When an outing turns ugly: A little knowledge and prep can go a long way in an outdoors emergency
Nancy Minett was swimming with her grandkids at Bridgeport in South Yuba River State Park when she began having chest pains.
As a nurse and Red Cross instructor, the 75-year-old Grass Valley woman realized she was having a heart attack. The children, ages 9 and 11 and both Scouts with first-aid training, calmly asked, “What can we do?” Minett directed them to run ahead to find a ranger, then she walked half way back to the parking lot. After questioning the children, park staff called the Lake Wildwood EMI, and Minett was transported to Sierra Nevada Memorial Hospital’s intensive-care unit.
Greg Silva of Reno and a friend were backpacking in the Sierra when a woman approached and said, “Our daughter is sick. Can you help her?” Both men were emergency medical technicians, but when they saw the victim – an overweight teen – she was in the advanced stages of high-altitude pulmonary edema. By morning, she was dead, although the elevation was just 8,000 feet.
An outdoors emergency may develop at any time with lightning-quick speed. Anticipate potential dangers associated with specific outings: high-altitude situations, dehydration and heat problems, problems caused by cold. Take into account the relative accessibility of outside professional medical care. Consider taking the American Red Cross’ first-aid training (272-3265).
The following suggestions are from the Sierra Club’s “Outing Leader Handbook.”
Immediate first aid
— Prevent further injury to the victim. Stop arterial bleeding, restore breathing, check for pulse, and, if necessary, begin CPR. Maintain adequate body warmth and treat for shock.
— Do not move the victim until you have ascertained the injuries.
— Practice the STOP scenario – Stop, Think, Observe, Plan. Thoroughly consider the situation before you plan a course of action. Speed is less important than correct response.
— Decide whether to evacuate the victim with available resources or send for help. Ideally, one person should stay with the victim and two should go for help. Messengers seeking help should have written information as to the location and nature of the injury. Advise messengers to save strength for the return trip.
— Heat stroke: Victim is uncoordinated, confused, delirious and convulsing. Body temperature must be lowered immediately by sponging with tepid water, fanning and cool drinks. Evacuation recommended.
— Heat exhaustion: Victim is cool, clammy, dizzy, has a headache, and may have cramps. Liquids and rest with a lowered head recommended.
— Acute mountain sickness: Caused by too rapid an ascent to above about 9,000 feet. Victim has headache, drowsiness, loss of appetite, nausea, vomiting and abnormal sleep patterns. Treat with descent to about 3,000 feet, rest, adequate fluid intake and headache pain medicine. Do not administer sleeping medicines as they may mask pulmonary edema symptoms.
— High-altitude pulmonary edema (HAPE): Symptoms are shortness of breath and rapid respiration, weakness, disorientation, cough, frothy pink sputum and racing pulse. Treatment is immediate descent, rest and oxygen.
— Frostbite: In its beginning stage, flesh is unfrozen but turns gray and waxy-looking. If there is no chance of refreezing, treat superficial frostbite by warming affected body parts in 102- to 106-degree water for 30 to 45 minutes. Unless you can maintain proper treatment, don’t begin it; you can walk on frozen feet but not on partially thawed feet. Rubbing or applying direct heat to the body parts increases damage.
— Hypothermia: This insidious drain of body energy is often not recognized until it is life-threatening. Always assess its potential and be prepared for changing weather. Avoid wet clothing and dress in layers. Beware of wind-chill factor and cover your head and hands. Take action as soon as symptoms begin.
With mild hypothermia, victim is indecisive, loses fine motor control, shivers, and is tired. Warm the person in any possible way, administer warm drinks, and get the victim into warm, dry clothing. Seek protection from the elements and maintain food and water.
With severe hypothermia, victim is sleepy, confused, irritable, staggers, and has slurred speech. Pulse is slow, pupils are dilated, and breathing is shallow. Place the naked victim in a sleeping bag and have he or she maintain skin-to-skin contact with another person.
— Rattlesnake bite: Get victim away from the snake to avoid a second strike. Victim should remain calm and lay down to keep the bite area above the heart. Put pressure on the bite with a pressure extractor pump or by an elastic bandage. Do NOT use tourniquets, cut the bite area, or suck venom from the wound. Evacuate victim immediately.
Common sense, combined with knowledge of the terrain, level of activity required and weather predictions, can spell life or death in an outdoors crisis.
THE 1O ESSENTIALS
These are 10 outdoors outing items Sierra Club leaders say you should never be without, whether on a day- or weeklong outing.
Some are handy for use at any time; others may be waterproofed and kept in your pack for emergencies.
– Map of area
– Flashlight with spare batteries and bulb
– Extra food and water
– Extra clothing, including gloves and warm hat
– Waterproof matches
– Candle for starting fires
– Pocket knife
– First-aid kit
– Pat Devereux
Pat Devereux is a copy editor for The Union and a member of the Nevada County Hiking Club. Contact her c/o The Union, 464 Sutton Way, 95945, or at firstname.lastname@example.org .
This article was originally published on 12/7/2001.
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