Bad day

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Bad day

  1. 1. Bad day at the office Wilderness & Expedition Medicine Conference Rural Clinical School, Bunbury 2-OCT-10 Tim Inglis Division of Microbiology & Infectious Diseases, PathWest Laboratory Medicine, WA
  2. 2. Outline •Perak, Malaysia 2008 •Expedition psychology •What is expedition stress? •Who gets it? •What can be done about it? •Can it be prevented?
  3. 3. Perak, 2008
  4. 4. Expedition psychology  group travel with a purpose  wilderness = outside comfort zone  independent of external resources  little redundancy  ragbag assortment, individuals, egotists  group aims > personal objectives  expedition paradox:  The need to maximise opportunity for individual expertise in order to achieve group objective
  5. 5. Expedition stress • Irritability, blame-shifting, abdication • Uncharacteristic behaviour • Anxiety • Loss of motivation, appetite, energy • Inability to sleep when tired • Depression • Threat of or attempts at deliberate self harm  NB malaria, other tropical infections, heat exhaustion can present with some of the above
  6. 6. Epidemiology? When - timeline 1 Preparation 2 Outward travel 3 Expedition 4 Return travel 5 Aftermath Who: • Prior psychological history • Vulnerable individuals: –first timers –overconfident –inflexible –intolerant –poorly prepared –substance dependent • Stress overloaded • Expedition leaders
  7. 7. Countermeasures • identify vulnerable people, key stressors, triggers • early recognition • stress-easing, relieving & abating activities – Task sharing – Communication – Rest & recreation • Avoid superficial, quick & easy solutions
  8. 8. Prevention •Selection •Preparation •Briefing •Teamwork •First aid •Leadership
  9. 9. Thanks to • Dr Abdul Russ Karim Hassan • Prof Savithri Puthucheary • Dr Richard Bradbury • Prof Vasanthi Thesanevam

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