These protocols examine commonly encountered medical and trauma assessments on expeditions and adventure travels. The new additions also include more details trauma/tactical EMS scenarios and standing orders. This is due to our provision of medical care in potentially hostile environments and our paramedics receiving additional Tactical EMS training. Everything from altitude sickness and diarrhea to blisters and penetrating chest trauma are covered. This represents an extraordinary effort on the part of many individuals working with Adventure Doc and I am very happy with the results.