1. Wilderness Emergencies  More than one hour from medical care  Refer to other texts dealing with “First Aid in the Wilderness”

2. Be Prepared For All Types Of Weather And Circumstances

3. Carry a variety of clothing – Bike ride to Vail

4. Know Your Physical Limits  Bike ride – tiger road

5. Wilderness Prevention #2  Carry first aid kit  Carry cell phone  Hiking in hunting season? – Orange vest  Wear a whistle  Carry a mirror  Let others know where you are going – Notes – Sign in at trail head – Back country permits

6. Wilderness: Prevention #3  Maps - Sometimes trail maps not accurate  Lost in the wilderness? – 3 fires – Stone formations – Create straight line formations  Survival in snow situations – Snow cave, sleeping surface if appropriate  Attend wilderness training sessions

7. Cardiac Arrest Guidelines For Special Circumstances  Start and continue CPR for more than 30 minutes in the following situations – Cold water immersion – Avalanche burial – Hypothermia – Lightning strike

8. Do Not Start CPR  Core temperature less than 60 degrees  Frozen chest  Submerged more than 60 minutes  Rescuer at risk  Lethal injury is evident

9. Dislocations in the Wilderness  Described in test p. 394-398

10. Avalanche Burial

11. Altitude Sickness  AMS (acute mountain sickness)

12. Altitude Sickness #2  Affects more than 70% who are from lower elevations and visit areas of 6,000 to 12,000 feet above sea level.  Altitude illnesses stem from a single problem: Hypoxia  Occurs due to less oxygen at higher altitude coupled with lower air pressure at higher altitudes

13. Altitude Illnesses  Acute mountain sickness: – Headache – Sleeplessness – Fatigue – Shortness of breath – Dizziness – Loss of appetite, vomiting  HAPE: High altitude pulmonary edema  HACE: High altitude cerebral edema

14. Factors That Determine Altitude Sickness  Speed of ascent (Pike’s Peak)  Altitude reached  Health status (father-in-law)  Individual and genetic differences

15. Prevention Of Altitude Illness  Allow time to acclimatize  Diamox Rx  Hydrate  Avoid alcohol the first few days  Avoid taking sleeping pills

16. Lightning Injuries  (Lightning strikes occur 20 million times, annually, in the U.S.)  Direct strike  Splash  Contact from holding object  Ground current  Blast effect

17. Causes Of Injury And Death  Cardiac arrest  Impairment to the central nervous system – Memory loss, seizures, paralysis – Sometimes permanent changes in the thought processes – Entrance and exit burns are rare – Internal injuries are more common

18. Lightning: What To Do  ABC’s  Stabilize spine  Treat for shock (raise legs if appropriate and keep warm)

19. To Avoid Lightning Strikes  Avoid: – Open water – Tractors, metal equipment – Pipes, fences, golf clubs, tennis racquets – Small isolated buildings in open areas  Do not lay flat on the ground  Stay low (ravine or gully)

20. Avoiding Lightning Strikes  In the woods? – Seek overgrown low area – Avoid getting under a large tree – If in a group, spread out (Scouts in Colorado)  A car is one of the safest places – Current travels around the metal, down to the ground (rubber tires are not the safety factor)

21. Avoiding Lightning Strikes  In the house: – Avoid open windows, doors, sinks, appliances, telephone, bath – Strike can be outside with lightning traveling along the lines

22. Wild Animal Attacks  Joggers on mountain trail

23. Wild Animal Attacks: Prevention  Make noise  Carry a walking stick  “Bear spray”  Properly store food – Food on bike ride – Kids camping in Col.  Stay in groups (child who ran ahead)  Do not approach cubs  Sleep in provided outdoor “shelters” if available

24. What To Do If You Encounter A Wild Animal  Don’t approach animal  Don’t turn and run  Back away slowly  Talk loudly (esp. mountain lions)

25. Wild Animal Encounters #2  Make yourself as large as possible – Don’t bend over or crouch down  Pick up any small children  Throw anything you can find (no food)  Fight back except for grizzly and bear with cubs

26. Beware Of Humans In Wilderness Areas  Extremist (Alma), Sally Barber Mine  Tent along road side on bike ride