​The American Osteopathic Association (AOA), a professional organization that seeks to improve the practice of osteopathic medicine, participated in the 2024 DO (doctor of osteopathic medicine) Day on Capitol Hill. DO Day on Capitol Hill allowed hundreds of osteopathic physicians, students, and advocates to gather and make their voices heard in Congress. During DO Day on Capitol Hill, AOA advocates focused on three key legislative initiatives which directly impact both the osteopathic profession and wider healthcare landscape.

The issues included protecting patient access to care and physician practices by strengthening the Medicare for Patients and Providers Act (H.R. 2474), to bring positive changes to Medicare physician payment. Other issues included creating a safe working environment for physicians and other healthcare staff by advocating for SAVE (Safety From Violence for Healthcare Employers) Act. In addition, AOA encouraged Congress to lobby for the REDI Act (S.704/H.R. 1202) to reduce the financial burden associated with student debt.

The commitment shown by AOA advocates made an impact, as several lawmakers expressed their support for the recommendations while acknowledging the important role of osteopathic physicians within the healthcare system. The deliberations were not only successful, but reminded everyone of the power of advocacy. Despite recent successes, AOA recognizes the importance of increased advocacy, considering health care is a constantly changing field with an ever-present need to adapt to meet new challenges.

​When planning to hike or climb in high-altitude areas, it is important to understand how to prevent altitude sickness. According to experts, one of the prevention measures is to allow the body adequate time to acclimatize to the reduced oxygen levels. Guidelines suggest ascending gradually once reaching 2,500 meters. Additionally, climbers should spend several days at intermediate elevations before moving higher.

Another recommended preventative measure is staying hydrated, with recommendations to drink plenty of water while avoiding alcohol and caffeine, which can lead to dehydration. A high-carbohydrate diet is also advised as it provides the body with the necessary energy to adapt.

There are medications, such as acetazolamide, which are highlighted for their role in preventing altitude sickness by accelerating the acclimatization process. However, it is recommended that individuals consult a healthcare provider before embarking on their trip to determine if this medication is appropriate for them.

Most important is the emphasis on paying attention to early symptoms of altitude sickness, including headaches, nausea, dizziness, and fatigue. In such cases, individuals should avoid ascending further and instead rest at the same altitude until improvement occurs. When the case is severe, then the affected person must descend to a lower elevation immediately.

​Traumatic injury is one of the leading causes of death among individuals under 45 years of age, with 80 percent of these cases resulting from blunt impact. These situations often need proper sonographic evaluation. The Focused Assessment with Sonography in Trauma (FAST) exam is an ultrasound protocol developed to assess for hemoperitoneum and hemopericardium, meaning blood in the abdominal cavity and blood around the heart. This process checks the abdomen and the sac around the heart to ensure there is no abnormal fluid present.

The FAST exam takes only a few minutes, is precise, and is noninvasive. Experienced providers can complete the FAST exam within five minutes, thus reducing time to surgery, patient length of stay, and the need for CT scans and diagnostic peritoneal lavage (DPL). The Extended FAST (eFAST) protocol involves checking both sides of the chest cavity for blood and air pockets. Some of the conditions that require the use of eFAST include blunt or penetrating abdominal trauma, thoracic trauma, undifferentiated shock, and abnormally low blood pressure.

Sonographic evaluation is an efficient tool for rapidly and accurately detecting injuries in trauma patients. The FAST examinations have continually improved trauma management, enhancing the speed of definitive surgical intervention, shortening the length of patient stays, and reducing the incidence of morbid events.

However, clinicians need to consider certain drawbacks associated with the use of ultrasound and seek the opinion of a radiologist if required. Healthcare professionals actively collaborate and communicate to ensure optimal patient selection for FAST examinations and deliver the best possible care.

​An emergency ultrasound is a goal-oriented and focused examination that answers specific questions about an organ or system. Over time, the concept of emergency ultrasound in medical practice has broadened. The system aids in visualizing clinical symptoms involving multiple organs using imaging techniques.

Emergency ultrasound is classified into five functional clinical categories: resuscitative, diagnostic, symptom/sign-related, intervention/procedure-directing, and therapeutic/monitoring. The UEMSA recognizes 11 core emergency ultrasound applications within these categories: trauma, intrauterine pregnancy, AAA, cardiac, biliary, urinary tract, DVT,, soft tissue/musculoskeletal, thoracic, ocular, and procedural guidance. The ultrasound's portability and ease of use make it ideal for remote and resource-limited areas. It also enables healthcare providers to monitor their patients in real-time, allowing for timely intervention and critical response.

The demand for emergency care is continuously growing, meaning that the role of emergency ultrasound will become increasingly important. The role of emergency ultrasound in emergency medicine is being emphasized because it equips physicians with the ability to manage emergency patients using ultrasound in regions with limited resources. As the specialty has broadened, it has become an essential component of emergency care. This likely indicates a growing trend toward the extensive application of emergency ultrasound, which will positively impact patient outcomes.

​A team of students from the University of Calgary in California explored the mountains of northern Chile to discover the effects of exposure to high altitudes on a person’s health. The researchers used an ALMA (Atacama Large Millimeter/submillimeter Array) observatory facility stationed at 2,000 meters above sea level as their base.

During the study, the team went high up to 5,000 meters above sea level and spent the night there. At this altitude, the researchers experienced extreme physical and mental challenges. They had difficulty breathing, which resulted in difficulty getting enough sleep. They particularly recalled having to awaken over and over again throughout the night. They experienced altitude sickness 5,000 meters above sea level, causing some to descend earlier than scheduled.

The researchers also experienced hyperventilation. They explained that the higher a person goes, the less oxygen they get. The thinning oxygen level leads to an increased breathing frequency. To counter this, they will have to exhale more carbon dioxide. During sleep, hyperventilation may trigger periodic stoppage in breathing for at least 15 seconds.

Back at the University of Calgary, the researchers continued their advocacy to increase awareness of the relationship between getting enough sleep and healthy well-being. The team also recommended regular physician visits to people with sleep problems.

​Adventure racing involves competitors participating in a multisport, off-road, navigation-based competition. Of the many different events, Coast to Coast is one of the best adventure racing events, according to a February 2024 Red Bull article.

Held in South Island, New Zealand, Coast to Coast lasts anywhere between one and two days, depending on which event participants sign up for. The race takes competitors from Kumara Beach on the West Coast to finish at the New Brighton Beach Pier on the East Coast. The one-day event, named the World Multisport Championship, is for the most fit competitors. 

However, most people compete in the two-day event, which involves a 30.5 km (~19 miles) mountain run that includes river crossings, 70 km (~43.5 miles) of paddling over the Waimakariri River, and a 70 km race across the Canterbury Plains that ends at the beach. By the end of the race, competitors will have run and paddled 243 km or approximately 151 miles.

The last race was held February 9 - 10, 2024. Since its inception in 1983, over 40,000 people have competed in New Zealand’s Coast to Coast.

Mountaineering, also called mountain climbing, is a popular pastime for adventure seekers. While mountaineering offers opportunities to explore new heights and take in breathtaking views, it has its fair share of dangers. Mountaineers should adhere strictly to safety precautions.

One of the safety tips for mountaineers is to eat a healthy breakfast before starting. A breakfast such as oatmeal gives mountaineers energy for the activity. A high-fiber breakfast also helps them feel full longer. Mountain climbers also must stay hydrated when embarking on a climb.

Considering how easy it is to get lost on a mountain, climbers should inform their friends and relatives before starting. If the mountaineers plan to follow a particular route, they should leave a copy of the map with friends or loved ones. This map will make things easier if a search party must look for the mountain climbers.

When climbing in an unfamiliar environment, mountaineers should take a compass, map, and guide. Electronic devices are often not the best option because GPS signals can fail. Therefore, a compass is a better choice for mountain climbing.

​Emergency ultrasound, also known as point-of-care ultrasound services (POCUS), is quickly becoming a standard tool for examinations in emergency rooms. The American College of Emergency Physicians (ACEP) considers it a fundamental skill for physicians in emergency medical services.

One of the primary applications of emergency ultrasound is the rapid evaluation of patients. Emergency ultrasound enables safer, faster, and more accurate diagnoses, reducing discrepancies. It also facilitates staged imaging, which is a medical imaging term that refers to the sequential use of several scans or imaging modalities to gain a better understanding of a patient's anatomy or condition. Staged imaging offers quick insights into clinical questions before resorting to more invasive and costly procedures.

Emergency ultrasound also helps diagnose chest pain by narrowing down potential causes, which leads to a faster and more accurate diagnosis, enabling prompt action to alleviate pain. Similarly, emergency ultrasound aids in diagnosing shortness of breath by helping physicians differentiate between cardiac and pulmonary causes. POCUS is also valuable for diagnosing abdominal pain and identifying kidney stones, gallstones, appendicitis, and bowel obstructions.

​Mountain climbing is an outdoor activity that is loved by adventure enthusiasts from across the globe. The thrill of ascending hills and enjoying the breathtaking views from the top brings much joy and fulfillment. However, mountain climbing is associated with risks that can increase because of the following mistakes.

Ignoring Sun Cream

Mountains have strong ultraviolet rays, which can cause serious skin damage. Even snow reflects sun rays, which can affect areas of the body such as behind the ears, in the palette of the mouth, and under the chin. Using sun cream is advised before embarking on mountain climbing. In addition, most exposed areas of the body should also be covered up.

Not Paying Attention to Hot Spots

Regular mountain climbers have formed blisters on the soles of their feet, commonly known as hot spots. Ignoring hot spots while climbing increases pain and can stop the mountain hike. After hot spots develop, they become red and accumulate serum (a clear fluid), raising the risk of infection. It’s often advisable to stop and rest when hot spots develop.

Quick Ascending of Hills

Some young and fit mountain climbers are often enthusiastic about completing their climbs in the shortest time possible to outshine previous hikers, increasing their chances of failing to complete the hike. This is often due to underestimating the trail. Successful mountain climbing is achieved through patience and good fitness. The best way to conquer mountains and attain satisfaction is to trek slowly and enjoy the scenery.

​A dedicated professional in the medical field, Dr. John "Joe" Fosbinder brings over two decades of experience to his role as an emergency physician at Bakersfield Heart Hospital in Bakersfield, California. Beyond his dedication to providing exceptional healthcare, John J. Fosbinder enjoys outdoor activities such as cycling and adventure racing.

Typically a challenging sport, adventure racing features a diverse and rugged course that typically incorporates elements of mountain biking, running, trekking, kayaking, and more. The sport requires endurance, so preliminary training and appropriate nutrition are relevant for the successful completion of the course.

Adventure racing newbies often need bike navigation training. The high speed makes map reading more challenging compared to navigation while walking.

Eating appropriately balanced carbohydrates, proteins, and vitamins during training and before the race is essential. Carbs such as pasta, rice, cereal, and bread provide the required energy during endurance training and deserve more emphasis. During the race, it's advisable to carry lightweight, high-energy food. Optimal choices for shorter races are high-energy bars and gels.

In adventure racing, each team has some time to plan the race after receiving checkpoint details. This extra time in this planning phase is crucial for a smoother race. Racers pay close attention during the pre-race briefing to gather important information on rules, out-of-bounds areas, checkpoint locations, and resupply points. Rushing into the game without knowing this information can undermine a team’s chance of winning any adventure race.