Schlein Sarah M, Marcolini Paul G, Marcolini Evie G
Division of Emergency Medicine, Department of Surgery, University of Vermont College of Medicine, Burlington, Vermont.
Wilderness Paramedic, Central Maine Medical Center, Tri-County EMS, Lewiston, Maine.
Semin Neurol. 2019 Feb;39(1):137-148. doi: 10.1055/s-0038-1676994. Epub 2019 Feb 11.
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.
野外医学研究属于严峻环境下医疗护理的范畴，涉及在难以获得确定性医疗护理、环境恶劣、设备有限以及患者和/或救援人员存在固有风险的情况下所开展的医疗实践。该主题的一部分内容包括对患有神经系统疾病和/或损伤患者的护理。我们将通过运用相关原则来挑选在野外环境中常见的五种神经系统问题：创伤性脑损伤、脱水、低钠血症、热射病、体温过低、脊柱损伤和雷击伤，从而阐述野外医学专业人员的五项最重要技能：决策、预防、准备、方案制定和教育。我们将重点关注野外医学最相关的方面：体征和症状、初始稳定与治疗、后送以及后续护理。一位敏锐的野外医学专家会将环境和医疗技能结合起来，以了解何时在现场进行治疗更好，以及何时尽管后送对患者和救援人员存在固有风险但却不可避免。
