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MASTER MEDIC As a wilderness EMT who’s spent more than 35 years leading outdoor trips, Paul Nicolazzo has treated everything from bee stings to broken bones. Here, the director of the Wilderness Medicine Training Center and author of The Art & Technique of Wilderness Medicine ($55; wildmedcenter.com) offers field-tested advice for creating—and avoiding—some common backcountry maladies.
KEEP WARM, AND BE COOL.
Relatively small fluctuations in core body temperature can mean major medical issues:
- 104 and up
- 100 to 103
- 97 to 99
- 90 to 95
- Below 90
Stop exercise, cool patient, and seek medical help.
Heat exhaustion possible.
Stop exercise and cool patient by immersing or misting; give sips of water.
Warm the patient with sleeping bags, hot drinks, fire, and your body heat.
Moderate to severe hypothermia.
Warm patient as above and seek medical help.
Treat A Wound
Reduce infection risk by cleaning cuts like a pro: Apply pressure to stop bleeding, then wash skin around the gash with soap and water. Flush using bursts of clean water from a sports bottle or plastic bag with a clipped corner. Pat dry and cover with a petroleum jelly-treated gauze bandage.
Wash Your Hands!
Sanitizer doesn’t eliminate germs as effectively as washing, especially when hands are visibly dirty. Scrub with soap and water for at least 20 seconds after bathroom breaks and before handling food to prevent the spread of nasty bugs. (And be sure to clean under your fingernails, too.)
Beware of Bee Stings
Remove stinger by scraping a credit card across it (tweezers can cause more venom to be released); wash the sting site, apply cool compresses, and give patient an antihistamine. For severe allergic reactions, an epinephrine shot is essential to treating anaphylaxis: Nicolazzo has saved more lives (four) with an EpiPen than with anything else.
Concussions are perhaps the most frequent serious backcountry injury. The proper response depends on the severity of the concussion: Mild (headache, temporary confusion, brief amnesia, and/or loss of consciousness): Slowly evacuate the patient. Severe (worsening symptoms): Can trigger a deadly increase in pressure within the skull;evacuate urgently.
Make Your Own Band-aids
Wounds don’t come in predetermined shapes and sizes, so why should bandages? Instead, Nicolazzo packs a roll of sterile gauze and flexible medical tape to custom-fit a dressing of any dimensions on the fly.
Nurse A Sprain
Rest if possible, and reduce pain and swelling with ibuprofen and a half-hour cold water immersion every 90 minutes.
Monitor Tummy Troubles
Stomach issues usually resolve in a day or two without meds, but severe vomiting and/or diarrhea—especially if the patient can’t keep fluids down—mean it’s time to seek help.
Cook With Caution
A few good habits in the camp kitchen can prevent many common backcountry boo-boos:
1. Hold mug when pouring in hot liquids.
2. Cut toward palm.
3. Set stove on an unstable surface.
1. Set mug down to avoid splashing hand.
2. Use a cutting board.
3. Place stove on ground to cook.
THE PERSON WHO’S STRUGGLING TO KEEP UP WITH MORE ADVANCED FELLOW HIKERS—AND WHO DOESN’T WANT TO ADMIT THAT HE’S IN OVER HIS HEAD—IS ALSO THE PERSON WHO’S MOST LIKELY TO GET HURT. “KNOW WHAT YOUR LIMITATIONS ARE,” NICOLAZZO SAYS.