Bad day at the officeWilderness & Expedition Medicine Conference

Rural Clinical School, Bunbury2-OCT-10

Tim InglisDivision of Microbiology & Infectious Diseases,

PathWest Laboratory Medicine, WA

Outline

•Perak, Malaysia 2008

•Expedition psychology

•What is expedition stress?

•Who gets it?

•What can be done about it?

•Can it be prevented?

Perak, 2008

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

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

Epidemiology?When - timeline1 Preparation2 Outward travel3 Expedition4 Return travel5 Aftermath

Who:• Prior psychological history• Vulnerable individuals:

–first timers–overconfident–inflexible–intolerant–poorly prepared–substance dependent

• Stress overloaded• Expedition leaders

Countermeasures• identify vulnerable people, key stressors, triggers• early recognition• stress-easing, relieving & abating activities

– Task sharing– Communication– Rest & recreation

• Avoid superficial, quick & easy solutions

Prevention

•Selection•Preparation•Briefing•Teamwork•First aid•Leadership

Thanks to• Dr Abdul Russ Karim Hassan• Prof Savithri Puthucheary• Dr Richard Bradbury• Prof Vasanthi Thesanevam