This document summarizes an expedition medicine conference presentation about expedition stress. It discusses an expedition in Malaysia in 2008, defines expedition stress as irritability, anxiety, and other changes in behavior from being outside one's comfort zone in an expedition setting. It notes that those particularly vulnerable include first timers, overconfident or inflexible individuals, and those with prior psychological or substance issues. The document outlines ways to counteract and prevent expedition stress through identifying vulnerable individuals, early recognition, stress-relieving activities, and proper selection, preparation, teamwork and leadership.

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. Outline
•Perak, Malaysia 2008
•Expedition psychology
•What is expedition stress?
•Who gets it?
•What can be done about it?
•Can it be prevented?

3. Perak, 2008

5. 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

6. 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

7. 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

8. Countermeasures
• identify vulnerable people, key stressors, triggers
• early recognition
• stress-easing, relieving & abating activities
– Task sharing
– Communication
– Rest & recreation
• Avoid superficial, quick & easy solutions

9. Prevention
•Selection
•Preparation
•Briefing
•Teamwork
•First aid
•Leadership

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