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Ch. 27-Wilderness Ch. 27-Wilderness EmergenciesEmergencies

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27.1 Prevention of Wilderness 27.1 Prevention of Wilderness EmergenciesEmergencies

Bring someone who knows:Bring someone who knows:

What terrain can be expectedWhat terrain can be expected What special equipment is needed for planned What special equipment is needed for planned

activitiesactivities What weather conditions are likelyWhat weather conditions are likely How long the trip will takeHow long the trip will take What hazards may be encountered and what level of What hazards may be encountered and what level of

risk is involved in the anticipated activitiesrisk is involved in the anticipated activities What resources will be available in case of What resources will be available in case of

emergency and how to send for helpemergency and how to send for help Maximum anticipated delay in getting medical help Maximum anticipated delay in getting medical help

to the area to the area

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PROGRESS CHECKPROGRESS CHECK

1. Before entering a wilderness area, you should 1. Before entering a wilderness area, you should specifically plan how you will handle ____________.specifically plan how you will handle ____________.

(animal attacks/food shortages/serious medical (animal attacks/food shortages/serious medical emergencies)emergencies)

2. The first aid leader should know the ____________ of 2. The first aid leader should know the ____________ of each member of the party. each member of the party. (medical (medical history/name/next of kin)history/name/next of kin)

3. First aid in wilderness settings often involves 3. First aid in wilderness settings often involves ____________ care. ____________ care. (advanced/long-term/specialized)(advanced/long-term/specialized)

4. A wilderness first aid kit should be packed to allow 4. A wilderness first aid kit should be packed to allow the group to handle a ____________.the group to handle a ____________.

(trauma/serious medical emergency/disaster)(trauma/serious medical emergency/disaster)

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ShelterShelter

Stay out of the bottom of valleys or canyons; Stay out of the bottom of valleys or canyons; heat rises, and the lowest area will also be heat rises, and the lowest area will also be the coldest.the coldest.

Avoid setting up a shelter on a ridge or the Avoid setting up a shelter on a ridge or the top of a mountain where you would be top of a mountain where you would be exposed to wind.exposed to wind.

Place your shelter downwind of some sort of Place your shelter downwind of some sort of windbreak, such as a large rock, mound of windbreak, such as a large rock, mound of dirt, or bank of trees or bushes. dirt, or bank of trees or bushes.

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FoodFood

Store food supplies some distance from your Store food supplies some distance from your campsite.campsite.

Store food supplies off the ground; hanging Store food supplies off the ground; hanging food in stuff sacks is advised.food in stuff sacks is advised.

Avoid cooking foods with especially strong Avoid cooking foods with especially strong odors, such as bacon.odors, such as bacon.

Remember that food refuse also will attract Remember that food refuse also will attract wildlife; burn as much as you can, then keep wildlife; burn as much as you can, then keep remaining garbage a safe distance from your remaining garbage a safe distance from your campsite and off the ground. campsite and off the ground.

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PROGRESS CHECKPROGRESS CHECK

1. A person can survive for approximately ____________ days 1. A person can survive for approximately ____________ days without water. without water. (2/3/4)(2/3/4)

2. The most important factor for survival in cold weather is 2. The most important factor for survival in cold weather is ____________. ____________. (food/water/shelter)(food/water/shelter)

3. When a victim faces a combined lack of shelter, water, and 3. When a victim faces a combined lack of shelter, water, and food, the “rule of ____________” goes into effect. food, the “rule of ____________” goes into effect. (survival/threes/convection)(survival/threes/convection)

4. Always try to construct a shelter ____________. 4. Always try to construct a shelter ____________. (in the bottom of (in the bottom of a canyon/downwind of a windbreak/ on top of a ridge)a canyon/downwind of a windbreak/ on top of a ridge)

5. Tents do not provide any ____________. 5. Tents do not provide any ____________. (moisture (moisture resistance/security/insulation)resistance/security/insulation)

6. The best method of purifying water in the wilderness is 6. The best method of purifying water in the wilderness is ____________.____________.(purification tablets/filtration/boiling)(purification tablets/filtration/boiling)

7. The higher the altitude, the ____________ you should boil water 7. The higher the altitude, the ____________ you should boil water to kill organisms. to kill organisms. (longer/less time)(longer/less time)

8. To protect yourself from predators, ____________ your 8. To protect yourself from predators, ____________ your food away from your campsite. food away from your campsite. (bury/hang/cover)(bury/hang/cover)

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27.3 Altitude-Related Problems in the 27.3 Altitude-Related Problems in the WildernessWilderness

Seek medical help immediately if the victim develops Seek medical help immediately if the victim develops any of the following:any of the following:

Noisy breathingNoisy breathing Persistent coughPersistent cough Shortness of breath while restingShortness of breath while resting VomitingVomiting Loss of balanceLoss of balance Confusion or disorientationConfusion or disorientation

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VocabularyVocabulary

Rule of Threes-Rule of Threes- A rule stating that survival time is A rule stating that survival time is considerably reduced if a victim is without all three considerably reduced if a victim is without all three factors required for survival: shelter, water, and foodfactors required for survival: shelter, water, and food

BillowingBillowing- Loss of heat inside a tent when the wind - Loss of heat inside a tent when the wind flaps the sides of the tent and warm air is replaced flaps the sides of the tent and warm air is replaced with cold airwith cold air

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Acute Mountain SicknessAcute Mountain Sickness

1. 1. Stop climbing immediately; Stop climbing immediately; rest and see whether rest and see whether symptoms improve.symptoms improve.

2. If symptoms do not improve within a day or two, 2. If symptoms do not improve within a day or two, descend 2,000 to 3,000 feet as quickly as possible.descend 2,000 to 3,000 feet as quickly as possible.

3. Prevent or correct dehydration by drinking at least 4 3. Prevent or correct dehydration by drinking at least 4 quarts of fluid every day; eat a high-carbohydrate, quarts of fluid every day; eat a high-carbohydrate, high-calorie diet while climbing.high-calorie diet while climbing.

4. Use aspirin to treat mild headache.4. Use aspirin to treat mild headache.

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High Altitude Pulmonary EdemaHigh Altitude Pulmonary Edema

The signs and symptoms of HAPE includeThe signs and symptoms of HAPE include

Severe shortness of breath, even when restingSevere shortness of breath, even when resting Cyanosis (bluish discoloration of the lips, fingernails, Cyanosis (bluish discoloration of the lips, fingernails,

and mucous membranes lining the mouth)and mucous membranes lining the mouth) ““Moist” breathing that produces rattling and Moist” breathing that produces rattling and

crackling crackling Cough that produces pink, frothy sputumCough that produces pink, frothy sputum

*A victim of HAPE needs *A victim of HAPE needs immediate immediate medical treatmentmedical treatmentin a compression chamber. in a compression chamber. The most importantThe most importantthing you can do is descend immediately thing you can do is descend immediately and seekand seekmedical help for the victim.medical help for the victim.

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High Altitude Cerebral EdemaHigh Altitude Cerebral Edema

Signs and symptoms include the following:Signs and symptoms include the following:

Severe headacheSevere headache Severe nausea and vomitingSevere nausea and vomiting Ataxia (inability to maintain balance)Ataxia (inability to maintain balance) DizzinessDizziness Extreme fatigue, progressing to comaExtreme fatigue, progressing to coma

*It is critical to get the victim to a lower *It is critical to get the victim to a lower altitude as quickly as possible. altitude as quickly as possible.

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PROGRESS CHECKPROGRESS CHECK

1. Altitude-related illness is caused by a lack of 1. Altitude-related illness is caused by a lack of ____________.____________.

(oxygen/fluids/nutrients)(oxygen/fluids/nutrients)

2. Acute mountain sickness causes symptoms much 2. Acute mountain sickness causes symptoms much like those of a severe ____________. like those of a severe ____________. (cold/hangover/migraine headache)(cold/hangover/migraine headache)

3. High altitude pulmonary edema is characterized by 3. High altitude pulmonary edema is characterized by ____________, even after rest.____________, even after rest.

(fatigue/muscle soreness/difficulty breathing)(fatigue/muscle soreness/difficulty breathing)

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27.4 Special Wilderness 27.4 Special Wilderness ConsiderationsConsiderations

Assessing the SceneAssessing the Scene Assessing the VictimAssessing the Victim Determining a PlanDetermining a Plan

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VocabularyVocabulary

Acute mountain sickness-Acute mountain sickness- An altitude related An altitude related illness that resembles a severe hangoverillness that resembles a severe hangover

High altitude pulmonary edema (HAPE)-High altitude pulmonary edema (HAPE)- An An altitude-related illness that causes fluid to go into altitude-related illness that causes fluid to go into the lungs from body cells the lungs from body cells

High altitude cerebral edema (HACE)-High altitude cerebral edema (HACE)- An An altitude-related illness that causes swelling of the altitude-related illness that causes swelling of the brain and increased pressure inside the skullbrain and increased pressure inside the skull

Foramen MagnumForamen Magnum The opening at the base of the The opening at the base of the skull that houses the brain stem skull that houses the brain stem

AtaxiaAtaxia Inability to keep balance Inability to keep balance

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C-H-A-R-TC-H-A-R-T

CC- Chief complaint (What did the victim tell you?)- Chief complaint (What did the victim tell you?)

HH- History (What happened?)- History (What happened?)

AA- Assessment (What signs and symptoms did you - Assessment (What signs and symptoms did you find?)find?)

RRxx- Treatment (What did you do for the victim?)- Treatment (What did you do for the victim?)

TT- Transport and disposition (After you cared for - Transport and disposition (After you cared for the victim, where did the victim go? Did the the victim, where did the victim go? Did the victim leave? Was it on foot, in a car, in an victim leave? Was it on foot, in a car, in an ambulance, in a helicopter?)ambulance, in a helicopter?)

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Determining a PlanDetermining a Plan

1. You can treat the victim where you are until the 1. You can treat the victim where you are until the victim has recovered enough to walk out on his or victim has recovered enough to walk out on his or her own or with minimal assistance.her own or with minimal assistance.

2. You can carry the victim to help, either on an 2. You can carry the victim to help, either on an improvised litter or with any of a series of carries.improvised litter or with any of a series of carries.

3. You can send a pair of people to get help—or, in a 3. You can send a pair of people to get help—or, in a critical enough situation, you can leave the victim critical enough situation, you can leave the victim alone while you go to get help.alone while you go to get help.

4. You can stay with the victim and call for help by 4. You can stay with the victim and call for help by cellular phone, radio, or signal; talking to emergency cellular phone, radio, or signal; talking to emergency medical personnel by phone or two-way radio can be medical personnel by phone or two-way radio can be an excellent source of information as you work to an excellent source of information as you work to care for the victim as well as plan for evacuation.care for the victim as well as plan for evacuation.

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First Aid for ShockFirst Aid for Shock

1. Increase and maintain the effective circulating 1. Increase and maintain the effective circulating volume of bloodvolume of blood

2. Reduce the oxygen debt being incurred by the 2. Reduce the oxygen debt being incurred by the body. body.

You need to place the victim in the correct position, You need to place the victim in the correct position, maintain a normal body temperature, and replace maintain a normal body temperature, and replace lost fluids.lost fluids.

*Special considerations in the wilderness setting *Special considerations in the wilderness setting include the following:include the following:

Maintaining temperatureMaintaining temperature Replacing fluidsReplacing fluids

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Cardiopulmonary ResuscitationCardiopulmonary Resuscitation

Generally, you should stop chest compressions if the pulse does not start Generally, you should stop chest compressions if the pulse does not start after 30 minutes of CPR, unless:after 30 minutes of CPR, unless:

The victim has hypothermiaThe victim has hypothermia The victim has been submerged in The victim has been submerged in cold cold water for less than one hourwater for less than one hour The victim was buried in an avalanche (these victims generally die The victim was buried in an avalanche (these victims generally die

from either suffocation or blunt-force trauma)from either suffocation or blunt-force trauma) The victim was struck by lightning The victim was struck by lightning

You should not begin CPR if:You should not begin CPR if:

The victim has been in cardiac arrest for more than 30 minutes, and The victim has been in cardiac arrest for more than 30 minutes, and there have been no efforts to resuscitate him or herthere have been no efforts to resuscitate him or her

The victim has an injury that is obviously fatalThe victim has an injury that is obviously fatal The victim’s chest is frozenThe victim’s chest is frozen The victim’s core temperature is lower than 60°FThe victim’s core temperature is lower than 60°F The victim has been submerged in water for longer The victim has been submerged in water for longer

than 60 minutes than 60 minutes Proceeding with CPR will place the rescuer at riskProceeding with CPR will place the rescuer at risk

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First Aid for Soft-Tissue InjuriesFirst Aid for Soft-Tissue Injuries

1. Irrigate the wound immediately to flush out as much 1. Irrigate the wound immediately to flush out as much bacteria, dirt, and debris as possible. bacteria, dirt, and debris as possible.

2. If tissue has been completely avulsed, wipe or scrub 2. If tissue has been completely avulsed, wipe or scrub it away with a gauze pad and sterile water or saline; it away with a gauze pad and sterile water or saline; if an avulsion is only partial, clean the tissue if an avulsion is only partial, clean the tissue thoroughly and place it in its normal anatomical thoroughly and place it in its normal anatomical position.position.

3. Bring the edges of the wound together as closely as 3. Bring the edges of the wound together as closely as you can to the position they were in before the skin you can to the position they were in before the skin was separated. was separated.

4. Dress and bandage the wound.4. Dress and bandage the wound.5. If dressings get soaked with blood, remove the 5. If dressings get soaked with blood, remove the

blood-soaked dressings, locate the bleeding vessel, blood-soaked dressings, locate the bleeding vessel, and apply direct pressure to stop the bleeding.and apply direct pressure to stop the bleeding.

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First Aid Care for Musculoskeletal First Aid Care for Musculoskeletal InjuriesInjuries

Shoulder DislocationShoulder Dislocation Kneecap DislocationKneecap Dislocation Finger DislocationFinger Dislocation Splinting a FractureSplinting a Fracture

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Death of a VictimDeath of a Victim

Immediately following the death, provide emotional Immediately following the death, provide emotional and psychological care to survivors, who will and psychological care to survivors, who will undoubtedly be disturbed by the deathundoubtedly be disturbed by the death

Depending on the religious beliefs of others in the Depending on the religious beliefs of others in the group, some sort of ceremony may be appropriate group, some sort of ceremony may be appropriate and comfortingand comforting

Note the time, cause, and location of the deathNote the time, cause, and location of the death Protect the body from predators and from the Protect the body from predators and from the

elements until you can transport it or until elements until you can transport it or until authorities arriveauthorities arrive

Notify authorities as quickly as possibleNotify authorities as quickly as possible

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PROGRESS CHECKPROGRESS CHECK

1. When assessing a victim in the wilderness, spend more 1. When assessing a victim in the wilderness, spend more time on the ____________ survey than you otherwise time on the ____________ survey than you otherwise would. would. (initial/primary/secondary)(initial/primary/secondary)

2. To manage a shock victim, insulate the victim from 2. To manage a shock victim, insulate the victim from ___________. ___________. (the air/the ground/moisture)(the air/the ground/moisture)

3. 3. Replace fluids in a shock victim by giving the victim Replace fluids in a shock victim by giving the victim ____________ of water.____________ of water. (small sips/one glass/large (small sips/one glass/large amounts)amounts)

4. 4. Wound management in the wilderness involves cleaning Wound management in the wilderness involves cleaning the wound and ____________.the wound and ____________. (removing dead (removing dead tissue/suturing the wound/changing the dressings)tissue/suturing the wound/changing the dressings)

5. 5. Whenever you splint a fracture or immobilize a victim to a Whenever you splint a fracture or immobilize a victim to a backboard, pay special attention to ____________.backboard, pay special attention to ____________.(strapping/padding/lashing)(strapping/padding/lashing)

6. 6. If a victim dies in the wilderness, it’s easiest If a victim dies in the wilderness, it’s easiest to ____________. to ____________. (have authorities come (have authorities come to the scene/carry the victim out)to the scene/carry the victim out)