Wilderness First Aid Basic Essentials • • • • • • • Hat Sunscreen Insect Repellant Boots Long pants (long sleeves) Rain gear Meat Tenderizer Hydration • Did you know that if you're thirsty, you're already partially dehydrated? • Drink to prevent thirst, not to quench it. • Heat Cramps: brief but painful involuntary muscle spasms. They usually occur in the muscles being used during the exercise, and are a result of insufficient liquid intake • Heat Exhaustion: difficulty breathing, headache, feeling hot on head and neck, dizziness, heat cramps, chills, nausea, irritability, vomiting, extreme weakness or fatigue • Heatstroke: rapid and shallow breathing, rapid heartbeat, unusually high or low blood pressure, lack of sweating, mental confusion and disorientation, unconsciousness, physical collapse Heat Exhaustion • • • • stop the activity, move into a cool environment, remove excess clothing drink hydrating liquids (NOT coffee, tea, sodas or juice!). ABC's and other Acronyms ABCD: First steps in assessing a victim for life threatening conditions. Sometimes E is added, for Exposure and Exam. • • • • A B C Airway open? Breathing? Circulation (pulse, major bleeding, and skin condition) D Disability? RAP ABC: Sequence of action for starting adult CPR Survey the Scene First • • • • • • • R A P Responsive? Activate EMS Position victim on back A B C Airway open? Breathing Circulation (pulse)? • LAF: Procedure used to determine injuries • L Look at the area for deformity, open wounds, swelling • A and • F Feel for deformity, tenderness, swelling • • • • • DOTS: Sign of injury D Deformity O Open Wounds T Tenderness S Swelling Sprains and Strains What Is the Difference Between a Sprain and a Strain? A sprain is an injury to a ligament--a stretching or a tearing. One or more ligaments can be injured during a sprain. The severity of the injury will depend on the extent of injury to a single ligament (whether the tear is partial or complete) and the number of ligaments involved. A strain is an injury to either a muscle or a tendon. Depending on the severity of the injury, a strain may be a simple overstretch of the muscle or tendon, or it can result in a partial or complete tear. What Are the Signs and Symptoms of a Strain? Typically, people with a strain experience pain, muscle spasm, and muscle weakness. They can also have localized swelling, cramping, or inflammation and, with a minor or moderate strain, usually some loss of muscle function. Patients typically have pain in the injured area and general weakness of the muscle when they attempt to move it. Severe strains that partially or completely tear the muscle or tendon are often very painful and disabling. RICE Therapy Rest Reduce regular exercise or activities of daily living as needed. Your doctor may advise you to put no weight on an injured area for 48 hours. If you cannot put weight on an ankle or knee, crutches may help. If you use a cane or one crutch for an ankle injury, use it on the uninjured side to help you lean away and relieve weight on the injured ankle. Ice Apply an ice pack to the injured area for 20 minutes at a time, 4 to 8 times a day. A cold pack, ice bag, or plastic bag filled with crushed ice and wrapped in a towel can be used. To avoid cold injury and frostbite, do not apply the ice for more than 20 minutes. Compression Compression of an injured ankle, knee, or wrist may help reduce swelling. Examples of compression bandages are elastic wraps, special boots, air casts, and splints. Ask your doctor for advice on which one to use. Elevation If possible, keep the injured ankle, knee, elbow, or wrist elevated on a pillow, above the level of the heart, to help decrease swelling. Fractures • • • • • • Prepare the casualty for splinting. a. Reassure the casualty if he or she is conscious and able to understand. Tell the casualty that you will be taking care of him or her. b. Loosen any tight or binding clothing. WARNING: Do Not Remove Any Protective Clothing Or Boots In A Chemical Environment. Apply The Splint Over The Clothing. WARNING: Do Not Remove Boots From The Casualty Unless They Are Needed To Stabilize A Neck Injury Or There Is Actual Bleeding From The Foot. c. Remove all jewelry from the affected limb and place it in the casualty's pocket. Tell the casualty that you are doing this to prevent further injury if swelling occurs later. 2. Get splinting materials. • a. Get splints (wooden boards, tree branches, poles,) long enough to reach beyond the joints above and below the broken part. • b. Get materials to pad the splints, such as a jacket, blanket, poncho, shelter half, or leafy vegetation. • c. Get tie materials, such as strips of cloth or belts, to tie the splints. • NOTE: If splinting materials are not available, use the chest wall to immobilize a suspected fracture of the arm and an uninjured leg to immobilize the fractured leg. Continue with steps 7 and 8. • 3. Pad the splints. Apply padding between the splint and the bony areas of the body. Suggested sites for padding are: wrist, elbow, ankle, knee, crotch, and the armpit. • 4. Check for signs of blood circulation problems below the injury. • a. Check light-skinned persons for color of skin (skin may be pale, white, or a bluish gray color). • b. Check dark-skinned persons by depressing the toenail or fingernail beds and seeing how fast the color returns. A slower return of color to the injured side indicates a circulation problem. • c. Check to see if the injured arm or leg feels colder than the uninjured one. • d. Ask the casualty about the presence of numbness, tightness, or a cold sensation. • WARNING: Evacuate The Casualty As Soon As Possible If Blood Circulation Problems Are Found. Bleeding • Apply direct pressure • Do not remove blood soaked dressings – Place sterile or clean dressing over wound • Protect yourself with gloves or plastic wrap or extra dressing – Elevate extremity above victim’s heart – Locate pressure point and apply pressure • Keep pressure over wound • 5. Put on a splint. • WARNING: If The Fracture Is Open, Do Not Attempt To Push Bones Back Under The Skin. Apply A Field Dressing To Protect The Area. • a. Splint the broken arm or leg in the position you find it. • NOTE: Do not try to reposition or straighten the fracture. • b. Place one splint on each side of the arm or leg. Make sure the splints reach beyond the joints above and below the fracture. • c. Tie the splints with improvised (or actual) cravats. • 1) Gently place the cravats at a minimum of two points above and two points below the fracture if possible. • WARNING: Do Not Tie Any Cravats Directly Over The Fracture. • (2) Tie nonslip knots on the splint away from the injury. 6. Check the splint for tightness. a. Make sure the cravats are tight enough to securely hold the splinting materials in place. b. Recheck circulation below the injury to make sure that circulation is not impaired. c. Make any adjustments without allowing the splint to become ineffective. 7. Apply sling if applicable. NOTE: A sling can be used to further immobilize an arm and to provide support by the uninjured side. a. Make a sling from any nonstretching material such as a strip of clothing or blanket, poncho, shelter half, belt, or shirttail. b. Apply the sling so that the supporting pressure is on the casualty's uninjured side. c. Make sure that the hand of the supported arm is slightly higher than the elbow. Open and Closed Fracture Positioning Splint and Padding Tie Nonslip Knots Immobilized Elbow Fracture or Dislocation Swathes Immobilize Unsplinted Extremity Bleeding • Apply direct pressure • Do not remove blood soaked dressings – Place sterile or clean dressing over wound • Protect yourself with gloves or plastic wrap or extra dressing – Elevate extremity above victim’s heart – Locate pressure point and apply pressure • Keep pressure over wound Puncture Wounds • Encourage wound to bleed • Take out splinters with sterile tweezers • Wash with soap and water, antibiotic ointment and bandage • If larger than a toothpick, do not remove – Especially if throbbing. BURNS • Cool immediately with cool water. • Do not open blisters • If blisters have opened, seek medical attention Head Injuries • A person is pushed to the ground or struck a hard object with the head but did not lose consciousness • • • • • Vomiting more than once Confusion Drowsiness Weakness or inability to walk Severe headache • • • • • • • • Bleeding or fluid coming from ear or nose Continuing or worsening headache Stiff neck Blurred vision Slurred speech Memory problems Clumsiness Unusual sensation Tick Bites • First, remove the tick. Forget any advice you've heard about applying petroleum jelly, fingernail polish, or a hot match to the end of the tick. Those home remedies almost never work. Instead of forcing the tick to withdraw, they're likely to kill the tick while it's embedded in the skin, which increases the risk of infection. • Although it's not foolproof, the best way to remove a tick is to pull it gently out with tweezers. • Grasp the bug as close to where it's connected as you can, and slowly lift it away from the skin. • Don't twist or jerk the tweezers or you may break off the tick's body, leaving the head behind, which can lead to infection. • Wash the bite area and your hands with soap and water after removing the bug. • If you live in an area where tick-borne diseases like Lyme disease or Rocky Mountain spotted fever occur, save the tick by putting it in a small container filled with rubbing alcohol. That way your doctor can test it if trouble arises. Otherwise, dispose of it in the toilet. Spider Bites • 2 Central punctums (as opposed to one with an insect bite • Watch, if open sore develops, see the health center • Black widow causes pain at site and GI upset Poison Plants • Wash area with warm soap water • Change clothing • Calamine and hydrocortisone cream Shock • keep the victim as calm • If thirsty, moisten lips, unless burn victim then give fluids if no danger of vomitting • Never give alcoholic beverages • KEEP AN INJURED PERSON WARM ENOUGH FOR COMFORT, BUT DO NOT OVERHEAT HIM. • When it is possible to place the injured person on his back on a bed, cot, or stretcher, you should raise the lower end of the support about 12 inches so his feet are higher than his head • When his face is flushed rather than pale or if you have any reason to suspect head injury, do not raise his feet. Rather, you should keep his head level with or slightly higher than his feet. • When the person has broken bones, you will have to judge what position is best both for the fractures and for shock. A fractured spine must be immobilized before the victim is moved to avoid further injuries. When you are in doubt about the correct position to use, have the victim lie flat on his back. THE BASIC POSITION FOR TREATING SHOCK IS ONE IN WHICH THE HEAD IS LOWER THAN THE FEET. Do the best you can, under the particular circumstances, to get the injured person into this position. In any case, never let a seriously injured person sit, stand, or walk around. Signs and Symptoms of Heart Attack • Uncomfortable pressure, fullness, squeezing or pain in the center of the chest lasting more than a few minutes. • Pain spreading to the shoulders, neck or arms. The pain may be mild to intense. It may feel like pressure, tightness, burning, or heavy weight. It may be located in the chest, upper abdomen, neck, jaw, or inside the arms or shoulders. • Chest discomfort with lightheadedness, fainting, sweating, nausea or shortness of breath. • Anxiety, nervousness and/or cold, sweaty skin. • Paleness or pallor. • Increased or irregular heart rate. • Feeling of impending doom. Snake Bite What are the symptoms of poisonous bites? While each individual may experience symptoms differently, the following are the most common symptoms of poisonous snake bites: •bloody wound discharge •fang marks in the skin and swelling at the site of the bite •severe localized pain •diarrhea •burning •convulsions •fainting •dizziness •weakness •blurred vision •excessive sweating •fever •increased thirst •loss of muscle coordination •nausea and vomiting •numbness and tingling •rapid pulse How are snake bites treated? Call for emergency assistance immediately if someone has been bitten by a snake. Responding quickly in this type of emergency is crucial. While waiting for emergency assistance: •Wash the bite with soap and water. •Immobilize the bitten area and keep it lower than the heart. •Cover the area with a clean, cool compress or a moist dressing to minimize swelling and discomfort. •Monitor vital signs If a victim is unable to reach medical care within 30 minutes, the American Red Cross recommends: •Apply a bandage, wrapped two to four inches above the bite, to help slow the venom. •This should not cut off the flow of blood from a vein or artery - the band should be loose enough to slip a finger under it. •A suction device can be placed over the bite to help draw venom out of the wound without making cuts. These devices are often included in commercial snake bite kits. Preventing snake bites: Some bites, such as those inflicted when you accidentally step on a snake in the woods, are nearly impossible to prevent. However, there are precautions that can reduce your chances of being bitten by a snake. These include: •Leave snakes alone. Many people are bitten because they try to kill a snake or get too close to it. •Stay out of tall grass unless you wear thick leather boots and remain on hiking paths as much as possible. •Keep hands and feet out of areas you cannot see. Do not pick up rocks or firewood unless you are out of a snake's striking distance. •Be cautious and alert when climbing rocks.