First aid is the first line of treatment administered to a patient in the event of a sudden injury. It is often provided as a temporary measure of sustaining the patient’s present medical condition, until a proper, and more advanced level of care is available.           

A first aid box is one of the most important things to have in your bag, regardless of your level of experience. This is especially important, because medical help will be very far from reach when you are out on a trek. (TIP: Try using a waterproof canvas bag instead of a metal box, it’ll save some weight, and will help keep out the moisture.)

You may face many medical problems, such as hypothermia, or various kinds of injuries (from fractures, or animal bites) when you are up in the mountains.

One needs to be able to understand the symptoms of his fellow climber and thus provide proper medical aid in a timely manner.

It is recommended that you consult a doctor before going on any expeditions, so that you can discuss if there are any extra medicines to be taken according to the climate of your intended destination.

When you consult your physician, he/she must be aware of each team member’s medical history so that he/she can provide the required prescriptions.

Your first aid kit should be small, lightweight, and spacious.

Ideally, it should be placed at the top of your knapsack/day pack, so that it can be easily accessible at all times.

 

Essential supplies in your first aid box/kit

 

  1. Acetazolamide (Diamox) – This is one of the most important medicines used in high altitude areas. The level of oxygen, and the atmospheric pressure is comparatively lesser in those areas which leads to physiological changes such as the accumulation of fluids in the human body. This medicine helps to remove the fluids from the tissue of the body.
  2. Adhesive bandages of various styles
  3. Aluminum foam splint – Acts as a malleable splint in case of a fracture.
  4. Antacid – Keep antacids in case of acidity.
  5. Antibiotics – Please descend before taking any antibiotics. Do not take antibiotics at a high altitude.
  6. Anti-diarrhoea medicines – for traveller’s diarrhoea
  7. Antidotes – for animal bites
  8. Anti-histamines –  for allergic reactions.
  9. Antiseptics – Betadine, for example, is very effective in cleaning wounds and preventing further infections.
  10. A pair of scissors – To help cut gauze, etc.
  11. Asthma inhalers – Helps in opening up the airways for a patient who is prone to asthma.
  12. Athletic tape – one roll per person, per week, for hiking. It’s good for preventing, and covering blisters, ankle taping, and much more.
  13. Burn creams – Helps in healing the burnt skin, and keeps out infections.
  14. Compression wraps –  Helps in applying pressure and reduces swelling.
  15. CPR mask and airway management – These masks are used to deliver breaths in the event of a cardiac arrest or other respiratory problem.
  16. Fire blanket – They help in putting out fires in an emergency. They’re especially useful in the absence of a fire extinguisher.
  17. Gauze – Make sure you have different sizes, since you may need to cater to various kinds of injuries.
  18. Gloves – Nitrile gloves are preferred, as vinyl is so porous, and latex is a common allergen. Bring a few more pairs than you think you may need, since you’ll only use a pair once. If you have had gloves in your kit for a long time, it is best to check them to make sure that they didn’t degrade in the heat, or cold temperatures.
  19. Glucose packets – To help in increasing blood sugar in case of dehydration or hypoglycaemia.
  20. Ibuprofen – It helps to recover aching muscles and provides relief from headaches.
  21. Insect repellant – Protects against insect bites.
  22. Mackintosh – They’re waterproof and windproof, and can also be used in place of a poncho.  
  23. Muscle relaxants –  Sometimes, when muscles are pulled or stretched beyond their limits, they start to pain. Muscle relaxants help in reducing muscular spasms, and are required if the pain is intolerable.  
  24. ORS – Oral Rehydration Salts packets. Keep as many as you need.
  25. Roller gauze – To hold a dressing in its place.
  26. Safety pins – To hold dressings or bandages together.
  27. Small magnifying glass – Having a magnifying glass makes it easier to see some kinds of wounds, helping us clean them better.
  28. Space Blanket – Also known as an emergency/survival blanket or a foil blanket. It is designed to reduce heat loss from a person’s body.
  29. Sterile Wet Wipes – To clean up fluids or blood from a wound. Also helps in general hygiene.
  30. Stethoscope – For listening to the internal sounds of a patient.
  31. Sunscreen lotion – Protects against the damaging UV rays of the sun.
  32. Temporary dental fillings – Helps protect a broken tooth temporarily so that it doesn’t get infected.
  33. Tweezers – To help peel off dead skin from a blister or to pull out splinters.
  34. Wound dressing – Bring along different types of dressing, both waterproof and water absorbing for a variety of injuries. Make sure they are sterile.

 

COLD INJURIES

 

Any injury which is caused due to prolonged exposure to low temperatures (freezing or non-freezing), is defined as a cold injury. Some examples of cold injuries include chilblains, frostbite, trench foot, hypothermia etc.

The degree of the cold injury not only depends upon the temperature it has been exposed to, but also upon how much time the body has been exposed to such a climate.

It is important to remember that the first stages are reversible in most cases.

However, if the injured part is not treated properly, it may change into a chronic problem. In fact, if the degree of the injury has progressed to a critical point due to the absence of adequate medical care, then we may need to amputate the body part in order to save the patient’s life.

If someone has suffered a cold injury, then these are the steps one should take:

  1. Remove any wet clothes, gloves, socks, and shoes.
  2. Make sure that you dry out the patient’s hands, feet, and head.
  3. Cover the patient’s hands, feet, and head with dry, warm clothes.
  4. Give warm fluids to the patient.
  5. Provide heated padding, if possible.
  6. If the patient is in a critical condition, then an IV solution that has been warmed up to a room temperature, should be given.  

 

High Altitude Sickness/Illness

 

These illnesses are mostly seen in areas of high altitude, which occur 9000 metres above sea level.

Acute mountain sickness, though, is not a serious problem on its own, if treated early enough.

However, if it progresses to more serious illnesses such as High Altitude Pulmonary Oedema (HAPO), or High Altitude Cerebral Oedema (HACO), then it could be fatal for the patient.

It is most important that first aid is provided as soon as possible, to increase the chances of survival.

Some of the symptoms of AMS include headaches, nausea, heaviness, or tightness in the chest, breathlessness at rest, and a lack of muscular coordination.

Ibuprofen is generally provided for headaches, while Diamox is usually prescribed for removal of fluids from the body. Therefore, it is imperative that the patient should take plenty of fluids to avoid dehydration.  A continuous supply of oxygen should be provided in more serious cases of AMS. It is also recommended to descend to a lower altitude if the patient’s condition does not improve during a stipulated period of time.

 

SKIN INFECTIONS: ALLERGIES, BLISTERS AND FUNGAL INFECTIONS

 

When you are at a higher altitude (especially on a mountain), the days are hotter, and there is more exposure to the sun’s UV rays.

Prolonged exposure to the sun may cause rashes, minor irritations, and mild sunburns. However, in some cases, sunburns can cause blisters, peeling of the skin, and in severe cases, hyperthermic shock.

Staying at a higher altitude also means that you get fewer showers, and relatively poorer hygiene, which can sometimes lead to other kinds of skin infections as well.

Hence, it is best to regularly keep changing dirty clothes, especially those with sweat, since sweat has a cooling effect on the body, and can be otherwise detrimental.

Sweaty clothes are also ideal breeding grounds for all kinds of bacteria and fungi, leading to a myriad of infections.

How do we know if our fellow team member is suffering from a skin infection?

Look out for these signs and/or symptoms:

  1. Reddish skin colour
  2. Itching in the affected area
  3. Blisters
  4. Pain in the affected area

In case of sunburns, cover the affected part, apply a generous amount of sunscreen lotion, or an aloe vera gel to provide relief.

If the patient has contracted a skin infection, we should use topical antibiotics, or anti-fungal creams and sprays. Oral antibiotics may also be given to the patient, if needed.

Blisters are small pockets of fluid that form on an area of the body when it has been exposed to regular friction. A blister can also form if an area of skin has been burnt.

When you are out hiking, it is more than likely that you will be walking 6 to 8 hours a day on average. At the end of the day, your feet are not only tired out, but they also need proper care, and adequate rest, so that they’ll be ready for the next day.

Blisters and fungal infections, are thus very common amongst hikers’ feet. There are many factors to these: dirty socks, sweat, ill-fitting shoes, sand, or even waterlogged shoes.  

If you can, it is best to keep checking your feet during a hike. Otherwise, always make sure that you clean your feet thoroughly and dry them out at the end of each day.

Most blisters occur in the epidermis, or the upper layers of the skin. The fluids in a blister are mostly serum, or plasma, but can be filled with blood, or pus if infected.

If the skin over the blister hasn’t broken yet, it’s providing a cover to keep the bacteria out. Do not drain the blister if it is small, or unobtrusive. If it is too large, or painful, follow the steps below to drain it properly.

  1. Wash your hands prior to touching the blister. Wash the affected area gently with warm, soapy water.
  2. Use any antiseptic or antifungal ointment that contains iodine (e.g. Betadine) to gently dab the area.
  3. Sterilise a sharp needle with an alcohol swab or by holding it to a flame for a few seconds.
  4. Puncture the blister near its edges so that you can drain it while keeping the skin intact.
  5. Apply petroleum jelly over the blister and cover it up with adequate dressing.

You should keep checking the blister every day so as to make sure that there isn’t any infection. You may use a sterilised pair of scissors to remove the dead skin after a few days. Make sure to cover the area once again with bandages until it is fully healed.

Most importantly, it is always wise to seek medical help if you are a diabetic or have other health conditions before puncturing the blister by yourself. It is also recommended to consult a medical professional if the blister has become infected so you don’t end up endangering your health.

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