Wilderness first aid

Wilderness first aid is the specific discipline of First aid which relates to care in remote areas, where emergency medical services will be difficult to obtain or will take a long time to arrive.

Evacuation

Transporting an injured person out of the wilderness on a stretcher can be a difficult exercise requiring considerable manpower.^[1]^[2] It is advised that at least one person stay with an injured party and that no one attempt to seek help by travelling alone over inhospitable terrain.^[1]

Specific conditions

Exposure

Exposure, sometimes called hypothermia, is a normal hazard of temperate wilderness. It occurs when a person's core body temperature falls below 33.7C (92.6F). If a person is wet, in a mild wind, it can occur in less than an hour at temperatures as high as 15°C (59°F).

Heat syncope: heat exhaustion or sunstroke

Both maladies tend to occur during heavy exercise in high humidity, or with inadequate water. Some chronically ill persons enter this state normally.

Cramps

There are two basic causes of cramping. One is inadequate oxygenation of muscle, and the other is lack of water or salt. Cramps from poor oxygenation can be improved by rapid deep breathing, and stretching the muscle. Cramps from lack of salt and water can be treated by stretching the muscle, drinking water and eating salt. What happens in a cramp is that lactic acid builds up because of normal anaerobic muscle metabolism. When the muscle burns sugar without enough oxygen, it makes lactic acid. The lactic acid finally becomes concentrated enough to trigger the contraction of the muscle. When the muscle lacks salt, the nerves firing the muscle are unable to recharge properly, causing a similar effect.

Insect and animal bites

Anaphylactic shock

Insect bites as well as exposure to allergens can trigger anaphylaxis in some people. Anaphylaxis is a life-threatening medical emergency because of rapid constriction of the airway, often within minutes of onset.

Altitude sickness

Altitude sickness can begin in susceptible people as low as 8,000 ft. The early symptoms are drowsiness, feeling unwell, and weakness, especially during exercise.^[3] Acute mountain sickness can progress to high altitude pulmonary edema (HAPE) or high altitude cerebral edema (HACE).^[3]

Wounds

The care of significant wounds in the wilderness presents a great challenge. Lack of access to sterile supplies and hospital care renders useless many aspects of routine wound care. The care of wounds can be broken down into acute care (immediate) and chronic (long term – day to day care).

Certification

Wilderness first aid is a relatively new field compared to regular or 'urban' first aid. For this reason, there are a number of boards and societies which have been formed in recent years to attempt to establish normalized standards for wilderness first aid certification and wilderness medicine in general. Currently, there is no "National Standards" for wilderness medicine, however one of the most popularly followed curricula is the "National Practice Guidelines for Wilderness Emergency Care" published by the Wilderness Medical Society.^[4]

The American Red Cross Wilderness & Remote First Aid (r.2010) certification is valid for 2 years.^[5]

In Canada the first wilderness first aid course were first taught in the mid 1980's and the first organization (now defunct 1986 to 1998) to adopt standards was the Wilderness First Aid and Safety Association of BC^{[citation needed]}.^[6]

The Boy Scouts of America is now also requiring a Wilderness First Aid certification for anybody who goes on a High-Adventure trek.^[7]

In Scouting

"Philmont requires that a least one person, preferably two, (either an advisor or a youth participant) in each crew be currently certified in Wilderness First Aid or the equivalent* and CPR from the American Heart Association, the American Red Cross, Emergency Care and Safety Institute (ECSI), or American Safety & Health Institute (ASHI). The preferred course is the American Red Cross, Wilderness First Aid, which is a sixteen-hour course designed to help in situations when help is not readily available. Several hours may be required for high adventure staff to reach a remote backcountry location after a message is delivered to the nearest staffed camp. First aid and CPR training will result in proper and prompt attention being given to injuries and/or illnesses. You must present current certification cards upon check in to verify this requirement.”

References

^ ^a ^b Wilkerson, James (2001). "Medicine for mountaineering & other wilderness activities". ISBN 978-0898867992. Retrieved 16 August 2011. work=books.google.co.uk {{cite web}}: Missing pipe in: |quote= (help)
^ Keller, William (2001). "Keller's Outdoor Survival Guide: How to Prevail When Lost, Stranded, or Injured in the Wilderness". books.google.co.uk. ISBN 978-1572232662. Retrieved 16 August 2011.
^ ^a ^b Cymerman, A; Rock, PB. "Medical Problems in High Mountain Environments. A Handbook for Medical Officers". USARIEM-TN94-2. US Army Research Inst. of Environmental Medicine Thermal and Mountain Medicine Division Technical Report. Retrieved 2009-03-05. {{cite journal}}: Cite journal requires |journal= (help)CS1 maint: multiple names: authors list (link)
^ www.wms.org
^ [1] redcross.org
^ [2] St. John Ambulance provides a Wilderness First Aid course
^ Boy Scouts of America, NCAC Council