Expedition rules

An occasional and growing series of expedition (medical) rules, from 3 decades and more experience as an expedition medic.

Rule #1

Expedition medicine is medicine on an expedition

Common things happen commonly

You are far more likely to see medical problems that commonly occur in similar groups undertaking normal activities than the esoteric and rare problems that one can find in extreme environments, such as tropical disease.

All that said you must be well prepared and informed to deal with the unusual presentations and should always consider the rare but serious diagnoses that require investigating and excluding.

The caveats to this are:

• Altitude; if at altitude, and it could be due to altitude, assume it is. Descend.
• Malaria; always consider malaria in a patient presenting with pyrexia in a malarious area, and if you can't exclude it then evac rapidly and consider giving standby treatment.