Changes in Factors Regulating Serum Sodium Homeostasis During Two Ultra-Endurance Mountain Races of Different Distances: 69km vs. 121km.

Overdrinking and non-osmotic arginine vasopressin release are the main risk factors for exercise-associated hyponatremia (EAH) in ultra-marathon events. However, particularly during ultra-marathon running in mountainous regions, eccentric exercise and hypoxia, which have been shown to modulate inflammation, hormones regulating fluid homeostasis (hypoxia), and oxidative stress, could contribute to serum sodium changes in a dose-dependent manner. To the best of our knowledge, the contribution of these factors, the extent of which depends on the duration and geographical location of the race, has not been well studied.

Performance Determinants in Short (68 km) and Long (121 km) Mountain Ultra-Marathon Races.

Background:  Standard performance parameters measured during a laboratory test have been shown to be related to mountain ultra-marathon performance up to a competition length of 75 km. It is not known if a similar relationship exists for longer races.

Objective:  This study aimed to investigate the association between laboratory-based performance parameters and performance times in a short (68 km) and a long (121 km) mountain ultra-marathon.

Accidental hypothermia in recreational activities in the mountains: A narrative review.

The popularity of recreational activities in the mountains worldwide has led to an increase in the total number of persons exposed to cold and extreme environments through recreation. There is little conclusive evidence about the risk of hypothermia for specific activities or populations, nor is it clear which activities are represented in the literature. This is a non-systematic review of accidental hypothermia in different recreational activities in the mountains, with a specific focus on outdoor or winter activities that potentially involve cold exposure.

Total Body Water Dynamics Estimated with Bioelectrical Impedance Vector Analysis and B-Type Natriuretic Peptide After Exposure to Hypobaric Hypoxia: A Field Study.

Strapazzon, Giacomo, Matiram Pun, Tomas Dal Cappello, Emily Procter, Piergiorgio Lochner, Hermann Brugger, and Antonio Piccoli. Total body water dynamics estimated with bioelectrical impedance vector analysis and B-type natriuretic peptide after exposure to hypobaric hypoxia: A field study. High Alt Med Biol.

Oxidative stress response to acute hypobaric hypoxia and its association with indirect measurement of increased intracranial pressure: a field study.

High altitude is the most intriguing natural laboratory to study human physiological response to hypoxic conditions. In this study, we investigated changes in reactive oxygen species (ROS) and oxidative stress biomarkers during exposure to hypobaric hypoxia in 16 lowlanders. Moreover, we looked at the potential relationship between ROS related cellular damage and optic nerve sheath diameter (ONSD) as an indirect measurement of intracranial pressure.

Burial duration, depth and air pocket explain avalanche survival patterns in Austria and Switzerland.

Aim: To calculate the first Austrian avalanche survival curve and update a Swiss survival curve to explore survival patterns in the Alps.

Methods: Avalanche accidents occurring between 2005/06 and 2012/13 in Austria and Switzerland were collected. Completely buried victims (i.

Avalanche Survival After Rescue With the RECCO Rescue System: A Case Report.

We report a case of survival of a completely buried avalanche victim after being located with the radar-based RECCO Rescue System. In the winter of 2015, 2 off-piste skiers were completely buried in an avalanche near the secured ski area in Baqueira Beret, Spain. The first victim was located with the RECCO Rescue System in less than 35 minutes and was alive and conscious at extrication.

Prehospital management and outcome of avalanche patients with out-of-hospital cardiac arrest: a retrospective study in Tyrol, Austria.

Aim: The aim of this study is to describe the prehospital management and outcome of avalanche patients with out-of-hospital cardiac arrest in Tyrol, Austria, for the first time since the introduction of international guidelines in 1996.

Patients And Methods: This study involved a retrospective analysis of all avalanche accidents involving out-of-hospital cardiac arrest between 1996 and 2009 in Tyrol, Austria.

Results: A total of 170 completely buried avalanche patients were included.

Risk of Avalanche Involvement in Winter Backcountry Recreation: The Advantage of Small Groups.

Objective: Avalanches are the primary hazard for winter backcountry recreationists and cause numerous deaths and injuries annually. Although recreationists usually travel in groups, there is little empirical knowledge on group-related risk factors. This study aims to explore the relative risk of avalanche accidents with respect to group size and to discuss underlying reasons for different risk levels.

Influence of low ambient temperature on epitympanic temperature measurement: a prospective randomized clinical study.

Background: Epitympanic temperature (Tty) measured with thermistor probes correlates with core body temperature (Tcore), but the reliability of measurements at low ambient temperature is unknown. The aim of this study was to determine if commercially-available thermistor-based Tty reflects Tcore in low ambient temperature and if Tty is influenced by insulation of the ear.

Methods: Thirty-one participants (two females) were exposed to room (23.

Apparent Cooling Rate of 7°C per Hour in an Avalanche Victim.

Avalanche victims can become hypothermic within 35 minutes of snow burial. However, reported cooling rates for avalanche victims are highly variable and it is poorly understood how much cooling is influenced by general factors (body composition, clothing, ambient conditions, duration of burial, and metabolism), unknown inter-individual factors or other phenomena (e.g.

Factors associated with B-lines after exposure to hypobaric hypoxia.

Aims: Increased extravascular lung water (EVLW) is seen as B-lines on chest ultrasonography. In lowlanders ascending to altitude the time course, relationship with the patient's clinical status and factors affecting B-lines are still unclear. The aim was to monitor B-lines, clinical status and N-terminal B-type natriuretic peptide (NT-proBNP) during exposure to high altitude.

Search and rescue response to a large-scale rockfall disaster.

Objective: To describe the prehospital management and safety of search and rescue (SAR) teams involved in a large-scale rockfall disaster and monitor the acute and chronic health effects on personnel with severe dolomitic dust exposure.

Methods: SAR personnel underwent on-site medical screening and lung function testing 3 months and 3 years after the event.

Results: The emergency dispatch center was responsible for central coordination of resources.

Defibrillation in rural areas.

Aim Of The Study: Automated external defibrillation (AED) and public access defibrillation (PAD) have become cornerstones in the chain of survival in modern cardiopulmonary resuscitation. Most studies of AED and PAD have been performed in urban areas, and evidence is scarce for sparsely populated rural areas. The aim of this review was to review the literature and discuss treatment strategies for out-of-hospital cardiac arrest in rural areas.

Pre-hospital core temperature measurement in accidental and therapeutic hypothermia.

Core temperature (T core) measurement is the only diagnostic tool to accurately assess the severity of hypothermia. International recommendations for management of accidental hypothermia encourage T core measurement for triage, treatment, and transport decisions, but they also recognize that lack of equipment may be a limiting factor, particularly in the field. The aim of this nonsystematic review is to highlight the importance of field measurement of T core and to provide practical guidance for clinicians on pre-hospital temperature measurement in accidental and therapeutic hypothermia.

The effectiveness of avalanche airbags.

Aim: Asphyxia is the primary cause of death among avalanche victims. Avalanche airbags can lower mortality by directly reducing grade of burial, the single most important factor for survival. This study aims to provide an updated perspective on the effectiveness of this safety device.

Factors associated with optic nerve sheath diameter during exposure to hypobaric hypoxia.

Objective: To monitor the changes in optic nerve sheath diameter (ONSD) induced by acute exposure to hypobaric hypoxia and to investigate factors associated with these changes, including development of acute mountain sickness.

Methods: In this cohort study, neurologic signs and symptoms, cardiovascular parameters, and ultrasonography of ONSD were prospectively assessed in 19 healthy lowlanders at baseline and after ascent to 3,830 m (3 hours, 9 hours, 24 hours, 48 hours, 72 hours, and 8 days) by blinded investigators. Potential confounding factors (e.

Basic life support trained nurses ventilate more efficiently with laryngeal mask supreme than with facemask or laryngeal tube suction-disposable--a prospective, randomized clinical trial.

Objective: In some emergency situations resuscitation and ventilation may have to be performed by basic life support trained personnel, especially in rural areas where arrival of advanced life support teams can be delayed. The use of advanced airway devices such as endotracheal intubation has been deemphasized for basically-trained personnel, but it is unclear whether supraglottic airway devices are advisable over traditional mask-ventilation.

Methods: In this prospective, randomized clinical single-centre trial we compared airway management and ventilation performed by nurses using facemask, laryngeal mask Supreme (LMA-S) and laryngeal tube suction-disposable (LTS-D).