in the order of their most likely occurrence
| Sources: | Far From Help! Backcountry Medical Care by Peter Steele; Mountain Sickness by Peter H. Hackett, MD; |
| Mountaineering Medicine by Fred T. Darvill Jr., MD, The Campers Pocket Handbook by John Goll |
To prevent: Have boots well broken in, sox that fit, and tape sensitive areas with adhesive tape or moleskin before starting out.
Remedy for "hot spots" the precursor of blisters: Stop, clean area, dry, and tape immediately.
Remedy for blisters: Do not open small blisters. Large blisters or those ready to pop should be drained. Sterilize needle tip with match flame and insert needle tip in normal skin just beyond the edge of the blister and pass it into the sac. Try not to break the skin. When the fluid has been removed cover with an "0" shaped moleskin to prevent pressure on the ruptured blister and apply a layer of second skin. Tape over with tape provided in kit. If a blister has ruptured, wash the wound carefully and do the same as above. Change dressing as needed to prevent infection.
To prevent: Encourage your group to drink water. Drink lots; stop the group to drink often. Most hikers do not hydrate themselves enough. Even moderate dehydration can contribute to hypothermia, hypothermia, and altitude sickness.
Remedy: Rest for at least a half hour, give plain water followed drinks with electrolytes. When you lose fluids you also lose salts... Move on when the victim feels able, not before.
To prevent. Look where you place your limbs....
Remedy for bleeding wounds: Use gloves and stop bleeding with direct pressure to wound with a sterile dressing, bandanna or shirt. For mild bleeding, hold pressure 5 min. For more serious bleeding, hold 10 min. Flush wounds with water. Clean area around any wound with soap and water and apply your iodine, sterile dressing, or Band-Aid depending on the size of wound. Butterfly bandages hold deep cuts together. Change dressing often to prevent infection.
Remedy for hematomas: Usually rest, elevation, and ice water.
Remedy for blood blisters (under nails): Open paper clip and heat the end over stove flame until red hot. Push hot end cautiously into the middle of the moon of the nail over the bruise so it bums through the nail but not into the nail bed. Old dark blood will spurt out.
Remedy for splinters: Wash area thoroughly. Sterilize needle or tweezers with flame, pry out, encourage bleeding, rewash, apply Band-Aid.
Sun: To prevent. Apply sunscreen on all exposed skin 1/2 hr before trotting down the trail. Maximum strength you need is 30sfp. Wear a brimmed hat and sunglasses.
Remedy for sunburn: Aloe and aspirin for mild bums. Severe cases should be treated like a thermal bum below. Rx prednisone 5mg tabs and/or Synalar Cream 0.025%. can be used.
Fire or stove:
To prevent: Watch where you put hands and feet.
Remedy for mild burns. Submerse in cold water within 15 min. for 2-5 min. Leave in open air to dry. Treat more serious burns with cold water, sterile Vaseline, gauze bandage and elastic wrap. to keep the wound clean. Do NOT use antibiotic or other creams.
To prevent Mosquitoes: DEET repels most insects. Keep it away from eyes and any cuts. Use mosquito head nets.
Remedy for mosquitoes: Itch and bear it. Calamine lotion. To prevent bees/wasps: same as above and awareness.
Remedy for bees/wasps: Remove stinger with tweezers, apply hot compress. Neutralize bee venom (acidic) by applying bicarbonate of soda or weak ammonia. Neutralize wasp venom (alkaline)by applying vinegar or lemon juice. Offer an antihistamine. Allergic people should have their own medications to avoid anaphylaxis shock.
To prevent snake: Be alert in snake country. Wear high boots and walk with a hiking stick tapping the ground. Snakes attack when frightened or provoked. Rattlesnakes are poisonous, cause a lot of pain, but most people don't die from their bites.
Remedy for snake: Wash bite thoroughly with soap and water. Do not suck or slash skin over the bite, or pee on it. Bandage firmly and tightly over the bite around the entire limb, splint and keep it dependent to reduce venom flowing into the bloodstream. Do not freeze or use tourniquets. Evacuate victim. To prevent poison oak: Learn to recognize it and stay out of it. Use a topical product called Oak and Ivy Armor as directed. Wear gloves when taking off boots. Immediately wash hands and exposed areas with Tecnu or Fels Naphtha soap,
Remedy for poison oak: Cortisone cream, calamine can help ease itching and weeping. Rx 0.05% cortisone and Lidex work well to control more serious cases.
There are three general categories of altitude sickness: Acute Mountain Sickness (AMS) is the most common. Manifesting itself with headache, nausea, and obvious fatigue, it feels like a bad hangover and usually goes away in a day or two. High Altitude Cerebral Edema (HACE) is far less common. It reveals itself through a massive headache, loss of coordination (staggering), and hallucinations (some charming, some horrible). Untreated, coma and death can overtake the victim in 48 hours. High Altitude Pulmonary Edema (HAPE) is also less common than AMS, but more dangerous because the lungs fill with fluid. Symptoms: excessive coughing and progressive shortness of breath, The hiker is weak and may slip into a coma. To HELP prevent: Give yourself and your group time to acclimate. Sleep at an elevation at 7,000' or higher the night before. Take your time climbing the mountain. Under 10,000' , don't gain more than 2,500' of elevation each day. 10,000' and above advance no more than 1,000' per day. Hike the group up hill at a slow pace (2/3 yours and their normal hiking speed). Make sure everyone drinks plenty of water to keep from dehydrating. Rest frequently, and discourage drinking booze the night before your trip.
Remedy for AMS: If not severe, make camp, make the victim rest and keep warm, give liquids and encourage victim to eat (soup is good) before offering any form of pain killer for headache. Watch the situation carefully. If condition worsens from headache and nausea, you hear a little rattle in the chest, there's continued vomiting, your course of action is to DESCEND the mountain promptly... Go down at least 3,000' and see how the patient responds. You may be able to spend the night and continue back up the next day so pack down a tent, sleeping bag, stove, water, soup and crackers. Send two responsible persons with the victim. If you have to go all the way out, call for medical help and wait with the patient until help comes. The immediate action for HAPE and RACE is to descend to the trailhead as rapidly as possibly, get to a phone and call 911. HAPE and HACE are very serious conditions.
A sprain is an injury to the joint. The most common is the ankle.
Remedy: Wrap the ankle with elastic bandage two turns then a figure 8 between the ankle and the mid section of the foot. Apply cold compresses to the area every 3-4 hrs for 24 hrs. If severe (substantial swelling and bluish purple discoloration 12 24 hours after injury), the leg cannot be used and the victim should be evacuated with the leg elevated prior to and during evacuation. NSAIDs and Codeine can be used to control inflammation/pain.
A strain is a rupture of the fibers of the muscle.
Remedy: Cold compresses to reduce swelling and inflammation. Use the stream or lake to soak limb. Repeat every 3-4 hrs. Offer Advil or Naprosin to reduce pain and swelling.
Giardiasis. Unless you're on a long trip the symptoms won't show up until victim gets home where he can call a doctor. Victim experiences explosive, watery, foul-smelling diarrhea, abdominal pains and bloating and possibly nausea. To prevent: Purify all water by a)bringing it to a rolling boil, b) iodine treatments. Use 1 drop of 7% solution to 1 liter water, wait 20-30 min. The longer the water sits and the warmer the water, the less you need, c) mechanical water purifier. : This stuff will not go away on its own. Evacuate the victim and call a doc. Hopefully she or he can walk back to the trailhead. Dehydration is a danger. Get the victim to drink fluids--ginger tea. Rx- Flagyl is a common treatment.
Other Cooties: similar symptoms. To prevent: Purify all water, wash all pots, dishes and eating utensils with soap. Store perishable (and if it ain't dried, or canned it's perishable) food appropriately (in water sacks in cold water during the day).
Remedy: Dehydration is a danger. Drink fluids. Ginger tea, chamomile tea, mint tea. To control diarrhea, take one Bactrim or Septra DS#6 a day. Rx-Lomotil # 10.
Hypothermia is generalized body chilling and can be fatal. It is worsened by the following: wet-cold, exhaustion, anxiety, injury, drugs and alcohol. The patient's core temperature drops, unconsciousness and death can follow. To prevent: Don't let your group get wet and chilled. Avoid exhaustion. Walking too far too fast with a too heavy a load and being cold, dehydrated, exhausted and hungry are the cornerstones of hypothermia. Advise against wearing cotton or jeans in inclement weather. Insist on good rain, wind and thermal gear. Know when to turn around!
Remedy for mild hypothermia: Get to a sheltered spot. Remove any wet clothing immediately and get the victim warm, especially cover head with warm cap. You may need to start a fire, set up a tent or get the victim into a sleeping bag insulated from the ground. Give hot tea or soup until victim stops shivering, is warm and stabilized. Then, depending on conditions, decide whether to make camp, move on, or go back. Keep in mind that others in your party may be cold, too, and that standing around will invite hypothermia for them.
Remedy for severe hypothermia: The victim's core temp will have dropped to 90* F or below. Shivering will have stopped on its own, and that is the last protective measurement the body has. While two hearty persons go for help with notes on your position and problem written on paper, do all of the above. Also pour very warm water into several water bottles and put in bag with victim, and prepare to have a warm and healthy body strip down and crawl into the sleeping bag with the victim. If the victim is conscious give hot tea, water or soup.
Heat Exhaustion includes all forms of heat induced water and salt depletion, short of heat stroke, and can occur at modest temps (60*F. Symptoms include: thirst, profuse sweating, headache, goose bumps, chills, nausea, unsteadiness. To prevent. Don't hike in the heat of the day, slow your pace in warm weather and on strenuous climbs. Rest frequently. Wear a broad-rimmed hat, loose, light clothes and drink lots of water.
Remedy: Have the victim rest in a cool place and give plenty of water, followed by drinks with electrolytes. Heat stroke (hyperthermia) is caused by severe overheating, causing the body's natural cooling system to break down and is a medical emergency! People die from it. Symptoms are dizziness, hot flushed skin, quick strong pulse, high temperature, unconsciousness. It can develop from heat exhaustion. To prevent: Same as heat exhaustion
Remedy: Act immediately. Get the victim to lie down in a cool place and remove clothing. Sponge down body with cold water and fan the victim. Keep doing this until temperature drops to 101 degrees. Do not body any lower. Evacuate as soon as possible, continue checking victim's temperature.
A word about PLAGUE. Rodents in some parts of the Sierra carry the fleas that spread Bubonic Plague. Keep tents and your camp kitchen away from rodent holes and resist any tendency to play with dead rats.