The Ultimate First-Aid Manual: Environmental Threats

As much as we try to protect ourselves from extreme elements, sometimes the elements hedge even our greatest efforts. Here's what to do when Mother Nature wins.

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Recognize Redness, tearing, and a sandpapery pain when opening or moving the eye are signs of sunburned corneas.

Treat First, don’t let the patient rub his eyes; it could further damage the corneas. Give ibuprofen for the pain, apply a cold compress, and cover eyes with gauze. Wear sunglasses and stay in a dark environment until vision returns to normal (usually in about 18 hours).


Recognize The person complains of feeling cold and shivers. More advanced hypothermia patients exhibit “the umbles:” stumbling, fumbling, mumbling, and grumbling.

Treat Get the patient into warm, dry clothes and place him in a sheltered area–such as in a sleeping bag, inside of a tent. (Don’t have a tent? Protect him from the elements by wrapping the sleeping bag in a tarp, plastic sheet, or garbage bags.) Give water and simple sugars, such as hot chocolate or candy, to generate quick body heat. For more advanced cases, build a fire nearby and put the patient in a “hypothermia wrap:” Start with a sleeping pad, put a zipped sleeping bag on top, then lay the patient (in a second sleeping bag) on that. Give him a hot-water bottle wrapped in clothing to hold in his hands. Put another sleeping bag on top, then wrap it all, burrito-style, in a tarp or plastic sheet.

Prevent the deep chill by learning how to spot and treat hypothermia in the backcountry.

Altitude Illness

Recognize Feeling hungover? If you’ve got a headache, nausea, insomnia, lack of appetite, and fatigue–and you’re above 8,000 feet–it’s probably Acute Mountain Sickness (AMS).

Treat Go no higher. Take ibuprofen for the headache, drink lots of water, and do light exercise around camp. If the symptoms don’t resolve within 48 hours, descend. Head down immediately if you experience loss of coordination or persistent shortness of breath at rest; it could be a more serious altitude-related condition.


Recognize Cold, pale, numb, and rigid skin means that tissue has frozen.

Treat Rapidly and immediately warm the area in a container of 99°F to 102°F water until skin is pink (it takes about 30 to 45 minutes), monitoring and adding more hot water as needed to make sure the temperature is constant. Give ibuprofen for the pain. Never rub the site or expose it to high heat. If blisters form, protect them from popping. Note: If there’s any chance of the tissue refreezing, do not warm the injury. Instead, keep it frozen until you can get the patient to a doctor.


Recognize Hey, we’ve all been burned (remember when you fell asleep after skinny dipping?).

Treat Cool the skin with cold water, apply a moisturizer, take ibuprofen for pain and inflammation, drink plenty of fluids, and stay out of direct sunlight. If blisters form, consult a doctor when you return.

Heat Exhaustion

Recognize Fatigue, thirst, nausea, dizziness, and heavy sweating while out in a hot environment are signs that the body’s core temperature is dangerously high.

Treat Have the patient rest in the shade and drink water, a sports drink, or a diluted sugary drink (add an electrolyte tablet from your first-aid kit). Spray or splash water on him, or place cold packs on his neck and groin.

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