Safe and Sound

Basic First Aid for Minor Musculoskeletal Injuries and Snakebites
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Hiker on Dark Gulch
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Be prepared. There is no substitute for preparedness.

Adherence to this basic rule will prevent or ease the majority of mishaps that occur in the wild. Proper education prior to situations of risk allows you to cope in a purposeful fashion, rather than in a state of fear and panic. At least two, and preferably all, members of a wilderness expedition should understand first aid and medical rescue. On a casual family outing, one responsible adult should be skilled in first aid. Manual skills, such as mouth-to-mouth breathing, cardiopulmonary resuscitation (CPR), and the application of bandages and splints, should be practiced beforehand. Become familiar with technical rescue techniques pertinent to the environment you will be in (for example, high-angle rock, swift water, or avalanche-prone areas). Be certain to carry appropriate survival equipment, such as maps, a compass, waterproof matches, a knife, non-perishable food, a flashlight, and adequate first-aid supplies. Minimize the need for improvisation.

Prior to undertaking a trip where you will be far from formal medical assistance, it is wise to attend to any obvious medical problems. If you have not done so within the past 6 months, visit a dentist. Make certain that all of your immunizations are up to date. If you have a significant medical problem, you should carry an information card or a MedicAlert bracelet or tag; the latter has imprinted medical information and a phone number link to more detailed medical information.


A sexually active woman of childbearing age should have a test for early pregnancy detection prior to a wilderness expedition. Any pregnancy under 8 weeks' gestation has a 25% chance of miscarriage. Furthermore, it might be sensible to confirm that the fetus is properly situated within the uterus, and that there is not a risk for an ectopic (outside-the uterus) pregnancy, which might rupture and threaten the mother's life.

Common Sense

Many accidents occur because people ignore warning signs or don't anticipate problems. Swimmers are stung by jellyfish outside protective net enclosures; non-swimmers drown while participating in hazardous whitewater rafting adventures. Pay heed to rangers, posted warnings, weather reports, and the experience of seasoned guides. Prepare for situations of risk by developing your skills in less challenging conditions. Wear recommended personal safety equipment, such as a flotation jacket, safety harness, or climbing helmet. Do not tolerate horseplay in dangerous settings.

Conditioning and Acclimatization

Many health hazards of wilderness travel, such as falls, can be avoided by a reasonable degree of strength and endurance which can only be acquired by conditioning. Every expedition member should begin from a state of maximum fitness. Other health hazards, such as temperature extremes and high-altitude disorders, can in certain circumstances be avoided by acclimatization to the environment. Acclimatization is a physiological adaptation that is often different from, and may be unrelated to, physical fitness.

Equipment

Be prepared for foul-weather conditions. Always assume that you will be forced to spend an unexpected night outdoors. Carry warm clothing and waterproof rain gear. Break in all footwear, and take care to pad rough edges and exposed seams. Consider carrying a compact emergency position indicating radio beacon (EPIRB).

All expedition leaders should carry safety and first-aid supplies for the most likely mishaps. Medical supplies must be arranged so that they can be rapidly located and deployed.

Communication

Prepare a trip plan (itinerary) and record it in a location (trailhead, ranger station, marina, or the like) where someone will recognize when a person or party is overdue and potentially lost or in trouble. Similarly, determine beforehand a plan for getting help in an emergency, whether it involves radio communication, ground-to-air or ship-to-shore signals, cellular telephone, or knowing the location of the nearest pay telephone, ranger station, or first-aid facility. If mobile rescue-grade equipment is to be used, it should be checked and double-checked prior to departure, and regularly scheduled communications prepared. At least two members of any expedition should be able to fashion standard ground-to-air distress markers. Make sure that children wear an item of bright clothing and carry a whistle that they know to blow if they are frightened or lost. If you carry a radio, know how to tune in to a weather information channel. The National Weather Service issues a"watch" when conditions are right for the development of a particular weather pattern, and a "warning" when its arrival is imminent.

Trip Plans

In most stories of miraculous ocean or wildland survival, the first chapter includes the account of how the victim lost his way. All wilderness travelers should carry maps, be proficient with compass routing, and know in advance where they intend to explore. People with specific medical disabilities, such as chronic severe lung disease, may be advised by a physician to avoid certain stressful environments, such as high altitude. If you are traveling in snow country, you should know how to avoid being caught in an avalanche, and consider carrying an avalanche transceiver that operates on dual frequencies: 457 kilohertz (kHz) (new standard) and 2,275 hertz (Hz) (old standard).

Medicines

There is no need to carry a drugstore on a day hike. On the other hand, drugs necessary to treat established medical problems (such as nitroglycerin tablets for a person with angina) should always be on hand. It is the responsibility of the trip leader to be aware of any potential medical problems and to insist that people in obviously poor physical condition not undertake activities that might endanger themselves or others. Any person with allergies, diabetes, epilepsy, or special medical instructions should wear an identification bracelet or carry a medical information card. Anyone who takes medications should carry a list of drugs and doses. If you travel abroad, it is wise to carry an adequate supply of routine medications, as well as a note from a physician stating their necessity, should you be questioned or need refills. All people should receive adequate anti-tetanus and other locally required immunizations prior to the trip.

Nutrition

Anyone who undertakes vigorous physical activity should consume adequate calories in a well-balanced diet. A debilitating weight-reduction program should not be continued in the wilderness, where a rescue might depend on extraordinary effort and endurance.

To avoid dehydration and exhaustion, take adequate time to eat, drink, and rest. Most adult males require 3,000 to 5,000 food calories each day in order to sustain heavy physical exertion. Women require 2,000 to 3,500 calories. A nutritious diet can easily be maintained with proper planning. Don't plan to live off the land unless you are a survival expert.

Consider carrying a supply of energy bars, such as the Cliff Bar, Promax Bar, or PowerBar. For example, the Cliff Bar weighs 68 g and delivers approximately 2 to 6 g fat, 45 to 52 g carbohydrates, and 4 to 12 g protein. For a less nutritive energy boost of carbohydrate, sodium, and potassium, carry Cliff Shot Energy Gel (64 g tube).

Fluid Requirements

Fluid requirements have been well worked out for all levels of exercise. Most people underestimate their fluid requirements. Encourage frequent rest stops and water breaks. If natural sources of drinkable water (springs, wells, ice-melt runoff) will not be encountered, you should carry at least a 48-hour supply. Carry supplies for water disinfection.


Published: 29 Apr 2002 | Last Updated: 3 Dec 2012
Details mentioned in this article were accurate at the time of publication
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