of preparing for seasonal work, the distinct fitness demands of ski patrollers versus search and rescue members, and the importance of chassis integrity and mental fitness. Rob highlights minimal equipment training plans that can be effective for mountain professionals and recreational athletes alike, and offers a special discount for the show's listeners. Additional topics covered include Rob's nutritional recommendations and the concept of the 'quiet professional,' someone deeply committed to the craft of their work. 

Offer

Are you involved in mountain or wilderness rescue? Rob is offering the first 50 listeners who reach out to him a 20% discount on a training plan. Send your rescue or professional credentials to rob@mtntactical.com to secure your discount.

Links

Training Plans Patrick Likes:

Mountain Base Fitness Greek Heroine Series

Busy Dad Training Packet 

Backcountry Ski Preseason Training Plan
 

Exercises Discussed:

Leg Blasters

Scotty Bobs

Touch Jump Touch
 

Rob's Resources:

Ideal bodyweights for mountain athletes

Nutritional guidelines

Mountain/Wilderness SAR Fitness Assessment Training Plan

Resilience vs. Discipline vs. Perseverance: Why the Distinctions Matter in Mental Fitness

The 8 Core Attributes of Mental Fitness


Chapters

00:00 Introduction to Wilderness Medicine
00:46 Guest Introduction: Rob Shaw from Mountain Tactical Institute
04:38 The Evolution of Mountain Tactical Institute
06:58 Training for Mountain and Tactical Athletes
11:43 Fitness Demands for Ski Patrol
19:13 In-Season Training and Professionalism
24:47 Fitness for Search and Rescue Volunteers
25:10 Integrating Training with Daily Life
25:15 Physical and Mental Demands of SAR
25:38 Uphill Endurance and Chassis Integrity
26:25 Step Ups and Efficient Training Methods
28:23 Chassis Integrity Explained
31:53 Mental Fitness and Resilience
35:45 Nutritional Recommendations for Athletes
37:49 The Quiet Professional
42:30 Conclusion and Resources

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> On this episode of Wilderness Medicine Updates, host Patrick Fink shifts focus from the science and literature of wilderness medicine to practical fitness tips for search and rescue personnel, ski patrollers, and outdoor rescuers. Patrick interviews Rob Shaw, founder and head coach of the Mountain Tactical Institute, about his specialized training programs for various types of mountain athletes, including those in industrial and tactical roles. They discuss the nuances of preparing for seasonal work, the distinct fitness demands of ski patrollers versus search and rescue members, and the importance of chassis integrity and mental fitness. Rob highlights minimal equipment training plans that can be effective for mountain professionals and recreational athletes alike, and offers a special discount for the show's listeners. Additional topics covered include Rob's nutritional recommendations and the concept of the 'quiet professional,' someone deeply committed to the craft of their work. 

Offer

Are you involved in mountain or wilderness rescue? Rob is offering the first 50 listeners who reach out to him a 20% discount on a training plan. Send your rescue or professional credentials to rob@mtntactical.com to secure your discount.

Links

Training Plans Patrick Likes:

Mountain Base Fitness Greek Heroine Series

Busy Dad Training Packet 

Backcountry Ski Preseason Training Plan
 

Exercises Discussed:

Leg Blasters

Scotty Bobs

Touch Jump Touch
 

Rob's Resources:

Ideal bodyweights for mountain athletes

Nutritional guidelines

Mountain/Wilderness SAR Fitness Assessment Training Plan

Resilience vs. Discipline vs. Perseverance: Why the Distinctions Matter in Mental Fitness

The 8 Core Attributes of Mental Fitness


Chapters

00:00 Introduction to Wilderness Medicine
00:46 Guest Introduction: Rob Shaw from Mountain Tactical Institute
04:38 The Evolution of Mountain Tactical Institute
06:58 Training for Mountain and Tactical Athletes
11:43 Fitness Demands for Ski Patrol
19:13 In-Season Training and Professionalism
24:47 Fitness for Search and Rescue Volunteers
25:10 Integrating Training with Daily Life
25:15 Physical and Mental Demands of SAR
25:38 Uphill Endurance and Chassis Integrity
26:25 Step Ups and Efficient Training Methods
28:23 Chassis Integrity Explained
31:53 Mental Fitness and Resilience
35:45 Nutritional Recommendations for Athletes
37:49 The Quiet Professional
42:30 Conclusion and Resources

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-17947677 Thu, 02 Oct 2025 15:00:00 -0600 2874 rob shaul, mountain tactical institute, physical training for rescuers 26 full true Ep. 25 - Tree Well Burial Study / Wilderness Med Careers AMA with Zack Majd Ep. 25 - Tree Well Burial Study / Wilderness Med Careers AMA with Zack Majd In this episode of Wilderness Medicine Updates, host Patrick Fink breaks down a recent research paper on the differences between simulated avalanche burial and tree well burial, analyzing the findings and their implications for skiers and outdoor rescue personnel. 

We then transition to a special Q&A session with pre-med student Zack Majd, tackling questions about forming a career in wilderness medicine. Patrick discusses the necessary educational paths, the benefits and limitations of fellowships, and the essentials of wilderness medical training. Additionally, the episode highlights upcoming educational events and provides practical advice on wilderness medical gear, psychological support techniques, and the integration of wilderness medicine with other medical disciplines. A must-listen for anyone interested in advancing their career in the field of wilderness medicine.

Links:

Kanaan NC, Abdul Cader J, Krakker J, Beasley H, Grissom CK, McIntosh SE. Simulated Avalanche vs Tree-Well Burial Effects on Human Physiology. Wilderness & Environmental Medicine. 2025;36(3):361-367. doi:10.1177/10806032251337476

Van Tilburg C, Paal P, Strapazzon G, et al. Wilderness Medical Society Clinical Practice Guidelines for Prevention and Management of Avalanche and Nonavalanche Snow Burial Accidents: 2024 Update. Wilderness & Environmental Medicine. 2023;35(1_suppl):20S-44S. doi:10.1016/j.wem.2023.05.014

Fink PB, Wheeler AR, Smith WR, et al. Wilderness Medical Society Clinical Practice Guidelines for the Treatment of Acute Pain in Austere Environments: 2024 Update. Wilderness & Environmental Medicine. 2024;35(2):198-218. doi:10.1177/10806032241248422

EP. 21 - Snow Immersion Suffocation 


Chapters:

00:00 Introduction and Episode Overview

00:43 Upcoming Events in Wilderness Medicine

Part 1

02:07 Tree Well Burials vs. Avalanche Burials

05:36 Study Findings and Analysis

08:23 Limitations and Implications of the Study

Part 2

11:21 Q&A: Careers in Wilderness Medicine

12:48 Zach's Journey and Career Questions

20:35 Balancing Wilderness Medicine with Other Careers

26:05 Pathways to Wilderness Medicine

30:32 Debating the Value of Wilderness Medicine Fellowships

32:21 Personal Experience with Wilderness Medicine Fellowship

34:29 Research in Wilderness Medicine

37:05 Essential EMS Gear for Wildland Firefighters

39:19 Prioritizing Care in Wilderness Settings

47:31 Psychological First Aid in Wilderness Medicine

50:49 Preparing for Wilderness Medicine Challenges

53:55 Future of Wilderness Medicine

57:33 Signoff

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> In this episode of Wilderness Medicine Updates, host Patrick Fink breaks down a recent research paper on the differences between simulated avalanche burial and tree well burial, analyzing the findings and their implications for skiers and outdoor rescue personnel. 

We then transition to a special Q&A session with pre-med student Zack Majd, tackling questions about forming a career in wilderness medicine. Patrick discusses the necessary educational paths, the benefits and limitations of fellowships, and the essentials of wilderness medical training. Additionally, the episode highlights upcoming educational events and provides practical advice on wilderness medical gear, psychological support techniques, and the integration of wilderness medicine with other medical disciplines. A must-listen for anyone interested in advancing their career in the field of wilderness medicine.

Links:

Kanaan NC, Abdul Cader J, Krakker J, Beasley H, Grissom CK, McIntosh SE. Simulated Avalanche vs Tree-Well Burial Effects on Human Physiology. Wilderness & Environmental Medicine. 2025;36(3):361-367. doi:10.1177/10806032251337476

Van Tilburg C, Paal P, Strapazzon G, et al. Wilderness Medical Society Clinical Practice Guidelines for Prevention and Management of Avalanche and Nonavalanche Snow Burial Accidents: 2024 Update. Wilderness & Environmental Medicine. 2023;35(1_suppl):20S-44S. doi:10.1016/j.wem.2023.05.014

Fink PB, Wheeler AR, Smith WR, et al. Wilderness Medical Society Clinical Practice Guidelines for the Treatment of Acute Pain in Austere Environments: 2024 Update. Wilderness & Environmental Medicine. 2024;35(2):198-218. doi:10.1177/10806032241248422

EP. 21 - Snow Immersion Suffocation 


Chapters:

00:00 Introduction and Episode Overview

00:43 Upcoming Events in Wilderness Medicine

Part 1

02:07 Tree Well Burials vs. Avalanche Burials

05:36 Study Findings and Analysis

08:23 Limitations and Implications of the Study

Part 2

11:21 Q&A: Careers in Wilderness Medicine

12:48 Zach's Journey and Career Questions

20:35 Balancing Wilderness Medicine with Other Careers

26:05 Pathways to Wilderness Medicine

30:32 Debating the Value of Wilderness Medicine Fellowships

32:21 Personal Experience with Wilderness Medicine Fellowship

34:29 Research in Wilderness Medicine

37:05 Essential EMS Gear for Wildland Firefighters

39:19 Prioritizing Care in Wilderness Settings

47:31 Psychological First Aid in Wilderness Medicine

50:49 Preparing for Wilderness Medicine Challenges

53:55 Future of Wilderness Medicine

57:33 Signoff

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-17811945 Mon, 08 Sep 2025 17:00:00 -0600 3683 wilderness medicine careers, tree well burial, avalanche burial, snow immersion suffocation 25 full false Zack Majd Patrick Fink MD, FAWM Ep. 24 - Airway Management in Austere Environments with Dr. Nicholas Weinberg Ep. 24 - Airway Management in Austere Environments with Dr. Nicholas Weinberg In this episode of Wilderness Medicine Updates, Dr. Patrick Fink discusses airway management in austere situations with Dr. Nicholas Weinberg. They explore two cases published in the Wilderness Medicine Journal, detailing the decision-making processes in managing critically injured patients. Dr. Weinberg shares his background in emergency and wilderness medicine, and highlights the importance of flexibility and the application of basic life support techniques in the wilderness. The episode emphasizes the significance of understanding the limitations and capabilities of the available tools in wilderness settings.

Links

WEM Article

Photo: Ledge from the fallen climber

Photo: Himalayan clinic resuscitation

Connect with Dr Weinberg: Nicholas.E.Weinberg@hitchcock.org

Timeline

00:00 Introduction and Overview

00:26 Meet Dr. Nicholas Weinberg

01:48 Dr. Weinberg's Background and Career

03:55 Case Introduction: The Climbing Accident

05:38 On-Scene Response and Initial Assessment

08:11 Airway Management and Rescue Coordination

11:05 Patient's Condition and Medical Interventions

18:34 Patient's Recovery and Conclusion

21:01 Reflecting on a Remarkable Case

21:30 Discussing the Second Case

22:59 Experiences in Wilderness Medicine

25:24 Challenges and Strategies in Remote Medical Care

30:31 Managing Airway in Austere Environments

37:42 Advice for Aspiring Wilderness Physicians

42:24 Concluding Thoughts and Listener Shoutouts

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> In this episode of Wilderness Medicine Updates, Dr. Patrick Fink discusses airway management in austere situations with Dr. Nicholas Weinberg. They explore two cases published in the Wilderness Medicine Journal, detailing the decision-making processes in managing critically injured patients. Dr. Weinberg shares his background in emergency and wilderness medicine, and highlights the importance of flexibility and the application of basic life support techniques in the wilderness. The episode emphasizes the significance of understanding the limitations and capabilities of the available tools in wilderness settings.

Links

WEM Article

Photo: Ledge from the fallen climber

Photo: Himalayan clinic resuscitation

Connect with Dr Weinberg: Nicholas.E.Weinberg@hitchcock.org

Timeline

00:00 Introduction and Overview

00:26 Meet Dr. Nicholas Weinberg

01:48 Dr. Weinberg's Background and Career

03:55 Case Introduction: The Climbing Accident

05:38 On-Scene Response and Initial Assessment

08:11 Airway Management and Rescue Coordination

11:05 Patient's Condition and Medical Interventions

18:34 Patient's Recovery and Conclusion

21:01 Reflecting on a Remarkable Case

21:30 Discussing the Second Case

22:59 Experiences in Wilderness Medicine

25:24 Challenges and Strategies in Remote Medical Care

30:31 Managing Airway in Austere Environments

37:42 Advice for Aspiring Wilderness Physicians

42:24 Concluding Thoughts and Listener Shoutouts

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink Buzzsprout-17659931 Tue, 12 Aug 2025 11:00:00 -0600 2775 airway management, wilderness medicine, austere medicine, mountain medicine, intubation 24 full false Dr. Nicholas Weinberg Patrick Fink MD, FAWM Ep. 23 - Inhaled Xenon Gas for Altitude Adaptation Ep. 23 - Inhaled Xenon Gas for Altitude Adaptation Exploring Xenon Gas for Altitude Acclimatization and Sport Performance
In this episode of Wilderness Medicine Updates, host Patrick Fink delves into the use of inhaled xenon gas for sports performance enhancement and altitude acclimatization. The discussion is prompted by a recent claim from a UK climbing team that xenon helped them achieve a rapid ascent of Mount Everest. Xenon, a noble gas traditionally used as an anesthetic, has been shown to trigger hypoxia response pathways and boost EPO levels in animal studies. However, human trials have yet to demonstrate significant performance benefits or lasting changes in blood composition. The episode also examines the safety concerns and potential risks associated with unsupervised xenon use. While xenon shows some promise, current evidence suggests it may be more of a placebo effect rather than a reliable tool for enhancing athletic performance or altitude adaptation.

Join us on social!
Instagram - Wildmedupdates
Bluesky - wildmedupdates.bsky.social
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Chapters
00:00 Introduction to Wilderness Medicine Updates
00:19 Xenon Gas in Sports and Altitude Acclimatization
02:26 The Science Behind Xenon Gas
06:13 Human Studies on Xenon Gas
12:19 Risks and Side Effects of Xenon Gas
15:50 Conclusion and Final Thoughts
18:04 Social Media Announcement

Sources
Dias, K.A. et al. (2019). Effect of acute and chronic xenon inhalation on erythropoietin, hematological parameters, and athletic performance. Journal of Applied Physiology, 127(6), 1503-1510

Lawley, J.S. et al. (2019). Safety, hemodynamic effects, and detection of acute xenon inhalation: rationale for banning xenon from sport. Journal of Applied Physiology, 127(6), 1511-1518

Ma, D. et al. (2009). Xenon preconditioning protects against renal ischemic-reperfusion injury via HIF-1α activation. Journal of the American Society of Nephrology, 20(4), 713-720

Pappas, S. (2023). “Did Inhaling Xenon Gas Really Help Mount Everest Climbers Reach the Summit in Record Time?” Scientific American

Hackett, P. (2025). “Xenon Gas and High-Altitude Performance: What We Know and What We Don’t.” Uphill Athlete


As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Exploring Xenon Gas for Altitude Acclimatization and Sport Performance
In this episode of Wilderness Medicine Updates, host Patrick Fink delves into the use of inhaled xenon gas for sports performance enhancement and altitude acclimatization. The discussion is prompted by a recent claim from a UK climbing team that xenon helped them achieve a rapid ascent of Mount Everest. Xenon, a noble gas traditionally used as an anesthetic, has been shown to trigger hypoxia response pathways and boost EPO levels in animal studies. However, human trials have yet to demonstrate significant performance benefits or lasting changes in blood composition. The episode also examines the safety concerns and potential risks associated with unsupervised xenon use. While xenon shows some promise, current evidence suggests it may be more of a placebo effect rather than a reliable tool for enhancing athletic performance or altitude adaptation.

Join us on social!
Instagram - Wildmedupdates
Bluesky - wildmedupdates.bsky.social
X - Wildmedupdates
YouTube - WildernessMedicineUpdates

Chapters
00:00 Introduction to Wilderness Medicine Updates
00:19 Xenon Gas in Sports and Altitude Acclimatization
02:26 The Science Behind Xenon Gas
06:13 Human Studies on Xenon Gas
12:19 Risks and Side Effects of Xenon Gas
15:50 Conclusion and Final Thoughts
18:04 Social Media Announcement

Sources
Dias, K.A. et al. (2019). Effect of acute and chronic xenon inhalation on erythropoietin, hematological parameters, and athletic performance. Journal of Applied Physiology, 127(6), 1503-1510

Lawley, J.S. et al. (2019). Safety, hemodynamic effects, and detection of acute xenon inhalation: rationale for banning xenon from sport. Journal of Applied Physiology, 127(6), 1511-1518

Ma, D. et al. (2009). Xenon preconditioning protects against renal ischemic-reperfusion injury via HIF-1α activation. Journal of the American Society of Nephrology, 20(4), 713-720

Pappas, S. (2023). “Did Inhaling Xenon Gas Really Help Mount Everest Climbers Reach the Summit in Record Time?” Scientific American

Hackett, P. (2025). “Xenon Gas and High-Altitude Performance: What We Know and What We Don’t.” Uphill Athlete


As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink, MD Buzzsprout-17292482 Fri, 06 Jun 2025 08:00:00 -0600 1174 xenon gas, anesthesia, epo, blood doping, altitude, altitude performance, acclimatization, Mt Everest 23 full false Ep. 22 - Moose Mutlow: Yosemite Swiftwater SAR, Family Liaison Officer, and longevity in rescue. Ep. 22 - Moose Mutlow: Yosemite Swiftwater SAR, Family Liaison Officer, and longevity in rescue. In this episode of Wilderness Medicine Updates, host Patrick Fink interviews Moose Mutlow, an experienced outdoor educator and search and rescue professional with nearly four decades of experience globally. Moose discusses his extensive career from being an Outward Bound instructor to working with Yosemite Search and Rescue, and his role as a Family Liaison Officer for the National Park Service. The conversation touches on the challenges faced by search and rescue teams, the importance of robust communication skills, and how to build resilience against trauma in high-stress professions. Moose also shares his personal experiences, reflecting on the value of mentorship, the significance of team dynamics, and the essential need for compassionate support during crises. The episode includes practical advice for those in the field of wilderness medicine and search and rescue, highlighting the necessity of emotional balance and continuous learning.

Connect with Moose:
Website
Blue Sky
Instagram
Substack
Book: Searching
Book: When Accidents Happen

Did you enjoy this episode? Contribute to YOSAR!

Links from the show:
The Stress Continuum
Responder Alliance
Quell Foundation
Dr. Nicola Lester: trauma informed practice

More Reading:
Ranger Confidential
Nature Noir
The Cold Vanish
The Last Season

CHAPTERS
00:00 Introduction and Guest Welcome
00:19 Moose Motlow's Background and Career
01:58 Challenges in Search and Rescue
02:58 The Importance of National Parks
05:23 Moose's Nickname and Early Career
07:07 Transition to the US and Outdoor Adventures
10:54 Search and Rescue Experiences
15:20 Swift Water Rescue Operations
19:38 Training and Mentorship in SAR
30:18 Role of Family Liaison Officer
45:24 Managing Emotional Burden as a Liaison Officer
47:12 Recognizing and Addressing Trauma
48:36 The Importance of Peer Support
49:44 Cultural Norms and Vulnerability
51:05 The Cost of Ignoring Trauma
53:37 Building Resilience and Longevity in Careers
58:51 Mentorship and Knowledge Sharing
01:03:11 The Role of Family Liaison Officers
01:05:50 Training and Communication Skills
01:17:52 Lighthearted Stories from the Field
01:23:14 Recommended Resources and Final Thoughts



As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> In this episode of Wilderness Medicine Updates, host Patrick Fink interviews Moose Mutlow, an experienced outdoor educator and search and rescue professional with nearly four decades of experience globally. Moose discusses his extensive career from being an Outward Bound instructor to working with Yosemite Search and Rescue, and his role as a Family Liaison Officer for the National Park Service. The conversation touches on the challenges faced by search and rescue teams, the importance of robust communication skills, and how to build resilience against trauma in high-stress professions. Moose also shares his personal experiences, reflecting on the value of mentorship, the significance of team dynamics, and the essential need for compassionate support during crises. The episode includes practical advice for those in the field of wilderness medicine and search and rescue, highlighting the necessity of emotional balance and continuous learning.

Connect with Moose:
Website
Blue Sky
Instagram
Substack
Book: Searching
Book: When Accidents Happen

Did you enjoy this episode? Contribute to YOSAR!

Links from the show:
The Stress Continuum
Responder Alliance
Quell Foundation
Dr. Nicola Lester: trauma informed practice

More Reading:
Ranger Confidential
Nature Noir
The Cold Vanish
The Last Season

CHAPTERS
00:00 Introduction and Guest Welcome
00:19 Moose Motlow's Background and Career
01:58 Challenges in Search and Rescue
02:58 The Importance of National Parks
05:23 Moose's Nickname and Early Career
07:07 Transition to the US and Outdoor Adventures
10:54 Search and Rescue Experiences
15:20 Swift Water Rescue Operations
19:38 Training and Mentorship in SAR
30:18 Role of Family Liaison Officer
45:24 Managing Emotional Burden as a Liaison Officer
47:12 Recognizing and Addressing Trauma
48:36 The Importance of Peer Support
49:44 Cultural Norms and Vulnerability
51:05 The Cost of Ignoring Trauma
53:37 Building Resilience and Longevity in Careers
58:51 Mentorship and Knowledge Sharing
01:03:11 The Role of Family Liaison Officers
01:05:50 Training and Communication Skills
01:17:52 Lighthearted Stories from the Field
01:23:14 Recommended Resources and Final Thoughts



As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink, MD Buzzsprout-17024287 Tue, 22 Apr 2025 16:00:00 -0600 5330 FLA, YOSAR, family liaison officer, yosemite search and rescue, moose mutlow 22 full true Ep. 21 - Snow Immersion Suffocation Ep. 21 - Snow Immersion Suffocation In this episode, we dive into one of the most overlooked but deadly hazards in deep powder skiing: snow immersion suffocation (NARSID). Unlike avalanches, snow immersion deaths happen silently—often within feet of a groomed run—when skiers and snowboarders fall into deep snow or tree wells and become trapped. We explore the research behind these incidents, where and how they occur, who is most at risk, and the tragic mechanics of asphyxiation in deep snow. Using studies from Van Tilburg, Baugher, and Cadman, we break down ra eal survival story, discuss prevention strategies, and how both bystanders and professional rescuers should respond. Whether you’re a backcountry adventurer, resort skier, or ski patroller, this episode will change the way you think about deep snow safety. Stay aware, ski with a partner, and stay out of tree wells.

Must Watch: GoPro Awards: Tree Well Rescue

Citations

Baugher, P. (2006). Risk trends at U.S. and British Columbia ski areas: An evaluation of the risk of snow immersion versus avalanche burials. In Proceedings of the 2006 International Snow Science Workshop (pp. 584–591). International Snow Science Workshop.
URL: https://arc.lib.montana.edu/snow-science/item/2076

Cadman, R. (1999). Eight nonavalanche snow-immersion deaths: A 6-year series from British Columbia ski areas. The Physician and Sportsmedicine, 27(13), 31–43.
URL: (No publicly available link found—may be available through institutional access)

Van Tilburg, C. (2010). Non–avalanche-related snow immersion deaths: Tree well and deep snow immersion asphyxiation. Wilderness & Environmental Medicine, 21(3), 257–261.
URL: https://doi.org/10.1016/j.wem.2010.04.004

Van Tilburg, C. S., Grissom, C. K., Zafren, K., McIntosh, S. E., Radwin, M. I., Paal, P., et al. (2017). Wilderness Medical Society practice guidelines for the prevention and management of avalanche and non-avalanche snow burial accidents. Wilderness & Environmental Medicine, 28(1), 23–42.
URL: https://doi.org/10.1016/j.wem.2016.10.001

Chapters
00:00 Introduction: The Hidden Dangers of Snow Immersion
00:37 Understanding Snow Immersion Suffocation
02:58 Historical Context and Research
03:09 Where and How Snow Immersion Happens
04:54 Mechanics of Snow Immersion Traps
06:23 Risk Factors and Victim Profiles
09:27 Prevention and Safety Measures
11:48 Rescue Techniques and Immediate Response
13:34 Professional Rescuer Guidelines
16:12 Advanced Medical Care and Resuscitation
20:11 Conclusion and Final Thoughts

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> In this episode, we dive into one of the most overlooked but deadly hazards in deep powder skiing: snow immersion suffocation (NARSID). Unlike avalanches, snow immersion deaths happen silently—often within feet of a groomed run—when skiers and snowboarders fall into deep snow or tree wells and become trapped. We explore the research behind these incidents, where and how they occur, who is most at risk, and the tragic mechanics of asphyxiation in deep snow. Using studies from Van Tilburg, Baugher, and Cadman, we break down ra eal survival story, discuss prevention strategies, and how both bystanders and professional rescuers should respond. Whether you’re a backcountry adventurer, resort skier, or ski patroller, this episode will change the way you think about deep snow safety. Stay aware, ski with a partner, and stay out of tree wells.

Must Watch: GoPro Awards: Tree Well Rescue

Citations

Baugher, P. (2006). Risk trends at U.S. and British Columbia ski areas: An evaluation of the risk of snow immersion versus avalanche burials. In Proceedings of the 2006 International Snow Science Workshop (pp. 584–591). International Snow Science Workshop.
URL: https://arc.lib.montana.edu/snow-science/item/2076

Cadman, R. (1999). Eight nonavalanche snow-immersion deaths: A 6-year series from British Columbia ski areas. The Physician and Sportsmedicine, 27(13), 31–43.
URL: (No publicly available link found—may be available through institutional access)

Van Tilburg, C. (2010). Non–avalanche-related snow immersion deaths: Tree well and deep snow immersion asphyxiation. Wilderness & Environmental Medicine, 21(3), 257–261.
URL: https://doi.org/10.1016/j.wem.2010.04.004

Van Tilburg, C. S., Grissom, C. K., Zafren, K., McIntosh, S. E., Radwin, M. I., Paal, P., et al. (2017). Wilderness Medical Society practice guidelines for the prevention and management of avalanche and non-avalanche snow burial accidents. Wilderness & Environmental Medicine, 28(1), 23–42.
URL: https://doi.org/10.1016/j.wem.2016.10.001

Chapters
00:00 Introduction: The Hidden Dangers of Snow Immersion
00:37 Understanding Snow Immersion Suffocation
02:58 Historical Context and Research
03:09 Where and How Snow Immersion Happens
04:54 Mechanics of Snow Immersion Traps
06:23 Risk Factors and Victim Profiles
09:27 Prevention and Safety Measures
11:48 Rescue Techniques and Immediate Response
13:34 Professional Rescuer Guidelines
16:12 Advanced Medical Care and Resuscitation
20:11 Conclusion and Final Thoughts

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink Buzzsprout-16861723 Tue, 25 Mar 2025 21:00:00 -0600 1416 snow immersion, tree well, tree well suffocation, tree well burial, snow immersion suffocation, nonavalanche snow immersion death, NARSID 21 full false Ep. 20 - Out of Hospital Airway Adjuncts: King Tube vs LMA Ep. 20 - Out of Hospital Airway Adjuncts: King Tube vs LMA King Tube vs IGEL for Airway Management

In this episode of Wilderness Medicine Updates, Dr. Patrick Fink addresses a listener's question on whether to use a King Tube or an IGEL as an out-of-hospital airway adjunct. The episode begins with an overview of airway management techniques from mouth-to-mouth resuscitation to supraglottic airway devices. Dr. Fink explains the benefits and drawbacks of various airway adjuncts, including oral and nasal pharyngeal airways. The discussion then shifts to a detailed comparative analysis of King Tubes and IGELs based on retrospective and prospective studies. Dr. Fink evaluates the evidence indicating that IGEL may be more effective and easier to use than King Tubes, particularly in pre-hospital cardiac arrest situations. The episode concludes with recommendations for pre-hospital providers and an encouragement for listeners to share their questions and feedback.

Links:

iGel LMA

King Tube

Smida T, Menegazzi J, Scheidler J, et al. A retrospective comparison of the King Laryngeal Tube and iGel supraglottic airway devices: A study for the CARES surveillance group. Resuscitation. 2023;188:109812. doi:10.1016/j.resuscitation.2023.109812

Smida, Tanner & Menegazzi, James & Crowe, Remle & Scheidler, James & Salcido, David & Bardes, James. (2023). A Retrospective Nationwide Comparison of the iGel and King Laryngeal Tube Supraglottic Airways for Out-of-Hospital Cardiac Arrest Resuscitation. Prehospital emergency care. 28. 1-13. 10.1080/10903127.2023.2169422. 

Lønvik, M.P., Elden, O.E., Lunde, M.J. et al. A prospective observational study comparing two supraglottic airway devices in out-of-hospital cardiac arrest. BMC Emerg Med 21, 51 (2021). https://doi.org/10.1186/s12873-021-00444-0

Chapters

00:00 Introduction and Listener Question

00:55 Understanding Airway Adjuncts

02:12 Basic Airway Management Techniques

06:34 Advanced Airway Devices: King Tube and LMA

11:35 Comparative Studies on Airway Devices

17:35 Prospective Data and Final Thoughts

25:24 Conclusion and Listener Engagement

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> King Tube vs IGEL for Airway Management

In this episode of Wilderness Medicine Updates, Dr. Patrick Fink addresses a listener's question on whether to use a King Tube or an IGEL as an out-of-hospital airway adjunct. The episode begins with an overview of airway management techniques from mouth-to-mouth resuscitation to supraglottic airway devices. Dr. Fink explains the benefits and drawbacks of various airway adjuncts, including oral and nasal pharyngeal airways. The discussion then shifts to a detailed comparative analysis of King Tubes and IGELs based on retrospective and prospective studies. Dr. Fink evaluates the evidence indicating that IGEL may be more effective and easier to use than King Tubes, particularly in pre-hospital cardiac arrest situations. The episode concludes with recommendations for pre-hospital providers and an encouragement for listeners to share their questions and feedback.

Links:

iGel LMA

King Tube

Smida T, Menegazzi J, Scheidler J, et al. A retrospective comparison of the King Laryngeal Tube and iGel supraglottic airway devices: A study for the CARES surveillance group. Resuscitation. 2023;188:109812. doi:10.1016/j.resuscitation.2023.109812

Smida, Tanner & Menegazzi, James & Crowe, Remle & Scheidler, James & Salcido, David & Bardes, James. (2023). A Retrospective Nationwide Comparison of the iGel and King Laryngeal Tube Supraglottic Airways for Out-of-Hospital Cardiac Arrest Resuscitation. Prehospital emergency care. 28. 1-13. 10.1080/10903127.2023.2169422. 

Lønvik, M.P., Elden, O.E., Lunde, M.J. et al. A prospective observational study comparing two supraglottic airway devices in out-of-hospital cardiac arrest. BMC Emerg Med 21, 51 (2021). https://doi.org/10.1186/s12873-021-00444-0

Chapters

00:00 Introduction and Listener Question

00:55 Understanding Airway Adjuncts

02:12 Basic Airway Management Techniques

06:34 Advanced Airway Devices: King Tube and LMA

11:35 Comparative Studies on Airway Devices

17:35 Prospective Data and Final Thoughts

25:24 Conclusion and Listener Engagement

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink Buzzsprout-16794566 Fri, 14 Mar 2025 16:00:00 -0600 1647 full false Ep. 19 - Methoxyflurane, the Green Whistle, with Dr. Ross Hofmeyr Ep. 19 - Methoxyflurane, the Green Whistle, with Dr. Ross Hofmeyr Exploring Methoxyfluorane for Wilderness Pain Management with Dr. Ross Hofmeyr

In this episode of Wilderness Medicine Updates, host Dr. Patrick Fink discusses the use of methoxyfluorane, an anesthetic gas for pain management in wilderness settings. Joined by guest Dr. Ross Hofmeyr, an anesthesiologist and wilderness medicine expert from South Africa, the episode delves into the history, usage, benefits, and limitations of methoxyfluorane. Highlighting its efficacy, ease of use, and safety, especially for pre-hospital scenarios, Dr. Hofmeyr shares insights into its ideal applications, contraindications, and personal experiences. The episode underscores the significance of methoxyfluorane as a potent analgesic suitable for acute traumatic pain and procedural analgesia in austere environments.

Links

Wild Medix

Ross Hofmyer on Instagram

The Inhaler Device

Methoxyflurane at Altitude - Case Report

Methoxyflurane in the Outback - Survivor Clip

WMS Pain Management Guidelines


Chapters:
00:00 Welcome to Wilderness Medicine Updates
00:55 Meet Dr. Ross Hofmeyr
03:14 Dr. Hoffmeier's Background in Wilderness Medicine
04:45 Methoxyfluorine: An Overview
12:20 The Mechanics of Methoxyfluorine Inhaler
20:15 Practical Applications in Pre-Hospital Pain Control
20:53 Analgesic Intervention: Quick and Effective
21:09 Using Methoxyfluorane in Wilderness Settings
22:42 Training Non-Medical Personnel
23:49 Procedural Analgo-Sedation
24:30 Regulatory Considerations and Prescriptions
26:33 Combining Methoxyfluorane with Other Medications
28:10 Monitoring and Safety
29:09 Ambulating Patients with Methoxyfluorane
31:31 Environmental Considerations: Temperature and Altitude
40:10 Cost and Practical Downsides
41:45 Conclusion and Final Thoughts



As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Exploring Methoxyfluorane for Wilderness Pain Management with Dr. Ross Hofmeyr

In this episode of Wilderness Medicine Updates, host Dr. Patrick Fink discusses the use of methoxyfluorane, an anesthetic gas for pain management in wilderness settings. Joined by guest Dr. Ross Hofmeyr, an anesthesiologist and wilderness medicine expert from South Africa, the episode delves into the history, usage, benefits, and limitations of methoxyfluorane. Highlighting its efficacy, ease of use, and safety, especially for pre-hospital scenarios, Dr. Hofmeyr shares insights into its ideal applications, contraindications, and personal experiences. The episode underscores the significance of methoxyfluorane as a potent analgesic suitable for acute traumatic pain and procedural analgesia in austere environments.

Links

Wild Medix

Ross Hofmyer on Instagram

The Inhaler Device

Methoxyflurane at Altitude - Case Report

Methoxyflurane in the Outback - Survivor Clip

WMS Pain Management Guidelines


Chapters:
00:00 Welcome to Wilderness Medicine Updates
00:55 Meet Dr. Ross Hofmeyr
03:14 Dr. Hoffmeier's Background in Wilderness Medicine
04:45 Methoxyfluorine: An Overview
12:20 The Mechanics of Methoxyfluorine Inhaler
20:15 Practical Applications in Pre-Hospital Pain Control
20:53 Analgesic Intervention: Quick and Effective
21:09 Using Methoxyfluorane in Wilderness Settings
22:42 Training Non-Medical Personnel
23:49 Procedural Analgo-Sedation
24:30 Regulatory Considerations and Prescriptions
26:33 Combining Methoxyfluorane with Other Medications
28:10 Monitoring and Safety
29:09 Ambulating Patients with Methoxyfluorane
31:31 Environmental Considerations: Temperature and Altitude
40:10 Cost and Practical Downsides
41:45 Conclusion and Final Thoughts



As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-16611362 Wed, 12 Feb 2025 12:00:00 -0700 2728 wilderness medicine, wilderness pain management, prehospital pain management, methoxyflurane 19 full false Dr. Ross Hofmyer Patrick Fink MD, FAWM Ep. 18 - Ketamine for Wilderness Pain Management with Dr. Christopher Van Tilburg Ep. 18 - Ketamine for Wilderness Pain Management with Dr. Christopher Van Tilburg Ketamine Use in Wilderness Pain Management: An Interview with Dr. Chris Van Tilburg

In this episode of Wilderness Medicine Updates, host Patrick Fink discusses wilderness pain control with guest Dr. Chris Van Tilburg, focusing on the effective use of ketamine. The episode delves into how ketamine serves as a versatile medication for pain management, sedation, and intubation in emergency and wilderness environments.

Dr. Van Tilburg, an expert in wilderness medicine with extensive field experience, shares insights on administering ketamine in challenging rescue scenarios, the limitations and benefits of various medications, and practical considerations for field use. The conversation touches on dose ranges, administration techniques, and patient management during rescues. Additionally, Dr. Van Tilburg talks about his soon-to-be-released book, 'Crisis on Mount Hood: Stories from 100 Years of Mountain Rescue,' celebrating the centennial of the Crag Rats, America's oldest mountain rescue team.

Links
WMS Guideline: Avalanche and Nonavalanche Snow Burial

WMS Guideline: Pain Management in Austere Environments 

Chris’s Linktree

Contact Chris through LinkedIn

Preorder Chris’s book “Crisis on Mt Hood”

Chris on Wikipedia

Crag Rats Mountain Rescue

Chapters:
00:00 Welcome and New Year Greetings
00:29 Introducing Today's Guest: Dr. Chris Van Tilburg
03:07 Podcast Shoutouts and Listener Appreciation
03:37 In Conversation with Dr. Chris Van Tilburg
05:58 Challenges of Wilderness Pain Management
09:37 Pain Management Strategies
14:23 Ketamine vs. Other Pain Medications
18:01 Ketamine Dosage and Administration
22:16 Nitty Gritty Tactics: Needle Sizes and Administration
23:02 Intramuscular Injection Sites and Techniques
24:22 Timing and Dosage of Ketamine Administration
25:16 Challenges in Mountain Rescue Situations
27:17 Case Study: Seizure Patient and Ketamine Use
29:18 Considerations for Head Injuries and Ketamine
33:03 Medications in Wilderness Medical Kits
34:02 The Art of Wilderness Medicine
37:54 Protecting Medications in the Field
38:55 Wrapping Up: Upcoming Book and Final Thoughts

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Ketamine Use in Wilderness Pain Management: An Interview with Dr. Chris Van Tilburg

In this episode of Wilderness Medicine Updates, host Patrick Fink discusses wilderness pain control with guest Dr. Chris Van Tilburg, focusing on the effective use of ketamine. The episode delves into how ketamine serves as a versatile medication for pain management, sedation, and intubation in emergency and wilderness environments.

Dr. Van Tilburg, an expert in wilderness medicine with extensive field experience, shares insights on administering ketamine in challenging rescue scenarios, the limitations and benefits of various medications, and practical considerations for field use. The conversation touches on dose ranges, administration techniques, and patient management during rescues. Additionally, Dr. Van Tilburg talks about his soon-to-be-released book, 'Crisis on Mount Hood: Stories from 100 Years of Mountain Rescue,' celebrating the centennial of the Crag Rats, America's oldest mountain rescue team.

Links
WMS Guideline: Avalanche and Nonavalanche Snow Burial

WMS Guideline: Pain Management in Austere Environments 

Chris’s Linktree

Contact Chris through LinkedIn

Preorder Chris’s book “Crisis on Mt Hood”

Chris on Wikipedia

Crag Rats Mountain Rescue

Chapters:
00:00 Welcome and New Year Greetings
00:29 Introducing Today's Guest: Dr. Chris Van Tilburg
03:07 Podcast Shoutouts and Listener Appreciation
03:37 In Conversation with Dr. Chris Van Tilburg
05:58 Challenges of Wilderness Pain Management
09:37 Pain Management Strategies
14:23 Ketamine vs. Other Pain Medications
18:01 Ketamine Dosage and Administration
22:16 Nitty Gritty Tactics: Needle Sizes and Administration
23:02 Intramuscular Injection Sites and Techniques
24:22 Timing and Dosage of Ketamine Administration
25:16 Challenges in Mountain Rescue Situations
27:17 Case Study: Seizure Patient and Ketamine Use
29:18 Considerations for Head Injuries and Ketamine
33:03 Medications in Wilderness Medical Kits
34:02 The Art of Wilderness Medicine
37:54 Protecting Medications in the Field
38:55 Wrapping Up: Upcoming Book and Final Thoughts

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-16424412 Sun, 12 Jan 2025 14:00:00 -0700 2733 ketamine, pain management, the crag rats, mountain rescue, wilderness medicine, wilderness pain management 18 full false Dr. Christopher Van Tilburg Patrick Fink MD, FAWM Ep. 17 - Resuscitation of the Buried Avalanche Victim, Part 2: The Rescue Algorithm Ep. 17 - Resuscitation of the Buried Avalanche Victim, Part 2: The Rescue Algorithm In episode 17 of Wilderness Medicine Updates, host Patrick Fink delves into the ICAR resuscitation algorithm for buried avalanche victims. The episode reviews the physiology of avalanche burial and discusses critical determinants of survival, such as duration of burial, airway patency, signs of life, and lethal injuries. The Basic Life Support (BLS) and Advanced Life Support (ALS) algorithms are explained in detail, with a focus on the practical application for both amateur and professional rescuers.

The episode also includes two detailed case studies that illustrate the application of the resuscitation algorithm, providing listeners with practical scenarios to better understand the protocols. Key insights on the importance of quick action, hypothermia, and ongoing CPR are highlighted, making this episode essential listening for anyone involved in avalanche rescue operations.

Ep. 12 - Resuscitation of the Buried Avalanche Victim, Part 1: Physiology

ICAR Rescue Algorithm

ICAR Paper in Resuscitation

Chapters:
00:00 Ep. 17 - Resuscitation of the Buried Avalanche Victim, Part 2
01:26 Review
08:52 BLS Algorithm
14:30 ALS Algorithm
25:30 Interlude
25:30 Case 1: Partner Rescue
31:01 Case 2: Professional Rescue
39:54 Conclusion/Outro

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> In episode 17 of Wilderness Medicine Updates, host Patrick Fink delves into the ICAR resuscitation algorithm for buried avalanche victims. The episode reviews the physiology of avalanche burial and discusses critical determinants of survival, such as duration of burial, airway patency, signs of life, and lethal injuries. The Basic Life Support (BLS) and Advanced Life Support (ALS) algorithms are explained in detail, with a focus on the practical application for both amateur and professional rescuers.

The episode also includes two detailed case studies that illustrate the application of the resuscitation algorithm, providing listeners with practical scenarios to better understand the protocols. Key insights on the importance of quick action, hypothermia, and ongoing CPR are highlighted, making this episode essential listening for anyone involved in avalanche rescue operations.

Ep. 12 - Resuscitation of the Buried Avalanche Victim, Part 1: Physiology

ICAR Rescue Algorithm

ICAR Paper in Resuscitation

Chapters:
00:00 Ep. 17 - Resuscitation of the Buried Avalanche Victim, Part 2
01:26 Review
08:52 BLS Algorithm
14:30 ALS Algorithm
25:30 Interlude
25:30 Case 1: Partner Rescue
31:01 Case 2: Professional Rescue
39:54 Conclusion/Outro

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink Buzzsprout-16110338 Thu, 14 Nov 2024 21:00:00 -0700 2543 avalanche victim, critical burial, avalanche resuscitation, ICAR, avalanche victim resuscitation checklist, resuscitation, hypoxia, trauma, asphyxia, wilderness medicine, ski patrol medicine, SAR medicine, mountain medicine 17 full false Ep. 16 - Medications for Alpine Hut Trips Ep. 16 - Medications for Alpine Hut Trips In this episode, I share an intense story of dealing with a suprise medical condition during a backcountry hut trip in Colorado. I walk through the diagnostic process, treatment options, and the importance of preparation for stays in remote places. Essential medications and tools needed for handling such emergencies in remote settings are discussed, along with advice on how to prepare for future expeditions.

My articles on The-High-Route.com

The Hut Medication Card

Chapters: 

00:00 Introduction and Personal Update

01:31 The Backcountry Hut Trip Begins

03:19 Will's Health Deteriorates

04:38 Diagnosing the Problem

07:04 The Emergency Descent

09:16 Lessons Learned and Preparedness

10:37 Essential Medications for Wilderness Trips

16:19 Final Thoughts and Conclusion

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> In this episode, I share an intense story of dealing with a suprise medical condition during a backcountry hut trip in Colorado. I walk through the diagnostic process, treatment options, and the importance of preparation for stays in remote places. Essential medications and tools needed for handling such emergencies in remote settings are discussed, along with advice on how to prepare for future expeditions.

My articles on The-High-Route.com

The Hut Medication Card

Chapters: 

00:00 Introduction and Personal Update

01:31 The Backcountry Hut Trip Begins

03:19 Will's Health Deteriorates

04:38 Diagnosing the Problem

07:04 The Emergency Descent

09:16 Lessons Learned and Preparedness

10:37 Essential Medications for Wilderness Trips

16:19 Final Thoughts and Conclusion

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink, MD Buzzsprout-16052427 Tue, 05 Nov 2024 10:00:00 -0700 1030 altitude illness, HAPE, medications, dexamethasone, acetazolamide, nifedipine, ibuprofen, acetaminophen, aspirin, diphenhydramine, ondansetron, loperamide, epinephrine 16 full false Ep. 15 - Airway Patency in Avalanche Victims Ep. 15 - Airway Patency in Avalanche Victims This episode, I look at a study from the Eurac research group on rates of airway occlusion in critically buried avalanche victims. Eurac looked at this critical feature of avalanche resuscitation triage as it both affects the way we treat buried avalanche victims, and it helps us to better understand whether technologies like the black diamond Avalung (retired) and the Safeback SBX can help us survive longer under the snow if buried.

Full study text HERE

The High Route article on the Safeback system HERE

Episode 12: Avalanche victim physiology. Listen on web, Apple Podcasts, or Spotify.

Episode 14: Spinal immobilization updates. Listen on web, Apple Podcasts, or Spotify.

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> This episode, I look at a study from the Eurac research group on rates of airway occlusion in critically buried avalanche victims. Eurac looked at this critical feature of avalanche resuscitation triage as it both affects the way we treat buried avalanche victims, and it helps us to better understand whether technologies like the black diamond Avalung (retired) and the Safeback SBX can help us survive longer under the snow if buried.

Full study text HERE

The High Route article on the Safeback system HERE

Episode 12: Avalanche victim physiology. Listen on web, Apple Podcasts, or Spotify.

Episode 14: Spinal immobilization updates. Listen on web, Apple Podcasts, or Spotify.

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-15939822 Wed, 16 Oct 2024 16:00:00 -0600 635 avalanche burial, critical burial, safeback sbx, eurac, avalanche safety 15 full false Ep. 14 - Spinal Immobilization Guidelines Update Ep. 14 - Spinal Immobilization Guidelines Update Today, we discuss updates in the WMS guidelines regarding the protection of patients with suspected spinal injuries.

The Wilderness Medicine Society Clinical Practice Guidelines are all open-access, and you can find links to all of these guidelines on the right sidebar of this page.

The education in this episode is based on the:

Wilderness Medical Society Clinical Practice Guidelines for Spinal Cord Protection: 2024 Update


If you've never seen a vacuum mattress before, this video (2:10) gives a good introduction.

If the brief mention of the Diploma in Mountain Medicine alpine skills course got you interested, you can learn more about the DiMM here.

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Today, we discuss updates in the WMS guidelines regarding the protection of patients with suspected spinal injuries.

The Wilderness Medicine Society Clinical Practice Guidelines are all open-access, and you can find links to all of these guidelines on the right sidebar of this page.

The education in this episode is based on the:

Wilderness Medical Society Clinical Practice Guidelines for Spinal Cord Protection: 2024 Update


If you've never seen a vacuum mattress before, this video (2:10) gives a good introduction.

If the brief mention of the Diploma in Mountain Medicine alpine skills course got you interested, you can learn more about the DiMM here.

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-15543665 Tue, 06 Aug 2024 21:00:00 -0600 815 spinal immobilization, spinal stabilization, backboard, vacuum mattress, cervical collar, clinical practice guideline 14 full false Ep. 13 - The High Route: Arguments for Avalanche Airbags Ep. 13 - The High Route: Arguments for Avalanche Airbags This episode is a repost of an interview that was first posted on The High Route Podcast. Hosted by the editor of The-High-Route.com, Jason Albert, we discuss my background in wilderness medicine, and then move on to discuss the research that support my argument and assertion that the avalanche airbag backpack should be standard equipment for backcountry skiers, snowboarders, snowmobilers, and anyone who regularly works or recreates in avalanche terrain.

Check out The-High-Route.com for awesome backcountry ski and ski-mountaineering content that is unbiased by financial relationships with gear companies and advertisers.

Show Note Links:

-ISSW Research Manuscript from my avalanche airbag study

-My personal website, Mountain Lessons

-The Backcountry Shit Kit, original post

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> This episode is a repost of an interview that was first posted on The High Route Podcast. Hosted by the editor of The-High-Route.com, Jason Albert, we discuss my background in wilderness medicine, and then move on to discuss the research that support my argument and assertion that the avalanche airbag backpack should be standard equipment for backcountry skiers, snowboarders, snowmobilers, and anyone who regularly works or recreates in avalanche terrain.

Check out The-High-Route.com for awesome backcountry ski and ski-mountaineering content that is unbiased by financial relationships with gear companies and advertisers.

Show Note Links:

-ISSW Research Manuscript from my avalanche airbag study

-My personal website, Mountain Lessons

-The Backcountry Shit Kit, original post

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-14821340 Wed, 03 Apr 2024 10:00:00 -0600 2931 avalanche airbags, The High Route, The-High-Route.com, Jason Albert, safety equipment, risk homeostasis 13 full false Ep. 12 - Resuscitation of the Buried Avalanche Victim, Part 1: Physiology Ep. 12 - Resuscitation of the Buried Avalanche Victim, Part 1: Physiology This is part 1 of a multi-part series on the resuscitation of critically buried avalanche victims. In this episode we learn the physiology that we need to understand the resuscitation algorithm. To learn the necessary biology, we follow a rider as they are carried in an avalanche, subjected to traumatic injury, and are then buried and begin to asphyxiate and cool. 

The background of this episode is useful to understand why:
-Cardiac arrest from trauma is usually unsalvageable;
-Arrest due to hypoxia can happen within minutes or be delayed more than an hour;
-Why we care if someone is really, really cold;
-Why potassium measurement is useful in the hospital treatment of severe hypothermia;
-And why we can largely forget about that other gas, CO2.

Look out for the next episode, where I''ll dive into the ICAR Avalanche Victim Resuscitation Algorithm.

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> This is part 1 of a multi-part series on the resuscitation of critically buried avalanche victims. In this episode we learn the physiology that we need to understand the resuscitation algorithm. To learn the necessary biology, we follow a rider as they are carried in an avalanche, subjected to traumatic injury, and are then buried and begin to asphyxiate and cool. 

The background of this episode is useful to understand why:
-Cardiac arrest from trauma is usually unsalvageable;
-Arrest due to hypoxia can happen within minutes or be delayed more than an hour;
-Why we care if someone is really, really cold;
-Why potassium measurement is useful in the hospital treatment of severe hypothermia;
-And why we can largely forget about that other gas, CO2.

Look out for the next episode, where I''ll dive into the ICAR Avalanche Victim Resuscitation Algorithm.

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-14384043 Fri, 26 Jan 2024 10:00:00 -0700 1116 avalanche, hypoxia, asphyxiation, CPR, hypothermia, hypercarbia, trauma, hyperkalemia 12 full false Ep. 11 - After the Avalanche with Michael Buchanan Ep. 11 - After the Avalanche with Michael Buchanan Episode 11 brings you  my conversation with Michael Buchanan is a flight paramedic and senior firefighter / paramedic at the West Valley City Fire Department. He is the founder and operation of Mountain Medical Academy, a passion-driven backcountry medical care education company.  We discuss the medical care of avalanche victims which Michael has made accessible to recreational skiers and riders who don't have a medical background.

Other topics that we discuss include:
-Finger sweeps to clear the airway
-How the presence of an air pocket changes your medical care
-How long to perform CPR after an avalanche
-What equipment may be useful to a lay rescuer
-The importance of psychological care after a critical event
And more.

Below are links to things discussed in this podcast:

Mountain Medical Academy - mountain medical education

After the Avalanche - Open source resources for responding medically and psychologically after an avalanche

Email Michael to Join a Class or Partner Up

Israeli Battle Dressing (affiliate link) - elastic compressive dressing for bleeding control

SWAT-T Elastic Tourniquet (affiliate link) - elastic tourniquet also useful in splinting

CPR Mask / Oral / Nasal Airways (affiliate link) - tools for rescue breathing / CPR

ICAR Avalanche Resuscitation Recommendations for advanced life support personnel

Responder Alliance - individual and organizational resilience for rescuers in the face of traumatic stress.

Not Alone complete film - Sarah Hueniken - a personal story of recovery from stress injury and trauma by a world class ice climber. 

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Episode 11 brings you  my conversation with Michael Buchanan is a flight paramedic and senior firefighter / paramedic at the West Valley City Fire Department. He is the founder and operation of Mountain Medical Academy, a passion-driven backcountry medical care education company.  We discuss the medical care of avalanche victims which Michael has made accessible to recreational skiers and riders who don't have a medical background.

Other topics that we discuss include:
-Finger sweeps to clear the airway
-How the presence of an air pocket changes your medical care
-How long to perform CPR after an avalanche
-What equipment may be useful to a lay rescuer
-The importance of psychological care after a critical event
And more.

Below are links to things discussed in this podcast:

Mountain Medical Academy - mountain medical education

After the Avalanche - Open source resources for responding medically and psychologically after an avalanche

Email Michael to Join a Class or Partner Up

Israeli Battle Dressing (affiliate link) - elastic compressive dressing for bleeding control

SWAT-T Elastic Tourniquet (affiliate link) - elastic tourniquet also useful in splinting

CPR Mask / Oral / Nasal Airways (affiliate link) - tools for rescue breathing / CPR

ICAR Avalanche Resuscitation Recommendations for advanced life support personnel

Responder Alliance - individual and organizational resilience for rescuers in the face of traumatic stress.

Not Alone complete film - Sarah Hueniken - a personal story of recovery from stress injury and trauma by a world class ice climber. 

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-13991697 Fri, 17 Nov 2023 12:00:00 -0700 3218 full false Ep. 10 - Tourniquets from Space Blankets Ep. 10 - Tourniquets from Space Blankets In this episode, I discuss the article "Arterial Occlusion Effectiveness of Space Blanket-Improvised Tourniquets for the Remote Setting". In this short blast I get into the meat of this article, and though the authors would tell you that space blankets aren't ready for primetime, I have some thoughts on the matter.

In the podcast, I mistakenly say that you need to be a WMS member to access this article, but you don't! It's available open access here:

https://www.wemjournal.org/article/S1080-6032(23)00043-1/fulltext

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> In this episode, I discuss the article "Arterial Occlusion Effectiveness of Space Blanket-Improvised Tourniquets for the Remote Setting". In this short blast I get into the meat of this article, and though the authors would tell you that space blankets aren't ready for primetime, I have some thoughts on the matter.

In the podcast, I mistakenly say that you need to be a WMS member to access this article, but you don't! It's available open access here:

https://www.wemjournal.org/article/S1080-6032(23)00043-1/fulltext

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-13762194 Mon, 23 Oct 2023 00:00:00 -0600 416 tourniquet, space blanket, improvised device, bleeding control 10 full false Ep. 9 - FEMA Urban Search and Rescue with Dr Graham Brant-Zawadzki Ep. 9 - FEMA Urban Search and Rescue with Dr Graham Brant-Zawadzki In this episode Dr BZ is back to talk about his experience deploying with the Federal Emergency Management Agency (FEMA) Urban Search and Rescue Task Force (USAR). Dr BZ just returned from a deployment with FEMA USAR to Lahaina, HI, where he served as a team physician supporting rescue and recovery efforts there.

We touch on:
-Training and gear
-Deployments and schedule
-Compensation
-The care of canines
-How you can get involved, and more!

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> In this episode Dr BZ is back to talk about his experience deploying with the Federal Emergency Management Agency (FEMA) Urban Search and Rescue Task Force (USAR). Dr BZ just returned from a deployment with FEMA USAR to Lahaina, HI, where he served as a team physician supporting rescue and recovery efforts there.

We touch on:
-Training and gear
-Deployments and schedule
-Compensation
-The care of canines
-How you can get involved, and more!

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-13761877 Wed, 11 Oct 2023 15:00:00 -0600 1998 FEMA, USAR, SAR 9 full false Ep. 8 - SAR Provider Injuries & Traveler's Diarrhea Treatment Ep. 8 - SAR Provider Injuries & Traveler's Diarrhea Treatment In this two-part episode, I review an article from the Annals of Emergency Medicine "Occupational Accidents Among Search and Rescue Providers During Mountain Rescue Operations and Training Events"

https://doi.org/10.1016/j.annemergmed.2022.12.015

In the second half, we review the treatment of diarrhea in the returning traveler.


As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> In this two-part episode, I review an article from the Annals of Emergency Medicine "Occupational Accidents Among Search and Rescue Providers During Mountain Rescue Operations and Training Events"

https://doi.org/10.1016/j.annemergmed.2022.12.015

In the second half, we review the treatment of diarrhea in the returning traveler.


As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-13308809 Fri, 28 Jul 2023 12:00:00 -0600 959 diarrhea, returning traveler, traveler's diarrhea, search and rescue, SAR, injuries in SAR 8 full false Fast Push #2.2 - Safety Third Fast Push #2.2 - Safety Third In this second Fast Push, you get a riff on a great article from JEMS entitled "Safety is Third, Not First, and We All Know It Should Be" by Christopher Davis MD et al.

Apologies to all who got V1.0-- something weird happened in post that made me sound like a chipmunk. I might be a medical professional, but I'm no AV specialist. 

Summary:

1. Get the Job Done
2. Have Fun
3. Safety Third

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> In this second Fast Push, you get a riff on a great article from JEMS entitled "Safety is Third, Not First, and We All Know It Should Be" by Christopher Davis MD et al.

Apologies to all who got V1.0-- something weird happened in post that made me sound like a chipmunk. I might be a medical professional, but I'm no AV specialist. 

Summary:

1. Get the Job Done
2. Have Fun
3. Safety Third

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-13217521 Thu, 13 Jul 2023 08:00:00 -0600 513 bonus false Ep. 7 - Wildfire Smoke and Your Health Ep. 7 - Wildfire Smoke and Your Health In this episode I go deep on the health effects of wildfire smoke, answering some key questions that are relevant to recreational athletes, outdoors professionals, wildland firefighters, and industrial athletes alike:

Why is wildfire smoke harmful?
Is there a safe level of exposure?
Can we trust the EPA's guideline levels? (Spoiler: no)
Does the benefit of exercise outweigh the damage of smoke exposure?
If you have to be outside, how can you limit harms?

And more. Get ready for a trip down nerd lane.

Links from the show:
Bad reporting from the NY Times
EPA Air Quality Index Infopage
Study: Effects of Air Pollution and Habitual Exercise
Respro Ultralight Particulate Mask
CDC Building Ventilation Info
PurpleAir Indoor Air Quality Monitor
AwAir Indoor Air Quality Monitor

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> In this episode I go deep on the health effects of wildfire smoke, answering some key questions that are relevant to recreational athletes, outdoors professionals, wildland firefighters, and industrial athletes alike:

Why is wildfire smoke harmful?
Is there a safe level of exposure?
Can we trust the EPA's guideline levels? (Spoiler: no)
Does the benefit of exercise outweigh the damage of smoke exposure?
If you have to be outside, how can you limit harms?

And more. Get ready for a trip down nerd lane.

Links from the show:
Bad reporting from the NY Times
EPA Air Quality Index Infopage
Study: Effects of Air Pollution and Habitual Exercise
Respro Ultralight Particulate Mask
CDC Building Ventilation Info
PurpleAir Indoor Air Quality Monitor
AwAir Indoor Air Quality Monitor

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-12906960 Tue, 23 May 2023 18:00:00 -0600 1569 wildfire smoke, smoke inhalation, pm2.5, pm 2.5, wild fire smoke, public health 7 full false Ep. 6 - EMS at the Wilderness Boundary with Dr. Graham Brant-Zawadzki Ep. 6 - EMS at the Wilderness Boundary with Dr. Graham Brant-Zawadzki In this inaugural interview episode I have the pleasure of grilling Dr. Brant-Zawadzki about operating an urban EMS system at a wilderness boundary.

We talk about:
- Improvising outside the protocol
- Interfacing with SAR, rangers, and road workers
- How response kit and expectations are changed beyond the pavement
- What a fellowship in Wilderness Medicine can do for you career
And more!

Show Links:
EMS Fellowship, U of U
Wilderness Fellowship, U of U
Unified Fire Authority
Become world class by combining multiple domains of knowledge (lesswrong)
Wilderness Medical Society (twitter)

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> In this inaugural interview episode I have the pleasure of grilling Dr. Brant-Zawadzki about operating an urban EMS system at a wilderness boundary.

We talk about:
- Improvising outside the protocol
- Interfacing with SAR, rangers, and road workers
- How response kit and expectations are changed beyond the pavement
- What a fellowship in Wilderness Medicine can do for you career
And more!

Show Links:
EMS Fellowship, U of U
Wilderness Fellowship, U of U
Unified Fire Authority
Become world class by combining multiple domains of knowledge (lesswrong)
Wilderness Medical Society (twitter)

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Graham Brandt-Zawadzki Buzzsprout-12588326 Tue, 04 Apr 2023 13:00:00 -0600 2961 wilderness medicine, wilderness ems, medical direction, ems protocols 6 full false Ep. 5 - Mechanical CPR for Ski Patrol and Mountain Rescue Ep. 5 - Mechanical CPR for Ski Patrol and Mountain Rescue In this episode we review the available evidence, and the pros and cons, of using mechanical CPR devices like the LUCAS or Autopulse for ski patrol and mountain rescue applications.

Episode links:

CPR With a Lucas Device - An example video from EMS training

Viglino et. al. - Outcomes of On-Hill Cardiac Arrests - More saves, probably because of younger patients, bystander CPR, shockable rhythms, and shorter time to defib.

WMS Guidelines on the Care of Avalanche Victims - Recommends LUCAS use for prolonged transports and extrications.

Putzer et. al. - LUCAS in Simulated Helicopter Rescue
"Physical strain during a realistic alpine rescue mission scenario at high altitude led to a significant reduction in quality of resuscitation. Resuscitation guidelines developed at sea level are not directly applicable in the mountain terrain."

Wang et. al. - CPR Quality at Altitude, Unacclimatized Rescuers

Egger et. al. - CPR Quality at High Altitude, Acclimatized Rescuers

Cascade Rescue 'Trauma One' Toboggan

YouTube: Alyeska Resort Patrol High Performance CPR in Toboggan

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> In this episode we review the available evidence, and the pros and cons, of using mechanical CPR devices like the LUCAS or Autopulse for ski patrol and mountain rescue applications.

Episode links:

CPR With a Lucas Device - An example video from EMS training

Viglino et. al. - Outcomes of On-Hill Cardiac Arrests - More saves, probably because of younger patients, bystander CPR, shockable rhythms, and shorter time to defib.

WMS Guidelines on the Care of Avalanche Victims - Recommends LUCAS use for prolonged transports and extrications.

Putzer et. al. - LUCAS in Simulated Helicopter Rescue
"Physical strain during a realistic alpine rescue mission scenario at high altitude led to a significant reduction in quality of resuscitation. Resuscitation guidelines developed at sea level are not directly applicable in the mountain terrain."

Wang et. al. - CPR Quality at Altitude, Unacclimatized Rescuers

Egger et. al. - CPR Quality at High Altitude, Acclimatized Rescuers

Cascade Rescue 'Trauma One' Toboggan

YouTube: Alyeska Resort Patrol High Performance CPR in Toboggan

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-12424506 Sun, 12 Mar 2023 14:00:00 -0600 1075 cascade toboggan, lucas device, autopulse, mechanical cpr, ski patrol, altitude, helicopter rescue, HEMS, hypothermic cardiac arrest 5 full false Ep. 4 - HOPE Score for Severe Hypothermia Ep. 4 - HOPE Score for Severe Hypothermia In this episode we discuss the HOPE score, a tool that improves our ability to select the severely hypothermic patients who can benefit from warming with extracorporeal life support (ECLS).

We begin the with the case of Tayyab Jafar, a young man who was successfully resuscitated from severe hypothermia with both cardiopulmonary bypass and ECMO, but not without incident. 

We then discuss the derivation and validation studies for the HOPE score.

You can calculate and use the HOPE score at HypothermiaScore.org.

HOPE score derivation PDF

HOPE score validation: not freely available

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> In this episode we discuss the HOPE score, a tool that improves our ability to select the severely hypothermic patients who can benefit from warming with extracorporeal life support (ECLS).

We begin the with the case of Tayyab Jafar, a young man who was successfully resuscitated from severe hypothermia with both cardiopulmonary bypass and ECMO, but not without incident. 

We then discuss the derivation and validation studies for the HOPE score.

You can calculate and use the HOPE score at HypothermiaScore.org.

HOPE score derivation PDF

HOPE score validation: not freely available

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-12282939 Thu, 23 Feb 2023 04:00:00 -0700 1347 hypothermia, hope score, derivation study, validation study, severe hypothermia, ecmo, cpb, ecls 4 full false Fast Push #1 - Beacon Interference Fast Push #1 - Beacon Interference For today, a new format, the Fast Push: Quick updates that you need to know sooner rather than later.

This fast push tackles the growing issue of avalanche beacon interference. To see the source post and useful graphics, check out this link to the Utah Avalanche Center:

https://utahavalanchecenter.org/blog/74828

TL:DR
-Electronics, magnets, heated/foil line clothes near your beacon are bad. 
-They need to be at least 20cm away from your transmitting beacon, and 50 cm away when you're performing a search. 
-When using radios or cell phones to call for help, stay at least 50 cm away from anyone who is searching. 
-Professional digital VHF radios need to be at least 1 m away.
-Don't search while on or within 3 m of a snowmobile. 

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> For today, a new format, the Fast Push: Quick updates that you need to know sooner rather than later.

This fast push tackles the growing issue of avalanche beacon interference. To see the source post and useful graphics, check out this link to the Utah Avalanche Center:

https://utahavalanchecenter.org/blog/74828

TL:DR
-Electronics, magnets, heated/foil line clothes near your beacon are bad. 
-They need to be at least 20cm away from your transmitting beacon, and 50 cm away when you're performing a search. 
-When using radios or cell phones to call for help, stay at least 50 cm away from anyone who is searching. 
-Professional digital VHF radios need to be at least 1 m away.
-Don't search while on or within 3 m of a snowmobile. 

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-12218629 Thu, 09 Feb 2023 08:00:00 -0700 502 avalanche safety, avalanche beacons, electronic interference, utah avalanche center bonus false Ep. 3 - Methoxyflurane for Prehospital Analgesia Ep. 3 - Methoxyflurane for Prehospital Analgesia Methoxyflurane: inhaled gas of the past and prehospital analgesic of the future? Only if we’re talking about ‘the future’ in North America. Used in Australian EMS for almost half a century, this safe and effective medication is only now starting to get the attention that it deserves outside of the down-under.

Today’s paper:

Trimmel, H., Egger, A., Doppler, R. et al. Usability and effectiveness of inhaled methoxyflurane for prehospital analgesia - a prospective, observational study. BMC Emerg Med 22, 8 (2022). https://doi.org/10.1186/s12873-021-00565-6

Open access PDF:

https://bmcemergmed.biomedcentral.com/counter/pdf/10.1186/s12873-021-00565-6.pdf

Penthrox inhaler “selfie” image:

https://bmcemergmed.biomedcentral.com/counter/pdf/10.1186/s12873-021-00565-6.pdf

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Methoxyflurane: inhaled gas of the past and prehospital analgesic of the future? Only if we’re talking about ‘the future’ in North America. Used in Australian EMS for almost half a century, this safe and effective medication is only now starting to get the attention that it deserves outside of the down-under.

Today’s paper:

Trimmel, H., Egger, A., Doppler, R. et al. Usability and effectiveness of inhaled methoxyflurane for prehospital analgesia - a prospective, observational study. BMC Emerg Med 22, 8 (2022). https://doi.org/10.1186/s12873-021-00565-6

Open access PDF:

https://bmcemergmed.biomedcentral.com/counter/pdf/10.1186/s12873-021-00565-6.pdf

Penthrox inhaler “selfie” image:

https://bmcemergmed.biomedcentral.com/counter/pdf/10.1186/s12873-021-00565-6.pdf

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-12204983 Tue, 07 Feb 2023 13:00:00 -0700 907 methoxyflurane, pain control, entonox, penthrox, wilderness medicine, austere medicine, remote medicine 3 full false Ep. 2 - Pain Management for Scorpion Stings Ep. 2 - Pain Management for Scorpion Stings Today we look at IV acetaminophen vs IV NSAID vs topical lidocaine vs placebo for treatment of pain due to scorpion stings, with some bonus learning on tramadol.

Turgut K, Yavuz E, Gülaçtı U, Aydın İ, Sönmez C, Aktaş N, Arslan E. Comparison of Intravenous Paracetamol, Dexketoprofen Trometamol, or Topical Lidocaine Use for Pain Relief in Scorpion Stings: A Placebo-Controlled, Randomized Study. Wilderness Environ Med. 2022 Dec;33(4):379-385. doi: 10.1016/j.wem.2022.08.002. Epub 2022 Oct 11. PMID: 36229383.
https://doi.org/10.1016/j.wem.2022.08.002

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Today we look at IV acetaminophen vs IV NSAID vs topical lidocaine vs placebo for treatment of pain due to scorpion stings, with some bonus learning on tramadol.

Turgut K, Yavuz E, Gülaçtı U, Aydın İ, Sönmez C, Aktaş N, Arslan E. Comparison of Intravenous Paracetamol, Dexketoprofen Trometamol, or Topical Lidocaine Use for Pain Relief in Scorpion Stings: A Placebo-Controlled, Randomized Study. Wilderness Environ Med. 2022 Dec;33(4):379-385. doi: 10.1016/j.wem.2022.08.002. Epub 2022 Oct 11. PMID: 36229383.
https://doi.org/10.1016/j.wem.2022.08.002

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-12112392 Tue, 24 Jan 2023 16:00:00 -0700 643 scorpion, scorpion sting, toxinology, toxicology, pain, pain management, pharmacology 2 full false Ep. 1 - Fentanyl on the Ski Hill? Ep. 1 - Fentanyl on the Ski Hill? Is intranasal fentanyl safe and effective for the treatment of acute severe pain on the ski hill?

Lynch TV, Callas PW, Peterson TD, Schlein SM. Intranasal Fentanyl for On-the-Hill Analgesia by Ski Patrol. Wilderness Environ Med. 2022 Sep;33(3):296-303. doi: 10.1016/j.wem.2022.05.003. Epub 2022 Jul 16. PMID: 35851192.

DOI: 10.1016/j.wem.2022.05.003

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Is intranasal fentanyl safe and effective for the treatment of acute severe pain on the ski hill?

Lynch TV, Callas PW, Peterson TD, Schlein SM. Intranasal Fentanyl for On-the-Hill Analgesia by Ski Patrol. Wilderness Environ Med. 2022 Sep;33(3):296-303. doi: 10.1016/j.wem.2022.05.003. Epub 2022 Jul 16. PMID: 35851192.

DOI: 10.1016/j.wem.2022.05.003

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-12109485 Tue, 24 Jan 2023 09:00:00 -0700 921 fentanyl, pain, pain management, pharmacology, ski patrol, intranasal medication 1 full false Ep.0 - An Introduction Ep.0 - An Introduction Welcome to Wilderness Medicine Updates! 

This podcast, new for 2023, delivers brief reviews of research in wilderness medicine, SAR, disaster/austere medicine, and wilderness EMS to help you stay current and provide the best care to patients in challenging environments. 

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Welcome to Wilderness Medicine Updates! 

This podcast, new for 2023, delivers brief reviews of research in wilderness medicine, SAR, disaster/austere medicine, and wilderness EMS to help you stay current and provide the best care to patients in challenging environments. 

As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.

Connect with us by email at wildernessmedicineupdates@gmail.com.

You can pay us a compliment and share the show with a new listener on any popular platform here.





]]> Patrick Fink MD Buzzsprout-12109466 Tue, 24 Jan 2023 09:00:00 -0700 211 wilderness medicine 0 full false