Case Report
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Published Online: 4 March 2020

Psychological Care Augmented by Telemedicine after a Polar Bear Encounter at an Arctic Research Station: A Case Report

Publication: Telemedicine and e-Health
Volume 26, Issue Number 3


Background: Psychologically stressful events can be particularly challenging in the wilderness or extreme environments due to a lack of immediate medical or psychological support. Telemedicine consultations may provide a means to supply medical providers in austere environments with expertise when confronted with these situations.
Methods: In this study, we detail a case of psychological care imparted to residents at a remote, arctic research station after they encountered a polar bear. The health care provider at the camp was not a dedicated mental health professional but was able to deliver psychological care with assistance from a trained provider through use of telemedicine. We provide a brief overview of the evidence behind psychological first aid and incident support sessions for the treatment of stress injuries. We also review the evidence for telemedicine for psychological care in wilderness situations and describe its use in this scenario.
Results: All station residents were able to resume regular arctic activities. Resident feedback was that the sessions were advantageous.
Conclusions: We anticipate the need for psychological care in austere situations to increase in the future, and further training in this field and the advancement of telemedicine consultation will be of benefit to wilderness providers.

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1. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.
2. Mcgladrey L. Psychological First Aid and Stress Injuries. In: Hawkins SC, ed. Wilderness EMS. Philadelphia: Wolters Kluwer.
3. Javidi H, Yadollahie M. Post-traumatic stress disorder. Int J Occup Environ Med 2012;3:2–9.
4. Elklit A, Christiansen DM. ASD and PTSD in rape victims. J Interpers Violence 2010;25:1470–1488.
5. Sareen J. Posttraumatic stress disorder in adults: Impact, comorbidity, risk factors, and treatment. Can J Psychiatry 2014;59:460–467.
6. McCaughey BG. The psychological symptomatology of a U.S. Naval disaster. Mil Med 1986;151:162–165.
7. Millegan J, Delaney EM, Klam W. Responding to Trauma at Sea: A case study in psychological first aid, unique occupational stressors, and resiliency self-care. Mil Med 2016;181:e1692-e5.
8. North CS, King RV, Fowler RL, et al. Delivery of Mental Health Care in a Large Disaster Shelter. Disaster Med Public Health Prep 2015;9:423–429.
9. Bishop LC, Thornby J. Psychiatric consultation with medical evacuees of Hurricane Katrina. Wilderness Environ Med 2009;20:1–5.
10. Nukui H, Midorikawa S, Murakami M, Maeda M, Ohtsuru A. Mental health of nurses after the Fukushima complex disaster: A narrative review. J Radiat Res 2018;59:ii108-ii13.
11. Wilder J, Vongraven D, Atwood T, Hansen B, Jessen A, Kochnev A, et al. Polar bear attacks on humans: Implications of a changing climate. Wildlife Soc Bull 2017;41:537–547.
12. McGwin K. Greenland Polar Bear Management Plan Seeks Balance Between Conservation and Exploitation. Anchorage, AK: Arctic Times, 2018.
13. Guly C. Polar bear kills man protecting his daughters in rare attack. The Telegraph. Ottawa, Canada 2018.
14. Tuckey MR, Scott JE. Group critical incident stress debriefing with emergency services personnel: A randomized controlled trial. Anxiety Stress Coping 2014;27:38–54.
15. Jacobs J, Horne-Moyer HL, Jones R. The effectiveness of critical incident stress debriefing with primary and secondary trauma victims. Int J Emerg Ment Health 2004;6:5–14.
16. Strand R, Felices K, Williams K. Critical incident stress management (CISM) in support of special agents and other first responders responding to the Fort Hood shooting: Summary and recommendations. Int J Emerg Ment Health 2010;12:151–160.
17. Adler AB, Litz BT, Castro CA, et al. A group randomized trial of critical incident stress debriefing provided to U.S. peacekeepers. J Trauma Stress 2008;21:253–263.
18. Rose SC, Bisson J, Churchill R, Wessely S. Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database of Syst Rev 2002; DOI: 10.1002/14651858.CD000560.
19. Mortimer AR. Mental health response to acute stress following wilderness disaster. Wilderness Environ Med 2010;21:337–344.
20. Everly GS Jr., Lee McCabe O, Semon NL, Thompson CB, Links JM. The development of a model of psychological first aid for non-mental health trained public health personnel: The Johns Hopkins RAPID-PFA. J Public Health Manag Pract 2014;20 Suppl 5:S24–S29.
21. Hobfoll SE, Watson P, Bell CC, et al. Five essential elements of immediate and mid–term mass trauma intervention: Empirical evidence. Psychiatry 2007;70:283–315.
22. Everly GS Jr., Lating JM, Sherman MF, Goncher I. The potential efficacy of psychological first aid on self-reported anxiety and mood: A Pilot Study. J Nerv Ment Dis 2016;204:233–235.
23. Everly GS Jr., Barnett DJ, Links JM. The Johns Hopkins model of psychological first aid (RAPID-PFA): Curriculum development and content validation. Int J Emerg Ment Health 2012;14:95–103.
24. Hori K, Uchida Y, Kan T, et al. Tele-auscultation support system with mixed reality navigation. Conf Proc IEEE Eng Med Biol Soc 2013;2013:4646–4649.
25. Poropatich R, Lai E, McVeigh F, Bashshur R. The U.S. Army Telemedicine and m-Health Program: Making a difference at home and abroad. Telemed J E Health 2013;19:380–386.
26. Fortney JC, Pyne JM, Kimbrell TA, et al. Telemedicine-based collaborative care for posttraumatic stress disorder: A randomized clinical trial. JAMA Psychiatry 2015;72:58–67.
27. Pelton D, Wangelin B, Tuerk P. Utilizing Telehealth to Support Treatment of Acute Stress Disorder in a Theater of War: Prolonged Exposure via Clinical Videoconferencing. Telemed J E Health 2015;21:382–387.
28. Todder D, Matar M, Kaplan Z. Acute-phase trauma intervention using a videoconference link circumvents compromised access to expert trauma care. Telemed J E Health 2007;13:65–67.

Information & Authors


Published In

cover image Telemedicine and e-Health
Telemedicine and e-Health
Volume 26Issue Number 3March 2020
Pages: 369 - 373
PubMed: 30912705


Published online: 4 March 2020
Published in print: March 2020
Published ahead of print: 25 March 2019
Accepted: 12 January 2019
Received: 12 January 2019


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Samuel P. Brown, BS
Uniformed Services University of the Health Sciences, School of Medicine, Bethesda, Maryland.
Hillary E. Davis, MD, PhD [email protected]
Department of Emergency Medicine and University of Colorado School of Medicine, Aurora, Colorado.
Laura McGladrey, PMHNP
Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado.
Leslie Brooks, PA, MS
Department of Emergency Medicine, Providence Regional Medical Center, Everett, Washington.
Anne K. Lorentzen, MD
Ilulissat Hospital, Avanna Region, Ilulissat, Greenland.
Luit Penninga, MD, PhD
Ilulissat Hospital, Avanna Region, Ilulissat, Greenland.
Christopher Davis, MD
Department of Emergency Medicine and University of Colorado School of Medicine, Aurora, Colorado.
Jay Lemery, MD
Department of Emergency Medicine and University of Colorado School of Medicine, Aurora, Colorado.


Address correspondence to: Hillary Davis, MD, PhD, Department of Emergency Medicine, University of Colorado School of Medicine, Mail Stop C301, 12631 E. 17th Avenue, Aurora, CO 80045 [email protected]

Disclosure Statement

No competing financial interests exist.

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