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Best Books on Wilderness Medicine/Street/Flight Medicine

bostonguy

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    I applying in IM, but I figured you guys would be the ones to ask. I used to be an EMT and still have an interest in wilderness medicine/ street or flight medicine...basically I mean by that is how to care for a patient when you don't have any CT scans or advanced gear. I think it is too bad a lot of come out of medical school not knowing what to do if we are trapped in an elevator with a pregnant woman or someone with a PTX or MI.

    Are there any books, websites or resources that you guys recommend?

    Thanks
     

    paiute

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    May 22, 2009
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      i bought "field guide to wilderness medicine" third edition P Auerbach, et al, Mosby Elsevier. it is a small handbook and a quick read. some topics need more depth. it has some good discussions on water purification. otherwise, i am left needing more information. there is a hugh textbook on wilderness medicine, name of which i forget, which i may buy next.
       
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      Lambofbob

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        Agree with both. The "Field Guide to Wilderness Medicine" by Auerbach et al is a great quick and dirty resource, something that is easily transportable.

        The big book is "Wilderness Medicine" by Paul Auerbach, now on its fifth edition. If you are just looking for quick info/general wilderness education, get the field guide. Also check out www.wms.org, it is the Wilderness Medical Society. They sponsor a fellowship that is a 5 year max longitudinal fellowship (ie do it while your in residency on your own time, or you can even start in med school). If you're fellowship interested, I'd reccommend the big book, its hugely in depth (I'm doing the fellowship and its what I use). If you just want more general info, get the smaller one, it has plenty of info.
         

        DeadCactus

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          Agree with both. The "Field Guide to Wilderness Medicine" by Auerbach et al is a great quick and dirty resource, something that is easily transportable.

          The big book is "Wilderness Medicine" by Paul Auerbach, now on its fifth edition. If you are just looking for quick info/general wilderness education, get the field guide. Also check out www.wms.org, it is the Wilderness Medical Society. They sponsor a fellowship that is a 5 year max longitudinal fellowship (ie do it while your in residency on your own time, or you can even start in med school). If you're fellowship interested, I'd reccommend the big book, its hugely in depth (I'm doing the fellowship and its what I use). If you just want more general info, get the smaller one, it has plenty of info.

          Can you elaborate on the fellowship? The website's information is a bit confusing.
           

          bostonguy

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            hey lambofbob,

            thanks for the great info. can you tell us a little more about the program. what are the total costs, is it really just the 225 or do you have to pay for each class as well, etc. how could a med student/resident realistically get the required 20 experience credits during training?

            thanks
             

            howelljolly

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              I applying in IM, but I figured you guys would be the ones to ask. I used to be an EMT and still have an interest in wilderness medicine/ street or flight medicine...basically I mean by that is how to care for a patient when you don't have any CT scans or advanced gear. I think it is too bad a lot of come out of medical school not knowing what to do if we are trapped in an elevator with a pregnant woman or someone with a PTX or MI.

              Are there any books, websites or resources that you guys recommend?

              Thanks

              Re-read your EMT texbook. Not knowing where you spend your free time, I think you're probably unlikely to run across an emergency in the wilderness.

              Also, remember to call 911. The last thing that an ER doc wants to hear is that the internist who happened to be nearby had decided to stick a ballpoint pen into their patients neck.
               

              Paseo Del Norte

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                I applying in IM, but I figured you guys would be the ones to ask. I used to be an EMT and still have an interest in wilderness medicine/ street or flight medicine...basically I mean by that is how to care for a patient when you don't have any CT scans or advanced gear. I think it is too bad a lot of come out of medical school not knowing what to do if we are trapped in an elevator with a pregnant woman or someone with a PTX or MI.

                Are there any books, websites or resources that you guys recommend?

                Thanks

                This is my take as a non-physician:

                The vast majority of what you can do in a situation where you have limited access and supplies will revolve around basic life support modalities. What is anybody going to do when trapped in an elevator with a pregnant person, talk about the weather until you are rescued I assume?

                If you are talking about working as a provider in a remote or non-permissive environment, then I really do not have advise about books or courses that could help a physician. I went through CONTOMS and the Gunsite Tactical Medicine courses with several physicians; however, this is a different focus than remote or wilderness medicine. You most likely have all the skills to perform the basic duties of this job following medical school? Small laceration repair and managing primary care complaints are pretty similar to what you did in school I would think?

                Even many of the survival and wilderness medicine books are pretty intuitive. The more "advanced" books such as "Ditch Medicine" by Mr. Coffee covers procedures such as laceration repair and local anesthesia that I would assume most every physician would know how to do coming out of medical school anyway?

                Most of the wilderness and remote stuff is researching the operational theatre and anticipating specific situations to the best of your abilities. This is similar to the concept of a comprehensive medical threat assessment. For example, malaria prophylaxis and treatment modalities when operating in an environment where it would be commonly encountered.

                With flight medicine, it's really an extension of the hospital in a different operating environment. Therefore, your best bet is to get with a flight company. Many companies allow third riding and as a physician I imagine it would be quite easy for you to third ride and learn as much as you want. However, I am not sure you will learn much in the way of actual medicine, just how to utilise what you already know in a different environment.

                I even flew with doctors in the sand box who had no operational experience and they picked it up pretty quick. Flew with a Ugandan doc who was specialised in primary care and dealing with managing pregnant patients with HIV. Figures, one of our first flights involved a guy who took a 7.62*39 through the pelvis with massive hemorrhage and failed hemostasis with hemostatic agents per the guys on the ground. Still, he picked it up just fine and we had fun chillin in Dubai following mission completion. :D

                Hope that helps, good luck. I would love to see more physician involvement in the flight environment, specifically HEMS in the United States.
                 

                howelljolly

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                  This is my take as a non-physician:

                  ...
                  Hope that helps, good luck. I would love to see more physician involvement in the flight environment, specifically HEMS in the United States.


                  Interesting post. Thanks.

                  Any thoughts on Critical Care physicians working on fixed wings? Traditionally its been ER docs for adults and Peds Critical Care for the little ones. What about intensivists for adults?
                   

                  Paseo Del Norte

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                    Interesting post. Thanks.

                    Any thoughts on Critical Care physicians working on fixed wings? Traditionally its been ER docs for adults and Peds Critical Care for the little ones. What about intensivists for adults?

                    I have never flown with a doc in the States. One of the most popular physician driven FW models I know of is the RFDS in Australia.

                    http://www.flyingdoctor.org.au/About-Us/Our-History/

                    I have no problem flying with physicians; however, the biggest problem I see is the issue of money in the States. Medevac is a hugh money making machine and the costs associated with paying physicians to fly as regular team members could be a problem.

                    However, specialty teams may be a different story? Honestly, most of the critical care patients I fly, I am simply maintaining interventions already started at the sending facility. With that, we do not fly neonatal patients nor do we fly OB patients outside of protocol.
                     
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