A simple way to carry an injured patient

This tip is from the excellent MedWild YouTube channel. Recommended!

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If you have to deal with a minor injury in the backcountry, the patient may need to be carried out. If there’s at least two people to share the load and some basic equipment, here is a quick and easy way to rig a carry.

You need:

• at least 2 rescuers

• 2 backpacks

• trekking poles, raft paddles, sturdy stick (or similar item)

• padding (sleeping pad)

Note: this is for someone with minor injuries, such as a sprained ankle, twisted knee, altitude illness, dehydration, etc.

Here’s a screen grab from the video to give you a quick idea of how it works. Rescuers are wearing backpacks, sticks/poles/raft paddles go on top of the pack waist belts, patient sits on those between the rescuers.

image: https://www.youtube.com/watch?v=sMeqn3P3WGc

Check out the short (4:16) video for the method.

Learn the "thermal burrito" for patient packaging

This tip and diagram comes partially from the American Alpine Institute blog. It was written by Jason Martin, AMGA Certified Rock and Alpine Guide, and Executive Director of the American Alpine institute, or AAI. The AAI blog has lots of solid backcountry tips, check it out.

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One thing you can count on with most backcountry medical emergencies: you’re far away from help, and any outside assistance is likely to take a LOT longer to arrive than you think.

So after the initial treatment of your patient, you need to keep them as dry, warm, and comfortable as possible, because you’re probably in for a long wait. Provided you have some basic gear with you, an excellent way to do this is with the “thermal burrito”. (This technique has several names, but thermal burrito is by far the catchiest. =^)

In addition to basic patient comfort, this is also a good treatment for hypothermia. If you're doing this just to warm someone up, you probably don't need the rope wrap as shown in the video.

If treating for hypothermia, the patient's clothing should be removed if it's wet, and ideally replaced with dry clothing.

If treating for some kind of injury, it's important to maintain access to the injured area so you can continually check the affected body parts, so don't wrap them up so tight that it's difficult to remove the packaging.

Good rule of thumb in wilderness medicine: use the patient’s gear when possible. (If your patient is going to be evacuated by any sort of ground rescue or helicopter, the chances of you ever seeing that equipment again are pretty low, so keep that in mind when you offer your sleeping bag. =^)

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Here's a nice article from the American Alpine Institute blog that discusses this technique. Direct quote and image from the article:

1. Lay out a tarp or ground cloth on the ground.

2. Place 1 or 2 pads down on top of the tarp. Two pads are always better than one.

3. Stack three sleeping bags on top of the pads.

4. Place the victim inside the sleeping bag in the middle.

5. Wrap the victim in the tarp.

6. If treating for hyperthermia, provide the victim with hot water bottles. These should be placed under the arms and at the crotch. Additional bottles may be held or placed at the victim's feet.

image: http://blog.alpineinstitute.com/2019/03/the-burrito-hypothermia-wrap.html

And, here's a video that discusses basically the same technique, with the addition of creating a daisy chained climbing rope around the patient. If you think you may have to transport your patient, even for a short distance, this is a nice feature to have.

Note the addition of trekking poles underneath the patient, this can give some rigidity to the rope litter if you need to carry it.

And finally, here’s a longer video from the excellent WildMed youtube channel, where they call it a “Cocoon Wrap”. They describe in detail a few extra components, such as the importance of padding, ways to keep the patient dry, and how to lay out the rope.

How to warm fingers and prevent frostbite

Cold hands are something everyone has endured. (And if you have Raynoud’s syndrome, where the smaller arteries that supply blood to the skin constrict excessively in response to cold, this can be especially problematic.)

Here's a solution - “windmill” your arms. The centrifugal force from doing this moves blood into your fingers and hands.

(Conversely, a lot of people will blow into their gloves, thinking the warmth from their breath will help warm up their hands. It actually has the opposite effect, because the water vapor from your breath chills your hands even further.)

Check out the short video below from the excellent MedWild YouTube channel.

Great source for wilderness medicine supplies

If you've ever taken a wilderness first aid class, you learn pretty quickly that the standard prepackaged off-the-shelf first aid kit is pretty useless for much more than a tiny cut on your finger and a headache. If you want quality supplies that can treat more serious injuries, you have to mostly build up your own kit from scratch. But then the question becomes, where can you find fairly priced, small quantities of good quality supplies? (Hint, not at Walgreens.)

Well, here’s one good option - WildMedcenter.com. This is a great online store for replenishing or stocking up your first aid kit with quality supplies. One thing that's especially nice is you can buy small quantities of things, rather than say a 10 pack of expensive dressings or a huge bottle of tincture of benzoin that you are unlikely to ever use up.

They also make very high-quality zippered first aid kits in several different sizes, and have a complete checklist of how to stock each one with the recommended supplies.

I recently went through my own first aid kit, tossed a bunch of outdated or not very useful items, and then spend about $20 restocking from this web store with proper supplies. Now my kit’s ready to go and I’m much better prepared.

Here are some examples of a few goodies from their web store.

For starters, how about four different sizes of sturdy first aid kits, sewn in the USA?

(Note, bottles and supplies not included.)

image: https://www.wildmedcenter.com

Tegaderm microfilm transparent bandages? Yes please. (These bandages are quite amazing, if you have not heard of them.) You can buy them individually, in two sizes, starting at $2 each.

How about lots of handy different sized Nalgene containers for storing just about anything in your kit?

(Tip - A pair of examination gloves or a roll of 2 inch gauze fits perfectly in the 50 mL snap top vial.)

image: https://www.wildmedcenter.com

Every kit should have a few a few extra large safety pins. No need to go to the fabric store, get a packet of 4 pins here.

image: https://www.wildmedcenter.com

Dealing with a shoulder dislocation

image: http://www.recoversportsmed.com.au/Shoulder-Dislocation.html

• Face planting off a mountain bike?

• Taking a hard fall while skiing or snowboarding?

• Getting your shoulder yanked kayaking on a whitewater river?

• Feet blowing off when crack climbing or ice climbing, and your weight falling onto your well buried ice tool or thumb down hand jam?

• Shoulder getting pulled when trying to self arrest with an ice axe?

These are all consequences of having fun in the mountains, and they are also all things that can easily lead to a dislocated shoulder. Chances are pretty high that sometime in your outdoor career you're going to have to deal with one, either yours or somebody else's. (And yes, I have some personal experience with number three and four listed above!)

Knowing how to diagnose, examine, reduce, and splint this injury can be extremely important in the backcountry, taking a situation from an “immediate evacuation” to “great relief and minor pain” in literally a few minutes. I think this is something every backcountry user should be familiar with, but often it’s not taught in entry level wilderness first aid classes.

Well good news, because this terrific video series from the MedWild YouTube channel walks you through every step. (The splinting technique shown in the last video is especially clever.)

There are several field techniques that work to reduce a dislocated shoulder. The one shown below is simple and effective.

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Note that the examination portion of this process is very important, as is the mechanism of injury (MOI).

If the MOI involves a traumatic sort of fall, such as bike crash, there's a chance that there can be some broken bone involved, which can complicate reducing the shoulder. This is mentioned in video number three. If you do have an impact sort of injury and possible broken shoulder, it might be best to evacuate and not reduce the shoulder, because reducing the broken shoulder over a small chip of bone could cause problems. This is why, in a hospital setting, an X-ray is almost always done before a dislocated shoulder is reduced, to determine if it's a shoulder fracture, dislocation or hopefully not both.

However, if the injury comes from something less impactful, like big whitewater pulling your kayak paddle, or crack climbing with your hand thumb down and having your feet blow out, (me on both), it's probable that there is no underlying bone chips or other damage, and a simple reduction technique as shown in this video is going to solve your problem quickly.

Also, there is a possibility for nerves to be compromised in a shoulder dislocation. As mentioned in video number two, an important part of the patient exam is testing for good CSM (Circulation, Sensation, and Movement). This means a good pulse at the wrist of the affected arm, proper blood perfusion to all of the fingers, and for good sensation and movement in all of the fingers.

And, here’s a direct quote from the video producers: “The distal neurological exam is mostly done to protect yourself from being blamed for any neurovascular compromise following the reduction. If you speak with the patient about it prior, or preferentially document it, there will be no question that any deficit was due to the injury and not the reduction. Neruovascular injury is virtually always due to the traumatic injury itself and not the reduction procedure.”

The big question is: how close are you to a medical facility? If you can protect the injured shoulder as best you can and be in a medical facility within a few hours, it might be best to walk out and have them take care of it. But, if you're in a more remote location, knowing these proper steps could really help you out.

Watch these videos carefully, learn the steps, and take a wilderness medicine class.

Video 1 - Shoulder dislocations, field diagnosis (2:17)

Video 2 - Dislocated shoulder exam (2:25)

Video 3 - How to reduce a dislocated shoulder (5:07)

Video 4 - shoulder splinting (2:54)

Three ways to improvise an arm sling

I saw a version of this in a recent wilderness first aid class that involved cutting up your shirt with scissors or a knife. It looked slick, but was pretty hard on the shirt!  Here are three simple (and easier to remember) methods that don’t require you to cut up your gear.

Note - After you make one of these improvised swings, it's a fine idea to further secure that arm to your body so it doesn't flop around. Several ways to do this are an ace bandage, tape all around your torso, or a couple of heavy duty safety pins.

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Method 1 - Elbow in coat hood

If you have a coat with a hood, insert the elbow of the injured arm into the hood, then tie the sleeves snug on your opposite shoulder.

Method 2 - Elbow in coat sleeve

If you have a coat, insert the elbow of the injured arm into the sleeve of your coat, which will bend your elbow and put your hand somewhere on your upper chest.  Zip up the coat (probably with the help of a friend) and your arm is secure.

(Bonus points to freak out your friend: Put your right hand inside your jacket, put your right sleeve in your pocket, and use your right hand some creative way - Pretend to have an actively beating “heart”, make it crawl out from the top of your shirt and start going around your neck, etc. Try it in a mirror, it looks amazing. :-)

Method 3 - Extra shirt “necklace”

If you only have one shirt, this works, but if you want your chest to stay covered, you’ll need  a second shirt.

1. Take your extra shirt, put your head all the way through it, and leave it around your neck like a necklace.

2. Let's assume your right arm is injured. Reach your right arm underneath the sling shirt, insert your hand down the left sleeve, tuck your right elbow into the right sleeve. Finally, tuck the extra fabric around your right elbow.

How to make a backcountry 911 call

This tip was written with expert advice from Steve Rollins, a long time member of Portland Mountain Rescue

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• Write down key information BEFORE you make the call.

• State your location first.

• If your battery is low and/or you have a poor cell signal, texting key info to your trusted contacts might be better.

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You, someone in your group, or someone you come across, has a serious injury in the backcountry.

You're fortunate enough to have cell phone service, or possibly can text with a satellite communication (satcom) device such as a Zoleo or Garmin InReach. (In this example we’re talking about using a phone primarily, but the pretty much same advice applies to using a satcom device. This article is also geared toward the United States; different countries of course have different emergency response systems.)

Note: Calling 911 is usually the first choice. If you’re using a satellite communication device that can only text, be aware that many 911 call centers, as of this writing in 2018, CANNOT receive text messages. If you have a satcom device that can only text, it's better to text your in-town emergency contact person, and have them forward the information to 911. But using a phone to directly call 911, if possible, is always the first choice.

However… if you have a weak battery and weak to minimal cell signal, sending a text to a trusted contact or 911 might be a better choice than a voice call. You might get lucky and 911 gets your text, but more likely your contact people will get it and transmit the information.

Before you grab your phone and dial 911 in a panic (or text your at-home emergency contact person), take a few deep breaths, get a pencil and paper, and write down some important information that Search and Rescue (SAR) will probably need. Note that 911 will probably not ask you for all of this information; you’ll need to volunteer some of it.

Keep a pencil stub and a few small sheets of tyvek paper, free from a cut up repurposed Priority Mail envelope, in your first aid kit for this very purpose.

If you have a few different people on your team, do a phone inventory before you make the call. See who has the strongest cell signal and battery level. Different cell phone carriers can have different signal strength in the mountains. You don’t have to use your own phone if a better battery and a stronger signal comes from someone else.

Be patient. The 911 operator is used to dealing with urban emergencies and may not initially understand that you are calling from the backcountry. They also are probably not familiar with things like UTM coordinates nor things like “I’m at the Hogsback on Mt Hood.” Be patient. Don’t get frustrated. They want to help you. Explain your situation, have them repeat back everything, and tell them to transmit the information to county SAR; more on that below.

One more tip - If you call 911, you are most likely going to initiate a rescue. Do not call 911 for a “We’re okay, but running late” type of call. That is a non-emergency, and should go to your contact person in town, not 911.

If your phone is cold or you have a weak signal, try to transmit the most critical information first. That's going to be 1) your location and a 2) description of the accident. If your phone cuts out in the middle of the call, hopefully you had time to share the important stuff first.

A boiled down way to think of it is this: Transmit the “where, who, what” information, ideally in that order. Where, general location, route, exact GPS coordinates if you have them. Who, your name and call back number. What, describe the accident, number of patients, and overall seriousness.

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1. Tell the 911 operator, “I am calling from a wilderness location and I do NOT have a street address.” (This hopefully gives them a heads-up that this isn’t a standard urban 911 call.)

2. Tell the 911 operator, “I’m going to give you some information that you normally do not need or ask for. I want you to relay ALL of it to county Search and Rescue.” (911 call centers have a protocol for urban emergencies that they usually follow, and this gives them notification that they need to record more than usual.)

3. Exact location of the accident. If you're at a well-known spot like a trail head, campground, or climbing route, start with that. If not, provide GPS coordinates. Try to use latitude longitude decimal degree format. Example: 45.1234, -122.1234. Providing coordinates in another format, such as latitude longitude degrees, minutes, seconds or UTM, is acceptable, but many 911 call centers may not be familiar with this format, so use decimal degree format if possible to reduce the chance of error. (It’s easiest to transmit decimal degree coordinates by voice, because they don’t have tricky extra things like zones, eastings, northings, single quotes, double quotes, and degree symbols.) It's best to start off with your location. If your phone battery dies or drops cell coverage during the call, at least 911 knows where you are.

4. Side note: You should always know how to get your coordinates from your phone, here's a tip how to do this. Having a phone app designed to do this is a fine idea, like my favorite “My GPS Coordinates” for the iPhone.

5. If you’re giving UTM coordinates, tell the operator, “I'm going to give you coordinates of our current position. You may not be familiar with them, but write them down exactly as I say, repeat them back to me when I'm done, and pass them onto SAR.” Once SAR gets the coordinates, they will know what to do with them, no matter what format they are in. But if you have a choice, decimal degree format is better.

6. A verbal description of terrain, map location, or climbing route. “We are at the base of the Hogsback on Mt. Hood”. The 911 operator will probably not know what this means, but SAR will. Give this in addition to your GPS coordinates. If the coordinates get messed up somehow, the verbal description is a backup.

7. The caller’s name and phone number, and your call back number, or perhaps two. If it’s not your phone, write these number(s) down before you call.

8. List of injuries, most serious first.

9. Patient name, age and gender.

10. The time of the accident.

11. The local weather conditions.

12. Number of people in your group.

13. Your plan for treatment. Stay put and wait for help, or maybe start moving to a specific location. Generally, once SAR knows where you are, even if you’re mobile, they want you to stay put.

14. A request for what form of help you think you need, such as litter, sled or helicopter. Note that the decision for this is not yours to make, it's up to the SAR team. If you have a very serious injury and think you need a helicopter, you can make this known, but it's no guarantee you're going to get one.

15. What county you’re in, if known. SAR is typically coordinated by the county sheriff. If you make a 911 call from a wilderness location, depending on the cell towers you reach, the 911 call might go to a county that’s not the one you’re in. The operator may transfer you to the correct county, let them make this decision.

16. Patient’s emergency contact person and phone number.

17. Ask the 911 operator to REPEAT this information back to you.

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More info . . .

Here's what will probably happen after you make the 911 call. The 911 call center will forward your information to the county sheriff search and rescue (SAR) coordinator. If you’re in a mountain environment, that SAR coordinator will probably contact the local mountain rescue team; hopefully there’s one in your area.

Either the SAR coordinator and/or the mountain rescue team may call or text you directly for additional information. After your initial 911 call, keep your phone warm in an inside pocket, available and charged. Don’t tie up your phone or use battery by texting or calling anyone else right after you make the initial call. SAR may want to know patient vital signs, weather conditions, altitude, wind direction and speed, and approximate snow conditions. This can dictate what equipment they need to bring and how to reach you most effectively. This may sound obvious, but if you get a call from a number you don't recognize, answer it! It may be SAR calling you.

Regarding battery life, a detailed text message uses a small amount of data compared to a voice message, and can transmit using a much weaker signal. If you have a weak cell signal, a text might make it out when a voice call will not. Compose a text to some trusted contacts. Don't use images or attachments. When you’ve composed your text, turn off airplane mode, hit send, and hope that your message gets out. Check after about five minutes to see if your text went out. If you didn't, moving to a higher location with less tree cover might help you get a better signal. Remember to turn airplane mode back on after you send it to save battery.

Consider monitoring your phone on the hour for 10 minutes to save phone battery; eg 11:00 to 11:10. (Hopefully you brought an auxiliary phone battery and a charging cable, the 11th essential.)

Avoid non-crucial texting and stay off social media. Sometimes easier said than done. There's been cases of someone trying to carefully conserve their phone battery, but turned their phone on and discovered loads of text messages and social media messages from concerned friends, which killed their battery. If you do get a pile of texts, try to not respond to them and save your battery for communication with rescue teams.

Giving your correct coordinates is extremely important. Write them down. Take time to get it right. Newer smartphones can access a greater number of satellites, such as the European Union and Russian satellite constellations, in addition to the United States satellites. This generally can give you a faster lock and more accurate position. This can become more important if you are in a deeper canyon or under heavy tree cover. So, if someone in your group has a newer phone, you might want to use theirs. Good news for climbers, being high up on the side of a mountain is going to give you about the best possible satellite reception. Again, try to give coordinates in latitude longitude, decimal degree format.

Be aware that a rescue can take a L O N G time. (At least that’s what it seems like when you’re waiting for one.) This is not the French Alps, when the Chamonix rescue helicopter can be on the scene in 20 minutes. There may be many people and resources that need to be mobilized. Sit tight and get comfortable, you're probably going to be there for a long time. So that means after you've stabilized your patient, you need to focus on making them and everyone else as warm and comfortable as possible. This may mean putting insulating pads, sleeping bags and warm clothing underneath the injured person, putting other clothing along their sides, and possibly wrapping them up mummy style in a tent or tarp, if you have one.

This is known in some circles as a “thermal burrito” patient package, and we cover it in detail at this tip.

Carry a first aid book on your phone

Your climbing partner just took a fall on lead when they were crack climbing, and managed to dislocate their shoulder. You're a two-day hike in, and if you can get that shoulder back into place, things are going to get better in a hurry. But dang, that first aid class you took a few years ago has faded to a distant memory, and you can't even remember if they covered shoulder reduction in the first place!

Yikes, what do you do?

One smart way to augment your hands-on first aid training is to have a wilderness first aid ebook on your phone. As a "virtual book" it weighs nothing, last forever, and could literally be a lifesaver someday in the backcountry.

Of course, having access to a first aid book in no way replaces taking a proper class, but this can be a good backup to refresh your knowledge.

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Here's a great option, the Wilderness Medicine Handbook Digital Edition. It’s from the excellent website wildmedcenter.com. This company also has a great online store, where you can purchase small quantity and high-quality supplies for your backcountry first aid kit which are often quite hard to find.

image: https://www.wildmedcenter.com/digital-wilderness-medicine-handbook-v60.html

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Here are a two more options. Click each image for a link to Amazon. (These are NOT affiliate marketing links and I make no money if you click through, I’m simply providing them as a convenience.)

Glove storage for your first aid kit

While gloves aren’t mandatory for a minimalist first aid kit, many climbers choose to carry them. (If you don't carry gloves and are treating someone else, do your best to wash your hands before and after you touch your patient.)

But, it’s a hassle to neatly store them.  Gloves easily tangle with other gear and can get punctured. Many people put them in a small sandwich bag, which works okay but can still allow damage.

One solution:  put the gloves in a 35mm film can. Two rolled gloves fit perfectly.  A clear film can lets you see what’s there. A label makes it easy for others to find if needed.

Yes, film cans can be hard to find these days. You can find ‘em on Amazon.

Or, another option, if you live in one of the progressive and liberated states in the US, your friendly neighborhood cannabis store sells fine herbal products in the perfect container. Dispose of the original contents in whatever way you like, and reuse the nice plastic bottle. =^)

Another option is a 50 ml Nalgene snap top bottle. You can get these at the excellent Wild Med Center website, a great place to stock up on hard to find wilderness first aid kit supplies.

Tick removal made easy

Have a tick buried in someone’s skin (hopefully not yours)

Make a "lasso" slipknot out of dental floss, tighten it around the tick’s head, and slowly pull the little bugger out.

Avoiding burns in the backcountry

• When pouring hot water into anything - cup, bowl, thermos, dehydrated meal - always put the receptacle onto a flat place, never hold it in your hand.

• When you’re tending your stove, try to do it from a squatting position and not sitting. If you’re squatting, you can jump up and more quickly move away from spilled hot water or a flaring stove.

• Lots of modern camp stoves might boil water in just a few minutes, but they are often tall and unstable. Try to secure your stove from tipping over by putting a few rocks around it to hold it in place.

• Modern outdoor synthetic fabric such as fleece, polyester and capilene can be extremely sensitive to flame. As in, they can melt in a second or two, sometimes directly onto your skin, resulting in a serious burn. If you’re wearing these fabrics, be very careful around campfires and the intense flame of a camping stove.

• Don’t step over a campfire or stove, step around it.

• Also, sparks from a campfire can easily land unnoticed on your nice fleece jacket and instantly burn a small hole through it. Probably won’t hurt you very much, but it’s sure not helping your gear.

First aid for minor burns

• Clean the affected area with cool water, not ice cold.

• Cool the area by putting on fabric soaked with cold water. Don’t put ice or snow directly on the burn, this can cause frostbite and restrict circulation, which is needed for healing.

• Moist dressings are fine for small burns (less than three percent of the body surface area). Use dry dressings on extensive burns.

• Check every 24 hours.

This tip is partially from the excellent NOLS blog.

Tincture of benzoin - what it is, how to carry it

Tincture of Benzoin is a brown liquid that looks like iodine, which toughens skin and makes it very grippy for tape application. 

Putting a dab on your heels be fore taping is a great way to get tape to stick on sweaty feet for blister prevention.

I always have it in my first aid kit. Put a few drops of benzoin on a fingertip, rub it over the area to be taped, and wait about 2 minutes for it to dry. Rip off some tape, and smooth it over the benzoined area. The benzoin will make the tape grip on your sweaty feet, and the surface of the tape provides a low friction surface to stop blisters from developing. 

However, benzoin generally comes in a heavy glass bottle that holds much more than you’d need on a weekend trip. 

It also comes prepackaged in some commercial first aid kits, in small glass vials or pre-applied on a Q-tip sort of thing. Both of these are Less Than Ideal, because the glass can break, and the single use Q-tip thing can dry out before you use it.

Here’s a great way to carry benzoin, with just the amount you need in a tiny container that will never leak.

1. Buy the tiniest (and cheapest!) bottle of eyedrops you can find – probably 1/8 of an ounce.

2. With a safety pin, slightly enlarge the dropper hole.

3. Squeeze out and discard the eyedrop solution.

4. Pour a bit of benzoin from the large drugstore bottle into a bottle cap or other small disposable container.

5. Squeeze the empty eyedropper bottle to make a vacuum, then place the tip into the bottle cap of benzoin.

6. Release, and the eyedropper bottle will partially fill with benzoin. Repeat until full.

7. Label the bottle. Cloth first aid tape and Sharpie pen works well.

8. Refill after a trip as needed. This weighs next to nothing, is leakproof, holds enough for many applications and it’s easily refillable. The original glass bottle is huge and holds more than you'll ever use, so feel free to share it with a friend.

Tiny eyedropper bottle about 1/2 full of benzoin, penny for scale.

The best liner socks to avoid blisters?

For a blister preventative, try this – polyester dress socks as a liner sock. Your climbing pals will envy you as the best dressed hiker at the trailhead, and your feet will be happy as the slick synthetic socks slide right over those problem areas of your heel. Blisters are typically caused by friction, and if you can minimize friction inside your boots, you decrease the chances of a blister forming.

I once had some boots that took a long time to break in, and I had constant blister problems. After trying most other blister preventative tricks out there, I gave this as try – even though it sounded pretty goofy. Not a single blister.

You can buy low-end dress socks for about 3 pairs for $10. Costco usually has multi-packs for a super low price.

It's fine to combine this with preventatively taping your known problem areas, such as the back of your heel. Remember to use tincture of benzoin on your skin before you put on the tape, to make sure the tape doesn't slide off.

Acute Mountain Sickness (AMS) - a quick field check

Acute Mountain Sickness (aka AMS, or altitude sickness) can bring you or a teammate to a halt with various mild symptoms such as loss of appetite, headache or nausea, Untreated, it can lead to more severe problems like cerebral or pulmonary edema.

In particular, ataxia, (doctor speak for "loss of coordination") can indicate more severe AMS, or may be a precursor to cerebral edema, which is extremely serious. 

Here’s a quick field test can help determine the degree of ataxia, and can help you decide if someone needs to descend.

Ask the AMS affected person to stand in a flat, safe place.  Have at least one other person standing alongside to catch them if they start to stumble.  Have the AMS “patient” stand with their feet together (insides of the boots touching) have hands at their sides, and finally close their eyes.

If they can hold this position for 10 seconds without a stumble or fall, they are okay to continue.  If they stumble, consider a prompt descent.

This tip was taken from from Rock and Ice magazine

A Gamow bag, used to treat severe altitude related illness, is NOT where you want to be on your climb. But it beats the alternative.

photo: http://expeditioncompany.co.uk/

Steri-Strips for the first aid kit

Steri-Strips, a cross between a band-aid and a suture, are narrow strips of super strong first aid tape that really stick to skin and are used to close cuts in place of a suture.  3M makes them, so you know the adhesive is good stuff.

They're inexpensive, weigh nothing, and could save the day if you need to care for a substantial cut in the backcountry. Consider adding them to your first aid kit.  Get them at better stocked pharmacies and medical supply stores, and through the usual online retailers.