“Nosebleed” versus “recalcitrant epistaxis with severe symptomatic hemorrhagic blood loss anemia requiring blood transfusion”

What’s in a name? Everything.

In the pre pandemic times several of us were at the Marine Safety Detachment Coast Guard base in Unalaska, out in The Aleutian Islands, watching Monday Night Football. The flight crew was out in the office completing paperwork from a rescue mission they had flown the night before. Their medical kit had been out on the Cutter out at sea so we had loaned them the supplies they thought they might need before they left. I heard a sigh from out in the office…

“Does anyone have another word for nosebleed?”

Everyone chuckled. “Why do…


Summits and Superstition

Aconcagua is generally regarded as the mountain with the highest death rate of any mountain in South America — around three per year average. It has the nickname, “Mountain of Death” for some people — which probably would have stopped me from climbing it truthfully had I known that. I take measured risks in my adventuring but I do not have a death wish and, after recovering from a broken back and four surgeries, I don’t like to be injured. Only about half of the people who attempt to summit Aconcagua will succeed and many of those…


HOCUS POCUS — the Magic of Point of Care Ultrasound in Remote and Rural Medicine. Just get one already.

Rogers et all wrote in their 2016 article “Barriers to point-of-care ultrasound use in rural emergency departments” that there are numerous barriers to normalization of the use of POCUS (Point of Care UltraSound) in the field and in remote/rural emergency medicine. Some of the barriers include difficulty maintaining skills, slow uptake/evolution, lack of equipment, funding, quality assurance etc. Over the last 20 years POCUS has come to play a role in larger emergency medicine centers. Most residencies offer ultrasound electives. Some…


A Tribute to the Unalaska Fire and EMS Department

The past 15 months in Unalaska/Dutch Harbor have been unprecedented in my 25 year (what!?!) career in EMS, SAR (Search and Rescue), and Emergency Medicine. Never before have I seen a mostly volunteer emergency response department respond to so many unusual — and personal — tragedies. The resilience and dedication of the Unalaska Fire and EMS staff is unparalleled. They did almost all of this without a Fire or EMS chief. Each of them stepping up to fulfill parts of leadership roles and were largely self-governed. They did not have a…


The Orange Light in the Sky: Collaborative Medevacs and Active Volcanos in The Aleutian Islands

“What is that orange light in the sky?” I asked the crew from the back of a United States Coast Guard (USCG) helicopter. I am not enlisted in the CG so how did I come to be riding in the back of one with a critical patient?

To answer that we must go back a little farther.

“What do you do for a living?” I get asked by literally everyone I meet. That is just what we ask each other right? Maybe it tells us…


Birth and Death in The Wilderness— What a Week

Birth and Death in The Wilderness — The Inevitable Circle of Life

The call came through over the radio and woke me from a near comatose sleep in my efficiency apartment above an after-hours, somewhat make-shift emergency room on a remote island in The Bering Sea. “There is a woman on her way to the clinic in labor” the dispatcher sounded as surprised as me. I am a very deep sleeper and an extremely vivid dreamer so I called and asked the dispatcher to repeat — just in case.

Pregnant women…


The Not Really An Asthma Attack

The call came through as a severe asthma attack. A 41 year old male had used his inhaler multiple times with no relief and had been getting worse over several hours. He was rushed from his F/V to our little island ER by a friend. We met them with a wheelchair — myself — a paramedic — and a laboratory technician — and ran inside with him slumped down in the wheelchair — working as hard as I have ever seen anyone work just to breathe tiny breaths.

My first impression was that this…


We were not planning on spending the night in the Charlotte airport but — these things happen. There was an issue with the plane- when they finally got a new plane — the flight crew hours timed out. We were set up with cots by the gate around 1:30 am and tried to get some sleep. Around 4 am, a woman in the area began making some odd, combative noises. We grabbed the limited medical kit with which we always travel and went to investigate. We gathered from the woman’s husband that she was diabetic, this had happened before, and…


While on a remote assignment, we had the unusual privilege of seeing to the comfort of a patient with a terminal illness and attending an anticipated death. If a patient finds comfort in the idea of dying at home, or in a remote location (like an island or mountain town) without tertiary hospital services, we believe we should do everything in our power to assist them. It was, of course, a sad but beautiful and ultimately peaceful event. A few days later, we were very surprised to be awakened to attend to an imminent birth, which occurred outside, in a…


#motionsickness #rollercoasters #themeparks #migraines #nausea #vomiting #disney #universal #roguemed #gorogue

A 40 year old healthy female contacted RogueMed regarding prevention of motion sickness prior to a trip to a theme park where she hoped to ride several roller coasters. She has a history of severe motion sickness that includes eventual severe migraines and vomiting. These episodes have been provoked by roller coasters, 3D movies, IMAX movies, and ocean voyages on small to medium sized craft. Other medical history includes multiple orthopedic injuries and surgeries, migraines for which she takes imitrex as needed, and an autoimmune disorder for which she takes…

RogueMed

Medical for expeditions, trips, backstage, events, competitions. Sports teams have docs on the sidelines — why not you? Is there a doctor in the house?

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