The WildeBeat

The audio journal about getting into the wilderness.


The WildeBeat edition 29: Wilderness First Aid Training

This is a supplementary transcript of our audio program. CLICK HERE to listen to the original program, and see the associated show notes.

Get prepared for injuries and illnesses in the backcountry, and they'll be less likely to happen to you. This week on The WildeBeat; Wilderness First Aid Training.

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News from the Wildebeat, the audio journal about getting into the wilderness.

This is program number twenty nine.

I'm Steve Sergeant.

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STEVE: When I talk to people who don't get into the wilderness, one of the reasons they give most often is that they're afraid of suffering some kind of injury or accident.

BOBBIE FOSTER: Actually the most common injury that happens on trips in the backcountry, according to the data that I've seen, is sprains and strains. And I know in my thirty years in the backcountry, never been involved in any kind of avalanche, and never been involved with any kind of animal attack. So in general, I'd say things typically don't happen.

STEVE: Bobbie Foster is the founder of Foster Calm. She and her company teaches wilderness first aid skills to casual backcountry travelers, college outdoor program instructors, professional wilderness guides, and to volunteer outing leaders for groups like the Sierra Club.

If you've never taken a wilderness first-aid class, you might think that it's all just about putting on bandages.

BOBBIE FOSTER: I think that one of the main things that you get when take a first aid class is a lot more information on how to prevent things from happening. So there's a lot of information about the importance of staying hydrated, and all those kinds of things. So in the basic, standard first aid class, which are usually now somewhere between one and a half to four hours, it's focused on just a few key things: How to recognize it's serious, call nine one one, and then what to do for five to ten minutes before help arrives. Well, in the backcountry help's not going to arrive quickly. We have a definition, wilderness medicine is when it takes more than an hour for advanced care to get to the patient. More than an hour to get your patient to the hospital.

STEVE: But almost all of the injuries you're likely to encounter in the backcountry are not the kind that require a spectacular helicopter rescue. The treatment for the most likely injuries are things most of us already have experience with.

For example, if you get a sprain or strain...

BOBBIE FOSTER: Don't walk it off! If you get a sprained ankle, you need to immediately stop, and RICE: Rest, ice, compress, and elevate. For at least twenty minutes. And then if it is a sprain, and nothing more serious, then with some athletic wrap, or an ace bandage, go ahead and stabilize your ankle. So it's pretty secure back in your boot. And then three/four times a day, for the next seventy-two hours, you're going to continue to rest, ice, compress, and elevate.

STEVE: The next most common injuries are cuts and abrasions. If this happens...

BOBBIE FOSTER: Very quickly determine how serious the cut is. If you have a cut, let's say on your arm, if you have good circulation past the cut, so your hand isn't numb and tingly, and it still has normal temperature, so that it's not any cooler than the other hand. And you can feel and you can move, then there's no circulation damage, there's no nerve and muscle and tendon damage, so that's a good sign. And then the key thing is, getting it clean. And for getting a wound clean, the key thing is water that's clean-enough to drink. And ideally, some kind of pressure irrigation. So some wilderness first-aid kits will add a syringe. If you don't have a syringe, just a plastic bag with a little hole, and you'll get some pretty good irrigation. But you've got to get it clean. You may have to get the tweezers and tweeze out the injury, but you don't need chemicals. Just water. And a little pressure, and you'll be able to clean the wound. Ten with whatever you've got, the cleanest thing you have, preferably sterile gauze, you cover it and you bandage it up, and at least once a day, look at it, and make sure that the infection doesn't get any worse. So make sure that the redness doesn't get any reader and it doesn't swell significantly. What you don't want to see are the red streaks, the swollen lymph nodes, or fever and chills. At that point, evac. Preferably helicopter. You've got a system-wide infection, and this is life-threatening.

STEVE: In cold winter trips, be concerned about frostbite.

BOBBIE FOSTER: What you don't want to have is a situation where the fluid in your tissue is starting to freeze. Cause that's start causing major, major tissue damage, and circulatory damage, and tissue's going to start to die. So you don't want that. So just really pay attention to your toes, your fingers, your nose, your ears, and your cheeks. If you start to feel like they're not feeling normal, and they start to maybe have some numbness and tingling, then at that point you need to stop, but you defintitely need to catch it before it becomes more serious.

STEVE: So if you're cautious and alert, you can avoid injuries pretty easily. But some of the illnesses are a little more subtle. But just as preventable.

BOBBIE FOSTER: The virus, the flu, and the diarrheas: The most common cause is camp hygiene, and mainly just personal hygiene related to hand washing. And you can make a significant, significant difference if you are constantly washing your hands, especially after using the latrine facilities, and definitely before you do anything with the food/kitchen you've got to keep your hands clean. 'Cause vomiting and diarrhea can lead to serious dehydration issues, and those become life-threatening.

STEVE: One of the harder things to learn is to be aware of symptoms that show up in your own behavior.

BOBBIE FOSTER: There's a belief by many wilderness first aid experts that almost every single accident that happens in the backcountry, the most likely cause for it, was hypothermia. So if you are aware of that, then if you can keep yourself from getting cold, making sure you don't get clumsy, making sure that you're still making good decisions, then most likely no accidents will happen on your trip.

STEVE: Of course, you'll want to carry a first-aid kit, but how do you choose one?

BOBBIE FOSTER: Buck Tilden, one of the wilderness first-aid experts has the five commandments for first aid kits. And one of the commandments is, it's not the first aid kit that going to save a life, it's the knowledge that you have. Then I'd say, what are the most common injuries and illnesses, and make sure you've got the supplies for that. So if we're talking sprains and strains, vomiting and diarrhea, wound care, and blister products. There are commercial wilderness first aid kits, and that's what I would recommend. But the key thing that I would add to all kits, is many more pairs of gloves. The other thing that I highly recommend that people have in their first aid kit is a first aid book.

STEVE: Anybody who gets into the wilderness should consider getting basic wilderness first aid training.

BOBBIE FOSTER: Some of the key things that you're going to learn in a wilderness first aid class versus and urban first aid class is mainly a system to follow when somebody is injured or hurt so you gte all of the clues as to what's wrong with your patient. The class is usually sixteen hours, and in that class typically there's information that's taught. But mainly, what you're going to be doing is practicing. The class typically costs anywhere from eighty to, I think the highest I've seen is about a hundred and seventy five dollars.

STEVE: If you're leading groups, or embarking on longer or more remote adventures, you should consider more in-depth training.

BOBBIE FOSTER: Wilderness first responder covers the same topics and then they add to it. You'll get more detail on why things happen and how things happen. And then you practice a lot more, and then it also will cover more information. And then the other key thing is, just lost and lots of scenarios with most of them including a long term care scenario. Most of the wilderness first responder classes are taught as eight day or ten day intensives. The cost typically tends to be in the four to six hundred dollar range.

STEVE: You can find out more about wilderness first-aid, and about training programs, on our web site.

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Next time -- the place your gear outfitter goes shopping.

The Wildebeat is produced by Steve Sergeant for Effable Communications. Our official website is WWW dot WILDEBEAT (that's W-I-L-D-E-B-E-A-T) dot NET. Please see our website for ways to support future editions of The WildeBeat. Contribute your comments to webmaster at wildebeat dot net, or call our comment line at 866-590-7373.

This has been The WildeBeat, program number twenty nine. Thank you for listening.

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