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Encyclopedia > Wilderness first aid

Wilderness first aid is the specific discipline of First aid which relates to care in remote areas, where emergency medical services will be difficult to obtain or will take a long time to arrive. Nursing care though not part of normal first aid is part of wilderness first aid. Image File history File links Merge-arrows. ... To meet Wikipedias quality standards, this article or section may require cleanup. ... First aid is a series of simple, life-saving medical techniques that a non-doctor or layman can be trained to perform. ... An Emergency medical service (abbreviated to initialism EMS in many countries) is a service providing out-of-hospital acute care and transport to definitive care, to patients with illnesses and injuries which the patient believes constitutes a medical emergency. ... Nursing is a profession focused on assisting individuals, families, and communities in attaining, re-attaining, and maintaining optimal health and functioning. ... First aid is a series of simple, life-saving medical techniques that a non-doctor or layman can be trained to perform. ...


Training in wilderness first aid is available in the US, UK, and Canada. Any group of persons traveling in wilderness should have at least one person trained in wilderness first aid and carry a first aid kit designed for the area they are traveling in. First aid kit of the French Army A first aid kit is a collection of supplies and equipment for use in giving first aid, particularly in a medical emergency. ...


See medical emergency for a list of medical emergencies and specific guidance directed towards first-aiders, Outdoor Emergency Care technicians and EMTs, often including evacuation criteria. {{Otheruses4|the medical term|the Australian television series|Medical Emergenc an immediate threat to a persons life or long term health. ... // Outdoor Emergency Care Technicians Outdoor Emergency Care (OEC) is a course for certification in first aid, CPR and other pre-hospital care and treatment for possible injuries in non-urban settings. ... The Star of Life, a global symbol for medical service EMTs loading an injured skier into an ambulance An Emergency Medical Technician (EMT) is an emergency responder trained to provide emergency medical services to the critically ill and injured. ...

Contents

Leaving or staying with an injured person

A classic problem is whether to leave an injured person or stay if only one person is ambulatory. Barring special circumstances, the injured one should be stabilized, placed in shelter, and marked in a way visible from the air (usually a single, long line of cut brush or trampled snow). Then the injured one should be left alone, while the other goes for help.


If there are three or more, the healthy group should be split into halves by speed, with the fastest going for help, and the others remaining to make the preparations. (In a party of four, it would be a rare hiker who would be better sent for help alone, rather than sent in a sub-party of two.)


Ensuring the rescuers can find the injured person is crucial. If a personal locator beacon is available, it should be triggered and placed with the injured person. If enough help is available, air-visible markings may be worthwhile. Where surveyor's tape is available within the party (and assuming clear trails are available), it should be used by the sub-party going for help, to back up memory and notes with tape-flagging of the toward-the-injury-location choices of trail at intersections. (When an injury location is off clear trails, by distances that make it impractical to keep blazes of tape within sight of each other, forks in watercourses should be treated as substitutes for trail intersections.) Emergency Position-Indicating Radio Beacons (EPIRBs), Emergency Locator Transmitters (ELTs) and Personal Locator Beacons (PLBs) are tracking transmitters that operate as part of the Cospas-Sarsat satellite system. ...


Specific conditions

Image File history File links Wikibooks-logo. ... Wikibooks logo Wikibooks, previously called Wikimedia Free Textbook Project and Wikimedia-Textbooks, is a wiki for the creation of books. ...

Exposure

Exposure, sometimes called hypothermia, is a normal hazard of temperate wilderness. It occurs when a person's core body temperature falls below 33.7C (92.6F). If a person is wet, in a mild wind, it can occur in less than an hour at temperatures as high as 15°C (59°F). Hypothermia is a condition in which an organisms temperature drops below that Required fOr normal metabolism and Bodily functionS. In warm-blooded animals, core [[body Temperature]] is maintained nEar a constant leVel through biologic [[homEostasis]]. But wheN the body iS exposed to cold Its internal mechanismS may be unable...


The basic early symptoms are uncontrollable shivering, stiffness and confusion. The conclusive evidence is a cool or cold stomach. If the hypothermia has not yet advanced to a critical stage, basic treatment is to warm the person in a sleeping bag. People with hypothermia may have such depressed metabolisms that they can no longer heat themselves. However, if the hypothermia has become severe - the victim is confused or unconscious - it is critical not to warm them suddenly. Evacuation would be the preferred option, with warming undertaken in a controlled medical environment. Sudden warming of a severely hypothermic person can send the heart into a fatal, irregular beating pattern or arrhythmia. A cardiac arrhythmia, also called cardiac dysrhythmia, is a disturbance in the regular rhythm of the heartbeat. ...


Heat syncope: heat exhaustion or sunstroke

Both maladies tend to occur during heavy exercise in high humidity, or with inadequate water. Some chronically ill persons enter this state normally.


The basic symptom of heat syncope is a body temperature above 40°C (104°F) with fainting, or weakness but without mental confusion. If unconsciousness, confusion or convulsions are present, it is sunstroke which is rarer, but far more severe condition, a true medical emergency. {{Otheruses4|the medical term|the Australian television series|Medical Emergenc an immediate threat to a persons life or long term health. ...


Note that some authorities do not distinguish heat syncope from sunstroke, and treat heat syncope as sunstroke in order to be safe. All authorities recognize that these are stages in the same process.


Heat syncope is caused by mild overheating with inadequate water or salt. In young people, it is far more common than true sunstroke. Blood pressure is lowered when the body dilates (widens) capillaries (small blood vessels) in the skin to radiate heat. Also, water is evaporated from the blood, reducing the blood's volume and therefore lowering blood pressure further. The result is less blood to the brain, causing light-headedness and fainting.


The basic treatment for heat syncope is to treat it like fainting: Have the victim sit, if sitting lay down, if laying down, raise legs. Then, administer water, and oral rehydration salt, slowly, and move the victim to a cooler area. Oral rehydration salts (ORS) are widely considered to represent the best method for combating the dehydration caused by diarrhoea. ...


With sunstroke, cool the victim. Remove their clothing, shade them, fan them and sponge with cool water. Massage limbs vigorously to move cooled blood into the body cavity. Ice or alcohol can cause damage. Get help immediately. Sunstroke, especially when the victim has been unconscious, often causes major damage to body systems such as brain, kidney, liver, gastric tract. Unconsciousness for more than two hours usually leads to permanent disability.


Cramps

There are two basic causes of cramping. One is inadequate oxygenation of muscle, and the other is lack of water or salt. Cramps from poor oxygenation can be improved by rapid deep breathing, and stretching the muscle. Cramps from lack of salt and water can be treated by stretching the muscle, drinking water and eating salt. Pounding on the muscle can increase soreness.


What happens in a cramp is that lactic acid builds up because of normal anaerobic muscle metabolism. When the muscle burns sugar without enough oxygen, it makes lactic acid. The lactic acid finally becomes concentrated enough to trigger the contraction of the muscle. When the muscle lacks salt, the nerves firing the muscle are unable to recharge properly, causing a similar effect.


Insect and animal bites

Most animal bites should be considered as possible sources of infection, including rabies. Wash the wound, ideally with povidone iodine soap. Loosely bandage it, and do not suture it. Know the venomous animals in your area. A small boy biting an older boy. ... For other uses, see Suture (disambiguation). ...


Animal bites by carnivores other than rodents should be considered possible cases of Rabies. If you are bitten, try to capture alive or kill the animal and preserve its head. Look for signs of Rabies (foaming mouth, self-mutilation, growling, jerky behavior, red eyes). If the animal lives for ten days and does not develop rabies, then no infection has probably occurred. The head can later be analyzed to detect the disease. Self-harm (SH) is deliberate injury to ones own body. ...


If the animal is gone, prophylactic Rabies treatment is recommended in most places. Certain places, such as Hawaii, are known not to have native Rabies. Treatment is generally available in North America and the Western European states. Away from these areas, try to get to the nearest embassy of one of these states and indicate an acute medical emergency. The embassy doctor is usually willing and able to help.


Many snake-bites, even by venomous snakes, are not envenomed, and these can be treated as animal bites. Croatilid (rattlesnake and pit-viper) venoms cause the bitten area to turn green or purple. Elapsid (coral and monay other non-U.S. snakes) venoms cause swollen lymph nodes. If symptoms appear, they should be treated by compressing and cooling the bite(many say the bite should not be cooled, http://www.fda.gov/fdac/features/995_snakes.html) and evacuating the victim, on a litter if possible. If a victim is unable to reach medical care within 30 minutes, a bandage, wrapped two to four inches above the bite, may help slow venom. The bandage should not cut off blood flow from a vein or artery. A good rule of thumb is to make the band loose enough that a finger can slip under it(American Red Cross, FDA/Office of Public Affairs:http://www.fda.gov/fdac/features/995_snakes.html). If available, antivenin should be administered. See below for phone numbers to locate antivenins. A snakebite, or snake bite, is a bite inflicted by a snake. ... For other uses, see Snake (disambiguation). ... Species 27 species; see list of rattlesnake species and subspecies. ...


The black widow spider, and some scorpions are dangerous mostly to small children and elderly adults. Only the Sydney funnel-web spider of Australia is frequently dangerous to adults, and it resides only within 100 miles of Sydney Australia. Treat as snake-bite. Antivenins are available in the U.S. for black widow spiders and the dangerous scorpions native to the U.S. Species Fabricius, 1775 Chamberlin & Ivie, 1935 Walckenaer, 1837 The black widow spider () is a spider notorious for its neurotoxic venom. ... Superfamilies Pseudochactoidea Buthoidea Chaeriloidea Chactoidea Iuroidea Scorpionoidea See classification for families. ... Binomial name Atrax robustus Pickard-Cambridge, 1877 The Sydney funnel-web spider, also called a funnel-web tarantula, (Atrax robustus) is regarded by some to be the most dangerous spider in the world. ... This article is about the metropolitan area in Australia. ...


To locate antivenins, the Anti-venin index in Oklahoma City, Oklahoma, USA (1-405-271-5454) maintains a 24-hour hotline to help locate rare antivenins. Another possible number is the Poisondex central office in Denver, Colorado, USA (1-800-332-3073). In Australia, contact Commonwealth Serum Laboratories, Parkville, Victoria. In Asia try Haffkine Biopharmaceutical Corporation, Parel, Bombay, India. In Africa try the South African Institute for Medical Research, Johannesburg, Republic of South Africa. In most moderately developed countries, the national hospital can treat local venomous bites. Downtown Oklahoma City The State Capitol of Oklahoma From The South Motto: Nickname: Capital of the New Century Founded 1889 Incorporated County Oklahoma County Cleveland County Canadian County Borough {{{borough}}} Parrish {{{parrish}}} Mayor Mick Cornett Area  - Total  - Water 1,608. ... For other uses, see Oklahoma (disambiguation). ... Denver redirects here. ... VIC redirects here. ... For other uses, see Asia (disambiguation). ... A world map showing the continent of Africa Africa is the worlds second-largest and second most-populous continent, after Asia. ... This article is about the city in South Africa. ...


Anaphylactic shock

Main article: Anaphylactic shock Anaphylaxis is a severe and rapid systemic allergic reaction to a trigger substance, called an allergen. ...


Insect bites as well as exposure to allergens can trigger anaphylaxis in some people. Anaphylaxis is a life-threatening medical emergency because of rapid constriction of the airway, often within minutes of onset. Call for help immediately. First aid for anaphylaxis consists of obtaining advanced medical care at once; rescue breathing (a skill that is part of CPR) is likely to be ineffective but should be attempted if the victim stops breathing. Look to see if a device such as an Epi-pen is available for administration of epinephrine by a layperson. An allergen is any substance (antigen), most often eaten or inhaled, that is recognized by the immune system and causes an allergic reaction. ... Anaphylaxis is an acute systemic (multi-system) and severe Type I Hypersensitivity allergic reaction in humans and other mammals. ... CPR redirects here. ... A 0. ... Adrenaline redirects here. ...


Altitude sickness

Main article: Altitude sickness Altitude sickness, also known as acute mountain sickness (AMS) or altitude illness is a pathological condition that is caused by acute exposure to high altitudes. ...


Altitude sickness can begin in susceptible people as low as 8,000ft. The early symptoms are drowsiness, feeling unwell, and weakness, especially during exercise. More severe symptoms are headache, poor sleep, persistent rapid pulse, nausea and sometimes vomiting, especially in children. More severe symptoms include pulmonary edema (fluid in the lungs- persistent coughing), confusion, psychosis, hallucination and death. Pulmonary edema is swelling and/or fluid accumulation in the lungs. ...


Victims can sometimes control mild altitude sickness by consciously taking ten to twelve rapid large breaths every five minutes. If overdone, this can blowoff too much carbon dioxide and cause tingling in the extremities of the body. The quickest cure is to reduce the victim's altitude if possible. Some mountain rescue groups carry acetazolamide (a prescription drug) to treat mountain sickness, injectable steroids to reduce pulmonary edema, and inflatable pressure vessels to relieve and evacuate severe mountain-sick persons. Acetazolamide, sold under the trade name Diamox®, is a carbonic anhydrase inhibitor that is used to treat glaucoma, epileptic seizures, benign intracranial hypertension and altitude sickness. ...


Altitude acclimatization has two stages. Overnight, the body can adjust its carbonic acid balance, and substantially improve its performance. Over four to six weeks, the body can grow more blood cells, strengthen the heart and make other tissue changes. Above 18,000ft, further altitude exposure weakens one, rather than strengthening one's acclimation. Acclimation is a change occurring in an individual as a result to prolonged exposure of a particular environmental condition, such as a horse shedding its winter coat to produce a lighter summer coat. ...


Wounds

The care of significant wounds in the wilderness presents a great challenge. Lack of access to sterile supplies and hospital care renders useless many aspects of routine wound care. The care of wounds can be broken down into acute care (immediate) and chronic (long term – day to day care).


For acute wounds, the most important aspect of care is to control bleeding. If not immediately addressed, there are two types of acute wounds you might encounter in the wilderness that could become life threatening; scalp lacerations and wounds with arterial bleeding (spurting blood). Direct pressure will control bleeding for most wounds. If there is arterial bleeding, put the pressure either right on the bleeding point or on the undamaged skin right adjacent to the bleeding point. Accurately applied pressure will control the bleeding in almost every wound. The only artery in your body that is bigger than your thumb is the aorta and if you have hit that, you will not be alive long enough to worry about the wound. For scalp wounds, there can be significant bleeding all along the edge of the wound, so your direct pressure will have to be applied along a broader surface. The pressure will have to be applied until the bleeding has stopped. Start by applying the pressure for 15 minutes without checking to see if it is still active. Ultimately, you may have apply pressure until you can seek professional help. The aorta (generally pronounced [eɪˈɔːtə] or ay-orta) is the largest artery in the human body, originating from the left ventricle of the heart and bringing oxygenated blood to all parts of the body in the systemic circulation. ...


Two common mistakes are made with bleeding wounds. The first is to wrap an extremity wound with a dressing but not apply enough direct pressure to actually stop the bleeding. In this scenario, the wound continues to bleed under the dressing and becomes life threatening. Take the dressing off and apply direct pressure. The other mistake is the incorrect use of a tourniquet. Proper use of tourniquet is beyond the scope of this article, but tourniquets should only be use when all of the above recommendations have failed. If left in place too long or applied incorrectly loss of limb will result. If a tourniquet is deemed necessary as a result of lack of access to professional help and uncontrolled bleeding, the tourniquet should be applied between the wound and the heart as close to the wound edge as possible. If possible, the tourniquet should be released every 1-2 hours for 10 minutes while direct pressure is used to stop most of the bleeding during interval. The tourniquet should only be applied with just enough force to stop the bleeding. Sleeping bag straps make a convenient tourniquet, but any item of clothing can be tied around the extremity and then a stick fitted under the item and twisted until bleeding stops. Stay well hydrated.


The chronic care of wounds is directed at preventing wound infection. The key to prevention is keeping the wound clean. If bleeding is controlled, the wound should be thoroughly washed. Although sterile saline is best for irrigating wounds (rinsing them out), it will not be available in the wilderness. The next best solution is to clean the wound from a fresh water source (preferably running clean water) and "camp soap". The more water you use, the better (surgeons routinely use 3 gallons of saline under pressure to clean open wounds). Remove as much of the visible dirt as possible. When you have cleaned the wound to the best of your abilities with what you have available, dressing the wound will keep further contamination from entering the wound. Sterile gauze is best, but a good substitute is any absorbent material that has been placed in boiling in water for at least 3 minutes. Such a dressing can even be safely reused if cleaned and boiled again. Change the dressing at least once a day and every time the area is heavily contaminated. If available, antibiotic ointment is useful and can be applied directly to the wound. Use of antibiotic pills should be reserved for treatment of actual wound infections – not for the prevention of infection. If evacuation is not possible in a timely fashion, some WFA courses provide instruction on the proper administering of antibiotic drugs to help treat serious infections.


The final treatment for significant wounds should be the most obvious; return to civilization as quickly and safely as possible and seek professional help.


Sucking chest wounds

See open pneumothorax. A person with a penetrating chest wound is experiencing a life-threatening medical emergency and needs immediate access to advanced medical care and equipment to save their life. One standard first-aid treatment is to cover the wound with a pressure bandage made air-tight with petroleum jelly or clean plastic sheeting. It is important not to completely close off the opening. Leave a flap or corner open so that air does not build up around the lungs yet the patient can still breathe. “Collapsed lung” redirects here. ... {{Otheruses4|the medical term|the Australian television series|Medical Emergenc an immediate threat to a persons life or long term health. ...


Fractures

Stabilize the break with splints, and move the injured party as little as possible unless they are certain to die from lack of shelter or care. The object is to prevent the bone from causing more injuries. If the skin is broken, treat it as a major wound.


Broken ribs are stabilized with tape. A person with a broken arm, collarbone or ribs can often be stabilized enough to walk out, however large amounts of pain indicate this is a bad idea. Waxed cardboard splints are inexpensive, very lightweight, quite waterproof and quite strong.


Toothache

The basic treatment is oil of cloves on packing in the sore tooth to reduce the pain. Systemic antibiotics and analgesic such as acetaminophen (paracetamol) or NSAIDs may also help if available. Although teeth may hurt terribly, most severe tooth infections simply result either in a dead tooth, or a tooth that falls out and are rarely life-threatening. An analgesic (colloquially known as a painkiller) is any member of the diverse group of drugs used to relieve pain (achieve analgesia). ... Acetaminophen (USAN) or paracetamol (INN), is a popular analgesic and antipyretic drug that is used for the relief of fever, headaches, and other minor aches and pains. ... Paracetamol (INN) (IPA: ) or acetaminophen (USAN), is the active metabolite of phenacetin, a so-called coal tar analgesic. ... Wikipedia does not yet have an article with this exact name. ...


CPR (Cardio-Pulmonary Resuscitation)

CPR is often portrayed in movies and television as being highly effective in rususcitating a person who is not breathing and has no circulation. A 1996 study by the New England Journal of Medicine showed that CPR success rates in television shows was 75%. The reality is that CPR administered outside hospitals has a 2-15% success rate on its own, and is most importantly used to sustain oxygen supply to the brain until specialized medical equipment and personnel can reach the scene (see defibrillator). This article or section does not adequately cite its references or sources. ...


If you are performing CPR, you can only stop:

  1. when a competent health professional takes responsibility for the patient; or
  2. when the rescuers are in danger; or
  3. when you are physically unable to continue.

The delivery of modern health care depends on an expanding group of highly trained professionals coming together as an interdisciplinary team. ...

See also

First aid is a series of simple, life-saving medical techniques that a non-doctor or layman can be trained to perform. ... Wilderness Emergency Medical Technician, or WEMT, is the highest level of wilderness medicine training available. ... Wilderness First Responders are individuals who are trained to respond to emergency situations in remote settings. ...

External links



 

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