Outdoor First Aid 101
Backcountry travel is one of the most inspiring ways you can see the outdoors. Day hiking is wonderful, but once you have a few successful nights sleeping in your tent out among the stars, you will be hooked.
Oftentimes you will be miles out, away from definitive care, and need to recognize and begin to treat basic medical situations before they become larger issues. Here is a short list of common medical problems that can occur during your adventure travels and how to troubleshoot them on the fly.
Blisters
Blisters are the bane of all hikers’ existence. A blister is a small pocket of fluid that gets trapped in the upper layer of skin due to forceful rubbing. Blisters are not typically a medical emergency, but left untreated, then can surely make your backcountry trip a terrible experience.
Signs/Symptoms:
A red spot (also known as a “hot spot”) forming in places on the body where excessive friction is taking place--think back of the heel or in between toes.
A visible bubble elevated on the skin surface
Often accompanied by pain at the sight of the wound, swelling, and redness.
Treatment in the field:
If it is a hot spot, medical tape on top of the hot spot is sufficient.
Apply a doughnut of moleskin to the affected area; place the hole of the doughnut on top of the blister. This will take direct pressure off the blister itself.
Plan ahead and prepare:
Allow adequate break in time for your hiking boots before your backpacking trip
Keep your feet dry and change socks often
Catch and treat blisters early
Dehydration
Dehydration occurs when your body loses more fluid than it takes in. If your body does not have enough fluids it will have trouble carrying out normal body functions. At home, this could mean an afternoon slump at the office and a visit to the water cooler. On a four day trip in the desert, dehydration can turn dangerous very fast.
Signs/Symptoms:
Excessive thirst
Darker than normal urine
Headache
Muscle cramps
Dry mouth
Lethargy, irritability (more severe)
Treatment in the field:
Stop often for water breaks and pace yourself
Eat snacks that contain water and salt--think fruit or salty nuts/chips
Get plenty of rest each night of your trip
If you are on a hot and sunny trip consider taking a siesta during the hottest part of the day and hiking your miles in the morning and early evening.
Plan ahead and prepare:
Study your route and know when and where your water refill spots will be.
Carry a water treatment option as well as a backup. At Outdoor Mavens we carry Aqua Mira and gravity filters on all backcountry trips.
Pack salty snacks, fresh fruit for day one (maybe day two), and oral rehydration salts for emergent situations.
Pre-hydrate before your trip even begins
Mountain Sickness (AMS)
Also known as acute mountain sickness or altitude sickness, this condition arises from a rapid exposure to a high altitude. Higher than normal elevation gains and lower levels of oxygen can leave your body feeling depleted and off kilter.
Signs/Symptoms
Lethargy/malaise (not feeling like yourself)
Dizziness
Headache
Nausea/vomiting
Trouble sleeping at elevation
Loss of appetite
Treatment in the field:
Stop ascending until symptoms clear up
Drink plenty of water
Use an OTC pain medication for headache
Use Diamox, a medication used to aid the symptoms of altitude sickness
Plan ahead and prepare:
If possible train for your trip at higher elevation to get used to it
Educate yourself on the more severe versions of altitude sickness--HACE and HAPE.
Plan extra days into your trip to acclimate to large changes in elevation
Fractures
Broken bones and dislocations can be a very serious occurrence on a multi-day backpacking trip. Fractures in the backcountry are most common in the ankle, wrist, or leg usually caused by a fall. If a fracture happens, the main goal is to immobilize the injury via splinting it.
Signs/Symptoms:
Obvious deformity of the bone(s) that took the fall
Pain and swelling at the injury site
Changes in range of motion
Inability to bear weight/put pressure on it
Crepitus (sound of bone rubbing on bone)
Treatment in the field:
Assess the injury--look, listen, and feel
Splint the injury in a position of comfort; use a rigid component such as a SAM splint or stick
Make sure the splint immobilizes the joint above and below the injury site.
Make a plan to evacuate the injured party rapidly
Plan ahead and prepare:
Carry adequate first aid supplies to splint a fracture--SAM splint, ACE wrap, and padding.
Learn how to build a basic wilderness splint
Navigate uneven terrain carefully
Frostnip/Frostbite
Frostnip is the precursor to frostbite. Frostnip is a result of vasoconstriction and is a non-freezing cold injury. At this stage the tissue is not yet frozen, however, if left untreated, it can escalate into frostbite. When frostbite occurs the tissue is frozen and is in need of careful re-warming by a trained medical professional.
Signs/Symptoms:
Tingling/stinging of the affected area
Deep cold feeling around the area
Discoloration (red, white, or yellowish)
Unlike frostbite, skin remains pliable and soft
Treatment in the field:
Move inside your tent/sleeping bag and put on warm dry layers of clothing
Try to re-warm the area using warm water, the key to re-warming is gradual.
Use OTC pain medication for pain/discomfort
Plan ahead and prepare:
Pack extra protective layers for exposed skin--i.e. A balaclava, hat, scarves
Limit your time in the elements if possible
Bring plenty of winter socks to change often during your trip
Drink warm drinks
Gain experience in warm weather backcountry travel before you attempt winter backcountry trips.
All of these tips and pointers are helpful yet not exhaustive by any means. We highly suggest educating yourself on some basic Wilderness First Aid before heading out on longer trips away from definitive medical care. The National Outdoor Leadership School (NOLS) offers comprehensive courses that vary in length and depth. Our guides recertify their Wilderness First Responder certifications every two years to keep up with the evolving curriculum.
