It’s outdoor season, and you’re bound to come across some safety concerns on the trail, while camping, or even at the beach. Here are 5 common outdoor first aid challenges and solutions from Dave Canterbury and Jason A. Hunt, Ph.D., the authors of Bushcraft First Aid.
1. TREATING A WOUND
Some of the most common outdoor injuries are cuts, scrapes, and puncture wounds. Often these are minor injuries but sometimes they are not. Even if a cut seems minor it can become infected if left untreated and lead to sepsis, a life-threatening illness.
Stop the Bleeding
The main goal in treating any bleeding injury is to stop the bleeding. To do this, apply direct pressure. Don’t place your bare hands directly on a cut or wound. Use gloves or another impermeable barrier to protect yourself.
If your patient has injured her arm or leg, raise the limb so it’s above the heart. This will help slow the bleeding and make your job easier. Press down on the area and maintain that pressure for five to ten minutes. After ten minutes, if the patient is still bleeding, spread the pressure over a wider area and maintain it for another ten minutes.
If the patient has lost a lot of blood, she may go into shock, indicated by rapid breathing and pulse and possibly loss of consciousness. In these circumstances, you should keep her warm and, if she’s awake, talk calmly to her to try to relieve her stress.
You need some nonabsorbent material to keep your skin and the blood apart. If you have any plastic bags (grocery, sandwich, etc.) those can do the job. So can a plastic trash bag or a Mylar blanket. If the injured party is known to you, and you’re reasonably sure he doesn’t have a condition that could be transferred to you through blood, you can forego using gloves or a substitute.
2. HANDLING HYPOTHERMIA
When your core body temperature falls below 95°F you are suffering from hypothermia. Untreated, it can lead to severe injury or death. If your temperature is 90°F–95°F, you are mildly hypothermic, but you should still address the problem immediately. If your core body temperature falls below 90°F you are severely hypothermic.
The first thing to do is to get into warmer temperatures, either by finding a shelter or building a fire. The environment should be dry rather than wet. Eat a carb-heavy diet and stay covered in dry, warm clothing.
Severely hypothermic people are extremely sensitive to touch. If you’re administering to one avoid sudden movements of her body. Watch her breathing carefully; you may have to perform rescue breathing.
If the patient’s clothing is wet, remove it carefully. Place him on a blanket on top of at least 4″ of compressed material so as to insulate him from the ground and wrap him in blankets or spare clothes. Heat metal canteen bottles and put them around his neck and groin, as well as under his arms. Create a vapor barrier from a drum liner or trash bag and wrap him in this. The barrier will trap heat in his body. Evacuate the patient as soon as possible.
The first step in self-aid is always prevention, but if you start to become cold, shiver, etc., you can check your current state by attempting to touch your pinky finger to your thumb. If you can still do this, then you have gross motor dexterity and now is the time to act. Fire is your friend in these conditions. Building a fire and using the reflectivity of a space blanket will help warm you up. Do not sit directly on the cold ground. It takes 4″ of compressed insulative material to combat conduction, so take care of that as well.
These activities—building a fire, creating an insulating pad for ground—will also increase metabolic heat, which in itself will help as a quick treatment. Make sure you remove and change any wet clothing if possible and also pay attention to a simple acronym (COLDER) when operating in cold environments.
C = Clean: Clothing clogged with dirt cannot breathe properly and will trap heat and moisture causing sweat, which can make you feel colder from convection.
O = Avoid overheating: This causes you to sweat, making you colder from convection more quickly.
L = Dress loose and in layers: This helps you adjust clothing easily to release excess heat or trap needed body heat between layers of clothing.
D = Keep clothing dry: This goes back to sweating, but also you need to be attentive to where you sit or kneel.
E = Evaluate your clothing: Review what you’re wearing and make adjustments accordingly.
R = Repair: Mend clothing if needed. Clothing with large holes, tears, etc., cannot perform as designed.
3. TREATING (AND PREVENTING) DEHYDRATION
You may have a mental picture of sitting by a crystal-blue lake, sipping a cup of water you’ve just drawn from it as you gaze at the herd of deer drinking a dozen yards away. That’s a nice picture, but get rid of it. In fact, fresh water is often contaminated.
Biological pathogens are the main water concerns if you’re traveling in the United States and Canada. You can use a water filter to get rid of protozoan cysts (such as Cryptosporidium parvum and Giardia lamblia) and bacteria (such as E. coli, Salmonella, Campylobacter, and Shigella).
Water purifiers go a step further by also combating viruses (such as hepatitis A, rotavirus, and norovirus) by the addition of chemicals such as chlorine or iodine, or UV light. If you’re traveling
in less-developed areas of the world, consider using a water purifier rather than relying on a water filter alone.
Pre-filtering is another important thing to consider. If you’re gathering water that is cloudy or silty, UV light purifiers and ceramic-style filters will not work as effectively, and the water may
require multiple treatments.
Boiling water remains the most low-cost and effective means of making water potable. At elevations under 10,000′, bringing water to a rolling boil (boiling about one minute) is all that’s required. In elevations above 10,000′, add one minute of boil time for every 1,000′ of elevation, not to exceed twenty minutes. So at 14,000′, you would boil for four to five minutes. Boiling the water and using a UV light or iodine will eliminate all potential contaminants, but this is overkill for much of the United States and Canada; you can generally get by with one or the other without issue unless you’re in a chemically contaminated area such as an industrial or agricultural runoff zone.
Straw filters (plastic pipe filters meant for one person to use) provide a lightweight, quick way to get water into your system, but only in small quantities. While this is fine when you’re on the move, it’s not good for a base camp or when you’re camping over multiple days. Also, when it’s cold, straw filters can shatter if dropped or freeze up all together if not properly cared for.
The key to remaining hydrated is to begin your trip fully hydrated. On your way to your destination, you should be drinking water every fifteen minutes or so until you get there. You should have already devised your water plan for the trip beforehand, so if you’re going to carry in 2 quarts of water (about 4 pounds) and rely on nature to provide the rest, have the appropriate gear to get water fast (such as a straw) and in large amounts (such as a gravity filter) for when you’re in camp.
Multiple containers such as stainless steel bush pots make boiling several servings of water at one time a cinch. But don’t wait until you’re dehydrated and thirsty to begin boiling; it’s already too late and you’re likely not going to catch up and rehydrate properly unless you spend a full day in one location boiling water in larger amounts (10 cups at a time). It’s not the boiling that’s difficult, but the cooling—it takes water longer to cool than it does to bring it to a boil—so consider placing the boiled container in a cooling puddle at the side of your water source. This will help speed the cooling process and aid in getting water into your body faster.
Remember that over-hydration is also dangerous as it can lead to hyponatremia. With this condition, the body holds onto too much water. This dilutes the amount of sodium in the blood and causes levels to be low. Symptoms include nausea, headache, confusion, and fatigue. So if you’re taking the time to rehydrate, but hit a point at which you begin forcing water into your system and start feeling tired and nauseous, ease off. Limit your fluid intake and rest. Hospitalization may be needed in advanced cases.
4. BATTLING INSECTS
Clothing is your first line of defense against the elements, including insects, and is considered one of the Ten Cs—a cover element. Therefore, it is also part of your shelter considerations.
Appropriate clothing for wilderness travel will vary slightly with the changing seasons but will always include a base layer and middle layer (which may serve as an outer layer in warmer months) and in cooler months, an outer layer or shell as well.
We need to distinguish between insect repellents and insecticides. Repellents are substances we put on our skin. An insecticide can’t be put on your skin; it’s for use on other materials (clothing, tent walls, etc.).
While the most widely used repellent is DEET, be careful! Using it in too high of concentrations on your skin can bring on an allergic reaction. Be cautious of using it on small children. These days a number of repellents are manufactured specifically for kids. Keep the repellent away from your lips, eyes, and any cuts or scrapes you have. In the battle against ticks, chiggers, fleas, sand flies, and mosquitoes, the best insecticide to use is permethrin. Never put it on your skin; use it only for clothing, tents, sleeping nets, or shoes.
Since it retains its power for weeks and even months, you probably won’t have to apply it more than once or twice a season. As well, it won’t stain or injure the fabric. Put DEET on your skin and permethrin on your clothes and tent and you’re likely to avoid the problem of insects.
You’re on the trail in a wooded area with some hiker friends when you feel a sting at your neck. You slap at it but whatever bit you is gone. At first you assume it’s just a mosquito bite but the sting gets worse as you continue to walk—way more pain than a mosquito would cause. Now what?
You ask one of your hiking buddies to take a look at the site of the bite. When he does so, he notices a stinger in the bite site. No one has a pair of tweezers along but you have a sail needle in your backpack, and he uses that to scrape out the stinger. You don’t have any history of allergies to bee stings. Once it’s out, you feel some relief, although the site of the bite is still sore. You clean the bite with soap and clean water, then hold a cold compress against it for about fifteen minutes, and that helps with the pain. Your buddy keeps an eye on you for the next hour to make sure you don’t develop an allergic reaction.
Long-sleeved shirts and long pants, even in summer months, will help protect you from insect bites. Tuck pant legs inside boots and then use duct tape for garters. This will help keep ticks from the legs. Mosquito netting can be placed around the head and face and can double as a minnow net for fishing. Many plants have a natural bug repellent factor. These include most with a volatile oil, such as birch. Many plants like yarrow can be rubbed on the skin as a raw plant and will do some good as well. One of the best things is a clay-based mud smeared on any exposed parts of the body.
5. MONITORING REACTIONS TO POISON IVY, POISON OAK, AND POISON SUMAC
If you touch any of these plants, their resins will begin to bond to your skin. The process takes about half an hour, so if it’s been more than thirty minutes since you made contact with the plant, it will take more than soap and water to remove. So it’s important to wash your skin immediately after exposure and to remove and wash any of your clothing that came in contact with the resin as well (being careful not to touch the surface with your bare skin).
If you are not able to immediately remove the resin, use an alcohol-based cleaner or a commercial preparation (Poison Oak-n-Ivy skin cleanser, for example). To treat:
•Wash hands and infected surfaces immediately with soap and plenty of water. Isopropyl alcohol (in hand sanitizers) works great for neutralizing the resin as well.
•Apply calamine lotion if available.
•Burleigh Balm and Fix’n Wax also work to slow spread and itching if applied regularly.
•Jewelweed and plantain also aid in the prevention of spread, redness, itching, and swelling.
If you’re suffering from an itch because you got too close to a pile of poison ivy, any plant or tree with a high concentration of tannins will constrict the pores of your skin and help push the oils to the surface where they can be neutralized more easily or scrubbed off. Oaks, both red and white, have high concentrations of tannins even in the leaves. You can create a cold infusion or a tea that will help as a wash. However, do not use warm liquid on an itch as this will only serve to aggravate the condition.
Why would you want to be outside in the first place, even with all this first aid knowledge? Because it’ll make your relationship stronger.
About the Authors
Dave Canterbury is the co-owner and supervising instructor at The Pathfinder School, which USA TODAY named one of the Top 12 Survival Schools in the United States. He has been published in Self Reliance Illustrated, New Pioneer, American Frontiersman, and Trapper’s World. Dave is the New York Times bestselling author of Bushcraft 101, Advanced Bushcraft, and The Bushcraft Guide to Trapping, Gathering, and Cooking in the Wild.
Jason A. Hunt is the Lead Instructor and Operations Manager at The Pathfinder School. He is the owner of Campcraft Outdoors, a rugged soft goods manufacturer, and is a Firefighter/ WEMT with degrees in recreation, theology and outdoor ministry leadership. Jason has been published in Survivor’s Edge, Self Reliance Illustrated, and Prepare Magazine.