Safety
Caution and sound judgment are the most important elements of wilderness emergency care. Being far from any sort of medical facility, one must always seek to avoid injury and dangerous situations. Although this may seem patronizing to note, one must be extra mindful of one’s health and welfare in the wild. Conditions that are easily aided in urban and suburban settings can be lethal in the out-of-doors.
Unfortunately, mishaps do happen. Therefore, in addition to prevention, preparation is key to dealing with outdoor injuries. Be sure to have at least one member of your party familiar with first aid practices. If you want to get out but have no first aid experience, consider going on a trip with the Outing Club, or becoming trained in first aid (there are courses available at the Medical School as well as through the DOC).
Here are a few things to keep in mind when in an emergency situation:
- Survey the situation and keep cool. Don’t panic. Decide exactly what steps to take before acting.
- Give necessary first aid to the victim (see below).
- Regroup all members of your party. Observe reactions of each member to insure that others are not in danger.
- Choose a messenger party to go for help.
- send at least two persons.
- leave at least one person with the victim.
- Give the messenger party a report of the injury and a map or sketch showing the exact location of the victim.
- Messenger party should:
- Take essential equipment (map, compass, flashlights, food, water, matches, protective clothing). Be prepared for a night out.
- Keep calm; hurry but stay safe.
- DO NOT SPLIT UP.
- Conserve strength to be able to lead a rescue party back, if necessary.
- Group with the victim should:
- Make victim more comfortable. Maintain their body temperature. Protect victim from the elements.
- Set up a temporary camp.
- Maintain group morale. Stay positive. Prepare hot food and drinks for group members.
- Assign one person to remain with the victim at all times.
- Keep written log on the condition of the victim. Observe victim constantly until the rescue party arrives. Watch for:
- breathing irregularities
- heartbeat irregularities
- signs and symptoms of shock (increase in breathing rate and/or heart rate)
- bleeding
- blockage of air passageway by blood, vomit, tongue, etc.
- Emergency telephone numbers:
- NH State Police (24 hours) — 911 or (800) 852-3411
- VT State Police (24 hours) — 911 or (802) 244-8727
- Dartmouth Safety & Security — (603) 646-2234
Distress Signals and Being Lost
In an emergency, the best way to signal is with three short calls (audible or visible) repeated periodically. Visual signals may include three flashes from a flashlight, three fires; or in the day time, sunlight reflected with a mirror, or smoke puffs. Anyone recognizing such a signal should acknowledge with two calls by the same method if possible, then proceed to the distressed. Most areas in New England are well traveled, so help should come soon. The best plan is to remain where you are, especially when lost.
However, as always, one’s best judgment must be used. If an area is remote, the situation desperate, or the weather bad, it might be best to study the map and determine a place where more people are likely to be. When traveling to this place, it might be helpful to leave heavy packs behind — but be sure to take all essentials in case the rescue is delayed. At night, try to seek or make shelter. It is helpful to know that even the most remote places in New England usually have highways and roads within a few hours walk. Following streams downward will eventually lead you to a road. Make sure to use your compass.
Often overlooked, it is an extremely good idea to leave a trip itinerary with friends before heading out, so that people know exactly where you are and when you expect to return.
First Aid
First aid should always be administered by a certified member of the group. If no one is first aid educated then follow these general guidelines. Keep in mind that these are only guidelines and cannot take the place of certification.
- BE CALM
- Do not move the patient until the extent of injury is determined. Treat the patient in the following order:
- AIRWAY
- Ensure that the airway is open. If the patient is unconscious, use the head-tilt, chin-lift maneuver or the jaw thrust.
- BREATHING
- Give mouth to mouth resuscitation if patient stops breathing. If heart stops beating, begin cardiac compressions (CPR) at a rate of approximately sixty compressions per minute.
- EXCESSIVE BLEEDING
- Apply direct pressure to any bleeding areas. If this does not control the bleeding, apply finger pressure to an artery where it passes over a bony surface between the wound and the heart. After appying dressings to the wound, do not remove them, just keep adding more guaze on top of the older dressings.
- SHOCK
- Elevate the lower body, keep warm and dry. Abate pain with aspirin-type drugs.
- FRACTURE
- Always check first for neck and back injuries before moving (see below). Splint with anything available including undamaged limbs. Pad well. Try to immobilize joint above and below fracture. If it is a femur fracture, pull traction and keep it pulled.
- HEAD INJURIES
- Control scalp bleeding by direct pressure.
- Look for unconsciousness, unequal pupils, or bleeding from the ears, mouth, or nose. These indicate urgent evacuation to the hospital.
- If above is not present and patient is conscious, victim may walk if: aware of time and place. minimal ache at spot of injury, no nausea or vomiting, no paralysis or weakness, and no neck stiffness; victim may not walk if: severe headache, unequal pupils, pulse rate less that forty-five beats per minute, nausea and vomiting, loss of orientation, or defect in visual field.
- NECK and BACK INJURIES
- Suspect neck and back injury in any fall of significance (three time body height) or violent trauma (car crash, etc.).
- If injury is suspected, patient will need to be immobilized (splinted) by trained personnel, then transported on a rigid stretcher. Send for help.
- In the meantime, the priority is to keep the victim warm and dry. Remove wet or damp clothing and replace with warm blankets or sleeping bag and rap a tarp outside the blankets. Get patient onto a foam pad, lifting whole body as a unit. Don’t be shy — a neck or back injury may not kill, but cold absolutely will.
First Aid Kit
Short of having full first aid training, always be sure to carry a small first aid manual. There are several small wilderness first aid manuals that outline the essentials, and are good to stuff inside your first aid kit on even the shortest excursions. Listed below is a good, inexpensive first aid kit. It is a good idea to put these items in a waterproof case (a heavy duty plastic zip-lock works well).
- Gauze Pads, 3" × 4"
- Band-Aids (all sizes)
- Pain Killer, aspirin-free, twenty tablets
- Athletic Tape
- Ace Bandage, 3"
- Moleskin, 6" × 6"
- Safety Pins
- Scissors (small is fine, but sharp)
- Tweezers
- Antibiotic Ointment
- Personal Medications
- Surgical Gloves
Finally, if the above-mentioned life-threatening injuries have discouraged you from venturing out-of-doors, know that the common blister is far and away the most common ailment. Moleskin works wonders in treating the symptoms, but first try to prevent the cause. Since the hands and feet are the most commonly afflicted areas, make sure that any foot and hand wear fit properly. Do all you can to break in equipment before venturing out. Tape known problem areas on feet with medical tape or duct tape before starting and treat all “hot spots” when they first become noticeable. Keep in mind that even well-worn equipment may cause blisters if the outdoors-person is not accustomed to a particular activity or motion.
