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 traditionally used as an anesthetic, has been shown to trigger hypoxia response pathways and boost EPO le...
Jun 06, 2025•20 min•Ep. 23
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...
Apr 22, 2025•1 hr 29 min•Ep. 22
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, Baughe...
Mar 26, 2025•24 min•Ep. 21
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 ...
Mar 14, 2025•27 min
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, espec...
Feb 12, 2025•45 min•Ep. 19
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 wilderness environments. Dr. Van Tilburg, an expert in wilderness medicine with extensive field experience...
Jan 12, 2025•46 min•Ep. 18
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 resc...
Nov 15, 2024•42 min•Ep. 17
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 The Hut Medication Card Chapters: 00:00 Introduction a...
Nov 05, 2024•17 min•Ep. 16
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. Full study text HERE The High Route article on the Safeback sy...
Oct 16, 2024•11 min•Ep. 15
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 Cord Protection: 2024 Update If you've never seen a vacuum mattress before, this video (2:10) gives a...
Aug 07, 2024•14 min•Ep. 14
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. Check out The-High-Route.com for awesom...
Apr 03, 2024•49 min•Ep. 13
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 is useful to understand why: -Cardiac arrest from trauma is usually unsalvageable; -Arrest due to hypo...
Jan 26, 2024•19 min•Ep. 12
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. Other topics that we discuss include: -Finger sweeps to clear the ...
Nov 17, 2023•54 min
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 to access this article, but you don't! It's available open access here: https://www.wemjournal.org/article/S1080-60...
Oct 23, 2023•7 min•Ep. 10
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. We touch on: -Training and gear -Deployments and schedule -Compensation -The care of canines -How you can get involved, and more! As always, thanks for listening to Wilderness Medicine ...
Oct 11, 2023•33 min•Ep. 9
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" https://doi.org/10.1016/j.annemergmed.2022.12.015 In the second half, we review the treatment of diarrhea in the returning traveler. As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. Connect with us by email at wildernessmedicineupdates@gmail.com . You can ...
Jul 28, 2023•16 min•Ep. 8
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. Apologies to all who got V1.0-- something weird happened in post that made me sound like a chipmunk. I might be a medical professional, but I'm no AV specialist. Summary: 1. Get the Job Done 2. Have Fun 3. Safety Third As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. Connect with u...
Jul 13, 2023•9 min
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: Why is wildfire smoke harmful? Is there a safe level of exposure? Can we trust the EPA's guideline levels? (Spoiler: no) Does the benefit of exercise outweigh the damage of smoke exposure? If you have to be outside, how can you limit harms? And more. Get ready for a trip down nerd ...
May 24, 2023•26 min•Ep. 7
In this inaugural interview episode I have the pleasure of grilling Dr. Brant-Zawadzki about operating an urban EMS system at a wilderness boundary. We talk about: - Improvising outside the protocol - Interfacing with SAR, rangers, and road workers - How response kit and expectations are changed beyond the pavement - What a fellowship in Wilderness Medicine can do for you career And more! Show Links: EMS Fellowship , U of U Wilderness Fellowship , U of U Unified Fire Authority Become world class...
Apr 04, 2023•49 min•Ep. 6
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. Episode links: CPR With a Lucas Device - An example video from EMS training Viglino et. al. - Outcomes of On-Hill Cardiac Arrests - More saves, probably because of younger patients, bystander CPR, shockable rhythms, and shorter time to defib. WMS Guidelines on the Care of Avalanche Victims - Recommends LUCAS use for ...
Mar 12, 2023•18 min•Ep. 5
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). We begin the with the case of Tayyab Jafar , a young man who was successfully resuscitated from severe hypothermia with both cardiopulmonary bypass and ECMO, but not without incident. We then discuss the derivation and validation studies for the HOPE score. You can calculate and use the HOPE score at Hypother...
Feb 23, 2023•22 min•Ep. 4
For today, a new format, the Fast Push: Quick updates that you need to know sooner rather than later. This fast push tackles the growing issue of avalanche beacon interference. To see the source post and useful graphics, check out this link to the Utah Avalanche Center: https://utahavalanchecenter.org/blog/74828 TL:DR -Electronics, magnets, heated/foil line clothes near your beacon are bad. -They need to be at least 20cm away from your transmitting beacon, and 50 cm away when you're performing a...
Feb 09, 2023•8 min
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...
Feb 07, 2023•15 min•Ep. 3
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. Turgut K, Yavuz E, Gülaçtı U, Aydın İ, Sönmez C, Aktaş N, Arslan E. Comparison of Intravenous Paracetamol, Dexketoprofen Trometamol, or Topical Lidocaine Use for Pain Relief in Scorpion Stings: A Placebo-Controlled, Randomized Study. Wilderness Environ Med. 2022 Dec;33(4):379-385. doi: 10.1016/j.wem.2022.08.002. Epub 2022 Oct 11. PMID: ...
Jan 24, 2023•11 min•Ep. 2
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. DOI: 10.1016/j.wem.2022.05.003 As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. Connect with us by email at wildernessmedicineupdates@...
Jan 24, 2023•15 min•Ep. 1
Welcome to Wilderness Medicine Updates! This podcast, new for 2023, delivers brief reviews of research in wilderness medicine, SAR, disaster/austere medicine, and wilderness EMS to help you stay current and provide the best care to patients in challenging environments. As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. Connect with us by email at wildernessmedicineupdates@gmail.com . You can pay us a compliment and share the show with a new listener o...
Jan 24, 2023•4 min0
