Pathophysiology Most Ovarian Cysts are small fluid-filled sacs that develop in a woman's ovaries as a normal part of a women’s menstrual cycle. During childbearing years a women produces a single egg once a month in a small sac called a follicle. The release of estrogen signals the sac to rupture and release the egg into the fallopian tube where it travels to the uterus. If the egg is fertilized, it implants on the uterine wall; unfertilized eggs are expelled with the uterine lining during menstruation. If the follicle fails to rupture and release the egg, fluid remains in the sac and a follicular cyst may form. Another type of cyst (corpus luteum cyst) can form even if the egg is released; this type of cyst contains a small amount of blood. Small cysts of either type—less than one half an inch—are common, produce no symptoms, and disappear on their own in a few weeks. A large cyst may cause pressure, bloating, pelvic pain, pain during intercourse if bumped, a increased desire to urinate, or a late period. Sudden and severe pelvic pain, often accompanied by nausea and vomiting, may be a sign of twisting of the ovary and reducing its blood supply or the rupture of a cyst and internal bleeding. If benign, the pain will improve dramatically within 45 minutes.
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Padded Aluminum Splints may be purchased at our online store and fit into the outside zippered pockets on our Guide and Expedition first aid packs.
Developing atherosclerosis, plaque rupture, and subsequent clotting of a coronary artery is the most common cause of heart attacks. Signs and symptoms commonly appear immediately and are due to a lack of oxygen in the affected tissue. Cardiac arrest is unpredictable and if it occurs is ultimately due to a change in the electrical impulses and conduction pattern in the specialized cardiac nerves that stimulate normal cardiac contractions. An injury to these nerves blocks the conduction pathway. The block prevents or delays the electrical impulses from reaching their destination and causes cardiac arrest. The potential for arrest from a heart attack is directly related to the type, location, and size of the compromised tissue. If the blocked artery services the specialized conduction cells that coordinate the pumping action of the heart, arrest occurs within seconds or minutes. If the blocked artery services the heart’s contractile fibers rather than its specialized conduction cells, the pumping action of the heart may be compromised. A reduction in the heart’s ability to pump blood efficiently may cause a back pressure in the pulmonary vessels and force fluid into the alveoli causing respiratory distress, fatigue, swelling in the hands and feet, indigestion and loss of appetite. Complete pump failure and arrest may develop if a significant amount of heart muscle has been injured and the heart cannot continue to meet the body’s demands for nutrients. Emergency aspirin therapy increases the chance of survival, minimizes permanent damage, and improves recovery. The longer arrest is delayed the more likely the patient will survive without immediate hospital treatment.
The American Red Cross offers a Wilderness & Remote First Aid Course based on the curriculum developed by the Boy Scouts of America. While the Red Cross has a long history in teaching urban first aid, their Wilderness and Remote First Aid course leaves much to be desired when compared to the Wilderness First Aid courses offered by most of the professional providers. If you are considering taking the ARC course—or becoming an instructor for one—below is a list of pros and cons.
Introduction
Spending time outside for work or play is part of human history, both past and present. Interest in the outdoors is constantly growing with new human-powered and motorized activities/sports emerging on a regular basis. The development of more sophisticated equipment allows access to more challenging terrain and environments...and greater risk. Use permits, once unheard of, are now the rule—and are increasingly difficult to procure for both individuals and organizations. Wilderness ethics are changing as use increases and "leave no trace" has become a mantra for many. In short, the outdoors has become a thriving industry. Introduction
Since 1962 when Outward Bound first introduced wilderness adventure programing to United States and the world in the mountains of Colorado, the field has grown exponentially. It is now commonplace to find successful wilderness recreation programs in K-12 schools, summer camps, military bases, and city and state parks. The use of outdoor adventure programs for therapeutic reasons has become it's own industry. And, enrollment in undergraduate and graduate degrees programs in outdoor recreation, education, and therapy is on the upswing. Within the college/university systems there are three types of outdoor programs:
Training outdoor leaders within a college/university setting requires a multidisciplinary approach that does not fit well into a standard quarter/semester format due to the type of terrain and time required teach outdoor skills. The purpose of this article is to briefly discuss the design of each program type, list their pros and cons, and provide a conceptual template for those training students to staff some of their programs. Thermoregulation & Cold PhysiologyHypothermia occurs when a person cannot maintain their normal body temperature in the face of a cold challenge. The cold challenge increases as a person is exposed to progressively decreasing temperature, increasing humidity, and increasing wind. People respond to a cold challenge by increasing their heat production through shivering and maintaining their core temperature through peripheral vasoconstriction. Heat production requires an efficient metabolism and accessible calories. The ability to produce heat via shivering or exercise drops as their available calories become depleted. Fitness, hydration, health, and injury all affect a person’s metabolism and their ability to produce heat.
The onset of hypothermia is variable and depends on the severity of the cold challenge, the length of exposure, and the health of the patient. Acute hypothermia may occur in minutes to hours with cold water immersion regardless of the victim’s health. Subacute hypothermia may occur in hours to days in a mountain or river environment where decreased calories predispose the climber, hiker, or paddler to hypothermia from a moderate cold challenge. Expedition members with predisposing factors (poor health, inadequate nutrition, poor hydration, etc.) can develop a chronic cold response during prolonged exposure (days to weeks) to cool environmental conditions due to limited caloric intake and no glycogen or fat stores. They may easily become hypothermic when presented with a slight increase in the cold challenge. It seems that hardly a week passes without a disaster: worldwide heat waves, typhoons in Taiwan, flooding in Texas and West Virginia, wildfires in Canada and California, mudslides in Japan, tornadoes in the mid-west, terrorist attacks in Europe and the middle East, home-grown shooter attacks in Florida, etc. What is going on? Are disasters really increasing, and if so, why? Are "natural" disasters part of an earth cycle or are we causing them?
It should come as no surprise that most definitions for disaster are at least somewhat anthropomorphic. The International Federation of Red Cross (IFRC) website defines a disaster as "...a sudden, calamitous event that seriously disrupts the functioning of a community or society and causes human, material, and economic or environmental losses that exceed the community's or society's ability to cope using its own resources." Disasters can be subdivided into five categories:
While the number of fatalities for some types of natural disasters—earthquakes, volcanic eruptions, tsunamis—is decreasing due to better warning systems and preparedness on the part of residents, their communities, and state and federal governments, the number of people affected by them—via non-fatal injuries, loss of homes, businesses, and infrastructure—is larger due to population growth and expansion into disaster prone areas. Regardless of the type of disaster, the management cycle each community experiences before, during, and after a disaster is the same and can be represented by the following graphic: Boaters go out in all kinds of weather. Each year numerous people die by falling into cold water or capsizing their small boats; some die quickly due to drowning, others more slowly from hypothermia. Some are on their own trips; others on guided trips. All are typically unprepared. Pathophysiology Water cools the body 25-30 times faster than air. Cooling occurs faster if the water is moving, as happens when a victim is immersed in current, whitewater, or waves, and even faster if the victim is swimming or struggling. Photo 1 shows heat loss from a body in the air; photo 2 shows heat loss from the core when an immersion victim remains motionless in cold water; photo 3 shows heat loss from the extremities while swimming cold water. Muscle tissue produces heat even at rest; during heavy exercise heat production increases more than ten-fold. The more insulation—clothing and/or fat—a victim has, the slower they cool. The rate of cooling is also proportional the victim's surface to mass ratio. Large, fat people cool significantly slower than small, thin people; adults cool slower than children. |
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Our public YouTube channel has educational and reference videos for many of the skills taught during our courses. Check it out!
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