Publications by authors named "Aaron D Campbell"

10 Publications

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Counseling for the Wilderness Athlete and Adventurer During a Preparticipation Evaluation for Preparation, Safety, and Injury Prevention.

Wilderness Environ Med 2015 Dec;26(4 Suppl):S92-7

University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii (Ms Raastad).

Wilderness sports and adventures continue to increase in popularity. Counseling is an essential element of the preparticipation evaluation (PPE) for athletes in traditional sports. This approach can be applied to and augmented for the wilderness athlete and adventurer. The authors reviewed the literature on counseling during PPEs and gathered expert opinion from medical professionals who perform such PPEs for wilderness sports enthusiasts. The objective was to present findings of this review and make recommendations on the counseling component of a wilderness sports/adventure PPE. The counseling component of a PPE for wilderness sports/adventures should take place after a basic medical evaluation, and include a discussion on sport or activity-specific injury prevention, personal health, travel recommendations, and emergency event planning. Counseling should be individualized and thorough, and involve shared decision making. This should take place early enough to allow ample time for the athlete or adventurer to further prepare as needed based on the recommendations. Resources may be recommended for individuals desiring more information on selected topics.
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http://dx.doi.org/10.1016/j.wem.2015.09.015DOI Listing
December 2015

Preparticipation Evaluation for Climbing Sports.

Wilderness Environ Med 2015 Dec;26(4 Suppl):S40-6

Division of Emergency Medicine, University of Utah Health Care, Salt Lake City, Utah (Drs Ng and McIntosh).

Climbing is a popular wilderness sport among a wide variety of professional athletes and amateur enthusiasts, and many styles are performed across many environments. Potential risks confront climbers, including personal health or exacerbation of a chronic condition, in addition to climbing-specific risks or injuries. Although it is not common to perform a preparticipation evaluation (PPE) for climbing, a climber or a guide agency may request such an evaluation before participation. Formats from traditional sports PPEs can be drawn upon, but often do not directly apply. The purpose of this article was to incorporate findings from expert opinion from professional societies in wilderness medicine and in sports medicine, with findings from the literature of both climbing epidemiology and traditional sports PPEs, into a general PPE that would be sufficient for the broad sport of climbing. The emphasis is on low altitude climbing, and an overview of different climbing styles is included. Knowledge of climbing morbidity and mortality, and a standardized approach to the PPE that involves adequate history taking and counseling have the potential for achieving risk reduction and will facilitate further study on the evaluation of the efficacy of PPEs.
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http://dx.doi.org/10.1016/j.wem.2015.09.014DOI Listing
December 2015

Risk Stratification for Athletes and Adventurers in High-Altitude Environments: Recommendations for Preparticipation Evaluation.

Wilderness Environ Med 2015 Dec;26(4 Suppl):S30-9

Institute for Altitude Medicine, Telluride, Colorado (Dr Hackett).

High-altitude athletes and adventurers face a number of environmental and medical risks. Clinicians often advise participants or guiding agencies before or during these experiences. Preparticipation evaluation (PPE) has the potential to reduce risk of high-altitude illnesses in athletes and adventurers. Specific conditions susceptible to high-altitude exacerbation also important to evaluate include cardiovascular and lung diseases. Recommendations by which to counsel individuals before participation in altitude sports and adventures are few and of limited focus. We reviewed the literature, collected expert opinion, and augmented principles of a traditional sport PPE to accommodate the high-altitude wilderness athlete/adventurer. We present our findings with specific recommendations on risk stratification during a PPE for the high-altitude athlete/adventurer.
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http://dx.doi.org/10.1016/j.wem.2015.09.016DOI Listing
December 2015

Ethical, Legal, and Administrative Considerations for Preparticipation Evaluation for Wilderness Sports and Adventures.

Wilderness Environ Med 2015 Dec;26(4 Suppl):S10-4

Department of Emergency Medicine, University of Colorado, Denver, Colorado (Dr D. S. Young).

Preparticipation evaluations (PPEs) are common in team, organized, or traditional sports but not common in wilderness sports or adventures. Regarding ethical, legal, and administrative considerations, the same principles can be used as in traditional sports. Clinicians should be trained to perform such a PPE to avoid missing essential components and to maximize the quality of the PPE. In general, participants' privacy should be observed; office-based settings may be best for professional and billing purposes, and adequate documentation of a complete evaluation, including clearance issues, should be essential components. Additional environmental and personal health issues relative to the wilderness activity should be documented, and referral for further screening should be made as deemed necessary, if unable to be performed by the primary clinician. Travel medicine principles should be incorporated, and recommendations for travel or adventure insurance should be made.
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http://dx.doi.org/10.1016/j.wem.2015.09.013DOI Listing
December 2015

Counseling for the Wilderness Athlete and Adventurer During a Preparticipation Evaluation for Preparation, Safety, and Injury Prevention.

Clin J Sport Med 2015 Sep;25(5):456-60

*Department of Family Medicine and Community Health, Division of Sports Medicine, University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii; †Family and Preventive Medicine and Sports Medicine, University of Utah, Salt Lake City, Utah; and ‡University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii.

Wilderness sports and adventures continue to increase in popularity. Counseling is an essential element of the preparticipation evaluation (PPE) for athletes in traditional sports. This approach can be applied to and augmented for the wilderness athlete and adventurer. The authors reviewed the literature on counseling during PPEs and gathered expert opinion from medical professionals who perform such PPEs for wilderness sports enthusiasts. The objective was to present findings of this review and make recommendations on the counseling component of a wilderness sports/adventure PPE. The counseling component of a PPE for wilderness sports/adventures should take place after a basic medical evaluation, and include a discussion on sport or activity-specific injury prevention, personal health, travel recommendations, and emergency event planning. Counseling should be individualized and thorough, and involve shared decision making. This should take place early enough to allow ample time for the athlete or adventurer to further prepare as needed based on the recommendations. Resources may be recommended for individuals desiring more information on selected topics.
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http://dx.doi.org/10.1097/JSM.0000000000000250DOI Listing
September 2015

Preparticipation Evaluation for Climbing Sports.

Clin J Sport Med 2015 Sep;25(5):412-7

*Family and Sports Medicine, University of Utah Health Care, Salt Lake City, Utah; †Department of Emergency Medicine, University of Colorado School of Medicine; ‡Kaiser Permanente, Department of Emergency Medicine, University of Colorado; §Division of Emergency Medicine, University of Utah Health Care, Salt Lake City, Utah; ¶Arizona Sports Medicine Center, Mesa, Arizona; and ‖Central Maine Sports Medicine (a Clinical Division of CMMC), Evergreen Sports Medicine Fellowship, Lewiston, Maine.

Climbing is a popular wilderness sport among a wide variety of professional athletes and amateur enthusiasts, and many styles are performed across many environments. Potential risks confront climbers, including personal health or exacerbation of a chronic condition, in addition to climbing-specific risks or injuries. Although it is not common to perform a preparticipation evaluation (PPE) for climbing, a climber or a guide agency may request such an evaluation before participation. Formats from traditional sports PPEs can be drawn upon, but often do not directly apply. The purpose of this article was to incorporate findings from expert opinion from professional societies in wilderness medicine and in sports medicine, with findings from the literature of both climbing epidemiology and traditional sports PPEs, into a general PPE that would be sufficient for the broad sport of climbing. The emphasis is on low altitude climbing, and an overview of different climbing styles is included. Knowledge of climbing morbidity and mortality, and a standardized approach to the PPE that involves adequate history taking and counseling have the potential for achieving risk reduction and will facilitate further study on the evaluation of the efficacy of PPEs.
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http://dx.doi.org/10.1097/JSM.0000000000000247DOI Listing
September 2015

Risk Stratification for Athletes and Adventurers in High-Altitude Environments: Recommendations for Preparticipation Evaluation.

Clin J Sport Med 2015 Sep;25(5):404-11

*Family and Sports Medicine, University of Utah Health Care, Salt Lake City, Utah; †Division of Emergency Medicine, University of Utah Health Care, Salt Lake City, Utah; ‡Department of Orthopedics, University of Utah, Salt Lake City, Utah; §Bay Area Pulmonary/Critical Care Medical Associates, Berkeley/Oakland, California; and ¶Institute for Altitude Medicine, Telluride, Colorado.

High-altitude athletes and adventurers face a number of environmental and medical risks. Clinicians often advise participants or guiding agencies before or during these experiences. Preparticipation evaluation (PPE) has the potential to reduce risk of high-altitude illnesses in athletes and adventurers. Specific conditions susceptible to high-altitude exacerbation also important to evaluate include cardiovascular and lung diseases. Recommendations by which to counsel individuals before participation in altitude sports and adventures are few and of limited focus. We reviewed the literature, collected expert opinion, and augmented principles of a traditional sport PPE to accommodate the high-altitude wilderness athlete/adventurer. We present our findings with specific recommendations on risk stratification during a PPE for the high-altitude athlete/adventurer.
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http://dx.doi.org/10.1097/JSM.0000000000000231DOI Listing
September 2015

Ethical, Legal, and Administrative Considerations for Preparticipation Evaluation for Wilderness Sports and Adventures.

Clin J Sport Med 2015 Sep;25(5):388-91

*Departments of Orthopaedic Surgery; and †Community and Family Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; ‡Family and Sports Medicine, University of Utah, Salt Lake City, Utah; §Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado; and ¶Department of Emergency Medicine, University of Colorado, Denver, Colorado.

Preparticipation evaluations (PPEs) are common in team, organized, or traditional sports but not common in wilderness sports or adventures. Regarding ethical, legal, and administrative considerations, the same principles can be used as in traditional sports. Clinicians should be trained to perform such a PPE to avoid missing essential components and to maximize the quality of the PPE. In general, participants' privacy should be observed; office-based settings may be best for professional and billing purposes, and adequate documentation of a complete evaluation, including clearance issues, should be essential components. Additional environmental and personal health issues relative to the wilderness activity should be documented, and referral for further screening should be made as deemed necessary, if unable to be performed by the primary clinician. Travel medicine principles should be incorporated, and recommendations for travel or adventure insurance should be made.
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http://dx.doi.org/10.1097/JSM.0000000000000246DOI Listing
September 2015

Mountaineering fatalities on Denali.

High Alt Med Biol 2008 ;9(1):89-95

Division of Emergency Medicine, University of Utah, Salt Lake City, Utah 84132, USA.

Mount McKinley, or Denali, is the tallest mountain in North America and attracts over 1,000 climbers annually from around the world. Since Denali is located within a national park, the National Park Service (NPS) manages mountaineering activities and attempts to maintain a balance of an adventurous experience while promoting safety. We retrospectively reviewed the fatalities on Denali from 1903 to 2006 to assist the NPS, medical personnel, and mountaineers improve safety and reduce fatalities on the mountain. Historical records and the NPS climber database were reviewed. Demographics, mechanisms, and circumstances surrounding each fatality were examined. Fatality rates and odds ratios for country of origin were calculated. From 1903 through the end of the 2006 climbing season, 96 individuals died on Denali. The fatality rate is declining and is 3.08/1,000 summit attempts. Of the 96 deaths, 92% were male, 51% occurred on the West Buttress route, and 45% were due to injuries sustained from falls. Sixty-one percent occurred on the descent and the largest number of deaths in 1 year occurred in 1992. Climbers from Asia had the highest odds of dying on the mountain. Fatalities were decreased by 53% after a NPS registration system was established in 1995. Although mountaineering remains a high-risk activity, safety on Denali is improving. Certain groups have a significantly higher chance of dying. Registration systems and screening methods provide ways to target at-risk groups and improve safety on high altitude mountains such as Denali.
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http://dx.doi.org/10.1089/ham.2008.1047DOI Listing
July 2008
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