Travel Reference
In-Depth Information
ableinwildernesscircumstancesmustberare.Whenavailable,thesupplementsareusually
supplied in a solution that can be added directly to the electrolyte solution.)
If a person with a healthy heart and normally functioning kidneys is provided with an
adequate intake of water (as glucose) and electrolytes (balanced salt solution), the kidneys
compensate for any imbalance. The inevitable inaccuracies inherent in measuring fluid in-
take and output are fully corrected. However, an individual with preexisting heart disease,
particularly congestive heart failure, a person with kidney disease, or someone with acute
renal failure as a result of his disease or injury requires much more precise therapy, which
can only be provided with hospital facilities. For such individuals, any error in administer-
ing fluids must be made on the side of not giving enough.
CARE FOR TRAUMA VICTIMS
Traumatic injuries are by far the most common medical problems encountered in the wil-
derness.
Emergencies
Truemedicalemergenciesinwhichadelayofafewminutesinprovidingcarecansigni-
ficantlyaffecttheoutcomearerare.Inwildernessaccidentstheopportunitytoprovidesuch
treatment may pass before anyone is able to get to the individual. Nonetheless, wilderness
travelers must be familiar with the procedures for treating traumatic medical emergencies
if they are to deal with them successfully when the rare opportunities do occur. True emer-
gencies do not allow time for referral to a textbook.
If immediate action is necessary to prevent loss of life following an accident, the order
in which problems should receive attention is as follows:
Cardiopulmonary Resuscitation (CPR).
Anopenairwaymustbeestablishedfirst;in-
terference with breathing by chest wounds must be immediately corrected. If needed,
CPR should be started. Emergency rescue personnel approaching an unconscious per-
son follow the acronym ABC, which stands for airway, breathing, and circulation.
Control of Bleeding.
After the person is breathing or being resuscitated, bleeding
should be controlled by direct pressure at bleeding sites, not by tourniquets or pressure
points.
Treatment for Shock.
After cardiac and respiratory function have been established
and bleeding has been controlled, attention should be directed to treating or preventing
shock.Treatment giveninanticipation ofshockismoreeffectivethantreatment institu-
ted after shock has developed.
Although the order of the first two actions may appear reversed because control of
severebleedingshouldtakeonlysecondsbutCPRcanbeprolonged,inrealitytheyarenot.
Anyone whose heart has stopped does not bleed. Therefore, CPR must take first priority.
Furthermore, anyone who has bled so severely the heart has stopped cannot be resuscit-
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