Semin Neurol 2019; 39(01): 137-148
DOI: 10.1055/s-0038-1676994
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Wilderness Neurology

Sarah M. Schlein
1  Division of Emergency Medicine, Department of Surgery, University of Vermont College of Medicine, Burlington, Vermont
,
Paul G. Marcolini
2  Wilderness Paramedic, Central Maine Medical Center, Tri-County EMS, Lewiston, Maine
,
Evie G. Marcolini
1  Division of Emergency Medicine, Department of Surgery, University of Vermont College of Medicine, Burlington, Vermont
› Author Affiliations
Further Information

Publication History

Publication Date:
11 February 2019 (online)

Abstract

The study of wilderness medicine is within the scope of medical care in the austere environment and addresses medicine as practiced in the setting of delayed access to definitive medical care, hostile environment, limited equipment, and inherent risks to the patient and/or rescuers. Part of this topic includes the care of patients with neurologic illness and/or injury.

We will address the five most important skills of a wilderness medicine professional: decision making, prevention, preparation, protocol development, and education by applying the principles to select common neurologic problems that occur in the extended environment: traumatic brain injury, dehydration, hyponatremia, heat illness, hypothermia, spine injury, and lightning injury. We will focus on the most pertinent aspects of wilderness medicine: signs and symptoms, initial stabilization and treatment, evacuation, and extended care.

An astute wilderness medicine specialist brings environmental and medical skill sets together to know when it is better to treat in the field and when evacuation, with its inherent risks to the patient and rescuers, is unavoidable.