The journal Annals of Primary Care and Wildlife Trauma has published a revolutionary new screening tool for busy primary care docs wondering whether their patient is at risk for bear-induced medical injury (BIMI). Bear-induced medical injury and bear-related limb reduction (BRLR) have been a part of human existence for thousands of years, but this is a first step toward reducing its devastating effect on human health. The authoritative Wikipedia articles “Bear Attack” and “List of Fatal Bear Attacks” do an excellent job of highlighting the need for better risk assessments.
“This is just what we’ve all been waiting for. We have screening tools for everything – heart disease, stroke, cancer – but I’ve had no way to know which of my patients were at risk for being mauled by a bear. Bears strike when you least expect it and undermine everything that I do as a primary care physician. I can spend years managing a patient’s blood pressure or cholesterol, but if I don’t consider bears, then I’m not truly guarding their health. After all, it doesn’t matter what your cholesterol level is when a bear has your head between its jaws,” said Bill Justerson, DO, who practices Internal Medicine in Newark, New Jersey.
“…It doesn’t matter what your cholesterol level is when a bear has your head between its jaws.”
The simple 4-question screening tool allows providers to designate a patient as low, intermediate, or high risk for BIMI.
BIMI RISK SCORE CALCULATOR:
1) How frequently do you encounter bears during an average week?
-Less than 3 times per week (0 points)
-Greater than 3 times per week (1 point)
2) When you encounter a bear, how much time on average do you spend with him or her?
-Less than 1 minutes (0 points)
-More than 1 minute (1 point)
3) How would you describe your attitude toward bears, in general?
-Avoidant (0 points)
-Aggressive or Curious (2 points)
4) Have you ever attempted to pet a bear cub?
-No (0 points)
-Yes (3 points)
Patient’s with a risk score of 0, can be reassured for they are at low risk for a bear attack. Patients with BIMI risk scores of 3 or higher may need further counseling about preventative measures for bear-related illness. Patients with scores of 7 (Highest Risk) should be advised to stay far away from anywhere where they might experience bear exposure.
Bear attack survivor, Jed Crewwallis, welcomes the new screening tool. Bear-induced medical injury struck him suddenly and without warning in Yosemite National Park when he tried to put a leash on a bear cub that he found in a rock crevice near his campsite. Inexplicably, a nearby aggressive adult female bear attacked leaving him with a ragged stump as a testament to the need for better preventative screening for such attacks.
“I call bear attacks the ‘not silent’ killer. Lots of men worry about their prostates or colons…but I’ll tell you that when a grizzly is swallowing your leg, colon polyps are the last thing on your mind. If I had known I was at high risk for a bear attack, I probably wouldn’t have ventured into Yosemite.”
“…when a grizzly is swallowing your leg, colon polyps are the last thing on your mind…”
The US Preventative Services Task Force (USPSTF) states that evidence is currently insufficient to recommend routine screening for risk related to bear attacks, but Dr. Justerson says he won’t let data or evidence-based recommendations stand in the way of practicing medicine the way he thinks is right; he has already implemented the new tool and is proud to report that not a single patient of his has suffered a bear attack since he began screening.
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