First Aid

Note: This blog post is not intended as medical advice, nor is the author qualified to dispense medical advice. Consult a physician for such advice.

Recently, I’ve spent quite a bit of time reading ultralight backpacking forums and have discovered that many people don’t really carry a first aid kit, and some consider a couple feet of duct tape to be their first aid kit. It seemed foolish to me, but one point that also came out of those discussions is that it’s even more foolish if you’re carrying around a bunch of first aid supplies that you don’t know how to use. So, I went through my first aid kit try to decide what to take, keeping in mind that I’m not only responsible for myself but my family, including a first-grader. I realized that I wasn’t really sure what scenarios would lead me to needing many of the supplies, so I packed a number of items because “you never know.” Of course, this is the antithesis of ultralight backpacking principles, toward which I am currently pushing myself.

That’s when I decided I could really use some training, so I signed up for a wilderness first aid class, which I completed last weekend. I took my class through Wilderness Medical Associates because of convenience and because it was sponsored through the local paddle shop Rutabaga. Although I’m now probably left with more questions than before taking the class, I have a better understanding of how I would approach a number of potential emergencies in the back country. The class really tried to emphasize a systematic approach to assessing the particular situation, including the surroundings, patient symptoms, vitals and health history, along with some rudimentary procedures for treatment.

Obviously, one cannot be a fully trained medical

Patient Assessment System

practitioner after a long weekend course, but the course did provide me with some confidence in how to approach potential emergency situations and even how to judge whether something is a true emergency. Many of these things may be common sense, and it’s likely that the end result or my “treatment” to many potential medical situations would have been similar without the course as it will be after taking the course. However, the course really provided some needed confidence and taught procedures for addressing these medical situations. For example, in the class we acted out a number of scenarios in which “patients” needed medical assistance, and in one scenario the patient had taken a fall and injured their abdomen and cut their hand. Victims were divided in categories related to how serious their injuries were, and in this scenario I encountered a woman who only had minor injuries but who was somewhat distraught. In the end, she only really needed a cleaning and a bandage on her hand, which is something that anyone with no medical training could do. However, our training taught us to assess the victim, reassure her, treat her most obvious/significant injuries and continue to assess her in terms of vitals, as well as medical history and a “head to toe” exam. In this scenario, patients were instructed not to disclose their abdominal injury until discovered by the first aid responder, so the assessment was critical, especially for those who “had” more serious injuries. Without follow-up assessment, patients with critical injuries may not receive the necessary treatment if serious injuries and their symptoms are not recognized.

Fake wound from a class scenario

For serious or life-threatening injuries, there are not many treatments for which this class trains its students. We were instructed in anaphylaxis treatment, stopping bleeding with and without a tourniquet, treating hypothermia, CPR and use of an automated external defibrillator (AED). Other than that, we’re basically at the mercy of the availability of advanced life support, and the course emphasized distinguishing when it’s time to “push the big red button,” which really has solidified my decision to purchase some type of emergency locator beacon.

It’s hard to express all the bits of knowledge I picked up during this class or to know exactly how it will affect my reaction to a medical situation in the back country. However, some of the more concrete take-homes or immediate realizations I had are as follows:

• Everyone should carry more than duct tape for their first aid kit as it could save a life even if many of us will go our whole lives without ever encountering such a scenario. To me, it’s worth the extra ounces, especially since I’m responsible for a child.
• It’s OK to bring a written guide to help you through some situations. The field guide we were supplied has some step-by-step instructions for handling assessments, and this could prove invaluable, especially if panic sets in during a crisis.
• Bring sterilized bandages and a means to secure them to a patient such that it will provide enough pressure to stop a bleed. In one exercise, I realized an ace bandage works wonderfully for this, but I had trouble using gauze rolls and triangle bandages to do so. The ace bandage will stay in my kit despite previously considering ditching it due to not knowing what I would really do with it. They also come in handy for securing splints.
• Know which medications are for which purpose. Diphenhydramine (Benadryl) is great for allergic reactions. Aspirin and ibuprofen are good for reducing inflammation and pain but tylenol will not reduce inflammation, although aspirin and ibuprofen are not recommended for bleeding patients
• Talking with patients, reassuring them and assessing their current condition and past health history is crucial and could be the difference in saving them as opposed to hurting them. As an example, the instructor said she was terribly allergic to povidone iodine, and it could lead to worse outcome to treat a wound with iodine. Before giving any medication, talk to and obtain consent from the patient, and know that many organizations prevent their trip leaders from giving medication.
• Monitor the patient’s vitals and mental health over a period of time to assess how their condition is changing.
• Have a method to record this medical information so that it can be handed off to other medical practitioners.
• Have a quick way to sterilize equipment. Alcohol wipes should work well.
• Some additional tools that could be useful in a medical emergency include a large syringe for washing wounds, a garbage bag for biohazard waste, gloves for protecting yourself and tweezers for removing embedded ticks or even bugs from body orifices.
• Carry a satellite-based emergency beacon, such as a personal locator beacon.
  
  

  

  Commercial first aid kits are a good place to start but should be customized

I would recommend taking a first aid class to everyone, and I especially urge those who frequent the back country and those responsible for children to improve up their skills and knowledge related to first aid. I’m sure that I’m forgetting something or will make mistakes if faced with an emergency, but I feel like the class gave me some basic skills and knowledge for how to approach first aid.