The CAWM2021 Virtual Conference was held November 5-7, 2021. Over the course of the weekend, participants heard 35 presentations from 44 speakers. All the speakers have a strong connection to Canada, and each presentation considered Wilderness Medicine in the Canadian context.
17:00 - 17:15 MDT - Welcome
17:15 - 17:45 MDT - The Sea Bear: Human - Polar Bear Conflict in the Circumpolar NorthDr. Katherine Breen
17:45 - 18:45 MDT - CMERT (Canadian Medical Emergency Response Team)Dr. Andrew McLaren
18:45 - 19:00 MDT - Canadian Wilderness Medicine Electives: the Present and the FutureDr. Andrew Belyea
19:00 - 19:15 MDT - 15 Minute Break
19:15 - 20:00 MDT - Bugs with Bugs: Overview of Vector-borne Infectious DiseasesDr. Yoko Schreiber
20:00 - 20:45 MDT - High Altitude Rescue in Kluane National ParkSteve Holeczi, Aaron Beardmore, Dr. Kyle McLaughlin
07:30 - 08:15 MDT - Yoga
08:15 - 08:30 MDT - Introduction
08:30 - 09:30 MDT - Strategies for Effective Scientific WritingDr. Neal Pollock
09:30-10:00 MDT - Upping your Gain: An Intro to MSK Ultrasound for an Austere EnvironmentDr. Robyn Rodger
One need not go far into the Twitter-verse to find the ED physician wielding ultrasound memes and the reputation is probably justified by the profession’s near-universal enthusiasm for the modality. Alongside emergency department staff, wilderness medicine experts and amateurs alike have embraced many a POCUS function. On review of the literature however, there is a paucity of data involving the application of MSK ultrasound to wilderness medicine scenarios.
This presentation will be case-based and provide an introduction to which injuries are amenable to point-of-care ultrasound. Some pathology containing images will be included to illustrate the simplicity of many MSK ultrasound functions. The content will be at a level accessible to all medical learners, including non-physicians. The intent is that after this presentation participants will consider MSK ultrasound a possible wilderness medicine adjunct.
10:00 - 10:30 MDT - Difficult Airway Techniques in a Rural/Remote ContextMike Webster, Drew Crandall
10:30 - 10:45 MDT - 15 Minute Break
10:45 - 11:15 MDT - Exploring Evidence-Based Recovery Principles in Rock Climbing InjuriesWilliam Bateman
11:15 - 12:15 MDT - Considerations for Medical Equipment in Extreme EnvironmentsDr. Steve Roy
12:15 - 13:00 MDT - Mid-Day 45 Minute Break
13:00 - 13:15 MDT - Tick Talk: A Primer to Emerging Tick-Borne Diseases in CanadaDr. Andrew McNaughton
13:15 - 13:30 MDT - Pre-Hospital Rescue and Management of the Drowning PatientKatie Gourlay
13:30 - 13:45 MDT - Mountain Injuries: The Mental Side of RecoveryDr. Elizabeth Cook
For those of us who spend our lives in the mountains, injuries often come with the territory. As wilderness medical professionals we discuss physical injuries at length, understanding injury mechanisms, extrication methods and treatment techniques for both recreational and professional practice. However, the mental side of such injuries is rarely discussed. After the patient is off the mountain, the journey has only just begun. Often that journey involves ongoing pain, a lengthy rehabilitation period and time away from mountain sport, as well as the mental distress that comes with it. Both professional and weekend warrior athletes are at risk for developing post-injury mental distress and illness, which can exacerbate suffering, affect rehabilitation engagement and ultimately return to sport. If we understand that grief process of sport injury and normalize the mental health impacts, we as mountain medical professionals can properly support our patients, friends, colleagues and ourselves going through sport injuries.
In this short presentation, I will discuss some of the statistics and research in the field of sport injury psychology in terms of normalizing the grief process that follows injury. I will discuss the recognition of when normal grief begins to affect an athlete’s ability to rehabilitate and practical ways to assist an athlete in transitioning mental distress into strength and goal orientated focus.
13:45 - 14:00 MDT - Frostbite Care in Canada: The Need for a National Quality Improvement NetworkLauren Klammer, Dr. Delphine Hansen, Sebastien Hebert
This presentation will give CAWM participants a snapshot of the current state of frostbite care in Canada and an understanding of existing gaps in Canadian knowledge, leading to research opportunities and increased pan-Canadian collaboration.
Frostbite care across Canada is inconsistent, and there is presently little information on best practices for treatment and patient outcomes. Based on a scoping review of the most up-to-date literature, this presentation will make the case for improved pan-Canadian collaboration in frostbite care through the formation of a national frostbite protocol. Using brief comparative vignettes we will highlight common presentations of frostbite in Canada and discuss current medical and surgical management options. The efficacy of care protocols and pre-printed order sets, as well as the use of iloprost as a pharmaceutical agent for severe frostbite will be reviewed. This presentation will conclude with a discussion of work that is currently underway to create a national frostbite protocol and community of practice, which aims to address the needs in frostbite care discussed throughout the presentation.
14:00 - 14:30 MDT - A Framework for Matching Risk Messages with User Processes - Lessons From Avalanche Risk CommunicationAnne St. Clair
14:30 - 15:00 MDT - The Last Antarctica Marathon - Ship, to Shore, to Finish LineDr. Paul Dhillon
15:00 - 15:15 MDT - 15 Minute Break
15:15 - 15:30 MDT - What Comes Out Must Go In – The Effectiveness of Training Ski Patrollers to Reduce Shoulder Dislocations in an Alpine EnvironmentDr. Ira Carson
15:30 - 16:00 MDT - Hypothermia: Lessons from the Patient Who Didn’t Follow the TextbookDr. Alana Hawley
16:00 - 16:30 MDT - Risk of Death and Major Injury from Natural Hazards in Mechanized Backcountry Skiing in CanadaDr. Pascal Haegeli
16:30 - 17:30 MDT - Keynote Presentation: Mountains of RiskWill Gadd
07:30 - 08:15 MST - Morning Coffee Social or Zwift Bike Ride (Sign up for a free one-week Zwift trial!)
08:15 - 08:30 MST - Introduction
08:30 - 09:15 MST - Strengthening Canadian Frostbite Care - Initial Results of the Canadian Frostbite Collaborative Project and Future DirectionsDr. Cait Champion, Dr. Alex Poole, Josianne Gauthier
The Canadian Frostbite Collaborative project is aimed at understanding the frostbite patient care needs and current practices in Canada to inform national quality improvement in frostbite care. This session will review preliminary research findings, facilitate discussion, and invite future participation in the development of a Canadian Frostbite Care Network in collaboration with the Canadian Association of Wilderness Medicine.
Scientific principles of frostbite pathophysiology and treatment in a Canadian context will be reviewed. Initial results from a national frostbite care survey identifying and describing frostbite care practices and protocol implementation in Canada will be presented. Participants will be invited to discuss the challenges and opportunities of implementing frostbite care best practices in rural and urban Canadian centres. Opportunities for participation in the development of a Canadian Frostbite Care Network to facilitate future quality improvement and research in frostbite care will be identified and discussed.
09:15 - 09:45 MST - Women in the WildernessDr. Robyn Johnston
09:45 - 10:15 MST - Empowering the Willing: The Feasibility of Tele-Mentored Self-Performed Ultrasound as Illustrated by Pleural Ultrasound Assessment for COVID-19 and Further Implications for Self-CareDr. Andrew W. Kirkpatrick
10:15 - 10:30 MST - 15 Minute Break
10:30 - 11:00 MST - Injuries in Rock ClimbingDr. Volker Schöffl
11:00 - 11:30 MST - AvSORT II: Multi-Casualty Avalanche Triage AlgorithmDr. Mike Inniss
11:30 - 11:45 MST - Improvised Medical Devices (mini-workshop)Mack Wardle
11:45 - 12:00 MST - Update on CAWM
12:00 - 12:45 MST - Mid-Day 45 Minute Break
12:45 - 13:00 MST - A Bite-Sized DilemmaDr. Kendra Young
13:00 - 13:15 MST - Managing Diabetes in the BackcountryAsha Kothari
Managing blood glucose is challenging at best when in controlled environments. During extended periods of physical exertion with altered caloric intake, maintaining strict serum glucose levels becomes significantly more difficult. For tens of millions of North Americans, diabetes management during intense or prolonged physical exercise is a complicated endeavour.
This presentation will focus on diabetes management in athletes, particularly during times of extended exertion in austere environments. It will begin with an overview of the physiology of glucose management during exercise, contrasting the differences between aerobic, anaerobic, and prolonged periods of exertion, highlighting the abnormalities present in individuals with diabetes. Building on this, the presentation will describe the effects of austere environmental conditions on the body’s ability to manage serum glucose, with a focus on extreme temperatures and altitudes (for example, identifying and managing hypoglycemia in the context of hypothermia and acute mountain sickness).
The remainder of the presentation will focus on how to anticipate and implement medication and glucose intake adjustments during wilderness excursions - emphasizing the importance of preparation with respect to insulin and glucose monitoring equipment. The information provided in this presentation will be particularly relevant to medical professionals who counsel patients with diabetes prior to wilderness excursions and to wilderness guides who may be directly involved in the treatment of diabetic emergencies in the backcountry.
13:15 - 13:30 MST - Drowning, Immersion, and Submersion injury: Managing the Life AquaticDr. Stefan Cowtan
13:30 - 13:45 MST - Travel Planning Considerations: MalariaDr. Helene Morakis
13:45 - 14:30 MST - Search and Rescue Medicine: Lessons Learned Practicing Medicine With a Helmet OnDr. Alec Ritchie
Follow an emergency physician as he goes on a mid-life journey from his career practising in-hospital emergency medicine to volunteer work in a challenging search and rescue environment, and the lessons he learned along the way to aid in this transition.
This presentation will provide an introduction to North Shore Rescue (NSR), one of Canada’s busiest search and rescue teams. Data from 25 years of NSR medical calls will be reviewed, as well as a discussion of how NSR currently manages medical calls. The use of three paradigms for an organized approach to SAR medical calls will be considered, and the utility of these paradigms will be demonstrated by applying them to several real calls. The presentation will thus be a combination of SAR medical facts and data, an organizational framework for SAR medical practice, and real life examples of SAR medical calls, using photographs from the actual calls and clinical information regarding the actual patient outcomes to enrich the stories told.
14:30 - 14:45 MST - Landslides: Considerations for the Medical First ResponderStuart Grant, Dr. Dirk Chisholm
If I were to ask a medical first responder what they would anticipate after a pedestrian versus car collision, or a diving board accident, how quickly would they be able to describe the likely mechanism of injury and potential injuries? Would you expect the same ability if I asked about responding to a suburb struck by a landslide?
Landslides occur frequently and commonly throughout the world everyday, many of which have zero impact on human life. However, landslides can become catastrophic events if they occur on the wilderness/human interface. As wilderness medical enthusiasts, this interface is our home, workplace and playground. This presentation introduces the basics of landslide 'anatomy' and develops the geological phenomenon into a medical mechanism of injury. Using publically available case studies, post-mortem reports and resources, the presentation aims to introduce the medical first responder to landslides and how to prepare for the care of treatment of landslide victims. Originally developed for medical specialists within a heavy urban search and rescue (HUSAR) team, the information may be equally valuable for wilderness medical professionals.
14:45 - 15:00 MST - 15 Minute Break
15:00 - 15:15 MST - Call of the Wild: Assessing a Wilderness Medicine Pre-Clerkship Elective for Medical Students in Alberta, CanadaGeordon Omand, Katie Gourlay, Michael Zeeman
15:15 - 15:45 MST - Anesthesia Delivery at AltitudeDr. Matthew Turnock
15:45 - 16:45 MST - Jasper National Park Icefield Bus Crash: a Wilderness Mass Casualty Incident (MCI) in the Canadian ContextDr. Brett Shaw, Mackenzie Wardle, Aaron Beardmore
16:45 - 17:00 - Closing Remarks and Thanks