Don’t forget… At the end of the year, we will select the 3 best submissions. The winners will receive $100 cash prize.  Send in a picture of yourself wearing your WMA course t-shirt to webmaster@wildmed.com in order to be eligible for the prizes.

Why is this important?  It is a reminder that despite the rarity, these bites can be lethal (only the second in 40+ years).  Antivenin has been the treatment of choice.  The problem of course is that Wyeth has not produced that antivenin for several years.  It was scheduled for expiration in October 2008 but was extended through Oct of 2009.  Do you know what to do?  Will there be anything available other than supportive care?  Would a pressure bandage like those used in other countries on more potent neurotoxins make a difference?  Dr Norris of Stanford, the lead author, has written and lectured on snake envenomations and updated the WMS lecture series (www.wms.org) on envenomations for 2009.  He had an article published in 2005 commenting on pressure immobilization techniques and how effective lay providers are in applying one.  I look forward to reviewing the article when it arrives.  By the way, the equine Crotalidae (pt vipers) antivenin has also expired and was not extended.  Fortunately we have CroFab antivenom. 

If you are really interested in this stuff, I would suggest you try and attend Venom Week 2009 in NM starting 1 June (http://hsc.unm.edu/conf/venomweek2009/index.shtml).  It sounds like quite a line-up.  It includes one of my favourites, Rick Vetter, an entomologist who has written about spider bite misdiagnosis and arachnophobia.  I wish I could go.  If anyone reading this does attend please send us some pearls of wisdom. 

Also, check out the Miami-Dade Fire Rescue Venom Response Program(http://www.miamidade.gov/mdfr/emergency_special_venom.asp).  According to their web page they “…maintain the largest and only antivenom bank for public use in the United States.”  They have have antivenoms for a all domestic and many international species that may have been imported into the US. 

WMA Canada instructors Dugg Steary and Mike Webster have been responsible for writing, developing, and coordinating all medical scenarios for MedWAR North for the past 5 years. Recently, WMA Canada instructors Aaron Orkin MD and Dave Vanderburgh MD have joined the simulation writing team. Other WMA Canada instructors including Lisa Barrett, James Innes, and Marty Pomerleau have been proctors and race officials at previous MedWAR North events.

Check back to see where the man will be traveling to next!

A: Interesting story. One can develop an allergic reaction to any medication or any of its ingredients. Antihistamine is a class of medications and there are a number of different ones that fall under that rubric. Diphenhydramine (e.g., Benadryl) is one. They can be used to treat allergic symptoms like hives and dampen or prevent them. Because drowsiness is a frequent diphenhydramine side effect, it is a commonly added ingredient in over-the-counter sleep aides in North America. It is not a naturally occurring hormone in our bodies so if this was indeed an immediate allergic/anaphylactic reaction, it or a chemical used during manufacture could have been the precipitant. Using the assumption that this was indeed an allergic reaction, the person could be allergic to any medication within the class. This could also have been an anticholinergic reaction to the diphenhydramine (e.g., flushed skin, dry mouth, anxiety, urine retention, constipation) or an anaphylactic reaction to something else the person was exposed to. True allergic reactions to antihistamines are unusual. Fortunately we have other better options for serious reactions (e.g., epinephrine, corticosteroids).

What about allergic reactions to epinephrine? Epinephrine is produced by the body endogenously. Most supposed allergic reactions are in fact caused by adrenergic side effects (e.g., rapid heart rate, shakes, vasoconstriction). Other reactions attributed to epinephrine may be caused by the xylocaine (anaesthetic) it is mixed with for local dental anaesthesia. Conceivably, a true allergic reaction during epinephrine administration could be caused by one of the preservatives (e.g., bisulfites, antioxidants) added during manufacture. These have to be exceedingly rare

Next time if you are are trying to sleep, try warm milk.

Does lightning really never strike twice in the same spot? Is it safe to touch the victim of a lightning strike? Get the answers to these questions and more by clicking here.

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The man is currently at Tsubaki Shrine in Mie Prefecture of Japan. WMA Lead Instructor Dave Ramsey sports our classic tee.

Send in your pictures and stories for our ‘Where’s the Man?’ section to webmaster@wildmed.com.

We wanted to make our new site easier to navigate, chock full of wilderness medical information, and featuring real people in videos. So we asked a recent group of WMA course graduates and this is what some said:

“Hey! Nice job with the web site. I like the eye catching header, the link to courses near me and the YouTube video. I keep describing to people how the course simulated real life situations and helped desensitize me to serious injuries, especially disfigurement, blood and guts (and Cabot’s projective vomiting!). It is great to have the YouTube clip to have my peers view and gain a better understanding of how I was trained.”

“New site looks great! I really like the Q & A and blog sections. Keep up the good work!”

“Like to new website, it was easy to navigate. I enjoyed the questions and answer part with Dr. Johnson the most.”

“The look and feel is really good. I like the Find a Course feature.”

Thanks to all the recent WMA grads who gave us such useful feedback.
Anne Rugg
General Manager

WMA has these new t-shirts that are given out to everybody on a WMA course (with the exception of a WFA course), featuring a da Vinci-inspired design of the Vitruvian Man. We are asking students, instructors, and like-minded individuals to send in their pictures to webmaster@wildmed.com. We’d like to know where the picture was shot, and we will feature your post right here on our blog! Don’t forget to send us a story to attach to your submission!

Check back to see where the man has been traveling to!