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As I looked down at the young man lying on the forest floor, I could see the pain in his dark eyes. His skin color was pale, his words where mixture of fear and anxiety, and his breathing was rapid. I quickly looked around the area and determined his injury, a possible fracture of the right leg, was the result of falling from a ledge approximately six feet above us. I knew, from the symptoms, he was suffering from shock. Shock is a condition that results when the circulation of blood is inadequate for the oxygen needs of the body’s tissues. What this means in a nutshell is a lack of oxygen to cells, which may result in cell death, and eventually it could lead to the death of the casualty.
Knowing the importance of reassuring the victim, I kneeled and spoke in a firm but kind voice to him. I kept talking to him as I determined his right leg appeared to be broken. I joked with him a little as I started treating his injury. I assured him that help was on the way, asked him about his pain, and eventually got him to talking about his new child. My goals of take charge, assess, and assure, had been met. Three days later I past him in the building we worked in. He had survived.
One aspect of the outdoors most of us pay little attention to is first aid. Why? I suggest that most of us think injuries will always happen to you, but not me. In psychology we call that attitude denial. It is an “it will never happen to me” attitude, and it is a very dangerous stance to have in the woods. See, all of us will sustain some type of injury eventually if we spend much time out of doors. It just happens.
Most of our injuries will be scrapes, shallow cuts, a fishhook in a thumb, or perhaps a small burn. These are easy to take care of and they usually never lead to larger problems. However, it is important to remember that the key in any emergency treatment is a two-step process (injury treatment and shock treatment).
First, you determine the extent of the injuries and ask yourself if you are qualified to treat them? Obviously, if someone is seriously injured or near death, you may be out of your level of treatment. Nonetheless, in any situation you can do some things to assist the victim until help arrives. In a remote location during a survival situation you may be all the help that will be available for some time. No, you should never attempt any medical treatment you are not qualified to do, nor should you sit on your duff and cry the “poor me” song out over and over.
Your first step is to assess the injury and take charge. But, keep in mind the most qualified individual should be in control. If you are the one to control the emergency, ask yourself the following questions;
First, is there still a danger in the area? Look around and ask yourself, what caused the injury and is it still able to hurt someone? This is important if the injury is the result of an electrical source, wild animal, human assault, weather, or other situations. I cannot cover all possible situations, but you do not want to become the second or third victim of a mishap.
Second, is the injury life threatening? If not, it is a very simple process usually to treat the injured person. You can determine if the injury is serious by checking for breathing and pulse. Even if the victim is conscious, be cautious. Some injuries will not show all of their symptoms until later. Treat all victims for shock, which is covered further along in this article.
When you approach a victim, check to determine if there might be neck or spinal injuries. Is the body bent at an awkward angle? Is there a loss of feeling in the spin or neck area? Is there intense pain in one or both of those areas? Do not lift or move the victim until you are able to determine the extent of injuries. If you remotely suspect a neck or spinal injury, do not move the casualty. Make them comfortable in place, if it is not life threatening to do so. At any rate, always remember your a, b, c’s….Check the airway, the breathing, and the circulation (abc).
Now, I cannot cover every type of emergency you could be faced with, but I will suggest you purchase a good quality first aid book and keep it on you at all times in the bush. If you must seek medical assistance, there are still some things you can do.
In any painful or frightening situation you may encounter a victim going into shock (Just like the man in my opening paragraph). Early signs of shock are,
- Pale skin, lips may have lost color
- Cold, clammy skin
- Increased rate of breathing or a shallow rapid pulse
- Severe thirst or vomiting
In the later stages of shock the victim may
- Show no interest or be unresponsive
- May lapse into unconsciousness
- Have vacant or sunken eyes
In all cases of shock you should do the following
- Reassure the casualty. Speak to them often and in an assuring voice.
- Cover the individual to maintain body temperature. Remember to cover both over and under the injured person.
- If no spinal or neck injury, elevate the persons feet approximately one foot.
- Loosen all clothing. The key here is to improve blood circulation to all tissue, especially the vital organs.
- Do NOT give any food or water. Remember, there may be internal injuries and in that case food or water could cause problems.
If the casualty is unconscious and you do not suspect spine or neck injuries, you can place them in a “recovery” position until help arrives. This is done by raising the persons closest arm above the head as you prepare to roll the individual towards you. Guarding the head, rotate the entire body toward you as one unit. Place the individuals other hand under their chin to maintain a clear airway. By doing this you will assist in keeping the head tilted slightly in the event the injured vomits.
In cases of open wounds, cuts and scrapes, make sure you clean the injured area. I usually use plain old soap and water to clean with, treat with a disinfectant, and then cover with a bandage. The key here is to clean the injured area and to cover it, to avoid infections. Small cuts and scrapes can become very serious if they become infected.
Another common day-to-day injury in the woods are burns. Most of the burns you sustain will be small burns, usually the result of picking up a hot lid to a pan, or from touching a smoldering piece of firewood. This type of burn is usually classified as a 1 st degree burn and while painful, it is a minor injury.
A 2 nd degree burn is identified by redness and the formation of blisters. This type of burn is serious and can be life threatening if large areas of the body are affected. In all burns, except minor 1 st degree burns seek medical treatment immediately.
The last type of burn is a 3 rd degree burn and it is by far the worse. The burned area will be charred or black in color. Seek medical attention immediate and treat for shock!
Just like at home, when we camp things can happen. You must know what to do and do it when the need arises. Remember to take charge, assess and assure. Be in control, evaluate the environment for other dangers, and assure your casualty that all is well. Treat the injury and then treat for shock.
By following my simple guidelines, reading about first aid, taking course offered by the Red Cross or other organizations, you too can develop the knowledge needed to treat all types of injuries. Only the person on the scene can accurately make the difficult calls that are often made in emergencies. The whole purpose of these articles is to stimulate your thought processes and to motivate you to learn more.