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Backpacker Magazine – November 2009

The Ultimate First-Aid Manual: Extreme First Aid

When you're miles away from medical help and it's serious: Here's how to handle extreme injuries in the backcountry.

by: Buck Tilton

The Ultimate First-Aid Manual
Wilderness Medicine Institute cofounder Buck Tilton boils down a lifetime's worth of experience into 62 tips

Photo Tutorials: First Aid Center
From splinting a broken leg to duct taping a bloody wound, the BACKPACKER First Aid Center is an invaluable resource for backcountry first aid.

Heart Attack
Look for chest pain that radiates to the shoulder, arm, or jaw (especially on the left side), nausea, lightheadedness, and pale, cool, sweaty skin. Keep the person comfortably at rest, cover him with clothing or a sleeping bag to prevent heat loss, and keep him as calm as possible. Give an aspirin tablet (to inhibit artery-clogging blood clots). Don't let the person walk. Get help.

Look for rapid, weak pulse; shallow breathing; clammy skin; and nausea. Caused by an inadequate flow of oxygenated blood, shock can result from any major injury, including blood loss, severe dehydration, and spinal cord damage. If the cause can be treated–such as rehydrating the dehydrated–do it. Put him in a sleeping bag or cover him with extra clothing. Keep the person calm and lying down on a sleeping pad with his legs comfortably elevated about 10 inches. If vital signs don't improve with treatment or the patient becomes less responsive, go for help. Left untreated, shock can be fatal.

Broken Back
Move the person as little as possible (if movement is necessary, don't bend or twist the spine). Place a SAM splint around the neck to restrict the head. Do not leave the patient alone. Have someone keep a hand on the person's head to discourage movement. Go for help.

Mushroom Poisoning
Treat all unknown 'shrooms as deadly–the bad ones are that bad. Induce vomiting as soon as possible after ingestion by having him stick a finger down his throat to stimulate the gag reflex. Give plenty of fluids to dilute the poison, keep a sample of the mushroom, and get to a doctor. Poisoning symptoms take six to 24 hours to appear–and by then, it's often too late.

Brain Injury
A blow to the head that results in unconsciousness often causes the brain to swell. Early signs include progressive disorientation, irritability, and combativeness (after consciousness returns). Evacuate the patient immediately. If he's unconscious, carefully roll him onto his side and go for help.

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