Wilderness Medicine Updates (Patrick Fink, MD)
Explore every episode of Wilderness Medicine Updates
| Pub. Date | Title | Duration | |
|---|---|---|---|
| 24 Jan 2023 | Ep.0 - An Introduction | 00:03:31 | |
Welcome to Wilderness Medicine Updates! As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 24 Jan 2023 | Ep. 1 - Fentanyl on the Ski Hill? | 00:15:21 | |
Is intranasal fentanyl safe and effective for the treatment of acute severe pain on the ski hill? Lynch TV, Callas PW, Peterson TD, Schlein SM. Intranasal Fentanyl for On-the-Hill Analgesia by Ski Patrol. Wilderness Environ Med. 2022 Sep;33(3):296-303. doi: 10.1016/j.wem.2022.05.003. Epub 2022 Jul 16. PMID: 35851192. As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 24 Jan 2023 | Ep. 2 - Pain Management for Scorpion Stings | 00:10:43 | |
Today we look at IV acetaminophen vs IV NSAID vs topical lidocaine vs placebo for treatment of pain due to scorpion stings, with some bonus learning on tramadol. As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 07 Feb 2023 | Ep. 3 - Methoxyflurane for Prehospital Analgesia | 00:15:07 | |
Methoxyflurane: inhaled gas of the past and prehospital analgesic of the future? Only if we’re talking about ‘the future’ in North America. Used in Australian EMS for almost half a century, this safe and effective medication is only now starting to get the attention that it deserves outside of the down-under. Today’s paper: Trimmel, H., Egger, A., Doppler, R. et al. Usability and effectiveness of inhaled methoxyflurane for prehospital analgesia - a prospective, observational study. BMC Emerg Med 22, 8 (2022). https://doi.org/10.1186/s12873-021-00565-6 As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 09 Feb 2023 | Fast Push #1 - Beacon Interference | 00:08:22 | |
For today, a new format, the Fast Push: Quick updates that you need to know sooner rather than later. As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 23 Feb 2023 | Ep. 4 - HOPE Score for Severe Hypothermia | 00:22:27 | |
In this episode we discuss the HOPE score, a tool that improves our ability to select the severely hypothermic patients who can benefit from warming with extracorporeal life support (ECLS). As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 12 Mar 2023 | Ep. 5 - Mechanical CPR for Ski Patrol and Mountain Rescue | 00:17:55 | |
In this episode we review the available evidence, and the pros and cons, of using mechanical CPR devices like the LUCAS or Autopulse for ski patrol and mountain rescue applications. As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 04 Apr 2023 | Ep. 6 - EMS at the Wilderness Boundary with Dr. Graham Brant-Zawadzki | 00:49:21 | |
In this inaugural interview episode I have the pleasure of grilling Dr. Brant-Zawadzki about operating an urban EMS system at a wilderness boundary. As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 24 May 2023 | Ep. 7 - Wildfire Smoke and Your Health | 00:26:09 | |
In this episode I go deep on the health effects of wildfire smoke, answering some key questions that are relevant to recreational athletes, outdoors professionals, wildland firefighters, and industrial athletes alike: As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 13 Jul 2023 | Fast Push #2.2 - Safety Third | 00:08:33 | |
In this second Fast Push, you get a riff on a great article from JEMS entitled "Safety is Third, Not First, and We All Know It Should Be" by Christopher Davis MD et al. As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 28 Jul 2023 | Ep. 8 - SAR Provider Injuries & Traveler's Diarrhea Treatment | 00:15:59 | |
In this two-part episode, I review an article from the Annals of Emergency Medicine "Occupational Accidents Among Search and Rescue Providers During Mountain Rescue Operations and Training Events" As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 11 Oct 2023 | Ep. 9 - FEMA Urban Search and Rescue with Dr Graham Brant-Zawadzki | 00:33:18 | |
In this episode Dr BZ is back to talk about his experience deploying with the Federal Emergency Management Agency (FEMA) Urban Search and Rescue Task Force (USAR). Dr BZ just returned from a deployment with FEMA USAR to Lahaina, HI, where he served as a team physician supporting rescue and recovery efforts there. As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 23 Oct 2023 | Ep. 10 - Tourniquets from Space Blankets | 00:06:56 | |
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. As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 17 Nov 2023 | Ep. 11 - After the Avalanche with Michael Buchanan | 00:53:38 | |
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 who don't have a medical background. As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 26 Jan 2024 | Ep. 12 - Resuscitation of the Buried Avalanche Victim, Part 1: Physiology | 00:18:36 | |
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. As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 03 Apr 2024 | Ep. 13 - The High Route: Arguments for Avalanche Airbags | 00:48:51 | |
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 anyone who regularly works or recreates in avalanche terrain. As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 07 Aug 2024 | Ep. 14 - Spinal Immobilization Guidelines Update | 00:13:35 | |
Today, we discuss updates in the WMS guidelines regarding the protection of patients with suspected spinal injuries. Wilderness Medical Society Clinical Practice Guidelines for Spinal Cord Protection: 2024 Update
As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 16 Oct 2024 | Ep. 15 - Airway Patency in Avalanche Victims | 00:10:35 | |
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 survive longer under the snow if buried. As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 05 Nov 2024 | Ep. 16 - Medications for Alpine Hut Trips | 00:17:10 | |
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 expeditions. My articles on The-High-Route.com 01:31 The Backcountry Hut Trip Begins 03:19 Will's Health Deteriorates 04:38 Diagnosing the Problem 07:04 The Emergency Descent 09:16 Lessons Learned and Preparedness 10:37 Essential Medications for Wilderness Trips 16:19 Final Thoughts and Conclusion As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 15 Nov 2024 | Ep. 17 - Resuscitation of the Buried Avalanche Victim, Part 2: The Rescue Algorithm | 00:42:23 | |
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 explained in detail, with a focus on the practical application for both amateur and professional rescuers. As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 12 Jan 2025 | Ep. 18 - Ketamine for Wilderness Pain Management with Dr. Christopher Van Tilburg | 00:45:33 | |
Ketamine Use in Wilderness Pain Management: An Interview with Dr. Chris Van Tilburg As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 12 Feb 2025 | Ep. 19 - Methoxyflurane, the Green Whistle, with Dr. Ross Hofmeyr | 00:45:28 | |
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, benefits, and limitations of methoxyfluorane. Highlighting its efficacy, ease of use, and safety, especially for pre-hospital scenarios, Dr. Hofmeyr shares insights into its ideal applications, contraindications, and personal experiences. The episode underscores the significance of methoxyfluorane as a potent analgesic suitable for acute traumatic pain and procedural analgesia in austere environments. Links Methoxyflurane at Altitude - Case Report Methoxyflurane in the Outback - Survivor Clip WMS Pain Management Guidelines Chapters: As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 14 Mar 2025 | Ep. 20 - Out of Hospital Airway Adjuncts: King Tube vs LMA | 00:27:27 | |
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 of various airway adjuncts, including oral and nasal pharyngeal airways. The discussion then shifts to a detailed comparative analysis of King Tubes and IGELs based on retrospective and prospective studies. Dr. Fink evaluates the evidence indicating that IGEL may be more effective and easier to use than King Tubes, particularly in pre-hospital cardiac arrest situations. The episode concludes with recommendations for pre-hospital providers and an encouragement for listeners to share their questions and feedback. Links: Smida T, Menegazzi J, Scheidler J, et al. A retrospective comparison of the King Laryngeal Tube and iGel supraglottic airway devices: A study for the CARES surveillance group. Resuscitation. 2023;188:109812. doi:10.1016/j.resuscitation.2023.109812 Smida, Tanner & Menegazzi, James & Crowe, Remle & Scheidler, James & Salcido, David & Bardes, James. (2023). A Retrospective Nationwide Comparison of the iGel and King Laryngeal Tube Supraglottic Airways for Out-of-Hospital Cardiac Arrest Resuscitation. Prehospital emergency care. 28. 1-13. 10.1080/10903127.2023.2169422. Lønvik, M.P., Elden, O.E., Lunde, M.J. et al. A prospective observational study comparing two supraglottic airway devices in out-of-hospital cardiac arrest. BMC Emerg Med 21, 51 (2021). https://doi.org/10.1186/s12873-021-00444-0 Chapters 00:00 Introduction and Listener Question 00:55 Understanding Airway Adjuncts 02:12 Basic Airway Management Techniques 06:34 Advanced Airway Devices: King Tube and LMA 11:35 Comparative Studies on Airway Devices 17:35 Prospective Data and Final Thoughts 25:24 Conclusion and Listener Engagement As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 26 Mar 2025 | Ep. 21 - Snow Immersion Suffocation | 00:23:36 | |
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 risk, and the tragic mechanics of asphyxiation in deep snow. Using studies from Van Tilburg, Baugher, and Cadman, we break down ra eal survival story, discuss prevention strategies, and how both bystanders and professional rescuers should respond. Whether you’re a backcountry adventurer, resort skier, or ski patroller, this episode will change the way you think about deep snow safety. Stay aware, ski with a partner, and stay out of tree wells. Must Watch: GoPro Awards: Tree Well Rescue Citations Baugher, P. (2006). Risk trends at U.S. and British Columbia ski areas: An evaluation of the risk of snow immersion versus avalanche burials. In Proceedings of the 2006 International Snow Science Workshop (pp. 584–591). International Snow Science Workshop. Cadman, R. (1999). Eight nonavalanche snow-immersion deaths: A 6-year series from British Columbia ski areas. The Physician and Sportsmedicine, 27(13), 31–43. Van Tilburg, C. (2010). Non–avalanche-related snow immersion deaths: Tree well and deep snow immersion asphyxiation. Wilderness & Environmental Medicine, 21(3), 257–261. Van Tilburg, C. S., Grissom, C. K., Zafren, K., McIntosh, S. E., Radwin, M. I., Paal, P., et al. (2017). Wilderness Medical Society practice guidelines for the prevention and management of avalanche and non-avalanche snow burial accidents. Wilderness & Environmental Medicine, 28(1), 23–42. Chapters As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||
| 22 Apr 2025 | Ep. 22 - Moose Mutlow: Yosemite Swiftwater SAR, Family Liaison Officer, and longevity in rescue. | 01:28:50 | |
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. The conversation touches on the challenges faced by search and rescue teams, the importance of robust communication skills, and how to build resilience against trauma in high-stress professions. Moose also shares his personal experiences, reflecting on the value of mentorship, the significance of team dynamics, and the essential need for compassionate support during crises. The episode includes practical advice for those in the field of wilderness medicine and search and rescue, highlighting the necessity of emotional balance and continuous learning. Connect with Moose: Did you enjoy this episode? Contribute to YOSAR! Links from the show: More Reading: CHAPTERS As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. | |||