Medical planning for expeditions.

Medical planning requires the expedition physician to draw from many aspects of the knowledge base of wilderness and environmental medicine and to learn and use lessons from those that have gone before. The medical plan is dependent on parameters of the expedition objective, scope, and resources and is developed cooperatively with the overall operational plan. The gathering of medical intelligence is crucial to the planning process and includes data specific to the location of the objective area and the expedition party itself.

Heat illness.

Heat stroke is reviewed in detail. Particular attention is paid to diagnosis and current emergency department treatment, and a brief overview of pathophysiology is included. Early complications, with recommendations for prevention and management, are described.

A prospective, double-blind study of metoclopramide hydrochloride for the control of migraine in the emergency department.

Study Objective: To determine the effectiveness of IV metoclopramide as sole therapy for relieving the pain of acute migraine in the emergency department.

Design: Prospective study. Fifty patients were divided randomly into subjects and placebo controls with blinding of the treating physician and the patient.

Animal procedure laboratory surveys: use of the animal laboratory to improve physician confidence and ability.

Animal laboratories have been used for many years to teach procedures. Our department has a weekly swine laboratory devoted to training residents, interns and students in resuscitative procedures. Physicians who participated in our swine procedure laboratory over the past three years were queried as to their prelaboratory and postlaboratory comfort levels with six different resuscitative procedures, and 57 (76%) physicians responded.