HIKING RELATED MEDICAL PROBLEMS

Transcription

1 HIKING RELATED MEDICAL PROBLEMS

2

3 S T O P SAFETY FIRST TAKE STOCK OPTIONS PLAN AND PROCEED

4 NEVER HESITATE TO CALL 911

5 Bandaids, various sizes Antibacterial Ointment Tweezers Gauze pads Tape, paper or cloth Moleskin, corn pads Hand Sanitizer and/or Wipes Splint (SAM) ACE Bandage FIRST AID KIT

6 Aspirin/Tylenol/Ibuprofen MEDICATIONS Antihistamine (diphenhydramine/benadryl) Pepto Bismol Personal Medications Blood Pressure Anti angina Inhalers Migraine Meds

7 SPRAINS AND FRACTURES

8 FRACTURE: Break or crack in a bone Rapid swelling, deformity SPRAIN: Stretching or tearing of ligaments/tendons/muscles Can be hard to distinguish from a fracture TREATMENT: Ibuprofen Splinting Elevation SPLINTING: Check circulation Unless circulation at risk or so deformed you cannot splint SPLINT THE INJURY IN THE POSITION YOU FIND IT Pad the injured area Try to immobilize the joint above and below

9 BLISTERS

10 BLISTERS: Fluid filled areas arising from shearing forces on skin HOT SPOTS: Reddened areas of shearing without separation and fluid PREVENTION: Break in your boots slowly Wear clean and soft socks Consider a sock liner Check for hot spots, and aggressively treat them TREATMENT: Don t drain blister unless it is too big to cover (nickel size) Dress with a donut of moleskin or corn pad Place a puff of cotton, blister pad, or dollop of ointment in middle Early Hot Spots can be treated with bandaid or change of socks

11 LACERATIONS AND ABRASIONS

12 CARE OF LACERATIONS, PUNCTURES, AND ABRASIONS STOP THE BLEEDING: Direct pressure with kerchief or gauze pad (5 30 minutes) WASH AND IRRIGATE: Irrigate with water (200cc) Clean with antiseptic pad/hand sanitizer PUNCTURE: Remove foreign material whenever possible DRESSING: Apply antibiotic ointment, cover and tape with a protective dressing FOLLOW UP: Medical visit if a deep puncture, retained material, or gaping wound Wound can be stitched or repaired up to 12 hours after injury PREVENTION: Active hikers should have a current Tetanus booster every 10 years

13 BITES AND STINGS

14 SCORPION STINGS Over 11, 000 stings/year in Arizona Most are Bark Scorpion and Centuroides SYMPTOMS: Local pain, swelling, redness Muscle twitching/spasm Difficulty breathing/sweating Muscle weakness/incoordination Vomiting/urination/defecation Toxins are proteins that attack the Nervous system and immune system TREATMENT: IMMEDIATE RETURN MEDICAL EVAL IF RED FLAG SYMPTOMS Wash the area Apply ice or cold water Ibuprofen and antihistamines (Benadryl) Antitoxin ANASCORP (within 6 hours)

15 RATTLER BITES 250 per year in Arizona, 4 8 fatalities, 50% disability Venom is proteins and enzymes that attack the blood SYMPTOMS: Sweating, nausea, dizziness Pain, bruising, blistering Difficulty breathing Muscle twitches and spasms TREATMENT: IMMEDIATE RETURN NO ice or medications Gently wash the area of bite Keep below heart and immobilize Remove rings, watches, tight clothes NO SUCTIONING If more than one hour from help: ACE wrap 2 4 inches above bite loose enough to put a finger under SEEK EMERGENCY ROOM CARE Crofab within 6 hours Remember: a dead snake can still give a venomous bite for up to 4 hours

16 HEAD TRAUMA RED FLAG SYMPTOMS: Increasingly severe headache Nausea/Vomiting Confusion Amnesia Seizure or weakness NO LOSS OF CONSCIOUSNESS: Rarely associated with severe injury If alert and NO Red Flag symptoms: MAY CONTINUE HIKING BRIEF LOSS OF CONSCIOUSNESS (< 2 MINUTES): MUST TERMINATE THE HIKE AND SEEK MEDICAL CARE If hiker is alert with NO RED FLAGS they can be walked out Any hiker > 65 with loss of consciousness MUST TERMINATE THE HIKE PROLONGED UNCONSCIOUSNESS (> 2 MINUTES): CALL 911 FOR EVACUATION Immobilize the neck RED FLAG SYMPTOMS: CALL 911 FOR EVACUATION

17 A Hiker on a hot day can easily sweat 1 2 liters/hour Bright sun alone can raise body temperature 3 degrees Even mild dehydration can raise body temperature INCREASED RISK: Elderly Overweight Deconditioned Diabetics Medicines: Diuretics, Beta blockers, Antidepressants Antihistamines

18 TREATMENT: Move hiker to a cooler, shady spot (or make shade with a tarp) Pour water on head and clothing and fan the hiker (evaporative cooling) Rehydrate aggressively (electrolyte solution or 1 tsp salt/liter) CALL 911 FOR EVACUATION IF: SIGNS OF HEAT STROKE CONFUSION NO SWEATING UNABLE TO STAND LOSS OF CONSCIOUSNESS

19 MUSCLE CRAMPS CAUSES: Overuse/fatigue Extreme strain Loss of sodium, potassium, calcium, or magnesium Medicines: Blood pressure Cholesterol lowering Inhalers (albuterol) Diuretics PREVENTION: Stretching Pre exercise hydration Salty snacks Electrolyte solutions (Hammer, Nuun) AVOID Gatorade or Powerade (sugary) Vitamin B complex, Vit E, Magnesium TREATMENT: Stretch the affected muscle Hydrate with electrolytes GENTLE massage to relax muscle

20 CHEST PAIN TREATMENT: Stop and rest Lie down if possible Chew 325mg aspirin Nitroglycerin: every 3 5 minutes until relief ask hiker ask others The local combination of strenuous hiking and altitude can stress the heart causing ANGINA CALL 911 Fastest time to hospital is the key to good outcomes If within one mile of the Trailhead it may be quickest to walk hiker to ambulance at Trailhead

21 WILDERNESS DIARRHEA

22 CULPRITS: E. Coli (70%), Salmonella, Shigella (bacteria) Viral infections are uncommon in the wilderness Giardia and Cryptosporidium (protozoans) Giardia: More than 50% asymptomatic 7 10 days before symptoms 90% self limited to 2 4 weeks SYMPTOMS: Watery, sometimes bloody diarrhea and cramps (bacterial) Bloating, gas, fatigue, 4 5 loose stools/day (protozoan) Cramps, fever, and decreased appetite common to all PREVENTION: Steri pens effective on all three Boiling water effective on all three Filtering can miss viruses Chemicals less effective on protozoans Pepto Bismol 2 tabs 2x daily 70% effective TREATMENT: Imodium (loperamide) safe and effective Pepto Bismol effective (black tongue & stool) Zithromax, Cipro, or Levaquin treat bacterial infections if symptoms are debilitating or last more than 48 hours STAY HYDRATED, use Electrolytes.

23 THE CHOKING HIKER