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Wilderness First Aid. ABC’s. Head - to - toe examination for injury should include: Head, neck, shoulders, chest, arms, abdomen, back, pelvis, legs & feet Vital signs you can check: Level of consciousness, pupils, pulse, skin color, body temperature, respiration & response to stimulus
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ABC’s • Head - to - toe examination for injury should include:Head, neck, shoulders, chest, arms, abdomen, back, pelvis, legs & feet • Vital signs you can check:Level of consciousness, pupils, pulse, skin color, body temperature, • respiration & response to stimulus • But First!The Primary SurveyEstablish ResponsivenessShake & Shout"Are you all right!" • If there is no response, begin the ABC's of CPR
Patient Assessment • Scene • Stop / fix • Head -> Toe Exam • SAMPLE • OPQRST
SAMPLE • S – Symptoms • A – Allergies • M – Medications • P – Pertinent medical History • L – Last oral intake, last bowel movement • E – Events
OPQRST • O – Onset • P – Provokes • Q – Quality • R – Radiation • S – Severity (0-10) • T – Time
Shock • Hypovolemic Shock is from fluid or blood loss • What to look for: • Restlessness, anxiety, weakness • Pale or blueish skin and lips • Moist, clammy skin • Thirst • Nausea, vomiting • Unconsciousness • Weak pulse • What to do: • Straighten victim's legs & elevate above heart 8" to 12" • Seek medical attention ASAP - as soon as possible! • Give fluids as tolerated
Choking • What to look for: • Unable to speak, breathe or cough • Clutching neck with one or both hands • Wheezing, gurgling noise in throat • Skin turning blue or ashen color Heimlich Maneuver • Stand behind victim with arms around victim's torso. • Clench one hand over the other; thumb side of fist pressing between the waist and bottom of ribs. • Apply pressure and jerk quickly upwards 4 times. • If alone, use your own fists and arms - or push down against any blunt projection.
Breathing Problems • Asthma • Pnuemonia • Pnuemothorax
Chest Pain • What to look for: • Uncomfortable pressure, squeezing, or pain in center of chest that lasts more than a few minutes or comes and goes • Pain spreading to the shoulders, neck or arms • Light-headedness, fainting, sweating, nausea, or shortness of breath • What to do: • Help victim get comfortable-usually sittng up, with back support, padding under the knees • Loosen any tight clothing and be calm and reassuring • Give nitroglycerin if the victim has any • CALL LOCAL Emergency Medical Service OR TRANSPORT VICTIM TO NEAREST MEDICAL FACILITY IMMEDIATELY
Chest Pain • Angina Vs. Heart Attack
External Bleeding • Direct pressure stops most bleeding. Place sterile gauze or clean cloth over wound and apply pressure. If bleeding doesn't stop in 5 minutes, replace cloth and continue to apply direct pressure to wound while adding pressure to pressure points (below). • *Use a tourniquet only as last resort & never apply below the elbow or knee • DANGER: • DO NOT use direct pressure on eye, embedded objects or open fractures • DO NOT rinse wound with full strenghth medicines • DO NOT close wounds with tape • DO NOT breathe or blow on a wound
External Bleeding “X” marks the spot to apply pressure to help slow bleeding!
Head Injuries • What to look for: • Unconsciousness • Memory loss • Vomiting or nausea • Seizures • Unequal pupils • Weakness or paralysis • Combativeness - with victim striking out randomly at nearest person • Headache, vision impairment, loss of balance • Blood or clear fluid leaking from ears or nose • Note! The signs and symptoms of brain injury may be observed immediately (as listed above) or may slowly develop over several hours. • Check out the victim by asking personal questions: name, birthday, home address, where they are, etc. If the victim can't answer these questions, it could indicate a concussion or closed head injury.
Spinal Injuries • If victim is sitting up, support their head between your arms and gently lean them backward - making sure you keep their head and neck immobilized - if you must go for help, stabilize the head on both sides with objectsTell victim not to move! • Note: Spinal injuries can be difficult to evaluate. Some indications are pain over neck or spine, inability to move arms or legs, tingling or numbness in arms or legs, inability to wiggle toes or to feel your touch on soles of feet. If you suspect a spinal injury-- whether you are certain or not -- be cautious! • Do not move victim unless victim is in a dangerous place. • In most cases, you should just stabilize the victim and wait for proffessional help to arrive.
Dislocations, Sprains, and Breaks • What to doA dislocation is displacement of a bone end from its normal position at the joint • Example: Displacement of humerus (upper arm bone) from shoulder socketCan cause a deformed looking shoulder • Arm and shoulder joints can be additionally stabilized by fashioning a sling and swathe as shown here • Prepare a splint with a thin board or foam board and wrap with bandages or clean cloth (t-shirt, etc.) • Seek medical attention as soon as possible! • Splint with boot onRestIceCompressionElevation • If you suspect an ankle sprain, use the RICE procedures listed at left. Do not apply heat until at least 48 hours after the injury - If swelling and pain don't decrease with in 48 hours, seek medical attention. • If you are hiking and sprain your ankle - Construct a splint over your boot until you return to camp or vehicle - Once boot is removed, hiking is finished - Don't push an injured ankle!
Dislocations, Sprains, and Breaks • Check: • CirculationSensationMovement • If body part is bent or deformed, apply gentle traction & apply a splint You can fold a triangular bandage into a sling • Seek medical attention as soon as possible with ANY broken bone. • Closed fracture - skin & muscle intact • Open Fracture - skin broken, bone open to contamination • *Do not apply traction, cover wound & splint as is
Hypothermia and Frostbite • Signs & Symptoms: • Early • Shivering begins • Apathy • Clumsiness • Slurred speech • Stiff fingers • Stumbling • Strange behavior • Late • Obvious mental deterioration • Incoherence • Unconsciousness • Treatment in Field:Raise victim's body temperature with dry clothing, shelter, insulation (sleeping bag, blankets etc.) & applied heat (hot water bottles, your own warm body) • Caution! Be careful not to burn skin with hot water. Give warm liquids to drink only if you are sure victim is conscious and can swallow.
Hypothermia and Frostbite • Frostbite • Frostbite is the freezing of a part of the body, most often the nose, ears, cheeks, fingers or toes. • Causes of frostbite: • Cold stress • Low temperatures • Wind chill • Poor insulation • Tight-fitting clothing or boots • dehydration • Clear blisters & discolored skin on extremities • Remove victim from cold exposure, remove clothing from affected body parts. If warm water is available, put parts in warm water until thawed & numbness decreases - Wrap parts in dry, clean gauze & seek medical attention as soon as possible. Do not rub affected areas! • Caution! Once you warm a body part you must keep it warm. If you cannot protect it from freezing again, it is better to leave it frozen until you can.
Shelter • Finding a shelter • Building a shelter
Finding Shelter • Rock overhangs • Crevice or cave • Tree well in snow • Deadfalls • Hollow log • Deadfalls or woodpile • Brush or debris pile • Depression or piles in the snow or earth
Fire • Preparing to start a fire • Types of Fire • Techniques to start a fire • Tricks to keep warm during the night
Preparing for a fire • 1. Waterproof, strike-anywhere matches are your best bet. Matches may be water-proofed by dipping them in nail polish. Store your matches in a waterproof container. • 2. A cigarette lighter is also a good way to produce a spark, with or without fuel. • 3. The flint and steel method is one of the oldest and most reliable methods in fire starting. Aim the sparks at a pile of dry tinder to produce a fire. • 4. The electric spark produced from a battery will ignite a gasoline dampened rag. • 5. Remove half of the powder from a bullet and pour it into the tinder. Next place a rag in the cartridge case of the gun and fire. The rag should ignite and then may be placed into the tinder. • 6. Allow the suns rays to pass through a magnifying glass onto the tinder. • Dry grass, paper or cloth lint, gasoline-soaked rags and dry bark are all forms of tinder. Place your tinder in a small pile resembling a tepee with the driest pieces at the bottom. Use a fire starter or strip of pitch if it is available. • It is important to keep in mind that smaller pieces of kindling such as, twigs, bark, shavings and gasoline, are necessary when trying to ignite larger pieces of fuel. Gather fuel before attempting to start your fire. Obviously dry wood burns better and wet or pitchy wood will create more smoke. Dense, dry wood will burn slow and hot. A well ventilated fire will burn best.
Modern Methods • Modem igniters use modem devices--items we normally think of to start a fire. • Matches Make sure these matches are waterproof. Also, store them in a waterproof container along with a dependable striker pad. • Convex Lens Use this method (Figure 7-6) only on bright, sunny days. The lens can come from binoculars, camera, telescopic sights, or magnifying glasses. Angle the lens to concentrate the sun's rays on the tinder. Hold the lens over the same spot until the tinder begins to smolder. Gently blow or fan the tinder into flame, and apply it to the fire lay. • Metal Match Place a flat, dry leaf under your tinder with a portion exposed. Place the tip of the metal match on the dry leaf, holding the metal match in one hand and a knife in the other. Scrape your knife against the metal match to produce sparks. The sparks will hit the tinder. When the tinder starts to smolder, proceed as above. • Battery Use a battery to generate a spark. Use of this method depends on the type of battery available. Attach a wire to each terminal. Touch the ends of the bare wires together next to the tinder so the sparks will ignite it. • Gunpowder Often, you will have ammunition with your equipment. If so, carefully extract the bullet from the shell casing, and use the gunpowder as tinder. A spark will ignite the powder. Be extremely careful when extracting the bullet from the case. • Primitive Methods • Primitive igniters are those attributed to our early ancestors. • Flint and Steel The direct spark method is the easiest of the primitive methods to use. The flint and steel method is the most reliable of the direct spark methods. Strike a flint or other hard, sharp-edged rock edge with a piece of carbon steel (stainless steel will not produce a good spark). This method requires a loose-jointed wrist and practice. When a spark has caught in the tinder, blow on it. The spark will spread and burst into flames. • Fire-Plow The fire-plow (Figure 7-7) is a friction method of ignition. You rub a hardwood shaft against a softer wood base. To use this method, cut a straight groove in the base and plow the blunt tip of the shaft up and down the groove. The plowing action of the shaft pushes out small particles of wood fibers. Then, as you apply more pressure on each stroke, the friction ignites the wood particles. • Bow and Drill The technique of starting a fire with a bow and drill (Figure 7-8) is simple, but you must exert much effort and be persistent to produce a fire. You need the following items to use this method: • Socket. The socket is an easily grasped stone or piece of hardwood or bone with a slight depression in one side. Use it to hold the drill in place and to apply downward pressure. Drill. The drill should be a straight, seasoned hardwood stick about 2 centimeters in diameter and 25 centimeters long. The top end is round and the low end blunt (to produce more friction). Fire board. Its size is up to you. A seasoned softwood board about 2.5 centimeters thick and 10 centimeters wide is preferable. Cut a depression about 2 centimeters from the edge on one side of the board. On the underside, make a V-shaped cut from the edge of the board to the depression. Bow. The bow is a resilient, green stick about 2.5 centimeters in diameter and a string. The type of wood is not important. The bowstring can be any type of cordage. You tie the bowstring from one end of the bow to the other, without any slack. • To use the bow and drill, first prepare the fire lay. Then place a bundle of tinder under the V-shaped cut in the fire board. Place one foot on the fire board. Loop the bowstring over the drill and place the drill in the precut depression on the fire board. Place the socket, held in one hand, on the top of the drill to hold it in position. Press down on the drill and saw the bow back and forth to twirl the drill (Figure 7-8). Once you have established a smooth motion, apply more downward pressure and work the bow faster. This action will grind hot black powder into the tinder, causing a spark to catch. Blow on the tinder until it ignites.
Food • Finding Food • Trapping Food • Fishing • Cooking Food
Heat-Related Emergencies • if it is hot, you may be the victim of heat cramps, heat exhaustion or, in extreme cases, heat stroke. • (Note: An ounce of prevention is worth a pound of cure. Drink plenty of liquids to avoid heat-related emergencies.) • Heat Cramps: These are the least serious and usually occur in the leg muscles due to loss of body salts from heavy perspiration. Move to a cool place, rest, affected muscle and drink water (cold water if available). • Heat Exhaustion: This can become serious and is indicated by cold, clammy skin, slightly elevated temperature and possibly loss of consciousness. Move immediately to cool place and elevate legs, give cool water, and seek medical attention ASAP - as soon as possilbe. • Heat Stroke: This is the most serious heat-related problem, and the typical symptoms are hot, dry or wet skin, 105° temperature or higher, usually loss of consciousness - Move immediately to cool place and elevate head and shoulders. After victim is cooled, transport immediately to nearest medical facility -Heat Stroke is life-threatening! • Caution! Be careful not to give liquids orally if victim is unconscious or cannot swallow.
Burns • Most burns in the field are thermal (heat) burns, caused by fire, over-exposure to sunlight, certain chemicals and hot surfaces or substances. • Note: If clothes catch on fire, STOP - DROP - ROLL • You can assist by smothering with blankets, sleeping bags, etc. • For measuring body surface, the palm of your hand is about 1% • 1st degree - Red/pink, hot skin2nd degree - Red/skin blisters3rd degree - Deep layers/charred skin What to do: • Determine the severity of burn (first, second and third degree burns increase in amount of skin layers destroyed) • Remove clothing from burned area (if burns aren't severe) • Douse with cool water until pain stops • Cover with dry, nonstick, sterile dressing, keep area clean • Watch for signs of infection and dehydration • If burn is over more than 15% of body, or appears to be deep (second or third degree) - seek medical attention immediately • Do not: • Apply ice • Break blisters if it can be avoided • Apply any type of salve, ointment, sprays or creams • Pull or cut away clothing around deep burns
