Wilderness Medicine Updates

That EpiPen in your kit expired eighteen months ago. Anaphylaxis is happening. Do you use it? This episode digs into a 2025 systematic review from the American Red Cross Scientific Advisory Council that asked a question most of us have quietly wondered about: do expired resuscitation medications still work? We walk through the evidence on the four drugs that matter most in the field — albuterol, a...

Prehospital Airway Fundamentals for BLS: Positioning, Pocket Mask, NPA/OPA, BVM, and LMA Dr. Patrick Fink presents a BLS-focused airway fundamentals episode for prehospital and wilderness/SAR responders, emphasizing an ingrained, stepwise approach to stave off respiratory badness.  Links: Airway Fundamentals Video Intersurgical iGel LMA Chapters: 00:00 Airway Basics Overview 01:52 Questions And Up...

In this episode, Dr. Patrick Fink reviews accidental hypothermia for wilderness providers, building on Ep. 27 Thermoregulation, explaining physiologic changes as core temperature falls  and why accurate core temperatures are difficult to obtain in the field.  We learn the modified Swiss staging system (0–4) based on signs and symptoms and outlines field management:  - 0 cold stress (shelter, dry/i...

Reevaluating Spinal Motion Restriction: Evidence Update In this episode of Wilderness Medicine Updates, host Dr. Patrick Fink delves into the evolving guidelines and practices concerning spinal motion restriction. Drawing from historical dogma and modern research, Patrick explores the inefficacies and potential harms of traditional spinal immobilization tools like rigid spine boards and cervical c...

Wilderness Orthopedics: Managing Trauma in Remote Environments with Dr. Chris Healy In this episode of Wilderness Medicine Updates, host Dr. Patrick Fink tackles orthopedic injuries in the wilderness with Dr. Chris Healy, an orthopedic surgeon and outdoor enthusiast. They explore the management of long bone fractures, traction for femur, pelvic binders, and the nuances of treating injuries in limi...

Understanding Stress Injuries in First Line Responders with Laura McGladrey This episode of Wilderness Medicine Updates, hosted by Patrick Fink, features a conversation with Laura McGladrey, founder of the Responder Alliance. They discuss the critical issue of stress injuries among first line responders, including professional ski patrollers, healthcare workers, and rescue team members. Through pe...

In this episode of Wilderness Medicine Updates, host Patrick Fink delves into the topic of thermoregulation, explaining how our bodies regulate temperature in response to environmental changes. Listeners will learn about methods of heat exchange (conduction, convection, radiation, and evaporation), how to measure core temperature, and the body's physiological responses—such as shivering, swea...

In this episode of Wilderness Medicine Updates, host Patrick Fink delves into groundbreaking technology designed to improve safety during avalanche events. The focus is on SafeBack SBX, a Norwegian-developed device that supplies air to users buried in avalanches, potentially extending survival time. Patrick reviews new research published in the Journal of the American Medical Association, which de...

On this episode of Wilderness Medicine Updates, host Patrick Fink shifts focus from the science and literature of wilderness medicine to practical fitness tips for search and rescue personnel, ski patrollers, and outdoor rescuers. Patrick interviews Rob Shaw, founder and head coach of the Mountain Tactical Institute, about his specialized training programs for various types of mountain athletes, i...

In this episode of Wilderness Medicine Updates, host Patrick Fink breaks down a recent research paper on the differences between simulated avalanche burial and tree well burial, analyzing the findings and their implications for skiers and outdoor rescue personnel.  We then transition to a special Q&A session with pre-med student Zack Majd, tackling questions about forming a career in wildernes...

In this episode of Wilderness Medicine Updates, Dr. Patrick Fink discusses airway management in austere situations with Dr. Nicholas Weinberg. They explore two cases published in the Wilderness Medicine Journal, detailing the decision-making processes in managing critically injured patients. Dr. Weinberg shares his background in emergency and wilderness medicine, and highlights the importance of f...

Exploring Xenon Gas for Altitude Acclimatization and Sport Performance In this episode of Wilderness Medicine Updates, host Patrick Fink delves into the use of inhaled xenon gas for sports performance enhancement and altitude acclimatization. The discussion is prompted by a recent claim from a UK climbing team that xenon helped them achieve a rapid ascent of Mount Everest. Xenon, a noble gas tradi...

In this episode of Wilderness Medicine Updates, host Patrick Fink interviews Moose Mutlow, an experienced outdoor educator and search and rescue professional with nearly four decades of experience globally. Moose discusses his extensive career from being an Outward Bound instructor to working with Yosemite Search and Rescue, and his role as a Family Liaison Officer for the National Park Service. T...

In this episode, we dive into one of the most overlooked but deadly hazards in deep powder skiing: snow immersion suffocation (NARSID) . Unlike avalanches, snow immersion deaths happen silently—often within feet of a groomed run—when skiers and snowboarders fall into deep snow or tree wells and become trapped. We explore the research behind these incidents, where and how they occur, who is most at...

King Tube vs IGEL for Airway Management In this episode of Wilderness Medicine Updates, Dr. Patrick Fink addresses a listener's question on whether to use a King Tube or an IGEL as an out-of-hospital airway adjunct. The episode begins with an overview of airway management techniques from mouth-to-mouth resuscitation to supraglottic airway devices. Dr. Fink explains the benefits and drawbacks...

Exploring Methoxyfluorane for Wilderness Pain Management with Dr. Ross Hofmeyr In this episode of Wilderness Medicine Updates, host Dr. Patrick Fink discusses the use of methoxyfluorane, an anesthetic gas for pain management in wilderness settings. Joined by guest Dr. Ross Hofmeyr, an anesthesiologist and wilderness medicine expert from South Africa, the episode delves into the history, usage, ben...

Ketamine Use in Wilderness Pain Management: An Interview with Dr. Chris Van Tilburg In this episode of Wilderness Medicine Updates, host Patrick Fink discusses wilderness pain control with guest Dr. Chris Van Tilburg, focusing on the effective use of ketamine. The episode delves into how ketamine serves as a versatile medication for pain management, sedation, and intubation in emergency and wilder...

In episode 17 of Wilderness Medicine Updates, host Patrick Fink delves into the ICAR resuscitation algorithm for buried avalanche victims. The episode reviews the physiology of avalanche burial and discusses critical determinants of survival, such as duration of burial, airway patency, signs of life, and lethal injuries. The Basic Life Support (BLS) and Advanced Life Support (ALS) algorithms are e...

In this episode, I share an intense story of dealing with a suprise medical condition during a backcountry hut trip in Colorado. I walk through the diagnostic process, treatment options, and the importance of preparation for stays in remote places. Essential medications and tools needed for handling such emergencies in remote settings are discussed, along with advice on how to prepare for future e...

This episode, I look at a study from the Eurac research group on rates of airway occlusion in critically buried avalanche victims. Eurac looked at this critical feature of avalanche resuscitation triage as it both affects the way we treat buried avalanche victims, and it helps us to better understand whether technologies like the black diamond Avalung (retired) and the Safeback SBX can help us sur...

Today, we discuss updates in the WMS guidelines regarding the protection of patients with suspected spinal injuries. The Wilderness Medicine Society Clinical Practice Guidelines are all open-access, and you can find links to all of these guidelines on the right sidebar of this page . The education in this episode is based on the: Wilderness Medical Society Clinical Practice Guidelines for Spinal C...

This episode is a repost of an interview that was first posted on The High Route Podcast . Hosted by the editor of The-High-Route.com , Jason Albert, we discuss my background in wilderness medicine, and then move on to discuss the research that support my argument and assertion that the avalanche airbag backpack should be standard equipment for backcountry skiers, snowboarders, snowmobilers, and a...

This is part 1 of a multi-part series on the resuscitation of critically buried avalanche victims. In this episode we learn the physiology that we need to understand the resuscitation algorithm. To learn the necessary biology, we follow a rider as they are carried in an avalanche, subjected to traumatic injury, and are then buried and begin to asphyxiate and cool.  The background of this episode i...

Episode 11 brings you  my conversation with Michael Buchanan is a flight paramedic and senior firefighter / paramedic at the West Valley City Fire Department. He is the founder and operation of Mountain Medical Academy, a passion-driven backcountry medical care education company.  We discuss the medical care of avalanche victims which Michael has made accessible to recreational skiers and riders w...

In this episode, I discuss the article " Arterial Occlusion Effectiveness of Space Blanket-Improvised Tourniquets for the Remote Setting ". In this short blast I get into the meat of this article, and though the authors would tell you that space blankets aren't ready for primetime, I have some thoughts on the matter. In the podcast, I mistakenly say that you need to be a WMS member...