Wilderness First Aid Brain Dump

Two hours ago, I finished a Wilderness First Aid course. “Wilderness” means you’re more than an hour away from definitive medical help. So, say my boyfriend and I are bikepacking from Moab to Crested Butte, for example, and he goes to impress me by boosting a four-foot gap jump. He comes in nose heavy, goes OTB and right into a prickly pear.

If you’d asked me before this course what three things I’d need to deal with that situation, I’d have told you:

  1. Bandaids
  2. Neosporin
  3. A cell phone

But now I know that list is more like:

  1. Gloves
  2. Duct tap
  3. Scissors
  4. An InReach

Why? That Duct Tape would be a lovely way to remove prickly pear spines; the scissors would maybe be the most useful piece of equipment (to cut t-shirt into strips for a splint and/or bandages if necessary); the gloves would keep Wilbur’s goo off me; and an InReach can call for help and share location where cell phones can’t.

I came out of the course with lots of interesting tidbits and morsels, and thought I’d document a few of them before I forget. Maybe you’ll find them useful.

1. North American snakes aren’t really all that much to worry about.

Image result for copperhead
This is totally fine!

Getting bitten by one would, on the scale from sucking to fatal, be decidedly on the suck side.

Ticks, on the other hand, will fuck your whole deal up. It takes as little as 15 minutes for a tick to vomit up its bacterial-viral guts straight into your blood stream. So, I will be re-investing in a tub o’ permethrin post haste.

2. Consider the elements

Blood loss, unconsciousness, and trouble breathing are all obvious high-priority problems. Nearly as important: getting people out of the elements as quickly as possible.

Being in a concrete-floored room the whole weekend for this first aid course demonstrated very nicely just how quickly cold surroundings can sap your body heat.

3. Bodies are strong

One of the things I loved the most about Tom Burroughs, our instructor, was how he kept circling back to evidence-based medicine. Everything he taught us to do had a rationale and studies proving good patient outcomes.

A surprising example from the front country? [Suspected back injury treatment. Everyone knows if someone messed up their back they should go on one of these things right?

Image result for patient on backboard
Abso-friggin-lutely not

Right, because the spine is a totally flat, straight line that feels most comfortable on a hard piece of plastic!

Actually, evidence shows that immobility, while causing quite a bit of pain, does not actually prevent any “secondary injuries.” (Check out this article for more info on that).

Along those same lines, you can and should let a hurt person help as much as they are comfortable with and move as much as they are able — even broken, our bodies are pretty sturdy. And they’re also wired to conduct pain signals. They know best where the hurt is and exactly what direction they shouldn’t move — let them choose.

The exceptions to this: pelvis, back and femur breaks. In those cases they shouldn’t move and you shouldn’t move them. Those injuries can be so serious, they need the big guns to help.

4. In the end, shock kills us all

Had to end this post on a cheery note, right? Shock happens when our organs don’t get enough blood or oxygen. Whether that’s because of heart failure, diabetes, an asthma attack or a bad rock climbing fall, it’s the same process.