Most common ailments and treatments in Remote Medicine

   In the practise of Remote and Austere Medicine you will find yourself without a lot of kit, in suboptimal locations, without a great light source, and with rain pelting down from all angles. In this unfortunate situation you will still be required to provide the best medical care that you can. 


   This is some good information given by a doctor practising in Central America. He is one of the coauthors of Remote and Austere Medicine: An Introduction. 


   Below are the results of his experience in the provision of health care in various remote and austere locations. He treated nearly two thousand people over a 15-month period. The record keeping was a bit unreliable at times, but the following summary is reasonably accurate.


The Top 20 injuries:

1. Minor musculoskeletal injuries (ankle sprains most common)
   
2. Upper respiratory tract infections
   
3. Allergic reactions/Hay fever/Anaphylactic reactions/Rashes
   
4. Minor open wounds
   
5. Gastroenteritis/Vomiting/Diarrhoea
   
6. Sexual health/Contraceptive problems
   
7. Skin infections/Cellulitis
   
8. Mental health problems
   
9. Dental problems
   
10. Abdominal pain (2 confirmed acute appendix + 1 gangrenous gall
    bladder; no cause found. Renal or biliary colic were most common)
    
11. Flu/Viral illness
    
12. Chest infections
    
13. Major musculoskeletal injuries (fractures/dislocations)
    
14. Asthma
    
15. Ear infections
    
16. Urinary tract infections
    
17. Chest pain
    
18. Syncope/Collapse/Faints
    
19. Early pregnancy problems
    
20. Burns
    

Top 12 prescribed drugs:

1. Paracetamol (Acetaminophen)
   
2. Loratadine (and other assorted antihistamines)
   
3. Diclofenac (and other assorted antiinflammatories)
   
4. Combined oral contraceptive
   
5. Flucloxacillin
   
6. Throat lozenges
   
7. Augmentin
   
8. Loperamide
   
9. Nystatin (and other antifungals)
   
10. Hydrocortisone cream
    
11. Ventolin inhalers
    
12. Morphine 
    
    
    
                       excerpt from Survival and Austere Medicine: An Introduction.
                                                      Download it here

How to become a Remote Medic

   Many students who come through RMI courses ask this question. There are many pathways to the practice of medicine in remote and austere conditions. Let's discuss a few of the most common options.

Bosnia Clinical Experience

   In January, 2012, an RMI instructor traveled to Sarajevo to have seven days of clinical experience on the ambulance service. The location has a large call volume of 999 calls as well as general practice treatment.

Blister care

   For the adventurous types foot care and treatment for blisters are a large part of our medical practise. Blisters can be debilitating and bring to an end an expedition.

Survival Blanket Review

   For those who spend a lot of time out in the rugged areas of the world, hypothermia is one of the constant threats that we face. As a Remote Medic it is important to have the best kit available to treat hypothermic casualties.

Dermoclysis - Subcutaneous Hydration for the Remote Medic

   Dermoclysis is the infusion of sterile saline fluids into the subcutaneous space in the belly of the casualty. For the Remote Medic, it is important to have the medical skills to deal with a hypovolemic casualty who needs rehydration fluids but who does not have an easily obtainable intravenous access. 

SAM Splint versus Commercial Cervical Collar

In an issue of Wilderness and Environmental Medicine (Volume 20, Number 2, 2009), Todd McGrath and Crystal Murphy have written an article entitled “Comparison of a SAM Splint-Molded Cervical Collar with a Philadelphia Collar.”