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Basic Wilderness First Aid

Please note, that these guidelines are quite basic and don’t substitute Wilderness First Aid training.


I. Victim Assessment

II. Burns and Wounds

III. Strains, Sprains and Fractures

IV. About Ticks, and the Diseases Connected to Them

V. Snake Bites

VI. Submersion (Near Drowning)

VII. Heat Illnesses

VIII. Hypothermia

IX. Cardiopulmonary Resuscitation (CPR)


I. Victim Assessment

1) Accurately and efficiently evaluate the scene of an accident or incident, covering all of the following steps:

  • Estimation of what happened.
  • Estimation of safety at the scene.
  • Estimation of the number of victims at the scene.
  • Estimation of additional bystanders and help available.
  • 2) Efficiently determine the victim(s):

  • Determination of the safety of the victim in his/her current location, and whether or not to move the victim.
  • Establish responsiveness and spine control: Assess for verbal or pain response and stabilize the spine.
  • Accurately assess for life-threatening conditions:
  • Look in the mouth, clear obstructions.
  • Listen to breathing. Expose chest injuries.
  • Assess for pulse, control life-threatening bleeding.
  • Check for spine injury, maintain manual stabilization.
  • Protect the victim from the environment (insulate from the ground, shield from the wind, cover with sleeping bag or other insulating material, get him/her into dry clothes).

    3) Call for emergency help if possible, but before make sure that victim is not under life-threatening conditions.
    Provide emergency service with the following information:

  • Who (sex, approximate age), what happened, when, where.
  • Suspected injury/ illness.
  • Observations: pulse, responsiveness, skin temperature/color/moisture.
  • *Have all of the pertinent information relating to the incident at hand when on the phone with the emergency dispatcher.

    4) Inspect, inquire, palpate, auscultate from head to toes to find all injuries suffered.

    5) Check the vital signs:

  • Responsiveness
  • Heart rate
  • Respiratory rate
  • Skin color
  • Temperature
  • 6) Give First Aid according to the priority of symptoms.

    II. Burns and Wounds.

    1. BURNS



    A first-degree burn involves only the outer layer of skin, and no lasting or permanent damage occurs. First degree burns usually heal within 2-3 days. Most sunburns are first degree burns. Symptoms of a first degree burn are generally limited to mild stinging pain and redness at the site of the burn.

    FIRST AID for a first degree burn, if any is needed, is usually limited to immediately flushing the burned area with cool (NOT COLD) water. Aloe vera gel, or a topical anesthetic spray (such as Solarcaine or Dermoplast) can be used to lessen the pain of the burn.


    Second-degree burns, also called partial-thickness burns, affect the top layers of the skin, and may occasionally affect part of the deeper layers of skin. With a second-degree burn, the skin is able to heal itself, but scarring may occur. Second degree burns typically heal within 2-3 weeks.

    Symptoms of second-degree burns include: the redness and pain associated with first-degree burns, although the pain may be more intense, as well as the formation of blisters at the site of the burn. Blisters form when the outer layers of the skin separate from the inner layers, and fluid accumulates within the space between the layers.

    FIRST AID for second-degree burns is the same as for first-degree burns, with an added caution: if blisters form at the site of the burn, DO NOT pop them! They are there for a reason (to help heal the skin) and popping them before they’re ready doesn’t help, and may even hinder, healing. A popped blister is very painful, and you certainly don’t want to add more pain to an already painful situation. Usually, the body will absorb the fluid inside a blister, and the blister will go away on its own.


    Third-degree burns are also called full-thickness burns, or critical burns. Third-degree burns destroy all the layers of skin, and can even affect fat, muscle, and other tissue below the level of the skin. Third-degree burns have even been known to destroy bones. Third-degree burns can be life-threatening, and require immediate medical attention.
    Symptoms of a third-degree burn vary greatly between those of first and second-degree burns. A third-degree burn is usually painless, due to the destruction of all nerve endings in the burned area. The burned area can range from an ashy-white color to charred brown or black, possible with white patches underneath.

    FIRST AID for third degree burns involves managing the victim’s situation until EMS arrives. DO NOT remove any clothing or material from the burned area—peeling clothing off a serious burn may cause more damage. Cover the burn with a CLEAN cloth or sterile dressing. Do not apply pressure. Covering the burn helps prevent heat and fluid loss. If evacuation will occur within 24 hours, do not redress wound. Otherwise, if supplies are available, change dressings every other day (soak off old dressings with cool, clean water). Hydrate patient, but avoid nausea and vomiting.
    The most serious threats to life from a third degree burn are the systemic (body-wide) effects the burn causes:

  • Loss of water and plasma.
  • Decreased blood circulation.
  • Decreased urine production leading to kidney failure.
  • A decrease in the body’s immune response.
  • A high risk of bacterial infection—the burn area provides an entry point for bacteria into the body.
  • CALL the rescue team for the following burn situations:

  • ANY suspected third-degree burn.
  • Any burn victim having trouble breathing.
  • Second-degree burns covering more than one body part, or affecting the genitals, head, neck, hands, or feet.
  • 2. WOUNDS

    There are four main types of wounds:

    1) SCRAPES--Scrapes are the mildest and most common type of wound. A scrape occurs when the outer layer of skin is scraped off. Scrapes can be very painful since the nerve ending just below the skin can be exposed.

    2) CUTS--A cut occurs when a sharp or blunt object splits the skin. Cuts range from mild (like a paper cut, although some paper cuts can hurt terribly!) to severe, such as a cut from a large knife. Deep cuts can damage all layers of the skin, fat, muscle, soft tissue, blood vessels, nerves, and even bones.

    3) PUNCTURES--Puncture wounds occur when a sharp object pierces the skin. Again, punctures can be mild, such as a pinprick, to life-threatening, like a gunshot. A stab wound, depending on the use of the knife, can be considered a cut or a puncture. Severe puncture wounds can damage blood vessels and even vital organs, if the puncture is deep enough.

    4) AVULSIONS-- An avulsion is a cut serious enough to partially or completely remove a significant amount of skin or soft tissue from the body. Some avulsions can even cause accidental amputation of a body part, such as a finger or toe.

    Symptoms of wounds will depend on the wound itself, but mainly involve some degree of bleeding and pain. Very deep wounds can cause internal bleeding and injury, so be sure to pay attention to any complaints the victim may have, even those that don’t seem related to the wound itself.


  • Wash the wound with iodine or soap and water, and dry thoroughly.
  • Apply a small amount of antibiotic ointment, if you have some.
  • Apply a bandage, if the wound is still bleeding. If not, leave exposed to the air.


  • Use clean water, possibly with povidone-iodine to clean in and around the wound.
  • Control bleeding. Cover the wound with a clean cloth or sterile dressing and apply pressure. If the wound is bleeding freely, do not wash
  • If bleeding is significant, control with direct pressure.
  • Elevate the wound above heart level if broken bones are not present or suspected.
  • Wrap and secure a bandage around the covering to keep it in place. Add more layers of covering if blood is soaking through. Do not remove any layers of covering already in place.
  • Seek medical attention at once.
  • Note: Consider closing only if the wound is small, clean, and otherwise, not at high risk for infection

    III. Strains, Sprains & Fractures.

    1. STRAINS --- A strain occurs when activity results in a stretch or tear in muscle fibers or tendons (the fibrous tissues that connect muscles to bones). Strains can be mild (where just a few muscle fibers tear), or major (when whole muscles tear and there is swelling, bleeding and bruising present).

    Causes of strains are typically attributed to one of three causes:

  • Muscle fatigue. Tired muscles are at an increased risk for injury—think about an overheated car: you can “push” it, but eventually something is bound to happen.
  • An imbalance in the strength of opposing muscles. If one set of muscles, such as your triceps, is stronger than the muscles on the other side of a joint, like your biceps, this can cause strain on the weaker muscles.
  • Poor conditioning. Trying to work muscles that are normally sedentary most of the time can cause strain. So PLEASE ignore the old saying, “No pain, no gain.” Pain is your body’s way of telling you to slow down, or stop, your activity.
  • Symptoms of strains:

  • Pain and/or tenderness at the site of the injury.
  • Swelling and possible bruising at the site of the injury.
  • FIRST AID for strains:

    • Immediately cease activity.
    • Apply a cold pack, or ice wrapped in a towel to the affected area. Apply the cold or ice to the injury for 20-30 minutes, then, remove for 20-30 minutes. Continue this for two hours, and repeat often for the first 1-2 days of the injury.
    • On the third day of the injury, switch from cold to heat. Use a hot pack, or heating pad, or a hot bath.
    • Tylenol or ibuprofen can be used for pain.
    • If there is excessive swelling or bruising, or the pain from your injury prevents you from moving the affected part, it is an evacuation situation from wilderness and help of doctor is required.

    2. SPRAINS

    A muscle sprain is just a more serious form of a muscle strain. Typically, a sprain occurs when the affected joint is twisted severely enough to damage not only muscles and tendons, but tear ligaments as well. Causes of sprains are the same as that for strains.

    Symptoms of sprains are the same as those of strains.

    for sprains is basically the same as for a strain. Rest the affected joint in an elevated position. Evacuation, if symptoms worsen, or do not begin to improve in three days is necessary.

    The most commonly strained muscles are the hamstrings (located on the back of the thigh), muscles in the groin, and muscles in the back.

    The most commonly sprained joints are the knee, elbow, and ankle.

    You may not be able to tell the difference between a strain and a sprain.


    A fracture is any type of break in a bone. Most broken bones are simple or greenstick fractures, but let’s define the common, as well as some uncommon types of fractures (be aware that more than one type of fracture may be present in one victim):

  • A complete fracture occurs when a bone is broken completely through. This results in a bone in two or more pieces.
  • A partial fracture is a break that does not go all the way through the bone.
  • A simple or closed fracture doesn’t break through the skin.
  • A compound or open fracture is one where the broken bone breaks through the skin.
  • A greenstick fracture occurs only in children. The bone breaks on one side, but only bends on the other side. The reason the type of fracture occurs only in children in because the bones of children are much more flexible than the bones of adults.
  • A stress fracture is a very small crack, or series of cracks, in a bone occurring after repetitive activity that puts stress on a bone. Runners and basketball players are especially prone to stress fractures. About 25% of all stress fractures occur to the tibia (shinbone).
  • In an impacted fracture, the broken ends of the bone are driven together.
  • A spiral fracture occurs when a bone is twisted until it breaks. Imagine a wet rag being wrung out until it rips in two.


  • The victim heard or felt a snap at the time of the injury.
  • The victim feels like bones in the injured area are grating together.
  • The victim is unable to use the affected body part in a normal fashion.
  • The injured body part looks deformed.
  • The injured area may be swollen and bruised.
  • The injured area may feel cold and numb.
  • Of course, bones protruding through the skin are a pretty good indication of a fracture!

    Evacuate as soon as possible. It takes a great amount of force to break a healthy adult bone. The incident causing the fracture may have caused other injuries. Care for any life threatening conditions first. Control any bleeding present. Apply an ice pack, or ice cubes wrapped in a towel, to the injured area. This will help to reduce swelling and reduce pain. Help the victim remain calm and as comfortable as possible.

    If you must move the victim of a fracture, or other injury (such as a bad sprain) that inhibits walking, first you must splint the injury:

  • A rigid splint can be created from anything that is made out of an inflexible material, such as a sleeping pad, boards, or cardboard. Secure the splint with towels or rags tied around the injured part and the splint.
  • You can use clothes, towels, a sleeping bag or any other material to create a SOFT splint.
  • An anatomic is when you use another body part to splint the injured area. For instance, a broken leg may be splinted to the other (uninjured) leg, or a broken arm can be secured to the torso to prevent movement.
  • When splinting an injury, remember these important tips:

  • Splint an injury only if you MUST move the victim.
  • Apply the splint to the injured area in the position you found it. Do not try to straighten out the injured area. This may cause further injury.
  • As well as the injured area, splint the joints directly above and below the injured area to make sure the affected area remains immobilized.
  • ALWAYS check the circulation around the injured area before and after splinting. If your splint is too tight, you may cut off circulation to the injured area, and possibly other areas, as well.
  • When transporting an injured person, make sure the victim is well splinted and well supported on both sides. If the victim is absolutely unable to walk (for example, two broken legs or unconsciousness), fashion a sled out of anything you can find—logs or branches secured together, or even a large cloth, and pull the victim, making sure your path is clear. If possible, have someone walk ahead of you to clear any debris out of your path.

    IV. About Ticks, and the Diseases Connected to Them

    1. Tick-borne encephalitis – a viral infection transmitted by ticks and occurring in the region surrounding Lake Baikal. This disease attacks the central nervous system. Infection is transmitted when an infected tick bites an organism and viruses are transferred through the saliva. The disease infects humans as well as some animals- rodents, domestic cattle, monkeys, and some birds.

    Ticks are most abundant in damp, wooded areas where ground cover is thick. More ticks are found in developed or partially developed areas (gardens, roads, tracks, etc.) than in areas of the forest untouched by humans. Ticks do not tolerate direct sunlight and dry air. The erroneous opinion is sometimes distributed that ticks inhabit trees and, attracted by the smell, drop down onto people below. Actually, ticks most commonly live in grass or bushes alongside roads and tracks and cling to the clothing of people passing by. Once latched onto a person’s clothing, the tick finds its way underneath clothing or to exposed areas and, gets in the skin using its sharp proboscis, then feeding on the blood of the host organism. In this way such diseases as Lyme disease and the more dangerous tick-born encephalitis may be transferred to the person.

    Ticks attach themselves to the places where the skin is more delicate and capillaries are closer to the surface: on the neck, behind the ears, in the arm-pits, on the back, in the hair part or in groin areas. It is possible to not feel a tick’s bite; when the tick bites, an anesthetizing chemical enters with the tick’s saliva.

    The incubatory period of disease on average is 1-2 weeks, sometimes delayed up to 3 weeks. It is possible to explain the varying duration of the incubatory period by the character of a bite - the longer the tick is attached to the skin, the more of the virus can penetrate into an organism and the faster the disease will develop.

    Disease develops quickly, within several days. The virus invades the grey matter of the brain, attacking peripheral nerves in the spinal cord, and neurons that control motor function. Symptoms include spasms, paralysis of separate muscles or entire groups of muscles, and decreased sensitivity of the skin. In later stages the virus multiplies and multiple serious symptoms may develop. These can include persistent headaches, vomiting and loss of consciousness. Infected person may become comatose or, on the contrary, experience psychomotor excitation with loss of orientation. The cardiovascular irregularities can occur, including (myocarditis, cardiovascular insufficiency, and arrhythmia.) In the digestive system, constipation, enlargement of the liver and spleen later may be marked. All listed effects can be symptomatic of eventual toxic defeat of the infected organism, culminating in a rise in body temperature of up to 39-40 degrees С (102-104 F). In some cases, upon attack of spinal nerves, disease may progress into a type of "radiculitis" (inflammation of the nerves surrounding the spinal cord).

    Tick-borne encephalitis can be avoided with the help of nonspecific and specific preventive maintenance.

    Nonspecific preventive maintenance You should use tick repellents to spray your clothes and each person should examine their clothes and body, and remove any ticks they may find.

    For removal of ticks stuck to the skin remove the tick using a tweezers or a loop of thread tightened around the tick, being careful not to shake it around when lifting it off the skin. It is important that the tick’s head does not become detached from its body and remain lodged in the skin. Once the tick is removed, it is necessary to burn it to keep it from possibly further spreading the virus. Treat the site of the tick bite with iodine or alcohol, and carefully wash hands afterward.

    Specific preventive maintenance is carried out with the help of vaccines. To avoid infection from tick bites, it is necessary beforehand (in autumn or in the winter, from November - March) to receive preventive inoculations against tick-borne encephalitis. Illness is easier to prevent than to treat. To receive an inoculation it is necessary to have: the obligatory medical insurance policy, information about any medical allergies, and a passport.

    Emergency preventive maintenance
    (preventive maintenance after a tick bite) may be carried out with the help of an injection of immunoglobulins within three days from the moment of a bite.

    If possible, keep the tick in a piece of a damp fabric for later laboratory research. The results of the analysis can help a doctor determine whether emergency preventative maintenance is necessary.

    2. Lyme Disease.

    Lyme Disease- an infectious disease caused by spirochetes and transmitted by ticks, leading to chronic effects on the skin, nervous system, motor function and heart.

    Development of illness- Infection occurs with the infected tick’s bite. Microbes enter with the tick’s saliva through the skin and multiply within several days, after which they are distributed to other areas of the body, both external (skin) and internal (heart, brain, joints, etc.). Microbes can live in the infected organism for a long time (years), causing chronic and recurrence of the disease. Chronic recurrence of illness may become more developed over a long period of time. Development of Lyme disease is similar to development of syphilis.

    The incubatory period - from 2 to about 35 days, on average - 7-10 days.

    Initial Characteristics of the beginning stages of the disease (in 70 % of cases) is reddening of the skin on the area surrounding the tick’s bite. The red mark (rash) gradually increases in diameter reaching 1-10 cm in diameter, sometimes up to 60 cm or more. The form of a rash may be round or oval, or less frequently, irregular. The outside edge of the rash is redder and slightly raised. These symptoms are accompanied by fatigue, weakness, headaches and muscular pains, joint pains, rise in temperature and swelling of lymph nodes. In due course the centre of the rash turns pale or acquires a bluish shade and the form of a ring is created. The tick’s bite, located in the center of the rash, develops a scab followed by a scar. Without treatment the scar??? disappears within 2-3 weeks.

    After 4-6 days, the microbes begin to attack the central nervous system, heart and joints. Recognition of illness. Persons who develop a red rash on the site of a tick bite should immediately be concerned about Lyme \disease. Diagnosis can be confirmed by blood analysis.

    Treatment should be carried out in a hospital where the proper specific treatment can be provided. Without such treatment the illness progresses, becoming chronically recurring, and, in some cases, can result in permanent physical disability.
    Prophylactic medical examination. Persons who have been ill with Lyme disease should remain under medical supervision for 2 years following treatment, receiving checkups at 3, 6, and 12 months, and after 2 years.

    Illness Prevention. Spraying of clothes with tick repellent can provide protection for an entire day of exposure to the tick’s habitat.

    V. Snake Bites.

    What snakes cause venomous bites at Lake Baikal?

  • Copperhead snake
  • Adder
  • What are the symptoms of venomous bites?

  • While each individual may experience symptoms differently, the following are the most common symptoms of venomous snakebites:

  • bloody wound discharge
  • fang marks in the skin and swelling at the site of the bite
  • severe localized pain
  • diarrhea
  • burning
  • convulsions
  • fainting
  • dizziness
  • weakness
  • blurred vision
  • excessive sweating
  • fever
  • increased thirst
  • loss of muscle coordination
  • nausea and vomiting
  • numbness and tingling
  • rapid pulse

  • Treatment:

    Call for emergency assistance immediately if someone has been bitten by a snake. Responding quickly in this type of emergency is crucial. While waiting for emergency assistance:

    • Wash the bite with soap and water.
    • Immobilize the bitten area and keep it lower than the heart.
    • Cover the area with a clean, cool compress or a moist dressing to minimize swelling and discomfort.
    • Monitor vital signs.
    • If a victim is unable to reach medical care within 30 minutes, the American Red Cross recommends:
    • Applying a bandage, wrapped two to four inches above the bite, to help slow the venom. This should not cut off the flow of blood from a vein or artery - the band should be loose enough to slip a finger under it.
    • _

      VI. Submersion (Near Drowning)

      Drowning occurs when a person dies by suffocation due to submersion in water (or occasionally, other fluids). The term near-drowning is used to describe victims who have been resuscitated and survive for at least twenty-four hours. If the victim dies within twenty-four hours of the original incident, drowning is listed as the primary cause of death. If the victim dies after the initial twenty-four hour period, death is attributed to the complications arising from the incident, with near-drowning listed as a secondary cause of death.

      If you must rescue the victim, make sure the scene is safe. Rescuing a victim who is caught in a current or other dangerous situation can be very dangerous to you.

      If the victim is conscious in the water, use a pole or other long object to extend to the victim, and pull the victim to safety.
      If you must enter the water to rescue the victim, cup one hand around the victim’s chin to hold the head out of the water, and swim to safety.
      When everyone is in a safe area, call the emergency service if possible, and assess the victim. Near-drowning presents a unique first aid challenge, as many different conditions may be present in the near-drowning victim.


    • Head, neck, and/or back injuries, or other injuries to the body, if the victim was in some sort of diving or other accident.
    • Poisoning, depending on the fluid involved in the incident.
    • Hypothermia, depending on the temperature of the fluid in which the victim was submerged.
    • The potential for cardiac arrest (cessation of heart function) if the victim is left unattended for a period of time.


    • Irreversible brain damage is common in near-drowning victims who do not receive immediate first aid and advanced medical care.
    • Many near-drownings occur due to diving accidents, and temporary or permanent paralysis of all or part of the body may be present, or even occur after the fact, due to improper movement of the victim. Moving a victim with a head, neck, or back injury may result in further injury.
    • Many respiratory complications can occur due to the damage the lungs incur during the incident. These complications may result in the need for mechanical ventilation of the victim for a few hours up to months, or longer. Respiratory complications can occur up to days after the near-drowning incident, which is why all victims of near-drowning should receive professional medical care as soon as possible after the incident.
    • _

      VII. Heat illness.

      There are basically three main types of heat illness: heat cramps, heat exhaustion, and heatstroke.

      1) HEAT CRAMPS are painful muscle contractions associated with heavy exercise in a warm or hot environment. These strong, painful muscle contractions occur in the stomach muscles or the large muscles on the back of the thigh. The specific cause of heat cramps is debatable: most experts agree that heat cramps are likely to occur when exercising in hot weather. But while some experts attribute heat cramps to dehydration and poor physical condition in addition to the heat, other experts claim heat cramps are caused by a lack of water and salt. These two theories are so similar that, in regards to treatment and first aid, there is no difference.

      2) HEAT EXHAUSTION is a mild to moderate heat illness, and can occur very suddenly, especially after vigorous exercise in hot weather. Heat exhaustion occurs when the body is in an excessively warm environment and there is an inadequate intake of fluids into the body. Heat exhaustion can evolve into heatstroke if ignored.

      3) HEATSTROKE is the most serious form of heat illness, and can be fatal if emergency medical attention is not sought immediately. Heatstroke is an advanced form of heat exhaustion. In heatstroke, the body’s mechanism of controlling body temperature fails, and the body’s temperature rises uncontrollably.

      Where are when does heat illness occur?

      Heat illness can occur whenever and wherever the environment you’re in is excessively hot. There is no “official” temperature at which heat illness is most likely.
      Rather, a combination of factors contribute to an individual’s risk for heat illness. These factors are:

      Symptoms of heat illness vary, according to the degree of heat illness:

      1) The symptoms of HEAT CRAMPS are painful, but localized and fairly mild. The muscles in the abdomen, legs, and sometimes the arms spasm, causing painful contractions. People who sweat profusely during exercise are at greater risk for heat cramps, due to the depletion of fluid (and salt) through sweat. Heat cramps may also be an indicator of heat exhaustion, so be aware of any other symptoms present. Heat cramps can occur during exercise, and last up to an hour after ceasing of activity.

      2) Signs of HEAT EXHAUSTION tend to be systemic (affecting the entire body), although heat cramps may be present during heat exhaustion. Symptoms may have a sudden onset, and remember that heat exhaustion doesn’t always occur with strenuous activity. Just spending a long day in the sun can cause heat exhaustion.

      Symptoms of heat exhaustion are:

    • Red or very pale skin
    • Skin that is warm or hot to the touch
    • Faintness and /or dizziness
    • Nausea, with or without vomiting
    • A low-grade fever may be present: above normal, but below 104 degrees F
    • A rapid pulse
    • 3) In HEAT STROKE, you’ll see the same signs as in heat exhaustion, since heat exhaustion is a precursor of heatstroke. The addition of a few much more ominous symptoms makes heatstroke a very dangerous condition:

      • A body temperature of greater than 104 degrees F is a direct indicator of heatstroke.
      • Changes in the victim’s mental state may range from irritability, mild confusion, and disorientation to a comatose state.
      • Rapid breathing
      • Fainting
      • In some cases, the victim may experience seizures.

      for heat illness depends on the type and severity of the illness:

      1) HEAT CRAMPS

      • Cease all activity, and find a shady, cool spot to sit and rest.
      • Get something to drink: NO ALCOHOL OR CAFFEINATED DRINKS. Drink clear juice (such as apple) or a sports drink, like Gatorade. Drink plain water if nothing else is available.
      • Forget any strenuous activity for the rest of the day. Not letting your body recover could lead to more heat cramps, or even heat exhaustion.
      • If your heat cramps don’t go away within an hour, call your doctor for medical advice.


      • Move the victim to a cool area—preferably in an air-conditioned environment, but at least, a shady spot out of the sun.
      • Loosen or remove any restrictive clothing.
      • Have the victim lie down in a comfortable position. Slightly elevate the victim’s legs.
      • Give the victim something to drink: as above, NO alcohol or caffeine. Avoid carbonation. A sports drink or water is best. Try to find something cold for the victim to drink, but do not put ice in the drink.
      • Misting the victim’s body with cool water gives the body a way to evaporate more heat, causing more rapid cooling of the body.
      • The victim may be placed in a cool (NOT COLD) tub of water. Monitor the victim at all times for changes in consciousness.
      • Monitor the victim for any worsening of symptoms, or the addition of additional symptoms. Heat exhaustion, if left untreated, can turn into heatstroke.

      3) HEAT STROKE

    • CALL Emergency service. Heatstroke is a life-threatening condition.
    • Follow the above instructions for heat exhaustion.
    • Cover the victim with damp sheets or other damp materials.
    • DO NOT put a victim of heatstroke in the tub—changes in mental status or consciousness may cause the victim to injure himself.
    • DO NOT give the victim anything to eat or drink if there are changes in the victim’s mental state or consciousness.
    • _

      VIII. Hypothermia

      Usually, everyone thinks about hypothermia occurring in extremely cold temperatures, but that doesn’t have to be the case. It can happen anytime that you are exposed to cool, damp conditions. Older people are more susceptible to hypothermia.

      Two things to remember about hypothermia are that:

      1. You don’t need to be experiencing sub-zero temperatures to encounter hypothermia..

      2. Your judgment will be impaired, making you much more likely to experience an accident.

      If you or someone in your group becomes hypothermic, take immediate action before it becomes a severe emergency!

      Hypothermia symptoms include:

    • Uncontrollable shivering (although, at extremely low body temperatures, shivering may stop)
    • Weakness and loss of coordination
    • Confusion
    • Pale and cold skin
    • Drowsiness – especially in more severe stages
    • Slowed breathing or heart rate.
    If not treated promptly, lethargy, cardiac arrest, shock, and coma can set in. Hypothermia can even be fatal.

    Hypothermia signs that can be observed by others:

  • Slowing of pace, drowsiness, fatigue
  • Stumbling
  • Thickness of speech
  • Amnesia
  • Irrationality, poor judgment
  • Hallucinations
  • Loss of perceptual contact with environment
  • Blueness of skin
  • Dilation of pupils
  • Decreased heart and respiration
  • Stupor
  • One of the most important rules of hypothermia treatment is that no one is dead until they are warm and dead. Allow medical authorities to determine death in all cases.

    When treating a victim of hypothermia, all efforts should be made to sustain life until they have been properly warmed at a medical facility.

    Hypothermia treatment is simple, but the proper treatment needs to be administered during different phases of the medical condition.

    Mild Hypothermia treatment:

    This is the most common form of hypothermia and one we have all suffered from at one time or another. It is the most easily treated, and the easiest to prevent.

  • Treat mild hypothermia by getting into a warm and dry environment. Windy conditions and wet clothes cause the body to lose heat. Seek shelter from wind and weather.
  • Insulate from ground – pine branches, leaves, moss, anything to provide insulation will work.
  • Change wet clothing for windproof, waterproof gear.
  • Add heat – if safe, start a fire.
  • Increase exercise, if possible.
  • Get into a pre-warmed sleeping bag or blankets/
  • Drink hot drinks, followed by candy or other high-sugar foods/
  • Apply heat to neck, armpits and groin.
  • Moderate Hypothermia treatment:

    • When a person has moderate hypothermia, in addition to the above listed items, get the person bundled up and out of the cold, covering the neck and head to minimize additional heat loss through the head.
    • Sudden movement and physical activity should be avoided. Rough handling of these victims may cause deadly heart rhythms.
    • You can apply warm bottles of water, or warm rocks to the armpits and groin area (comfortably warm when touched by a hand flat on the stone and held in place).
    • Fully conscious victims can sip lukewarm sweetened, non-alcoholic fluids. If their condition is clearly improving, then more fluids and warmth can be administered.
    • Medical attention should be sought out, even if a full field recovery is achieved.
    • Severe Hypothermia treatment:

      This is an extreme medical emergency and a high priority should be placed on summoning a rescue team immediately to transport the victim to a medical facility as rapidly as possible.

      • Maintain the body temperature of victims of severe hypothermia. Improper warming can create a condition called metabolic acidosis that can cause shock and heart failure. Warming should only be preformed in these states by a medical facility.
      • The critical thing when a person has severe hypothermia is to be gentle with them. Sudden or rough movements, forcing them to move or walk can pull very cold blood from the extremities into the warmer core that can cause shock. You need to be gentle and supportive. Rubbing of the skin and moving of the joints should be avoided. This causes more harm than good.
      • In severe hypothermia, the best hypothermia treatment is best for three people to get under a pile of blankets or in a sleeping bag. Skin on skin contact of the torso works best with a person on each side of the victim. You should ignore their pleas to be left alone or allowed to go to sleep, but be gentle with them.
      • You should not administer fluids or make any other attempts to increase body temperature.
      • Maintaining temperature and preventing further loss is the most important thing.
      • If a person becomes unconscious from hypothermia monitor their breathing and pulse carefully.
      • Summon an Emergency Response Team.
      • If you can detect a faint pulse, do not do CPR to support their heart. Only start rescue breathing, chest compressions or full CPR if you cannot detect any breathing, any pulse or both. Check frequently to see if they start breathing on their own, even if it is shallow (the same for a pulse).
      • Administering CPR to someone, even someone with a slight pulse can cause his or her heart to stop.

      Remember, make all efforts to keep them alive until help arrives, and they have been warmed and declared dead. People have recovered in morgues from hypothermia and have had profoundly low body temperatures and still recover.
      Never give up hope with a hypothermia victim who does not have any other serious medical complications (like severe injuries from a fall or extreme altitude sickness).

      IX. Cardiopulmonary Resuscitation (CPR)

      CPR Function:

      CPR is used when a person has stopped breathing and has gone into sudden cardiac arrest, meaning their heart has stopped and they have no pulse. At that moment, the person is dying. CPR is used to maintain a level circulation and provide oxygen to a person who is unable to do either. CPR is designed to keep oxygenated blood flowing until advanced medical care can arrive and revive the victim. To perform CPR, a bystander must place the victim on her back on a hard surface and then check to see if she is breathing. If not, the rescuer places one hand on the forehead, another under the chin, and tilts the victim's head back. The rescuer blows two breaths into the victim's mouth, while pinching the nose. Then, the rescuer draws an imaginary line between the nipples. Place the heel of one hand on the victim's breast bone and use the other to interlock their fingers. Keeping their arms straight, the rescuer presses down, depressing the chest 1 ½ to 2 inches. After 30 compressions, give two breaths.

      SPR guidelines:

      1. CALL EMERGENCY SERVICE if possible.

      Check the victim for unresponsiveness. If the person is not responsive and not breathing, or not breathing normally, call the emergency service and return to the victim.

      2. Open the airway and look for objects. Look, listen and feel for breathing for 10 seconds.

      3. Attempt to ventilate: 2 slow breaths (1 second per breath), allow for exhalation between breaths. If chest rises, check carotid pulse and other signs of circulation for at least 10 seconds. If no carotid pulse or other signs of circulation, begin CPR.

      4. PUMP

      If the victim is still not breathing normally, coughing or moving, begin chest compressions. Push down in the center of the chest 2 inches, 30 times. Pump hard and fast at the rate of at least 100/minute, which is faster than once per second.

      5. BLOW

      Tilt the head back and lift the chin. Pinch nose and cover the mouth with yours and blow until you see the chest rise. Give 2 breaths. Each breath should take 1 second.


      Complications of CPR

      • Vomiting is the most frequently encountered complication of CPR. If the victim starts to vomit, turn the head to the side and try to remove or wipe off the vomit. Continue with CPR.
      • The spread of infection from the victim to the rescuer is exceedingly rare. Most cardiac arrests occur in people's homes - relatives or friends will be the ones needing to do CPR. Even CPR performed on strangers has an exceedingly rare risk of infection. There is NO documentation of HIV or AIDS ever being transmitted via CPR.

      Checking the Pulse

      The pulse check is no longer taught or expected of laypersons. Instead, if there is no response after two mouth-to-mouth breaths, begin to pump on the chest. Please note that the pulse check is still expected of health-care providers.