Outdoor Medicine 2010
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1 Outdoor Medicine 2010
2 Outdoor Medicine Preparation Priorities Common injuries and illnesses High altitude illness
3 Preparation Itinerary Extra food and water, filter or iodine Clothes base layer, insulation, waterproof Fire Compass, knife, emergency blanket, light, string 1 st aid kit
4 1 st aid kit Waterproof bag Separate supplies in ziplock bags Continually restock Personal touch family, daytrip, medications
5 Wound Care Adhesive tape electrical or duct tape 4" x 4" sterile gauze pads Tensor bandages Bandaids (all sizes) Exam gloves Nonadhesive pads (Telfa) Pocket mask for CPR Resealable plastic bags Safety pins (large and small) Triangular bandages Moleskin
6 Miscellaneous Tweezers Knife or razor blades Waterproof matches or lighter Flashlight Scissors Sunscreen Iodine tablets Alcohol hand wash Thermometer
7 Medications Benadryl Tums Pepto Bismol Gravol Immodium Aspirin Ibuprofen Polysporin Electrolyte tablets Personal meds + rescue meds epi pen, puffer
8 Priorities in Care Hazards ABCDE
9 Priorities in Care Airway and cervical spine Breathing Circulation Disability Environment and Exposure
10 Airway and C spine Awake and talking Non tender Normal rotation Foreign bodies, jaw lift Immobilize neck or recovery position
11
12
13 Breathing Look listen and feel Artificial respiration Heimlich/CPR Position sitting, recovery, splinting
14 Circulation Shock? Bleeding? Check pulse Precordial thump, CPR
15 Disability Awake? Responding to pain or questions? Moving all 4 limbs?
16 Environment and Exposure Examine entire body Limit heat loss Should I stay or should I go?
17 Casualty transport Drags Carries Stretchers
18 Packstrap Carry
19 Blanket Drag
20
21 Recovery Position
22 Shelter
23 Heat Fire tinder, kindling, fuel Reflector Nalgean bottle Skin to skin
24 Injuries and Illnesses
25 Head injury No treatment possible in the field Evacuate for any head injury Reasonable to wait several hours for casualty to wake up before departing
26
27
28 Neck Injury Immobilize Get out
29 Chest Injury Penetrating 3 sided dressing Flail chest splint Pneumothorax
30 Abdominal Injury Penetrating Cover it Get out Blunt Get out if pain worsening or abdomen firm
31 Extremity Fractures Splinting Above and below? Reduction Only if cold, white, ++painful
32
33 Diarrhea Prevention clean water and handwashing Fluids Electrolytes Immodium if unbearable No role for antibiotics in the bush
34 Hypothermia Prevention water, food and clothing Mild vs. Severe
35 Hypothermia Mild Feeling cold Shivering Painful hands and feet
36 Hypothermia Severe Apathy No shivering Confusion Difficulty walking
37 Hypothermia treatment Rewarming in the field Mild Exercise, food, hot tea, warm clothes Put your hands in your pants and dance! Severe Risk of ventricular fibrillation Strip and dry, skin to skin Hot water (nalgean bottle or boiled clothes in bags) neck, armpits, groin
38 Frostbite
39 Frostbite Don t rewarm until you can stay warm Aspirin
40 Heatstroke Shade Rest Sunscreen Water Electrolytes
41 Infections Take little cuts seriously in the bush Rinse and polysporin Red, hot, swollen, pus means it s infected
42 Panic Sympathetic vs. Parasympathetic Talk down Breathing out slowly
43
44 Altitude Physiology Problem is not with percent O 2 but with partial pressure.
45 Altitude Physiology Your body adapts to this low pressure of oxygen by: Increasing your breathing rate Increasing how much blood your heart is pumping Changing your urine and how much you urinate
46 Altitude Illness When your body does not respond well enough, several illnesses can occur: Acute mountain sickness (AMS) High altitude pulmonary edema (HAPE) High altitude cerebral edema (HACE)
47 Acute Mountain Sickness Most common of altitude illnesses (40-50% of climbers at 15,000ft) Symptoms include headache, GI symptoms (nausea, vomiting, anorexia), fatigue or weakness, dizziness or lightheadedness, and difficulty sleeping Cheyne-Stokes breathing during non-dreaming sleep
48 Prevention: Acute Mountain Sickness Slow ascent Ascend less than 1000 ft sleeping altitude per day Climb high, sleep low Copious hydration Keep urine Gin Clear Acetazolamide (Diamox) mg once or twice a day Ginkgo Biloba has shown to be ineffective, though many climbers still use it
49 Acute Mountain Sickness Treatment: Do not proceed to higher sleeping elevation for 24 hours Immediately descend if symptoms worsen Start Diamox, if not taking already Take Tylenol for headaches Avoid sleeping pills Consider descending m
50 Questions?
Contents. Adapted from NC Hunter Safety Course; Ruth Hoffman contributor.
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