Shows
Wilderness Medicine UpdatesEp. 28 - Laura McGladrey, Responder Alliance, and Stress Injury: How to Get Back to Green and Save Living While Saving Lives.Understanding Stress Injuries in First Line Responders with Laura McGladreyThis 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 develop, and the importance of early detection and mitigation. The episode highlights the need for both individual and organizational strategies to support resilience and manage stress. Listeners...
2025-11-1459 minWilderness Medicine UpdatesEp. 27 - Thermoregulation: The Physics and Physiology of Body Temperature RegulationIn 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 stressors, and pregnancy on thermoregulation, as well as the importance of understanding these principles in the context of treating conditions like hypothermia and heat-related illnesses.00:00 Introduction and Epi...
2025-11-0532 minWilderness Medicine UpdatesFast Push #3: Safeback SBX for Avalanche Asphyxia PreventionIn 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 episode provides an in-depth analysis of SafeBack SBX, its mechanisms, study results, and its comparative and complementary role alongside existing safety technologies like airbags. Concluding with potential applications and limitations, Patrick aids...
2025-10-1017 minWilderness Medicine UpdatesEp. 26 - Physical Training for Mountain Rescue Professionals with Rob Shaul of Mountain Tactical InstituteOn 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 seasonal work, the distinct fitness demands of ski patrollers versus search and rescue members, and the importance of chassis integrity and mental fitness. Rob highlights minimal equipment...
2025-10-0247 minWilderness Medicine UpdatesEp. 25 - Tree Well Burial Study / Wilderness Med Careers AMA with Zack MajdIn 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 of fellowships, and the essentials of wilderness medical training. Additionally, the episode highlights upcoming educational events and provides practical advice on wilderness medical gear, psychological s...
2025-09-091h 01Wilderness Medicine UpdatesEp. 24 - Airway Management in Austere Environments with Dr. Nicholas WeinbergIn 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 emphasizes the significance of understanding the limitations and capabilities of the available tools in wilderness settings.LinksWEM ArticlePhoto: Ledge from the...
2025-08-1246 minWilderness Medicine UpdatesEp. 23 - Inhaled Xenon Gas for Altitude AdaptationExploring Xenon Gas for Altitude Acclimatization and Sport PerformanceIn 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 levels in animal studies. However, human trials have yet to demonstrate significant performance benefits or lasting changes in...
2025-06-0619 minWilderness Medicine UpdatesEp. 22 - Moose Mutlow: Yosemite Swiftwater SAR, Family Liaison Officer, and longevity in rescue.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...
2025-04-231h 28Wilderness Medicine UpdatesEp. 21 - Snow Immersion SuffocationIn 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...
2025-03-2623 minWilderness Medicine UpdatesEp. 20 - Out of Hospital Airway Adjuncts: King Tube vs LMAKing Tube vs IGEL for Airway ManagementIn 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...
2025-03-1427 minWilderness Medicine UpdatesEp. 19 - Methoxyflurane, the Green Whistle, with Dr. Ross HofmeyrExploring Methoxyfluorane for Wilderness Pain Management with Dr. Ross HofmeyrIn 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...
2025-02-1245 minWilderness Medicine UpdatesEp. 18 - Ketamine for Wilderness Pain Management with Dr. Christopher Van TilburgKetamine Use in Wilderness Pain Management: An Interview with Dr. Chris Van TilburgIn 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, shares insights on administering ketamine in challenging rescue scenarios, the limitations and benefits of various medications, and practical considerations...
2025-01-1245 minWilderness Medicine UpdatesEp. 17 - Resuscitation of the Buried Avalanche Victim, Part 2: The Rescue AlgorithmIn 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. The episode also includes two detailed case studies that illustrate the application of the resuscitation algorithm, providing listeners with practical scenarios to better...
2024-11-1542 minWilderness Medicine UpdatesEp. 16 - Medications for Alpine Hut TripsIn 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.comThe Hut Medication CardChapters: 00:00 Introduction and Personal Update01:31 The Backcountry Hut Trip Begins03:19 Will's Health Deteriorates
2024-11-0517 minWilderness Medicine UpdatesEp. 15 - Airway Patency in Avalanche VictimsThis 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 HEREThe High Route article on the Safeback system HEREEpisode 12: Avalanche victim physiology. Listen on web, Apple...
2024-10-1710 minWilderness Medicine UpdatesEp. 14 - Spinal Immobilization Guidelines UpdateToday, 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 UpdateIf you've never seen a vacuum mattress before, this video (2:10) gives a good introduction. If the brief mention of the Diploma in Mountain Medicine...
2024-08-0713 minWilderness Medicine UpdatesEp. 13 - The High Route: Arguments for Avalanche AirbagsThis 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 awesome backcountry ski and ski-mountaineering content that is unbiased by financial relationships with gear companies and advertisers. Show Note...
2024-04-0348 minWilderness Medicine UpdatesEp. 12 - Resuscitation of the Buried Avalanche Victim, Part 1: PhysiologyThis 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 hypoxia can happen within minutes or be delayed more than an hour;-Why we c...
2024-01-2618 minWilderness Medicine UpdatesEp. 11 - After the Avalanche with Michael BuchananEpisode 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 airway-How the presence of an air pocket changes your medical care-How long to perform CPR after an av...
2023-11-1753 minWilderness Medicine UpdatesEp. 10 - Tourniquets from Space BlanketsIn 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/S1080-6032(23)00043-1/fulltextAs always, thanks for listening...
2023-10-2306 minWilderness Medicine UpdatesEp. 9 - FEMA Urban Search and Rescue with Dr Graham Brant-ZawadzkiIn 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 Updates, hosted by Patrick Fink MD FAWM.
2023-10-1133 minWilderness Medicine UpdatesEp. 8 - SAR Provider Injuries & Traveler's Diarrhea TreatmentIn 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.2022.12.015In 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 pay us a compliment and share the show with a new listener on...
2023-07-2815 minWilderness Medicine UpdatesFast Push #2.2 - Safety ThirdIn 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 Done2. Have Fun3. Safety ThirdAs always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM.
2023-07-1308 minWilderness Medicine UpdatesEp. 7 - Wildfire Smoke and Your HealthIn 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 lane.Links from the show:...
2023-05-2426 minWilderness Medicine UpdatesEp. 6 - EMS at the Wilderness Boundary with Dr. Graham Brant-ZawadzkiIn 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 careerAnd more!Show Links:EMS Fellowship, U of UWilderness Fellowship, U of UUnified Fire AuthorityBecome world class by combining multiple domains...
2023-04-0449 minWilderness Medicine UpdatesEp. 5 - Mechanical CPR for Ski Patrol and Mountain RescueIn 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 trainingViglino 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 prolonged transports and extrications.Putzer et...
2023-03-1217 minWilderness Medicine UpdatesEp. 4 - HOPE Score for Severe HypothermiaIn 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 HypothermiaScore.org.HOPE score derivation PDFHOPE score validation: n...
2023-02-2322 minWilderness Medicine UpdatesFast Push #1 - Beacon InterferenceFor 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/74828TL: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 search. -When using radios or cell phones to...
2023-02-0908 minWilderness Medicine UpdatesEp. 3 - Methoxyflurane for Prehospital AnalgesiaMethoxyflurane: 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/s12873-021-00565-6Open access PDF:https://bmcemerg...
2023-02-0715 minWilderness Medicine UpdatesEp. 2 - Pain Management for Scorpion StingsToday 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: 36229383.https://doi.org/10.1016/j.wem.2022.08.002As always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM...
2023-01-2510 minWilderness Medicine UpdatesEp. 1 - Fentanyl on the Ski Hill?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.2022.05.003As 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 on any popular platform...
2023-01-2415 minWilderness Medicine UpdatesEp.0 - An IntroductionWelcome 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 on any popular platform here. Connect with us on social! In...
2023-01-2403 min
Future PositiveUsing AI to Preserve Indigenous KnowledgeFor many indigenous communities, passing down knowledge to the next generation is critical to cultural survival. The preservation of these cultures have traditionally been done through the study and documentation of languages, traditions and rituals. In today’s episode, we’ll start by hearing from Burr Settles, Head of Research and AI at Duolingo, and go into a discussion between Davar Ardalan from IVOW AI, AI writer Chamisa Edmo, Alva Lim from Agora Food Studio, AI Researcher Victor Yarlott, and Tracy Monteith, Senior Software Engineer at Microsoft who spent 20 years putting the Cherokee language in Microsoft Word. Our guests dive...
2020-10-2346 min
In the 'VerseSafe | FireflyWelcome to In the 'Verse: Song Crafting for the Firefly Universe. Here are some of the themes discussed in this episode: loyalty and safety. SHOW TIMES 2:42 Upcoming Shows with Marc Gunn 3:29 Upcoming Show with Mikey Mason 3:59 Geek Music News 8:10 Marc's Song: Favor of Dance 9:29 Mikey's Songs: Captain Tightpants and Sad Little King 12:01 Plot Summary 14:42 Discussion of Episode 5 "Safe" 38:41 Mikey's thanks and song "Safe" 42:18 Marc's thanks and song "Like a Big Damn Hero" SHOW NOTES MARC: My name...
2019-02-2046 min