Medicine for the Outdoors

Hydration Question

2008-05-07T08:10:00.000-07:00

A reader writes: “I have been told that under most circumstances a properly hydrated person should be urinating every 1 and 1/2 to 2 hours. Is this accurate?” This is probably a reasonable statement, although there is no absolute correlation of time interval between episodes of spontaneous (e.g., associated with the urge to urinate) urination and state of hydration. For instance, a person might...

Thank You to Suture for a Living for Grand Rounds

2008-05-06T20:44:00.001-07:00

Thank you to Suture for a Living for including my post about seabather's eruption in this week's edition of Grand Rounds. Grand Rounds is a weekly compilation of posts related to health care compiled by a host, who makes a great effort to compile an interesting collection for readers.

Sea Bather’s Eruption

2008-05-02T09:15:00.000-07:00

From the month of May through September, oceangoers along the U.S. Gulf coast need to be concerned about a particular form of skin rash caused by tiny jellyfish. As the summer season progresses, this can also become a problem along the entire eastern seaboard. I've been afflicted while scuba diving in Cozumel, Mexico, and the episodes can be much more than a minor annoyance. Indeed, the intensity...

Lifeguard Situation in California

2008-04-30T11:50:00.000-07:00

Here's a recent communication that originated with the Orange County (California) Register: Wednesday, April 9, 2008 State lifeguard funding gets a reprieve. Public safety mandates staffing. By FRED SWEGLES The Orange County Register Lifeguard service at area state beaches will be as robust as in years past this spring and summer – but after Labor Day, all bets are off. That's the message...

Thank You to Doc Gurley for Grand Rounds

2008-04-29T13:27:00.000-07:00

Thank you to Doc Gurley for including my review of Sharkwater in this week's edition of Grand Rounds. Grand Rounds is a weekly compilation of posts related to health care compiled by a host, who makes a great effort to compile an interesting collection for readers. Doc Gurley has certainly accomplished that feat in an entertaining and novel way this week! As a high school wrestling coach, I like...

Sharkwater

2008-04-26T10:06:00.000-07:00

The oceans are our greatest wilderness. On a recent trip to Hawaii, I was in an aquatic mood and watched the recently-released DVD entitled "Sharkwater." It is a very fine production that should be watched by every person interested in marine conservation, because it describes eloquently what is happening to one of the most important species on our planet. The story line revolves around Rob...

More Bee Story

2008-04-23T15:30:00.000-07:00

Jeremy Joslin, MD has left a new comment on your post "Question About a Bee Sting": "Thanks for posting this very interesting case. Your blog really helps me learn through cases that I don't ordinarily see. Dr. Auerbach, do you think this could be a Type 4 hypersensitivity reaction alone which is causing the drawn-out symptoms? Like you said, the inflammatory mediators alone could be causing...

Thank You to Dr. Val and The Voice of Reason for Grand Rounds

2008-04-22T12:47:00.000-07:00

Thank you to Dr. Val Jones of Dr. Val and The Voice of Reason for including my post about blisters in this week's edition of Grand Rounds. Grand Rounds is a weekly compilation of posts related to health care compiled by a host, who makes a great effort to compile an interesting collection for readers. Dr. Jones has done a superb job, which is very much appreciated.

Blisters

2008-04-19T09:30:00.000-07:00

Blisters are the bane of hikers. These clear fluid- or blood-filled vesicles have probably ended more outings than all major illnesses combined. They can be prevented by keeping feet dry, wearing adequate and properly fitting socks, wearing thin liner socks (polypropylene or polyester) under heavier wool-blend hiking socks, breaking in footgear prior to the expedition, and padding all rough edges...

Jellyfish Question

2008-04-16T08:00:00.000-07:00

A reader writes (paraphrased by me): “Here in Corpus Christi, today, while surfing, I practically picked up a large man-o-war while surfing. The burn is intense as I write. I felt severe pain immediately. I panicked in the water. The tentacles clung on to me. I felt pressure on my heart and my feet began to itch. It was a long trip for a remedy, but I finally rinsed the burning skin with vinegar,...

Thank You to Women's Health News for Grand Rounds

2008-04-15T10:50:00.000-07:00

Thank you to Rachel Walden of Women's Health News for including my book review of Mountains Beyond Mountains in this week's edition of Grand Rounds. Grand Rounds is a weekly compilation of posts related to health care compiled by a host, who makes a great effort to compile an interesting collection for readers.

Mountains Beyond Mountains

2008-04-12T05:00:00.000-07:00

With my busy schedule, I don't have much time to sit down and read, so when I am able to do that, it is precious for me. I've just finished Tracy Kidder's Mountains Beyond Mountains, subtitled "The Quest of Dr. Paul Farmer, A Man Who Would Cure the World." For many of us in the field of wilderness medicine, and certainly for healthcare professionals involved with international medicine, travel...

Multiple Bee Stings

2008-04-09T20:30:00.000-07:00

A reader writes (about bee stings): "But what can be done for a victim stung many times, but who is not having an allergic reaction? I imagine this venom begins to become systemically dangerous after around 2-300 stings (assuming 500 is a lethal threshold)." The most common cause for dangerously low blood pressure (shock) after a bee sting is an allergic reaction to the venom. The chance for...

Thank You to Dr. Wes for Grand Rounds

2008-04-08T20:33:00.000-07:00

Thank you to Dr. Wes for including my post about reflection on the Hospitalito Atitlan in this week's edition of Grand Rounds. Grand Rounds is a weekly compilation of posts related to health care compiled by a host, who makes a great effort to compile an interesting collection for readers.

Reflections on Hospitalito Atitlan

2008-04-05T09:45:00.000-07:00

It has already been useful for me to take a step back and reflect upon my week in Santiago, Guatemala working at the Hospitalito Atitlan. My overwhelming impression is positive, for many reasons. Perhaps I was lucky, but without exception, the people I encountered were upbeat and made every effort to be productive. It is a challenging situation, but that does not deter the healthcare...

Zanfel™

2008-04-02T10:30:00.000-07:00

Poison ivy (oak and sumac) season will soon arrive, and much will be written in the press about remedies for the itchy rash caused by exposure to urushiol, the resin found in these plants. In addition to the standard method of washing with soap and water, there are commercial products touted to facilitate physical removal of the oily resin, which theoretically reduces the exposure and lessens the...

Thank You to GruntDoc for Grand Rounds

2008-04-01T20:35:00.000-07:00

Thank you to GruntDoc for including my post about a young man with a high voltage electrical injury in this week's edition of Grand Rounds. Grand Rounds is a weekly compilation of posts related to health care compiled by a host, who makes a great effort to compile an interesting collection for readers.

Tick Attachment Sites

2008-03-30T13:42:00.000-07:00

The first issue of Volume 19 of the journal Wilderness & Environmental Medicine has just been published. It contains some very interesting information, some of which I will share with you in this and another post. In an article entitled "Tick Attachment Sites," Abdulkadir Gunduz and his colleagues looked at the location of attached ticks in 67 patients who presented to their emergency department...

Hospitalito Atitlan 5

2008-03-26T21:30:00.000-07:00

Towards the end of my week at the Hospitalito, one of the staff members asked me to speak with the parents of a teenager who had suffered an electrical injury in the past few days. The young boy had climbed onto a roof in pursuit of a kicked soccer ball. The young man was sweating, and he recalled wearing a wet tee-shirt. The ball had come to rest near the business end of a power-supplying...

Thank You to monash medical student for Grand Rounds

2008-03-24T16:02:00.000-07:00

Thank you to monash medical student for including my post about the upcoming 25th Anniversary & Annual Meeting of the Wilderness Medical Society in this week's edition of Grand Rounds. Grand Rounds is a weekly compilation of posts related to health care compiled by a host, who makes a great effort to compile an interesting collection for readers.

Picaridin-Based Insect Repellent

2008-03-22T09:51:00.000-07:00

There is a plethora of insect repellents on the market. Many of the newer repellents are intended to replace DEET (N,N diethyl-m-toluamide), which is an excellent and reliable repellent, but which carries a distinctive odor, can dissolve certain fabrics, and has been associated with rare reports of toxicity when used in high concentrations. Newer insect repellent choices include picaridin, which...

25th Anniversary & Annual Meeting of the Wilderness Medical Society

2008-03-19T08:00:00.000-07:00

It is a great pleasure to announce the 25th Anniversary and Annual Meeting of the Wilderness Medical Society. It's hard to believe that it has been 25 years since I collaborated with Ed Geehr, M.D. and Ken Kizer, M.D. to create the WMS. "Combining Your Profession With Your Passion" has been the theme since the beginning, and the meeting this summer is no exception. You can register and learn more...

Thank You to Polite Dissent for Grand Rounds

2008-03-18T11:42:00.000-07:00

Thank you to Polite Dissent for including my post about providing pain management in suboptimal settings in this week's edition of Grand Rounds. Grand Rounds is a weekly compilation of posts related to health care compiled by a host, who makes a great effort to compile an interesting collection for readers.

Pain Management in Difficult Situations

2008-03-15T10:15:00.000-07:00

A reader writes: "I just came back from an elective in Nepal in orthopedics. A lot of what you describe (about Guatemala) sounds eerily familiar... especially what you mentioned about pain management. If the situation in Guatamela is anything like it was in Nepal, I think it's not that they're more stoic there... they tolerate the pain because there is no choice. And I think that tolerate is...

Question About a Bee Sting

2008-03-12T14:39:00.000-07:00

A reader writes: "I was stung by bee on the palm of my hand and forefinger 6 weeks ago. My palm remains inflamed and swollen, which worsens as the day progresses; all joints remain tender. I have a small pebble-like knot under the skin approx 1/4" to 1/2" from where I was stung. I have been to 6 different doctors without receiving much explanation. I recently saw a hand specialist who diagnosed...