“Live as if you were to die tomorrow. Learn as if you were to live forever.”
Long before emergency care was a science, it was an aspect of faith, a type of magic. History is littered with nonsensical ancient cures for all sorts of illnesses and injuries. The Greeks would implore Apollo, the god of medicine, to help heal trauma incurred in warfare. In seventeenth century Ireland, it was said that whooping cough could be cured by drinking water from a bishop’s skull.
In parts of old Europe, people would hang cans of dog fat over their shoulders, swallow monkey gallstones, and use lizard’s blood to treat day-to-day maladies. Medical care has unquestionably come a long way since the days of believing that rubbing pure Mercury on a scraped knee would aid in healing. We have attained a deeper understanding of anatomical science and of the organisms that live in our world, and this has helped to elevate our effectiveness in treating a multitude of medical concerns.
The surge in our knowledge of emergency medicine was born from the blood of the thousands of veterans who have been injured or killed on the innumerable battlefields throughout the centuries. As the weaponry used in combat became more sophisticated, the injuries that the soldiers sustained became more complicated and gruesome.
Field doctors initially learned through trial and error and later, expansions in scientific development aided them in their ability to treat the wounded. We hikers, mountaineers and all around adventurers owe a debt of gratitude to these soldiers, doctors and nurses of war. We can go on our legions of wondrous quests armed with the medical insights given to us by these courageous men and women.
Of course, I am a bit biased. Being a former US Navy corpsman serving with the Marines made me realize that even a seemingly small injury, bite or blister, left untended, can incapacitate us – or even kill us. Furthermore, basic first aid should be something you know no matter if you’re bugging out, hiking the mountain summits or local nature trails, or at the neighborhood playground with the kids.
While there are many books written on first aid – and I recommend all of us have at least two, one for basic and advanced life support in our libraries – I’ve only covered the very basic, top four or so here. Each of us has personal experiences where a first aid treatment has helped us cope with an immediate need. I know I have several – I even used a yak bone once to splint a broken arm – but I’d like to know some of your experiences. In the field, at home, anyplace that you’ve treated injury or illness as a first responder when friends and family is what I’m interested in hearing about.
Remember, this article is just to get you thinking about making yourself confident in your skill sets, and therefore, safer no matter where you are or no matter what situation you may find yourself. Consider it a refresher for those in the know, and a jumping off point for those just embarking on their journey.
A Few Common First Aid Issues When on the Trail
Blisters are injuries that many underestimate. It may seem like a small matter but it can quickly become a major concern. Blisters usually develop because of repeated pressure or friction to the skin. The best course of action is to make sure you are wearing proper footwear. A rookie mistake is to try and break in your brand new hiking boots on a long outing. This will guarantee that you will have blister problems. I remember being at Camp Pendleton during field medical training. We were on a 4-day training mission and two corpsman in training left wearing a new set of combat boots. One developed heel blisters so bad he had to be carried from the field. The other guy developed severe blisters on the side of his small toe. He, too, was removed from the field. That’s two casualties as a result of bad decision making at the outset. It was compounded by not getting proper care when the blisters first appeared.
You want to make sure that your boots are well broken in before you attempt an extensive trek. It’s best to keep a blister intact. If you are able the bear the pain, then try not to break the skin. Unbroken skin over a blister provides a natural barrier to bacteria and reduces the risk of infection. Cover a small blister with an adhesive bandage and cover a large one with a porous, plastic-coated gauze pad that absorbs moisture and allows the wound to breathe. To relieve blister-related pain, drain the fluid while leaving the overlying skin intact. Below is basic blister care. However, I NEVER leave home without some moleskin tucked safely away in my first aid kit. While it shouldn’t be used directly against a blister, I’ve used it in conjunction with a gauze pad with great success.
How to properly drain a blister
- Wash your hands and the blister with soap and warm water.
- Swab the blister with iodine or rubbing alcohol.
- Sterilize a clean, sharp needle by wiping it with rubbing alcohol.
- Use the needle to puncture the blister. Aim for several spots near the blister’s edge. Let the fluid drain, but leave the overlying skin in place.
- Apply an antibiotic ointment to the blister and cover with a bandage or gauze pad.
- Cut away all the dead skin after several days, using tweezers and scissors sterilized with rubbing alcohol. Apply more ointment and a bandage.
A sprained ankle can immobilize you and that is a situation you do not want to be in out in the wild. A good way of remember what to do when faced with a sprained ankle is: RICE.
- R- Rest
- I-Apply Ice
- C-Apply compression to the ankle
- E-Elevate the injured ankle
Hikers are very susceptible to burns. The most easily acquired burn is the sunburn. So many hikers forget how dangerous it can be when the skin is exposed to the sun for numerous hours on end. A simple thing like remembering to apply the appropriate amount of sun block protection, will save you from a great deal of pain and discomfort. Especially at higher elevations. I learned the hard way once that snow can lead to some really bad sunburns. Ever had your eyelids burned? Or how about your nostrils? It can happen. Wear sunblock appropriate for your skin type. For me, I wear SPF 100 when at elevation. Some say beyond SPF 50 is redundant. So be it. Call me redundant. And don’t forget the most overlooked body part when it comes to sunburn: the tips of your ears.
Campfire injuries are also another cause of burn injuries in the outdoors.
There are variant degrees of burns
- First-Degree Burn is the least serious of the burns. In a first degree burn, only the outer layer of skin is burned, but not all the way through.
- The skin is usually red
- Pain sometimes is present
**Treat a first-degree burn as a minor burn unless it involves substantial portions of the hands, feet, face, groin or buttocks, or a major joint, which requires emergency medical attention.
- Second-Degree burns occur when the first and second layer of skin is burned.
- Blisters develop
- Skin takes on an intensely reddened, splotchy appearance
- There is severe pain and swelling.
If the second-degree burn is no larger than 3 inches in diameter, you can treat it as a minor burn. But if the burned area is larger or if the burn is on the hands, feet, face, groin or buttocks, or over a major joint, treat it as a major burn and get medical help immediately.
- Third-Degree burns are the most serious burns. Third-degree burn involve all layers of the skin and cause permanent tissue damage. Fat, muscle and even bone may be affected.
- Areas may be charred black or appear dry and white.
What to Do:
(Mayo Clinic Recommendations)
- Minor Burns, including first-degree burns and second-degree burns limited to an area no larger than 3 inches (7.6 centimeters) in diameter, take the following action:
- Cool the burn.Hold the burned area under cool (not cold) running water for 10 or 15 minutes or until the pain subsides. If this is impractical, immerse the burn in cool water or cool it with cold compresses. Cooling the burn reduces swelling by conducting heat away from the skin. Don’t put ice on the burn.
- Cover the burn with a sterile gauze bandage. Don’t use fluffy cotton, or other material that may get lint in the wound. Wrap the gauze loosely to avoid putting pressure on burned skin. Bandaging keeps air off the burn, reduces pain and protects blistered skin.
- Take an over-the-counter pain reliever. These include aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve) or acetaminophen (Tylenol, others). Use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 2, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. Talk to your doctor if you have concerns.
**Minor burns usually heal without further treatment. They may heal with pigment changes, meaning the healed area may be a different color from the surrounding skin. Watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. If infection develops, seek medical help. Avoid re-injuring or tanning if the burns are less than a year old — doing so may cause more extensive pigmentation changes. Use sunscreen on the area for at least a year.
- Do Not use ice. Putting ice directly on a burn can cause a person’s body to become too cold and cause further damage to the wound.
- Do Not apply egg whites, butter or ointments to the burn. This could cause infection.
- Do Not break blisters. Broken blisters are more vulnerable to infection.
- DO NOT remove burned clothing. However, do make sure the victim is no longer in contact with smoldering materials or exposed to smoke or heat.
- DO NOT immerse large severe burns in cold water. Doing so could cause a drop in body temperature (hypothermia) and deterioration of blood pressure and circulation (shock).
- Regularly check for signs of circulation (breathing, coughing or movement). If there is no breathing or other sign of circulation, begin CPR.
- Elevate the burned body part or parts. Raise above heart level, when possible.
- Cover the area of the burn. Use a cool, moist, sterile bandage; clean, moist cloth; or moist cloth towels.
There are a myriad of flying and crawling critters that can wreak havoc on your adventure.
- Mosquitoes are notorious pests who are usually just an annoyance. If you can bring DEET with you, that helps a great deal. The higher concentrations are what you want. 30% concentration is minimal that I’ll use. And don’t buy the fru-fru stuff with smell-good additives. After being on the trail and sweating over campfires, what’s a little chemical smell among friends? Also, having a mosquito net with you will make your nights more tolerable.
- Bees & Wasps are very commonly encountered on hikes and if you are stung, I recommend doing the following: Remove the stinger with a pair of tweezers and then immediately apply a hot compress. Bee venom can be neutralized by applying baking soda. A wasp’s venom can be neutralized by applying vinegar or lemon juice. Having Benadryl or another brand of antihistamine at your ready will offer some relief from possible allergic reactions. Also, having one of those “No-Sting” medicine sticks you can pick up at any big-block pharmacy store is a must for your field kit.
It’s good to note that most North American snakes are not venomous – most. The list of venomous snakes are: Coral snake, Rattlesnake (several varieties), Water Moccasins (Cottonmouth), and Copperhead-I believe I’ve listed all of them. You are most likely going to run into a snake or two on your journey and sometimes, it’s difficult to tell the venomous from non-venomous snakes. The safest thing you can do when you come across a snake is assume it is dangerous and slowly back away. If you take all precautions and are still bitten, try not to panic. Do your best to stay as calm as possible. You will want to then do the following:
- Immobilize the bitten arm or leg, and stay as still as possible in order to keep the venom from spreading through your body.
- Try and remove any jewelry that might constrict you in any way once you start to swell.
- Try and position yourself so that the bite is at or below the level of your heart.
- Cleanse the wound, but don’t flush it with water, and cover it with a clean, dry dressing.
- Restricting your movement is important so apply a splint to reduce movement of the affected area, but keep it loose enough so as not to restrict blood flow.
- DO NOT use a tourniquet or apply ice.
- DO NOT cut the wound or attempt to remove the venom.
- DO NOT drink caffeine or alcohol.
- DO NOT try to capture the snake, but do your best to memorize its color and shape so you will be able to describe it to the medical staff.
There are countless things that can go awry on a trek. The unpredictability of life follows as you ascend mountains and venture deep into the backwoods. A gash, a fracture, a burn, a bite. A fever, a stumble, a creature in the night. Any of these matters can be the thief that steals the journey from you. Navigate the trails with wisdom, my friends.
“Be afraid of nothing but be aware of everything.”~Rajan Shrestha
Wilderness First Responder, 3rd: How to Recognize, Treat, and Prevent Emergencies in the Backcountry … by Buck Tilton
The Wilderness First Aid Handbook by Grant S. Lipman Paperback
Wilderness First Aid: A Waterproof Pocket Guide to Common Sense Self Care (Pathfinder Outdoor Survival … by J.M. (Jill) Kavanagh
The Survival Medicine Handbook: A Guide for When Help is Not on the Way by Joseph Alton
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