Preparing medical personnel for expeditions

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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

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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.

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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

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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

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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

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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 20008 279
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Need for expedition medical personnel?

• Remote from medical care
• Legislative/legal/safety requirement
• Nature of participants/selling feature
• Risk of injury/illness

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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

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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

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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

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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

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What is my liability?

• Employer may have some responsibility?
• Depends on contract and whether indemnified
• Discuss with medical defence or insurance
  organisation

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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

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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
  20053213-23
• Expedition, wilderness and travel medicine
  courses, eg
• http//www.wildernessmedicaltraining.co.uk/about.h
  tm (accessed 5 April 2006)