First Aid Critical In Wilderness

It takes special training to handle accident victims in the wilderness.

The companion or rescuer must be able to do many of the things that would be done in a hospital if the same injury occurred in an urban area, said Philip V. Gormley of Bryant Pond, Maine, president of Wilderness Medical Associates, which trains outdoors enthusiasts in first aid.

Three things dictate the need for wilderness first aid training: length of time needed to get to professional care; extreme environments such as hot or cold or extremely rugged terrain, which can put rescuers at risk; and the need to improvise, because outdoorsmen can never carry everything they’ll need.

“The biggest difference is the amount of time you’re dealing with the patient. The typical concept taught in an emergency medical technician’s course is the ‘golden hour”’ to get the patient to a hospital, Gormley said. “There’s no golden hour in the wilderness - maybe a golden 10 hours.”

So people going on long treks should know extensive first aid. That includes such things as how to pop a separated shoulder back into its socket, CPR, giving shots, stopping bleeding and cleaning wounds, and diagnosing spinal injuries.

In a city, a person with a severe reaction to a sting can get to a hospital in minutes. In the wilderness, his life may depend on whether a companion can administer a shot of epinephrine, Gormley said.

“We have students in our courses inject each other with saline,” he said. “It’s a pretty intimidating thing giving an injection the first time, so we have our students practice.”

Hikers, hunters and campers should know how to clean wounds to prevent infection, stop bleeding and dress wounds. In a serious accident, such as a victim becoming impaled on a sharp object, the object should be removed.

“The simplest way is to wipe away all blood, and see the bleeding source,” Gormley said. “Usually the source is small. Put direct pressure on it. Use a cloth or dressing to even out the pressure. Then elevate the injured area.

“If bleeding continues, you missed the source. Clean the area again, visualize the source and put direct pressure on it.”

Rescuers should know how to diagnose spinal injuries to decide whether an injured person can walk out or must be carried.

“There are tremendous problems associated with carrying a person 10 or 15 miles,” Gormley said.

Another must is knowing when it’s too late.

When treating a victim of electric shock or drowning whose heart has stopped, the rule in an urban area is to keep at it until a professional arrives, a physician pronounces the victim dead, the patient recovers or the rescuer is exhausted.

“In the wilderness, chances are your only out up there is that you’re exhausted, which places tremendous emotional baggage on the rescuer,” who then quits trying, he said.

He said his recommendation is to stop CPR if the victim has been without a pulse for 30 minutes.

The best way to avoid an accident is to use good judgment.

“People do stupid things in the wilderness,” Gormley said. “Don’t get hurt in the first place.”