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1.
Wilderness Environ Med ; 35(1_suppl): 112S-127S, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38425235

RESUMEN

The Wilderness Medical Society (WMS) convened an expert panel in 2011 to develop a set of evidence-based guidelines for the recognition, prevention, and treatment of heat illness. The current panel retained 5 original members and welcomed 2 new members, all of whom collaborated remotely to provide an updated review of the classifications, pathophysiology, evidence-based guidelines for planning and preventive measures, and recommendations for field- and hospital-based therapeutic management of heat illness. These recommendations are graded based on the quality of supporting evidence and the balance between the benefits and risks or burdens for each modality. This is an updated version of the WMS clinical practice guidelines for the prevention and treatment of heat illness published in Wilderness & Environmental Medicine. 2019;30(4):S33-S46.


Asunto(s)
Trastornos de Estrés por Calor , Medicina Silvestre , Humanos , Medicina Ambiental , Trastornos de Estrés por Calor/prevención & control , Sociedades Médicas
2.
Wilderness Environ Med ; 30(4S): S33-S46, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31221601

RESUMEN

The Wilderness Medical Society convened an expert panel in 2011 to develop a set of evidence-based guidelines for the recognition, prevention, and treatment of heat illness. We present a review of the classifications, pathophysiology, and evidence-based guidelines for planning and preventive measures, as well as best practice recommendations for both field- and hospital-based therapeutic management of heat illness. These recommendations are graded based on the quality of supporting evidence and balance the benefits and risks or burdens for each modality. This is an updated version of the original Wilderness Medical Society Practice Guidelines for the Treatment and Prevention of Heat-Related Illness published in 2013.


Asunto(s)
Trastornos de Estrés por Calor/prevención & control , Pautas de la Práctica en Medicina , Medicina Silvestre/normas , Trastornos de Estrés por Calor/clasificación , Trastornos de Estrés por Calor/fisiopatología , Trastornos de Estrés por Calor/terapia , Humanos , Sociedades Médicas , Medicina Silvestre/métodos
3.
Wilderness Environ Med ; 25(4 Suppl): S55-65, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25498263

RESUMEN

The Wilderness Medical Society (WMS) convened an expert panel to develop a set of evidence-based guidelines for the recognition, prevention, and treatment of heat illness. We present a review of the classifications, pathophysiology, and evidence-based guidelines for planning and preventive measures as well as best practice recommendations for both field and hospital-based therapeutic management of heat illness. These recommendations are graded on the basis of the quality of supporting evidence, and balance between the benefits and risks or burdens for each modality. This is an updated version of the original WMS Practice Guidelines for the Prevention and Treatment of Heat-Related Illness published in Wilderness & Environmental Medicine 2013;24(4):351-361.


Asunto(s)
Trastornos de Estrés por Calor/prevención & control , Pautas de la Práctica en Medicina , Medicina Silvestre/métodos , Trastornos de Estrés por Calor/clasificación , Trastornos de Estrés por Calor/fisiopatología , Trastornos de Estrés por Calor/terapia , Humanos , Sociedades Médicas , Medicina Silvestre/normas
6.
Wilderness Environ Med ; 24(4): 351-61, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24140191

RESUMEN

The Wilderness Medical Society (WMS) convened an expert panel to develop a set of evidence-based guidelines for the recognition, prevention, and treatment of heat-related illness. We present a review of the classifications, pathophysiology, and evidence-based guidelines for planning and preventive measures as well as best-practice recommendations for both field- and hospital-based therapeutic management of heat-related illness. These recommendations are graded based on the quality of supporting evidence and the balance between the benefits and risks or burdens for each modality.


Asunto(s)
Trastornos de Estrés por Calor/etiología , Trastornos de Estrés por Calor/prevención & control , Medicina Silvestre/métodos , Trastornos de Estrés por Calor/clasificación , Trastornos de Estrés por Calor/fisiopatología , Estados Unidos
7.
Clin Chem ; 49(3): 357-79, 2003 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-12600948

RESUMEN

BACKGROUND: Exposure to drugs and toxins is a major cause for patients' visits to the emergency department (ED). METHODS: Recommendations for the use of clinical laboratory tests were prepared by an expert panel of analytical toxicologists and ED physicians specializing in clinical toxicology. These recommendations were posted on the world wide web and presented in open forum at several clinical chemistry and clinical toxicology meetings. RESULTS: A menu of important stat serum and urine toxicology tests was prepared for clinical laboratories who provide clinical toxicology services. For drugs-of-abuse intoxication, most ED physicians do not rely on results of urine drug testing for emergent management decisions. This is in part because immunoassays, although rapid, have limitations in sensitivity and specificity and chromatographic assays, which are more definitive, are more labor-intensive. Ethyl alcohol is widely tested in the ED, and breath testing is a convenient procedure. Determinations made within the ED, however, require oversight by the clinical laboratory. Testing for toxic alcohols is needed, but rapid commercial assays are not available. The laboratory must provide stat assays for acetaminophen, salicylates, co-oximetry, cholinesterase, iron, and some therapeutic drugs, such as lithium and digoxin. Exposure to other heavy metals requires laboratory support for specimen collection but not for emergent testing. CONCLUSIONS: Improvements are needed for immunoassays, particularly for amphetamines, benzodiazepines, opioids, and tricyclic antidepressants. Assays for new drugs of abuse must also be developed to meet changing abuse patterns. As no clinical laboratory can provide services to meet all needs, the National Academy of Clinical Biochemistry Committee recommends establishment of regional centers for specialized toxicology testing.


Asunto(s)
Técnicas de Laboratorio Clínico , Servicio de Urgencia en Hospital , Intoxicación/diagnóstico , Antidepresivos Tricíclicos/envenenamiento , Pruebas Respiratorias , Etanol/envenenamiento , Humanos , Inmunoensayo , Centros de Control de Intoxicaciones/organización & administración , Intoxicación/sangre , Intoxicación/orina , Detección de Abuso de Sustancias/métodos , Toxicología/métodos
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