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How to organise a camp
Climbing should be fun. But we must consider it is also a
dangerous one. NEVER under-estimate the power of the mountains. RESPECT it and
you shall be welcomed.
ORGANISING A CLIMB
INTRODUCTION
Mountaineering is one sport that can be enjoyed either with a team, a group of friends, with a partner or even on your own. It is good to experience each one of them once in a while but before one should venture out into the wilderness on his own, it is advised that he first join an organised climb and learn the basic mountaineering skills for safety and enjoyment. It is advisable for an individual to join some mountaineering group where he could learn and experience the basics extensively through the courses they offer. Just be sure that the organisation one joins, offers such services.
This chapter deals with the details of organising a climb. Although most mountaineers love the idea of freedom and spontaneity than rules and organisation, these structures were meant for the climber’s safety and the protection of the environment at the same time thus it’s importance should never be undermined.
The organiser should have mastered the basic skills at the minimum and have a good record of experiences before he leads a group. This is due to the fact that still, mountaineering has dangerous aspects.
PLANNING A CLIMB
In planning a climb here are points to be considered:
Decide where to go.
Choose your companion or target participants.
Collect route information and other useful information on the destination considered. It is advisable to contact local mountaineering group to get current information on the status of the trails, costs, permits, etc.
Assess the physical fitness of the group.
Arrange for food and equipment distribution.
Check weather forecast.
Acquire permits in advance if necessary.
Assign climb officials.
Conduct pre-climb meeting or briefings.
CLIMB COMPOSITION
Although there are no rules on the number of persons to join an expedition, three is the suggested least number of people in an expedition. This is because if an emergency occurs, one can accompany the victim while the other goes out for help considering the injured is only one of the participants; or even two if one has only minor injuries. With regards to the number of maximum participants, these should depend on the carrying capacity of the place although there are no set rules. Too many climbers make the team slow and stressful to the environment. Eight is the ideal number based on the principles of a military squad.
Following is a list of basic climb officials and their duties and responsibilities.
Team Leader
Lead man (trailblazer,
lead packer)
Sweeper (tail ender)
First- aiders
TEAM LEADER
The team leader is the final authority during the climb, and all participants are expected to support and comply with his decisions. Any negative evaluation of his conduct of the climb should be brought out during the post-climb meeting. However, the team leader is expected to consult with the participants before making major decisions that affect the itinerary or conduct of the climb.
He is expected to exercise good judgement and to consider safety, comfort and fun.
The team leader assigned for any climb preferably must have had prior climb experience on the same route unless it is an expedition climb, or when a local guide is available. In any event general familiarity with the route is required.
Preparatory activities
Consult
those who are familiar with the terrain and locality particularly the
security situation, trail conditions, campsite limitations and travel
restrictions.
Conduct
a survey of the route when possible or when advisable.
Prepare
the climb itinerary.
Conduct
physical diagnostics.
Pre-climb
Objective
of the climb based on its nature (initiation, fun, training, induction or
expedition)
General
information, historical significance, folklore, etc. of the location of
the climb.
Itinerary
and highlights of the climb.
Route
condition and trail hazards.
Water
sources and its condition.
Main
and alternative campsites.
General
weather conditions.
Local
weather conditions or peculiarities.
Cultural
peculiarities of the locale (beliefs, taboos, etc.)
Contact
persons in the locality and residence.
Special
medical precautions on malaria, typhoid, dengue, etc.
Purchase
opportunities in the locale.
Special
equipment checklist and assignments (for overall group equipment such as
ropes, harness, etc.)
Transportation
arrangements.
Budget.
Review
of ethics, policies and Basic Mountaineering Course when necessary.
Assignments
of groupings and climb officers. (it is important to remind all the
participants of the functions, responsibilities and authorities of these
key climb officers)
Review
of the itinerary. (It is best to distribute copies of the itinerary to all
participants. If copies are unavailable, remind them to copy the itinerary
as presented)
Pre-departure
In
case of any pre-departure change in itinerary or plans, the team leader
shall immediately notify all participants. At the pre-departure assembly
point, the team leader shall ensure that all present have actually
complied with all mandatory requirements that apply to them and shall
require compliance with those that are not yet complied with.
The
team leader must prepare a list of participants before departure. It shall
be the basis for periodic head counts and allocation of common expenses.
If possible, a copy of the list should be left with a contact person at
the point of departure in the event that a rescue becomes necessary.
Climb Proper
Before the start of the trek and at every major rest stop. Check the head count and general physical conditions of all participants.
As needed, consult with the other climb officers or participants any need to modify the itinerary due to weather, injury, unforeseen trail hazards, etc. After consultation, make the decision and notify all the participants.
Control the overall pacing of the climb so as not to unduly delay the trek without sacrificing safety of any participant.
Check that proper trail signs are installed at critical places like forks and trail splits.
At the campsite, ensure that camp protocol and proper practices are observed as well as compliance with organisation ethics, rules and regulations.
Observe the conduct and comfort of participants.
Observe and monitor performance of climb officers.
Ensure that the campsite is left clean before taking off.
Establish/maintain contact with local community leaders and dwellers along the trail but more particularly at or near campsites.
Emergency Situations
In
case of any situation requiring extreme deviation from the climb schedule,
the team leader shall, in so far as practicable, consult with the
participants. In any event, the team leader must make the final decision
taking overall and individual safety into consideration.
In
case of incapacitating injury to any member of the party, the team leader
must call-off the climb. Steps must be taken to protect and care for the
victim/s. If a provisional camp is established to stabilize the victim, a
team of at least 2 experienced climbers must be sent ahead to alert the
base camp and contact rescue authorities as well as the contact person of
the victim. The team leader may allow other members of the party to
proceed down while ensuring that experienced and strong climbers are left
to attend to the injured member/s until a rescue party reaches them. At
all times, the team leader must maintain composure and keep all members
calm but alert.
In
case of prolonged lack of contact with tail-enders, the team leader must
make the decision on whether or not to send a search party to backtrack
and assist the tail- enders as needed. In this case, strong and
experienced climbers must be sent while the main body set up a temporary
holding camp as needed. The leadsman should be notified to either hold
their position or rejoin the main body.
Post Climb Briefing
As soon as possible, preferably within a week after the completion of the climb, the team leader shall take up the following:
Review and assessment of the climb: general conduct, trail, pointers for subsequent climbs, etc.
Comments, admonitions, congratulations regarding conduct of individual participants.
LEADMAN
As
much as possible, the assigned leadman should not be team leaders
themselves. Exceptions can be made in cases of small groups (12 or less)
which are not likely to get separated, climb of short duration, or absence
of qualified members.
He
must have prior experience on the particular trail unless accompanied by
local guides.
He
should be selected among the stronger, healthier, experienced and patient
members of the party. For a large climbing party or a long duration climb,
more than one should be assigned.
He
has the duty to put in place the proper trail markers for the guidance of
the following groups. When in doubt, or when the possibility of doubt
exists, the trail must be marked in such a manner that no confusion could
arise in its interpretation.
He
must stop and wait for re-assembly at designated major rest stops, and
they must remain within whistle-hearing distance of the next group at all times.
He
should not deviate from the planned route without waiting for the team
leader’s decision.
He
shall implement the pacing as instructed by the Team Leader.
SWEEPERS
As
much as possible, the assigned sweepers should not be team leaders
themselves. Exceptions may be made in cases of small parties, (12 or less)
which are not likely to get separated; climbs of short duration; or
absence of qualified members.
They
must have prior experience on the particular trail unless accompanied by a
local guide.
They
must be self-contained as completely as practicable.
The
sweepers must be selected from among the stronger, healthier, experienced
and patient members of the party. For a large climbing party or a long
duration climb, more than two must be assigned.
The sweeper
must remain at the tail end of the climbing party at all times. He must be
ready to assist lagging climber/s who may need assistance, and must
maintain the pace, and control the rest stops of the lagging participants,
taking into consideration their physical situations, safety needs, and the
climb schedule.
In
case of incapacitating injury or illness, or danger brought about by
unexpected weather, darkness or natural occurrence, the sweeper may decide
to set-up a temporary camp at his direction. Other members of the group,
who are capable of going on, must be sent ahead to notify the team leader
of the actions taken, so that the latter may make the necessary decisions.
Again, safety is first considered.
One
of the sweepers must be assigned to remove trail markers put up by the
lead group.
FIRST
AIDER
Expedition first-aiders should preferably be chosen from among those who had proper training under the auspices of the Red Cross, or had professional medical training. In this connection, the organization shall endeavor to maintain a pool of trained members.
At least one should be assigned per climb. For large parties, more than one should be designated. If more than one is assigned they should be distributed over more than one team.
In the event of an injury, the first aider shall have the responsibility for applying the necessary aid, prescribing medication, and recommending corrective action or assistance. If necessary to deviate from the itinerary, he shall make his recommendation known to the team leader for his decision. In the presence of a designated first-aider, no other member shall intervene with the treatment of a victim unless he/she is requested by the first aider to assist.
CAMP MANAGEMENT
There is an ever-growing interest in the great
outdoors. It is quite heartening to see people get close to nature. However,
many are still lacking in awareness of the proper care for the wilderness.
And so, as more and more people take interest in
mountain climbing and other similar sports, there must be a continued education
on the proper way of treating nature. There are such ways to enjoy the thrill
of the great outdoors without substantially withdrawing from the environment.
One word for all campers to keep in mind:
LOW-IMPACT. No matter how much advances there may be in the realm of outdoor
gadgetry and gears, the basic ethics of low-impact camping must not change:
Take nothing but pictures;
Leave nothing but footprints;
Kill nothing but time. Campers ensue the greatest
impact on the environment at the campgrounds. Therefore, one must take utmost
care in choosing a campsite and make efficient use of it.
Take home garbage. Do not leave any refuse from
cooking and camping at the campsite (as well as along the trail).
As is, where is. Leave the camp ground exactly the
way you found it. Campfire’s nice. But do not cut down trees for firewood. Use
fallen branches, instead.
Ensure detergent-free Washing. Wash dishes by
cleaning first the remnants off the plates and utensils and drying them with
cloth (or tissue) or sand, when available. Then rinse with water away from any
body of water. Go Organic. Use biodegradable soaps and shampoos.
Silence please. Keep voice tone and volume at
minimum, some other creatures need their rest, too.
CHOOSING A CAMPSITE
Enjoying the great outdoors depends mostly in
finding a good campsite. For one thing, the itinerary should clearly point out
that the campsite must be reached by mid-afternoon in order that the camp is
set and cooking dinner is well under way before nightfall. This would also
provide ample time for checking the surroundings for possible dangers.
Select an established campground as much as
possible. If an established campsite can not be located, choose a place
conveniently away from the trail and try not to disturb much the present
environment.
Most campsites require that a permit be secured
ahead of time. Permits are usually issued by Forest Department. Make sure that
you and your group register your names so that mountain rangers and local
officials know where to go looking in case of any danger.
Tent. Place your tent on relatively flat terrain,
sheltered, and dry. Do not pitch your tent near the inside bend of a river
because this area is prone to flooding. Erect your tent with its entrance
facing the leeward. You have a choice in erecting your tent either you set it
up under trees or open space. The latter is preferable since after a rainfall
the sun comes up and everything is dried quickly. Under trees however will only
save you if there is heavy downpour but will leave wet for hours since the
trees is still dripping the rainwater.
Latrine.Building a latrine is not that quite common to mountaineers and
backpackers as well. Usually when the number of people exceeds 12 by all means,
designate a common place away from any water source to prevent surface-water
contamination. Check for wind direction. Be sure that you dig your latrine
downwind.
Fire. For mountaineers, it is not advisable to build a
campfire. It will just stress the already damaged environs. Locate the fire
close enough to the tent area in order to smoke out insects without creating any
risk of setting the tent on fire.
Water. Fetch drinking and cooking
water well upstream and away from any campsite.
LOCATING WATER
An ideal campsite would be one with available
source of water for drinking and cooking. Actually, it is one of the criteria
in choosing a campsite. In the absence of rivers and lakes, water might still
be available in the not so obvious places.
Where there is an extensive growth of mosses at
the edge of a mountain means that this area has cut across a groundwater source
and could possibly be a source of water. River crevices or natural ponds can be
source of rainwater. Extra caution, however, must be taken in getting utility
water from this origin because these are stagnant water sources. Water can also
be located under dried riverbeds.
TENT PITCHING
One must learn the art of pitching a tent quickly
and sturdily. This will be certainly necessary in cases when there is a storm
coming.
Steps in erecting your Tent
1. Clear the ground of any sharp objects like
stones and tree branches. Free the surface of any bumps by spreading ample
amount of dried leaves or grasses. Then spread over this area a ground sheet to
provide extra covering against any moisture from the ground to enter the tent,
2. Lay down the tent over the ground sheet with
the entrance facing the leeward of the wind. Quickly peg down all the corners.
Make sure that the pegs are secured enough into the ground.
3. Insert all the poles in their proper position and the tent canvass making the tent stand.
4. Cover the tent with the flysheet. Secure the
flysheet into the ground ensuring that tension is equalized around it.
5. Inside your tent. Organize your tent in a
manner that you can reach almost anything without leaving the comforts of your
sleeping bag.
Useful Tips
In places where there is stiff or hard surface,
where the pegs could not penetrate, use large rocks, onto which the tent will
be tied.
Do not allow the tent and the flysheet to touch in
order to maintain an insulating layer of air in between the two.
FIRE BUILDING
Fire building is a basic technique all campers
must learn. Its importance is not only limited to cooking (especially now that
portable stoves are available), but to a large extent on survival. From a
source of heat in cold weather, to smoking away insects and to restraining some
wild animals to enter the campsite and to signaling positions in order to aid
search and rescue teams.
However, campers must check for any restrictions on making a fire in a particular campsite. For as much as it is useful, it can be rendered dangerous in places, which are prone to forest fires.
Starting a fire is different from lighting a fire.
Although our basic concern here is the former, it is important to note that
there are technologies available now which far more efficient than rubbing two
stones together. There is the basic wooden match and butane lighters, never
ever leave for the mountains without them. Magnifying glass but this can only
be used during daytime. And in very damp conditions, the use of a magnesium
fire starter is one safety accessory that must be made available in any camping
trips.
Whatever method of lighting a fire you should choose, the next steps in building a fire is as basic as ABC.
First, one must gather more than enough materials
to sustain the fire. Fire ingredients include the following:
Tinder. Dried tree bark, twigs and other smaller
pieces of wood which are highly combustible. Kindling. Dried leaves and small
sticks not thicker than an inch, which is, place at a pyramidal position over
the tinder. Wood. Branches and logs which are placed loosely over the tinder
and kindling; starting with a slightly larger piece of wood than the kindling
and adding much bigger wood in intervals.
Then dig a circular trench not deeper than 30 cm.,
which would provide protection from the wind for the tinder fire. Place on the
center of the trench a generous amount of tinder material. Build a teepee shape
with the use of kindling materials. Balancing four sticks in a pyramidal
position and adding more and even larger sticks in the same manner does the
teepee shape. Strike a match or use a lighter to light up the tinder materials.
Add more tinder and kindling material until the fire stabilizes and is able to
burn the bigger sticks.
When the teepee catches fire, it will then
collapse into a bed of ember, which can be fed, with larger pieces of wood.
Eating Outdoor and Food Preparation (Wilderness
Kitchen)
Eating in the wilderness is much affected by time. Main meals are usually breakfast and dinner. A heavy breakfast helps to get you going throughout the activities of the day. Short snacks shall be taken intermittently along the trail. A quick lunch will sustain your strength until the end of the day. Do not continue without taking enough sustenance along the trail because fatigue will suddenly fall on you. A substantial and hot meal at night is the best way to replace the calories lost during the trek.
TYPICAL BREAKFAST
It is always a great sensation to start the day with
something hot; hot chocolate, coffee, tea, milk. Hot drinks keeps you company
while you are cooking up a large breakfast. Rice, dried fish, eggs or
Champorado with processed meat.
TRAIL FOOD
It is advisable to take little but often small meals along the trail. Jelly-ace is a sweet source of sugars necessary for giving energy to your body. Fruits like oranges, apples or singkamas give sugars as well as fluids to your body. Salty food like nuts and chips are also necessary to prevent muscle cramps. Taking in salts also re-hydrates your body.
TYPICAL LUNCH.
Most of the time, lunch will be taken along the
trail, the most typical is having soups and sandwiches. This would require
minimal preparation and your body would not be required be as full as it did
during breakfast time.
TYPICAL DINNER.
The biggest meal of the day. Usually, you have the
luxury of time preparing for this meal. Hence, dinner must have a wide variety
of food, a complete course; from soup to main meal to desert.
AT BEDTIME.
Make sure that you have had drank plenty of
liquids before retiring to bed to prevent dehydration. In cold conditions it is
best to have a hot, highly sugared drink to keep you warm throughout the night.
It is also advisable to keep warm water ready in a flask for the hot drink of
the next morning,
OUTDOOR CULINARY SKILLS
Golden rule is to bring enough food, but not too
much. PLANNING the menu is the biggest factor in making outdoor cooking a
success. Make a plan as what to eat, how much of each ingredient to bring, and
who will be bringing the ingredients as well as the cutlery and plastic
containers, plates, pots and pans and stove, and do not forget the matches.
Some food items and spices must be kept handy in every trip. These are:
Stock Cubes Pepper Chili Rice
Onion Salt Garlic Egg
Safe Camping (Safety First, as Always)
In the premise that every precaution was taken in
choosing a safe campsite, one must then run a safe campsite.
Some safety precautions are:
Keep fire
at a conveniently far distance away from the tent.
Do not
cook inside the tent.
Have a
sand bucket readily available to put out the fire.
Provide
guide ropes in going to the latrine area and provide ample lighting, too.
Rope off
any unsafe areas.
SAFEGUARDING YOUR FOOD.
The smell of food might attract insects, birds,
and mammals alike ensuing danger to the inhabitants of the campsite. Make sure
that food is sealed in plastic bags and left hanging from a tree branch.
CAMPSITE PESTS
Keep a close guard on some pests, which may cause
harm or may be a risk to health.
Flies and Mosquitoes are known to be disease carriers. As much as possible prevent them from getting in contact with your skin and food.
Ants usually come in groups. Always look out for ant nests before you pitch camp.
Scorpion is known to be highly poisonous. Make
sure that you always shake your sleeping, boots and clothes as a measure to
eject any presence of scorpions.
Snakes are quite a scary danger in the wilderness.
When in doubt always check your tent and sleeping bags for any presence of
snakes.
Rats always go for your food. Take extra care not
to leave food just lying around the campsite.
STRIKING CAMP
As a last goodwill gesture to nature and to those
who will follow in the trail, ensure that all garbage had been picked up and
packed out and taken home away from the wilderness. This etiquette is known to
almost everybody but is still often ignored. Unless we take on this
responsibility by heart, the following damages of overuse will overtake that
which was once beautiful:
Garbage
Barren, stripped land
Exposed tree roots
Downed plants, or absence of vegetation
Numerous firepits on a single campsite
Absence of ground wood for campfires
Scarred tree where branches have been torn away
Bottles, cans, and plastics, in or near sources of
water.
Clearing the campsite, some practical ways of
maintaining the beauty of the wilderness:
Put out fire completely. Scatter the ashes and collect and take unburned debris.
Packall rubbish in plastic bags and take it home with you.
Latrine must be filled in, returfed, and labeled to inform future campers
Dismantle tent and leave site after your equipment is fully packed.
WILDERNESS ETHICS (A REVIEW)
All climbers most especially those belonging to
organized climbs should strictly follow the wilderness ethics. Behavior of the
group would reflect the kind of organization or the kind of leadership the
group has. Here is some internationally accepted wilderness ethics.
Prepare well. Know
about your route and the area. Take adequate food. Bring clothing that will
keep you dry & comfortable. Know the basics of first aid, navigation and
minimum impact camping. Know what to do in case of overheating, hypothermia or
landslide danger.
Local practices. Know the local practices in
the area. Respect local customs and traditions. Respect other people’s desire
for privacy and solitude. Unnecessary disturbances (noise and horseplay) should
be avoided.
Trekking.While trekking into the wilderness avoid widening the trail. Stay off
the shoulder and walk in the middle of the trail. Suppress the desire to
shortcut switchbacks. Cutting switchbacks tramples vegetation and leads to
erosion. Use established trail when possible. On rest breaks, select a hardened
area to absorb your impact. Select footwear appropriate for comfort, safety and
the terrain. Heavy lug-soled boots have an adverse impact on fragile terrain.
Use light footwear in camp.
Camping.Select a level campsite with adequate water runoff, and use a plastic
sheet under your tent to stay dry without ditching. Locate your site at least
100 feet away from natural water sources. Generally, select a shelter site that
has already been used, to eliminate further expansion of the camp. Whenever
possible, position your tent so it blends with the environment. Careful
selection of campsite helps preserve the atmosphere of solitude even in popular
areas. Choose your site and use it lightly, leaving it in as natural state as
possible.
Garbage.Carry out all of your non-biodegradable garbage. Bury only
biodegradable trash. Pick up litter as you encounter it. Burning of non-paper
trash should be minimized since complete cremation is difficult. Remember
litter attracts more litter.
Sanitation.Use established latrines if these are provided. Use a cat hole if there
are no established latrines. Proceed with a trowel inn hand to an area at least
100 feet away from water sources trail and camp. After carefully removing the
surface duff, dig a hole several inches into the dirt. Replace the dirt and
duff.
Washing yourself. Even biodegradable soap is a
stress on the environment, so do as much of your cleanup without soap. Try a
soapless bath or clothes-wash, for all but the most persistent dirt. When using
soap, even biodegradable soap, wash yourself, your hair and your clothing at
least 100 meters away from water. Pour soapy water into highly absorbent
ground. Brush your teeth well away from water sources.
Washing dishes.Try a soapless cleanup. For health reasons, wash dishes with hot water
when possible. Wash at least 100 meters away from natural water sources.
Basic Emergency Care in the Wilderness
Adventure through the wilderness is an
exhilarating feeling for an avid backpacker and most especially a mountaineer.
Either to escape the metro or to be one with nature, the thrill of going into
untamed territory tests a person’s skill in coping up with his basic resources.
Certain medical conditions may arise on such
events and knowing how to handle them can make the difference of continuing to
enjoy the trek or become a full-blown emergency. This chapter deals with such
conditions that maybe encountered and dealt with accordingly.
THE FIRST AID KIT
Equipping oneself with the basic medical aid kit is the first step for a less precarious trip in the back country. There are available emergency first aid kits that are sold locally and abroad but you can assemble a set of your own by just knowing the essentials at a lesser cost. The list rundowns the supplies and instruments that you should have on hand.
Bandage
Scissors
Oral
Thermometer (preferably with own plastic case for preventing it to be broken)
Tweezers
(for removing splinters)
Safety
pins
Snakebite
kit (scalpel and suction for the venom)
Flashlight/penlight
Syringe
needle gauze 21
Sterile
gauze pads individually packed
Roll of
gauze bandage
Band-aids
Butterfly
bandage or steri-strips (small bandage for facial/gaping cuts)
Adhesive
tape, 1 inch size recommended
Elastic
bandage 3 inch size
Cotton
tipped swabs
Roll of
absorbent cotton
Hydrogen
Peroxide
Calamine
Lotion
Povidone-Iodine
solution
Rubbing
(70% Isopropyl) Alcohol or Bar of plain soap
Over the counter medicines that maybe useful. (OTC
Meds)
Aspirin or
an Analgesic (i.e. Mefenamic acid*) or an Anti-inflammatory (Ibuprofen)
Paracetamol
tablets
N.B. Aspirin/Mefenamic/Ibuprofen should not be
given to persons with allergic reactions to these medicines. Asking before
administration is a must.
Individuals who have specific medications to carry
should bring it along, i.e. anti-asthmatic inhalers or anti-allergy meds, and
inform their companions of their health status.
TIP:
Do not
minimize or forego portions of the kit. Doing so will undermine the First Aid
Kit’s use and it will be to your disadvantage.
Place the
kit in a water repellant pack to prevent the materials from getting soaked if
such occasions arise.
A Swiss
Army Knife or any multi-purpose device that you bring along may already have
tweezers and scissors as well as a penlight. This can spare you a few grams off
your pack.
VITAL SIGN
Proper taking of the pulse, temperature and
breathing is easy but must be done properly. Such vital signs monitor a
person’s condition along the trail that guide the one administering the first
aid of what to do.
Areas that a pulse can be monitored: Should be
taken for one full minute.
Common
Carotid (Neck)
Radial
(Wrist area)
Femoral
(Inguinal /Crouch area)
Dorsalis
Pedis (Top portion of foot)
NORMAL: Resting Pulse of an average
Normal adult is between 60 to 100.
Clean the
bulb of the thermometer.
Hold the
thermometer at the stem and shake it until the mercurial reading is at least
down to 35C or 95F
Read the
baseline temperature and place the mercurial bulb under the patient’s tongue.
Instruct the patient to close his lips tightly.
Leave the
thermometer for 3 minutes after which you remove it and get the temperature
reading.
Clean the
bulb and stem of the thermometer before replacing it in its container.
NORMAL:
Average range of a resting individual is between 36 to 37.5 C (96.8 to 99.5 F)
BREATHING:
Monitor
the breathing by looking at the chest expansion of the patient.
Look for
any signs of labored breathing such as:
Gasping
for air through the mouth
Enlarging
nostrils
Use of
neck muscles for breathing
Asymmetry
or unequal expansion of the right and left side of the chest
Monitor
for a full minute:
NORMAL: Average range of a resting
Respiratory rate is 24/min
WHAT TO Do’s:
Open Wounds: (Scrapes/Scratches, Cuts/Lacerations, Puncture Wounds)
Basic procedures for any of the above injuries are the following:
Wash your
hand or rub with alcohol before treating the wound.
If there
is bleeding, stop or control it. If it is continuous or severe, SEE Management
of severe bleeding.
Remove as
much as possible any dirt that is around and within the wound.
If
possible, wash the injured area with soap and water. Plain clean water for
washing off dirt will do.
Sterilize
or disinfect any instrument to be used for the care of the wound.
Objectives of managing open wounds are to:
Stop bleeding
Prevent contamination and infection
Seeking medical attention if wound is severe.
After doing the basic procedures. PICT:
Pat the
wound dry
Place an
antiseptic like povidone iodine on the wound.
Large areas of wound or areas most likely to be
reinjured or soiled should be covered with sterile gauze and bandage.
Minor
scrapes can be left exposed to the air.
Watch for
any signs of infection
CUTS
(LACERATIONS)
Primary
concern is to stop the bleeding with the basic procedures in mind.
When
bleeding stops, wash the wound to remove the dirt or other foreign materials in
and around the wound. Pat the wound dry
Do not
remove foreign objects deeply inserted in the muscle or any deeper tissue, this
may cause serious bleeding.
If no
foreign object is imbedded, apply an antiseptic over the wound
Cover the
cut with sterile dressing and use a bandage around it. If cuts are gaping,
especially in the face area, apply steristrip or butterfly bandages to appose
the wounds.
PUNCTURE WOUND
This results from a sharp, pointed object that
pierces the skin and deeper tissues. Nail, splinter, horn, or teeth/fang marks
are samples of puncture wounds.
Assess the
wound if any object had broken off and remained inside the wound (deeper than
the skin).
Do not
attempt to remove it since serious bleeding may ensue.
Do not
manipulate, poke or put medication into the wound.
Cover the
wound with sterile gauze and bandage it.
Seek the
nearest medical attention.
For minor
puncture wounds, objects lodged no deeper than the skin may be carefully
removed with tweezers.
Press on
the edge of the wound to encourage bleeding to wash out germs inside the wound.
Cover the
wound with sterile gauze and bandage it.
MANAGEMENT OF SEVERE BLEEDING:
Continuous or profuse bleeding is a medical emergency that needs prompt management and control. Bleeding can come from the veins or arteries or both. Venous blood is characterized by a dark red color and flows steadily while arterial blood is bright red and spurts from the wound. Immediate treatment can be done by a.) Direct pressure to the wound, b) application of pressure points or c) tourniquet.
Direct Pressure:
The first and preferred choice to control bleeders.
This is usually all that is needed to prevent further lose of blood.
Apply a thick clean gauze or soft clean cloth, i.e. a towel or handkerchief, directly over the entire wound to act as a compress. In extreme situations, bare hands or fingers can be used to compress the bleeder, but be sure that it should be clean as possible. Keep the pressure steady over the wound.
Do not remove or disturb blood clots that have formed on the compress.
Apply another pad over the initial compress if this gets soaked with blood. Do not remove the initial compress. Apply a firmer pressure over a wide area.
Elevate the bleeding limb/portion above the victim’s heart level. Do not do these if a fracture is suspected.
Once bleeding stops, apply a pressure bandage to hold the compress in place.
Placing the center of the gauze directly over the compress does this. Pull it while wrapping both ends around the injury. Tie the knot over the compress.
The ties should not be to tight that it cuts circulation. Check the pulse distal to the wound or check the nailbeds if they become bluish in color. Any change means it is too tight.
Keep the limb elevated.
Pressure Points:
This should be used only if bleeding cannot be
abated by direct pressure. This requires pressure on the artery supplying blood
to the wound against an underlying bone and cuts off the arterial supply to
that area affected. This should be used with direct pressure and elevation.
ARM:
Hold
victim’s arm bone midway between the elbow and armpit. The thumb should be on
outside the victim’s arm. The other fingers should be on the inside of the arm.
This places the arm bone in between the thumb and 4 fingers.
Squeeze
the fingers firmly toward the thumb against the arm bone. This compresses the
arterial vessel. Do this until the bleeding stops.
LEG:
Position
the patient by letting him lay on his back. Supine position.
Press at
the front center of the thigh, at the crease of the groin, by using the heel of
you hand.
N.B. Pressure point technique is used no longer
than necessary. If bleeding recurs, it may be reapplied.
Tourniquet:
This is a measure that is used as a last resort
for life-threatening situations where the two above management are
non-relieving. Weighing its use is based on fact of either losing a limb or
bleeding to death.
Requirements of a tourniquet:
2 or more
inches wide.
Length
should be enough to wrap around the limb twice with ends for tying.
Procedure:
Place the
tourniquet just above the wound. Wrap it around twice.
Do a half-knot.
Place a
stick or straight object on top of the half knot.
Tie then 2
full knots over the stick
Turn the
stick to tighten the tourniquet. This is done until bleeding stops.
Secure the
stick in order to hold its place by tying the loose ends of the tourniquet to
the stick..
Do not
remove tourniquet.
Attach a
note to victim’s clothes or body as to what time the tourniquet is place.
Don’t
cover the tourniquet.
Bruises
The most common type of injury that is sustained
from a fall or blow to the body. Small blood vessels break beneath the skin
that causes discoloration and even hematoma.
Assess if there are any broken bones. See Splinting:
If there are no suspected fractures, apply immediately a cold compress on the affected area to minimize swelling, pain and hematoma formation.
Apply pressure on the affected area.
Elevate the part or limb affected
Stabilize or immobilize the joint as needed.
Burns arising from camping stoves, fires or hot utensils and boiling water are the most common causes one will encounter.
Cool
running water or cold water compress over the burned area is an ideal immediate
management which is applied for about 5 to 10 minutes. This is to give pain
relief over the site.
Protect or
cover the area with sterile gauze or clean bandage. In less than ideal
settings, a clean polyethylene bag wrapped around maybe used.
DO NOT
apply any butter or grease to a burn area. Locals have the habit of placing
even toothpaste or powdered antibiotics to the burn site. Just keep the area
cleans and protected.
If
blisters form, (sign of second-degree burn), do not puncture or remove the skin
covering. This helps keep the wound safe and free from infection.
N.B. Second degree burns that are more than 15% of the body surface for an adult needs medical care immediately. Rough estimate is by using the palm of the hand with the fingers to represent 1% of total body surface that is burned. Injuries covering the face, groin, hands and feet or has inhaled smoke that could have injured the lungs are also included for prompt medical attention.
Blisters:
Usually caused by excessive rubbing of skin over
clothing or equipment (i.e. boots).
Minor, small, unopened blisters that will have no further irritation can be managed by placing a sterile gauze pad and bandage over it. If it was accidentally opened, wash the wound with clean water and cover it with a sterile dressing.
Puncturing large blisters that are prone to be broken is a last option wherein just sterile dressing will likely fail. Puncture site should be at the lower edge of the blister. A sterile needle is needed to puncture the blister. Press the blister slowly until it flattens. Cover with sterile gauze
Watch out for signs of infection such as redness or pus. This needs prompt medical management.
Blisters caused by burns should not be opened. Fluid imbalance may occur if this is done especially if it covers a lot of area.
Splinters:
Wash the area and clean your hand.
Sterilize a sewing needle (ideal is a syringe needle) and tweezers by boiling for 5 minutes or holding it on an open flame.
Splinters stuck inside the skin with a portion exposed can be pulled out gently with the tweezers placed at the same angle as to which it entered.
Use the needle to loosen the skin around the splinter if it is not deeply imbedded and remove it with the tweezers at the same angle as which it entered.
Once removed, clean it and cover it with sterile dressing.
Watch for any signs of infection.
Foreign
bodies in eye/ear.
a. EYE:
Foreign particles that are floating in the eyeball
or inside the eyelid can be removed with proper care. NEVER attempt to remove
particles that are piercing the eyeball. Trained medical personnel should
handle such cases. Protect the area and bring him/her down to the nearest
medical facility.
Management for foreign bodies that are floating on
the eye is as follows:
Do not let
the patient rub the eye.
Wash your
hands.
Flush the
eyes with warm water until particle is removed.
If
particle is still not washed-out and is attached to the inside of the upper
lid, ask the patient to look down.
Hold the
upper eyelid down. Place a cotton bud handle horizontally across the outside of
the lid. Flip the eyelid backward over the lid causing the inner portion to be
exposed with the foreign particle.
Remove the
particle with moistened corner of a cloth or handkerchief.
If the
particle is on the inside of the lower lid, gently pull down the lower eyelid
and carefully remove it with the handkerchief tip.
If
particle remains, cover the eye and seek medical attention.
b. EARS:
Insects may find the ear canal a tempting place to
investigate and buzz over with the result of getting stock and you in anxious
haste.
Placing
several drops of oil (cooking, baby) is warranted if the insect is alive and
buzzing all over. This will immobilize and kill it. N.B. Do not use oil on
foreign objects that may absorb it and make it more difficult for extraction.
Flushing
with warm water may also be a next option for removing insects.
Attempts
to remove clearly visible foreign objects may be tried. Do not poke or proceed
if the object is unyielding or goes in further. Seek medical attention.
Nosebleed or Epistaxis
Epistaxis or nosebleeding occurs on certain
situations such as high altitudes, hot weather or even persons with high blood
pressures.
Make the
patient sit down and lean the head forward. Keep the mouth open.
Pinch the
nose for 15 minutes. Release it slowly, if bleeding recurs, pinch it again for
5 minutes. Check and continue this until it stops.
Place cold
compress/cloth against the nose to help constrict the blood vessels.
Don’t let
the patient swallow the blood or blow his nose
Insect Stings
Stings from bees, wasps or hornets can cause local
swelling, pain, redness, and a burning or itching reaction to the bitten site.
Mostly this is non-life threatening unless the bitten patient is allergic to
the venom. Shock may ensue. Backpackers known to be susceptible to such
reactions should bring their own medications and instruct their companions on
how to use it.
Removing
the stinger is by using a knife blade and scraping it off. Tweezers should not
be used since you may squeeze and push the venom into the skin.
Wash it
with water.
If
available, wrap it with a cold compress.
Calamine
lotion, paste of baking soda and water may be used to relieve discomfort.
Animal
bites.
Bites from wild animals carry the risk of
bacterial or tetanus infection. Animals infected with rabies may introduce this
condition to the ailing victim. Treatment should be sought if this occurs.
Wash or
pour water over the wound for around 5 to 10 minutes to remove as much as
possible the saliva and other foreign object introduced with the bite.
Bleeding
should be managed by applying continuous pressure until it stops and sterile
dressing placed over the wound site.
Venomous bites/Stings
Scorpions
Scorpions just like bee stings can cause severe burning pain at the site of the sting. Signs and symptoms that develop vary from the amount of venom introduced to the victim. Adults rarely die from such stings* except that they are particularly harmful to young children* or adult individuals who show signs of shock or convulsions. Numbness or tingling sensation may be felt or even difficulty in swallowing and breathing for extreme cases.
Immediate
treatment by maintaining an open airway and restore breathing should be done.
Simply
clean the wound and the surrounding area with water or alcohol
Keeping
the bitten part lower than the level of the heart will help minimize spreading
the venom.
Place ice
compress on the bitten site is also advisable.
Watch out
for any signs of shock or allergic reactions.
Secure him
to the nearest medical center if symptoms progress
Grade I to II scorpion envenomations such as local
pain/and or numbness at the site of envenomation or remote from the site of
sting are treated symptomatically with oral analgesics. They are observed for 3
to 4 hours to note for any progression of the symptoms.
Grade III and IV such as blurring of vision,
hypersalivation, trouble swallowing or breathing, slurring of speech or even
jerking of extremities needs immediate medical attention to the nearest health
center.
Snake bites:
Bitten by a snake, entails one to immediately
assess if the snake is a poisonous or non-poisonous variety.
Poisonous snakes have slitlike eyes, poison sacs
or deep pits between the nostrils and the eyes and sharp long fangs leave a
distinctive 2 piercing fang marks. In comparison with non-poisonous snakes that
have rounded eyes and no deep pits.
Grading of envenomation by signs and symptoms is
helpful in assessing the current state of the patient.
Dry Bite (Do not result in
envenomation)
Minimal
Moderate
Severe
Puncture wound, pain, little or no swelling. No systemic symptoms or
progression.
Localized pain, edema, ecchymosis or blood clot formation on the site
Massive edema, hematoma. Unstable vital signs. Coma, seizure or
respiratory distress. Signs of clinical coagulopathy or bleeding.
N.B. Dry bites produce no signs or symptoms other
than the mechanical puncture wound. Sudden severe pain at the bite site
followed by progressive swelling and/or numbness is a sign of envenomation.
Immediate care for snake bites:
Maintain
an open airway and breathing if this is affected.
Position
the bitten part lower than the victim’s heart.
A light
constricting band at bites on the arm or leg can be placed 2 to 4 inches above
the bite toward the body. It should not be too tight that it cuts circulation
to the affected limb. Feel for the pulse on the distal portion. A finger should
be able to slip under the band. The wound should ooze.
Replace
the band another 2 to 4 inches above from its previous position if swelling
reaches its initial position.
Do not
remove the band until the patient is safely brought to medical care.
Wash the
bite area and immobilize the limb
For Dry
bites, cleaning the wound with vigilant monitoring up to 12 hours should be
done to note for any changes or progression of symptoms. Medical attention
should be done as soon as possible.
Loose
(lymphatic) tourniquet, incision and suction are probably effective if used
within 30 minutes of envenomation but are not substitutes for definitive care
in the nearest medical facility.* Reference
A Snake
bite kit is helpful in this situation. A sterile knife should be used to make a
one-eight to one-fourth inch deep cut through each fang marks. This should be
in the direction of the length of the leg or arm, not across. The incision
should not be more than one-half inch long. Do not make cross mark cuts.
Incision should be done not any deeper than the skin since muscle or tendon may
be damaged.
Suction
cups are then used to draw out the venom on each fang mark. Continue suctioning
for 30 minutes. Suctioning the venom by mouth can be used if free from cuts,
sores or open wounds. Don’t swallow the venom. It must be spitted out. Rinse
the mouth after finishing the suctioning.
Cover the
wound with sterile dressing, keeping the victim calm. Do not let the victim
walk unless extremely necessary.
Do not
give alcohol or water if victim is nauseated, vomiting or unconscious. If
he/she has no difficulty in swallowing, sips of water is permitted.
Prompt
medical care to the nearest facility is a must.
Take note
of the time of envenomation, vital signs of the patient during the course of
management.
Plant
Irritations:
Itching, redness of the skin or blister formation,
and even headache or fever can occur if such irritating plants touch the skin
of a backpacker. Plants like the poison ivy can have a very annoying effect.
Remove the
clothing and wash the area with soap and water.
Apply
rubbing alcohol to the affected site.
Application
of calamine lotion will help alleviate the itchiness.
Wash the
clothes used to remove unwanted irritants.
Heat and Cold induced conditions
Hypothermia
Body temperature is a function of the production
and loss of heat.* Hypothermia occurs if heat production fails to balance heat
loss. Hypothermia is defined as a core (Rectal) temperature less than 35C
(95F). It can be a.)Mild (32-35C) b.)Moderate (28-32C) or c.) Severe (<28C).
It can be characterized as acute (<6 hours duration) or Chronic (> 6
hours). N.B. Oral temperature is normally 0.5C lower than the rectal temp
Mild hypothermia causes shivering, difficulty in doing complex
motor functions with noted cooling or vasoconstriction of the peripheral area
like the fingers and toes. Shivering can be stopped voluntarily.
Moderate hypothermia causes loss of fine motor coordination, apathy
“I don’t care attitude” or confusion, slurred speech, and violent
involuntary shivering. Shivering increases body temperature by 0.5 to 1C per
hour.Paradoxical undressing may happen which is: a person starts to take off
his clothes even though he is feeling cold.
Severe hypothermia can make a person shiver in violent waves wherein
the interval between shivers increases until it totally stops. This is a telltale
sign of a critical condition. The person cannot walk, muscle rigidity develops,
the skin is pale, and pupils dilate. The pulse rate decreases too.
Cold, wet weather on high altitude with poor
raingear and warming clothes is a sure way to acquire hypothermia. Water
dissipates heat away for the body 25 times faster than air. Wet clothes
increase the potential for conductive heat loss to 5x normal.
Mild-Moderate Hypothermia:
Rules to live by:
Reduce
heat loss by
Removing wet clothing and replace with dry ones
Increase or add more layers of clothing; a large
plastic bag covering his body and extremities can help retain heat for the
victim.
Increase muscle/physical activity
Keep the victim warm and dry in a shelter
Adequate
hydration and food intake
Carbohydrates are a good source for energy. i.e.
bread, rice, candies
Hot liquids helps a lot in increasing the core
temperature
Never take
in alcohol (a fallacy), caffeine or tobacco/nicotine. All of these may
aggravate heat loss.
Add heat
by:
Fire or other heat source
Body to body contact with dry clothing on.
Severe Hypothermia
Reduce
heat loss by placing a hypothermia wrap. The patient should be dry. A 4″
insulation covering the entire neck, body and extremity should be done using
blankets, sleeping bags, or clothing. A space blanket could be used.
Give a
dilute solution of warm water with sugar every 15 minutes. Severe hypothermic
victims’ stomachs usually will not digest heavy, solid food.
A full
bladder increases the loss of core heat. Let the patient urinate but make sure
the insulating material will not get wet from the urine.
N.B.
Afterdrop – core temperature
decreases or drops during re-warming. Peripheral vessels in the arms and legs
dilate causing cool blood flow to the core. This is best avoided by just re-warming
the core and not the peripheral area (hands, feet)
Heat
Illnesses:
Heat cramps are due to muscle fatigue
combined with water and salt depletion.*
Heat exhaustion results from dehydration
with inadequate fluid and electrolyte replacement.* This may progress to
heatstroke.
Heat stroke is due to severe dehydration
with failure of the body’s thermoregulation causing body temperatures above 40C
(105-106F).
Heat Cramps/Exhaustion:
Patient
may complain of headache, nausea or vomiting, dizziness, weakness and fatigue
and even disorientation.
Find a
cool shady place and keep victim there.
Apply cool
clothes. Give adequate ventilation and cool the patient using a fan. Stop if he
develops shivers. Do not over cool him.
Instruct
the victim to take in fluids if conscious. Intake of a mixture of 1 pint water
with 1 teaspoon of salt every 30 minutes is advisable.
Don’t give
patient alcohol beverages and cigarettes. Do not leave him alone until he is
stable.
Heat Stroke:
Patient
may present with mental confusion or disorientation, incoherent speech or even
unconsciousness. Victim develops flushed, dry or warm skin with extremely high
body temperature.
Immediately
place him on a cool shady place.
Remove
most of his clothes. Apply cool compress if possible. Fan may increase heat
dissipation.
Don’t give
fluids, alcohol to incoherent or unconscious victims. Don’t overcool him by
causing shivers. Monitor the patient until he is stable. Transporting to the
nearest medical facility is warranted if condition does not improve. Do not
give medications for lowering fever, it is not effective.
SPRAIN/STRAINS
Sprain is an injury to the supporting ligaments of
a joint while strains are injuries that occur on the muscle or tendon. Sprain
occurs commonly on the ankle for backpackers when there is poor hold of the
foot while stepping on slippery surfaces. Strains usually occur at the lower
back during sudden lifting of the packs from a forward bending position at the
hip area.
Sprains:
Assess if the area affected is just a sprain or a
broken bone. If there is high suspicion of a fracture, treat it as a fracture.
(See Splinting)
Ankle/Knee:
If
possible, place cold compress on the sprained area 15 to 30 minutes
intermittently. Do not apply warm compress for the first 24 hours since this
will aggravate the swelling or edema. Note for the amount of swelling and or
any signs of hematoma formation. Sudden enlargement of the joint due to
swelling and presence of a hematoma are signs of a severe ankle sprain or a
possible broken bone.
Keep the
affected part elevated to minimize further swelling.
Bandage or
support with a blanket the site. Loosen the bandage if numbness or increased
swelling is seen. The bandage is then to tight at this point.
If victim
need to walk, minimize bearing weight on the affected foot, secure a sturdy
stick or wood that can be used as a crutch or cane. General rule is placing the
stick opposite the affected limb, this will serve as a support during walking.
When going downhill, the bad leg first before the good one. Uphill is good leg
first before the bad. Easier to remember is by the saying “Good leg to
heaven, Bad leg to hell!”
Medical
attention should be done as soon as possible.
Wrist/Elbow/Shoulder:
If
possible, place cold compress on the sprained area 15 to 30 minutes
intermittently. Do not apply warm compress for the first 24 hours since this
will aggravate the swelling or edema.
Just like
in the ankle, elevate and bandage/support the area. A supporting bandage can be
used for the wrist
Seek
medical care as soon as possible.
Strains:
Victims
may have a difficult time in moving the area, especially if it occurred at the
back. Rest it immediately. Apply cold compress if possible. No warm compress
for 24 hours.
Look for
medical assistance if pain or swelling is severe.
N.B. Anti-inflammatory over the counter
medications like “Alaxan”, which is a combination of
Paracetamol/Ibuprofen, can be tried to help alleviate the pain. DO NOT give it
if the victim is known to have allergic reaction to this medicine or to
aspirin. Ibuprofen is usually the culprit for such allergic reactions. DO NOT
also give it if victim is known to have a stomach ulcer. Oral intake of the
medicine is contraindicated.
Hematoma
under toenail: Subungal hematoma
Injuries of the toes either by tripping on a rock
or root or heavy object falling over the boots can cause hematoma formation
below the nailbed. Prolonged walking causing contusion of the toe over the
inner portion of a poorly fitted shoe can also cause this. Options for this
condition is either letting it as is and place cold compress on the nailbed
affected or to evacuate the hematoma if there is severe pain.
Draining the blood.
Clean the
nail and toe.
Use a
sterile needle and gently press the nail doing a screw-like motion. Do this
until you feel a ‘give’. You have then reached the inner end of the nail.
Another option: If you have a straightened paper clip, heat it up until it
turns red. Apply the heated end to the nail and it will bore through the nail
with minimum pressure.
Drain the
blood by pressing on the sides of the nail.
Apply
povidone-iodine and cover it with a dressing.
N.B. Consider delaying in doing the removal of the blood if you will still go over a lot of mud or dirt trail that may soil or infect the toe. If needed, make sure you always clean and apply a new dressing to the punctured
LEECH MANAGEMENT
The “Limatik” or “Linta” in the common dialect is notorious for its stealth like feature. It has a covert way of attaching to the skin and sucking blood without ever knowing it until you bleed. This is very common especially on the wet season, wet forest areas or after a rain in the woods.
DO NOT
pull off the leech, its suckers may be left attached to the skin.
Apply a
hot material, knife or any metal object put over a flame, on the leech. This
will make it detach by itself. Application of rubbing alcohol may also do the
trick.
Bleeding
over the site of attachment will be noted. This is due to the anti-clotting
factor that the leech uses for to get the blood. Some itchiness maybe noted.
Wash it thoroughly.
Diarrhea:
There are many causes for diarrhea. Trying to
deduce through the victim’s history would help in knowing the probable culprit.
This may range from food poisoning, intake of medications, emotional stress,
excessive alcohol beverage, and viral or bacterial infection.
Assess the victim if there are any signs of
dehydration. The victim is dehydrated if the mouth and tongue is dry, restless
and irritable attitude and very thirsty.
Replace
the same amount of fluid solution (1-liter clean water, 1-teaspoon salt and 1
tablespoon sugar) with the amount of loose stools.
Vomiting
may also be present. Let the patient sip the fluid solution gently and slowly
to avoid further vomiting.
Loose
stools that are blood tinged or bloody or even black in color warrants
immediate medical attention. These may be an internal bleeding or an infectious
type of diarrhea.
Techniques in bandaging, Splinting, basic cardio-pulmonary resuscitation. CPR:
Practice makes perfect, is the key ingredient for
proper use of medical materials. With limited resources in the backcountry, you
must make use of this in the most efficient way.
Circular Bandage:Placed over the sterile gauze covering the wound
to keep it in place and avoid further contamination.
This is used on areas that have a relative uniform
width, like in the forearm or leg.
Place the
end of the gauze over the affected part. Make 2 to 3 turns around the wound at the
same spot. This serves as the anchor for the bandage.
If the
site to be bandaged is large, make additional turns by overlapping the bandage
strip one from the other by around 3/4 the width of the previous turn. This is
done until all of the area to be protected is covered.
Secure the
bandage by applying tape or safety pin. If it is not available, tie a knot by
rolling out the gauze for about 8 inches in length from the underside of the
arm/leg. By using the thumb or any finger, place it in the middle of the rolled
out gauze and pull the half section back under the wrist to the opposite side.
Then tie the knot with double gauze on one side (the one with the loop), and
single gauze on the other side
Figure of eight bandage:
Its use is for the ankle, wrist or hand that need
stability and a little mobility.
Anchoring
the bandage is first done at the distal (toe area). Make 1 to 2 circular turns
around the same area.
The
bandage is then brought diagonally across the top portion of the foot and
around the ankle.
The
bandage is continued across the top of the foot and passing under the arch.
Follow the
#2-3 procedure with each turn overlapping the previous one by 3/4 of its width.
Continue
this until the foot, ankle and lower leg are completely covered. Make sure the
bandage is snugly in place. DO NOT cover toes in order to assess if the bandage
is too tight. Bluish discoloration of the toes is indicative of a too
constrictive bandage.
Secure the
bandage with clips or tape.
Finger Bandaging:
Suspected fracture or injury to the finger could
be immobilized by using the buddy taping.
Appose the
affected finger with the adjacent good finger.
Use a tape
or gauze to anchor the two together. Make sure the tape is placed at the
farthest/distal end as well as the portion near the base of the fingers. This
secures the fingers. Tape between this if needed.
A cut
tongue depressor or flat wood can by used to secure the palm side of the finger
for better stability.
Triangular bandage:
Can be used as a shoulder sling.
A 40-inch
square cloth cut diagonally from corner to corner makes two equal triangular
halves.
One end is
placed over the non-injured shoulder. This makes the base and the other end is
hanging down over the chest. The point should be under the elbow of the injured
shoulder/arm.
Position
the hand 4 inches above the level of the elbow
Wrap the
injured forearm/arm/elbow by lifting the lower end of the bandage over the
shoulder of the affected extremity. Tie the two ends over the side or back of the
neck.
Fold the
point forward and secure it with a pin on the outside portion.
N.B. Fingers should not be included in the
covering to assess if there are any circulatory compromise.
Splinting:
Fractures of the arm and leg should be immobilized
during transport. This is to protect it from further harm during the travel to
the nearest medical facility.
Lower extremity:
If
necessary, gently straighten the injured extremity. Stop if pain increases
during the procedure.
Place padding
such as folded blankets between the victim’s extremity.
A board
placed underneath is the most ideal way of immobilizing the affected extremity.
If not available. Using sturdy wood placed on both sides of the extremity may
be used. Length of the board/wood should stretch from the heel to the buttock
area. Secure it by tying it at the following areas.
Just above
the ankle
Just above
and below the knee
Above the
thigh, near the groin.
DO NOT tie
directly over a broken area
Another
alternative is to tie the injured extremity to the uninjured extremity with the
ties at the same positions in securing one with a splint.
Watch for
signs of circulatory compromise, bluish toenails, poor distal pulses
Upper extremity:
This follows the same principle like in the lower
extremity.
Use a
sturdy board or stick to immobilize the injured area. A rolled blanket may be
used.
Tie it at
both ends and in between, just below and above the elbow.
Don’t
cover the fingers. Watch for any circulatory compromise.
Neck:
Suspected fractures on the neck is a possible
life-threatening situation. Any wrong movement of the neck can result to
paralysis or death. Seek medical assistance.
If the
victim’s life is of immediate danger in the vicinity and needs to be moved,
immobilization of the neck is a MUST. Do this by placing a rolled towel or
blanket around the neck and tie it in place. The tie should not interfere with
the breathing. If a flat wide wood is available, place it behind the neck and
back. Secure the neck by tying the board to the victim around the forehead and
under the armpits.
Lifting
the head is done together with the shoulders and upper trunk with no twisting
motion (Log rolling technique). The one giving the first aid should position
himself at the top of the victim’s head. Place both palms of the hand at the
back of the shoulder with the forearms at the side of the head. Press the head
to secure it by using the forearms. Once it is secured, lift the head and neck
together with the shoulders.
If there
is difficulty in breathing, slightly tilt the head backward to maintain an open
airway.
Place the
victim in a secure location and seek for medical assistance.
Rigid
boards or a make shift stretcher must be used for transport of the victim.
Cardio-Pulmonary Resuscitation (CPR)
A life-saving procedure for victims not breathing
and has no pulse. The first priority in suspected arrest is that if the patient
is breathing or not. Remembering the “ABC” of CPR that stands for
Airway, Breathing and Circulation are the basic steps for CPR. First assess if
the patient is conscious or not. Then do the following if unconscious.
Airway:
Lay victim
on his back on a firm surface, such as the ground.
Check the
mouth and airway if there are any foreign objects i.e. dentures that may block
the airflow.
Assess if
there is a suspected neck injury.
If this is
suspected, gently tilt the head with the head-tilt/chin-lift procedure. Place
one palm of the rescuer on the forehead of the victim with the other hand,
using two fingers, under the chin. Simultaneously, tilt the head back with the
hand/finger in place. This is to clear the airway.
Breathing. If not breathing
Keep the
head tilted
Feel and
see if the patient is breathing. Placing an ear of the rescuer near the nose of
the victim such as the rescuer is facing towards the chest will help him detect
if there is breathing from the nose and lifting of the chest. If there is none
then continue the procedure.
The hand
that is placed on the victim’s forehead is used to pinch the nose using the
thumb and index finger.
The
rescuer takes a deep breath in order to blow air into the victim’s open mouth
(mouth to mouth). Make sure it is effective by noting a rise from the chest
with your mouth completely sealed during the blowing. Inflate the lungs rapidly
for 3-5 times. (Take deep breathes in between)
Feel for
the carotid pulse. If pulse is present, continue blowing air at the rate of 12
per minute.
Mouth
to nose resuscitation may be warranted if the victim’s mouth is blocked for
free air passage.
Circulation: If pulse is absent
Feel for
the carotid pulse. If pulse is absent begin cardiac compression. General rule:
One
rescuer: 15 compressions then 2 quick breaths.
Two
rescuers: 5 compressions then one breath
Palpate
with the index finger one of the victim’s lowest ribs then slide upward until
the sternum or breastbone is felt meeting with the rib. Keep the index finger
there.
Use the
other hand’s heel by putting it over the breastbone above the index finger.
This is where compression is done.
Place the
other hand over the other one pressed on the breastbone. Keep your elbow
straight, lean over the casualty and press down vertically and release. Depress
the sternum approximately 4-5 cm.
This is
done until spontaneous pulse returns.
Dangerous Diseases:
The table below lists the diseases to watch out
for.
Disease
Source of infection, How it is transmitted
Sign and Symptoms
Typhoid
Contaminated food and drinks from infected
stools.
Transmitted by fecal to oral route.
Fever for days to weeks, headache, vomiting,
even diarrhea. Abdominal pains
Malaria*
Female anopheles mosquito. Introduction of
malaria parasite into the blood
On and off chills, fever and sweating with
feeling of well being in between. Headache, anorexia, nausea, vomiting.
Hepatitis A
Fecal to oral pathway with stool/urine of
infected individuals contaminating food and water.
Fever, anorexia with urine becoming dark yellow;
skin, eyes become icteric (yellowish in hue)
Cholera
Ingestion of food or water contaminated with
stools or vomitus of infected individuals
Abrupt onset of diarrhea, profuse watery
“rice water-like” stools. Stools may be odorless or fishy in
character.
Vomiting, may lead to severe dehydration in a
short span.
Tetanus**
Spores of bacteria entering a wound. Found in
the soil, rusty materials, nails, pins.
Fever, Stiffness of muscle of the jaw,
extremities.
Rabies
Saliva of rabid or infected wild animals, i.e.
bats, wild cats
Fever, loss of appetite, nausea, vomiting,
restlessness, agitation, confusion, hallucinations*
Lethal disease if left untreated.
*Malaria prophylaxis is advised on locals that are
endemic with the disease. Locally available medications are Fansidar
(Pyrimethamine/Sulfadoxine) and Chloroquine. Consult a physician on its proper
use and precaution. Some individuals may have adverse reactions to these
medicines i.e. rashes, tinting, deafness.
**It is advisable to secure a tetanus shot from
your physician and remembering when was the last booster shot. This would help
the attending physician in knowing the recommended form of tetanus immunization
once the situation arises.
Emergency Signals: Signaling for help.
A. Ground Markers
Using ground markers for aircraft to spot the
signal is a good way to send your message across. Make sure signaling the
serious injury marker is used with utmost importance. There is no room for
false information.
B. Smoke:
Creating a campfire and signaling using its smoke
may be used to attract attention. Windy or rainy situations limit the
capability of this type of signal.
C. Sun:
A mirror or a heliograph (reflective surface with
a hole in the center) can be effective in seeking attention from flybys. Use
the sun to reflect a bright beam focused on the vehicle’s cockpit. Move the
reflected beam to and fro to catch attention rather than focused on one place.
D. Morse Code:
An international standard of transmitting messages
that still has its use. It takes time to know it by heart, but it is worth the
effort.
Practice it with the following phrase:
“The quick brown fox jump over the lazy
dog”
E. Semaphore:
It is an alphabet signal using arm/hand positions
for transmitting messages. A person deciphering the message needs binoculars if
the person signaling is at a very distant location. Do it slowly. Flags (Square
with red and yellow divided diagonally) are held with arms extended.
The arm patterns are fashioned like a clock but
with only ten positions, Up, Down, Out, High, Low each for the left and right.