Improvised first aid

So you are hiking along a trail with your buddies when suddenly Joe falls and sprains his ankle. You are miles from civilization and have no signal on your cell phone. What do you do?

When it comes to improvised first aid, the possibilities are endless. You can use any and everything for about any type of injury or illness. I'll give you a head start on some innovative ideas to treat injuries and illnesses on the trail. 

Allergic reaction

Say someone gets stung by a bee or gets poison ivy and is hyper-sensitive too it. If they don't have a history of anaphylaxis, they probably won't have and epipen. If your read my post on gear lists, you know I carry Benadryl in my first aid kit. Benadryl is an antihistamine and will lessen the effects of the reaction, if not cure the symptoms. 

Speaking of poison ivy, how do you treat it on the trail? In today's day and age, we are used to lotions and treatments for poison ivy to the point we don't know how to treat it without the luxuries of a medicine cabinet. First thing you want to do is wash the areas thoroughly. Find running water such as a stream or river and make sure you are washing downstream from camp. Use any type of soap you happen to have. If you by chance bring laundry detergent, use that. If you carry alcohol pads in your first aid kit and have plenty, occasionally cleanse the area with alcohol. Hand sanitizer will work as well. Make sure to put some gauze over it to keep it from spreading and always change gauze after cleansing the site. 

Broken bones - extremities

If you happen to (or your buddy happens to) break a bone in an extremity (arm or leg), you need to get medical attention as quickly as possible. It's important to stabilize the bone to prevent further damage. You can use the metal frame from an internal frame pack as a splint. These work amazingly well being how they will shape to the extremity. This also works for immobilizing a wrist in the case of a wrist or hand injury. If you have spare lashing straps, use those to secure the splint. Gauze rolls work great too. About anything will work. If you are climbing as well and have tubular webbing, that is ideal. Just remember to minimize movement of the extremity. 

Dislocation, sprain, and strain

If you end up with a dislocated joint, you can always try to reset it. However, there's complications to doing that so do it at your own risk. To be honest, even though I know the complications, I would probably still attempt it on the trail. If you can't reset it in 2 attempts, stop there and don't try anymore. If it's a shoulder or elbow, make a sling from clothing or bandana to immobilize the extremity. Fingers can be taped together (works for fractures too). Knees, hips, and ankles get tricky. You are probably better off getting rescue. It will be difficult to reset and if you happen to succeed, it will still be difficult and painful to walk as well as harmful. 

Sprains and strains are treated with ice. If you have ice packs in your first aid kit, use it. In winter, you have the advantage of ice and snow being readily available. In summer, take a soaking wet bandanna and wrap around the effected area. Make sure the skin is fully exposed. Find some way to expose it to wind. The convection will cool the bandana and the site. It's not as good as ice, but better than nothing. 

All of these injuries should be wrapped and compressed after treated. You can use clothing, bandana, ace bandage, whatever you have. If the injury involves the hips and down, make sure to rest often and stay off your feet as much as possibly 

Bleeding

In the event you get a cut or even amputation, be sure to stop the bleeding. If it's not serious, clean the wound first. Use your gauze, bandana, etc. as a dressing to apply direct pressure to the round. You want it as sterile as possible so always have gauze. Hold tight pressure for at least 5 minutes. If the bleeding is serious, you may need to hold pressure longer. 

If the blood starts to soak through the dressing, add additional dressing on top. DO NOT remove the dressing! If you do stop the bleeding and then pull up the dressing, it could pull a clot and start bleeding again and you could risk an embolism. 

If pressure doesn't work, make a tourniquet. Use rope, bandana, anything you can find to tie around the extremity. Use a stick and slide it under the tourniquet and begin twisting. Twist until the bleeding stops then secure the stick. Note the time the tourniquet was placed and get to a hospital immediately. 

If you get the bleeding controlled and continue with the trek, be sure to occasionally clean the wound with filtered water and change the dressing to prevent infection. If you suspect infection (prolonged inflammation, puss, increased pain), get to a hospital. 

In the event of amputation, treat the bleeding as described above. If the amputated part is retrievable, clean it then put it in a zip lock bag (you should always have these). Put it on ice if possible. Again, in winter you have snow and ice available. Get to the hospital as quickly as possible. 

There are many plants out there that can be used to treat infection and simple ailments such as nausea, headache, and diarrhea. I will follow up with a post on natural medicine. I will also follow up with a post on treating environmental emergencies so stay tuned. 

This is just to get you started. Each injury and illness will come about differently so you will have to use ingenuity to treat each case. Stay tuned for additional posts on this subject. Comment any additional ideas you have. 

Treating frostbite

This has been a cold winter. In Iowa, temperatures have been regularly dropping into the subzero range. There are many ailments that come along with this much cold, from hypothermia to pulmonary edema. One the most common ailments with cold is frostbite. You don't really have to be outside very long in subzero temperatures to get frostbite. You have probably watched movies such as Vertical Limit, Touching the Void, or The North Face and seen how bad frostbite can get. Unfortunately, most people think frostbite won't happen to them if they aren't alpine climbing, but even a day hike on a trail in Iowa can result in frostbite. 

To better understand frostbite, we should know how it works and effects us. Frostbite occurs when skin is exposed to severe cold and usually affects areas with less circulation, such as fingers, toes, and face. When the body gets cold, it will begin to cut off circulation to extremities to preserve body heat for the vital core organs. A cold wind chill or being wet will speed up the process of frostbite significantly. 

Frostbite is really a type of burn, a cold rather than heat burn and there's different degrees just as there are with thermal burns. First degree will normally just result in numb skin and redness. Second degree will lead to blistering. And third degree results in the black, charred look that will sometimes be bone deep. When it gets this bad, it can become gangrene and may have to be amputated because it's hard to restore a third degree frostbite. 

The biggest complication of frostbite is infection. The higher the degree of frostbite, the higher the risk of infection. Obviously, when it reaches third degree and develops into gangrene, infection can develop rapidly and may enter the bloodstream, causing sepsis. 

Prevention

The best way to go about frostbite is simply preventing it. If it's windy and cold out, it's good to take regular breaks and get out of the wind. This isn't always possible, but ideal for avoiding frostbite. When going out in the cold, ALWAYS dress appropriately. If it's subzero weather with wind (or even without wind), wear wind proof clothing and make sure to layer well. Wear thick, warm wool socks and consider a second pair of socks (of wicking material). Just make sure it's not too tight as to cut off circulation and make your feet colder. With gloves, you want to make sure to have liners. Normally, you would want a waterproof ski glove with a warm, thinner liner, preferably wool. Make sure to not expose your hands any more than you have to. That's why you want a thinner liner to perform precise tasks without exposing your hands. 

Keep your face covered as much as possible. Get a gater or balaclava. The reason people get frostbite to their faces is because they are exposed to the wind and cold. If you suspect severe cold and wind such as in alpine climbing, you may want ski goggles, this will keep the wind off from around your eyes as well as keep the snow and wind out of your eyes. If you wear a stocking cap or hat of some sort, also use the hood on your coat. This will help keep the cold off your neck and blocks some of the wind. A key sign of early frostbite is your skin going numb, if any part becomes numb, make sure to warm it actively to prevent it from turning to frostbite. 

Treatment

When on the trail or mountain, you probably won't have too many treatment options. However, there are some ways to treat frostbite. Early frostbite (or frostnip) can be treated by simply boiling snow and holding the warm cup in your hands out of the wind. You can add layers if it's available or use hand warmers. You can, for the most part, actively warm frostnip if you need to. 

When it progresses to second or third degree frostbite, DO NOT actively warm. Doing so may cause farther harm. By actively warming, I mean rubbing your hands together, using warm water, etc. You can put your hands in your coat or pockets to help reward them SLOWLY. Warming too fast may cause further problems. If it starts to blister (or worse), wrap it in clean sterile dressing such as gauze. This will help to keep infection down. If it does blister, do your best not to pop the blisters. A popped blister is more susceptible to infection than a closed one (not to mention painful ). You probably don't carry antibiotics with you, so you need to get somewhere as quickly as possible for treatment. I could tell you that as soon as you get frostbite, get home and if it's bad, get medical attention. However, I'm the kind, as with most people, who will finish a trek with frostbite. Just make sure to keep the frostbite clean and change the dressings if you need to. Although, if it progresses to third degree frostbite, you need medical attention as soon as possible. 

Frostbite is no laughing matter and needs to be taken seriously. Even if your not climbing Everest and may only be hiking a small park trail, you can still get frostbite. Take precautionary measures to avoid it and your trek will be much more enjoyable.