Wilderness Medicine Updates

Epizode

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  Ep. 33 - Heat Illness Fundamentals: Recognize the Spectrum, Cool First, Transport Second 30.07.2026 44min

  Dr. Patrick Fink reviews the spectrum of heat illness using 2024 Wilderness Medical Society guidelines, covering recognition, physiology, field treatment, and key mimics. He distinguishes heat edema, heat cramps (salt-depletion vs exercise-associated), heat syncope and exercise-associated collapse, and defines heat exhaustion by preserved mental status versus heat stroke by altered mental status in a heat context, warning not to wait for a temperature threshold. He explains heat stroke pathop...
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  Fast Push #4: Expired Resuscitation Medications 02.06.2026 12min

  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, aspirin, epinephrine, and naloxone — and what the science actually says when in-date meds aren't a...
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  Ep. 32 - Airway Fundamentals for Austere Settings 19.05.2026 44min

  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 Upcoming Episodes 04:04 Scenario Mountain Biker 05:33 Airway Positioning Jaw Thrust 09:42 P...
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  Ep. 31: Hypothermia Basics 11.03.2026 49min

  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/insulate, warm calories; avoid alcohol), - 1 mild hypothermia (ataxia/fine mo...
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  Ep. 30 - Rethinking Spinal Immobilization: EMS Evidence Update 09.02.2026 22min

  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 collars. Instead, he advocates for more flexible, evidence-based approaches such as using well-pad...
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  Ep. 29 - Wilderness Orthopedics with Dr. Chris Healy 18.01.2026 1h 18min

  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 limited-resource environments. The episode covers strategies for handling common injuries like should...
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  Ep. 28 - Laura McGladrey, Responder Alliance, and Stress Injury: How to Get Back to Green and Save Living While Saving Lives. 14.11.2025 59min

  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 personal stories and expert insights, Laura explains the concept of stress injuries, how they devel...
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  Ep. 27 - Thermoregulation: The Physics and Physiology of Body Temperature Regulation 04.11.2025 32min

  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, sweating, and blood flow control. The episode also touches on the effects of age, metabolic stressor...
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  Fast Push #3: Safeback SBX for Avalanche Asphyxia Prevention 10.10.2025 17min

  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 demonstrates significant efficacy in delaying hypoxia during simulated avalanche burials. The episo...
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  Ep. 26 - Physical Training for Mountain Rescue Professionals with Rob Shaul of Mountain Tactical Institute 02.10.2025 47min

  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, including those in industrial and tactical roles. They discuss the nuances of preparing for season...
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  Ep. 25 - Tree Well Burial Study / Wilderness Med Careers AMA with Zack Majd 08.09.2025 1h 1min

  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 wilderness medicine. Patrick discusses the necessary educational paths, the benefits and limitations ...
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  Ep. 24 - Airway Management in Austere Environments with Dr. Nicholas Weinberg 12.08.2025 46min

  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 flexibility and the application of basic life support techniques in the wilderness. The episode em...
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  Ep. 23 - Inhaled Xenon Gas for Altitude Adaptation 06.06.2025 19min

  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...
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  Ep. 22 - Moose Mutlow: Yosemite Swiftwater SAR, Family Liaison Officer, and longevity in rescue. 22.04.2025 1h 28min

  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 rob...
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  Ep. 21 - Snow Immersion Suffocation 25.03.2025 23min

  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, Baug...
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  Ep. 20 - Out of Hospital Airway Adjuncts: King Tube vs LMA 14.03.2025 27min

  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...
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  Ep. 19 - Methoxyflurane, the Green Whistle, with Dr. Ross Hofmeyr 12.02.2025 45min

  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, es...
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  Ep. 18 - Ketamine for Wilderness Pain Management with Dr. Christopher Van Tilburg 12.01.2025 45min

  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 expe...
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  Ep. 17 - Resuscitation of the Buried Avalanche Victim, Part 2: The Rescue Algorithm 14.11.2024 42min

  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 r...
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  Ep. 16 - Medications for Alpine Hut Trips 05.11.2024 17min

  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 In...