Julia Heinz, MD
Welcome to Outdoor Medicine.
Some first aid can be accomplished with a minimum of supplies. As always, the best safety measures are prevention, communication, and a clear mind. By anticipating possible danger, one can often avoid injury.
Bleeding can usually be stopped with less than 10 minutes of direct pressure. Sterile gauze beneath a bandana works well. Once bleeding is controlled, thoroughly clean the wound with a quart of water using a syringe and 18 gauge needle. Cleaning with pressure through the syringe is much more affective then soaking.
I close the wound with thin strips of duct tape or glue placed perpendicular to the laceration. Then, I make sure there is enough open skin to allow the byproducts of infection to escape if the wound does become infected.
If an arm or leg bone is broken, make sure there is a pulse in the foot and hand. If there isn’t any pulse and the end of the extremity looks white from lack of blood, then I must consider providing traction to the extremity to get a pulse. For a splint, I use something firm like hiking poles padded with clothing and duct tape, and I extend the splint to the joint below and above the fracture.
Suggestion: Find your own pulses now so you know where to look for them in an emergency. Also, get training in advance so you know how to provide traction in the case of a broken limb.
Sprains and Strains
When tissue such as an ankle or wrist is strained and swells, I use cold river water and Ibuprofen to reduce inflammation. I make sure the injured person stays warm. One trick I use is to place the injured person by the fire and bring them cold rocks from the river every 10 minutes.
To help cure simple eye infections, I bring Erythromycin eye ointment. If your eyes become irritated, be sure to remove your contacts. For simple mouth, wound, or urinary tract infections, I bring Augmentin. Having experienced Giardia, I also always carry Metrondizole. If fever develops, then the infection is serious. Call for advice.
Environmental injuries include cold, sunburn, insect bites and blisters. I always carry dry matches or a lighter and build a fire before I get too cold. I also carry sun screen, bug repellent and blister pads. When I am hiking many miles, I carry an extra pair of dry socks and change them mid-day to stay warm and prevent blisters.
Life-Threatening Health Conditions
- When there is severe injury, communication with an emergency system can save lives. A clear mind is always helpful for making the best decisions.
- If someone develops fever, abdominal pain, chest pain or any concerning symptom, call for advice and possible evacuation. In addition to the above antibiotics, I also carry aspirin to use as a possible thrombolytic in case someone has a heart attack.
- For those who have no pulse, the basic life support procedure (BLS) procedure has changed from "airway, breathing, and circulation" (ABC) to "circulation, airway, and breathing" (CAB). It is important to learn to perform adult CPR properly.
This article has some basic information but is far from comprehensive. I recommend that everyone become certified in wilderness first aid or as a wilderness first responder. These courses are offered throughout the country.
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