Does Ibuprofen protect against Acute Mountain Sickness?

The issue of prevention of Acute Mountain Sickness (AMS) has been debated extensively on the high altitude walking tracks around the world and also in the literature. For any of you lucky enough to explore the world above the clouds, the questions surrounding the role of Acetazolomide (Diamox) and Dexamethasone far outweigh the answers. Nevertheless, […]

Exercise Associated Hyponatraemia


A recent coroner’s finding about the death of a Tasmanian bushwalker has reinforced the need for awareness of Exercise Associated Hyponatraemia, particularly in those participating in prolonged exercise and ultra-endurance events.   What is EAH? Exercise associated hyponatraemia is a condition of low blood sodium (salt) levels which can occur with exercise.  It can cause […]

What is the dose of Australian snake antivenom?

Brown Snake at Rukenglen

When Commonwealth Serum Laboratories (CSL) developed the first Australian snake antivenom (Tiger Snake Antivenom) in the 1930’s, the recommended dose was 1 vial. Over time the recommended dose increased to 4 vials and there are many case reports of much higher doses being administered. This trend has not been specific to Tiger Snake Antivenom with […]

Lightning Injuries

An expert panel from last year’s Wilderness Medical Society Annual Meeting have produced Guidelines for the Treatment and Prevention of Lightning Injuries.  Of course, there is not a great deal of high quality evidence in this area but the guidelines are a good summary of expert opinion. To provide guidance to clinicians about best practices, […]

The Crystal Cave – Naica, Mexico


It was hard to knock back the opportunity to join 60 Minutes Australia for a trip into The Crystal Cave in northern Mexico. After 2 years of (no doubt costly) negotiation, producer Danny Keens was given permission to take a crew into the the tightly guarded cave located a mile beneath the surface within the […]

Water Purification

Water boiling

Gastrointestinal disease (including diarrhoea) is very common in wilderness travelers.  The vast majority of these diseases are transmitted through contaminated food and water.  Several different organisms/pathogens are responsible for water-borne infection including bacteria (E.coli, Shigella, Campylobacter), Viruses (Hepatitis A, Norovirus), Protozoa (Giardia, Crypotosporidia) and occasionally Helminths (worms).  Whilst in many cases a trail ultramarathoner will […]

Kokoda part 2 – On the Trail


Fluids Your body’s fluid balance will be placed under considerable stress while hiking in the humid mountain jungle of Papua New Guinea. Risks of dehydration include strenuous exercise, hot climate and illnesses such as diarrhoea. Some blood pressure medications called diuretics can also increase your risk of dehydration. Symptoms include increased thirst, dry mouth, decreaed […]

ACEM Winter Symposium – Marine envenoming

ACEM Winter Symposium

Marine Stinger Suits stinger suits work because they are non-organic material not because they provide an impenetrable barrier – does not stimulate tentacles only need to be millimeter thick to be effective if you irritate a box jellyfish with an electric shock itWeill sting you through a stinger suit! (not recommended) The Role of Vinegar […]

ACEM Winter Symposium – Irukandji

ACEM Winter Symposium

Irukandji is increasingly common – normal habitat is moving south – increasingly frequent sightings as far south as Fraser Island Clinical presentation Distressed and agitated – catecholamine storm – severe pain Often no visible signs of sting – no welts / weals Frequently latent period of 30 minutes before symptoms develop – may not immediately […]

ACEM Winter Symposium – Box Jellyfish

ACEM Winter Symposium

A few pearls from Drs Jamie Seymour and Mark Little: Box Jellyfish The box jellyfish depends on the reef for its life cycle so it is not moving into southern waters like some other jellyfish The release of box jellyfish from the reef can be linked to daylight hours – not related to weather / water temperature etc The […]