 | |||
|
| |||
First Aid
Basic first aid diagnosis, prevention and treatment skills are a must for any hiker hitting
the trail in Ohio. The Ohio woods are home to biting insects and stinging plants. The
trails can be tripping hazards, with jutting rocks and twisting roots hidden under plants
or fallen leaves. Temperatures can be extremely hot or cold and weather conditions
changeable. Improperly fitted footwear can cause painful blisters. It's just plain old
common sense to say that no pack should leave the trailhead without a first aid kit.
Kits specifically pre-assembled for campers and hikers are available from many brick
and mortar and Internet outdoor retailers. If you choose to assemble you own first
aid kit, the following minimum items should be included:
The following are strategies for diagnosis, prevention and treatment of ailments most common to hiking in Ohio's outdoors. Most of us will only have to deal with mild itching, pain and swelling from the more common trail biters and stingers inhabiting our woods: mosquitoes, bees and biting flies (deer and black). For all bites and stings, clean the area first and apply a cold compress. A clean towel or washcloth dipped into a cold stream works in a pinch. For itchiness, apply calamine lotion, hydrocortisone cream, or even baking soda powder to ease the discomfort. Try to limit scratching, which can tear open the skin. Acetaminophen can be taken for pain. Bees leave a stinger in the skin that should be removed by scraping the sting area with your fingernail or a knife blade. Trying to grab the stinger with your fingers or tweezers can cause more venom to be released from the venom sac, causing additional pain and swelling. Prevention of bites includes applying Deet-based repellents to exposed skin. Severe reactions to stings or bites on the trail can cause Anaphylaxis, a life-threatening condition. Anaphylactic symptoms include: difficulty breathing, swelling of lips or throat, faintness, confusion, rapid heartbeat, hives and nausea. If you have known sensitivity to bees or other biters and stingers, you should never leave the trailhead without epinephrine and an antihistamine like Benadryl. Epinephrine is the treatment for Anaphylaxis. A device called an EpiPen has become a popular portable epinephrine auto-injector for people on the go. It's about the size of a marker and slips easily into your pocket. A doctor's prescription is required to obtain one. Ticks hang out in grassy and shrubby areas waiting to tag a ride on a potential warm-blooded "meal". Ticks can carry diseases, such as Lyme disease, so conducting an overall tick check at the end of your hike should become routine, especially when hiking through their prime habitat. Ticks are most active during the months of May through September. Tick bites are typically painless, so you may not notice the presence of one until it has firmly attached itself to your skin. To remove a tick, use tweezers to carefully flip the tick over onto its back. Grasp the tick firmly with the tweezers--without crushing--as close to the skin as possible. Gently pull the tick until it comes free. Twisting or turning the tick does not make removal easier because the mouthparts are barbed, not spiraled. Thoroughly cleanse the bite area with soap and water or a mild disinfectant and observe the bite area for several days for development of a reaction or infection.
Non-poisonous snakebite wounds should be cleaned and disinfected the same as any other wounds. Any bleeding should be allowed to stop on its own unless severe. Apply antibiotic ointment and cover the wound with bandages. A tetanus shot will be needed, so see a physician. Blisters are formed by friction on the skin. For hikers, the source of this friction usually comes from improperly fitted footwear or a pebble in the boot. Wet feet from sweat or water are susceptible to blisters as moisture softens the skin. Hiking boots should be properly broken in before an extended trek and wearing wool or synthetic socks (not cotton) will wick away moisture. Consider building in a friction layer by wearing a silk or polypro liners under hiking socks so that friction occurs between sock layers instead of against your skin. Treat the area of a pre-blister "hot-spot" immediately to prevent a blister from forming. Take off your boots and socks and remove any sand or gravel from your feet. Let your feet dry and cool down and then apply medical tape, a band-aid, or moleskin over the hot area. Once a blister has formed, it should be drained and properly treated to avoid further irritation. Wash the area thoroughly, then with a sterilized needle, puncture along the base of the blister and massage out the fluid, keeping the outer skin intact to protect the tender skin underneath. Next apply antibiotic ointment to the area and affix a donut shaped piece of moleskin around the sore, centered on the deflated blister. Apply a second layer if needed to keep pressure off the sore and eal the whole site off with medical tape.
Most cases of poison ivy can be self-treated with calamine lotion, and Benadryl to help reduce itching. Medical attention should be sought for severe or widespread breakouts on the body. Avoidance is the best measure of prevention. Learn how to identify poison in the field and watch where you walk and what you grab. Stay on established trails, and wear pants and long-sleeved shirts if bushwhacking is in your plans. If you come in contact with the plant, wash exposed skin thoroughly with soap and cool water. Hot water opens the pores and allows urushiol to penetrate. Consider packing an over-the-counter lotion-like IvyBlock--which absorbs urushiol before it contacts the skin. Here is where hiking in all those trees will serve some benefit--lots of dense foliage to block out the harmful sun. This may be true but there will be times when you are exposed to the sun, so precautions still need to be taken. To avoid sunburn, wear a sunscreen with an SPF of 30 or higher and perhaps wear or have at hand a wide-brimmed hat to protect your face and ears and sunglasses for eye protection. Consider wearing pants and a long-sleeved shirt if you burn easily. Many outdoors retailers sell SPF-rated hiking clothes designed for lightweight UV protection. If you do get sunburned, apply sunburn cream or aloe vera--containing no alcohol--to the affected areas and avoid further sun exposure. Take an over-the-counter painkiller if needed. Heat Injuries are the result of elevated body temperatures and excessive fluid loss during periods of exertion, like hiking, in hot conditions. In Ohio, the hot and muggy days of July and August pose the biggest risk, but heat injuries can occur during hot spells in other months as well. Heat cramps are the mildest form of heat injury and occur when sweating causes salt levels to drop during a period of being active. Symptoms include muscle cramps or spasms. To keep heat cramps from becoming a more serious heat injury, take a break, replace fluids and stretch the muscles. Heat exhaustion is more serious and occurs when fluid loss through sweating and respiration exceeds your internal fluid reserves. Essentially, there is not enough coolant to cool the engines. Symptoms include sweating; cramps; pale, clammy skin; fatigue; headache and dizziness. Start your treatment by resting in a shaded, cool location and slowly drinking water or a sports drink containing electrolytes. If feelings of dizziness or faintness persist, lie down and elevate you legs and feet slightly. Splashing or sponging yourself with cool water from a nearby stream can quicken the cooling process. The onslaught of heat stroke occurs when the body's heat-regulating system starts to fail. Heat stroke is a life threatening condition requiring immediate medical attention. Symptoms include hot, dry and flushed skin; elevated body temperature; rapid heartbeat; disorientation, confusion or even seizures. In the field, remove clothing and begin dampening of the body with cool, wet towels until medical help arrives. Fluid replacement should begin as well. Prevention of heat injuries relies on staying properly hydrated. Drink before you feel thirsty and take plenty of breaks. Sports drinks replace important minerals and salt lost during excessive sweating and should be included in your daily fluid intake. Stay away from alcohol or sugary drinks when hiking in hot weather--these actually cause you to lose more fluids. Wear lightweight breathable synthetic clothing. Cold injuries should not be mistaken for injuries sustained only when the mercury dips below 32 degrees. In fact, hypothermia can occur in conditions much above freezing. If you are halfway through a trip and caught unprepared for colder, wetter and windy weather, you are putting yourself in position to enter a hypothermic state. Hypothermia is defined as an internal body temperature less than 95 degrees Fahrenheit. Initial symptoms include shivering, loss of coordination, confusion and a rapid heart rate. As hypothermia progresses and internal body temperatures continue to drop, shivering stops, confusion and delirium advance and heart rates slow. Survivors of advanced hypothermia report losing all sense of reason and logical decision-making. Many have even reported the feeling of warmth returning. Treating hypothermia begins with getting yourself or the victim to a warm shelter or tent, protected from the wind. Any wet clothes should be replaced and the victim wrapped in blankets or a sleeping bag. Re-warming should occur with attention made to the trunk. Warm water bottles or heat packs should be applied to the neck, armpits, groin and the abdomen. If these are not available, consider skin-to-skin contact as an option. Drink warm fluids to stay hydrated. Any person who has been active outdoors in the winter season has felt the sting of freezing air on exposed skin. Prolonged exposure to these conditions can lead to frostbite. Frostbite does not always occur with hypothermia or mean that hypothermia is imminent. Frostbite is a condition where ice crystals actually form in the cells of our tissue as a result of reduced blood flow through constricted blood vessels. Mild frostbite symptoms include burning or throbbing pain. Skin may be red, white or gray in color but remains soft and resilient. If you press against the tissue, the skin indentation springs back. If frostbite is allowed to progress, the skin tissue will lose sensation and may feel cold and solid. Skin will lose resiliency and start to appear pale, blue-tinged and waxy. Small blisters containing clear or bloody fluid are likely to form. At the blister forming stage of frostbite you will need to seek medical attention. More advanced frostbite results in tissue death and full thickness freezing involving muscle tissue and bone. Basic treatment of frostbite is similar to treatment of hypothermia. First, you or the victim must be taken out of the cold to a warm shelter or tent. Change out of any wet or damp clothing. Warm your hands by tucking them under your arms or burying them in the groin area. If your nose, ears or face is frostbitten, warm the area by covering it with dry, gloved hands. Cold feet should be wrapped in a sleeping bag with dry socks on. Never rub or massage frostbitten areas. Warm, not hot, water bottles pressed on the skin can provide spot warming for mild cases of frostbite. Never us an open flame to treat frostbite. Campfires are okay for warming up when chilled but not recommended for thawing frozen skin, as this can lead to burns. Common sense prevention is the best defense against cold weather injuries. For cold weather hiking, always pack a little extra for sake of preparedness. Any cold weather injury is not worth the pound or two of pack weight saved by packing conservatively. Dressing should be in lightweight, non-bulky layers. Layers allow you to add and remove clothing as daily temperatures and your level of exertion fluctuate throughout the day. It is also important to stay dry as wet or damp skin and clothing accelerate chilling. Start with a wicking layer to transport sweat and moisture away from your skin. Next, put on an insulating layer of fleece or wool followed by a wind/rain repellent outer shell. Whatever you do, stay away from cotton. One rule to remember when dressing for a winter trip is that dead space is insulating space. This means airspace between layers and around feet and hands provides insulation, warmth and draws moisture away from the skin. Wearing tight clothing or cramming feet with thick winter socks into undersized boots will only cause you to become colder more quickly. Always carry extra socks in case your feet get wet. A hat is a must for retaining body heat. As with heat injuries, adequate nutrition and hydration protect the body against cold weather injuries. You can lose fluids though sweating in sub-freezing temperatures while not realizing it. Limiting or eliminating alcohol and tobacco use during a winter trip will help keep your core body temperature up. Use of pocket heaters or foot warmers is advised. These air-activated, dry chemical bags provide heat for hours and are inexpensive and easy to find. Every hiker will trip, stumble or fall at some point in time on the trail. With any luck you'll walk away uninjured or mildly sprained. If it's not your lucky day, then you'll likely suffer a trip ending dislocation or bone fracture. Sprains are a result of an accidentally overstretched ligament. Strains are injury to muscles or tendons. The signs and symptoms for sprains or strains include pain, swelling, tenderness and possibly black and blue discoloration. For treatment think RICE, but not the kind you eat. R-Rest. I-Ice (if available) or cold compresses the first day for 20 minutes every 3-4 hours. C-Compression with an Ace bandage to stabilize. E-Elevate the affected area. For ankle sprains, don't compromise circulation by forcing boots on over a swollen foot. Seek medical attention when an affected joint or limb becomes numb, cannot be moved, looks disfigured or buckles under normal use. A dislocation occurs when two bones become separated at the joint. Dislocations can be very painful and the possibility exists for injury to tissue and blood vessels around the separation. A fracture is a break in the bone. Several types exist, but fractures resulting in bone penetration through the skin (called a compound fracture) are more dangerous. Tenderness, swelling, deformity and discoloration occur with both fractures and dislocations. If nerves are affected, sensation may be lost below the dislocated area. Bleeding can occur with compound fractures.
Treatment for fracture and dislocations begins with applying a cold pack to the
injured area to decrease pain and swelling. The injured area needs to immobilized
with a splint made from any available material, like sticks or trekking poles,
to reduce the risk of further injury. Pain relievers should be taken for pain
management. Open wounds associated with compound fractures should be flushed with
clean, fresh water and covered with dry dressing. Although there is some support
by wilderness medicine practitioners for immediate bone reduction (setting into place)
of dislocated bones, unless you have had medical training, you may not know the
severity of the dislocation and could cause additional trauma to the bones, joints
or surrounding tissue and nerves. It wise to err on the side of caution here,
immobilize the dislocation and then work on a plan for evacuation. Remember, you
are in Ohio, so medical help is likely just hours away, and not days.
Next Section -->
|
CURRENT MOON
|
||
The likelihood of being bitten by a snake on the trail is very slim.
Keeping a keen eye focused on the areas you step, sit or reach will minimize your chances
of an unpleasant encounter. Being able to identify Ohio's poisonous and non-poisonous
snakes in the field will help you choose the course of action required in case of a bite.
As discussed earlier, Ohio hill country is home to two poisonous snakes, the Northern
copperhead and timber rattlesnake. A third, the Eastern massasauga, is not found in hill
country. Bites inflicted by any one of the venomous trio can cause pain and illness but
are rarely fatal. A number of old first aid snakebite treatments you may be familiar with
have fallen out of favor and are no longer recommended by the medical community. These
include cut and suck techniques, use of tourniquets and constricting bands and applying
ice or alcohol to the bite area.
Revised recommendations for treatment call for little or no effort to remove or restrict
the flow of venom as this can lead to tissue damage or infection, although use of
negative-pressure suctioning devices-like the Sawyer Extractor-have shown some benefit
if used within several minutes of envenomation. If you are bitten, remain calm and immobilize
the affected limb below the heart. Loosely splint it if necessary. Any jewelry that could
restrict blood flow as swelling occurs should be removed. Next, you will need to seek medical
attention as soon as possible. If your only option is to walk out, do so in a calm manner,
using the affected limb as little as possible. Don't walk back to your car if other points
of contact with people are closer, like a house or road. If you are carrying a cell phone,
check for service often and call for help at the moment a signal is detected. In a group,
the victim should be kept still and not try to walk out. Other members of the group should
seek help while some stay behind to comfort and monitor the victim.
As a child, if you spent any time at all in the out of doors, your parents probably
warned you about poison ivy. It may be one of Ohio's most identifiable plants. Poison
ivy grows as vines or shrubs with smooth or even notched leaves clustered in groups of
three. The itchy rash that develops after touching poison ivy is actually an allergic
reaction to an oil, called urushiol, secreted by most parts of the plant. The rash usually
develops within 24-72 hours of contact with the plant and starts as small red bumps and
later develops into blisters. Only skin exposed to the plant's oil develops a rash; the
rash does not spread by scratching or oozing blisters. If the hands are exposed to urushiol,
touching other parts of the body can transfer the rash inducing oil.