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Oxford Handbook of Expedition and Wilderness Medicine


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Table of Contents

1: Expedition medicine 2: Preparations 3: Caring for people in the field 4: Ethics and responsibilities 5: Crisis management 6: Emergencies - diagnosis 7: Emergencies - trauma 8: Emergencies - serious illness and collapse 9: Treatment - skin 10: Treatment - head and neck 11: Treatment - dental 12: Treatment - chest 13: Treatment - abdomen 14: Treatment - limbs and back 15: Treatment - infectious diseases 16: Psychological and psychiatric problems 17: Risks from animals 18: Plants and fungi 19: Anaesthesia in remote locations 20: Cold climates 21: Mountains and high altitude 22: Inland and coastal waters 23: Offshore 24: Underwater 25: Hot dry environments - deserts 26: Hot humid environments - tropical forest 27: Caving 28: Medical kits

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Winner of the Primary Health Care category of the British Medical Association Book Awards 2016

About the Author

Dr Chris Johnson overwintered in Antarctica and completed a research degree in environmental physiology at a time when both travel and communications were far more tenuous than nowadays. This stimulated a lifelong interest in both travel and medicine in remote areas, and his journeys include regular trips to Scandinavia, Iceland, Greenland and northern Canada, whilst his Caribbean-born wife demands visits to other, hotter, climes. Working as a consultant anaesthetist in Bristol he has specialised in head & neck anaesthesia, is a keen medical educator, and has been involved in the development of appraisal processes and their associated information systems Dr Sarah R. Anderson is a Consultant in Communicable Disease Control and works in London. She has a long affiliation with expeditioning; her expedition experience includes the outback of Australia, the arctic north of Norway, a variety of trips to African and the mountains of Nepal. While at University she led an expedition to Uganda and was President of the Cambridge University Explorers' and Travellers' Club. Sarah is a UK Summer Mountain Leader and medical adviser to the Royal Geographical Society's Medical Cell; she co-edited the first edition of the OHEWM, and was co-author of Expedition Health and Safety - a risk assessment (JRSM 2000; 93:557-562). In 2001 Sarah acted as the medical officer to the RGS - Shoals of Capricorn Programme. She has a Diploma in Tropical Medicine and Hygiene and has worked in hospitals in Uganda, Zimbabwe and South Africa, and as a flying doctor in Kenya with AMREF. Sarah has research interests in infectious disease epidemiology and expedition health and safety. Dr Jon Dallimore is a General Practitioner in South Wales and a specialty doctor in the Emergency Department of Bristol Royal Infirmary. Jon's expedition experience varies from the deserts of Namibia, Sinai and Northern Kenya to the jungles of Sulawesi, Belize, Thailand and Ecuador, and high altitude climbs and treks to Nepal, Greenland, Pakistan, Iceland, Morocco, East Africa and the Andes. Jon is an International Mountain Leader, a member of the Alpine Club and a member of faculty on the UK Diploma in Mountain Medicine. Jon is medical consultant to four British expedition companies and is regularly involved with training expedition team members and leaders on the medical aspects of travel to remote areas. Shane Winser is responsible for expeditions and fieldwork at the Royal Geographical Society (with IBG). She heads Geography Outdoors: the centre supporting field research, exploration and outdoor learning (formerly known as the Expedition Advisory Centre) which provides advice, information and training to some 1,500 plus scientific, educational, and adventurous expeditions each year. Shane has sat on a number of national committees concerned with benchmarking good practice including BSI's technical panel for BS 8848 the British Standard for orgnaising and managing visits, fieldwork, expeditions and adventurous activities outside the United Kingdom. Shane assisted in the planning and organisation of the RGS's own research programmes to the tropical forests of Sarawak and Brunei, the mountains of the Karakoram, and the drylands of western Australia, Kenya and Oman. Professor David Warrell's current post is International Director (Hans Sloane Fellow), Royal College of Physicians, and Emeritus Professor of Tropical Medicine and Honorary Fellow of St Cross College at the University of Oxford, UK. In 2006, he retired as Professor of Tropical Medicine and Infectious Diseases and Head of the Nuffield Department of Clinical Medicine in Oxford. Chris Imray is a consultant vascular and renal transplant surgeon at UHCW NHS Trust, and is also a Professor at Warwick Medical School. He started climbing whilst at school and has continued to travel all over the world to fulfill this passion. He took part in the 2006 Xtreme Cho Oyu expedition to Tibet, as one of the medical officers and was the Deputy Climbing Leader of the 2007 Caudwell Xtreme Everest Expedition. He summited both Cho Oyu (8201m) and Everest (8848m) and has the dubious distinction of having the second lowest arterial gases ever recorded in an adult (N Engl J Med. 2009 Jan 8;360(2):140-9) He has the Diploma in Mountain Medicine and with Dr Paul Richards and Dr Dave Hillebrandt, he runs the UK internet based frostbite service (). His real job is as a vascular/renal transplant surgeon with a particular interest in the management of the high risk carotid patient. His PhD is on the hypoxic and ischaemic brain. James Moore is a travel nurse specialist and Director of Travel Health Consultancy, an independent travel clinic based in Exeter, UK. He consults for a number of companies, charities, schools and organisations on travel health related matters. His background as an Emergency Department charge nurse and Nurse Practitioner led him to the field of Expedition and Wilderness Medicine, where he also works as an expedition medic and leader for various schools, charities, television production teams and private companies. James has over 14 years experience in training in expedition medicine. He teaches on the Diploma in Mountain Medicine, the Diploma in Travel Medicine and for the Royal Geographical Society. In addition to mountain leadership qualifications, he has diplomas in Travel Medicine, Tropical Nursing and a degree in Emergency Care. He is the Honorary Secretary for the British Global and Travel Health Association and member of the Medical Cell for the Royal Geographical Society.


`...a comprehensive guide to expedition planning and clinical field management in a host of hostile environments...whether you are a leather-skinned expedition leader, or simply considering travelling to unusual territory, a copy of this book, tucked into the to of your rucksack, will be one piece of extra weight you'll be glad you opted for.' British Journal of Hospital Medicine `The book describes so many risks from plants and fungi, animals, food, water and poor hygiene that it is a wonder than anyone travels at all.' Nursing Standard

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