Banff Wilderness Care Conference

Dr. Cait Champion, Dr. Alex Poole and Josianne Gauthier are kicking off Day 3 of #CAWM2021 on Nov 7th at 8:30 MST with their talk "Strengthening Canadian Frostb...ite Care - Initial Results of the Canadian Frostbite Collaborative Project and Future Directions". 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. Dr. Champion is a rural General Surgeon in Parry Sound, ON and Assistant Professor at the Northern Ontario School of Medicine. She has an MSc in Health Systems with a focus on rural care access and is a strong believer in improving patient care through collaborative networks. She has an interest in wilderness medicine and is engaged in collaborative frostbite care research. Dr. Poole is a rural and remote multidisciplinary general surgeon. He has practiced general surgery in the Yukon for 19 years. His interest in mountain medicine and frostbite in particular has been fostered by having lived and worked in the Yukon, British Columbia, and Iceland. He has been on a mission to modernize Canadian frostbite care since 2015. And Josianne Gauthier (BPharm, MSc Pharm) is a Clinical Pharmacist at Whitehorse General Hospital in the Yukon Territory since 2010. She was instrumental in the development and implementation of the WGH Frostbite Protocol and its subsequent iterations. She has contributed to recent publications and has presented in both local and international conference on the topic of frostbite. She is well-known in the Canadian hospital-pharmacy community for her expertise in the pharmacological management of frostbite and the use of iloprost. She spends her free time trail running, skiing and canoeing in the Yukon wilderness with her partner and two young daughters. For more info head to the conference website www.cawm.ca/cawm-2021/. Register today! #CME #FAWM #frostbite #virtualconference #Yukon

Marc was a big supporter of the Banff Wikderness Care Conference. Thank you sir for that.

Following coverage in the press, we have had a number of requests to comment on the benefits of using the What Three Words (W3W) app to report location in the... event of a backcountry emergency. In short we do not advocate its use. To be clear, if that is the way an emergency location is reported, we will respond to it like we would any other, but the app has no meaningful benefits, and a number of shortcomings, relative to simpler traditional means. If you wish to know more about this please read on. The majority of backcountry emergencies in our area occur outside of cell service. As such, a satellite communication device and/or a trip plan remain the gold standard for summoning an emergency response. W3W does not help outside of cell range. For those emergencies that actually occur within cell range we have a number of solutions that work incredibly well:- (1) The reporting party states the latitude and longitude on their phone’s compass or location page; and/or (2) Screenshot and send the information in (1); and/or (3) Use of the Trailforks app to share location using the Emergency Info button; and/or (4) Obtain a ‘ping’ of a cellphone’s location from the cell provider; and/or (5) SAR send the cellphone a special link via text that when pressed shares your location with us. The last one is especially useful it will work using a minimal amount of battery power, and will work when people are on the fringes of cell coverage, when only an intermittent signal is available. No app, download, or other action is required on your part. So what is the What Three Words (W3W) app? W3W is a location system that has split the entire planet into 3 metre by 3 metre grids, each one assigned a unique name made out of three random words. You download the W3W app and the app then uses your phone’s geo-locator to tell you what grid you are in. In an emergency you can report that grid name to 911 (assuming you have good enough cell service and battery life to speak). As such, the location information has the same accuracy as your compass, Trailforks or map app, it is simply where your phone thinks you are, but that is generally pretty good. The benefit claimed is that it avoids confusion between different longitude and latitude formats. So why are we not so keen on it? For a number of reasons:- (1) Some of the recent articles give the impression that this app has value beyond cell range it does not. A cell signal is required to report the location; (2) Most people do not have this app, so will waste precious battery life and time downloading it if asked to by 911; (3) Latitude and longitude is the language of Search and Rescue SAR, helicopter pilots, SPOT and InReach devices all work on this standard if a lat/long is acquired via any of the methods described above, SAR responders will make sure the format is correct. If it is acquired as a W3W location it will need converting to lat/long another opportunity for error; (4) The biggest problem is that the three words are random and bear no correlation from grid to grid. So if you report dog.pig.ant as your location, and it is written as dog.pig.ants that location could be on the opposite side of the planet. A lat and long that is transcribed wrongly is almost always decipherable. Have we had experience of this app in live rescues? Yes, we have, and for an injured mountain biker on a trail above Fernie we were given a location that corresponded to a location in the Northern Territories of Australia. This was because just one of the words was transcribed in the singular rather than the plural by the dispatcher. In another we had a subject waste time trying to download the app in spotty cell coverage and fail to get it to work, when a simple Trailforks share established an exact location. Fernie SAR is not alone in BC as reporting issues with this app wasting SAR resources and delaying responses. In conclusion, SAR will work with whatever we are given, including W3W, but this app will potentially slow down the response. For backcountry travel satellite communicators and/or a solid trip plan continue to be the most important tools in emergency situations. If you happen to be in cell range there are many options, and W3W would be at the bottom of the list. #searchandrescue

Join us at #CAWM2021 on Nov 6th at 13:45 MST for our next talk "Frostbite Care in Canada: The Need for a National Quality Improvement Network" presented by Laur...en Klammer, Dr. Delphine Hansen and 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. This is incredibly exciting and truly reflects one of CAWM's main missions to advance the care of wilderness medicine across Canada. Be sure to check it out! More info about the three all-stars responsible for this presentation: Lauren Klammer is a third year medical student at the University of Saskatchewan Regina campus. Prior to medicine she obtained a MPA from Queen’s University and held positions in the Office of the Prime Minister, Office of the Minister of State (Finance), and Yukon Management Board Secretariat. Lauren’s professional interests include rural generalism, wilderness medicine, and technology in medicine. Her hobbies include hiking, rock climbing, cross country skiing, and indoor vegetable gardening. Delphine Hansen is originally from Montreal, Quebec, where she earned her medical degree from McGill University. An ocean guard as a teenager, a cross-country Varsity athlete during her collegiate years and an enthusiastic hiker, Delphine always enjoyed the outdoors and being in the wilderness. Delphine is currently completing her Emergency Medicine residency at Université de Montreal. Her professional interests include wilderness medicine, knowledge translation and medical education. And finally, Sebastien Hebert is currently a second-year medical student at Dalhousie Medical School, in Halifax, Nova Scotia. Prior to medical school, he attended the Royal Military College of Canada where he obtained a Bachelor of Arts and commission as a naval officer. He then served in the Royal Canadian Navy as a Naval Warfare Officer and as a Submarine Officer. His service includes 3 operational deployments. After the Navy, he obtained his Primary Care Paramedic certificate in Halifax. Where he worked until starting Medical School. Sebastien is an avid diver, rock climber, and cyclist. For more info and to register - www.cawm.ca/cawm-2021. #frostbite #FAWM #CME #VirtualConference #wildmed

CAWM virtual conference registration now open.