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A Comprehensive Guide to Wilderness & Travel Medicine

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A COMPREHENSIVE GUIDE TO WILDERNESS & TRAVEL MEDICINE ERIC A. WEISS, M.D., F.A.C.E.P. The Choice of Outdoor Professionals Worldwide DEDICATION This book is dedicated to Amy and Danny Weiss — my © Copyright 1992, 1997, 2005 by Adventure Medical Kits. two favorite indoor and outdoor companions. All rights reserved. No part of this book may be reproduced in any manner without the express written consent of the publisher, This book is also dedicated to my mother and father for except by a reviewer who may quote brief passages in a review. their steadfast support and unconditional love. They have unselfishly devoted their lives to the health and happiness of Published by Adventure Medical Kits their children. P.O. Box 43309, Oakland, CA 94624 Finally, I’d like to dedicate this edition to the memory of Printed in the United States of America Oscar V. Lopp. As the Director of the Sierra Club’s Mountain First Edition November, 1992 Medical Institute, Oscar introduced more people to wilder- Second Edition July, 1997 ness medicine than any other human. He had an extraordi- Third Edition July, 2005 nary level of energy, a contagious sense of humor, and an indomitable spirit. Illustrations: Rod Nickell, Danny Sun, Butch Collier, and Patricia A. Jacobs Book Design and Layout: Dan Armstrong and Russ Fry Primary Editor: Nis Kildegaard Cover Photo: Lannie Johnson Thomserku Peak in the Himalaya, Nepal Library of Congress Catalog-in-Publication Data Weiss, Eric A Comprehensive Guide to Wilderness & Travel Medicine by Eric A. Weiss – 3rd Edition ISBN 0-9659768-1-5 1. Wilderness First-Aid 2. Travel Medicine 3. Backpacking First-Aid 4.Wilderness Survival ACKNOWLEDGMENTS PREFACE I’d like to thank and acknowledge my close friends and This book goes far beyond traditional first aid and em- colleagues in wilderness medicine, Howard Donner, M.D., braces a new philosophy in wilderness medicine education. Lanny Johnson, FNP/PA, Paul Auerbach, M.D., Peter Hack- It brings to fruition a juxtaposition of more than 10 years of ett, M.D., Gene Allred, M.D., Robert Norris, M.D., Findlay research, clinical experience, and teaching into a powerful Russell, M.D., Joe Serra, M.D., Henry Herrman, D.D.S., Jim guide for those who travel far from modern civilization. Bagian, M.D., Tim Erickson, M.D., and Gary Kibbee for Revolutionary advances in emergency medicine knowledge, their companionship, inspiration, and guidance. techniques, and equipment, as well as a new standard of first- aid practice, permeate the text and provide the foundation for Eric A. Weiss, M.D., F.A.C.E.P. lay people to provide vital emergency care in remote settings. This book is also unique in that it specifically addresses the components included in most Adventure Medical Kits when discussing the treatment of medical emergencies, and it introduces a myriad of improvised techniques that empower the reader to provide meaningful emergency care, even when first-aid materials are not readily available. The information in these pages is intended to help you manage medical emergencies in remote environments when professional medical care or rescue is not readily available. It is not a substitute for taking a comprehensive first-aid or wil- derness medicine course, or for seeking prompt medical care in the event of an illness or accident. Whenever someone be- comes ill or injured, obtaining professional medical attention should take priority after administering appropriate first aid. The reader should use this book for guidance in difficult and remote situations only and should not attempt to perform any procedure that he is not comfortable with or trained to render, unless the victim will die without that intervention. Legally, a rescuer is always liable for his own actions and should never take any unnecessary risks or perform any medical procedure unless it is absolutely necessary. Consult your physician concerning any medication that you carry and inquire about potential complications or side effects. Make sure you are not allergic to any drugs that you intend to use. Sharing medications with others is potentially dangerous and is not recommended. Remember, the value of any first-aid book or medical kit is both enhanced and limited by the ability of the owner to use the information and contents effectively and creatively. Taking a course in Wilderness First Aid, Wilderness First Responder or Emergency Medical Technician, and practicing your skills before you leave home, will better prepare you to manage an emergency when it occurs. The author and publisher disclaim any liability for injuries, disability or death that may result from the use of the infor- mation in this book, correct or otherwise, or the products in any Adventure Medical kit. May all of your journeys be safe, healthy, and filled with adventure! v v CONTENTS Collapsed Lung (Pneumothorax)..................................40 Tension Pneumothorax..............................................40 THE THREE ABCS OF WILDERNESS FIRST AID..............2 Open (Sucking) Chest Wound.....................................42 THE SECONDARY SURVEY............................................11 ABDOMINAL (BELLY) INJURIES...................................44 Organize a Rescue Team............................................11 GUNSHOT WOUNDS AND ARROW INJURIES.................46 LIFE THREATENING EMERGENCIES............................12 SPRAINS........................................................................48 Rescue Breathing (adult)............................................12 Ankle Sprain...........................................................49 Rescue Breathing (child)............................................12 Sprained or Ruptured Achilles Tendon..........................52 CPR...............................................................................15 Knee Sprain............................................................52 Chest Compression: Adult..........................................16 Torn Menisci (Cartilage)............................................53 Chest Compression: Child (Older Than One Year)...........17 Patellofemoral Syndrome...........................................54 Choking/Obstructed Airway........................................18 STRAINS........................................................................55 Cricothyrodotomy (Surgical Airway)...........................20 BACK PAIN....................................................................55 SHOCK..........................................................................22 Back Strain............................................................52 HEAD INJURIES.............................................................23 KIDNEY Stones...........................................................57 Skull fractures.........................................................25 FRACTURES..................................................................58 Scalp wounds..........................................................26 Treatment of Open Fractures.......................................59 HEADACHE...................................................................27 Realignment of Closed Fractures................................60 Tension Headache.....................................................27 Splinting.................................................................60 Migrane Headache...................................................27 Treatment of Specific Fractures...................................61 EYE PROBLEMS............................................................30 Neck and Spine.......................................................61 Trauma...................................................................30 Jaw Fracture............................................................66 Scratched Eye.........................................................31 Facial Fracture.........................................................66 Snow Blindness........................................................31 Collarbone Fracture..................................................66 Scratched Eye..........................................................32 Shoulder & Upper Arm Fracture.................................67 Subconjunctival Hemorrhage.....................................32 Elbow, Forearm, & Wrist Fracture...............................67 Infections...............................................................33 Hand & Finger Fracture............................................69 Styes & Abscesses....................................................33 Pelvis Fracture.........................................................69 nosebleeds................................................................34 Thigh Bone (Femur) Fracture.....................................76 Dental EMERGENCIES...............................................36 Knee Fracture..........................................................77 Toothache...............................................................36 Lower Leg Fracture..................................................77 Loose Tooth...........................................................37 Ankle and Foot Fracture............................................78 Displace Tooth.........................................................37 Toe Fracture............................................................78 CHEST INJURIES...........................................................38 DISLOCATIONS..............................................................79 Broken Ribs............................................................38
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