Preparing medical personnel for expeditions
Dr Peter A. Leggat
MD, PhD, DrPH, FAFPHM, FACTM, FACRRM Anton Breinl Centre for Public Health and Tropical Medicine James Cook University Townsville Australia
About the author
Dr Peter Leggat has co-ordinated the Australian postgraduate course in travel medicine since 1993. He has also been on the faculty of the South African travel medicine course, conducted since 2000, and the Worldwise New Zealand Travel Health update programs since 1998. Dr Leggat has assisted in the development of travel medicine programs in several countries and also the Certificate of Knowledge examination for the International Society of Travel Medicine.
Objectives
In this session we will look at: What are the types of expeditions? Why be part of an expedition? Need for expedition medical personnel What will you do? What training is needed? Are there any issues to consider? How do I find an expedition? Further resources
What are the types of expeditions?
Professional expeditions:
– conservation, educational, scientific or adventure
Commercial travel and premium expeditions Sporting/recreational/charity expeditions School/university/cadet/defence expeditions
Why be part of an expedition?
Inexpensive or free travel Ability to visit remote or unusual areas Life experience/discovery/be famous! Development of medical skills and experience
Expeditions force your own life into sharper focus by presenting a contrast with the rest of the world. Expedition medicine offers the rewards of overcoming unexpected challenges in the face of bizarre adversities…..
Source: Student BMJ 2000;8: 279
Need for expedition medical personnel?
Remote from medical care Legislative/legal/safety requirement Nature of participants/selling feature Risk of injury/illness
What will you do?
Training and development of skills Risk assessment Travel health plan for participants Medical planning/stores/equipment Assessment and management of medical problems on expedition Medical debriefing/post-travel health plan
What training is needed?
Usually doctor, nurse or paramedic
Broad general training:
– General/rural practice, accident and emergency, infectious diseases
Travel and tropical medicine:
– General risks of travel, destination related issues, tropical diseases
Activity dependent:
– Altitude, diving, aviation, boating, camping, aid to the population – Remoteness may demand surgical, anaesthetic & dental experience
• eg Australian Antarctic Division, Some cruise expeditions
Participant dependent:
– Children, older persons, disabled persons
Are there any issues to consider?
Length of trip Lost holidays, salary and goodwill Risk of a serious incident in remote area Risk of litigation
Are there any issues to consider?
Need to be able to deal with worst case scenario
Need to be familiar with common problems associated with expeditions
Needs to be able to undertake multiple tasks
What is my liability?
Employer may have some responsibility? Depends on contract and whether indemnified Discuss with medical defence or insurance organisation
How do I find an expedition?
Register with major expeditionary organisations, eg:
– Royal Geographical Society, Australian Antarctic Division, Raleigh International (British based charity)
Commercial/travel/cruise expeditions
Volunteer/school/university/cadet/adventure training groups, military
Resources
Expedition Medicine (2004).
– Warrell & Anderson, Royal Geographical Society
Ch. 15. Altitude and Expedition Medicine (2001)
– Murdoch, Pollard & Gibbs. In Zuckerman J (Ed) Principles and Practice of Travel Medicine. Wiley.
The Medical preparation of expeditions: the role of the medical officer (2005).
– Shaw & Dallimore. Travel Med Inf Dis 2005;3:213-23
Expedition, wilderness and travel medicine courses, eg
– http://www.wildernessmedicaltraining.co.uk/about.htm (accessed 5 April 2006)