Q: Is there a connection between shellfish allergies and iodine?

August 4th, 2010 by David Johnson, MD

Q: Is there a connection between shellfish allergies and iodine?

Equating an allergy to shellfish with an allergy to iodine is a fairly common misconception.  Fish and radiographic contrast allergies are also erroneously equated with iodine allergies.

Iodine is essential for proper thyroid function.  Without it, people become ill with thyroid problems.  As it turns out, seafood and crops fertilized with seaweed are a good source of iodine.  As people moved from coastal areas inland, the incidence of thyroid deficiency increased.  Beginning in the 20th century, it became a common additive in many varieties of table salt.  As a result, now you have to work hard to completely avoid it.

The allergen in shellfish is a protein, not iodine.  Some people with iodine allergies really have a topical sensitivity to iodine (e.g., povidone iodine; Betadine), usually a much different kind of reaction than the immediate reaction found with anaphylaxis.

Bottom line: A shellfish allergy should almost never preclude the use of iodine for water disinfection. If you are concerned, get more information about the true nature of the allergy.  If the person has not had problems with other seafood (saltwater) or table salt, iodine is not the culprit.  There are, of course, other reasons for not using iodine as a water disinfectant.

Share and Enjoy:
  • Digg
  • Sphinn
  • del.icio.us
  • Facebook
  • Google Bookmarks
  • MySpace

Where’s the Man?: Belize

July 28th, 2010 by Admin

Where’s the Man?: Belize

Here is the man (with me) in front of and inside Actun Tunichil Muknal, a 3.5 mile long Mayan Cave in Belize in the San Ignacio Cayo.  The ATM is a national archeological site and considered a “living museum” with over 1500 Mayan artifacts inside including 14 skeletons from sacrafices.  2nd photo taken over 1km underground.

Click on the photos to enlarge. These entries were submitted by Kevin Collopy, a WMA instructor, while on a Wilderness First Responder course in Belize.

Send in Your Photos!

Send an email to webmaster@wildmed.com with a picture of you wearing your ‘Where’s the Man?’ t-shirt alongside a caption to be eligible to win. At the end of the year, we will select three entries to receive $50 gift certificates to our online gear store.

Share and Enjoy:
  • Digg
  • Sphinn
  • del.icio.us
  • Facebook
  • Google Bookmarks
  • MySpace

Where’s the Man?: Pacific Crest Trail, WA

July 8th, 2010 by Admin

Click on the image to enlarge.

Where’s the Man?: Pacific Crest Trail, WA

WMA-certified Wilderness First Responder (WFR),  LT, sent us this photo of him cruising along with the man alongside the caption below. Thank you for making the trails a better place!

“The man soaring over White Pass, Washington.  He joined my crew and I as we performed 6 months of restoration work along the PCT from Washington to Southern California for the Pacific Crest Trail Association.”

Send in Your Photos!

Send an email to webmaster@wildmed.com with a picture of you wearing your ‘Where’s the Man?’ t-shirt alongside a caption to be eligible to win. At the end of the year, we will select three entries to receive $50 gift certificates to our online gear store.

Share and Enjoy:
  • Digg
  • Sphinn
  • del.icio.us
  • Facebook
  • Google Bookmarks
  • MySpace

Where’s the Man?: Anchorage, AK

July 5th, 2010 by Admin

Click to enlarge.

Where’s the Man?: Anchorage, AK

Jerimiah was putting “The Man” hard at work while rebuilding Rome for his vacation bible school. Jerimiah is a medical missionary and is certified as a Wilderness First Responder.

Send in Your Photos!

Send an email to webmaster@wildmed.com with a picture of you wearing your ‘Where’s the Man?’ t-shirt alongside a caption to be eligible to win. At the end of the year, we will select three entries to receive $50 gift certificates to our online gear store.

Share and Enjoy:
  • Digg
  • Sphinn
  • del.icio.us
  • Facebook
  • Google Bookmarks
  • MySpace

Where’s the Man?: Golan Heights of Northern Israel

June 29th, 2010 by Admin

Click on the photo to enlarge.

Where’s the Man?: Golan Heights of Northern Israel

Kevin Z., a WMA certified Wilderness First Responder, was hiking the Golan Trail and decided to take this photo of him next to a minefield (yes, a minefield). I don’t know if this would go beyond the first triangle in the Patient Assessment system.

Send in Your Photos!

Send an email to webmaster@wildmed.com with a picture of you wearing your ‘Where’s the Man?’ t-shirt alongside a caption to be eligible to win. At the end of the year, we will select three entries to receive $50 gift certificates to our online gear store.

Share and Enjoy:
  • Digg
  • Sphinn
  • del.icio.us
  • Facebook
  • Google Bookmarks
  • MySpace

Where’s the Man?: Isla Bella, Panama

June 28th, 2010 by Admin

Where’s the Man?: Isla Bella, Panama

WMA Instructor, Stephen Leavins, sent in this photo of him while he was on a sea kayaking trip. The locals dug him out some canoes and great paddles.

Submit Your Entries

Send an email to webmaster@wildmed.com with a picture of you wearing your ‘Where’s the Man?’ t-shirt alongside a caption to be eligible to win. At the end of the year, we will select three entries to receive $50 gift certificates to our online gear store.

Share and Enjoy:
  • Digg
  • Sphinn
  • del.icio.us
  • Facebook
  • Google Bookmarks
  • MySpace

Heat Stroke Treatment: What is the best way to cool off a heat stroke victim?

June 28th, 2010 by David Johnson, MD

What is the best way to cool off a heat stroke victim?

The simple answer? Using the resources at hand, aggressively lower the person’s body temperature to 39°C (102.2°F) as quickly as possible.  Anything longer than 30 minutes has the potential to have more profound and long lasting pathophysiologic effects. The debate about treatment revolves around the efficacy and safety of cold water/ ice bath immersion versus the mist/ fanning method.  When feasible, I advocate cold water immersion. In fact, it is at least twice as fast as the best misting methods.  It appears to be as safe and maybe safer when one considers the relative rates of cooling.

How so? Cold water dissipates heat from the body 20 to 30 times faster than air does at the same temperature. Evaporation speeds cooling but not as much. People argue against cold immersion for fear that the cold will induce vasoconstriction and/or shivering and therefore inhibit cooling or even increase body temperature.  If these factors are important, one would expect to find clinically relevant support in the medical literature. I have never found any. (Jump into cold lake and see what your body temperature does!) In addition, some worry that cold immersion for heat stroke will precipitate a cardiac arrest.  Again, the literature does not appear to support this concern clinically, even in the elderly.  In the end, temperature height and duration are the key factors linked to morbidity and mortality in heat stroke.

The real question regarding treatment should revolve around what means are at hand to modify those factors that caused the heat stroke to begin with.  First, stop the heat stress by leaving the environment and resting. If there is insufficient cold water for immersion, apply water in small droplets, like mist from a spray bottle, and get the air moving.  The misted water will evaporate more quickly and probably cool better than pouring a bottle over your patient’s head.  A combination of techniques can work well, too.  On the other hand, ice bags in the groin and around the neck do not cut it.  Because the problem with heat stroke is related to increased heat production and/or decreased dissipation, not the thermostatic readjustment in the hypothalamus seen with a fever, don’t use antipyretics (e.g., ibuprofen, acetaminophen).  And don’t forget about appropriate volume replacement.

Greg Friese from CentreLearn sent me this link to a pretty good, non-scientific article about recovery from heat stroke.

Share and Enjoy:
  • Digg
  • Sphinn
  • del.icio.us
  • Facebook
  • Google Bookmarks
  • MySpace

Where’s the Man?: Cape Peninsula, South Africa

June 24th, 2010 by Admin

Where’s the Man?: Cape Peninsula, South Africa

Allie sent in this photo of herself showing off the man in Cape Peninsula, located near Cape Town, South Africa.

Submit Your Entries

Send an email to webmaster@wildmed.com with a picture of you wearing your ‘Where’s the Man?’ t-shirt alongside a caption to be eligible to win. At the end of the year, we will select three entries to receive $50 gift certificates to our online gear store.

Share and Enjoy:
  • Digg
  • Sphinn
  • del.icio.us
  • Facebook
  • Google Bookmarks
  • MySpace

Where’s the Man?: Boston, MA – Run of the Charles

June 24th, 2010 by Admin

Where’s the Man?: Boston, MA – Run of the Charles

Henry Chance was on hand in Boston, MA for the annual Run of the Charles Canoe Race. The only major medical incident that day was a collection of bruised egos.

Submit Your Entries

Send an email to webmaster@wildmed.com with a picture of you wearing your ‘Where’s the Man?’ t-shirt alongside a caption to be eligible to win. At the end of the year, we will select three entries to receive $50 gift certificates to our online gear store.

Share and Enjoy:
  • Digg
  • Sphinn
  • del.icio.us
  • Facebook
  • Google Bookmarks
  • MySpace

Wilderness First Responder – Scope of Practice (Draft)

June 11th, 2010 by Admin

In order to establish guidelines for comprehensive, thorough, and more consistent wilderness medical training, AORE and other organizations that hold a respectively large place in the field of wilderness medicine have signed off on the Wilderness First Responder SOP (Draft), a document that complements the Wilderness First Aid Scope of Practice.

Please consider helping AORE make a difference by reviewing this document if you have ever sponsored a WFR course, attended at WFR course, or instructed a WFR course. Does this document include the topics that you want your staff to know? As a participants of a Wilderness First Responder course, is this training enough to prepare you for backcountry medical emergencies? Are the elective topics sufficient? Please be clear, professional, and thorough.

Click here for the Wilderness First Responder Scope of Practice.

Please send your comments to Tim Mertz (mertzt@uwstout.edu). Comments received will be consolidated and then presented to the wilderness medical providers for consideration in the final document.

Share and Enjoy:
  • Digg
  • Sphinn
  • del.icio.us
  • Facebook
  • Google Bookmarks
  • MySpace