When journeying into the wilderness it is important to carry a complete first aid kit and book. It is also wise to take a first aid course. A good diet, cleanliness and appropriate clothing will lower the risk of harmful situations. Disease, infection and often, insect bites can be avoided when maintaining a proper diet. It is important to bathe daily but if this is not possible be sure to wash your hands frequently. Soap can be made using ashes and animal fat or by boiling the inner bark of a pine tree. Construct a toothbrush by mashing the end of a green twig. When setting out for your journey remember to pack a wide range of clothing and extra footwear. Your First Aid Kit Everyone should have a well-stocked first aid kit handy at home, in the car and in the workplace. The contents of your kit will vary depending upon the number of people it is designed to protect as well as special circumstances where it will be used. For example, a first aid kit in a factory where there may be danger of flying debris getting into the eye should certainly have a sterile eyewash solution in its kit. If a family member is a known diabetic, your kit at home should have a glucose or sugar solution. When assembling your first aid kit, whether for use in the home, car or at work, you should consider possible injuries you are likely to encounter and then select kit contents to treat those conditions. It's also important to check your kit periodically to restock items that have been used and to replace items that are out-of-date. It's also advisable at home and at work to have both a stationary kit, stored in a cabinet or drawer, as well as a compact portable kit that can be taken quickly to the site of an emergency. Recommended Contents for a First Aid Kit [Modify to suit your particular needs] Activated Charcoal (for poisoning emergencies) Adhesive strip bandages - assorted sizes Adhesive tape Alcohol - rubbing 70% Alcohol wipes Antacid Antibiotic ointment Baking soda Calamine lotion Chemical ice packs Chemical hot packs Cotton balls Cotton swabs Decongestant tablets & spray Diarrhea medication Disposable latex or vinyl gloves Elastic bandages Face mask for CPR First aid guide Flashlight Gauze pads - various sizes Hot-water bottle Household ammonia Hydrocortisone cream .5% Hydrogen Peroxide Hypoallergenic tape Ice bag Insect repellent Insect sting swabs Matches Meat tenderizer (for insect bites) Moleskin Needles Non-adhering dressings [Telfa] Oil of Cloves Over-the-counter pain medication [aspirin] Paper & pencil Paper drinking cups Roller guaze - self adhering Safety pins Salt Scissors Soap Space blanket Sam splint Sugar or glucose solution Syrup of Ipecac Thermometer - oral & rectal Tongue blades Triangular bandages Tweezers Waterproof tape FIRST AID If an accident occurs in the wilderness it will be your responsibility to deal with the situation. The specific sequence of actions when dealing with this situation is: 1. Remain calm, providing your patient with quiet, efficient first aid treatment. 2. Keep the patient warm and lying down. Do not move this injured person until you have discovered the extent of the injuries. 3. Start mouth-to-mouth artificial respiration immediately if the injured person is not breathing. 4. Stop any bleeding. 5. Give your patient reassurance. Watch carefully for signs of shock. 6. Check for cuts, fractures, breaks and injuries to the head, neck or spine. 7. Do not allow people to crowd the injured person. 8. Do not remove clothing unless it is imperative. 9. Decide if your patient can be moved to a proper medical facility. If this is not possible, prepare a suitable living area in which shelter, heat and food are provided. SHOCK Shock is a depression of all of the body processes and may follow any injury regardless of how minor. Factors such as hemorrhage, cold and pain will intensify shock. When experiencing shock the patient will feel weak and may faint. The skin becomes cold and clammy and the pulse, weak and rapid. Shock can be more serious than the injury itself. Use the following method to prevent and control shock: 1. When treating injuries: i. restore breathing ii. stop bleeding iii. treat breaks and fractures 2. If there are no head or chest injuries place the patient on his/her back with the head and chest lower than the legs. This will help the blood circulate to the brain, heart, lungs and other major organs. 3. If severe head and chest injuries are present elevate the upper body. If chest injuries are present, elevate the injured side to assist in the functioning of the uninjured lung. 4. If the injured person becomes unconscious, place him/her in a face down position to prevent choking on blood, vomit or the tongue. 5. Keep your patient warm and under shelter. STOPPED BREATHING If breathing has stopped, begin mouth-to-mouth resuscitation. Place the patient on his/her back and follow these steps: 1. To open the airway lift the patient's neck and tilt the head back. 2. Keeping the neck elevated, pinch the nostrils to prevent air leakage. 3. Place your mouth completely around the victim's mouth and blow, watching for chest expansion. 4. After removing your mouth, listen for air leaving the patient's lungs and watch for the chest to fall. Check for an airway blockage if the chest does not rise. Repeat these steps approximately 12 to 15 times per minute. If treating a child, cover the nose and mouth with you mouth. Use smaller puffs of air and repeat this method 20 to 25 times per minute. Obstructions in the Airway NOTE: Emergency treatment of airway obstructions is taught as part of CPR training and only through classroom practice can the necessary skills be mastered. The mechanics of handling airway obstructions are presented in this tutorial for background insight only If an individual is choking - but can speak or cough forcibly - there is an exchange of air (although it might be diminished) and you should encourage the victim to continue coughing while you just stand by! On the other hand, if a victim is choking, but CANNOT speak or cough, an airway obstruction exists which must be treated immediately! The treatment for an obstructed airway in a conscious victim involves use of the HEIMLICH MANEUVER which is performed as follows: · Stand behind the victim. · Wrap your arms around the victim's waist. · Make a fist with one hand and place the thumb side of the fist against the victim's abdomen just above the navel and well below the lower tip of the breast bone. · Grasp your fist with your other hand, with elbows out, and press your fist into the victim's abdomen with quick, upward thrusts. Each thrust is a distinct, separate attempt to dislodge the foreign object. · Repeat thrusts until foreign object is cleared or the victim becomes unconscious. Emergency treatment of airway obstructions in an unconscious victim is taught in CPR classes. Heart Attack Heart attacks are among the leading cause of death in the United States. A heart attack happens when one or more of the blood vessels that supply blood to the heart become blocked. When this occurs, cells in the heart begin to die when they cannot get blood for vital nourishment. If a large part of the heart is deprived of blood, the heart stops beating and the victim suffers CARDIAC ARREST! When a victim's heart stops beating, they require CARDIOPULMONARY RESUSCITATION (CPR) which provides vital oxygen through rescue breathing and which maintains circulation through chest compressions. PROPER TRAINING IS REQUIRED TO PERFORM CPR, HOWEVER ANY HEART ATTACK CAN LEAD TO CARDIAC ARREST AND IT IS THEREFORE VITAL FOR FIRST AIDERS TO BE ABLE TO RECOGNIZE THE EARLY WARNING SIGNS OF A HEART ATTACK SO THE VICTIM CAN RECEIVE PROMPT PROFESSIONAL ATTENTION! A heart attack victim whose heart is still beating has a much better chance of survival than a victim whose heart has stopped! Most heart attack victims who die succumb within 2 hours after having their heart attack. Many of these victims could be saved if bystanders recognize the symptoms of a heart attack and get the victim to a hospital quickly! Indeed, many victims of heart attacks think they are experiencing HEARTBURN or other minor discomfort when in fact their life is in jeopardy! The most significant sign of a heart attack is chest pain. The victim may describe it as pressure, a feeling of tightness in the chest, aching, crushing, fullness or tightness, constricting or heavy pain. The pain may be located in the center of the chest although it is not uncommon for the pain to radiate to one or both shoulders or arms or to the neck, jaw or back. In addition to pain, victims may experience sweating, nausea or shortness of breath. Many victims deny they may be having a heart attack. Others may have their condition worsened by fear of dying. With all victims of heart attacks - and with all victims receiving first aid for any condition - it is important for the rescuer to constantly reassure the victim and keep them as calm and relaxed as possible. The psychological value of reassurance is as important in first aid as any treatments! FIRST AID FOR A HEART ATTACK: · Recognize the signs & symptoms of a heart attack · Comfort & reassure the victim · Have the victim stop whatever they were doing and sit or lie in a comfortable position · Summon emergency medical help quickly · If the victim become unconscious, be prepared to perform CPR [IF YOU ARE TRAINED TO DO SO] All of us can reduce the risk of heart attack by controlling high blood pressure, limiting cholesterol in the diet, watching weight, exercising, giving up smoking and minimizing stress. BLEEDING To control bleeding, elevate the wounded area above the heart and apply pressure using either gauze, clean cloth, dried seaweed or sphagnum moss. Use pressure at the pulse point between the injured area and the heart if bleeding fails to stop. If bleeding still persists, use a tourniquet between the injury and the heart. This method should only be used in extreme situations. After bleeding has been controlled, wash the wounded area with disinfectant and apply a dressing and bandages. FRACTURES A fracture is classified as either a simple (closed) or compound (open). Signs that a fracture is present include: 1. Pain at the affected area. 2. The area may or may not be deformed. 3. The victim is unable to place weight on the area without experiencing pain. 4. A grating sensation or sound may be present during any motion of the injured area. Treatment is as follows: 1. If in doubt, treat the injury as a fracture. 2. Splint the joints above and below the fracture. 3. If the fracture may penetrate the skin, it could be necessary to apply traction to straighten the deformity. 4. Be sure to pad your splints. 5. Check the splint ties frequently to be sure they do not hinder circulation. 6. Cover all open wound with a clean dressing before splinting. DISLOCATION Dislocation happens when the ligaments near a joint tear, allowing the movement of the bone from its socket. It is unwise to treat a dislocation unless you are a trained professional as permanent damage may occur. The affected extremity should be supported using a sling or other device and pain controlled with aspirin or other suitable drugs. SPRAINS Treat sprains by applying cold to the area for the first 24 hours then once the swelling has subsided, let the sprain sit for a day. Apply heat the following day to aid in the healing process. The sprain should be splinted and rendered immobile until the pain has completely disappeared. CONCUSSIONS Concussions or other head injuries are often accompanied by a leakage of watery blood from the nose or ears. Other symptoms may include convulsions, an unresponsiveness of the pupils or headache and vomiting. Keep the injured party warm, dispense a pain killer regularly and allow time for the body to rest and repair. HEAT EXHAUSTION Heat exhaustion is not uncommon when water is not sufficient. The body becomes dehydrated and salt-depleted, resulting in nausea, faintness, a weak, rapid pulse and/or cold and clammy skin. Treatment includes plenty of rest, liquid and salt tablets. SUNSTROKE Sunstroke may occur when the body is exposed to excessive sun. The body becomes overheated and provides too much blood to the circulatory system resulting in a flushed, hot face, rapid pulse, headache and/or dizziness. Treat sunstroke by resting in a cool area and applying and consuming cold liquid. Prevent sunstroke by wearing proper headgear. MUSCLE CRAMPS Muscle cramps occur when the muscle accumulates excessive lactid acid or a loss of salt through perspiration. Treatment includes resting, deep breathing and stretching. Restore the salt balance immediately. BURNS Burns are most commonly followed by shock. Administer a pain reliever immediately, apply gauze covered in Vaseline to the affected area and bandage. The patient should consume more water than usual. SNOWBLINDNESS Symptoms of snowblindness include scratchy or burning eyes, excessive tearing, sensitivity to light, headache, halos around light and temporary loss of vision. Bandage the victim's eyes and use cold compresses and a painkiller to control the pain. Vision will generally be restored after 18 hours without the help of a doctor. Always wear snow goggles or sunglasses in snowy areas to prevent snowblindness FROSTBITE Frostbite occurs when the tissue of an area, most commonly the toes, fingers or face, is frozen either from direct exposure to the elements or high wind. First degree frostbite turns the area cold, white and numb. When heated the area becomes red and can be compared to a first degree burn. A blister will form after warming with second degree frostbite. Dark skin, gangrene, and a loss of some skin and tissues is common in third degree. Fourth degree frostbite causes irreparable damage. The affected area will remain cold and lifeless and generally a part of the area is lost. With adequate clothing frostbite can easily be avoided. Superficial frostbite may be treated by cupping one's hands and blowing on the affected area, warming from another warm hand or, with fingers, placing them in your armpits. For more severe cases, medical aid should be sought. BLISTERS Blisters are the painful, and common, result of ill-fitting footwear. At the first sign of discomfort, remove boots and socks and place a piece of adhesive tape over the affected area. If it is absolutely necessary, open a blister by first washing the area thoroughly then inserting a sterilized needle into the side of the blister. Apply disinfectant and a bandage. HEADACHES Headaches are often experienced in the mountains due to inadequate eye protection, tension in the neck, constipation or "water intoxication", a swelling of the brain tissue which happens when the hiker has sweated excessively over a period of days and consumed large quantities of water without taking salt tablets. Aspirin may be used to alleviate the pain but one should find the source of headache to prevent further discomfort. SNAKE BITES Snake bites are not overly common in British Columbia. One species of venomous snake, a rattlesnake is found in the dry belt of the southern interior. If you come across a snake slowly ease back. A snake bite rarely causes death; victims may be left untreated for up to eight hours. After an attack occurs: 1. Keep the person calm, reassuring them that bites can be effectively treated in an emergency room. Restrict movement, and keep the affected area just below heart level to reduce the flow of venom. 2. Remove any rings or constricting items because the affected area may swell. Create a loose splint to help restrict movement of the area. 3. If the area of the bite begins to swell and change color, the snake was probably poisonous. 4. Monitor the person’s vital signs -- temperature, pulse, rate of breathing, blood pressure. If there are signs of shock (such as paleness), lay the victim flat, raise the feet about a foot, and cover the victim with a blanket. 5. Get medical help immediately. BEE STINGS Bee stings are common and harmless unless you are allergic. Remove the stinger then apply disinfectant and clod water to reduce the swelling. DIARRHEA A change of diet, dirty cooking utensils or the consumption of tainted water may result in diarrhea which in turn will cause a loss of nutrients and precious body fluids. Take extra care in cleanliness and boil water for an additional three to five minutes to avoid diarrhea. HYPOTHERMIA When the temperature of your body falls to a level at which your vital organs can no longer function you are experiencing hypothermia or exposure sickness. Hypothermia will develop rapidly and is caused by cold, wet and/or windy weather that chills the body at a speed faster than it can produce heat. A lack of energy-producing food and proper clothing will heighten the speed at which hypothermia will affect you. Always remember to bring extra clothing. It is important to hike at the speed of the slowest member of your party. Take frequent breaks and keep a close watch for members experiencing signs of fatigue. Exposure sickness generally occurs in temperatures of less than 10 C (50 F). Symptoms are easily recognizable: 1. Feeling cold and constantly exercising to keep warm. 2. Uncontrollable shivering and numbness. 3. Violent shivers. Your mind becomes slow and starts to wander. 4. Violent shivering ceases and muscles begin to stiffen and become un-coordinated. Exposed skin becomes blue and thoughts are foggy. Victim usually lacks the capability of realizing how serious the situation is. 5. Pulse and respiration slows. 6. Victim will not respond and becomes unconscious. 7. The section of the brain controlling the heart and lungs ceases functioning. Treatment must be quick and efficient: 1. Move the victim to a sheltered area, out of the elements. 2. Remove wet clothing and replace with dry clothes and if possible, a sleeping bag. 3. Wrap warm rocks and place them near the patient. 4. Do not let the victim fall unconscious. 5. Give the victim a warm, non-alcoholic drink. 6. Allow another person in the sleeping bag to share body heat. 7. Exhale warm air near the vicinity of the patients mouth and nose. HYPERTHERMIA Hyperthermia is a result of the body being overheated due to increased air temperature, solar or reflected radiation, poorly ventilated clothing, a low fitness level or excess bulk. Symptoms include: 1. Heat cramps may occur and should be treated by moving the victim to a shady area and supplying water and salt tablets. 2. Heat exhaustion is a mild form of hyperthermia and includes symptoms such as headache, dizziness, fainting, clammy skin, blurred vision, nausea and vomiting. Treatment is the same as heat cramps. 3. Heat stroke is the most serious degree of hyperthermia. The victim will have little or no perspiration, a hot and flushed face, full pulse, and become either apathetic or aggressive. Cool the victim as quickly as possible paying extra attention to the head, neck and chest. If the bodies temperature continues to rise, unconsciousness, delirium, convulsions and ultimately death may occur. To avoid hyperthermia, avoid strenuous activity on hot days, wear loose clothing and a hat, drink plenty of fluids and take salt tablets. Diabetic Emergencies Sugar is required in the body for nourishment. Insulin is a hormone that helps the body use the sugar. When the body does not produce enough Insulin, body cells do not get the needed nourishment and diabetes results. People with this condition take Insulin to keep their diabetes under control. Diabetics are subject to two very different types of emergencies: Insulin Reaction (or Insulin Shock) This condition occurs when there is TOO MUCH INSULIN in the body. This condition rapidly reduces the level of sugar in the blood and brain cells suffer. Insulin reaction can be caused by taking too much medication, by failing to eat, by heavy exercise and by emotional factors. SIGNS & SYMPTOMS: Fast breathing, fast pulse, dizziness, weakness, change in the level of consciousness, vision difficulties, sweating, headache, numb hands or feet, and hunger. Diabetic Coma This condition occurs when there is TOO MUCH SUGAR and too little INSULIN in the blood and body cells do not get enough nourishment. Diabetic coma can be caused by eating too much sugar, by not taking prescribed medications, by stress and by infection. SIGNS AND SYMPTOMS: Diabetic coma develops more slowly than Insulin shock, sometimes over a period of days. Signs and symptoms include drowsiness, confusion,deep and fast breathing, thirst, dehydration, fever, a change in the level of consciousness and a peculiar sweet or fruity-smelling breath. First Aid for Insulin Reaction and Diabetic Coma Looking for the signs and symptoms listed above will help to distinguish the two diabetic emergencies. In addition, if the patient is conscious, you can ask two very important questions which will help determine the nature of the problem: · ASK "HAVE YOU EATEN TODAY?" Someone who has eaten, but has not taken prescribed medication may be in a diabetic coma. · ASK "HAVE YOU TAKEN YOUR MEDICATION TODAY?" Someone who has not eaten, but did take their medication, may be having an Insulin reaction. DISTINGUISHING BETWEEN THE TWO TYPES OF DIABETIC EMERGENCIES CAN BE DIFFICULT. (Always look for an identifying bracelet which may reveal a person's condition) OF THE TWO CONDITIONS, INSULIN SHOCK IS A TRUE EMERGENCY WHICH REQUIRES PROMPT ACTION! A PERSON IN INSULIN SHOCK NEEDS SUGAR, QUICKLY! IF THE PERSON IS CONSCIOUS, GIVE SUGAR IN ANY FORM: CANDY, FRUIT JUICE OR A SOFT DRINK! SUGAR GIVEN TO A PERSON IN INSULIN SHOCK CAN BE LIFE-SAVING! IF THE PERSON IS SUFFERING FROM DIABETIC COMA, THE SUGAR IS NOT REQUIRED BUT WILL NOT CAUSE THEM FURTHER HARM. Monitor victims carefully. Seek professional help. Seizure SEIZURES are fairly common occurances, but are very misunderstood! Seizures, per se, are not a specific condition. Rather, they may be caused by many different types of conditions such as insulin shock, high fevers, viral infections of the brain, head injuries or drug reactions. When seizures recur with no identifiable cause, the person is said to have epilepsy. Signs and Symptoms Many individuals have a warning AURA (or sensation) before the onset of a seizure. Many times, a person about to have a seizure will physically move themselves from danger (as from the edge of a train platform) before the seizure begins. Seizures can range from mild to severe. Mild seizures may take place and end in a matter of seconds. Severe seizures may involve uncontrollable muscle spasms, rigidity, loss of consciousness, loss of bladder and bowel control, and in some cases, breathing that stops temporarily. Many epileptics carry cards or bracelets which identify their condition. First Aid Summon professional help. Prevent the person from injuring themselves by moving furniture or equipment. DO NOT ATTEMPT TO RESTRAIN A PERSON SUFFERING A SEIZURE AND DO NOT PUT ANYTHING IN THEIR MOUTH! Loosen clothing. If they vomit, turn on their side to allow fluids to drain. Stay with the person until they are fully conscious. If trained, administer rescue breathing or CPR, if required.