This is going to come as a great big "duh," but the best way to treat the big 3 killers out in the bush is to prevent it from happening in the first place.
HYPOTHERMIA
Weather in my Personal Space is generally hot. Winter in East Texas generally only lasts a month or two, but is known to freeze for up to a week at a time. However, one does not necessarily need absolute freezing temperatures to become hypothermic if one does not have adequate personal protection from the elements, or has allowed themselves to mix moisture and cold on their bodies.
Prevention: We hairy mammals are well suited for the hot environs, but have little natural defense against cold, other than using our brain, i.e. being aware of our surroundings and wearing warm clothing.
- Know your enemy
- Be prepared for wet, wind, and cold.
- Wear fabrics that stay warm when wet (NO COTTON).
- Stay dry and well hydrated.
- Snack often on quick-burning carbs (sugar).
- Be attentive to yourself, to your companions, and to the environment.
- Do not tolerate the cold or cold extremes.
- React early and quickly.
Stages: Stages are generally associated with the body's core temperature:
98.6F: Normal
97F: Brain impacted. Judgement fails, protective ans survival instincts fade.
96F: Shivering begins as a constant (uncontrollable) fine motor tremor.
94F: Shivering increases, coordination fails, tripping and falling begin.
92F: Shivering becomes intense, patient is unable to walk.
90F: Shivering becomes convulsive, fetal position is adopted, unable to talk.
86F: "Metabolic Icebox." Unconscious, ashen gray, may appear pulseless/breathless.
Signs/Symptoms Any of the following signs/symptoms of hypothermia should be treated immediately.
- Uncontrolled shivering
- Slow, slurred or unclear speech
- Stumbles when walking
- Cannot think clearly
- Feels very tired
- Inability to perform complex tasks
Treatment (Mild to Moderate) Mild to moderately hypothermic victims can warm themselves if allowed to shiver in a dry, insulated environment with adequate caloric intake.
- Change the environment: Find shelter out of snow, off cold ground and/or out of water/rain.
- Replace wet with dry clothing. Dampness in clothing can be subtle; check carefully.
- Add wind and waterproof layers of clothing if possible.
- Insulate the victim
a. add insulation under and around the victim using a ground pad and clothing.
b. insulate victims head and neck, hands and feet.
- Make a fire. If possible, heat stones and wrap in cloth. Place warm stones next to chest, back, groin. Use heat packs if available.
- Encourage victim to eat a meal, preferably starchy or sugary foods.
- For mild hypothermia, light exercise may be beneficial if it can be accomplished safely.
Treatment (Severe)
- Handle victim gently. Avoid rough movement.
- Assist breathing for 5-15 minutes prior to movement.
- Field warming is unrealistic. Prevent further heat loss with hypothermia wrap and evacuate.
- If available, add well-insulated heat packs to victims hands, feet, armpits, groin and neck.
- Get to medical ASAP.
DEHYDRATION
Dehydration underlies many wilderness medical problems and can be serious by itself. It is easily treated if caught early. It develops very quickly and is most dangerous in smaller children. Apart from the obvious (perspiration and inadequate water intake), dehydration can be caused by vomiting, diarrhea, fever, certain medications, alcohol and caffeine (anti-diuretic hormone increased kidneys excretion of water), and respiration.
Prevention:
- drink plenty of water, between 5 to 13 quarts a day
- know your environment
- tailor work to fit the environment (short periods of work and short periods of rest)
Signs/Symptoms
(early)
- Thirst is an early sign, but is not always reliable
- Little no urine output
- Dark urine color
- Dry mouth - not always reliable
- Weakness or fatigue
(latent)
- Dizziness
- Loss of elasticity of skin ("tenting" when pinching skin)
- Increased Heart Rate
- Fainting
- Decreased Blood Pressure
- Swollen Tongue
- Loss of Consciousness
- Shock
Treatment
1. Move to shady/cool area.
2. Give lots of fluids if conscious. Continue to drink until urine becomes clear.
3. Rehydration mix with electrolytes is best, if available
- 1 liter water
- 1/2 teaspoon salt
- 8 teaspoons sugar
4. Find the cause of the dehydration and correct (vomiting, diarrhea, fever, etc)
5. If dehydration is severe, medical intervention will be necessary, as this can quickly lead to life-threatening shock.
SHOCK
Shock is a life-threatening condition. Shock is an inadequate supply of oxygen rich blood to the brain and other body organs and cells.
Prevention: Prevention of shock entails prevention of the contributing cause of the shock itself (severe dehydration, trauma, etc.).
Signs/Symptoms
(early)
- Anxiousness, restless, mild confusion
- Increased heart rate
- Increased respiratory rate
- Pale, cool, clammy
- Victim may feel nauseated (and may vomit) and may complain of dizziness and/or thirst
(late)
- Decreased consciousness
- Blood pressure becomes dangerously low
- Pulse cannot be felt at wrist
Treatment
- Treat before serious signs develop.
- Treat the cause, if known.
- Keep the victim calm.
- Loosen victim's belt, clothing.
- Keep victim flat with legs elevated no more than 12 inches (unless head injury)
- If conscious, give sips of water.
- Watch closely
- If not quickly resolved, seek medical attention.
- If consciousness loss:
- lay victim on left side with head low
- focus on airway, breathing, circulation
- Dont give anything by mouth until regaining consciousness.
- Get to medical quickly
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