Wilderness First Aid

One of the unique characteristics of backpacking is that it puts you in control of your own destiny in a very real, but sometimes dangerous, manner. There are no hospitals, usually no access to roads or ambulances, and very few doctors in the backcountry. So if someone in the group gets sick or injured, then it is up to the leaders to provide first aid. Their training, preparation, equipment, and attitude can literally make the difference between life and death in extreme circumstances.

The information on the site is a summary of the First Aid section of “Backpacking For Boys.”

When confronted with an emergency medical situation, go through the S.A.M.P.L.E checklist of questions: Symptoms, Allergies, Medications, Past Medical History, Last Ins & Outs, and Events leading up to it. For a complete discussion of this process, read the blog about it. S.A.M.P.L.E. method of figuring out what is wrong. Click here

Mountain Maladies
While just about anything can happen, there are a few common maladies that must be understood and leaders should “Be Prepared” to deal with them.

• Stomach Problems – Diarrhea: Backpackers occasionally experience minor stomach problems from eating unfamiliar food, unaccustomed physical exertion, and even from the stress of adapting to the unfamiliar wilderness. It can get much worse if the food is spoiled, bacteria is passed from dirty hands, or the cooking utensils do not get cleaned properly. (Usually, stomach problems from contaminated water take several days to cause symptoms and hikers are often home before they experience any symptoms.) First Aid for minor stomach problems is to provide antacids like Tums or Pepto Bismol. If diarrhea is the problem, then give the unfortunate hiker a couple of Imodium tablets. Always make sure they are drinking extra water to avoid dehydration.

• Dehydration: Everyone needs to be aware of the need to drink 3-4 liters of water every day (minimum) and buddies should make sure their buddies drink enough, even when everyone has to slow down and pump the water. In addition to heat, dehydration can be caused by medications, illness, and excessive sweating caused by wearing too many layers. Dark urine and headaches are the first sign of dehydration, followed by dizziness, vomiting, stumbling, and it gets worse from there. Clear and copious (urine) is the goal. First Aid is to take a rest and drink water or sports drink.

• Sunburn: First degree sunburns are caused by UV radiation rather than heat, and there is less natural protection against these rays at high altitudes. Wear sunscreen, especially on ears and face – the higher the SPF the better. First Aid for sunburn is to apply aloe or another cooling agent and cover with loose clothing.

• Heat Illnesses: Heat Cramps, Heat Exhaustion, and Heat Stroke are all caused by strenuous physical exercise in hot weather, which is a common scenario during late summer backpacking trips. Heat cramps lead to slowing circulation and fatigue. Heat Exhaustion means dizziness, weakness, nausea, and headache. Heat Stroke is characterized by noticeably red skin and the complete failure of heat loss mechanisms, which can quickly result in death. First Aid is to get into the shade, pour water on the victims head and torso, and rest until their body cools down. When in doubt – always treat the potential victim.

• Hypothermia: It’s very easy to get very cold during a summer trek if the weather turns unexpectedly frigid or you get caught in storm. The first sign of hypothermia is shivering, but the condition can quickly evolve into stumbling, mumbling, and eventually fumbling (loss of motor control) if nothing is done for the victim. People in second stage hypothermia often show no symptoms (they stop shivering) as their bodies begin to divert circulation from extremities to the body’s core to increase their chances for survival. By this time, they are losing motor control and might try removing clothing they believe is restricting their movement. Often they resist the idea that they are in trouble and might not want to accept help. First Aid for hypothermia is to get the victim out of any wet clothing (even if he has to borrow clothes), shelter him (tent, dry sleeping bag, or extra dry clothing), build a fire, and provide hot beverages. In extreme cases, these remedies might have to be forced on unwilling or uncooperative hikers.

• Extreme Hypothermia: Once the body loses its ability to regulate body heat, core temperatures can quickly drop to the point where the body shuts down. In severe cases, the victim might be experiencing extreme fatigue, disorientation, and will want to go to sleep. They cannot help themselves. Saving their life depends on arresting the drop in their body temperature. Don’t let the victim fall asleep, but remember that hikers in this condition are very vulnerable and sudden movements might cause their heart to stop. First Aid is to remove any wet clothing and get him into a sleeping bag. Two other hikers in light clothing can then hug the sleeping bag. Others can pile sleeping bags and blankets over and under the freezing hiker. (Make a giant “Scout burrito” out of all the sleeping bags.)

• Altitude Sickness: Every 1,000 feet of elevation gain reduces the body’s maximum work capacity by 3%. So the higher you climb, the more difficult it is for your body to operate successfully. Since many backpacking trips involve climbing mountains and crossing mountain passes, altitude sickness is very common. Symptoms include headache, nausea and vomiting, puffy hands and face, weakness, shortness of breath, and decreased appetite. It can affect experienced hikers as well as boys on their first outing. Usually, hikers acclimate to the altitude and the symptoms recede within 24 hours. First Aid is to drink lots of fluids and rest. If someone is having problems with altitude sickness, and the hike profile is showing several days of high altitude hiking, look for an alternative route at a lower altitude.

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