Connecticut Water Trails Association
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Connecticut Water Trails Association |
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Connecticut Water Trails Program
DISCLAIMER: The following information is not
intended, nor should it be assumed to be, a substitute for formal
training in First Aid treatment and procedures. This information is
presented to raise awareness of some medical conditions which can arise
on paddling trips so that participants may better prepare themselves for
all eventualities. The information presented is not intended to replace
advice or instructions given by trained professional medical personnel.
Information herein is taken from various professional medical resources.
It must be realized that improper or inadequate treatment of injuries
can result in damages that sometimes are greater than doing nothing at
all. Whenever possible and practical the assistance of trained,
professional medical personnel should be summoned to administer
treatment for serious injuries. The nature of outdoor recreation is such
that injuries sometimes occur in remote areas far from available
professional assistance. The information in this section is intended to
be a helpful guide for treatment of injuries in such cases when getting
professional help is not immediate and the nature of the injuries
requires prompt attention. It is recommended that paddlers take an
outdoor first aid training course such as Wilderness First Aid.
There are several health risks or conditions that
you may encounter in paddling. Since medical help and facilities are not
readily available in the outdoors, immediate care must be given to the
person who is in a risky or even life-threatening situation.
The information provided below is in no way complete
but will give you some of the basics of first aid. It is important to
undergo formal first aid training and know the ins and outs of giving
immediate care.
Everyone knows that prevention is always the best medicine. Here are some tips to keep in mind that will help you avoid potential injuries:
Using common sense, not pushing ones self beyond
personal limits and having a respect for the potential dangers of
wilderness travel will keep 99% of canoe campers safe and free from
major injuries. Since immediate medical help can be quite a distance
away, knowing how to splint a leg, provide mouth-to-mouth resuscitation,
or cardiopulmonary resuscitation (CPR) prior to the trip is advisable.
Should a severe injury occur, use the following check list to ensure the
victim will be as comfortable as possible until help arrives.
Remove victim to a safe spot if they are in a
dangerous or life threatening location. DO NOT immediately move them if
a neck or back injury is suspected. Instead, properly immobilize the
neck and back before moving to prevent further injury.
Paddling is a sport that is enjoyed in places where
many types and species of things that bite and sting exist. Some of
these creatures include mosquitoes, chiggers, ticks, spiders, ants,
bees, wasps, hornets, scorpions and other unsavory critters. While
generally nothing more than a nuisance, bites and stings can have very
serious consequences on some people due to allergic reactions or
poisoning, as with certain spiders and scorpions. For the rest they can
produce varying levels of discomfort, sometimes distracting a paddler
from the tasks at hand when running a river where attention is
necessary. In rare cases bites and stings can result in serious injury
or even death. For these reasons it is advisable to know and understand
how to identify and avoid certain insects and spiders, and treat
injuries inflicted by bites and stings that may occur while paddling.
Because of the diverse nature of these types of injuries and their
treatments this section will be broken down into discussions about each
significant malady.
Sometimes, paddlers encounter biting animals such as
dogs, cats, raccoons, skunks, rats, bats, or a number of other animals
that may exist in areas on or near rivers. Animal bites can be very
serious, and can sometimes lead to crippling diseases or death. Rabies
is one of the worst diseases that can be acquired from animal bites,
especially in the wilderness, and its treatment is costly and painful.
Wild animals should generally be observed, but not approached whenever
possible. Pets taken along on river trips should be restrained to
prevent them from confrontations with diseased animals.
In the event an animal bite is suffered the
following steps should be taken to reduce injury:
f you must kill an attacking animal after a bite is suffered, then DO NOT damage its head - instead, remove the head carefully, place it in a sealed plastic bag, and bring it to the medical facility along with the victim. In the case of rabies the brain must be examined to determine the presence of the disease so that appropriate treatment may begin as soon as possible. Rabid animals act irrationally, display a general fear of water (hydrophobia) and may exhibit foaming around the mouth, depending upon the stage of development of the disease within them
Common Bites and Stings Common allergic reactions frequently occur from the
bites or stings of fire ants, hornets, honey bees, yellow jackets and
wasps. Commercially available remedies for these types of injuries
should be a standard component of any good First Aid kit. Depending upon
the severity of the bite or sting reaction may vary from a minor
nuisance to serious complications. Some common signs and symptoms of
insect bites and stings may include:
1. Itching, swelling, redness and/or pain around the
afflicted area; 2. Breathing difficulties, trouble swallowing,
abdominal cramps, flushing, hives or similar traits; 3. In extreme cases, shock or even death.
Depending upon the nature and severity of the bite
or sting, and the allergic reaction of the victim, the flowing actions
may be required to treat the injury and its symptoms:
1. Keep the victim lying down, calm, still and warm; 2. Immobilize the wound, keeping it at or just
slightly below the level of the heart; 3. Unless the victim objects, remove anyjewelry or
restrictive clothing around the affected area; 4. Scrape stingers away from the wound using the
edge of a plastic card, plastic picnic knife or other non-cutting object
- do NOT use tweezers to remove a stinger; 5. Using soap and water, carefully wash and rinse
the affected area twice; 6. Use a cold pack or cold compress to prevent or
reduce pain and swelling; 7. Remember your ABC's - monitor airways, breathing
and circulation, and treat any complications; 8. If necessary, treat for shock or state of shock; 9. Get professional medical assistance as quickly as
possible, if needed or if unsure.
Some spiders are capable of inflicting very painful,
and sometimes deadly, injuries. In order of priority, the two most
serious spider bites resulting in injury or death are from the black
widow and the brown recluse. These can be as dangerous, or more so, than
the bite of a poisonous snake, and great care should be taken to avoid
them whenever possible.
The black widow is a small, jet-black spider with a
red hourglass-shaped marking on the underside of its abdomen. Those
spiders with a similar-looking white marking on their backs are
NOT
black widows, though they are frequently mistaken for them. The bite of
a black widow may produce these symptoms and signs: 1. Pain and spasms in the chest, shoulders, back and
abdominal muscles within 30 minutes after a bite; 2. Nausea, vomiting and rigidity in the abdomen; 3. Anxiety, fear, rashes and sweating.
If you know of, or suspect, a black widow bite, then
these actions should be taken immediately: 1. Apply cold packs to the bite area (do
NOT use ice!); 2. Monitor airways, breathing and circulation,
treating any complications that arise; 3. Treat for shock or state of shock, if necessary; 4. Transport the victim (and the spider, if
possible) to the nearest professional medical treatment center
ASAP! The second most serious spider bite is that of the
brown recluse, a yellow to dark brown spider with long legs and a
distinctive marking on its upper back that resembles a violin. The bite
of a brown recluse is very serious - it is a non-healing injury that
requires skin grafts to repair. Contact with the brown recluse should be
avoided whenever possible, and especially in remote areas where
professional medical treatment is unavailable for an extended period of
hours or days.
A brown recluse bite will produce these symptoms and
signs: 1. A white area surrounded by a blue "bulls-eye"
that eventually turns red; 2. Nausea, vomiting, chills, fever and pain in the
joints within 24 hours; 3. An ulcer within 10 days.
If you know of, or suspect, a brown recluse bite,
then these actions should be taken immediately: 1. Monitor airways, breathing and circulation,
treating any complications that arise; 2. Treat for shock or state of shock, if necessary; 3. Transport the victim (and
the spider, if possible) to the nearest professional medical treatment
center
ASAP!
Ticks come in a wide variety of sizes and shapes,
and most pose nothing more than a minor inconvenience, though it is
always best to remove them as soon as possible. Ticks are bloodsuckers,
and can carry diseases such as Lyme Disease, Rock Mountain Spotted Fever
and many other bacterial diseases that are transmitted directly into the
bloodstream. The most serious of these illnesses is Lyme Disease, a
condition that is transmitted by the Deer Tick, a very small, and hard
to detect species of ticks. We are fortunate in that Deer Ticks are not
generally found in Texas and surrounding states (most cases reported
have been in the far northeast U.S.), but that could always change. Hats
should always be worn in the wilderness, where ticks are known to
populate, and animals taken into tick country should be pre-treated to
repel tick bites.
1. A reddish circular rash, sometimes with a crusty
border around it; 2. Chills and fever; 3. Blurred vision, joint and muscle pain and
stiffness, and difficulty moving; 4. Symptoms of arthritis.
Signs and symptoms often associated with
Rocky Mountain Spotted
Fever include nausea, vomiting, general weakness and
abdominal pains, such signs usually appearing about 10 days after the
bite. Treatment for tick bites is as follows: 1. Grasping the tick as close to the skin as
possible using tweezers, remove it as soon as possible; 2. Wash the tick bite area with soap and water; 3. Make a note of the date on which the bite was
received for future reference in the event of complications.
Each year, about 9,000 people are bitten by
poisonous snakes in the U.S. Only about 15-25% actually receives venom,
and U.S. deaths from snakebites only total about ten or fewer people
annually. In 2002, there were only 9 snakebite deaths in the US. Yet,
snakebites are one of the most feared of the problems that can confront
paddlers, hikers, campers and others who enjoy the outdoors. Most
snakebite deaths occur in small, young children whose lack of body mass
and immune system development make them more susceptible to snake venom.
However, a far larger number of people suffer medical complications
ranging from mild to serious problems from improper treatment than the
number who die. Therefore, knowing what to do to avoid snakebites and
how to properly treat them if they occur is critical to preventing
permanent injury or death.
The most serious complication from improper
snakebite treatment is amputation of a foot, leg, hand or arm, the parts
of the body where most snakebites are most commonly received. If you
have a snakebite kit, then THROW
IT AWAY! According to the American Medical Association, snakebite
kits are useless at best and dangerous at worst. Since most people do
not have serious long-term complications from snakebites it is generally
best to seek professional medical help as soon as possible after a bite.
The only acknowledged practical field treatment of a poisonous snakebite
is use of a Sawyer Extractor, but it must be used within 30 minutes of
the bite to be effective. By the very nature of paddlesports, getting
professional help may be many hours, or even days, away. Therefore,
field treatment may be necessary and paddlers should know how to
properly administer the type of treatment that will prevent serious
complications. A good place to start is by knowing about snakes and
snakebites.
In the U.S. there are about 20 species of poisonous
snakes belonging to four families and two groupings. The most common
group includes the families of rattlesnakes, copperheads and water
moccasins, snakes commonly referred to as "pit vipers" because of the
heat-sensing pits located near their eyes and used to detect
warm-blooded creatures and direct strikes to their targets. This group
of snakes produces "hemotoxic" poisons that work by invading the
lymphatic stream to reach the hearts of victims. The most common snakes
of this group are the various species of the rattlesnake family, but the
ones most commonly encountered by paddlers are water moccasins, also
known as "cottonmouth" water moccasins because of the white color of
their inner mouths. Copperheads are the least commonly encountered. All
are excellent swimmers and tree climbers.
It is important to realize that all these snakes are
very timid, and will avoid human contact whenever possible. Most
snakebites occur when stepping on or attempting to handle snakes. Water
moccasins are very curious, but they tend to flee once they realize that
their presence is detected. Many bites from rattlers and copperheads
occur from people lifting wood, rocks or other ground cover under which
the snakes are taking shelter from the sun. Turning ground cover with a
stick, pole or other long object should always be done prior to lifting
when in snake country. Gathering firewood at night is highly
inadvisable. Walking barefoot, walking in the dark at night, placing
hands or feet where snakes may be resting and stepping over, rather than
on, logs are common ways of getting bitten.
DO NOT
attempt to handle snakes. And, do not indiscriminately kill them either
- snakes serve a very significant purpose in the ecosystem and are more
useful in killing and eliminating disease-plagued rodents than they are
harmful to humans.
On and around rivers the most commonly encountered
snakes are the poisonous water moccasin and the non-poisonous water
snakes. Water moccasins tend to be colored charcoal grey, black or dark
brown, with yellowish-white bellies and a white inner mouth. Like all
pit vipers, they have vertical slit eyeballs and triangular heads. Their
bodies are generally thin, with an adult length of 3-4 feet, though they
may be larger and longer on some occasions. Water moccasins are seldom
found on cold-water rivers, though that is not a hard and fast rule.
They will usually be seen from late spring to early fall, and become
very inactive in cold weather.
Water snakes have round eyeballs, thick bodies, and
may reach lengths of 5-6 feet or more. While water moccasins tend to
swim completely on the surface of the water a diamondback water snake
will probably have nothing but its head above water. Its body mass is
too great to be supported by the surface tension of water. Also, water
snakes primarily feed on fish, crawdads and other creatures found
underwater, so they spend most of their time beneath the surface, coming
up mainly for a breath of fresh air.
The second group of snakes found in the U.S. is the family of coral snakes, a relative of cobras, adders and mambas. These snakes have round eyes, rounded heads, and neurotoxin poison that directly attacks the central nervous system resulting in interruption of lung, heart and other organ functions leading to paralysis and/or death. Coral snakes have no fangs, and must chew to inject venom. For that reason most adults are not candidates for coral snake bites. Coral snakes are very rare, and most injuries from them are caused by handling, where they can bite on the soft tissue of fingers, hands or the areas between fingers, feet, toes or the soft tissue between toes. Because of the small size of coral snake heads they cannot open their mouths wide enough to bite on large surface areas, nor would their teeth be likely to penetrate tough skin. Coral snakes bear a very strong resemblance to the much larger and non-poisonous king snakes. Both have alternating bands of red, black and yellow with black heads. The easiest way to tell the difference is the sequence of color bands. Remember this - Red touches black is a friend of Jack; red touches yellow kills a fellow. Coral snakes are found almost exclusively in the southern and southeastern U.S, while pit vipers may be found in almost any state except Alaska, Hawaii and Maine.
There are actions that can be taken to treat
poisonous snakebites while getting a victim to professional medical
treatment. Whenever possible, these should be administered enroute to a
hospital or other professional help. However, at times it may be
necessary to provide as much treatment in the field as possible due to
remoteness and distance from (or time required to get to) professional
assistance. Help can usually be found at hospitals, ranger stations,
fire stations with EMS services, doctors' offices or similar places.
Field treatment is only helpful when done properly, and administering
treatment improperly may result in serious injury or death to the
victim. The main points to remember are these: Apply a splint and sling,
if possible, and transport the victim to professional medical attention
as quickly as possible. There are very few effective measures that can
be taken by a layman in the field, and most actions taken will increase
the damage from the snakebite injury. In the case of a pit viper bite in
the United States,
DO NOT apply
ANYTHING that in any way impedes blood flow and circulation.
Such actions often result in severe dermal necrosis (tissue death in the
constricted area where poison is trapped.) Below are some Do's and
Don'ts for treating snakebites:
Things To Do
Things Not To Do
Following the above protocols will greatly reduce
the chances of serious complications from snakebites. Bear in mind that
few people die from poisonous snakebites and the vast majority of
snakebite victims are not even venomized. Snakes generally reserve their
venom for prey they intend to eat. If you encounter a snake that can eat
you, then you have a much bigger problem than poisoning! No such snakes
exist, especially in the U.S. Above all else,
DO NOT
PANIC! Snakebites are more a
nuisance than a serious medical problem in most cases, and in the other
cases panic will merely result in a loss of efficiency in getting a
victim to professional treatment, which may result in serious injury or
death.
Bleeding (or hemorrhaging) is the flow of blood from
veins, arteries and capillaries, either internally or externally. Veins
carry blood to the heart, arteries carry blood away from the heart and
capillaries are the very small channels that carry blood to all parts of
the body. Blood flowing from a capillary will be slowly oozing, as from
a minor cut. Flowing from a vein, blood will be a steady flow of a red
or dark red color. Arterial bleeding will spurt from a wound in a bright
red color, and is definitely life-threatening - it must be stopped
quickly to prevent death to the victim, but it is also difficult to
control, especially without proper medical training. It is important to
understand how blood flows, why it flows and what can be done to control
blood loss without causing the onset of gangrene, a condition that often
results in amputation and/or death.
The body of an adult contains roughly 10-12 pints (5-6 quarts) of blood, and can lose about a pint without serious side-effects, as is the case when donating blood. However, a loss of 2 pints will usually cause the onset of shock, and losing 5-6 pints will usually result in death. Depending upon the nature and severity of bleeding, prompt actions should be taken to stop the loss of blood and save the life of a bleeding victim. In the case of an internal broken bone determining the presence and extent of bleeding may be very difficult, but with open fractures it is quite evident. Internal bleeding can be diagnosed by observing blood flow from the mouth, eyes, ears, nose, rectum or other body openings. While severe, there is generally adequate time to calmly think and act with measures that will control bleeding and reduce injury to the victim.
To properly apply a tourniquet, follow these
procedures: 1. Apply pressure to the proper pressure point
between the injury and the heart; 2. Place the tourniquet between the heart and the
wound, but leaving at least two inches of uncovered area around the
wound - DO NOT place the tourniquet directly over the wound!; 3. Place a sterile pad or other cloth covering
directly over the artery; 4. Wrap the tourniquet around the arm or leg TWICE,
then tie with a single (half) knot on the upper surface; 5. Place a short stick or other rigid object
directly over the half knot, then secure it with a square knot; 6. Twist the stick to tighten the tourniquet until
bleeding stops or is controlled; 7. Secure the stick in place to maintain pressure on
the artery - Do NOT cover the tourniquet! 8. Using lipstick, a felt tip marker or some other
method, make a "T" and the time the tourniquet was attached on the
victim's forehead; 9. NEVER
loosen or remove a tourniquet once it has been applied - to do so could
dislodge blood clots and cause cause additional blood loss, shock and/or
death.
Do not touch open wounds with your hands, fingers or
anything that may expose the injury to contamination, germs, bacteria or
pathogens. Whenever possible, avoid direct contact with the blood of
another person. Immediately after treating a bleeding wound wash your
hands thoroughly using soap and water (hot water, if available.) The
transmission of blood-born diseases cannot be taken for granted. Even if
you wore surgical gloves or used another barrier between the wound and
yourself, wash your hands thoroughly after treatment is applied. If time
allows, it would also be a good idea to wash them before beginning
treatment to reduce the chances of introducing contaminants into the
wound.
Signs of internal bleeding
include anxiety and restlessness, excessive thirst, nausea and vomiting,
pale and moist skin (cold and clammy feeling), rapid breathing, rapid,
weak pulse and bruising or discoloration around the injury area. If
internal bleeding is suspected, then follow these procedures
IMMEDIATELY:
1. For bruising, apply cold packs to reduce swelling
and pain; 2. For severe internal bleeding, A. Summon professional medical assistance at once; B. Monitor airway, breathing and circulations
(ABC's); C. Treat for shock; D. Make the victim as comfortable as possible; E. Maintain a normal body temperature; F. Keep the victim calm and reassured that
everything is being done to help him or her, and that professional
assistance has been called.
1. Keep the victim sitting up, still, quiet and with
the head tilted forward; 2. If the cause of the nosebleed is not a fracture,
then pinch the nose shut, put ice packs or cold packs on the bridge of
the nose, apply pressure to the upper lip just below the nose, and tell
the victim not to pick, blow or rub is or her nose; 3. If the nosebleed is the result of high blood
pressure, or if the bleeding continues or restarts, then get
professional medical assistance quickly; 4. If the victim loses consciousness, then lay him
or her on the side so blood can drain, and get professional medical
assistance at once.
If a foreign object is lodged in the nose, then do NOT try to remove it, as doing so may result in nasal damage. Seek professional medical help. Attempts by unqualified persons to remove a foreign object from the nose may result in pushing it further into the nose and increasing the degree of injury. Severe bleeding, either internally or externally, should be treated promptly by trained medical personnel. Do NOT waste time in summoning a doctor or paramedic for such injuries. All bleeding victims should be treated for shock to prevent its onset or to reduce its effects after it has started to occur. What may appear to be minor bleeding to the untrained eye may be a symptom of a major medical condition that requires professional medical assistance quickly.
Broken bones are an infrequent, but occasional,
occurrence that sometimes happen to paddlers. More often than not, bone
fractures will be the result of body slamming rocks or trees while
running whitewater or wild water rivers. They are classified as either
simple or compound, a simple fracture being one in which a bone is
broken with no abrasion of the outer skin and a compound fracture being
one resulting in broken bones protruding through the skin and exposed.
Both are very painful, but a compound fracture is worse, by far. In
addition to treating the bone break one must also treat the broken skin
to prevent internal infection and stop excessive bleeding. Since
professional medical help may not be readily available paddlers should
have a good knowledge of how to properly field-treat broken bones before
transporting a victim to a hospital or other medical service. Another
possible side effect of broken bones and blood loss can be shock or a
state of shock, either of which must be recognized and treated properly
and swiftly.
It is almost always necessary to splint broken bones
to prevent further pain and reduce the chances that a jagged edge of a
bone will cause internal or external bleeding. Because compound
fractures are so serious you should have a basic understanding of blood
flow, which must be contained always, and especially in cases where the
fracture is compound (open).
Splints can be made of just about any rigid material
including wood, metal, heavy plastics, or thick folds of newspapers,
clothing, paddles, rifles, wire mesh, sticks, tree limbs or anything
else that is available and which can be securely attached both above and
below the suspected or known break area. Splints should always be
paddled to reduce discomfort and prevent further damage. Any article of
clothing, blankets, sleeping bags, grass, leaves, newspaper, PFDs or
other soft items may be used to pad a splint, which is then secured
using pieces of torn cloth, rope, wire or anything else available that
will hold the splint in place. It is imperative that open wounds not be
exposed to anything that can cause infections, such as using grasses or
leaves for padding, and it is also critical that rope, wire or other
items used to secure the splint do not cut into the skin or otherwise
cause additional injury. The objective is immobilize the injury for
transportation to professional medical assistance. Naturally, a
pneumatic or tension splint would be optimal, but few paddlers carry
those with them.
1. Control bleeding with direct pressure or indirect
pressure (use a tourniquet only as a last resort); 2. Treat for shock or a state of shock if victim
shows any signs of such condition; 3. Carefully check the airway, breathing, and
(blood) circulation (ABCs); 4. Gently cut away any restrictive clothing so that
movement of the injured part does not occur causing further damage.
Remove all jewelry from the injury site unless the victims resists; 5. Check the pulse around the injured part and, if
pulse is absent, gently move it to restore blood circulation; 6. Cover all wounds, including open fractures, with
sterile dressings. Avoid pushing bone ends back into the skin. Avoid
excessive pressure on or around the wound area; 7. Apply a stiff splint -
DO NOT attempt to straighten broken bones; a. Apply and maintain traction until the splint has
been secured. b. Wrap from the bottom of the splint to the top
firmly but not so tightly as to cut off blood flow and circulation. c. Check the pulse above and below the injury to
ensure that circulation is still present. If the pulse cannot be felt,
then loosen the splint until circulation returns.
DO NOT move the victim until the injury has been
securely splinted. 8. Summon professional medical assistance at once, if possible. All suspected fractures require professional medical treatment. If professional medical help is not readily available, then secure the injury as best you can, immobilize the victim, and prepare to evacuate the victim on a stretcher or using a sling carrying method that will minimize movement of the broken bone area. Carry a bone-break victim downriver in a canoe only if a measure of last resort, and try to avoid running any rapids, dams or other drops that can cause further injury.
Hypothermia
Hypothermia is a medical condition which usually
occurs when the body is exposed extreme cold for a certain period of
time. It can be really dangerous when the body temperature drops very
quickly. In paddling, exposure to cold water even for just a short
period of time can lower the body’s core temperature. Initial symptoms
include shivering and paleness. Lethargy, dull eyes, and slurred speech
are some of the signs of worse cases of Hypothermia.
Hypothermia can be fatal if not prevented so
precautions must be made to avoid getting this health risk. Before
running the rapids, make sure you are wearing appropriate
Paddling Clothing. You can follow the Three Layer System,
wherein you wear two to three layers of clothes that will keep you warm,
dry, and protected during the trip.
When a paddler gets Hypothermia, warm the victim up as soon as possible and seek medical assistance. You can also create a warm and sheltered environment by sharing body warmth with the victim.
1. Wearing gloves, carefully remove contaminated
clothing, being careful not to spread the contamination to the affected
person or others; 2. Carefully brush away dry substances and/or absorb
liquid substances; 3. Thoroughly flush the affected area with large
quantities of clean water (use a shower or hose, if available); 4. Monitor the airway, breathing and circulation
(ABC's) of the victim; 5. Treat for shock, if necessary; 6. Contact local or national Poison Control Center
or professional medical help immediately, if necessary; 7. Get immediate medical help for absorption
poisoning. DO NOT overreact! Some contact poisonings are very minor, and may cause nothing more than an inconvenience and minor discomfort. However, if there is any doubt as to the severity of the poisoning, then do not delay in summoning professional medical assistance or transporting the victim as quickly as possible. If symptoms appear to be serious, or the victim reacts in such a way as to suggest the onset of major complications, then take no chances and seek professional help immediately.
Cuts and abrasions are common injuries that occur
during outdoor recreation activities. Usually, such injuries are minor,
and can be adequately treated at the scene by almost anybody with even a
rudimentary knowledge about First Aid. Serious cuts, however, can result
in substantial blood loss, shock, temporary or permanent loss of use of
a body part or, in extreme cases, even death. It is important for those
participating in outdoor recreation activities to be able to identify
the severity of cuts and abrasions, and then take appropriate actions to
field treat those injuries while making decisions about the need for
professional medical assistance.
In most cases, a cut or abrasion can be effectively
treated by cleaning the wound with clean water and a sterile gauze pad
or piece of cloth, then sterilizing the injury with hydrogen peroxide
before applying a bandage to prevent dirt or other foreign matter from
getting into the cut or abrasion. In the case of simple abrasions,
treatment can be as easy as applying an appropriate quantity of
hydrocortisone ointment or cream, then covering to prevent
contamination. If substantial blood loss is occurring, then it is
mandatory to stop the bleeding and get the victim to professional
medical help as quickly as possible. Proper steps should be taken to
prevent shock and further injury (see
Treating Bleeding
Injuries for additional information about health and safety aspects of
bleeding injuries.)
Bleeding
(or hemorrhaging) is the flow of blood from veins, arteries and
capillaries, either internally or externally. Veins carry blood to the
heart, arteries carry blood away from the heart and capillaries are the
very small channels that carry blood to all parts of the body. Blood
flowing from a capillary will be slowly oozing, as from a minor cut.
Flowing from a vein, blood will be a steady flow of a red or dark red
color. Arterial bleeding will spurt from a wound in a bright red color,
and is definitely life-threatening - it must be stopped quickly to
prevent death to the victim, but it is also difficult to control,
especially without proper medical training. It is important to
understand how blood flows, why it flows and what can be done to control
blood loss without causing the onset of gangrene, a condition that often
results in amputation and/or death.
The body of an adult contains roughly 10-12 pints
(5-6 quarts) of blood, and can lose about a pint without serious
side-effects, as is the case when donating blood. However, a loss of 2
pints will usually cause on the onset of shock, and losing 5-6 pints
will usually result in death. Depending upon the nature and severity of
bleeding, prompt actions should be taken to stop the loss of blood and
save the life of a bleeding victim. In the case of an internal broken
bone determining the presence and extent of bleeding may be very
difficult, but with open fractures it is quite evident. Internal
bleeding can be diagnosed by observing blood flow from the mouth, eyes,
ears, nose, rectum or other body openings. While severe, there is
generally adequate time to calmly think and act with measures that will
control bleeding and reduce injury to the victim.
For a complete reading on
treating bleeding please click
HERE.
Cuts can often be effectively treated by cleaning and sterilizing, then covering with a Band Aid. However, due to the nature of outdoor recreation activities, where strenuous activity is exerted, and especially where immersion in water is likely, the wound should be covered with a gauze bandage or Telfa pad, and then securely taped into place to prevent its premature removal. A good First Aid kit should contain everything an outdoorsman needs for treating minor cuts and abrasions. Injuries of a more serious nature must be treated immediately and effectively enough to stop or greatly reduce the loss of blood before transporting the victim to a hospital or other medical facility. Direct pressure on the wound is often required stop the flow of blood, and a secure bandage that is tight enough to prevent excess bleeding, while remaining loose enough not to completely cut off blood circulation, is necessary as a field dressing. Butterfly bandages, if available, are very effective ways of closing cuts, but strips of cloth can be effective in a crunch when other materials such as tape or butterflies are not available, as long as unsterilized material is kept away from the wound.
Through the activities of daily living, the average
day's loss of fluid is four liters, which is generally replaced by the
fluid we drink and the food we eat. But the amount of fluid required can
be significantly increased by exercise, sweating, diarrhea, temperature
or altitude. The most common cause of increased fluid loss is exercise
and sweating.
The effects of even mild dehydration are decreased
coordination, fatigue, and impairment of judgment. These factors can
increase the difficulty of your paddle outing and could lead to an
accident.
On a global basis heat-related illnesses are a major
cause of preventable injury and death. Due to the nature of paddle
sports heat-related injuries are quite common, especially where paddlers
are running cold water in warm weather and wearing wetsuits, drysuits or
Goretex (tm) clothing that repel water and trap body heat. It is
important to know the types of heat-related injuries that can occur, how
to recognize the onset of these problems and what to do to effectively
prevent them, treat them and forestall serious injury or death.
The major illnesses are heat exhaustion and heat
stroke, generally caused by electrolyte loss, dehydration and a failure
of the body's temperature regulatory system, which should kick in
automatically to vent excess core heat and prevent heat-related
problems. However, there are several other heat-related illnesses, some
or all of which can and will presage the onset of the two more serious
injuries. These include heat cramps, hyperthermia and a host of similar
symptomatic signs of impending heat exhaustion or heat stroke.
Heat-related illnesses occur in young and old alike,
though usually for completely different reasons. Paddlers risk
heat-related injuries when running rivers in hot, humid conditions where
solar exposure, outside air temperatures, high humidity and lack of
adequate fluids intake combine to affect the active body. This is
complicated by the wearing of wetsuits, drysuits or other insulating
garments that do not allow radiated or evaporated body heat to escape.
Heat exhaustion is an acute heat-related injury characterized by
hyperthermia caused by severe dehydration. Whenever environmental and/or
bodily regulatory mechanisms fail and prevent the dissipation of heat
the body is in jeopardy of heat exhaustion.
Prolonging a hyperthermic condition can lead to heat
exhaustion. Left untreated, that can lead to heat stroke and possibly
death. The body naturally fights the effects of heat-related problems
through radiation and evaporation. However, the body loses its ability
to radiate heat at outside air temperatures of 95° F, at which time only
evaporation remains as a means of venting heat from the body's core.
Wearing protective river gear can, and often does, prevent effective
evaporation while trapping escaping heat on the skin's surface and
insulating the body from cooling conditions. The National Oceanic and
Atmospheric Administration (NOAA) estimates that nearly 200 Americans
die each year from heat-related problems, and that number increases to
around 1,500 deaths during heat waves. Deaths are evenly split between
males and females. Active athletes usually succumb from over exertion,
while elderly people are usually the victims of excessive environmental
exposure.
Heat-related problems can be avoided, in most cases,
by minimizing exertion during periods of extreme hot and humid
conditions, rehydrating frequently, resting, venting internal core
temperatures by loosening clothing, getting direct air flow ventilation
to the body, applying ice packs or other cold wraps and shading from
direct solar exposure. Just as wind chill factors are a considerable
component of coldness problems, so too must temperature humidity index
(THI) factors be considered when thinking about and planning where to
paddle, how long to go between rest stops and the types and quantities
of fluids to drink for rehydration. Consuming alcoholic beverages in
high temperature conditions will hasten fluid losses through evaporation
leading to dehydration, impaired judgment and loss of physical energy
and performance ability.
Combating Heat -- Rules of Thumb:
1. Stay well hydrated and eat salty snacks. 2. Rest often, out of the sun. 3. Wear clothing that allows evaporation and a
brimmed hat or cap. 4. Give heat exhaustion patients lots of water with
a teaspoon of salt per liter. Let them rest. 5. Cool heat stroke patients as rapidly as possible.
Douse with water, fan, and massage extremities. Evacuate as soon as
possible.
If the heat continues to build up inside the body a
person can suffer from heat exhaustion. Symptoms include dehydration,
fatigue, weakness, headaches, nausea, vomiting and hyperventilation.
(increasing in severity as heat-related problems become more extreme),
muscle cramps and irritability. Left untreated, heat exhaustion can
become heat stroke, characterized by central nervous system (CNS)
dysfunction, bizarre behavior (like feeling cold and adding more
clothing), an altered mental state including hallucinations, confusion,
disorientation, coma and possibly death. Seek medical help as quickly as
possible. Bring the victim in a cool environment. Drink cool beverages.
If seriously overheated, remove all clothes and bathe in cool, not cold,
water. You can also apply wet compresses to the skin of the victim.
If the situation becomes worse, a person might
suffer from heat stroke. The body is no longer able to control the
body's temperature which can rise to dangerous levels. Signs of a heat
stroke are: hot and dry skin, severe headaches, dizziness, weakness,
disorientation, fatigue, seizure, loss of consciousness. It is essential
to get the body temperature down as quickly as possible to avoid brain
damage or even death. Take off all the victim's clothes and if possible,
submerge the conscious victim in cool water or cover him or her with
cold compresses. Keeping the victim hydrated will be helpful in cooling
him or her.
1. Anxiety, restlessness or fainting; 2. Nausea and vomiting; 3. Excessive thirst; 4. Eyes with dilated pupils that do not seem to
focus on anything, as if staring blankly into outer space; 5. Shallow, rapid and irregular breathing, possibly
leading to hyperventilation; 6. Clammy, cold, pale, pasty skin; 7. A rapid, weak or absent pulse.
1. Place the victim on his or her back and elevate
the legs about 6-12 inches to keep blood flowing to the brain. If the
victim is vomiting or bleeding from the mouth, then place him or her on
their side, or place them on their back with the head turned to one side
to expel the vomit or blood and prevent choking. If a head or neck
injury is known or suspected, then keep the victim lying flat on their
back and still; 2. Remove any unnecessary and/or hysterical people
as far away from the victim as possible; 3. Use a head tilt, chin lift or jaw thrust to
maintain an open airway for breathing; 4. Using either direct pressure, elevation, indirect
pressure or a tourniquet, as required by the circumstances, control any
bleeding that may be occurring; 5. Splint any broken bones to relieve pain and
prevent further injury; 6. Make the victim as comfortable as possible, and
try to maintain a normal (98.6° F) body temperature. If possible, remove
any wet or restrictive clothing, and place blankets or other padding
under the victim. Cover the victim with blankets, if necessary, to
maintain normal body temperature. Use NO artificial means to warm the
shock victim's body; 7. Keep the victim calm and as comfortable as
possible. Do not allow the victim to see his or her injuries. Avoid any
excitement of the victim or anybody else nearby. Avoid excessive
handling, as that may aggravate the problem leading to more serious
complications. Make sure the victim knows that somebody is already
calling for professional medical assistance, and that it is actually
being done by somebody who can provide a clear and concise description
of the problems as well as giving directions to where the victim is
located; 8. Administer mouth-to-mouth resuscitation, if
necessary; 9.
DO NOT give a shock victim
ANY
food or drink. If the victim indicates thirst, then wet a towel and use
it to wet his or her lips; 10. Have somebody with leadership and organizational
skills working to organize the group, gear and boats, and begin making
preparations for whatever actions must be taken next, including
transportation of the victim if in a remote area where professional
medical assistance will not be readily available.
You need training and knowledge about first aid and there are things to be taken into consideration before you can administer it.
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Spider
Bites
Tick Bites 
External Bleeding
Broken
Bones
A common
problem which afflicts paddlers is contact poisoning from plants
containing allergic reaction juices such as poison ivy, poison oak and
poison sumac, among others. Pollutants such as industrial and consumer
lawn and garden insecticides and chemicals also cause allergic reactions
in some people, either through skin absorption or inhalation. Contact
with poisonous plants or airborne pollutants don’t affect everybody, but
may adversely affect some. It should be recognized that direct contact
with these plants is not the only way to become infected by them.
Burning brush or high winds may carry the poisons from plants or
insecticides and chemicals long distances.
Shock occurs
whenever the heart and blood vessels fail to supply an adequate amount
of oxygen-rich blood to the other vital organs of the body. Studies have
shown that there is some degree of shock in almost every illness or
injury. Shock can be life-threatening, and left untreated (or
mistreated) it can cause death. Depending upon the nature and severity
of illnesses or injuries one sustains shock will have varying symptoms
and effects, some of which will appear immediately and others that may
be delayed by several hours.