Wilderness Medicine Podcast December 2019 - Wilderness & Environmental Medicine Live
Dec 17, 2019
Scott McIntosh, lead author of the 2019 Wilderness Medical Society frostbite guidelines, shares expert insights on frostbite prevention and treatment. He advises controlled rewarming in water baths and discusses surprising findings, like the potential low harm in walking on frostbitten extremities. The discussion also touches on improvised medicine techniques, including using coconuts for IV fluids and innovative suturing methods. Additionally, climate change's impact on health is covered, with attention to glacier retreat and wildfires.
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Walking On Frostbitten Tissue May Be Okay
- Recent evidence suggests walking on frozen frostbitten tissue to evacuate may cause less damage than previously thought.
- Avoid walking when possible, but evacuation walking is not as harmful as older guidance claimed.
Follow Evidence Grades For Water Methods
- The WMS water-disinfection CPG grades recommendations by strength and evidence (e.g., 1A strongest).
- Use the grade to pick methods: 1A = strong/high evidence; 2C = weak/low evidence.
Boil Or Combine Filtration With Disinfection
- For field use, prioritize boiling, filtration, UV, or halogens depending on contaminants and turbidity.
- Boil for visible rolling boil; filter then disinfect for best combined protection when boiling is impractical.
