Repeated freezing to very low temperatures does not impact the amount ejected from EpiPen® and Jext® adrenaline autoinjectors.

It has previously been shown that EpiPen® autoinjectors are likely to activate normally following up to five excursions to -25°C but data about the post-freezing performance of other brands of adrenaline autoinjectors has not previously been published. Additionally, conditions experienced by polar medics may be substantially colder than this and the performance of adrenaline autoinjectors following more extreme freeze-thaw cycles remains uncharacterised. Investigators in Antarctica and the United Kingdom performed laboratory testing on two brands of adrenaline autoinjector, EpiPen® and Jext® (12 devices of each type).

Orientation affects the integrity of glass ampoules of 1 in 1000 adrenaline on exposure to very low temperatures.

In very cold environments, it may be burdensome or impossible for the polar medic to prevent medicines from freezing. We sought to investigate whether orientation affected the risk that glass ampoules of 1 in 1000 adrenaline, an important emergency drug, would break during freezing and subsequent thawing. Ampoules of adrenaline were orientated either upright, horizontally or inverted.

Optimising remote health care delivery in Antarctica: a review of the current capabilities utilised in the British Antarctic Territory.

Injury in Antarctica can have a significant impact when considering transfer timelines of several weeks. Medical support to the British Antarctic Territory (BAT) is provided by deployed healthcare professionals and the utilisation of "reach-back" with telemedicine. This is paired with robust training and familiarisation with a system of modularised deployed equipment.

Can iloprost be used for treatment of cold weather injury at the point of wounding in a forward operating environment? A literature review.

Introduction: Cold Weather Injury (CWI) represents a spectrum of pathology, the two main divisions being Freezing Cold Injury (FCI) and Non-Freezing Cold Injury (NFCI). Both are disabling conditions associated with microvascular and nerve injury often treated hours after initial insult when presenting to a healthcarestablishment. Given that iloprost is used for the treatment of FCI, could it be used in a forward operating environment to mitigate treatment delay? Is there a role for its use in the forward treatment of NFCI? This review sought to evaluate the strength of evidence for the potential use of iloprost in a forward operating environment.

Fellowships and defence engagement: from clinical niches to strategic impact.

Medical fellowships have traditionally developed the individual rather than furthering military or national strategic objectives. This paper describes a medical fellowship with the British Antarctic Survey to illustrate the benefits to the individual, to the military and to wider international defence engagement efforts.By rebranding such fellowships as Defence Healthcare Engagement and by treating international organisations on a par with partner nations, the humble fellowship can facilitate enduring, mutually beneficial healthcare engagement at low cost and with minimal additional resources.