Bio

Clinical Focus


  • Emergency Medicine

Academic Appointments


Administrative Appointments


  • Medical Advisor, California Outward Bound (2012 - Present)
  • Medical Director, Stanford Outdoor Education, Stanford University (2009 - Present)
  • Director, ED Fast Track, Division of Emegency Medicine, Stanford University School of Medicine (2012 - Present)
  • Co-Director, Wilderness Medicine Fellowship (2014 - Present)
  • Editorial Board / Reviewer, Wilderness and Environmental Medicine (2004 - Present)
  • Executive Board Member, American College of Emergency Physicians Section of Wilderness Medicine (2006 - 2014)

Honors & Awards


  • Research Award, Wilderness Medical Society (2013)

Professional Education


  • Residency:St Luke's-Roosevelt Hospital Center/Columbia University College of Physicians and Surgeons (2004) NY
  • Medical Education:St George's University School of Medicine (2001) West Indies
  • Board Certification: Emergency Medicine, American Board of Emergency Medicine (2005)
  • BA, Connecticut College, Environmental Studies (1995)
  • MD, St. George's School of Medicine, Medicine (2001)
  • Residency, St. Luke's -Roosevelt Hospital, Emergency Medicine (2004)
  • Fellow, Stanford University Hospital, Wilderness Medicine (2005)

Research & Scholarship

Current Research and Scholarly Interests


Acute Mountain Sickness: prevention and novel interventions. Injury prevention in ultra-marathon runners. Acute Kidney Injury and electrolyte imbalances in ultra-endurance athletes. Heat induced illness and novel treatments.

Clinical Trials


  • Prevention of Altitude Illness With Non-steroidal Anti-inflammatory Study (PAINS) Not Recruiting

    This is a research study on Altitude Illness. From the information collected and studied in this project we hope to learn more about Altitude Illness, including factors that may affect and prevent the development and progression of this condition. We hope to learn if the commonly used non-steroidal anti-inflammatory medication, ibuprofen can prevent altitude illness. Possible participants in this study are healthy adults who indicated they would like to participate, learn about altitude illness, and desire to hike Barcroft Peak. Stanford University researchers hope to enroll about 100 participants.

    Stanford is currently not accepting patients for this trial. For more information, please contact Grant Lipman, (650) 723 - 6576.

    View full details

  • Study Looking at End Expiratory Pressure for Altitude Illness Decrease (SLEEP-AID) Recruiting

    The study is examining if an over-the-counter device (Theravent) worn while sleeping can reduce acute mountain sickness upon awakening in a high altitude trekking population.

    View full details

  • Chemical Ice Packs for Cooling Hyperthermic Patients Recruiting

    A common tool to cool people in the pre-hospital setting is the chemical ice pack. These are used by athletic trainers, EMS personnel, ER staff, and people in the prehosoital setting. The ability of these to cool a person has never been quantified, the efficiency and extent of cooling, as well as location of placement of ice packs is purely anecdotal. The purpose of this study is to determine whether strategically placed chemical ice packs will provide benefit to individuals subjected to heat stress.

    View full details

  • Prevention Trial Assessing Paper-Tape in Endurance Distances (PreTAPED) Not Recruiting

    Blisters are a very common complaint in both the general population and also the athlete. This study's aim is to determine whether applying paper tape (an inexpensive and common component of most foot care kits) to the foot of endurance runners prevents the frequency and severity of friction blisters.

    Stanford is currently not accepting patients for this trial. For more information, please contact Grant Lipman, (650) 725 - 9445.

    View full details

Teaching

2013-14 Courses


Publications

Journal Articles


  • Wilderness medical society practice guidelines for the prevention and treatment of heat-related illness. Wilderness & environmental medicine Lipman, G. S., Eifling, K. P., Ellis, M. A., Gaudio, F. G., Otten, E. M., Grissom, C. K. 2013; 24 (4): 351-361

    Abstract

    The Wilderness Medical Society (WMS) convened an expert panel to develop a set of evidence-based guidelines for the recognition, prevention, and treatment of heat-related illness. We present a review of the classifications, pathophysiology, and evidence-based guidelines for planning and preventive measures as well as best-practice recommendations for both field- and hospital-based therapeutic management of heat-related illness. These recommendations are graded based on the quality of supporting evidence and the balance between the benefits and risks or burdens for each modality.

    View details for DOI 10.1016/j.wem.2013.07.004

    View details for PubMedID 24140191

  • Ibuprofen Prevents Altitude Illness: A Randomized Controlled Trial for Prevention of Altitude Illness With Nonsteroidal Anti-inflammatories ANNALS OF EMERGENCY MEDICINE Lipman, G. S., Kanaan, N. C., Holck, P. S., Constance, B. B., Gertsch, J. H. 2012; 59 (6): 484-490

    Abstract

    Acute mountain sickness occurs in more than 25% of the tens of millions of people who travel to high altitude each year. Previous studies on chemoprophylaxis with nonsteroidal anti-inflammatory drugs are limited in their ability to determine efficacy. We compare ibuprofen versus placebo in the prevention of acute mountain sickness incidence and severity on ascent from low to high altitude.Healthy adult volunteers living at low altitude were randomized to ibuprofen 600 mg or placebo 3 times daily, starting 6 hours before ascent from 1,240 m (4,100 ft) to 3,810 m (12,570 ft) during July and August 2010 in the White Mountains of California. The main outcome measures were acute mountain sickness incidence and severity, measured by the Lake Louise Questionnaire acute mountain sickness score with a diagnosis of ? 3 with headache and 1 other symptom.Eighty-six participants completed the study; 44 (51%) received ibuprofen and 42 (49%) placebo. There were no differences in demographic characteristics between the 2 groups. Fewer participants in the ibuprofen group (43%) developed acute mountain sickness compared with those receiving placebo (69%) (odds ratio 0.3, 95% confidence interval 0.1 to 0.8; number needed to treat 3.9, 95% confidence interval 2 to 33). The acute mountain sickness severity was higher in the placebo group (4.4 [SD 2.6]) than individuals receiving ibuprofen (3.2 [SD 2.4]) (mean difference 0.9%; 95% confidence interval 0.3% to 3.0%).Compared with placebo, ibuprofen was effective in reducing the incidence of acute mountain sickness.

    View details for DOI 10.1016/j.annemergmed.2012.01.019

    View details for Web of Science ID 000305302300008

    View details for PubMedID 22440488

  • Core Content for Wilderness Medicine Fellowship Training of Emergency Medicine Graduates ACADEMIC EMERGENCY MEDICINE Lipman, G. S., Weichenthal, L., Harris, N. S., McIntosh, S. E., Cushing, T., Caudell, M. J., Macias, D. J., Weiss, E. A., Lemery, J., Ellis, M. A., Spano, S., McDevitt, M., Tedeschi, C., Dow, J., Mazzorana, V., McGinnis, H., Gardner, A. F., Auerbach, P. S. 2014; 21 (2): 204-207

    Abstract

    Wilderness medicine is the practice of resource-limited medicine under austere conditions. In 2003, the first wilderness medicine fellowship was established, and as of March 2013, a total of 12 wilderness medicine fellowships exist. In 2009 the American College of Emergency Physicians Wilderness Medicine Section created a Fellowship Subcommittee and Taskforce to bring together fellowship directors, associate directors, and other interested stakeholders to research and develop a standardized curriculum and core content for emergency medicine (EM)-based wilderness medicine fellowships. This paper describes the process and results of what became a 4-year project to articulate a standardized curriculum for wilderness medicine fellowships. The final product specifies the minimum core content that should be covered during a 1-year wilderness medicine fellowship. It also describes the structure, length, site, and program requirements for a wilderness medicine fellowship.

    View details for DOI 10.1111/acem.12304

    View details for Web of Science ID 000331297500013

    View details for PubMedID 24438590

  • A Prospective Cohort Study of Acute Kidney Injury in Multi-stage Ultramarathon Runners: The Biochemistry in Endurance Runner Study (BIERS). Research in sports medicine Lipman, G. S., Krabak, B. J., Waite, B. L., Logan, S. B., Menon, A., Chan, G. K. 2014; 22 (2): 185-192

    Abstract

    The purpose of the study was to evaluate the prevalence of acute kidney injury (AKI) during a multi-stage ultramarathon foot race. A prospective observational study was taken during the Gobi 2008; Sahara 2008; and Namibia 2009 RacingThePlanet 7-day, 6-stage, 150-mile foot ultramarathons. Blood was analyzed before, and immediately after stage 1 (25 miles), 3 (75 miles), and 5 (140 miles). Creatinine (Cr), glomerular filtration rate (GFR), and incidence of AKI were calculated and defined by RIFLE criteria. Thirty participants (76% male, mean age 40 + 11 years) were enrolled. There were significant declines in GFR after each stage compared with the pre-race baseline (p < 0.001), with the majority of participants (55-80%) incurring AKI. The majority of study participants encountered significant renal impairment; however, no apparent cumulative effect was observed, with resolution of renal function to near baseline levels between stages.

    View details for DOI 10.1080/15438627.2014.881824

    View details for PubMedID 24650338

  • Ibuprofen for prevention of acute mountain sickness: is bigger really better? Wilderness & environmental medicine Lipman, G. S., Kanaan, N. C. 2013; 24 (2): 177-178

    View details for DOI 10.1016/j.wem.2012.11.007

    View details for PubMedID 23434167

  • Injury and illnesses prevention for ultramarathoners. Current sports medicine reports Krabak, B. J., Waite, B., Lipman, G. 2013; 12 (3): 183-189

    Abstract

    The popularity of ultramarathon races continue to grow with runners participating in races throughout the world. These events offer challenges unique to an ultramarathon compared to a marathon race. These challenges require the athlete to focus on factors including race distance, race stages, race environment (temperature, humidity, and altitude), appropriate training, nutritional preparation, and equipment. Athletes ill prepared for these challenges will be at risk from injury and illness. The goal of this article is to review preventive strategies for managing commonly encountered musculoskeletal injuries and medical illnesses in ultramarathon runners.

    View details for DOI 10.1249/JSR.0b013e3182913c98

    View details for PubMedID 23669089

  • Chemical Cold Packs May Provide Insufficient Enthalpy Change for Treatment of Hyperthermia WILDERNESS & ENVIRONMENTAL MEDICINE Phan, S., Lissoway, J., Lipman, G. S. 2013; 24 (1): 37-41

    Abstract

    Heat illness is a common ailment that, if left untreated, is associated with high morbidity and mortality. Chemical cold packs (CCPs) and ice packs are widely used in the pre-hospital setting and by those with limited resources, yet no controlled studies have compared the cooling of ice to that of CCPs. This study determined the theoretical cooling of CCPs on a benchtop model, comparing the results to similarly sized ice packs, and is the first known comparison of these hyperthermia treatments.The CCPs used in Stanford University's Emergency Department were activated in an insulated volume of water (2 L), and temperature was recorded at 1-second intervals in a controlled environment (41C at 20% humidity). The procedure was repeated with 1-quart ice packs.The CCPs resulted in a 5.25C degree temperature drop, with a time constant (time to 63% of initial temperature--a common engineering characterization metric) of 1.72 minutes for the test volume. Ice packs resulted on average in a 19.8C temperature change, with a time constant of 26.8 minutes. The CCPs provide less overall temperature change and were shorter lived. Application of 6 CCPs on a 50th percentile male (weight 86.6 kg, height 1.7 m), assuming ideal heat transfer, would result in less than 0.5C temperature change. Similarly configured ice packs would result in a 2.5C change.Experiments demonstrate that CCPs are inferior to similarly sized ice packs for thermal regulation, and lose their effectiveness more quickly. These findings support the consideration of ice packs as an alternative to chemical cold packs when cooling hyperthermic patients.

    View details for Web of Science ID 000315473300010

    View details for PubMedID 23312558

  • Pharmacologic Prevention for Acute Mountain Sickness-Lack of Appropriate Inclusion of the Available Evidence ANNALS OF EMERGENCY MEDICINE Lipman, G. S., Gertsch, J. H. 2012; 60 (4): 538-539
  • Prospective, Double-Blind, Randomized, Placebo-Controlled Comparison of Acetazolamide Versus Ibuprofen for Prophylaxis Against High Altitude Headache: The Headache Evaluation at Altitude Trial (HEAT) WILDERNESS & ENVIRONMENTAL MEDICINE Gertsch, J. H., Lipman, G. S., Holck, P. S., Merritt, A., Mulcahy, A., Fisher, R. S., Basnyat, B., Allison, E., Hanzelka, K., Hazan, A., Meyers, Z., Odegaard, J., Pook, B., Thompson, M., Slomovic, B., Wahlberg, H., Wilshaw, V., Weiss, E. A., Zafren, K. 2010; 21 (3): 236-243

    Abstract

    High altitude headache (HAH) is the most common neurological complaint at altitude and the defining component of acute mountain sickness (AMS). However, there is a paucity of literature concerning its prevention. Toward this end, we initiated a prospective, double-blind, randomized, placebo-controlled trial in the Nepal Himalaya designed to compare the effectiveness of ibuprofen and acetazolamide for the prevention of HAH.Three hundred forty-three healthy western trekkers were recruited at altitudes of 4280 m and 4358 m and assigned to receive ibuprofen 600 mg, acetazolamide 85 mg, or placebo 3 times daily before continued ascent to 4928 m. Outcome measures included headache incidence and severity, AMS incidence and severity on the Lake Louise AMS Questionnaire (LLQ), and visual analog scale (VAS).Two hundred sixty-five of 343 subjects completed the trial. HAH incidence was similar when treated with acetazolamide (27.1%) or ibuprofen (27.5%; P = .95), and both agents were significantly more effective than placebo (45.3%; P = .01). AMS incidence was similar when treated with acetazolamide (18.8%) or ibuprofen (13.7%; P = .34), and both agents were significantly more effective than placebo (28.6%; P = .03). In fully compliant participants, moderate or severe headache incidence was similar when treated with acetazolamide (3.8%) or ibuprofen (4.7%; P = .79), and both agents were significantly more effective than placebo (13.5%; P = .03).Ibuprofen and acetazolamide were similarly effective in preventing HAH. Ibuprofen was similar to acetazolamide in preventing symptoms of AMS, an interesting finding that implies a potentially new approach to prevention of cerebral forms of acute altitude illness.

    View details for Web of Science ID 000282163300007

    View details for PubMedID 20832701

  • Possible Unilateral Ultraviolet Keratoconjunctivitis During an Expedition-Length Desert Race WILDERNESS & ENVIRONMENTAL MEDICINE Lipman, G. S., Constance, B. B., Ladbrook, M. 2010; 21 (2): 171-172

    View details for Web of Science ID 000279235900017

    View details for PubMedID 20591383

  • Carbon monoxide toxicity at high altitude WILDERNESS & ENVIRONMENTAL MEDICINE Lipman, G. S. 2006; 17 (2): 144-145

    View details for Web of Science ID 000238243900013

    View details for PubMedID 16805152

  • Survival rates and cardiopulmonary resuscitation CRITICAL CARE MEDICINE Borzotta, A., Lipman, G., Dunn, P. M. 1998; 26 (7): 1293-1294

    View details for Web of Science ID 000074755500036

    View details for PubMedID 9671386

Conference Proceedings


  • Optic Nerve Sheath Diameter Changes on Ascent to High Altitude LIPMAN, G. S., Kanaan, N., Constance, B., Holck, P., Grimm, E., Jeffrey, G., Williams, S. MOSBY-ELSEVIER. 2011: S185-S186

Footer Links:

Stanford Medicine Resources: