Trail First Aid Advice for Advisors John Blackwell

Transcription

1 Trail First Aid Advice for Advisors John Blackwell NCAC High Adventure Committee Philmont Training III - March 11, 2016

2 Trail First Aid Advice for Advisors Wilderness First Aid Context Crew Advisor s Role What to Look Out For and How to Prepare Common Trail Maladies Hazardous Conditions Crew Medical Management

3 Wilderness First Aid Context Extended Patient Management You are responsible for patient care normally handled at a hospital Golden hour vs. Golden day Harsh Environment May complicate the injury Can make treatment and evacuation more difficult Limited Equipment You have to treat a patient with what you have with you But, that can be more than what you might think (McGyver!) Wilderness First Aid Is What Happens When Someone Calls For Help In the Woods And Gets You

4 Training Crew Advisor s Role Philmont s Requirements (2 each WFA/CPR) Awareness Review all crew medical forms Be aware of existing preconditions and medications Discuss medical and emotional issues with parents Observe crew on shakedowns Ensure an adequate supply of personal medications Prevention Monitor yourself and your crew on the trail and in camp Stress individual responsibility Management Handle those situations within your capabilities Know when and how to get help from Philmont

5 Too Wet - Too Cold Hypothermia lowered core body temp Prevention: Layers of polypro/wool (no cotton); rain gear! Signs/symptoms: Cold, disoriented, shivering, gradual onset Observe crew, have them look out for each other Treatment: Get dry & warm immediately (burrito wrap) Too Hot - Too Dry Dehydration loss of fluids (low humidity, wind, sun) Prevention: Camel up, drink 4-8L/day, monitor urine output (clear & copious); get on trail early; 3:1 water:gatorade

6 Too High Altitude sickness poor adjustment to reduced O2 partial pressure, more common > 8000 Prevention: Acclimation, hydration, difficult to predict who Signs/symptoms: Headache, nausea, lack of appetite, confusion Prevention: Increase fluid intake, decrease altitude Nosebleeds more susceptible in dry humidity; dehydration Prevention: light coat of Vaseline in each nostril, hydrate Sunburn higher elevation increases effect of UV light Prevention: sun block (ears, nose, lips, back of legs); hat

7 Too Dirty Personal cleanliness remove salt, prevent rash Wash PTA, change or wash clothes, use Gold Bond Crew gear cleanliness dirty pot trots Pre-meal sterilization is the single most important factor!!! Supervise dishwashing, make sure final rinse is hot Clean water Supervise water purification, use pumps, filters, tablets No need to treat cooking water since you will be boiling it Never share water bottles (easy to pass virus) Diarrhea - treat your water, clean your dishes Can compound a dehdratio problem Give OTC meds (Imodium AD)

8 Blisters Blisters skin irritation caused by friction Prevention: Wear liner socks and make sure boots are laced properly Treat hot spots immediately Powder feet in camp Signs/symptoms: Monitor crew on the trail Individual responsibility: crew stops if someone has a hot spot Treatment: Blister packs - moleskin, gel bandages, Second Skin, tincture of benzoine May have to drain; sterile needle

9 Sprains and Strains Strains - stretch injuries to muscles or tendons Sprains - stretch injuries to the ligaments Prevention: Often results from dehydration and fatigue Monitor crew, take breaks! Watch where you walk Treatment: Leave boot on, ankle wrap (Ace bandage) RICE to control swelling, Vitamin I» Rest - limited use, get backpack off and into camp» Ice - cold compresses for first 24 hours» Compression - ACE bandage» Elevation - keep injured limb elevated

10 Weather Lightning Storms usually occur mid to late afternoon each day Immediately seek protection away from single tall trees, exposed ridgelines or open meadows Spread crew out, remove packs and squat on sleeping pad hugging knees and keeping feet together Hail Some thunderstorms can bring hail Watch for hypothermia, it will be cold

11 Safety No bare feet in camp, put on camp shoes! Supervise filling/lighting/operating stoves, water purification and dishwashing Avoid frisbee and volleyball games in camp Third Day Syndrome Observe ALL bear procedures Buddy System/Notify CA if a crew member leaves camp The $2500 Mistake

12 First Aid Kits If you don t know how to use it, don t bring it! Individual responsibility everyone carries hot spot kit Crew Kit larger, trauma supplies, spare OTC meds Discuss OTC and any other meds with parents Read some good Wilderness First Aid books Be prepared from the very first shakedown hike!

13 Personal Urgent Care Medications Individual responsibility Urgent care meds don t go in the bear bag Carry sufficient meds for entire trek (including to/from) Tent mate and advisors must know where meds are At least one other crew member must know how to administer (EPI-pen, insulin, etc.)

14 First Aid Quiz True or False If you are sweating on the trail at Philmont, it is a good sign that you are becoming dehydrated More people die of snakebites than bee stings in the US A hypothermia victim is usually aware of the symptoms In a lightning storm, the crew should stay together to assist each other Your least physically fit crew member will generally be affected by altitude first Draining a blister aids in its healing A heat stroke victim will have cool clammy skin