Many people are exchanging vacations on a tour bus for more adventurous ones, such as climbing Mt. Rainier or scaling a glacier in New Zealand. While this is a great way for adventurous tourists to deepen their connection to nature, it can also lead to more serious injuries, especially in cold weather. More and more doctors are entering the wilderness medicine space to address the lack of access to good medical care in remote places, but what exactly is wilderness medicine?
Wilderness medicine is a diverse and ever-changing field which encompasses many medical disciplines. The habitats in which wilderness medicine is needed vary from tropical locations to snowy mountaintops. Even if you’re not in the medical field yourself, it’s important to be aware of the wilderness medicine resources near your remote adventure locations and to educate yourself on wilderness safety.
What is wilderness medicine?
The adventure tourism industry is growing faster than ever before, but it puts many tourists in harm’s way. From poisonous snake bites to falling off cliffs, there are many potential hazards to consider with adventure tourism. Because many of these trips take place in remote locations, medical care facilities are often far away.
The field of wilderness medicine is designed to fill the need for medical care in these remote locations. A growing number of physicians are turning to wilderness medicine to ensure adventurers get the best care possible in remote and perilous environments.
While the field has expanded today, it began as mountain medicine in the 1980s. Physicians would try to figure out better care practices to treat injured hikers, those affected by the higher altitude, and other issues which can arise from adventures in the mountains.
Even if it formally started in the 1980s, it has been around for much longer. The standardizing of the field and adding wilderness medicine resources to more formalized healthcare institutions and outdoor education facilities in the 1980s made wilderness medicine more effective.
Much of this early mountain medicine also revolved around colder environments. Compounded with already dangerous activities, colder weather can bring extra risks such as frostbite, difficulty getting medical transportation into snowed-in places, and avalanches.
Today, the wilderness medicine field not only uses mountain medicine, but it also draws expertise and practices from sports medicine, travel medicine, environmental medicine, and emergency medicine.
Wilderness medicine not only encompasses the immediate medical care after a natural disaster, but also encompasses trauma care and physical recovery after an emergency or accident happens in the wilderness.
As you might imagine, this is a vast, evolving field which will play a bigger role in the medical field as more travellers turn to adventure tourism.
Types of Wilderness Medicine
A 2014 study looking at the development of the discipline identified a few primary areas of interest for wilderness medicine practitioners. Some of those areas include:
- High altitude: whether to ski or to hike Machu Picchu, more and more people are venturing to higher altitudes. Altitude sickness, or acute mountain sickness, is estimated to affect over 25% of people and can lead to death. The most common treatments are administration of oxygen and descent from higher altitudes.
- Dive Medicine: diving is becoming a more popular activity for tourists, though it does come with some risk. Decompression illness is one of the most common problems divers face and should be treated as early as possible.
- Envenomation: the management of snake bites, arthropod stings, and other venomous injuries can vary wildly. This type of wilderness medicine is more diverse in treatments and causes than many others.
- Hyper- and Hypothermia: being exposed to extremely hot or cold temperatures can cause serious health concerns including death in severe cases. Hyperthermia, exposure to extreme heat, and hypothermia, exposure to extreme cold, both have a similar initial treatment: removal from the adverse weather climate. Beyond that, the treatment for these two conditions can vary.
- Trauma: the leading cause of wilderness trauma is injury to the head during a fall. Trauma encompasses any sort of bodily trauma whether it happened during an off-road mountain bike trip or in the car on the way to remote locations.
Wilderness Medicine and Cold Weather
Cold weather exaggerates many of the adverse health impacts of the different types of wilderness injuries. From hypothermia to frostbite, the cold is not your friend when injured in a remote location.
Usually, colder locations have more cases of wilderness injuries. In Colorado alone, over 78,000 individuals were involved in search and rescue missions between 1992 and 2007.
Two of the biggest concerns related to cold weather are frostbite and hypothermia. Once your body temperature falls below 95 degrees Fahrenheit or 35 degrees celsius, your body is at a greater risk for adverse effects.
Adverse effects of hypothermia can include cardiac arrest, neurological damage, and death. Compared to other types of wilderness medicine, hypothermia has a lower recovery rate.
To treat hypothermia, wilderness medicine professionals try to prevent further heat loss, rewarm the patient’s body, and provide physiological support.
Frostbite affects skin exposed to adverse weather conditions. It can lead to cell death and tissue damage. If your body is repeatedly thawed and refrosted, frostbite is even more dangerous.
Treatment for frostbite includes pain control and placement of protective dressings. This condition can also be prevented by you, even if you’re not a medical professional, if you make sure you wear appropriate clothing for the weather.
Along with these two medical conditions, colder weather can lead to more avalanches, icier paths, and other dangers which can increase your chance of needing wilderness medicine. If you participate in adventurous activities in colder environments, make sure to take necessary precautions and educate yourself on best practices.
If you want to learn more about wilderness medicine, check out the MedWild Youtube channel or visit a local outdoor education center which offers wilderness medicine courses.
As the wilderness medicine field develops, it will be interesting to see how best practices change and how medical care facilities work to make medical care more accessible to remote locations.
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