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WMT has been made aware of a risk of the Emerade auto injector failing to deliver a dose of adrenaline from the syringe due to blockage of the needle.

This issue was first detected in June 2018 during routine stability testing of the syringe component of Emerade with the potential to affect 1.5 in every ten thousand pens; therefore considered a rare event. However, recent information indicates that the potential occurrence of needle blockage in batches on the market is higher than first estimated and so it is being brought to the attention of users.

The full text release from the MHRA can be read here.

The potential for units on the market to have a blockage of the needle which could lead to Emerade failing to deliver a dose when activated is now estimated to be 0.23 %, which would affect 2.3 in every thousand pens. (This estimate is based on simulated laboratory conditions without the auto-injector component which may lower the potential rate of failure to deliver.)

However, because the dose of adrenaline in an adult Emerade auto injector is 0.5mg (0.5ml), even a faulty auto injector is likely to deliver more adrenaline than an Epipen (or Jext / Anapen) device which all routinely have 0.3mg (0.3ml) in them.

The Medicines and Healthcare products Regulatory Agency (MHRA) is not recalling batches of Emerade.

The manufacturer conducted extensive investigations and has implemented corrective actions. Emerade manufactured with all the corrective processes has been introduced into the market from mid-July 2019.

My recommendation is to do nothing but this notice is for awareness and transparency (in case you see other articles in the press on this matter).

Dr Harvey Pynn
Medical Director
31 August 2019

On 19th August ’19, WMT published a Medical Director’s Bulletin with revised guidance on treating traveller’s diarrhoea (TD) with antibiotics. Read the BULLETIN.

WMT Explorer course alumni are directed to this WMT web page where they will find a note to download to keep with their WMT manual and med kit for reference. The note includes the algorithm below and dosing advice for the antibiotics now recommended.

The headline message is STOP using ciprofloxacin to treat TD and follow the new guidelines in Dr Pynn’s Medical Director’s Bulletin

Feel free to share this information widely with other explorers. It’s a major change to how TD has been treated for several decades.

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Expedition Medicine & Field Skills wrapped up a week ago in Chamonix. The course group was incredibly diverse; 40 delegates ranging from paramedic students, med students, nurses and doctors/GPs/consultants of whom 50% were NOT from the UK/Ireland. Truly an international band of like-minded adventure lovers keen to develop their medical skills in the outdoors. This photo perhaps sums up the spirit the week. It shows the whole course group circled up at our high altitude bivouac campsite after an intense afternoon of training exercises against the backdrop of beautiful mountains and the setting sun. They continued well into dark; playing games, singing songs and entertaining each other. Such cohesion and enjoyment – both key aims of any expedition project. See many more great photos and vidoes on Instagram @wildmedtraining

Delegate Dr O.J., a HEMS physician, reviewed the course as “Perfect! The best and most interesting course I’ve been to. Great combination of theory/practice and medical/field skills.”

Expedition Medicine & Field Skills next runs in Chamonix 22-26 June 2020.

WMT Newsletter May 2019

Welcome!
In this edition, read about faculty and alumni travels, importing medicines overseas, how to inspect your climbing gear, upcoming courses (including Chamonix winter 2020 events) and more. We’ve saved the best item for last – 44 year-old WMT alumni and family man GP Dr Mark Fresch launches a portfolio career incorporating expedition medicine. His story is sure to inspire!

Read the full newsletter here and find out what this photo is about.

We’ve just opened up the 2-day Expedition Medic component of Expedition Skills to bookings. Arrive 6pm Wednesday 10 July for dinner and enjoy two days of forest living and medical and outdoor skill instruction in the heart of the Lake District. See the drone video below of our stunning tarn-side private camp. Depart camp 4pm Friday 12 July. Or join for the full 5 day course and spend 3 days learning bushcraft with our partners Wild Human, then wilderness medicine with WMT. For full details, online booking and downloads, visit the respective course page via the linked text above.

We’ve added 10 half priced medical student places for Expedition Medicine and Field Skills in Chamonix 17-21 June. That’s a saving of £275 tuition only. This intensive 5-day course combines wilderness medicine with learning many field skills needed to work in diverse environments including the mountains and jungle. Taught by a seasoned teaching team of leading expedition doctors and mountain professionals, the broad lecture programme with problem solving/planning exercises and case studies is dove-tailed with outdoor training sessions; the highlight of which is an overnight high mountain camp. All grades of medics attend. Earn 30 CPD hours and MSc credits. Easy access to Chamonix from Geneva airport. Optional glacier expedition after the course. Share accommodation with other delegates via WMT’s Facebook. Accommodation, travel and meals are not included. “A fun-filled, inspiring big kids holiday with enough medical theory to stimulate our brains.”

Later in July we’re running a special med-student only 7-day Expedition Skills course near Windermere, Lake District 22-28 July. Expedition Skills is a unique camping based multi-disciplinary 7-day programme for medical students delivered by WMT and Wild Human at a stunning, lake-side camp in the Lake District, England. See the drone video below! You’ll learn a solid set of expedition-proven skills ranging from bushcraft and expedition preparation to bush mechanic training, personal security and GPS navigation and concluding with wilderness medicine training that is largely scenario based. The course is delivered by the UK’s leading training providers in these respective fields. No previous camping or expedition experience is required. It’s an immersive, detailed and fun camping based experience.

WMT is pleased to promote the following event:

The Global Health Collaborative (GHC) based at the University of Plymouth and covering the whole South West are holding this international conference on 24 May focusing on effective engagement of UK volunteers and partners in Global Health (GH) initiatives.

The conference will bring together a range of stakeholders from across the peninsula and other regions to:

– learn from innovative approaches for global citizenship, hearing first-hand about Wales’ future generation act and Health Education England’s Global Engagement Strategy
– hear from centres of excellence within the UK – speakers from Cambridge Global Health Partnerships and Kings College London Centre for Global Health will talk about their respective journeys in forming GH networks
– gain a unique opportunity to hear from some of our low and middle income countries partners visiting from Kenya, Uganda and Sierra Leone
– visit a marketplace that showcases local examples of ongoing GH work and opportunities for involvement and research
explore the reciprocal benefits to the workforce and health system in the South West and future direction.

For the first time, we invited poster submissions for the annual Chamonix Expedition Medicine course 21-25 January. 12 quality posters covering a range of topics were submitted. Subjects ranged from high altitude cases and research to snake bite, eye problems, rabies and managing uncertainty in the wilderness. Course delegates agreed the posters added to the educational robustness of the conference. Acetazolamide: does it help on Kilimanjaro? was the winner. Congratulations to authors Nathan Hudson-Peacock, Anna Wallace and Craig Miller and many thanks to everyone who contributed. Download this file to view all the posters: WMT Jan 2019 posters x12

There was a lot of demand for the kit we no longer needed and in the end we split the 2 dozen stethascopes and a dozen BP cuffs between the Liverpool University Wilderness Medicine Society for training and the Kiwoko hospital in Uganda that Sandra Aurora will take to Africa with her shortly.

Action Challenge has an urgent position for a leader / medic on a Kilimanjaro Trek in March. Details below. Please direct all enquiries directly to AC.

It’s a small team – only 6 PAX – so nice and manageable, on the dates below:

Group Name Outbound Inbound Date back in UK
Open Kili Lemosho Mar B Thu 14/03/19 Sat 23/03/19 Sun 24/03/19

The group flight details are:

DATE OF
TRAVEL DEPARTURE
AIRPORT DEPARTURE
TIME ARRIVAL
AIRPORT ARRIVAL
TIME
14-Mar-19 LHR 2155 DOH 0740
15-Mar-19 DOH 0910 JRO 1540
23-Mar-19 JRO 1710 DOH 2340
24-Mar-19 DOH 0130 LHR 0620

As a leader medic, it would be a paid position, at £110 per day for 10 days.

Please can you reply if you are able to take this on as soon as possible. Due to the urgency, the position will be on a first-come, first-served basis.

Best wishes,

Jan Smolaga
International Business Manager
Action Challenge UK Ltd
London
www.actionchallenge.com

Tel: +44 (0) 207 609 6695