According to the WHO, antimicrobial resistance (AMR) is one of the top global public health and development threats facing humankind. The prolonged misuse and overuse of antimicrobial medications in humans, animals and plants has resulted in the emergence and spread of drug-resistant pathogens which threatens our ability to treat common infections and perform life-saving procedures. Regardless of where they work, clinicians will be used to consulting local antibiotic prescribing guidelines, and many may have noticed changes as their hospitals or communities adjust to changing resistance p ..read more

Click to read my latest article published by GP Online, by clicking here or on the image below ..read more

Introduction   Ankle injuries are common amongst hillwalkers and, depending on their severity, these can end a day out in the hill and result in a mountain rescue callout.  Studies reviewing attendance records from eight emergency departments in the UK estimate an incidence rate of 52.7 ankle sprains per 10,000 people, however the true incidence is probably higher as many people will see their GP instead or self-manage their symptoms at home.    As always prevention is the best strategy. Pre-trip it is sensible to advise clients on choosing suitable footwear with appr ..read more

Blisters are a common problem and neglecting foot-care can turn a great hike into a painful experience. We have probably all suffered from blisters at some point, and even if these are small, they have the potential to ruin a day out on the hill. In this article I hope to give you some advice that you can pass onto clients on future trips or use when looking after your own feet. As with all potential medical issues, prevention is better than cure. If you have the ability to send a kit-list to participants in advance of a hill day, it is helpful to specify the type of footwear they will need f ..read more

In October 2023, I visited China, working as an expedition doctor to support a charity trek along the Great Wall of China. The wall is vast, measuring a total of 13,171 miles and it can be seen from space. Therefore, our week long itinerary was only going to show us a snapshot of the wall, which is one of the Seven Wonders of the World. We experienced a journey through different dynasties as we walked along the wall, and the segments we visited ranged from fully restored barricades to more remote and derelict parts. The wall actually started life as multiple smaller walls before these were jo ..read more

Whether you are out walking in the Brecon Beacons or traversing the Cairngorms plateau this winter, it is important to have an awareness of how to keep warm and reduce the risk of hypothermia. This short article will cover some common pitfalls and explore how to manage a cold casualty out in the field. As shown in figure 1 below, there are four main mechanisms by which humans lose heat: Radiation, Conduction, Convection and Evaporation. Figure 1: The Four Mechanisms of Heat Loss The way in which we dress for cold conditions is designed to minimise the impact of these four mechanisms. For exa ..read more

The UK has some of the highest prevalence rates of allergic conditions in the world, with over 20% of the population being affected by one or more allergic disorder. Many of these people will participate in outdoor activities and therefore it is important to have some knowledge of how to manage allergies when out on the hill. What is an Allergy? An allergy occurs when someone reacts to something that is normally harmless, such as pollen, food or an insect sting. The term “allergy” encompasses a spectrum of conditions and symptoms, ranging from mild hay-fever through to full blown anaphylaxis ..read more

Bryony Palmer, RN, from Instagram’s @Cutterbove Sailing My husband and I are undertaking a circumnavigation on our 41ft, steel sailboat named Rhythm. This venture is showing itself to be a platform for practicing and understanding the unique ways in which sailing, wilderness medicine, and risk assessments intersect, with heavy weather sailing lending itself well to these topics. The wind and the waves. Advice recommends not putting a vessel through waves over 30%-60% its waterline length in size, which for us means >12.5ft, as larger waves breaking on the beam have potential to capsize the ..read more

Over the next few weeks I am going to share a series of articles that I have written for the Mountain Training Association on how to manage common medical issues when out on the hill. These articles are targeted at lay people and outdoor guides, however they will hopefully also be useful as an aide-memoire for any expedition medics and wilderness first responders, whilst also being a useful resource for patients going into the wilderness. Please note the disclaimer at the bottom of the article and always consult a medical professional if you are unsure! What is Asthma? Asthma is a long-term co ..read more

It's 5am and the phone rings... I wake up and answer- a child with a headache, vomiting and a petechial rash is inbound to the base so that I can assess him, in case he needs a blue light ambulance or the helicopter retrieval service. I met the child and his mother at the health centre. I had a large amount of kit with me, including IM antibiotics to manage potential meningococcal sepsis. Luckily in this case, the patient was relatively well and it seemed more likely to be a case of a facial petechial rash secondary to cough and a viral illness. The nearest hospital in Inverness was 45 minute ..read more