BOOK
Travel and Adventure Medicine, An Issue of Medical Clinics of North America, E-Book
Paul S. Pottinger | Christopher A. Sanford
(2016)
Additional Information
Book Details
Abstract
This issue of Medical Clinics of North America, guest edited by Paul S. Pottinger and Christopher A. Sanford, is devoted to Travel and Adventure Medicine. Articles in this issue include: Immunizations; Malaria; Personal Protection Measures; Traveler’s Diarrhea; Urban Medicine and Trauma; Care of the Healthcare Provider; Evaluation of the Ill Returned Traveler; The Ethics of Medical Volunteerism; High-Altitude Medicine; Dive Medicine; Wilderness Medicine, Including First Aid & Hypo/Hyperthermia; The Medical Kit; Adventure Sports: Spelunking, water exposures; and Resources for the Provider and Opportunities in Further Training in Travel and Adventure Medicine.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Travel and Adventure Medicine \r | i | ||
| Copyright\r | ii | ||
| PROGRAM OBJECTIVE | iii | ||
| TARGET AUDIENCE | iii | ||
| LEARNING OBJECTIVES | iii | ||
| ACCREDITATION | iii | ||
| DISCLOSURE OF CONFLICTS OF INTEREST | iii | ||
| UNAPPROVED/OFF-LABEL USE DISCLOSURE | iii | ||
| TO ENROLL | iv | ||
| METHOD OF PARTICIPATION | iv | ||
| CME INQUIRIES/SPECIAL NEEDS | iv | ||
| MEDICAL CLINICS OF NORTH AMERICA\r | v | ||
| FORTHCOMING ISSUES | v | ||
| May 2016 | v | ||
| July 2016 | v | ||
| September 2016 | v | ||
| RECENT ISSUES | v | ||
| January 2016 | v | ||
| November 2015 | v | ||
| September 2015 | v | ||
| Contributors | vii | ||
| CONSULTING EDITORS | vii | ||
| EDITORS | vii | ||
| AUTHORS | vii | ||
| Contents | xi | ||
| Foreword: Travel and Adventure Medicine\r | xi | ||
| Preface: Travel and Adventure Medicine\r | xi | ||
| The Ethics of Medical Volunteerism\r | xi | ||
| Immunizations\r | xi | ||
| Travel Medical Kit\r | xi | ||
| Care for the Health Care Provider\r | xii | ||
| Malaria in the Traveler: How to Manage Before Departure and Evaluate Upon Return\r | xii | ||
| Personal Protection Measures Against Mosquitoes, Ticks, and Other Arthropods\r | xii | ||
| Traveler’s Diarrhea\r | xii | ||
| Road Traffic and Other Unintentional Injuries Among Travelers to Developing Countries\r | xiii | ||
| Wilderness Medicine\r | xiii | ||
| High-Altitude Medicine\r | xiii | ||
| Adventure and Extreme Sports\r | xiii | ||
| Illness in the Returned International Traveler\r | xiv | ||
| Travel and Adventure Medicine Resources\r | xiv | ||
| Foreword:Travel and \rAdventure Medicine | xv | ||
| Preface:Travel and \rAdventure Medicine | xvii | ||
| The Ethics of Medical Volunteerism | 237 | ||
| Key points | 237 | ||
| BACKGROUND | 237 | ||
| ETHICAL CHALLENGES IN MEDICAL VOLUNTEER WORK | 238 | ||
| Context | 238 | ||
| Limited Time and Resources | 239 | ||
| Cultural and Language Barriers | 239 | ||
| LESSONS FROM INTERNATIONAL RESEARCH | 240 | ||
| PRINCIPLES FOR MEDICAL VOLUNTEERISM | 240 | ||
| Mission | 241 | ||
| Partnership | 241 | ||
| Preparation | 241 | ||
| Reflection | 241 | ||
| Support | 242 | ||
| Sustainability | 242 | ||
| Evaluation | 242 | ||
| SUMMARY | 242 | ||
| REFERENCES | 243 | ||
| Immunizations | 247 | ||
| Key points | 247 | ||
| ROUTINE VACCINES | 248 | ||
| Tetanus, Diphtheria, Pertussis | 248 | ||
| Measles, Mumps, Rubella | 249 | ||
| Rotavirus | 249 | ||
| Polio | 249 | ||
| Hepatitis A | 250 | ||
| Hepatitis B | 250 | ||
| Haemophilus Influenzae Type b | 250 | ||
| Human Papillomavirus | 250 | ||
| Influenza | 251 | ||
| Meningococcal Disease | 251 | ||
| Pneumococcal Disease | 252 | ||
| Varicella (Chickenpox) | 253 | ||
| Zoster (Shingles) | 253 | ||
| TRAVEL VACCINES | 253 | ||
| Typhoid Fever | 253 | ||
| Japanese Encephalitis | 254 | ||
| Rabies | 254 | ||
| Yellow Fever | 255 | ||
| VACCINES THAT ARE NOT ROUTINELY ADMINISTERED IN THE UNITED STATES | 256 | ||
| Tick-borne Encephalitis | 256 | ||
| Tuberculosis | 256 | ||
| Cholera | 256 | ||
| Oral Polio Virus | 256 | ||
| Smallpox | 256 | ||
| ADDITIONAL CLINICAL CONSIDERATIONS | 257 | ||
| Live Vaccines | 257 | ||
| Vaccine Interactions | 257 | ||
| Vaccine Hesitancy | 257 | ||
| REFERENCES | 257 | ||
| Travel Medical Kit | 261 | ||
| Key points | 261 | ||
| INTRODUCTION | 261 | ||
| Personal Health | 261 | ||
| Prescriptions | 262 | ||
| ALLERGIC REACTION | 262 | ||
| High-Altitude Medicine | 263 | ||
| EYE CARE | 263 | ||
| FIRST AID | 263 | ||
| GASTROINTESTINAL DISORDERS | 269 | ||
| Traveler’s Diarrhea Treatment | 270 | ||
| Other Gastrointestinal Symptoms | 270 | ||
| Nausea | 270 | ||
| Gastroesophageal Reflux Disease | 270 | ||
| Constipation | 270 | ||
| ARTHROPOD AVOIDANCE | 271 | ||
| Permethrin (0.5% Solution) | 271 | ||
| MOTION SICKNESS | 272 | ||
| MALARIA PREVENTION | 272 | ||
| RESPIRATORY ILLNESS | 273 | ||
| SLEEP DISRUPTION/JET LAG | 273 | ||
| SKIN CONCERNS | 273 | ||
| Zanfel | 274 | ||
| Sunscreen | 274 | ||
| SEXUAL HEALTH | 274 | ||
| WOMEN’S HEALTH | 274 | ||
| Vaginitis | 275 | ||
| Contraception | 275 | ||
| Emergency Contraception | 275 | ||
| Urinary Tract Infection Treatment | 275 | ||
| REFERENCES | 276 | ||
| Care for the Health Care Provider | 279 | ||
| Key points | 279 | ||
| INTRODUCTION | 279 | ||
| PREVENTING MORBIDITY AND MORTALITY | 280 | ||
| PRECOUNTRY PLANNING/ADVICE | 282 | ||
| Health Care Provider Kit and Packing List | 284 | ||
| IN COUNTRY CARE | 284 | ||
| Food and Water Precautions | 284 | ||
| Water Disinfection | 284 | ||
| Needle Sticks and PostExposure Prophylaxis | 284 | ||
| Special Conditions | 286 | ||
| FUTURE CONSIDERATIONS/SUMMARY | 287 | ||
| REFERENCES | 287 | ||
| Malaria in the Traveler | 289 | ||
| Key points | 289 | ||
| OVERVIEW | 289 | ||
| MALARIA | 290 | ||
| PREVENTION: 4 STEPS TO SUCCESS | 291 | ||
| Step 1: Determine Whether a Patient Is at Risk of Malaria | 291 | ||
| Geographic risk assessment | 291 | ||
| Host risk assessment | 291 | ||
| Step 2: Counsel on Mosquito Avoidance Techniques | 292 | ||
| Step 3: Prescribe Chemoprophylaxis | 293 | ||
| Geographic considerations: new world versus old world | 293 | ||
| Chloroquine | 293 | ||
| Mefloquine | 295 | ||
| Atovaquone/proguanil | 296 | ||
| Doxycycline | 296 | ||
| Step 4: Educate on Warning Signs of Malaria | 296 | ||
| CLINICAL PRESENTATION: ALWAYS SUSPECT MALARIA IN AN ILL RETURNING TRAVELER | 297 | ||
| DIAGNOSIS | 298 | ||
| Smear | 298 | ||
| Rapid Diagnostic Tests | 299 | ||
| Species Difference: Clinical Considerations | 300 | ||
| TREATMENT | 300 | ||
| REFERENCES | 301 | ||
| Personal Protection Measures Against Mosquitoes, Ticks, and Other Arthropods | 303 | ||
| Key points | 303 | ||
| INTRODUCTION | 304 | ||
| DESTINATION AND VECTOR CONSIDERATIONS | 304 | ||
| TRAVELER CONSIDERATIONS | 305 | ||
| General Protective Measures | 305 | ||
| Traveler’s Diarrhea | 317 | ||
| Key points | 317 | ||
| INTRODUCTION | 317 | ||
| Definition, Incidence, and Risk Factors | 317 | ||
| Cause | 318 | ||
| Impact on the Traveler | 318 | ||
| PRETRAVEL PREPARATION | 318 | ||
| Prevention | 318 | ||
| Impact of food and water hygiene measures | 318 | ||
| Vaccines | 319 | ||
| Probiotics | 319 | ||
| Bismuth subsalicylate | 320 | ||
| Antibiotic chemoprophylaxis | 320 | ||
| Traveler-Initiated Symptomatic Treatment | 321 | ||
| Oral rehydration | 321 | ||
| Antidiarrheal medication | 321 | ||
| Early antibiotic self-treatment | 322 | ||
| When to seek medical care | 323 | ||
| SPECIAL POPULATIONS | 323 | ||
| Pregnant Women | 323 | ||
| Children | 324 | ||
| Immunocompromised Host | 324 | ||
| Comorbid Disease | 324 | ||
| POSTTRAVEL MANAGEMENT | 324 | ||
| Persistent Diarrhea After Travel | 324 | ||
| Evaluation | 325 | ||
| Postinfectious Sequelae | 325 | ||
| Postinfectious irritable bowel syndrome | 325 | ||
| Reactive arthritis | 326 | ||
| Guillain-Barré syndrome | 327 | ||
| SUMMARY | 327 | ||
| ACKNOWLEDGMENTS | 327 | ||
| REFERENCES | 327 | ||
| Road Traffic and Other Unintentional Injuries Among Travelers to Developing Countries | 331 | ||
| Key points | 331 | ||
| INTRODUCTION | 332 | ||
| ROAD TRAFFIC INJURIES | 333 | ||
| Epidemiology | 333 | ||
| Differences in Road Traffic Injuries Between High-income and Low- and Middle-income Countries | 333 | ||
| Road Safety in Low- and Middle-income Countries | 334 | ||
| Road Traffic Injury Risk Among Travelers | 334 | ||
| Pretravel Advice on Road Traffic Injuries | 335 | ||
| DROWNING | 336 | ||
| Epidemiology | 336 | ||
| Drowning Risk Among Travelers | 336 | ||
| Pretravel Advice on Drowning | 337 | ||
| OTHER UNINTENTIONAL CAUSES OF TRAVELER INJURY | 337 | ||
| OPPORTUNITY FOR ADVOCACY | 337 | ||
| REFERENCES | 340 | ||
| Wilderness Medicine | 345 | ||
| Key points | 345 | ||
| INTRODUCTION | 345 | ||
| PLANNING AND PREPARATION | 346 | ||
| Clothing | 346 | ||
| Medical Kit | 346 | ||
| Education and Training | 346 | ||
| PREVENTION | 347 | ||
| Waterborne Illness | 347 | ||
| Boiling | 347 | ||
| Halogens | 347 | ||
| Filtration | 347 | ||
| Ultraviolet radiation | 347 | ||
| Vector Control | 348 | ||
| Sunscreen | 348 | ||
| INJURY AND ILLNESS | 349 | ||
| Heat-Related Illness | 349 | ||
| Hypothermia | 350 | ||
| Allergic Reactions | 351 | ||
| Head Injuries | 351 | ||
| Spinal Injuries | 352 | ||
| Thoracic and Abdominal Injuries | 352 | ||
| Musculoskeletal Injuries | 353 | ||
| Fractures and sprains | 353 | ||
| Dislocations | 353 | ||
| Wounds | 354 | ||
| Burns | 354 | ||
| Blisters | 354 | ||
| EVACUATION | 355 | ||
| SUMMARY | 355 | ||
| REFERENCES | 355 | ||
| High-Altitude Medicine | 357 | ||
| Key points | 357 | ||
| INTRODUCTION | 357 | ||
| DEFINING “HIGH ALTITUDE” | 358 | ||
| THE ENVIRONMENT AT HIGH ALTITUDE | 358 | ||
| PHYSIOLOGIC RESPONSES TO HIGH ALTITUDE | 358 | ||
| ACUTE ALTITUDE ILLNESS | 358 | ||
| Acute Mountain Sickness and High-Altitude Cerebral Edema | 358 | ||
| Definitions and clinical features | 358 | ||
| Epidemiology and risk factors | 360 | ||
| Prevention | 360 | ||
| Treatment | 360 | ||
| High-Altitude Pulmonary Edema | 360 | ||
| Definition and clinical features | 360 | ||
| Epidemiology and risk factors | 362 | ||
| Prevention | 362 | ||
| Treatment | 363 | ||
| WHEN THE HIGH-ALTITUDE TRAVELER COMES TO CLINIC | 363 | ||
| The Altitude-Naïve Traveler | 363 | ||
| The Returning Traveler | 363 | ||
| The Potentially Risky Traveler | 364 | ||
| A framework for assessing risk | 364 | ||
| Question 1: Is the individual at risk for severe hypoxemia or impaired tissue oxygen delivery? | 365 | ||
| Question 2: Is the individual at risk for impaired ventilatory responses to hypoxia? | 365 | ||
| Question 3: Is the individual at risk from the expected pulmonary vascular responses to hypobaric hypoxia? | 365 | ||
| Question 4: Will environmental features of high altitude or the expected physiologic responses to hypobaric hypoxia worsen ... | 365 | ||
| Further evaluation | 365 | ||
| SUMMARY | 367 | ||
| REFERENCES | 367 | ||
| Adventure and Extreme Sports | 371 | ||
| Key points | 371 | ||
| INTRODUCTION | 371 | ||
| ALPINE SNOWBOARDING AND SKIING | 372 | ||
| Overall Epidemiology | 372 | ||
| Environment | 372 | ||
| Demographics | 372 | ||
| Injury | 372 | ||
| Ulnar collateral ligament injury in skiers | 374 | ||
| Upper extremity injuries in snowboarders | 374 | ||
| Anterior cruciate ligament injury | 374 | ||
| Fracture of the lateral process of the talus in snowboarders | 375 | ||
| Spinal injuries | 375 | ||
| Fatalities | 375 | ||
| Prevention | 375 | ||
| SKATEBOARDING | 376 | ||
| Overall Epidemiology | 376 | ||
| Environmental | 376 | ||
| Demographics | 376 | ||
| Injury | 377 | ||
| Head injury | 378 | ||
| Upper extremity injury | 378 | ||
| Lower extremity injury | 378 | ||
| Fatality | 379 | ||
| Prevention | 379 | ||
| SURFING | 379 | ||
| Overall Epidemiology | 379 | ||
| Demographics | 379 | ||
| Environment | 379 | ||
| Injury | 379 | ||
| Head injury | 380 | ||
| Ocular injury | 380 | ||
| Otologic injury | 380 | ||
| Extremity injury | 381 | ||
| Back injury and surfer’s myelopathy | 381 | ||
| Dermatopathology | 381 | ||
| Chronic injury | 382 | ||
| Prevention | 382 | ||
| BUNGEE JUMPING | 383 | ||
| Illness in the Returned International Traveler | 393 | ||
| Key points | 393 | ||
| INTRODUCTION | 393 | ||
| GASTROINTESTINAL DISORDERS IN THE RETURNING TRAVELER | 394 | ||
| Pathophysiology | 394 | ||
| Clinical Presentation | 394 | ||
| Patient History | 394 | ||
| Physical Examination | 394 | ||
| Diagnostic Testing | 394 | ||
| Management Goals | 395 | ||
| Self-management Strategies | 395 | ||
| Pharmacologic Strategies | 395 | ||
| FEVER | 400 | ||
| Work-up | 403 | ||
| DERMATOSES | 403 | ||
| Cutaneous Larva Migrans | 403 | ||
| Localized Cutaneous Leishmaniasis | 407 | ||
| Myiasis | 407 | ||
| OTHER CAUSES OF ILLNESS IN RETURNED INTERNATIONAL TRAVELERS | 408 | ||
| REFERENCES | 408 | ||
| Travel and Adventure Medicine Resources | 411 | ||
| Key points | 411 | ||
| PROFESSIONAL ASSOCIATIONS AND SOCIETIES | 411 | ||
| CONTINUING MEDICAL EDUCATION COURSES | 412 | ||
| ONLINE COURSES | 412 | ||
| PRINTED MANUALS AND TEXTBOOKS | 413 | ||
| COURSES IN TROPICAL MEDICINE | 413 | ||
| FELLOWSHIPS | 414 | ||
| E-MAIL LISTSERVS | 414 | ||
| CERTIFICATES OF EXPERTISE | 414 | ||
| INFORMATION ON CRIME, SECURITY, TERRORISM | 415 | ||
| SUBSCRIPTION SERVICE | 415 | ||
| APPLICATIONS | 415 | ||
| REFERENCES | 415 | ||
| Index | 417 |