Basic Wilderness First Aid

Wilderness First Aid is first aid applied in the wilderness where you are required to use improvised equipment and cope with wilderness-specific conditions. On a BCEP Team Hikes, climbers are expected to be able to perform basic first aid to themselves. At minimum, you should know how to care for personal non-traumatic injuries and know how to assemble a first aid kit. A short lecture or chapter cannot prepare you for all the medical situations that may occur while climbing.

Students are encouraged to develop their skills and take the next step with courses like CPR or a Wilderness First Aid course (WFA) such as the one offered by the Mazamas or through a professional organization who specializes in backcountry setting. There are Wilderness Medical professionals and Volunteers whom specialize in backcountry settings that seek higher level training such as; Wilderness First Responder (WFR), Wilderness Emergency Medicine Technician (WEMT), Wilderness Therapists, among many other opportunities. 

Lesson Objectives

After reading this page students should be able to:

• Know the definition of Wilderness First Aid. 

• Assemble a First Aid Kit appropriate for alpine climbing that you know how to use.

• Understand the importance of communicating injuries to the climbing team. 

• Learn how to prevent and treat blisters.

• Know how to prevent, recognize, and treat hypothermia. 

• Know the difference between: dehydration, hyponatremia, heat exhaustion, and heat stroke. 

• Be able to prevent and treat each of these. 

• Know the symptoms of acute mountain sickness, High-altitude pulmonary edema (HAPE), and High-altitude cerebral edema (HACE). 

Backcountry First Aid is first aid applied in the wilderness where you are required to use improvised equipment and cope with wilderness-specific conditions. Climbers may become ill or injured far from definitive medical care. Emphasis is placed on personal care management and injury evaluation.

Watch Presentation:
Basic First Aid by former Climb Leader and BCEP Yunlong "Long" Ong
Click to read more about his incredible journey on p. 24-27 in Mazamas Bulletin

This course is not a substitute for a Basic First Aid/CPR or Wilderness First Aid program.

On all Mazama Activities, participants are expected to carry their own personalized first aid kit. Much of this information is covered within the book. Take time to look around and find what works for you. Many climbers opt to cut First Aid equipment out of their pack in order to save weight. Yet, as a member of a climbing team it is expected that all members contribute as part of a team by carrying their own safety equipment. Talk to others about what they bring and why. Many leaders and assistants have good tips that you wouldn't find in a textbook. 

Dehydration

For the average person, 2 percent dehydration equates to sweating out about a liter of water. In the heat, one may be unaware as to how much water loss occur through sweating, breathing, and movement. Adequate water supply is essential to:

• Breathing- a considerable amount of water loss is through respiration. Water supports oxygen acclimation to elevation.

• Muscle regeneration and endurance- necessary processes, such as cellular regeneration, are inhibited as water supply is limited and redirected.

• Cognitive Performance - dehydration can limit mental processes such as judgement, complex task processing, executive functioning, and many other processing that can highly increase risk and lower the safety with just a small reduction in water loss.

• Mood and Mental Health - Irrititability and Anxiety are linked is common signs of inadequate water intake.

Common signs:
Heat Exhaustion, Irritability, Dry Mouth, Infrequent and fragrant urination, Sleepiness, Feeling Dizzy, Food craving, Headache, Heat cramps, Dry Skin don't bounce back, Weakness, Confusion, Delirium, Thirst, Impaired Judgment, and many more.

Essential Electrolytes 

It is recommended to hydrate on days leading up to the intended labor intensive activity. Dehydration is very common and many may not be able to identify it in themselves. In the heat, one may be unaware as to how much water loss occur through sweating and breathing.  (sodium, potassium, calcium, magnesium, and phosphate.)

Weather related issues occur generally in the presence of temperature extremes such as cold and heat.

Cold Related Conditions

• Hypothermia

  • This occurs when the body is unable to self-regulate to maintain a warm temperature (below 95 degrees). Symptoms range from individual. 

• Frostbite

  • This means that tissues in the body have become frozen from the formation of ice crystals in the body's internal fluids. Symptoms are cold, hard/inflexible, discolored, and numb appendages. It is common on fingers, toes, ears, tips of the nose, and lips. 

  • Frostbite can be prevented with: 

    • Packing extra dry gloves, socks, hats, and other clothing 

    • Heat pads

Heat-Related Conditions

• Heat Exhaustion

  • Occurs when blood and water circulations reduce as a tactic the body uses as self-preservation. 

• Heat Cramps

  • This occurs when the body is dehydrated or an electrolyte imbalance is present. Always rest, drink water, massage for circulation, and stretch gently before pressing on to give your body time to rebound.

• Heatstroke

  • When this occurs, this is a life-threatening situation that needs to be handled immediately as the body is unable to self-regulate. This happens when the core body temperature rises to 105 degrees Fahrenheit. The most reliable symptoms are irritability, disagreeableness, combativeness, delusions, or incoherent speech. 

Foot Blisters 

Foot blisters are the most common first aid condition you will encounter. Almost everyone gets blisters. For some people, this occurs every time they put on boots, others only occasionally. Finding boots, shoes, and socks that fit properly is the best way to reduce blister occurrence.

The best treatment for blisters is prevention!
You can identify a blister by what is a felt sensation called a "hot spot". Blisters are caused by localized, concentrated pressure on the skin, usually the result of rubbing (friction) which produces heat. The heat separates the layers of skin and fluid develops between the separated layers. This fluid-filled pocket is the blister.

There are several measures that you can take:

• Break in boots before use by wearing them on the trail 

• Use liner socks under regular socks

• Bring an extra pair of dry socks

• Tape hot spots areas with adhesive tape or duct tape.

• Stop and care for a hot spot before it becomes a blister

• Use a lubricant on your feet

• Use underarm deodorant on your feet to reduce perspiration

• Do not remove covering skin if still intact

• If unbearable, pierce blister and squeeze out fluid clean and cover with blister ampoules then tape or moleskin (not recommended though as it can introduce bacterias etc if not cleaned well)
  
  

Products that may help with blister pain and healing:

• Spenco 2nd Skin: A hydrogel made of mostly water, it reduces friction to prevent blisters from forming and to soothe blisters once you have them. Sticks best when used in conjunction with adhesive knit. 

• Band-Aid Blister Ampoules (and generic brands): Once you have a blister, this cushioning gel pad relieves pain while protecting the blister. Waterproof, superior adhesive stays in place for multi-day use.

• Blist-o-Ban: The bandage is composed of several laminated layers of breathable plastic film bonded together, except for a “bubble” in the center, where the layers are free to glide across each other.

If you are prone to blisters, you may consider placing blister treatment before starting your hike or climb.

Additional First Aid Gear

You will see some Mazamas carrying lightweight sleeping pads on day hikes. They are to provide insulation from the ground in case an injury requires the team to wait in place for an extended period in time. A sleeping pad can also be used as part of an improvised split. Extra webbing with buckles serve well for cinching splints to body parts. Lightweight reflective blankets and bivy bags are light and easy to carry.

https://www.elevatedtrips.com/blog/first-aid-kit/