Cover -- Half Title -- Title Page -- Copyright -- Dedication -- Contents -- Contributors -- Foreword by Jim Fowler -- Preface -- Acknowledgments -- Part I. Expedition Planning -- 1 The Expedition Physician -- Six Liters -- Expedition Medical Mindset -- Heroic Fantasy -- Attitudes -- Expedition Medicine 101 -- Preexpedition Considerations -- Expedition Considerations -- Standards -- Final Thoughts - "Physician, Heal Thyself" -- Acknowledgments -- 2 Assessing Expedition Medical Needs -- History Thresholds -- The Physical Examination -- Mountain Travel Sobek: History and Physical Form -- Cardiology Clearance -- Age-related Risk -- Continued Monitoring During the Trip -- References -- 3 Expedition Medical Kit -- Purpose of the Trip -- Level of Medical Training -- Destination -- Participant Medical Conditions and Age -- Length of Trip/Resupply -- Time for Evacuation or Medical Rescue -- Size of the Party -- Bulk, Weight, and Cost -- Accessibility -- Risk of Loss or Diversion -- Replenishment -- Preservation -- Expectations -- Diagnostics -- Improvisation -- Modular Kits -- References -- 4 Immunizations -- Introduction -- Background -- Routine Immunizations -- Required Vaccinations -- Recommended Vaccinations -- Conclusion -- Suggested Readings -- 5 Legal Considerations during Expedition Planning -- Risk Management Planning -- Structuring the Expedition to Optimize Its Goals and Minimize Liability -- Understanding and Minimizing or Mitigating Liabilities -- Additional Legal Considerations for the Expedition's Medical Professional -- Other Legal Considerations for the Expedition -- Conclusion/Summary -- References -- Suggested Readings -- 6 Travel Safety -- New Trends in Travel: Growth in the Nontraditional Travel Industry -- Health Risks: Real Versus Perceived Risks -- Most Common Risks to Travelers -- Personal Safety: Start with Proper Packing.

Travel Intelligence and Information Gathering Prior to Travel -- Local Customs, Laws, and Conduct -- Travel Insurance -- Planes, Trains, and Automobiles -- Vehicle Safety Tips -- Walking and Using Local Transport -- Trains and Rail Stations -- Hotels and Lodging Safety -- Sexual Harassment -- Avoiding Legal Problems -- Travel to High-risk Areas -- Travel Health -- Manage Your Money -- If You Are Victim of a Crime -- Take Home Points -- Summary -- References -- 7 Nutritional Support for Expeditions -- Introduction -- Planning Nutrition Support -- Logistics: Weight/Volume Considerations -- Practical Guidance and Suggestions -- Suggested Readings -- 8 Water Treatment -- Field Water Disinfection -- Risk and Etiology -- Disinfection Methods -- Miscellaneous Disinfectants -- Preferred Technique -- Prevention and Sanitation -- References -- 9 Special Considerations -- Classifications of Expeditions, Venture Activities, and Participants -- Universal Considerations -- Special Considerations -- Summary -- Epilogue -- References -- 10 Communications Planning for the Expedition Medical Officer -- Modern Communications and Telemedicine -- Communications Planning -- Expedition Focus -- Using Telecommunications Equipment -- Expedition Environment -- Medical Records -- Choosing Equipment and Services -- Communications Packages for Medical Use -- Summary -- References -- Appendix -- 11 Minimizing Risk on an Expedition -- Introduction -- Risk Assessment and Insurance -- Expedition Medicine -- The Impact of Travel and the Need for Insurance -- The Basics of Travel Insurance -- The Need for Evacuation -- Policy Coverage Exclusions -- Selection of Services -- Summary -- References -- 12 The Expedition Returns -- Introduction -- Responsibilities -- Summary -- Links -- Annex 1: Reportable Diseases -- Suggested Readings -- Part II. Expeditions in Unique Environments.

13 Tactical and Protective Medicine -- Introduction -- Historical Background -- Current Practices -- Tactical and Protective Medicine Providers -- Mission Support -- Threat Assessments -- Tactical Casualty Combat Care -- Tactical Triage and Rapid Remote Assessment -- Requests for Evacuation -- Tactical Medical Provider as Team Doctor -- Conclusions -- References -- 14 Hostile Geopolitical Environments -- Introduction -- Characteristics of Modern Conflicts -- Danger by Geography: the World's Most Dangerous Places -- Travel to High-Risk Areas and Hostile Environments -- High-risk Situations -- Landmines and Unexploded Ordnance -- Kidnapping and Hostage Situations -- Terrorism -- Working in a Conflict Region -- Human Vulnerability and Health Considerations in Displacement -- Health Threats in Displaced Populations -- Sexual and Gender-Based Violence in Conflict -- Summary: Traveling and Working in a Conflict Zone -- References -- 15 Aerospace Medicine -- Introduction -- History and Development -- Aerospace Environments -- Aerospace Medicine Practice in the United States -- Risk and Prevention -- The Longitudinal Study of Astronaut Health -- The Future of Aerospace Medicine -- References -- 16 Polar Medicine -- Contrasts Between the Arctic and Antarctica -- Populations -- History of Polar Expedition Medicine -- Epidemiology -- Health Care on Expeditions -- Health Care Services -- Predeparture Medical Screening -- Selection and Training of Medical Staff -- Orientation and Medical Training of All Participants -- Facilities, Equipment, and Supplies -- Telemedicine and Medical Informatics -- Medicolegal -- Research -- Specific Polar Medical Problems -- Conclusion -- Acknowledgments -- Suggested Readings -- 17 Tropical Medicine for Expeditions -- Global Burden of Disease -- The Major Tropical Diseases of Expeditions and Adventure Travelers.

Soil-Transmitted Tropical Diseases -- Food-Borne Tropical Diseases -- Waterborne Tropical Diseases -- Person-Person or Animal-Person Direct Contact -- Vector-Borne Transmission -- Summary -- References -- 18 Subterranean Medicine -- Introduction -- Subterranean Environmental Hazards -- Cave Diving -- Cave Rescue -- Cave Medical Kit -- Summary -- Suggested Readings -- 19 High-Altitude Medicine -- Definitions -- The High-Altitude Environment -- Altitude Acclimatization -- Altitude Physiology -- Sleep at High Altitude -- Neurologic Syndromes at Altitude -- Acute Cerebral Hypoxia -- High-Altitude Cerebral Edema -- Focal Neurologic Conditions Without Ams or Cerebral Edema -- Cognitive Changes at High Altitude -- High-altitude Pulmonary Edema -- Reentry Pulmonary Edema -- High-Altitude Deterioration -- Thrombosis: Coagulation and Platelet Changes -- Peripheral Edema -- High-Altitude Pharyngitis and Bronchitis -- The Eye at Altitude -- Common Medical Conditions and High Altitude -- High-Altitude Medical Kits -- Summary -- Suggested Readings -- 20 Medicine at Sea -- Introduction -- Predicting and Addressing Health Care Needs Afloat -- Ship Health: Underway Medical Concerns -- Prevention: Safety and Public Health Concerns -- Suggested Readings -- Useful Web Sites -- References -- Acknowledgements -- 21 Event Medicine -- Introduction -- Expedition-Length Adventure Races -- Medical Support for Mass Gatherings -- Medical Support Plan Development -- Penalties for Acceptance of Medical Care -- Medical Disqualification -- Legal Considerations -- Conclusion -- References -- 22 Telemedicine in Evolution: Implications for Expeditionary Medicine -- Introduction -- History -- Telemedicine Successes -- The Unique Nature of Expeditionary Medicine -- The Military Experience with Telemedicine -- Telemedicine Versus Local Decision Making -- Selecting a Telemedicine Platform.

The Future of Telemedicine -- Summary -- Suggested Readings -- 23 Dive Medicine -- Introduction -- Diving Physics -- Barotrauma -- Physiologic Limits of Gases -- Decompression Sickness -- Treatment -- In-Water Recompression -- Adjunctive Treatment -- Flying After Diving -- Fitness to Dive -- Search and Rescue Procedures and the Lost Diver -- Conclusion -- References -- Part III. Illness and Injuries on Expeditions -- 24 General Medical -- Introduction -- Allergic Reactions -- Blood-Borne Pathogens -- Deep Vein Thrombosis and Pulmonary Embolism -- Electrical Injuries -- Epistaxis -- Gastroenteritis -- Skin and Soft Tissue -- Urological Emergencies -- Suggested Readings -- 25 The Diarrhea of Travelers -- Introduction -- The Clinical Illness -- Etiologic Agents -- Protozoa -- Etiologic Diagnosis -- Epidemiology -- Prevention -- Treatment -- Possible Sequela to Travelers' Diarrhea -- Summary -- References -- 26 Malaria: Diagnosis, Prevention, and Treatment for the Traveler -- Introduction -- History -- Geographic Distribution -- Parasite Biology and Life Cycle -- Clinical Malaria -- Prevention -- Treatment -- Conclusion -- References -- 27 Wild Animal Attacks and Injuries -- Epidemiology -- Prevention -- Prehospital Care -- Evaluation and Treatment -- Wound Care -- Infection -- Tetanus -- Zoonoses -- Rabies -- Psychiatric Consequences of Animal Attack -- Animals That Attack -- Primates -- Herbivores -- Big Cats -- Bears -- Marsupials -- Large Birds -- Venomous Mammals -- Hazardous Aquatic Life -- Amazonian Species -- Summary -- References -- 28 Snake and Arthropod Envenoming -- Introduction -- Approach to the Envenomed Patient -- Pretravel -- Venomous Arthropods -- Venomous Arachnids: Spiders, Scorpions, and Ticks -- Venomous Mammals -- Venomous Snakes -- Treatment -- Summary -- References -- 29 Hazardous Marine Life -- Introduction.

Marine Life That Bite.