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!
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:
Dear friends and followers,
It is with a very heavy heart that I have to inform you that we will not be departing for Snow Hill Island in the next few days. We’ve been forced to make the difficult (and costly!) decision to postpone the trip by a season or two for safety considerations. This is not an easy call to make, especially with the heavy emotional, financial and time investment we all have made in the expedition, but we believe it is the right course to follow.
As you are no doubt aware, the ice conditions in the Antarctic are at a record high this year, which has made the approach to the Antarctic Peninsula uncertain within our time-frame. This led to the two team members doing penguin research to withdraw or risk losing their research window this year. After a lengthy discussion and much examination of the ice data, the remaining 6 team members decided to continue with the expedition.
It came as a heavy blow when (only 10 days before departure) one of the core team members was also forced to withdraw at the eleventh hour due to a life-threatening illness in his immediate family. Faced with unusually bad ice conditions and a team now dangerously reduced in numbers, we have elected to postpone the expedition. Effectively, this means we will have to try again next October or the year thereafter.
We see this not as a failure, but as a challenge and change in schedule. We are now in a stronger position, having laid the groundwork for all the logistics, gathered vast amounts of data, done endless preparation and provisioning, and ironed out many potential problems with equipment. The knowledge, contacts and systems we have developed will facilitate our next effort.
For our planned physiological research, we see this as an opportunity to expand the conceptual basis. We have already (in the last week) embarked on two projects which were deferred to get the expedition underway, but will actually enhance our fieldwork. Taking a long view, this may be a blessing in disguise. We have already opened some doors (through the Snow Hill preparation) that may accelerate the research far beyond what we envisioned on this expedition…exciting times ahead.
On a personal note, Franelise and I will still be traveling to the Falklands in a few days, where we will sort out, store, and recover some of the expedition gear. We’ll be meeting with role players there and putting the pieces into position for the Snow Hill Island Expedition to come. Thereafter we’re going to disappear into the mountains and fjords of Patagonia for a well-needed break 😉
We are deeply indebted to the individuals and companies that have been so supportive of the expedition, and will be doing our utmost to meet your expectations now and in the future. We take to heart the words of Roald Amundsen: “Obstacles are merely things we overcome”.
I stumbled across this article online to day, which I didn’t know was available other than in the print version of Junior Doctor magazine years ago. It’s a nice vignette for people thinking about working as a polar expedition doctor. Brings back warm memories of SANAE IV, and heightens the longing to get back down south. One month to go before we depart for the Snow Hill Island Expedition…
Have a look at the article on JuniorDoctor.com here: Extreme Medicine – The Antarctic Doctor
I’ve uploaded another two talks onto the ‘Presentations’ page. These are lectures I gave recently as part of the ILS Aviation Health Care Practitioner’s course at the Red Cross Air Mercy Service here in Cape Town. The should be considered introductory, and there is a lot of (verbal) content not in the presentations, but the framework may be of interest. I’m getting more familiar with using Prezi and liking it more every time. Click the arrows to advance or rewind through my sequence. FYI – You can click, drag and zoom freely at any time, and return to the sequence by clicking on the arrows again. Enjoy!