Table 1

Canadian research relevant to wilderness medicine

RESEARCH AREA	STUDIES’ RESULTS
Hypothermia treatment¹ Prehospital torso-warming modalities for severe hypothermia: a comparative study using a human model	“In non-shivering subjects, external heat application was effective in attenuating core temperature afterdrop and facilitating safe core rewarming. ... The modalities studied appear sufficiently practical and portable for pre-hospital use.”
Hyperthermia treatment² Cooling hyperthermic firefighters by immersing forearms and hands in 10°C and 20°C water	“Distal limb immersion in cool water is simple, [practical,] reduces heat strain, and may increase work performance in a hot, humid environment. With 20°C water, forearms should be immersed with the hands to be effective. At lower water temperatures, forearm and/or hand immersion will be effective, although [increasing surface area for heat transfer with] forearm immersion will [be advantageous].”
Altitude-induced cerebral and pulmonary edema³ Effects of acetazolamide on ventilatory, cerebrovascular, and pulmonary vascular responses to hypoxia	“Acetazolamide has benefit in alleviating ... hypoxia-induced pulmonary vasoconstriction and increased pulmonary artery pressures and as such may be a valuable means to prevent or treat high-altitude pulmonary edema [and noncardiogenic pulmonary hypertension].”
Avalanche-induced trauma and asphyxiation⁴ Comparison of avalanche survival patterns in Canada and Switzerland	“Observed differences in avalanche survival curves between the Canadian and Swiss samples were associated with the prevalence of trauma and differences in snow climate. Although avoidance of avalanches remains paramount for survival, the earlier onset of asphyxia, especially in maritime snow climates, emphasizes the importance of prompt extrication, ideally within 10 minutes. Protective devices [helmets, avalanche air bags or transceivers] against trauma and better clinical skills in organized rescue may further improve survival.”