Outdoor Health Emergencies - Prevention, Treatment And Symptoms
Common Outdoor Health Emergencies
When you spend a lot of time outdoors, especially if it's far away from medical attention, it's a great idea to be familiar with these possible health emergencies, their prevention and treatment. Considering that it only takes a moment to get too close to a fire, become too hot or cold, or step where you wish you hadn't, extra care should be taken when you're in the wilderness, off grid, or outdoors in general. This page lists some common health emergencies, ways to prevent them, and how to react if you have one. Remember to always to err on the side of caution, and if you're a caregiver, staying calm is one of the best things you can do!

Prevention -
•Wear warm, multi-layered clothing with good hand and feet protection (avoid overly constricting wrist bands, socks, and shoes).
•Wear warm headgear. This is particularly important since significant heat is lost through an unprotected head.
•If possible, change into dry clothes whenever clothing becomes wet.
•Find appropriate shelter to stay warm.

Symptoms -
•Uncontrolled shivering
•Slow or unclear speech
•Feeling extremely tired
•Stumbling when attempting to walk
•Confusion (person cannot think clearly)
•Semi-consciousness or unconsciousness

Treatment - **WARNING: Do not warm a person too fast.
•Bring the person indoors or to a dry place protected from the wind.
•Remove wet clothing and cover the person with dry blankets. Make sure to cover the head, hands, and feet.
•Put the person in a cot or bed next to a warm -- not hot -- heater.
•Lie under the covers next to the person to transfer your own body heat. If possible, have someone else lie on the other side.
•Give the person warm -- not hot -- broth or soup. Do not give alcohol to drink.
•Wrap an infant inside your own clothing against your skin.

Heat Exhaustion & Heat Stroke
Prevention -
Don't wait until you're thirsty to drink.
•During heavy exercise in a hot environment, drink two to four glasses (16-32 ounces) of cool fluids each hour.
•Choose lightweight, light-colored, loose-fitting clothing.
•If exertion in the heat makes your heart pound and leaves you gasping for breath, STOP all activity. Get into a cool area or at least into the shade, and rest, especially if you become lightheaded, confused, weak, or faint.

Symptoms -
Warning signs of HEAT EXAUSTION may include -
•Heavy sweating
•Muscle cramps
•Nausea or vomiting

Warning signs of HEAT STROKE vary but may include the following -
•An extremely high body temperature (above 103°F, orally)
•Red, hot, and dry skin (no sweating)
•Rapid, strong pulse
•Throbbing headache

Treatment -
Treatment of HEAT EXAUSTION-
•Cool, nonalcoholic beverages
•Cool shower, bath, or sponge bath
•An air-conditioned environment
•Lightweight clothing

Treatment of HEAT STROKE -
•Get the victim to a shady area.
•Cool the victim rapidly using whatever methods you can. For example, immerse the victim in a tub of cool water; place the person in a cool shower; spray the victim with cool water from a garden hose; sponge the person with cool water; or if the humidity is low, wrap the victim in a cool, wet sheet and fan him or her vigorously.
•Monitor body temperature, and continue cooling efforts until the body temperature drops to 101-102°F.
•If emergency medical personnel are delayed, call the hospital emergency room for further instructions.
•Do not give the victim fluids to drink.
•Get medical assistance as soon as possible.

Prevention -
•Do not go outside in very cold weather after a recent bath or shower.
•Wear warm clothing and dress in layers.
•Layer 1 – wear clothes that will keep moisture away from the skin. Thermal underwear, moisture-reducing winter sportswear, cotton socks and mitten and glove liners are good items to use. The first layer, like the other layers, should not be so tight that circulation is impeded.
Layer 2 – wear loose clothing that is intended to resist dampness and maintain body temperature. Heavy pants, sweaters and sweatshirts are good items for layer two.
Layer 3 – wear tightly woven moisture-resistant outerwear. Moisture-resistant coats and jackets, hats, scarves, gloves and mittens and boots are good third layer items.
•Bring children in at regular intervals and inspect fingers and noses for signs of frostnip and frostbite.
•If you are away from home, take extra clothing along.
•Keep dry. Wet clothes increase chance of heat loss.

Symptoms -
Early frostbite is characterized by waxy, white and hard skin that feels numb and has a persistent burning sensation. In more severe cases, frostbitten skin will become blue and mottled or splotchy.

Treatment - ** WARNING: Do not rub or bump the affected area. Do not use direct heat such as a heating pad or hair dryer to warm the affected area. Do not pop blisters that appear. Popping blisters on frostbitten skin can cause infection.

•Protect your skin from further exposure. If you're outside, warm frostbitten hands by tucking them into your armpits. Protect your face, nose or ears by covering the area with dry, gloved hands.
•Get out of the cold. Once you're indoors, remove wet clothes.
•Gradually warm frostbitten areas. Put frostbitten hands or feet in warm water — 104 to 107.6 F (40 to 42 C). Wrap or cover other areas in a warm blanket.
•Don't walk on frostbitten feet or toes if possible. This further damages the tissue.
•If there's any chance the affected areas will freeze again, don't thaw them. If they're already thawed, wrap them up so that they don't become frozen again.
•Get emergency medical help. If numbness or sustained pain remains during warming or if blisters develop, seek medical attention.

Prevention -
To prevent dehydration, drink plenty of fluids and eat foods high in water such as fruits and vegetables. Letting thirst be your guide is an adequate daily guideline for most healthy people. Fluids can be obtained not just from water but also from other beverages and foods. But, if you're exercising, don't wait for thirst to keep up with your fluids.

Symptoms -
Thirst isn't always a reliable gauge of the body's need for water, especially in children and older adults. A better indicator is the color of your urine: Clear or light-colored urine means you're well hydrated, whereas a dark yellow or amber color usually signals dehydration.

Mild to moderate dehydration is likely to cause:
•Dry, sticky mouth
•Sleepiness or tiredness — children are likely to be less active than usual
•Decreased urine output — no wet diapers for three hours for infants and eight hours or more without urination for older children and teens
•Few or no tears when crying
•Dry skin
•Dizziness or lightheadedness

Severe Dehydration Symptoms -
•Extreme thirst
•Extreme fussiness or sleepiness in infants and children; irritability and confusion in adults
•Very dry mouth, skin and mucous membranes
•Lack of sweating
•Little or no urination — any urine that is produced will be dark yellow or amber
•Sunken eyes
•Shriveled and dry skin that lacks elasticity and doesn't "bounce back" when pinched into a fold
•In infants, sunken fontanels — the soft spots on the top of a baby's head
•Low blood pressure
•Rapid heartbeat
•Rapid breathing
•No tears when crying
•In the most serious cases, delirium or unconsciousness

Treatment -
**The only effective treatment for dehydration is to replace lost fluids and lost electrolytes. The best approach to dehydration treatment depends on age, the severity of dehydration and its cause.

•Avoid milk, sodas, caffeinated beverages, fruit juices or gelatins, which don't relieve dehydration and which may make symptoms worse.
•Use an oral rehydration solution. Unless your doctor advises otherwise, use an oral rehydration solution such as Pedialyte for infants and children who have diarrhea, vomiting or fever.
•For exercise-related dehydration, cool water is your best bet. Sports drinks containing electrolytes and a carbohydrate solution also may be helpful. There's no need for salt tablets — too much salt can lead to hypernatremic dehydration, a condition in which your body not only is short of water but also carries an excess of sodium.
**You can make your own oral rehydration solution by mixing 1/2 teaspoon salt, 6 level teaspoons of sugar and 1 liter (about 1 quart) of safe drinking water.

Poisonous Snake Bites
Prevention -
•Be aware of snakes that may be swimming in the water to get to higher ground and those that may be hiding under debris or other objects.
•If you see a snake, back away from it slowly and do not touch it.

Symptoms -
Depending on the type of snake, the signs and symptoms may include:
•A pair of puncture marks at the wound
•Redness and swelling around the bite
•Severe pain at the site of the bite
•Nausea and vomiting
•Labored breathing (in extreme cases, breathing may stop altogether)
•Disturbed vision
•Increased salivation and sweating
•Numbness or tingling around your face and/or limbs

Treatment -
•If you or someone you know are bitten, try to see and remember the color and shape of the snake, which can help with treatment of the snake bite.
•Treat for shock and preserve body heat.
•Remove any rings, bracelets, boots, or other restricting items from the bitten extremity. (It WILL swell.)
•Apply a light constricting band about 2" above and below the bite, however never place the bands on either side of a joint (such as above and below the knee or elbow). This band should be made up of wide, soft material, which could be a handkerchief or shredded clothing. The band should only be as tight as the band the nurse applies when taking a blood test.
NOTE: The purpose of constricting bands is to restrict lymphatic flow, not blood, so they should not be too tight. Check pulses below the bands and readjust the bands as necessary when they tighten due to swelling.

•Wash the bite with soap and water (if available).
•If the victim has to walk out, sit calmly for 20-30 minutes to let the venom localize at the site, then proceed calmly to the nearest source of help and try to avoid unnecessary exertion which will stimulate circulation of the venom.
•Get the victim to definitive medical care for antivenin, which will provide the greatest relief from the toxic effects of the bite.

What NOT To Do if You or Someone Else is Bitten by a Snake:
•DO NOT cut the bite. The additional tissue damage may actually increase the diffusion of the toxins throughout the body.
•DO NOT apply a tourniquet. Such action can result in the loss of the limb.
•NEVER try to suck out the venom by mouth. You can try the suction cup in a snakebite kit if it doesn't delay other needed treatment. Suctioning seldom provides any measurable advantages, however.
•Do not apply cold and/or ice packs or immerse the wound in water. Recent studies indicate that application of cold or ice makes the injury much worse.
•Do not pick up the snake or try to trap it (this may put you or someone else at risk for a bite). 
•Do not drink alcohol as a pain killer.
•Do not drink caffeinated beverages.

Snow Blindness
Prevention -
Avoidance of snow blindness is simply with sunglasses, preferably of good quality with protective sidepieces. These should be worn at all times in snow. In emergency, sunglasses can be made from a piece of bark, leather or cardboard with small slits in it tied around the head.
Symptoms -
Snow Blindness results from exposure to sunlight reflected off of snow, ice, or water. Even on gray overcast days the eye is exposed to UV rays and this exposure can result in the burning of the surface of the eye, as well as the retina. Symptoms may not be  apparent until up to 12 hours after exposure. Snow blindness is characterized by red, painful, gritty eyes with photophobia (aversion to light).  Eyes initially feel irritated and dry; then, over time, eyes feel as though they are full of sand. Blinking and moving the eyes may be extremely painful. The eyelids are usually red, swollen, and difficult to open. 
Treatment -
Treatment includes antibiotic ointment (Oc. Chloramphenicol tds), cycloplegic drops to relieve the pain of ciliary spasm (G. Cyclopentolate tds), rest and light avoidance. Recovery is usually within 24 hours but beware of secondary infection as snow blindness renders the eye vulnerable.

Sunburn And Burns
Prevention -
Burns result on the skin from getting to close to or too much of - the sun, heat, fire or corrosive chemicals
Symptoms -
1st-degree burn
The least serious burns are those in which only the outer layer of skin is burned, but not all the way through.

•The skin is usually red
•Often there is swelling
•Pain sometimes is present
•Treat a first-degree burn as a minor burn unless it involves substantial portions of the hands, feet, face, groin or buttocks, or a major joint, which requires emergency medical attention.

2nd-degree burn
When the first layer of skin has been burned through and the second layer of skin (dermis) also is burned, the injury is called a second-degree burn.

•Blisters develop
•Skin takes on an intensely reddened, splotchy appearance
•There is severe pain and swelling.
•If the second-degree burn is no larger than 3 inches (7.6 centimeters) in diameter, treat it as a minor burn.
•If the burned area is larger or if the burn is on the hands, feet, face, groin or buttocks, or over a major joint, treat it as a major burn and get medical help immediately.

3rd-degree burn
The most serious burns involve all layers of the skin and cause permanent tissue damage. Fat, muscle and even bone may be affected. Areas may be charred black or appear dry and white. Difficulty inhaling and exhaling, carbon monoxide poisoning, or other toxic effects may occur if smoke inhalation accompanies the burn.

Treatment - **Warning! Don't use ice. Putting ice directly on a burn can cause a person's body to become too cold and cause further damage to the wound.Don't apply egg whites, butter or ointments to the burn. This could cause infection.Don't break blisters. Broken blisters are more vulnerable to infection.

For minor burns including first-degree burns and second-degree burns limited to an area no larger than 3 inches (7.6 centimeters) in diameter, take the following action:

•Cool the burn. Hold the burned area under cool (not cold) running water for 10 or 15 minutes or until the pain subsides. If this is impractical, immerse the burn in cool water or cool it with cold compresses. Cooling the burn reduces swelling by conducting heat away from the skin. Don't put ice on the burn.
•Cover the burn with a sterile gauze bandage. Don't use fluffy cotton, or other material that may get lint in the wound. Wrap the gauze loosely to avoid putting pressure on burned skin. Bandaging keeps air off the burn, reduces pain and protects blistered skin.
•Take an over-the-counter pain reliever. These include aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve) or acetaminophen (Tylenol, others). Use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 2, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin.
Minor burns usually heal without further treatment. Watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. If infection develops, seek medical help. Avoid re-injuring or tanning if the burns are less than a year old — doing so may cause more extensive pigmentation changes. Use sunscreen on the area for at least a year.

For major burns:
1.Don't remove burned clothing. However, do make sure the victim is no longer in contact with smoldering materials or exposed to smoke or heat.
2.Don't immerse large severe burns in cold water. Doing so could cause a drop in body temperature (hypothermia) and deterioration of blood pressure and circulation (shock).
3.Check for signs of circulation (breathing, coughing or movement). If there is no breathing or other sign of circulation, begin CPR.
4.Elevate the burned body part or parts. Raise above heart level, when possible.
5.Cover the area of the burn. Use a cool, moist, sterile bandage; clean, moist cloth; or moist cloth towels.

Credit For Content:
North Carolina State University Cooperative Extension
Centers For Disease Control And Prevention (CDC)
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