Prenatal opioid exposure, neonatal abstinence syndrome diagnosis, and child welfare involvement.

Background: Neonatal abstinence syndrome (NAS), or withdrawal from prenatal opioid exposure at birth, can trigger a referral to child protective services (CPS). However, there is some evidence of selection into NAS diagnosis because NAS screening is not universal. Such referrals may protect the infant, help connect the mother to services, or cause harm.

Active ascent accelerates the time course but not the overall incidence and severity of acute mountain sickness at 3,600 m.

Acute mountain sickness (AMS) typically peaks following the first night at high altitude (HA) and resolves over the next 2-3 days, but the impact of active ascent on AMS is debated. To determine the impact of ascent conditions on AMS, 78 healthy Soldiers (means ± SD; age = 26 ± 5 yr) were tested at baseline residence, transported to Taos, NM (2,845 m), hiked ( = 39) or were driven ( = 39) to HA (3,600 m), and stayed for 4 days. AMS-cerebral (AMS-C) factor score was assessed at HA twice on (HA1), five times on and (HA2 and HA3), and once on (HA4).

Day of Ascent Dosing of Acetazolamide for Prevention of Acute Mountain Sickness.

Acetazolamide is the most common medication used for prevention of acute mountain sickness (AMS), usually administered the day or night before ascent. The objective of this study was to evaluate the efficacy of day of ascent dosing of acetazolamide for AMS prevention. Double-blind, randomized, controlled noninferiority trial of acetazolamide 125 mg twice daily beginning either the night before or the morning of ascent.

Improvised Hydration Bladder Air Splint: A Wilderness Case Report.

This case report describes the use of a hydration bladder as an improvised air splint for a left forearm fracture in an austere environment. The literature regarding the use of air splints in the prehospital and wilderness environments is scarce, and it does not appear that this technique has been previously described in the literature. Given the widespread use of hydration bladders, the adjustable nature and overall comfort of the splint, and the anecdotal success of this technique without any complications or harm to the patient, the authors believe this is an important improvised splinting option to add to the quiver of any outdoor enthusiast or wilderness medical professional.