Preparing medical personnel for expeditions

Dr Peter A. LeggatMD, 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 personnelWhat 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

Source: Student BMJ 2000;8: 279

Expeditions force your own life into sharper focus by presenting a contrast with the rest of the world.

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…..

Expedition medicine offers the rewards of overcoming unexpected challenges in the face of bizarre adversities…..

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)