Wilderness and Rescue Medicine 7th Edition Jeffrey Isaac, PA-C and David E. Johnson, MD

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Acknowledments	11
About the Authors	12
Preface	13
Notes for the 7th Edition	14
Introduction	15
SECTION I: General Priciples	18
Chapter 1: Physiology and Pathology	19
Oxygenation and Perfusion	19
Three Serious Problems	20
Patterns and Trends	20
Mental Status and LOC	20
Swelling and Pressure	21
Obstruction to Infection	22
Ichemia to Infarction	22
Anticipated Problem	22
Most People Live	23
Chapter 1 Review	24
Chapter 2: Wilderness Medicine	25
Serious or Not Serious	25
The Risk/benefit Ratio	25
Probability & Consequence	26
Generic to Specific	26
Ideal to Real	27
Focus on Important	27
The Problem List	28
Medicine is Dynamic	28
Chapter 2 Review	29
Chapter 3: Patient Assessment and SOAP Format	30
Gathering Information	30
The Scene Size-Up	30
The Primary Assessment	31
The Secondary Assessment	32
Creating a Problem List	35
Chapter 3 Review	38
SECTION II: Critical Body Systems	42
Chapter 4: The Circulatory System	43
Structure and Function	43
Shock	44
Volume Shock	45
Vascular Shock	47
Cardiogenic Shock	47
Acute Stress Reaction	48
Risk vs Benefit in Shock	49
Chapter 4 Review	50
Chapter 5: The Respiratory System	51
Structure and Function	51
Respiratory Problems	52
Respiratory Distress	53
Upper Airway Obstruction	53
Lower Airway Obstruction	54
Alveoli	55
Chest Wall and Diaphragm	55
Nervous System Drive	56
Risk vs Benefit	57
Chapter 5 Review	58
Chapter 6: Nervous System	59
Structure and Function	59
Brain Failure	59
Assessing the Level of Consciousness	60
Differential Diagnosis of Brain Failure	60
Increased Intracranial Pressure	61
Non-Traumatic Brain Injury	62
Traumatic Brain Injury	62
Assessment of TBI	62
Risk vs Benefit in TBI	63
Post Concussive Syndrome	64
Stroke	64
Seizure	65
Treatment of Seizure	65
Exercise Associated Hyponatremia	66
Treatment of Exertional Hyponatremia	66
Chapter 6 Review	67
SECTION III: Critical System Problems and Treatment	72
Chapter 7: Basic and Advanced Life Support	73
Respiratory Failure	73
Circulatory Failure	75
Cardiac Arrest	75
Severe Bleeding and Shock	76
Brain Failure	77
Risk vs Benefit in BLS	78
Chapter 7 Review	79
Chapter 8: Allergy and Anaphylaxis	80
Allergy	80
Anaphylaxis	81
Treatment of Anaphylaxis	82
Risk vs Benefit	83
Chapter 8 Review	84
Chapter 9: Severe Asthma	85
Risk vs Benefit	86
Chapter 9 Review	87
Chapter 10: Problems with Sugar	88
Diabetic Emergencies	88
Hypoglycemia	88
Treament of Hypoglycemia	89
Risk vs Benefit	89
Chapter 10 Review	91
SECTION IV: Trauma	94
Chapter 11: General Priciples of Trauma	95
Energy and Injury	95
Deceleration	96
Cavitation	96
Pay Attention to History	97
Problems are Cumulative	97
Critical Systems Come First	97
Chapter 11 Review	99
Chapter 12: Pain Management	100
Pain Medication	100
Risk vs Benefit	102
Chapter 12 Review	104
Chapter 13: Musculoskeletal Injury	105
Structure and Function	105
Unstable Injury	106
Traction into Position	107
Special Wilderness Considerations	110
Femur Fracture	110
Pelvic Fracture	111
Clavicle Fracture	111
Compartment Syndrome	111
Open Fracture	112
Joint Infection	113
Impending Surgery	113
Stable Injury	113
Overuse Syndromes	114
Risk vs Benefit	115
Chapter 13 Review	116
Chapter 14: Dislocations	117
Shoulder Dislocations	118
Treatment of Shoulder Dislocations	119
Patella Dislocations	121
Treatment of Patella Dislocations	121
Dislocations of Fingers and Toes	122
Treatment of Digit Dislocations	122
Difficult Dislocations	123
Risk vs Benefit	123
Chapter 14 Review	125
Chapter 15: Spine Injury	126
Field Assessment of Spine Injury	127
No Spine Injury	129
Low Risk Spine Injury	129
High Risk Spine Injury	130
Risk vs Benefit	131
Chapter 15 Review	133
Chapter 16: Wounds and Burns	134
Wounds	135
Wound Assessment	135
Low Risk Wounds	135
High Risk Wounds	136
Field Treatment of Wounds	137
Impaled Objects	139
Bandages and Dressings for a Hostile Environment	139
Evisceration	141
Traumatic Amputations	141
Treatment of Traumatic Amputation	141
Rabies	142
Wound Infection	142
Treatment of Wound Infection	142
Burns	143
High Risk Burns	144
Treatment of Burns	144
Blisters	145
Treatment of Blisters	145
Risk vs Benefit	146
Chapter 16 Review	147
SECTION V: Environmental Medicine	152
Chapter 17: Thermoregulation	153
Hypothermia	154
Mild Hypothermia	155
Severe Hypothermia	157
Heat Related Illness	159
Heat Exhaustion	159
Heat Stroke	160
Risk vs Benefit	161
Chapter 17 Review	162
Chapter 18: Cold Injuries	163
Frostbite	163
Superficial Frostbite	163
Deep Frostbite	164
Prevention of Frostbite	166
Trench Foot	166
Treatment of Trench Foot (or Hand)	166
Raynaud's Phenomenon	167
Risk vs Benefit	167
Chapter 18 Review	168
Chapter 19: Altitude Illness	169
Cerebral and Pulmonary Edema	170
High Altitude Cerebral Edema	170
High Alititude Pulmonary Edema	172
Other Altitude Illnesses	173
Risk vs Benefit	174
Chapter 19 Review	175
Chapter 20: Medical Aspects of Avalanche Rescue	176
Treatment	177
Risk vs Benefit	178
Chapter 20 Review	179
Chapter 21: Water Related Injury	180
Drowning	180
Treatment of Drowning Injury	181
SCUBA Diving Injuries	182
Pulmonary Overpressure Syndromes and Decompression Sickness	182
Ear pain and Mask Squeeze	183
Risk vs Benefit	184
Chapter 21 Review	185
Chapter 22: Lightning Injuries	186
Lightning Injuries	186
Scene Safety	187
Treatment of Lightning Injury	188
Prevention of Lightning Injury	188
Risk vs Benefit	189
Chapter 22 Review	190
Chapter 23: Toxins, Envenomation and Disease Vectors	191
Disease Vectors	191
Ingested Toxins	192
Drug Overdose	192
Food Poisoning	192
Topical Toxins	194
High Risk Topical Exposures	194
Inhaled Toxins	194
Injected Toxins	195
Snakebite	195
Pit Vipers	195
Coral Snakes	196
Marine Toxins	197
Spiny Injury	197
Nematocyst Sting	198
Insects and Arachnids	199
Black Widow	199
Brown Recluse	200
Centruroidies	200
Tick Paralysis	200
Arthropod Disease Vector	200
Mosquitoes	202
Fleas, Lice, and Mites	202
Insect Repellents	203
Risk vs Benefit	204
Chapter 23 Review	205
SECTION VI: Backcountry Medicine	208
Chapter 24: An Approach to Illness	209
Generic Assessment of the Ill Patient	209
Risk vs Benefit	210
Chapter 24 Review	211
Chapter 25: Head, Eyes, Ears, Nose and Throat	212
Red Eye	212
Treatment of Red Eye	213
Foreign Body Injury	213
Sunburn	214
Infections	214
Chemical Exposure	214
Contact Lenses	214
Nosebleed	215
Treatment of Nosebleed	215
Dental Problems	215
Dental Trauma	215
Dental Infection	216
External Ear Infection	217
Treatment of Swimmer's Ear	217
Middle Ear Infection and Sinusitis	217
Treatment of Middle Ear Infection and Sinusitis	218
Sore Throat	218
Risk vs Benefit	219
Chapter 25 Review	220
Chapter 26: Abdominal Pain	221
Practical Abdominal Anatomy	221
Assessment of Abdominal Pain	222
Hollow Organ Problems	222
Other Abdominal Problems	223
Risk vs Benefit	224
Chapter 26 Review	225
Chapter 27: Chest Pain	226
Myocardial Ischemia	226
Risk Factors	227
Stable Angina	227
Risk vs Benefit	228
Chapter 27 Review	229
Chapter 28: Gastrointestinal Problems	230
Diarrhea	230
Assessment of Diarrhea	230
Treatment of Diarrhea	231
Constipation	231
Treatment of Constipation	231
Nausea and Vomiting	232
Treatment of Vomiting	232
Risk vs Benefit	232
Chapter 28 Review	233
Chapter 29: Genitourinary Problems	234
Vaginitis	234
Treatment of Vaginitis	235
Urinary Tract Infection	235
Treatment of Uninary Tract Infection	236
Urinary Tract Obstruction	237
Bladder Outlet Obstruction	237
Kidney Stone	237
Testicular Pain	237
Risk vs Benefit	238
Chapter 29 Review	239
Chapter 30: Repiratory Infection	240
Respiratory Infection	240
Treatment of Respiratory Infection	241
Risk vs Benefit	241
Chapter 30 Review	242
Chapter 31: Behavioral Issues	243
Assessment of Behavioral Problems	243
Field Treatment of Behavioral Problems	244
Drug and Alcohol Overdose	244
Drug and Alcohol Withdrawal	245
Chapter 31 Review	246
SECTION VII: Roles, Responsibilities adn Technology	250
Chapter 32: The Expedition Medical Officer	251
Responsibilities	251
Medical Screening	252
Risk vs Benefit	252
Chapter 32 Review	253
Chapter 33: The Medical Role in Search and Rescue	254
Medical Roles	254
Incident Management System	254
Response Preparation	255
Risk vs Benefit	255
Chapter 33 Review	257
Chapter 34: Appropriate Medical Technology	258
Backcountry Medical Equipment	258
Medications	259
Fluid Replacement	259
Risk vs Benefit	260
Chapter 34 Review	261
Chapter 35: Training for Performance Under Stress	262
Stress and the Brain	262
How We Respond	263
Improving the Odds	263
Risk vs Benefit	264
Chapter 35 Review	266
Appendix A: Abbreviations, Acronyms, and Mnemonics	267
Appendix B: Conversion Tables	269
Appendix C: Glasgow Coma Scale	270
Glossary	271
Index	281
Photo and Image Credits	285

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