Wilderness Medical Society Practice Guidelines for Basic Wound Management in the Austere Environment

Quinn, Robert H.; Wedmore, Ian; Johnson, Eric L.; Islas, Arthur; Anglim, Anne M.; Zafren, Ken; Bitter, Cindy; Mazzorana, Vicki

doi:10.1016/j.wem.2014.04.005

Cited by 22 publications

(35 citation statements)

References 144 publications

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“…Upon drying, polymer solutions were converted into drug polymer films. Various research groups have studied the mechanism of film formation from polymer dispersions [11]. The film formation occurs in three stages: A prerequisite for the successful preparation of the films was the compatibility of the dissolved drug and the used polymers.…”

Section: Mechanism Of Film Formationmentioning

confidence: 99%

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Formulation And Evaluation Of Buccoadhesive Films of Lidocaine Hydrochloride

Mahrous

Shazly

Zidan

et al. 2020

Journal of advanced Biomedical and Pharmaceutical Sciences

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Buccal delivery is considered the most suitable, easy, and safest route of administration. So it can be used as an alternative route to the peroral route for the systemic administration of drugs. Oral films (OFs) are used as a unique approach, because it dissolves quickly in the mouth and directly reaches to the systemic circulation. The aim of this study is to formulate and evaluate an anesthetic drug lidocaine (LH) and improve its local effect. Oral films were prepared by using chitosan and polyvinylpyrolidone. OFs were assessed for compatibility studies, surface pH, swelling properties, In-Vitro bioadhesion, mechanical properties, disintegration time, dissolution time and in-vitro drug release. It was found that actual LH content in the prepared patch was in the range of 95-105 % of the claimed content. The addition of propylene glycol as a plasticizer gave good mechanical properties in concentration of 40 %. The prepared oral films swelled and reached an Equilibrium state of swelling. The prepared polymeric films showed good adhesion and acceptable pH. It could be concluded that the release of LH is higher from films contain 1 % chitosan. Increasing chitosan concentration to 2 % resulted in decreasing the initial dissolution rate. The combination of chitosan (2 %), PVP (10 %) and PG at 40 % w/w gave a reasonable LH release.

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Section: Mechanism Of Film Formationmentioning

confidence: 99%

“…Moreover, these films are very easy to be used and are suitable for geriatric, pediatric, bedridden patients [10]. Lidocaine, lignocaine, is used to anesthetize the tissue in a defined area and so it is called local anesthetics [11]. Usually, lidocaine is used parenterally in the gum and this causes pain to patients [12].…”

Section: Introductionmentioning

confidence: 99%

Formulation And Evaluation Of Buccoadhesive Films of Lidocaine Hydrochloride

Mahrous

Shazly

Zidan

et al. 2020

Journal of advanced Biomedical and Pharmaceutical Sciences

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“…Given the frequency and impact of wound infections, future work should synthesize key elements from wilderness wound care practice guidelines to be standardized across WFR courses and incorporated into staff trainings. 9 Although none of the 4 head injuries involved loss of consciousness, 3 presented with symptoms concerning concussion, including headache, dizziness, difficulty with concentration and memory, and blurry vision. Staff must be able to quickly differentiate between symptoms of concussion and intracranial hemorrhage and should be knowledgeable about current guidelines for concussion management.…”

Section: Injuriesmentioning

confidence: 99%

Medical Incidents and Evacuations on Wilderness Expeditions for the Northwest Outward Bound School

Wells

Warden

2018

Wilderness & Environmental Medicine

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Introduction-Outdoor education (OE) expeditions travel far from definitive care and have unique epidemiology. Most OE expedition studies have examined a single organization and results may not generalize. This study examines the injuries, illnesses, medical evacuations, and nonmedical incidents of the Northwest Outward Bound School (NWOBS) to broaden our understanding and demonstrate commonalities within the field. Methods-This retrospective database review examined incidents and evacuations on NWOBS expeditions from June 1, 2014 through October 31, 2016. Incident rates, evacuation rates, and incident type frequencies were calculated. Frequencies of incidents during different expedition time periods were compared with a 1-sample x 2 test. The odds ratio that each type of incident would require evacuation was calculated and compared with other incident types using Fisher exact test. Results-The study period included 59,058 program days, 277 incidents, 143 medical incidents, 75 medical evacuations, and no fatalities. Injuries occurred at a rate of 1.64 per 1000 program days and illnesses at a rate of 0.78 per 1000 program days. The most common injuries were strains, sprains, and trauma or infection of the skin and soft tissue. Most injuries occurred while backpacking, hiking, or moving around camp. The most common illnesses were nausea, vomiting, diarrhea, abdominal pain, asthma, respiratory infections, and urinary tract infections. The medical incidents with the highest odds of evacuation were fractures, urinary tract infections, abdominal pain, and asthma. Conclusions-Results from the NWOBS database are consistent with those from other expeditionary OE programs. These findings should guide risk-management strategies and staff medical training.

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“…Finally, those participating in wilderness outings, such as mountaineering, endure prolonged physical exertion coupled with inadequate sleep, further compromising host response. 20 Hypoxia reduces the number of CD4 cells and functionality of T lymphocytes in general. 1 Since T lymphocytes instruct the adaptive immune response, the functionality of other immune cells may also be affected.…”

Section: Bacteria: Staphylococcus Streptococcus and Yersiniamentioning

confidence: 99%

Animal, Microbial, and Fungal Borne Skin Pathology in the Mountain Wilderness: A Review

Brandenburg

Levandowski

Califf

et al. 2017

Wilderness & Environmental Medicine

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Mountains are home to numerous organisms known to cause skin disease. Bites, stings, poisons, chemicals, toxins, trauma, and infections all contribute to this end. Numerous plants, animals, fungi, bacteria, viruses, and protozoa are responsible. This paper aims to review skin illness and injury sustained from organisms in the mountains of North America. Other factors such as increased ultraviolet radiation, temperature extremes, and decreasing atmospheric pressure along with human physiologic parameters, which contribute to disease severity, will also be discussed. After reading this review, one should feel more comfortable identifying potentially harmful organisms, as well as diagnosing, treating, and preventing organism-inflicted skin pathology sustained in the high country.

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Wilderness Medical Society Practice Guidelines for Basic Wound Management in the Austere Environment

Cited by 22 publications

References 144 publications

Formulation And Evaluation Of Buccoadhesive Films of Lidocaine Hydrochloride

Formulation And Evaluation Of Buccoadhesive Films of Lidocaine Hydrochloride

Medical Incidents and Evacuations on Wilderness Expeditions for the Northwest Outward Bound School

Animal, Microbial, and Fungal Borne Skin Pathology in the Mountain Wilderness: A Review

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