Journal of wilderness medicine最新文献

Objective

To determine the mechanisms and patterns of injury due to falls from tree stands associated with hunting, identify risk factors, and suggest injury prevention and control measures.

Design

Retrospective medical chart reviews were performed. Telephone interviews were also conducted to obtain additional information.

Patients: All patients who presented to two emergency departments during a 5-year period after sustaining injury while using tree stands.

Results

Twenty-four male deer hunters comprised the study group. These 24 patients sustained a variety of injuries, including 7 with vertebral fractures, 6 with extremity fractures, 4 with multiple rib fractures, 3 with pelvic fractures, and 3 with head injuries. These injuries resulted in hospitalization of 16 (66.7%) of the 24 patients and prolonged disability (> 1 month) in 5 patients (20.8%). Average height of fall was 21.1 ft. In 7 (35%) of 20 cases, the fall resulted from mechanical failure of the tree stand or harness. The remaining majority of falls (13/20 or 65%) could be traced to judgment error or careless behavior on behalf of the hunter, usually during ascent or descent of the tree and in the absence of a safety belt.

Conclusions

A significant number of patients presented with a variety of injuries after falls from tree stands. The majority of these injured patients required hospitalization, and a significant percent had prolonged disability. Risk factors associated with these falls were identified.

Sport climbers are at high risk for overuse injuries. These injuries are usually soft tissue injuries. The following is the first case report of a stress fracture of the phalanx in a rock climber and a review of the literature of sport climbing injuries.

Continuous ambulatory polygraphy (electroencephalogram and electrooculogram) was recorded on a 34-year-old female mountaineer acclimatized to an altitude of 5350 m, using a portable Oxford Medilog 9000 cassette recorder over 8 consecutive days. The recordings at altitudes of 5000 to 7600 m were performed while attempting to climb Mount Everest without an oxygen mask. The subject slept only at night. Altitude sleep measures were compared to data obtained at 300 m altitude during one 24-h recording performed before the expedition departed. The sleep–wake organization was barely influenced by altitude. Intrasleep wakefulness was augmented, leading to a decrease in sleep efficiency. No slow-wave-sleep curtailment was found, and day-to-day sleep–wake variations were more likely due to anxiety, fatigue owing to strenuous effort, nighttime cold, or daytime heat exposure.

Reports of tick parasitism were recorded for US Air Force personnel (n = 410) from 30 states and the District of Columbia. Of 462 ticks involved in attacks on people, the lone star tick, Amblyomma americanum, and the American dog tick, Dermacentor variabilis, were the most common species represented (34.2% and 34.0%, respectively). Two vectors of Lyme disease, Ixodes pacificus and Ixodes scapularis (including the former Ixodes dammini) also parasitized people but were less common (1.7% and 9.1%, respectively). In addition, 34 (7.3%) brown dog ticks, Rhipicephalus sanguineus, were identified from human hosts. Most ticks submitted for identification were adults (66.5%) and nymphs (29.1%). Larvae were submitted infrequently (<5%). Of those specimens examined for feeding status, 50.0% had blood-fed to some degree. Patients from which ticks were removed were predominantly male (56.8%) and ranged in age from 1 to 76 years with 55.3% (n = 152) being under 20 years. The head and neck area and the lower extremities were the most common sites of attachment by ticks (37.7% and 24.3%, respectively), but ticks were found attached on other areas of the body also, including the trunk, upper extremities, buttocks, and groin. Most ticks (65.5%) bit their victims during May, June, or July, but parasitism occurred during all months of the year. Our data suggest that people from all age groups and from across the United States are vulnerable to parasitism by ticks and, potentially, tick-borne diseases.