1st AID

About halfway through the trip, Lucy developed incredibly painful chafing on the thighs. It was so bad it probably would have been a trip ender if we hadn't brought some "tour de France" chafing creme along. It was bad. I was also surprised how dry my hands got by the time we were at Red's Meadow. I had sand paper hands and suddenly lotion became worth the weight. Remember folks: the air is very dry up there! We carried coconut oil both for cooking trout in foil and moisturizing skin.  

Finally: It is essential for each person to carry their own lip balm. The best is Mentholatum SPF30.

I found Backcountry First Aid and Extended Care by Buck Tilton helpful and though we're no doctors, following are some 1st aid notes Pilastr compiled:

Dehydration (10% dehydration causes 30-40% decrease in thermal control)
  • Fatigue, Heat oppression, Thirst
  • Irritability, Dizziness, Dark, concentrated urine
  • Headache, Loss of group cooperation
Later signs
  • Rapid pulse, pale sweaty skin, Weakness and nausea
  • Loss of balance, Changes in mental awareness, Tenting
Serious signs
  • Inability to swallow, swollen tongue, Sunken eyes
  • Loss of consciousness, Delirium
Treatment for Dehydration
(Rehydrate as rapidly as tolerated, but at least 16-32 ounces of water an hour)
Dehydration at Altitude main cause is the need for rapid and deeper breathing, and dulling of the sensation of thirst that accompanies the loss of appetite at altitude. solution: force yourselves to drink large amounts of water. Thirst alone is often not a reliable indicator. Needs can be greater than four liters per day.

Heat-related Illness
Headache, Cool, moist, pale, or ashen skin (earlier stages)
Dry, red, hot skin (later stages)
Nausea, Exhaustion, Progressive loss of consciousness
Rapid, weak pulse, shallow breathing (later stages)
High body temperature (later stages)
Care for Heat Exposure
Give small amounts of cool water to conscious victim
Have victim lie down in a cool, shady area, elevate legs, Loosen or remove clothing.
Apply cool, wet towels or cold packs to wrists, armpits, groin, and legs. Fan victim

Hypothermia “impairs intellectual, muscular and cardiac function"
Cool skin
Shivering, progresses to shivering you can't stop voluntarily then waves of violent shivering
Poor coordination (sometimes uncoordination can precede shivering).can't zip jacket, stumbles
Glassy stare, Difficulty speaking, (brain can first to go because it is most sensitive to cold)
Indifference, apathy, personality changes, especially irritability
Decreasing level of consciousness, Rigid posture, curls into fetal position
Care for Hypothermia
Initially, exercise can warm people up the fastest, hike briskly to nearby shelter.
Remove victim from cold, wet, windy environment, protect from any further heat loss.
Remove wet clothing. Add layers, plastic, insulate from ground. Warm rocks against side of chest, neck and abdomen (test hotness yourself).
Summon more advanced medical personnel, Reassure victim, Handle victim gently
Hot water bottle, drinking water bottle full of warm water,
More calories if they can eat. Warm food is good but not necessary.

Guidelines for Initial Snakebite Care
Take victim to medical care immediately
Wash wound if possible
Immobilize affected part, Minimize victim’s movement
Keep affected part lower than heart
Summon more advanced medical personnel
Do not use razor blades/suction, do not apply ice, cut the wound or use an electric shock

Signs and Symptoms of Shock
Restlessness/irritability, Drowsiness/loss of consciousness
Rapid pulse, breathing, Excessive thirst
Pale, ashen, or bluish/cool/moist skin
Nausea and vomiting
Body Compensates for Blood Loss The heart beats faster, Breathing rate increases, body moves blood / fluid from areas where it is less needed (stops making saliva, less blood to skin -- superficial blood vessels contract; less blood to digestive system) to where it is needed (brain)

Do not pack burns in ice which are over 20% of body surface
Do not leave wet coverings on burns for more than two hours to reduce the risk of hypothermia
Elevate burned extremities to reduce swelling
Have victim gently and regularly move burned areas as much as possible
Evacuate victim by the fastest means possible, 12-19 hours for major burns 20%+ body

Crouch on something insulating if possible, such as your ensolite sleeping pad, or climbing rope. Even dry moss or grass or a snow patch is better than bare rock. Especially if you have to sit instead of crouch, get some insulation under your buttocks.
Get metal objects away from you (they don't attract lightning but they carry induced currents.) Stay out of small depressions. Pick a slight rise instead. Not in standing water or a puddle.
Hey! Spread out your group so you aren't all hit at once.(NOLS says 50 feet apart.)

Preventing Altitude Sickness: "Climb high, Sleep low"
The key to avoiding AMS is a gradual ascent that gives your body time to acclimatize. People acclimatize at different rates, so no absolute statements are possible, but in general, the following recommendations will keep most people from getting AMS:
  • At altitudes above 3000 meters (10,000 feet), your sleeping elevation should not increase more than 300-500 meters (1000-1500 feet) per night.
  • Every 1000 meters (3000 feet) you should spend a second night at the same elevation.

Remember, it's how high you sleep each night that really counts; climbers have understood this for years, and have a maxim "climb high, sleep low". The day hikes to higher elevations that you take on your "rest days" (when you spend a second night at the same altitude) help your acclimatization by exposing you to higher elevations, then you return to a lower (safer) elevation to sleep.

1 comment:

  1. Hey, Thanks for all the good info, great pix and useful links. That Bearcant altitude chart is pretty daunting to gaze at. I'm planning a four llama S/N trip in August...we're going to take a month and do a lot of fly fishing along the way.
    Cheers, jc