I was tickled and humbled to be invited as the guest on a recent episode of the Critical Care Scenarios podcast. Catch it here: http://icuscenarios.com/episode-25-wilderness-medicine-with-ross-hofmeyr We talked about high altitude medicine, technical rescue, priorities, decision-making, suspension syndrome, altitude prevention, high altitude ultrasound and more! Great fun with excellent collaborators.
Stephan Thaele once again showing his mastery of iPhone movie making in the field while actively teaching and participating on an expedition!
In response to the recent press about the possibility of a cableway being built on Mt Kilimanjaro, I was recently interviewed by Pippa Hudson on CapeTalk/Radio702. Her questions focused on the basics of altitude illness, and some reflection on what the medical risks of a cableway would entail. You can read the MCSA/UIAA statement on the proposed cableway here.
You can listen to the radio interview below, or if that fails at one of the links.
- CapeTalk Afternoons with Pippa Hudson: Risks of altitude sickness when mountaineering
- Afternoons with Pippa Hudson on Apple Podcasts
- Omny.FM Travel: Risks of altitude sickness when mountaineering
One of our expedition participants, Dr Stephan Thaele, produced this amazing video along the way by working a little on it each day on his phone as the expedition unfolded. What a great source of memories!
Oliver Page, one of our enthusiastic course participants made this short video of his experience on our WildMedix Canyoneering Medicine course in February this year. Check it out and give him some love!
Labour of love and quite a few years work: my mother Robynn and I have written a guide “by divers for divers” to the dive resorts of Mozambique. This was more of a challenge than anticipated, as the sociopolitical climate in Mozambique means that there is a continually shifting landscape when it comes to dive operators, and some significant regional differences. Although there are some very well established resorts and operators, many of the smaller, newer or more exclusive venues are unknown, and no-one could give an accurate estimate of the actual number.
The book has been thoroughly researched but is filled with actual impressions and practical reviews of the many resorts, and is worth acquiring simply for the hundreds of original photographs from a plethora of contributors.
It is available from September 2017 from various online vendors, and SA bookstores. Click here to go to the publisher’s site to purchase a copy.
I’ve created a fixed page for this presentation and the reference materials, so that I can add to the thoughts and resources over time. You can access the permanent page with all the references here.
Living on the Edge
Presentation for SASA Western Cape Anaesthesiology Update in April 2017, and a repository for materials on the topic.
- Bailey, D. M., C. K. Willie, R. L. Hoiland, A. R. Bain, D. B. MacLeod, M. A. Santoro, D. K. DeMasi, A. Andrijanic, T. Mijacika, O. F. Barak, Z. Dujic and P. N. Ainslie (2016). “Surviving Without Oxygen: How Low Can the Human Brain Go?” High Alt Med Biol.
- Berger, M. M. and M. P. W. Grocott (2017). “Facing acute hypoxia: from the mountains to critical care medicine.” British Journal of Anaesthesia 118(3): 283-286.
- Cannon, B. and J. Nedergaard (2004). “Brown adipose tissue: function and physiological significance.” Physiol Rev 84(1): 277-359.
- Dunn, J. O., M. G. Mythen and M. P. Grocott (2016). “Physiology of oxygen transport.” BJA Education 16(10): 341-348.
- Fenzl, A. and F. W. Kiefer (2014). “Brown adipose tissue and thermogenesis.” Horm Mol Biol Clin Investig 19(1): 25-37.
Grocott, M., A. Richardson, H. Montgomery and M. Mythen (2007). “Caudwell Xtreme Everest: a field study of human adaptation to hypoxia.” Crit Care 11(4): 151.
- Grocott, M. P., D. S. Martin, D. Z. Levett, R. McMorrow, J. Windsor, H. E. Montgomery and G. Caudwell Xtreme Everest Research (2009). “Arterial blood gases and oxygen content in climbers on Mount Everest.” N Engl J Med 360(2): 140-149.
Grocott, M. P., S. D. Martin, M. H. Wilson, K. Mitchell and S. Dhillon (2010). “Caudwell Xtreme Everest Expedition.” High Alt Med Biol 11(2).
- Gustafsson, I. M., A. Lodenius, J. Tunelli, J. Ullman and M. Jonsson Fagerlund (2017). “Apnoeic oxygenation in adults under general anaesthesia using Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) – a physiological study.” Br J Anaesthesia 118(4): 610-617.
- Mythen, M. “‘Everest in Utero’ – Lessons for critical care.”
- Mythen, M. “The oxygen trail: measurement.”
- Patel, A. and S. A. Nouraei (2015). “Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE): a physiological method of increasing apnoea time in patients with difficult airways.” Anaesthesia 70(3): 323-329.
- Tan, P. C. and A. T. Dennis (2016). “High-flow humidified nasal pre-oxygenation in pregnant women.“ Anaesthesia 71(7): 851-852.
- van der Lans, A. A. J. J., J. Hoeks, B. Brans, G. H. E. J. Vijgen, M. Visser, xEb, G. W. lle, M. J. Vosselman, J. Hansen, xF, J. A. rgensen, J. Wu, F. M. Mottaghy, P. Schrauwen and W. D. van Marken Lichtenbelt (2013). “Cold acclimation recruits human brown fat and increases nonshivering thermogenesis.” The Journal of Clinical Investigation 123(8): 3395-3403.
- West, J. B. (1993). “Acclimatization and tolerance to extreme altitude.” J Wilderness Med 4(1): 17-26.
Having spent many years enjoying the wilderness across 6 continents (hold on Oceania, I’m coming), including wintering over in Antarctica and years of service in mountain rescue, and then gaining the perspective afforded to me by having my own serious wilderness accident, I am very mindful of how we balance the risks and rewards of wilderness adventures. Greg Hill captures the essence of some very simple but powerful advice for staying safe in this brief video. Watch and reflect!
Transcribed here in my words:
Greg Hill’s 5 Rules for Staying Safe in the Wilderness
- Be afraid – be aware of the risks, and cognitive of the risks.
- Be prepared – get educated, find mentors, be guided, get good equipment, take the courses, develop your own mountain sense.
- Have a great team – find good partners.
- Have a plan – prepare for eventualities, have an escape route
- Be vigilant – maintain situational awareness, reassess plans fluidly.
Actually, that sounds like a good set of 5 rules for prehospital emergency medicine, anaesthesia, or any other high-stakes game!
More info at www.wildmedix.com or ping me in the comments!
As promised, open access to my two talks from the Mountain Medicine Workshop hosted at the MCSA in Cape Town, 2 May 2016. Please feel free to use for reference, or direct questions to me!
Austere & Confined Space Airway Management:
Practical Wilderness Analgesia: