New to Meducation?
Sign up
Already signed up? Log In
Foo20151013 2023 ysxsdd?1444774299

Dying to do an expedition

Written by Dr Rachel Saunders · Tuesday 15th July 2014

As a hospital doctor, surgeon or GP we encounter death frequently. We quickly learn to cope. It helps when we know that we have done everything within our power to prevent death. When death is close we have the ability, medication and specialists services to make the process as 'comfortable' as possible. In the final moments it is rare that the patient is alone; whether in the company of family, friends or health care professionals.

When an individual dies on expedition it may have been avoidable, you have very little kit to prevent it, they may be alone and they probably were your friend.

No one prepares you for the potential of a client dying. But it happens.

First of all, I am not trying to put you off doing an expedition. I love expedition medicine and have dedicated the last five years of my life to it. But I was not prepared for my first near death experience and I want to make sure you are.

AVOIDABLE DEATHS

During an expedition injuries, near misses and deaths are sometimes avoidable. There may have been a faulty bit of kit, medication which wasn't packed or route marker that fell down ... Hindsight is a wonderful thing. You, the team and the organisers work within what is feasible and normal health and safety don't and can't apply. I am NOT saying it is ok to be negligent, but a degree of pragmatism is need. What you need to remember is the competitors/ clients are aware of the dangers and, as medics, we should be too.

LIMITED KIT

Many medics are shocked by the lack of kit taken on expedition. But you need to think about the environment you are in and then think rationally. If your nearest decompression chamber is 3 days away by boat, is there much point taking oxygen on a diving expedition? If you are on expedition in the middle of the jungle is there any point taking a defib if any client in need of a defib is unlikely to survive extrication. You have to work within the limits of your environment and with the kit you have. As the medic you need to be aware of the nearest hospital and their facilities, the nearest large hospital with surgical and ITU facilities and the casevac plan.

THE CLIENTS

During expeditions the clients often become good friends. You will experience their highs and lows and share incredible experiences. This makes it especially hard when unfortunate events occur. At this point our role as medic often broadens to counsellor and bereavement officer. The other clients, organisers and medics need support during this time. Try to start this process whilst you are out there.
Even with near misses, the psychological effect on people can be huge. Signs and symptoms are generally easy to spot, but screen for them at clinics. Be aware during race events that grief may manifest though clients pulling out, loss of performance and increased injuries due to lack of sleep, low mood or poor concentration.

No matter what happens when you are on expedition my advice is; you can only work within your skill set and with the equipment you have. As a foundation doctor, if you’re faced with an unresponsive client - you are not expected to perform RSI and intubate. Work through your ABCDE and work within your limitations.

If you would like to suggest any other blog topics or have any questions please post below.

Responses

Tom Reilly
·
Medical Student - Leicester
·
Posted over 1 year ago
Hi Dr Saunders, great blog post! I'm a 4th yr med student and would love the opportunity to experience wilderness/expedition/pre-hospital medicine for my elective - any advice or contacts you could help me with? Thanks
Like
(0)
Respond
Zapyaforpc
·
Posted 9 months ago
Download Zapya for PC to share files and folders easily from PC to Mobileasxcx
Like
(0)
Respond
Sunmugam Chidambaram
·
Defence - India
·
Posted 6 months ago
Great blog Thanks Download xender for pc Very good for share FILES ,PICTURES PC To any Android
Like
(0)
Respond
Zapyaforpc
·
Posted 6 months ago
Superb information it is. Thanks for this kind of information. Zapya apk
Like
(0)
Respond
ucbrowser
·
student - India
·
Posted 5 months ago
Like
(0)
Respond
siteocean
·
Posted 5 months ago
Like
(0)
Respond
Zapyaforpc1
·
Student - Bristol university
·
Posted 5 months ago
Like
(0)
Respond
Zapyaforpc
·
Posted 30 days ago
Like
(0)
Respond
Wings Io
·
Posted 16 days ago
Thanks for the information you brought to us. They are very interesting and new. Look forward to reading more useful and new articles from you! html color
Like
(0)
Respond