Mountain & Marine Medicine Blog

Marine and Hyperbaric Medicine in the Phillipines

2011-11-01T06:29:00.001-07:00

Mountain and Marine Medicine is excited to help present a new Dive Medicine CME program in combination with Long Beach Memorial hospital. Our next course is scheduled to take place in the Phillippines.

Preparing for Austere Situations

2010-03-17T21:15:00.000-07:00

Our folks at MMM are constantly training for whatever environment we will encounter on any of our trips, be it in the mountains, desert, or ocean. We took our wilderness medicine group in Taos under a sketchy snowpack to ski and train. This week we are headed to the desert for some different training, including helping man medical stations at the Bataan Death March Marathon in White Sands, NM. Take a look at our student page on the right to keep up with some of these exciting activities!

Training in the heat works, if you are careful!

2010-02-16T17:24:00.000-08:00

I am putting the survival medicine training into practice as I type from Haiti. Sorry, no photos, but will say that, despite 95 degree HUMID heat, the training previously described has worked. I got to train with the 82nd Airborne last night, doing a nice, hot workout. Thirty minutes was good, and I made sure I took in plenty of water and lytes. There have been some previous workers who got heat illnesses-we found that many of these individuals had increased body mass indices. So, the key is to take it slowly, and monitor yourself and your water. Signing off now-orevwa!

Survival Medicine?

2010-02-11T01:59:00.000-08:00

Hi folks, seems like I am going to a non-mountainous environment-Haiti. The Anderson Coopers and Sanjay Guptas have left, yet there is still medical needs. How does one prepare for an austere, tropical environment such as this? Hard to say. Many working with me in the DMAT and IMSuRT teams have become ill from heat illness, maybe being a bit on the high end of the BMI scale, and consequent cardiopulmonary problems. Though fortunate to have been in horrifically humid environments, I still cannot exactly predict how this will go. As Louis Pasteur said, "Chance favors the prepared mind." Well, mental is 90% of this-being compassionate to the suffering, working many hours, being in a state of privation-and heat.

For those of you planning on joining us for any of our excursions, physical preparation is not only a good idea, but also necessary for survival, and a modicum of confidence. For a few weeks, my regimen has been similar to Mark Twight's "Gym Jones" training regimen-pretty tough workouts with weights and kettlebells (not sure if I will be lifting concrete, but why not be ready?), with half the workout in a steam room. As I write this, I feel sick to my stomach. Yet I have adapted well. Humans adapt very well to altitude and muscular exertion, and pretty well to heat; we do not really adapt well physiologically to cold, and not at all to dysbaric diving stress. Briefly, let's discuss the benefits of heat training.

With heat, our cellular proteins become undone with the unfolding of amino acids, eventualy leading to cell death. Heat shock proteins, built up with time in heat, attempt to refold the protein, restoring its bundled structure and protecting the cell. Enzymes are also saved with the protective heat shock protein-the enzyme is therefore not unraveled. Heat shock protein 70 is the most well studied. When the body temperature climbs a few degrees, large amounts of the protein are produced.

Macroscopically, cardiac output increases with an increase in peripheral vasodilatation, allowing sweat to occur. Initially the sweat is not as profuse as later, and salt is excreted. With time, salt is preserved, and a dilute sweat is produced. Hopefully, the sweat will cool the skin via convective wind current: it is more difficult to cool down without wind, and basically impeded with humid environments, which will make it seem hotter ("heat index"). Thus, it is imperative to avoid working in daylight heat, and take work slowly. Avoid fats and eat carbohydrates; and if planning a trip, trim excess body weight. Note that there are not to many rotund folks who live in the jungle-they are thin, and often, larger people succumb to a tropical environment. And please, drink PURIFIED water; a diarrheal illness will dehydrate and kill you!

Don't tell yourself that this lesson doesn't apply to you as you make your way up the Khumbu icefall, either. Temperatures can reach 100 degrees F there, too. So, in whatever environment you are going to, train hard, and train smart. Take your time; let those little proteins develop and do their work. And I will let you know if my crazy training paid off.

Dario

Zermatt Switzerland!

2010-01-11T18:48:00.000-08:00

Mountain and Marine Medicine is going to the Matterhorn this summer! We had such a fantastic time in Chamonix France in 2007 that we decided to go back to the same neighborhood. Switzerland is known for its exceptional hospitality! And the mountain beckons...

go to www.mmmedicine.com and click on the contact us section for more information.

Cheers,
Joe Alcock MD MS FAAEM

Rainer Redux!

2009-03-03T21:00:00.000-08:00

This is a photo from our very successful Mt. Rainier CME course on High Altitude Medicine from last summer. We are hosting the course again with the sponsorship of the Wilderness Medical Society this summer. The course will be at the lovely Nisqually Lodge in Ashford Washington. Dates of the course are: July 21 through July 24th, 2009. A guided climb of Mt Rainier will be offered following the CME course!
contact us for information.
Course Details
Contact Mountain & Marine Medicine

Avalanche Awareness & Video Link!

2008-08-03T11:43:00.001-07:00

This video is a graphic description of both the allure of backcountry skiing and the risk to those who tempt steep powder slopes!

http://revver.com/video/310519/a-dozen-more-turns/

We are going to post this as a permanent link at our sister site:

http://unmwildernessmed.blogspot.com/

Great video, Thanks Diane for the link!

Joe Alcock MD

What to bring to Rainier

2008-07-19T10:39:00.000-07:00

As I am winding my way up to Seattle via Colorado and Wyoming, the Rockies have been warm. August will be nice at Rainier, too. But don't relax...bring mountain clothes!

For those NOT climbing, I recommend:
Jacket and waterproof or water resistant shell; rainjacket
Layers of clothing for upper body and pants (possible water resistant pant shell as well)-from material that wicks the sweat away from the body
Warm hat and a cap
Sunglasses, sunblock or the like
Gloves
Sturdy pants for outings, hiking boots or sturdy trail shoes
Daypack, water container
Warm socks
Thermal underwear
CAMERA
Writing implements
Personal medical kit: blister kit, ibuprofen/Tylenol, tape, personal meds; acetazolamide (if tolerated) if going up high and you have a history of acute mountain sickness)
Hint: for activewear, I avoid cotton, opting for Coolmax or similar clothing. Nothing worse than wearing your sweat when a blast of cold air blows in from Alaska!

Since we are hoping to take a hike to a snowfield (time permitting), in addition to the above, you may ALSO want to bring these as options (but don't knock yourself out in buying these if you don't have):
Crampons, snow climbing boots on which the crampons fit
Long ice axe
Trekking poles
Gaiters
Climbing harness, locking carabiner (large)
Climbing helmet
Duct tape
A Release waiver (see website)-this outing is not required as part of the course!

For climbers, consult the IMG website (http://www.mountainguides.com/rainier-gear.shtml). I am leaving the cannister of oxygen at home, but bringing, in addition to all the above:
Down jacket
Insulated winter gloves (waterproof) and and EXTRA PAIR!
Plastic bags (for trash, and for vapor barrier liners)
Glacier glasses
Rope (for 2)
Prusiks or jumars
extra cord/cordelettes and extra carabiners
Sleeping bag, bivy sac, insulated foam pad/Thermarest equivalent
Tent (four season), groundcloth/tarp
Implements and small stove for cooking, food
Survival kit (map, compass or GPS, knife, fire starter, chocolate bars or glucose gels, cell phone, signal mirror (on my compass), HEADLAMP with extra batteries
Shovel, avy beacon, probe

Happy packing

Darryl

High Altitude Medicine Course at Mt. Rainier National Park

2008-07-14T15:39:00.000-07:00

Mountain & Marine Medicine is pleased to report that our upcoming course at Mt Rainier National Park is nearly Sold Out!

If you are on the fence about coming, now is the time to send in your payment or pay online.

We have great group of participants with a diverse background. There will be plenty of opportunities for great conversations, starting on July 31

at the Nisqually Lodge.

Bob Quinn MD at rquinn@salud.unm.edu ,as always, is available to give details about the optional climb of Mt. Rainier immediately following the course. Don't miss this special event.

PS. The photo is from our climb last summer of Mont Blanc in France, not Rainier!

Joe

The Value of Pre-Acclimatization

2008-07-13T23:26:00.000-07:00

We encourage everybody to who is planning on the climb of Rainier to make an effort to visit high altitude prior to the course. This is easier for some than others. Look back to this blog for more details!

Physical Preparation for Rainier

2008-06-20T17:43:00.000-07:00

Now it’s time to think about our climb to Rainier. Physically preplanning your summit day will enhance your chances of getting to the top, and enjoying it. If you have not been exercising, do so now. Cardiovascular fitness will be key. Engaging in activities specific to the goal will be important. Running and/or walking around with a heavy backpack (at least a third of your weight) for 30 minutes for 3 times a day will help. Get your heart rate up to 80 percent of maximal (220 minus age is your “maximal”-an easy formula). Cross train at least once a week doing a favorite activity, preferably climbing and or swimming for overall conditioning. If you are not fit, start your exercise slowly. If you are in good shape, you can double these workouts.
Increase complex carbohydrate intake (pasta for example) once you are doing this regimen, unless you need to shed a few pounds. In the latter case, decrease carbohydrate content, but keep protein intake the same. Substitute red meat intake for chicken or fish, or beans with corn or rice. Stop smoking, and if you have any health problems or are over 50, get a medical exam if you haven’t done so before.
If you are around high altitude, begin acclimatizing. This will be crucial. Initiate by going up to 8,000-foot elevations once or twice a week to walk in the first week for at least 2 hours. If possible, spend three days over 8,000 feet the second week, with a sojourn to 10,000 feet, walking. Spend the third week doing three of your routine workouts over 8,000 feet, going to at least 80 percent of maximal heart rate for 20-30 minutes. If adventurous, do one of your workouts at 10,000 feet. Rest at least a day between workouts.
Continue this the fourth week, especially if you were unable to do this routine during week 3. For the fifth and sixth week, if possible, add a hike (with a backpack) to 12,000-14,000 feet, or whatever is highest for you. Keep well hydrated at all times, and consider drinking “Endurox” or “Accelerade” to your hydration regimen. For “extra credit,” sleep above 10,000 feet once a week on weeks 3-5.
This regimen should reduce your chances for high altitude illness. Before you undertake this suggested program, MAKE SURE YOU CLEAR IT WITH YOUR PERSONAL PHYSICIAN FIRST, AND DO NOT UNDERTAKE THIS PARTICULAR REGIMEN IF YOU HAVE CARDIOPULMONARY DISEASE OR OTHER ILLNESSES THAT MIGHT FLARE UP AS A RESULT OF THIS REGIMEN. AND EXERCISE CAUTIOUSLY AT ALTITUDE IF YOU HAVE HAD PROBLEMS AT ALTITUDE BEFORE. You may contact us for further information.
dario

2008-05-28T15:29:00.000-07:00

One of our Rainier participants writes:

" I am looking forward to the conference in just a couple of months. I was wondering if you knew through your blogging or people signing up.....if there are any folks sharing rides from SEA TAC down to Ashford for the conference? I was hoping to rideshare with some one, pay for gas, etc..."

Now is the time to but tickets to Seattle and make travel arrangements. I can help coordinate rideshares if there is interest. Send an email to info@mmmedicine.com

Cheers,

Joe Alcock

Arriving in Seattle

2008-05-16T10:27:00.000-07:00

When you arrive at the Seattle-Tacoma (SeaTac) airport, you may find a spectacular view of Rainier to the south. The anticipation of a new, and different medical conference rises in your mind, and the anticipation of summiting this beautiful, Fuji like peak creates excitement. You might not even know much about high altitude, but you know you will after the conference. You have been running and training a bit at the gym in order to prepare you for a more adventurous type of CME. But you forgot a few supplies. No worries, because beautiful Seattle has it all! You can go to REI at 222 Yale North in Seattle (phone 206-223-1944, see http://www.rei.com/seattle for store locations) to load up or rent equipment for our excursions. Besides, a little detour is worth it. Nearby boasts the Space Needle, built for the World Expo in 1962, with a surrounding park, zoo, and museums (http://www.spaceneedle.com/restaurant). You might even plan to stay by the seaside community of Queen Anne and eat seafood overlooking the spectacular waterfront.

The Puget Sound, and the surrounding islands are rich with open air markets, kayaking possibilities in the San Juan Islands, fishing, and excursions to Victoria Island. Before or after the conference, Seattle is not to be missed! TripAdvisor.com can keep you apprised of good places to stay. Your family will enjoy these options, as well. Don't hesitate to contact us at worlddoc@comcast.net for more information.

Telluride Mountainfilm 2008

2008-04-30T14:56:00.000-07:00

The 30th Mountainfilm in Telluride, Colorado will be held on May 23 - 26. This is a four-day experience that draws athletes, artists, and activists from around the world. The wide range of short and feature length films aims to inspire and challenge the audience. Mountainfilm in Telluride seeks to explore critical and compelling issues the world is facing while showcasing the art of documentary and filmmaking.

A few highlights from the upcoming lineup of non-film events include:
“Moving Mountains Symposium on Water”
“Tribute to the Late Sir Edmund Hillary” hosted by David Breashears
“Foreign Policy Roundtable, Hot Spots Around the World” with Christiane Amanpour, Richard Holbrooke, Roger Cohen and Samantha Power
“The Village Green,” a discussion Ashton Hayes, England, and its efforts to be carbon neutral

Big names in the world of travel, art, adventure, and environmental awareness will grace the event. Early bird tickets are on sale until May 1. For more information please visit mountainfilm.org.

International Activities-A Refocus

2008-04-11T12:05:00.000-07:00

Our phenomenal month with our wilderness medicine class has catapulted us to many activities in the wilderness and international medicine scene. Our Mount Rainier 2008 conference on July 31 to August 3 is gonna be amazing, and many of you know about it. But in the works is an amazing international emergency medicine conference in Buenos Aires, Argentina. On June 11-13, we will join in with the American College of Emergency Physicians (ACEP) and the Argentine Society of Emergency Medicine (SAE-Sociedad Argentina de Emergencias) to bring participants an exceptional educational event, whether you speak Spanish or English. Not only will talks on emergency and wiliderness medicine be given, but a unique opportunity to meet with the "movers and shakers" in emergency medicine throughout the Americas will be there. And don't forget the Patagonia backcountry skiing and jungle tours to take place after the conference! More information can be found at http://internationalemergencymedicine.blogspot.com.
Also in the makings are a four day mountain medicine survival course in October, and an opportunity to participate in many other activities in the future. Feel free to mail us at mail@mountainandmarinemedicine.com for more info!

Congratulations to Wilderness Medicine Class Participants

2008-04-01T21:18:00.001-07:00

Our March Wilderness Medicine Class at the University of New Mexico was our best yet! Congratulations to our student and physician participants. We wish you well in all your future endeavors.

Our next course will be our Mt. Rainier High Altitude Medicine Course this July 31 - August 3, 2008.

Sneak Peak of upcoming courses: events for the upcoming fall and winter will include a some courses a little closer to home here in New Mexico. We are busy planning a weekend survival course in a spectacular little-known wilderness area and a wilderness medicine course for non-medical providers!

Check back for more details!

Joe Alcock MD

Wilderness Medicine Tip of the Week

2008-03-20T11:17:00.000-07:00

Woman killed by Eagle Ray! Mortality from stingrays is increasingly reported. Read on...

The LA times today reports that a woman encountered a stingray that leaped into the boat she was traveling in. She may have died from a wound inflicted by the calcium carbonate barb of a full size eagle ray (example pictured above).

The UNM wilderness medicine class visited the stingray exhibit 2 days ago for a scenario-based learning experience; marine stings were discussed in great detail at the Albuquerque Biopark aquarium. As we discussed, approximately 4 instances of stingray barbs penetrating the heart have been reported in Australia. Most readers no doubt are aware of Steve Irwin's well-publicized untimely death by this mechanism. Exsanguination and arterial lacerations have also caused human deaths.

Short of cardiac penetrating trauma, first aid consists of immersion of the affected extremity in non-scalding hot water. The venom that surrounds the calcium carbonate barb is heat labile. Prompt hot water treatment results in impressive pain relief. Xrays may be necessary to rule out retained foreign bodies. Tetanus vaccination is indicated - as in all lacerations. Be aware that marine injuries may be complicated by unusual pathogens - such as Vibrio species and Mycobacterium marinum.

The best approach is to avoid being stung altogether. Most bathers can avoid injury by shuffling their feet when entering the water. Otherwise - avoid cornering a large sting ray in shallow water - as Steve Irwin reportedly did. The recent death of the boater encountering a leaping ray, while seemingly bizarre, has been reported more than once in Australia. If a ray leaps into your boat, you may just be out of luck! Be aware that the stinging barb is located about 1/3 of the distance down the tail from the body of the fish.

Finally, note that hot water is the treatment of choice for most penetrating marine stings, including stonefish, scorpionfish, even invertebrate stings such as urchins. Hot water is increasingly recognized as effective treatment for box jellyfish stings and portuguese man of war stings. More on that later!

Médecine de la montagne/Medicina de la montaña

2008-03-03T09:58:00.001-08:00

For Francophones and Castillano wilderness enthusiasts:

Médecine de la montagne et de l’environnement.
Ici vous avez un site pour l’information sur la pratique de médecine dans les terrains extrêmes, et la médecine “d’improvisation.” Il y aura des podcasts sous cette rubrique en français dans l’avenir. Notre conférences sur la médecine de la montagne à Quito Equateur et Chamonix faisaient un, no, deux tabacs! Nous avons un mois de médecine de l’environnement chaque mars à Nouveau Mexique, et nous aurions notre prochaine course de médecine de la montagne à Mont Rainier, dans l’état de Washington. Nous sommes en train de collaborer avec l’Ifremmont (www.ifremmont.org) pour developer la formation de médecine de l’environement en français et anglais. Voilà une photo de notre course de survie et navigation dans le désert de Nouveau-Mexique. Vous pourriez nous contacter a www.mountainandamrinemedicine.com/contact/ pour plus d’infos.

Medicina en ambientes extremos
Aquí hay un sitio dedicada a la medicina en terrenos remotos, incluyendo medicina en el yermo y medicina improvisaciónal. Para los hispanohablantes, hemos proporcionado “minicursos” sobre estos tópicos. Infórmense aquí en este sitio lo que estamos haciendo en cuanto de la capacitación de un tópico muy interesante. Recientemente, hemos hecho un congreso de mal de montañas y altura a Quito Ecuador y Chamonix Francia, un curso de buceo en Bonaire (al mar caribe) y tendremos un congreso a Monte Rainier, en el estado de Washington. Hemos hablado en el congreso internacional de la Sociedad Mexicana de Medicina de Emergencias (a México, DF.) sobre la tema de “Hipotermia,” y vamos participar al congreso de la Sociedad Argentinas de Emergencias, a Buenos Aires el 11-13 junio 2008. La foto es una foto de navegación y supervivencia en el desierto de Nuevo México. Escriben al sitio de www.mountainandamrinemedicine.com/contact/ para mas información. También hay información sobre el sitio de www.reeme.org.

Bizarre death in Chamonix

2008-03-02T21:24:00.000-08:00

According to reports, a man fell from a cable car (gondola) in Chamonix, France to his death. The gondola was one that travels to get to Planpraz, the mid-station to Le Brevent. This is of interest, because I took that gondola as did many of the Chamonix High Altitude Medicine participants during our marvelous excursion and course there last summer.
Read more
http://snowheads.com/ski-forum/viewtopic.php?t=37292

This is what the area looks like in winter.

Link to description of our course in July, 2007.

Hypothermia Lab

2008-02-28T20:12:00.000-08:00

Wow, what a day up at the top of Sandia Peak today as a group of us tested some of the techniques of backcountry rewarming in cases of hypothermia. All were mildly hypothermic as measured clinically and by vital signs. There were slight afterdrops in all except the pair rewarming inside a sleeping bag. Definitely comfortable for the one being warmed, but not for the one warming! The shivering really burned energy, as all the participants were fatigued after the experience. A truly unforgettable learning experience!

Mac Guyver Medicine-does it work?

2008-02-27T20:48:00.001-08:00

On Wednesday, February 27 2008, the UNM Wilderness Medicine course participants tested out the commonly accepted, tried and true ideas that are taught in many wilderness medicine courses. Problem is, most classes are in auditoriums of over 400 people, with a keynote speaker in the front. We found many of the ideas to work, but not as well as you would think. We devised ideas that are not normally taught in wilderness settings. Paul Romo is demonstrating yet another use for a foley...as a stethoscope! A good friend, Ken Iserson, gave me this idea with the baby nipple, and we thought of the foley. By the way, Ken will have a great book about MacGuyver medicine coming out this year-a tome that will pique the interest of the wilderness medicine or international medicine traveler alike. At any rate, the usual improvised airway control ideas were taught in our lab today, but the a question comes up...how do you improvise on the BVM?
Dario

UNM Wilderness Course is Underway!

2008-02-25T17:03:00.000-08:00

This afternoon, students and medical residents from around the country met at the base of the Sandia Mountains in Albuquerque, NM to initiate the 9th consecutive UNM Wilderness Medicine elective.

The first part of the course teaches wilderness life support, the general approach to wilderness scenarios, and environmental emergencies. The UNM School of Medicine has provided the BATCAVE (basic advanced trauma computer-assisted virtual experience), a computerized human patient simulator, to teach wilderness ACLS and BLS principles. Skills and breakout areas are dedicated to basic and advanced airway techniques using mannequins. Students learn how to use bag valve masks, oral and nasal airways, multilumen airways, laryngeal mask airways, as well as endotracheal intubation and surgical cricothyrotomies. Other sessions are devoted to intravenous and alternative access for fluid resuscitation. Wilderness resuscitation scenarios with computerized mannequins allow students to practice their response to emergencies and understand when to terminate efforts.

Improvisational techniques are emphasized during this first week to provide a framework for subsequent scenario-based training. An entire day is spent at a local ski lodge, where 4 instructors teach students outdoor medical skills. In addition, we cover airway and breathing management, hemodynamic stabilization, splinting, and patient transport scenarios. A hypothermia laboratory session is performed in which 3 volunteers are cooled outside and are promptly rewarmed.

The first weekend of the course is devoted to wilderness survival and land navigation, which evolved from a 4-hour classroom gathering to a 2-day field trip in the New Mexican high desert. Shelter, matchless fires (flint and steel, bow and drill, and several other methods), water procurement, filtration, food, and weather prediction are covered during the first day's session. Three instructors teach 3 groups of 6 to 7 students in 3 stations covering the above topics. The second day consists of training on the use of a map and compass. Students learn a primitive means of route finding, and ways in which to measure distance and time. The course continues with a nighttime land navigation course, using a compass or the stars as a directional indicator. This field trip is consistently rated as one of the most valuable in the course; students feel more confident in dealing with a survival situation, both physically and psychologically.

Half- and full-day field trips near Albuquerque are educational as well as recreational. These trips are introductions to various types of activities, which also allow instructors to evaluate group strengths and weaknesses. A half-day mountain biking trip incorporates approximately 10 mini-lectures with patient scenarios during rest stops. A day of rock climbing instruction is usually performed nearby, where the basics of climbing, rappelling, anchors, knots, technique, and safety are practiced. Although New Mexico lacks an ocean, the excellent Albuquerque Biopark Aquarium is available as a classroom. Diving emergencies, marine envenomations, and marine biology are very popular subjects taught there. Professional divers (who staff the aquarium) demonstrate scuba diving equipment, mock dysbarisms, and marine envenomations. Land envenomations are taught by staff of the New Mexico Poison Control Center. A backcountry yurt near the Taos Ski Valley is our venue for a ski clinic and avalanche awareness course. Snow camping in Taos gives students opportunities to build snow shelters and experience high-altitude at nearly 12,000 feet.

The last module of the course is a 5 day trip to the Cedar Mesa primitive area of southeastern Utah. This remote canyon country provides a spectacular backdrop for lectures on dehydration, lightning injury, flash flood danger, medicinal plants, and land navigation. An hour each day is devoted to wilderness medicine scenarios in rugged sandstone terrain. These lessons demonstrate the difficulty of initiating a rescue effort and transporting patients in the backcountry.

The survival and land navigation training (as well as the medical and leadership aspects of wilderness medicine taught during the month) culminates during the day-long timed exercise called the Eco-Resus Challenge. Students are randomized into groups with an equivalent distribution of ability, gender, and physical conditioning. Each participant is given a general orientation to this grueling event, which takes place in a rugged area outside Albuquerque. All backpacks are examined for items that are deemed contraband (eg. GPS units, radios). Students are staggered into groups that are evenly matched in terms of physical and navigational abilities. These teams must navigate their way to a patient care station and stop to treat and/or transport that patient. Students are given a topographic map for navigation and are expected to use skills obtained during the course to find patients. Groups must navigate their way through the desert into a mountainous woodland. Tasks must be completed at patient care stations that must be completed before continuing to the next objective. Each group must fill out log sheets describing patient encounters in standard format. Simulated patients are to be treated in an appropriate manner for the existing conditions. "Victims" often will require evacuation to the next station. During the course, participants are expected to use a signal device to communicate to an incident commander. Each group is accompanied by an instructor familiar with the course who does not offer assistance, unless necessary for safety.

Students and faculty will finish this course on March 22, 2008 after the Eco-Resus challenge. The most effective rescue teams will be celebrated during a debriefing of the event. Students are encouraged to keep a journal of their experiences during the 4 week elective. Previous participants have contributed original artwork, song, poetry, videos, photo-journals, and even, yes, blogs to the UNM Wilderness Medicine historical record.

Exerpts from the best creative journals will be posted at this site, along with new videos, podcasts, and photography.

The UNM Wilderness Medicine Website is here:
UNM Wilderness

For further reading:
Wilderness and Environmental Medicine

Joe Alcock MD

Airline Emergencies

2008-02-25T03:59:00.000-08:00

A recent story in the LA Times highlights the death of an airlines passenger, allegedly because of faulty medical equipment. Click on the picture to right to see the medical kit/equipment that large commercial airliners should have available.

The article in the New England Journal of Medicine "Responding to Medical Events during Commercial Airline Flights" is available here:
http://content.nejm.org/cgi/content/extract/346/14/1067

We will be discussing this and other articles during a fireside UNM Wilderness Medicine journal club later this month in Utah!

Update on the death in the skies:
Woman dies on American Airlines flight

JA

The Basic Medical Kit

2008-02-25T03:45:00.000-08:00

The components of a basic medical kit can include:

Cpr mask
Ace wrap
Safety pins
Epipen
Duct tape
Superglue
Soap
Sunscreen
Sam Splint
Tweezers
Gloves
Iodine water tabs
Aspirin & Ibuprofen
Antibiotics, (Narcotic Analgesics)
Moleskin, bandages
Hand Sanitizer
Syringe
Survival Gear
Clothing
Whistle
Cellphone

Note that a stethoscope and blood pressure cuff are unnecessary for this basic kit. Prescription medications and controlled substances are optional and will be the subject of another post.

Survival kit and comprehensive medical kit information can be found here:
Medical Kits

Wilderness Medicine Tip of the Week

2008-02-23T08:08:00.001-08:00

While great media attention is devoted to victims of avalanches, the Everest death zone, and shark attacks, it is easy to lose sight of more broadly useful wilderness medicine information.

This winter, several parties of skiers got lost near our regional ski areas. At the time of this writing, two snowboarders have not been found and are presumed to have perished on the mountain. Another group included a wilderness medicine trained physician. They ultimately survived after building a snow cave and calling for help.

Training and appropriate gear are paramount when trying to survive the unexpected night out in the snow. To that end, we will be posting several entries on the wilderness medical kit.

Our medical kit changes depending on whether we are traversing glaciers in the Alps, diving in the Caribbean, or hiking in the Rockies. However, the medical kit should always contain personal protective gear such as sunglasses, sunscreen, and gloves. Medications should include OTCs like ibuprofen, antihistamines, as well as prescription analgesics and antibiotics. Wound care and dressing supplies are important. Finally, survival gear is essential. We are not talking about shark-repellants and grizzly stun-guns here.

Wilderness Medicine Tip of the Week:

Bring a signaling device in the backcountry.

Survival gear includes a communication device. This could be as simple as bringing a cell phone or radio to call for help. (One should bear in mind that cell phone reception is spotty at best in much of the backcountry - but the "pings" between cell towers and the phone can aid in finding victims even when the signal is too weak to make a call). Some authors recommend bringing extra cell phone batteries on a backcountry trip. Don't forget about signal mirrors. Signal mirrors are effective when the sun is shining. Commercial products are available at your sporting goods store. Alternatively signal mirrors may be improvised from a compact disk, the inside of a soda can, or anything shiny. You should also bring a whistle. Some backpacks have an integrated whistle in the chest strap. Even if your backpack doesn't have that feature, whistles are lightweight and are very helpful in a rescue scenario. Other options include visible signals, such as bright clothing, a smoky fire (assuming you are not going to cause the biggest forest fire in the history of Arizona!) and nighttime strobe lights. Divers can carry whistles that attach to their supplemental air supply. Aviators sometimes carry dyes that stain the water if they have to parachute into the ocean. While diving, I carry an inflatable "safety sausage" balloon-like device that is visible from a distance. So while circumstances matter, the concept of a communication device is of utmost importance!

Refer back for more. Soon we will post examples of lightweight and comprehensive medical kits at our websites.

Thanks go to Stephen Guine for providing the classic in wilderness medicine literature: "How it Feels to Be Attacked by a Shark"

Joe Alcock MD

Good Conditions for the Wilderness Class

2008-02-22T18:31:00.000-08:00

We went to the Sandia Crest today to check on conditions for the upcoming Wilderness Medicine Elective. The verdict? Great snow for the beginning part of the course. The wilderness medicine course has several modules, including the hypothermia lab in the Sandias, desert survival at Cabezon, backcountry snow camping and avalanche awareness at Taos, and canyon country backpacking in Utah. March is a great month to experience the variety of environments and weather conditions in the high desert of the Southwest. In some years past, we have had very little precipitation, however, for our snow-dependent activities. This year promises to be a good year for our Sandia Mountain and Taos excursions! This photo was taken today by my wife, Satkirin Khalsa. The well-dressed attractive individual in this photo is our dog Nanda.

Avalanche Awareness & Video Link!

2008-02-22T09:07:00.000-08:00

UNM Wilderness Medicine Course Blog

2008-02-21T21:43:00.000-08:00

The UNM Wilderness Medicine Elective starts in 4 days! We are very excited about this year's course, which promises to be a very educational and action-packed four weeks. We have some great additions to our faculty, with Jason Williams of Albuquerque Mountain Search and Rescue playing a prominent role in the planning of this year's course. We will be introducing other faculty and personalities of the elective in upcoming posts.

Jason's photo is posted at our a new blog that is dedicated to the UNM Wilderness course.
you can find the blog here:

http://unmwildernessmed.blogspot.com/

The site you are currently reading - Mountain and Marine Medicine Blog - will continue to bring news of the UNM wilderness medicine events but not on a daily basis.

UNM Wilderness Medicine News will contain directions to events, brief descriptions of the people involved in the course, lecture handouts and useful information for students!

We hope you enjoy the new blog!

Joe Alcock MD

More on the Sandia Ski Area Lab

2008-02-20T08:03:00.001-08:00

The upcoming Wilderness Medicine Course is visiting the Sandia Ski area. (Most people do not know that Albuquerque is one of the few major metro areas with its own ski area. In fact, you can access the slopes from the Sandia Tramway which leaves from the Albuquerque foothills.) We will be meeting at the ski lodge area next week. Directions to the Sandia Ski area from Albuquerque are: I40 East to Tijeras. Take route 14 north to Sandia Park. Follow the signs to the Sandia Ski area and park at the lodge for lectures on hypothermia and survival in the snow!

Joe Alcock MD

Travel Medicine Can't Miss Diagnoses

2008-02-19T11:05:00.000-08:00

Can't miss diagnoses in travel medicine.

The majority of returned travelers with health complaints have garden variety illness such as gastroenteritis and upper respiratory infections. However, health care providers need to be aware that life threatening travel-related illness also occurs. Some of the "can't miss" diagnoses in returned travelers include:

1) Falciparum malaria

2) Malaria, especially falciparum, in pregnant females

3) Viral hemorrhagic diseases, including ebola virus, marburg virus, lassa fever, and rift valley fever. Dengue shock syndrome and yellow fever can also he complicated by hemorrhagic manifestations. While the viral hemorrhagic fevers are relatively rare, the high mortality rate makes them "can't miss" diagnoses.

Further reading here:
Viral Hemorrhagic Fever

Joe Alcock MD

Sandia Ski Area Hypothermia Lab

2008-02-19T07:52:00.000-08:00

Next week the faculty of Mountain and Marine Medicine will accompany students of the Wilderness International and Improvisational Medicine Course to the Sandia Ski area. There, we lecture on hypothermia and frostbite, among other topics. At right is photo of a volunteer who was (temporarily) underdressed for the elements. Faculty and students have "chilled" outside for a few minutes. Students then practice rapidly rewarming these "victims" in a hypothermia wrap and plentiful hot chocolate.

Students who will be joining us should look at this gear list:

Outdoor snow gear - ski wear - sunglasses/screen -swimsuit for some!
Daypack
Ski area: Alpine/Telemark or Snowboards
Backcountry: X-country skis or Snowshoes
Bring or buy lunch/drinks
You may rent cross-country skis/snowshoes at REI - (505) 247-1191
Other gear at Sportz Outdoor (505) 837-9400
Ski Systems (505) 296-9111
UNM outdoor shop 277-8182

Joe Alcock MD
www.mmmedicine.com

Travel Medicine Case (?)

2008-02-18T11:13:00.001-08:00

This is the case of a 44 year old male who presented to an Albuquerque hospital after passing a pale 1 meter long parasite. Pictured at right is the worm, which has the appearance of fresh linguine.

The specimen was taken to the lab where it was placed in fixative and then sent to the hospital media department for photographs.

History revealed that the man had not in fact traveled, but was an aficionado of fresh seafood. Additional questioning revealed that he had enjoyed salmon sushi, made at home, prepared from fresh fish. It is unknown whether he used wasabi or a fine sake with his meal!

As for the parasite ID:
Click here to see what happened to our patient:
Answer

2008-02-17T11:53:00.001-08:00

When the UNM Wilderness Medicine Course begins next week - we will start by explaining the general approach to wilderness medicine patients: The Scene size-up. The scene size-up has three components: First - Check the scene safety - Is it safe for rescuers to approach and attend to victims. Second - Assess the mechanism of injury - Consider what injury patterns might arise from such a mechanism. Third - Find how many victims are involved - the number of injured persons has large consequences for the rescue effort.

Go to the UNM website for additional information about our March Wilderness Medicine course!

UNM Wilderness Medicine

Hope to see you soon!

Joe Alcock MD
www.mmmedicine.com

Brand New Website

2008-02-16T23:25:00.000-08:00

You can find our listing of wilderness medicine CME courses at our brand spanking new website:
http://www.mmmedicine.com/index.cfm
Be sure to bookmark the page!

Joe Alcock MD

UNM Wilderness Medicine Course News

2008-02-16T12:33:00.000-08:00

In a little more than 1 week, Darryl Macias MD and I will welcome 20 students for the University of New Mexico's Wilderness International & Improvisational Medicine Course! The first week of the course will take students to the Sandia Mountains for high desert hiking and backcountry and alpine skiing adventures. Each excursion has a heavy didactic component and features scenario-based learning. We will end the week with a visit to the BATCAVE, a computer-driven human mannequin that allows students to practice life-saving techniques in wilderness cardiac and respiratory arrest scenarios. Later, we will visit a backcountry yurt in Taos, the remote desert of north central New Mexico (pictured above), and the canyon country of Utah! Visit this blog for upcoming updates as we track our progress through the month!

Joe Alcock MD
www.mmmedicine.com

New Logo

2008-02-16T00:11:00.000-08:00

Mountain & Marine Medicine has a new Logo! Among the many new developments at Mountain & Marine Medicine (M3) is this new image that will soon be emblazoned on new T shirts and other M3 merchandise. Email us for details!
www.mmmedicine.com/contact/

Many props go to our new web designer, Joe Black, for this well-produced emblem that conveys what Mountain and Marine Medicine is all about. Thanks, Joe!

Visit this site frequently for lots of new and exciting changes at M3!!!

Joe Alcock MD

2008-02-16T00:02:00.000-08:00

Wilderness Medicine Course pictures can be found at our new Mountain & Marine Medicine Multimedia Page:
http://www.mmmedicine.com/multimedia/
Pictured here is a workshop from our High Altitude and Mountain Medicine Course on Mont Blanc!

Joe Alcock MD

Wilderness Medicine Tip of the Week

2008-02-15T17:30:00.000-08:00

This is a New Feature of the Mountain & Marine Medicine Blog:
Each week we will publish a wilderness medicine "pearl", explaining priorities of caring for patients in the out of doors.

Wilderness Medicine Tip of the Week!

Foot fractures are common injuries among climbers, as in this example of a 29 year old male who fell while bouldering.

Calcaneus fractures can be obvious as in the radiograph above, or they can be subtle. The inability to bear weight is an important clue. However, don't forget to finish your exam. Rapid deceleration from a fall from height delivers energy sufficient to break bones elsewhere in the body. This week's tip: 10% of patients with a calcaneus fracture will have a lumbar spine compression fracture. Always protect the victim's neck and back & examine the spine for tenderness!

Check back next week for more! And don't forget to visit
www.MMMedicine.com for great wilderness medicine adventures!

Joe Alcock MD

UNM Wilderness, Improvisational and International Medicine 2008

2008-02-14T20:50:00.000-08:00

Hello from Albuquerque to all taking the March class!
We are excited to have you come out at the end of February. Things are on track for another OUTSTANDING course-so get ready to learn, live, and laugh! Although I am honing my survival skills a bit (practicing with a bow and drill for firestarting), I have been "checking" out the snow for you as well. The backcountry skiing and snowshoeing is really good this year, and the weather is mild after several weeks of pretty cold weather. Dress properly...we are all meeting at the Copper open space for orientation at 1pm on Feb 25. You should have received a map. Registration will be done first (we will also do a little "accounting" work). Then, on a nice hike. Give us a jingle at 505-272-5062, or email me at dmacias@salud.unm.edu for questions. If you have anything that you would like to learn other than what is on the WIIM website, let us know. And tell your friends and family not to get too jealous while you embark on this fun educational event...
Cheers, aloha, namaste, and hasta...Darryl (Dario)

High Altitude Medicine

2008-02-08T14:19:00.001-08:00

High Altitude Medicine - Rainier July 31, 2008 - August 2 2008

Mountain & Marine Medicine LLC 's Rainier High Altitude Course has been endorsed by the American Academy of Emergency Medicine.

And...the course has been approved for AAFP CME credit for 21.75 prescribed credits. See our site for the full statement:
www.mmmedicine.com

Join us for this exciting event in July 2008!

Hyperbaric Medicine

2007-12-08T20:27:00.000-08:00

Our upcoming courses in Honduras and Fiji will include hyperbaric medicine updates. Pictured here are faculty and a participant from our May 2007 Bonaire Dive Medicine course. A huge success!

Dive Medicine Plans for 2008/9

2007-12-08T20:06:00.000-08:00

Mountain & Marine Medicine is pleased to announce our most fabulous dive CME expedition ever - to Fiji. This course will take place in spring/early summer of 2009. It is a long time away, we agree. But it will take that much time to assemble the world's best faculty for a dive course in one of the worlds most diverse marine hotspots.

Planning for this course is underway. We will be accepting deposits for this course in early 2008.

If you can't wait that long, come along to Roatan Honduras this May!

Check out:

http://www.mountainandmarinemedicine.com/Roatan2007.html

email Alan Lewis for details about the Honduras course.

drbabar77@gmail.com

Rainier High Altitude Pricing Announced

2007-12-08T19:53:00.000-08:00

Mountain & Marine Medicine is pleased to publish very reasonable tuition fees for our upcoming course at Mt Rainier National Park:

Physicians $645

Non-Physicians $595

Students/Trainees $545

Lodging is even cheaper. Rooms rates are as low as $45 per person based on double occupancy at the Nisqually Lodge for course participants. Email us for details!

Now is the time to make plans for your summer CME needs. Email Bob Quinn MD at rquinn@salud.unm.edu for details about the optional climb of Mt. Rainier immediately following the course. Don't miss this special event.

Rainier High Altitude Medicine

2007-11-19T08:13:00.000-08:00

Join Mountain and Marine Medicine for a High Altitude Course at Mt. Rainier in Washington State. The course will take place at the Nisqually Lodge, near the Mt. Rainier National Park, and the course will culminate in an optional 3 day guided climb to the summit.

Contact Bob Quinn MD for details about the climb.
rquinn@salud.unm.edu

http://www.mountainandmarinemedicine.com/Rainier.html

Diving CME

2007-01-25T20:43:00.000-08:00

Pictured here is a group photo from our dive CME course last summer. The faculty from that trip, Michael Strauss MD, Cameron Crandall MD PhD, and Darryl Macias MD and Joe Alcock MD will be presenting new topics in Bonaire this spring. You will learn travel medicine topics, as well as unique perspectives on diving physiology and mammalian adaptations to diving. Don't miss this opportunity to gain CME in one of the best dive locations in the world.
Bonaire, May 20-25, 2007

Bonaire Diving Medicine

2007-01-19T12:10:00.000-08:00

Now is the time to sign up for our May 2007 Bonaire diving medicine course.

We have new topics, new guest speakers, and a terrific diving program lined up. Learn about drowning, mammalian adaptations to diving, and physiologic challenges of divers from Michael Strauss MD, author of Diving Science and a leading hyperbaric medicine instructor and researcher.

Pictured here is a denizen of the Bonaire reef: the yellow headed jawfish.

Don't miss this chance to earn 24 CME hours while exploring one of the finest dive sites in the world.

Not to mention: this is one of the least expensive dive medicine courses and travel packages you will find anywhere! Our inclusive week-long package provides tuition, flight, rental car, luxury hotel, daily boat diving, unlimited shore diving and breakfast starting at $2200!

Register today! Visit: http://www.mountainandmarinemedicine.com/Bonaire2007.html

Advanced Wilderness Life Support Course

2007-01-18T21:41:00.000-08:00

Mountain and Marine Medicine is proud to host a Advanced Wilderness Life Support Course - March 23-25, 2006.

This course will be taught in part by the faculty of Mountain & Marine Medicine and is our least expensive course for 2007. Pictured here is a view of Albuquerque from the Sandia foothills. We have had lots of snow this year, so we expect skiing even late in the season. There will be lots of opportunities for outdoor recreation. Not to mention medical continuing education that is second to none! So please register today: AWLS Link

New Courses!

2006-11-06T13:13:00.000-08:00

At long last, Mountain & Marine Medicine is ready to publish our course offerings for 2007! Our 2007 itinerary is our most ambitious ever! We will Include an Advanced Wilderness Life Support Course in Albuquerque, NM, offered through the University of New Mexico in March 2007.

We have reserved the Plaza Resort Hotel in Bonaire in the Carribean for our 3rd annual Marine & Diving Medicine course. This will take place on May 18-25, 2007.

Finally, we plan an exciting High Altitude medicine course for July 2007. More details to follow!

Email us at mail@MMMedicine.com for more details.

Cotopaxi High Altitude Course

2006-07-13T09:20:00.000-07:00

These are photos from Mountain & Marine Medicine's High Altitude Medicine Course in Ecuador last month. We had a group of 19 participants who took part in lectures at the UTE university in Quito before leaving for Tambopaxi refuge in the Cotopaxi National Park. We enjoyed lectures and skills labs at Tambopaxi and then hiked up to the Jose Rivas Refuge on the Cotopaxi volcano. These photos are from the climb on Cotopaxi. 40% of our group made it to the top, 19,300 feet! I turned around at 18,500, so none of these photos show the summit. Check back in a few days for a group photo and summit pictures. Most of us exceeded our climbing goals and achieved our highest altitude ever. But the meeting was really about a fantastic education experience in a stunning setting. We met good friends, learned a great deal about altitude medicine, and look forward to our next experience!

Check out our travels and lectures:
http://www.mountainandmarinemedicine.com/HighAlt.html

Our meeting in Kailua Kona also promises to be an exceptional course, with a unique approach to medical education and terrific guest speakers.
http://www.mountainandmarinemedicine.com/Kona2006.html

email us at: mail@MMMedicine.com

Patent Foramen Ovale & Diving

2006-07-12T17:44:00.000-07:00

Pictured here is a rash suffered by a professional diver after a typical day of diving. The profile was well within no-deco limits and his dive computer showed that his nitrogen tissue saturation was not substantial. This diver suffered vertigo and dizziness along with the rash, making it a type II decompression sickness (DCS) event. This episode is an illustration of undeserved bends. The diver did everything right, yet suffered severe symptoms of DCS, requiring treatment in the chamber above.

What causes undeserved bends? Occasionally dehydration, illness, or abnormal complement immune function may contribute. However, the cardiac abnormality known as a patent foramen ovale can predispose to DCS in some divers.

Patent Foramen Ovale is an opening between the left and right atria in the heart, allowing blood to bypass the lungs. Divers often develop bubbles in veins, a common occurance (30-100% in some series). Most of the time these bubbles are harmless and are filtered out by the lungs. A patent foramen ovale allows these bubbles to pass by the lungs and go into the brain, where they can cause stroke-like symptoms. In fact, the onset of DCS in divers with a patent foramen ovale can occur rapidly. This can look like a arterial gas embolus, which generally occur when divers hold their breath during a rapid ascent. In PFO however, the diver may have just finished an uneventful dive with no warning from their dive table or computer - hence the term undeserved bends.

So this sounds scary and unavoidable. Scarier still if you consider that about 30% of the population has a PFO! And it seems to be even more prevalent in divers than in the general population. Even doing a valsalva maneuver may open up a closed PFO. Some depressing studies have illustrated a correlation between PFO and brain injury in recreational divers.

But don't quit diving yet. PFOs, while common, rarely cause DCS. And those brain injury studies are fraught with methodologic problems - so far.

We will discuss these issues in great detail this August in Kailua Kona. This information should be of great interest to anybody who dives. In particular, frequent divers, deep divers, and professional divers should know about this research.

Aloha,

Joe Alcock MD
www.MMMedicine.com
mail@MMMedicine.com
http://www.mountainandmarinemedicine.com/Kona2006.html

Hyperbaric Medicine Updates

2006-07-08T10:58:00.000-07:00

During our upcoming Marine & Diving Medicine Course, Aug 22-26th, 2006, we will be discussing the latest in hyperbaric oxygen therapy for diving injuries.

If you are a medical provider on a dive trip, you may be called upon to help make a decision about evacuating an diver to a chamber. How will you make that call?

If you are in Cozumel, Mexico, as pictured here, or Honolulu, you are lucky because a hyperbaric chamber and dive physician is nearby. Often, though, a chamber will not be readily available. Kona Hawaii lacks a chamber.

As a medical provider on a diving trip you will be confronted with divers who may minimize or deny their symptoms, captains who have a financial interest in continuing a dive trip, and obstacles to safe evacuation, like unpressurized aircraft.

We will discuss indications for hyperbaric oxygenation in a future post.

Remember, the number for DAN, Divers Alert Network, is 1-919-684-8111. Remember to call local EMS first! A DAN diving physician can offer advise for diving accidents, medical evacuations, and whether hyperbaric oxygen is appropriate.

We strongly recommend DAN travel insurance for participants, a good deal, particularly if you go on several dive trips per year.

Aloha,

Joe Alcock MD
www.MMMedicine.com
www.mountainandmarinemedicine.com/Kona2006.html

Pre-conference Shore Dive

2006-07-07T15:00:00.000-07:00

The faculty of Mountain and Marine Medicine are planning a shore dive at Pu'uhonua o Honaunau on August 20th before our Marine and Diving Medicine course begins in Kailua Kona Hawaii. This will be a good opportunity to get acquainted with some of the best diving the Kona coast has to offer. It is a truly special place with frequent visits of Honu or Green Turtles. Green turtles are an endangered species but thankfully common in Hawaii.

You are welcome to dive with us - send us an email at:
mail@mountainandmarinemedicine.com

Above is one of my photos of a green turtle at this dive site.

Joe Alcock MD
www.MMMedicine.com

2006-07-06T21:30:00.000-07:00

Mountain & Marine Medicine warns: Don't let this happen to you!

We will cover dangerous marine vertebrates, like this needlefish, which caused the loss of an eye, but not death, in this Japanese victim. See another account of needlefish, or Aha, injury in Hawaii: Aha Injury
And check out this link on Needlefish from the Hawai'i lifeguard site: Aloha

Its is best to protect yourself from the knowledge that will come from our Marine and Diving Course this August.
Visit our Kailua-Kona Course.

Be safe!

Joe Alcock MD
Co-director Mountain and Marine Medicine, LLC
www.MMMedicine.com

Preparing for Marine & Diving Medicine Course

2006-07-05T20:11:00.000-07:00

Mountain & Marine Medicine's faculty are getting ready for our CME course in Kailua Kona this August 22-26, 2006 by preparing lectures AND dusting off our dive gear!

We recommend that participants get their regulators and B/C's checked out at a local dive shop. For us, that means stopping by the Scuba Company in Albuquerque NM.

http://www.scubaadventures.com/

Remember, dive gear is your life support system underwater! Do make sure that it is in good working order.

For more information about Marine and Diving Medicine, visit:
http://www.mountainandmarinemedicine.com/Kona2006.html

Mahalo,

Joe Alcock MD
Co-director Mountain and Marine Medicine
www.MMMedicine.com

Dive Medicine in Kailua Kona HI, August 22-26th

2006-07-04T21:25:00.000-07:00

Happy 4th of July! From Mountain & Marine Medicine, LLC

Here are some recent photos from Mountain & Marine Medicine's preparation trip to Kona to get ready for our event in August.

We have assembled a great group of participants and faculty for this year's Marine and Diving Medicine Course. This interactive CME conference will be bigger and better than last year! Members of the diving community in Kailua Kona are welcome to join us for an engaging discussion of real life diving accidents and problems encountered by Hawaii swimmers and divers!

Be sure to check out:
http://www.mountainandmarinemedicine.com/Kona2006.html

Live aloha!

Joe Alcock MD
Co-director Mountain & Marine Medicine, LLC
www.MMMedicine.com

After Cotopaxi

2006-06-26T20:38:00.000-07:00

Mountain & Marine Medicine is refreshed and energized from our recent successful CME course in Ecuador: High Altitude Medicine. We had a good turnout among US participants and Ecuadoreans. We will be assembling and posting amazing photos from our ascent of Cotopaxi, a live volcano at 19,300 feet in the Ecuadorean Andes.

Next stop: Kailua Kona Hawai'i

Here is our recent posting from the tenfootstop blog:

Joe Alcock writes:I am organizing a continuing medical education course on dive medicine: Marine and Diving Medicine at Jack's Diving Locker in Kailua-Kona, Hawaii this August. Topics will include marine envenomations, DCI and the significance of patent foramen ovale, hyperbaric medicine updates, tech diving, and a variety of other subjects of interest to members of this forum. Our guest faculty includes Michael Strauss MD, director of the baromedical unit at Long Beach Memorial Hospital and co-author of "Diving Science". We also arranged diving charters and will practice simulated diving accidents and first aid on the dive boat. We expect a small group of attendees - about 25 or so - that will permit hands-on teaching and a more interactive approach than most conferences. CME is provided by the University of New Mexico, up to 24 category 1 AMA credits.The course weblink is:
http://www.mountainandmarinemedicine.com/Kona2006.html
If this sounds interesting, I invite you to join us!Joe Alcock
mail@mountainandmarinemedicine.com