title: Faculty of Prehospital Care, Royal College of Surgeons Edinburgh guidance for medical provision for wilderness medicine.
abstract: To support leaders and those involved in providing medical care on expeditions in wilderness environments, the Faculty of Pre-Hospital Care (FPHC) of The Royal College of Surgeons of Edinburgh convened an expert panel of leading healthcare professionals and expedition providers. The aims of this panel were to: (1) provide guidance to ensure the best possible medical care for patients within the geographical, logistical and human factor constraints of an expedition environment. (2) Give aspiring and established expedition medics a 'benchmark' of skills they should meet. (3) Facilitate expedition organisers in selecting the most appropriate medical cover and provider for their planned activity. A system of medical planning is suggested to enable expedition leaders to identify the potential medical risks and their mitigation. It was recognised that the scope of practice for wilderness medicine covers elements of primary healthcare, pre-hospital emergency medicine and preventative medicine. Some unique competencies were also identified. Further to this, the panel recommends the use of a matrix and advisory expedition medic competencies relating to the remoteness and medical threat of the expedition. This advice is aimed at all levels of expedition medic, leader and organiser who may be responsible for delivering or managing the delivery of remote medical care for participants. The expedition medic should be someone equipped with the appropriate medical competencies, scope of practice and capabilities in the expedition environment and need not necessarily be a qualified doctor. In addition to providing guidance regarding the clinical competencies required of the expedition medic, the document provides generic guidance and signposting to the more pertinent aspects of the role of expedition medic.
authors.affiliation: Academic Department of Military Anaesthesia and Critical Care, RCDM, Birmingham, UK ; Cardiothoracic Anaesthesia, James Cook University Hospital, Middlesbrough, TS4 3BW UK ; Carnegie Institute for Sport and Human Performance, Leeds Beckett University, Leeds, UK.
authors.forename: Adrian
authors.initials: A
authors.lastname: Mellor
authors.affiliation: Academic Critical Care Foundation Doctor, Aberdeen Royal Infirmary, Aberdeen, UK.
authors.forename: Naomi
authors.initials: N
authors.lastname: Dodds
authors.affiliation: Centre for Health and Human Performance, London, UK ; Summerfield Urgent Care Centre, Birmingham, UK.
authors.forename: Raj
authors.initials: R
authors.lastname: Joshi
authors.affiliation: Department of Emergency Care, University of Birmingham, Birmingham, UK ; Faculty of Pre Hospital Care, Royal College of Surgeons of Edinburgh, Edinburgh, UK.
authors.forename: John
authors.initials: J
authors.lastname: Hall
authors.affiliation: The Centre for Altitude Space and Extreme Environment Medicine (CASE Medicine), Institute for Sport, Exercise and Health (ISEH), London, UK ; Medical Cell, The Royal Geographical Society, 1 Kensington Gore, London, UK.
authors.forename: Sundeep
authors.initials: S
authors.lastname: Dhillon
authors.affiliation: Primary Care and Occupational Medicine, Ministry of Defence, London, UK ; Ultimate Travel Company, London, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Hollis
authors.affiliation: Department of Emergency Medicine, Defence Medical Services, Whittington, UK ; Department of Emergency Medicine, Queen Elizabeth University Hospital and Emergency Medical Retrieval Service, Glasgow, UK.
authors.forename: Pete
authors.initials: P
authors.lastname: Davis
authors.affiliation: UIAA Medcom, Manchester, UK ; British Mountaineering Council, Manchester, UK.
authors.forename: David
authors.initials: D
authors.lastname: Hillebrandt
authors.affiliation: Queen Elizabeth Hospital, Birmingham, UK.
authors.forename: Eva
authors.initials: E
authors.lastname: Howard
authors.affiliation: Adventure Medic Ltd, Edinburgh, UK ; Royal Infirmary of Edinburgh, Edinburgh, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Wilkes
authors.affiliation: Adventure Medic, Edinburgh, UK ; Expedition and Wilderness Medicine, Devon, UK.
authors.forename: Burjor
authors.initials: B
authors.lastname: Langdana
authors.affiliation: Gloucestershire, UK.
authors.forename: David
authors.initials: D
authors.lastname: Lee
authors.affiliation: Gloucestershire, UK.
authors.forename: Nigel
authors.initials: N
authors.lastname: Hinson
authors.affiliation: Gloucestershire, UK.
authors.forename: Thomas Harcourt
authors.initials: TH
authors.lastname: Williams
authors.affiliation: Gloucestershire, UK.
authors.forename: Joe
authors.initials: J
authors.lastname: Rowles
authors.affiliation: Department of Emergency Medicine, Defence Medical Services, Whittington, UK ; Department of Emergency Medicine, University Hospitals Bristol, Bristol, UK ; Great Western Air Ambulance, Bristol, UK ; Wilderness Medical Training, Kendal, UK.
authors.forename: Harvey
authors.initials: H
authors.lastname: Pynn
keywords: Austere environment; Expedition; Medical planning; Risk assessment; Wilderness medicine