Wilderness Medicine

By Gevork Mosesi

I think I can speak for most landscape photographers, the majority of us got into the art of making photos because of the love of nature and wilderness. Most activities in nature have a degree of risks. Landscape photography is no exception.

You are probably taking steps to reduce some of the risks, such as packing warm clothing, flashlights for the dark, and carrying water for those long hikes.

Fortunately, most of the locations we visit aren't too far from civilization, and given the popularity of these locations, we often aren't alone. If an emergency were to occur, chances are we would be helped. However, one can never be over-prepared for an emergency, especially when backpacking into remote locations. Being prepared and knowing what to do in an emergency or even urgency, could mean the difference between reducing risks of further harm, even death.

Important Disclaimer

This article is not a substitute for proper training in wilderness medicine or first aid. Rather it is meant to function as a starter guide into basic wilderness first aid, more importantly, to get photographers thinking about what essentials are needed for each trip and what the risks are.

I encourage anyone who is interested in learning more about wilderness first aid to visit the following websites for courses and resources:

• NOLS Wilderness Medicine Courses
• American Red Cross
• Backpacker Magazine First Aid Guide
• REI Wilderness First Aid Basics

Series Overview

Due to the depth of the topic, this article is divided into two sections. In this first section, we will cover:

1. Basic Essentials
2. Hydration
3. Tick Bites
4. Spider Bites
5. Poison Plants
6. Snake Bites

Part 2 will cover: Blisters, Burns, Wounds and Infections, Knee and Ankle Injuries, Hypothermia, and Altitude Sickness.

Basic Essentials

The basic essentials may differ from one trip to the other, based on the location, environment, temperature extremes, and terrain. The essentials for most environments include:

• Hat and sunscreen
• Insect repellent
• Boots
• Long pants and sleeves, extra clothing
• Rain gear
• Map of the area (GaiaGPS app recommended)
• Compass
• Flashlight with extra batteries
• Sunglasses
• Pocket knife
• Matches in waterproof container or fire starter
• First Aid kit
• Water and water filtration systems
• Duct tape
• Ground insulation for overnight stays

Hydration

If you are thirsty, you are partially already dehydrated. You should drink to prevent thirst, not to quench it. Proper hydration is essential for the function of your joints, muscles, gastrointestinal system, circulation, kidney function, and mentation, all of which are crucial when hiking.

Proper hydration can prevent electrolyte imbalances, such as low or high sodium (hyponatremia and hypernatremia respectively). Sodium irregularities can lead to neurological and cardiac conditions, which can be life-threatening.

Signs of Dehydration

Mild dehydration includes dry lips and mild thirst. More severe dehydration can lead to fatigue, muscle aches and cramps, irritability, frustration, and brain fog, which can lead to poor decision making.

Heat-Related Conditions

Heat Cramps: Brief but painful involuntary muscle spasms, usually occurring in muscles being used during exercise, resulting from insufficient fluid intake.

Heat Exhaustion: Difficulty breathing, headache, feeling hot on the head and neck, dizziness, heat cramps, chills, nausea, irritability, vomiting, extreme weakness or fatigue.

Heatstroke: Rapid and shallow breathing, rapid heartbeat, unusually high or low blood pressure, lack of sweating, mental confusion and disorientation, unconsciousness, physical collapse. This is a medical emergency.

In the event of heat exhaustion, stop the activity, move into a cool environment under shade, remove excess clothing and drink hydrating liquids slowly. Seek immediate medical care when possible. Always avoid caffeinated and sugary drinks as they can lead to further dehydration.

Tick Bites

Although most tick bites are harmless, proper handling can prevent complications such as Lyme disease or Spotted Fever Rickettsiosis (SFR). Lyme disease is endemic to the north-east and parts of California's central coast. SFR is endemic to south-eastern states. Peak months are May through August.

Prevention

Treat your clothing with Permethrin 0.5%. Walk in the center of trails. After returning from hikes, check your clothing and body thoroughly. The longer the tick stays on your body, the higher the risk of transmitting disease.

Tick Removal

Remove the tick as soon as you notice it by grasping it with tweezers as close to the skin as possible, pulling it straight out. Avoid twisting. Wash the bite area with soap and water. Save the tick in a container with rubbing alcohol for lab identification if needed. Watch for signs of infection such as rash, fever, and body aches.

Spider Bites

Spider bites typically show two central punctum marks (as opposed to one with an insect bite). Seek medical care if pain is severe, difficulty breathing, or upset stomach occurs.

Two Common Poisonous Spiders

Brown Recluse: Most commonly found in midwestern and southern states. Bite causes stinging sensation with localized pain, small white blister develops.

Black Widow: Found throughout North America, more common in southern and western states. Venom is a neurotoxin producing pain at bite area that spreads to chest, abdomen and entire body.

Treatment

Stay calm. Identify the spider if possible. Wash the bite area with soap and water. Apply cold compress to reduce swelling. Elevate bite area. Do not attempt to remove venom. Seek professional medical care immediately.

Poisonous Plants

Poison Ivy, Poison Oak, and Poison Sumac contain urushiol, a sticky oil that causes an itchy, blistering rash after contact with skin. The reaction is delayed, often hours to one day after exposure (delayed hypersensitivity reaction). The rash can peak within a week but can last as long as 3 weeks.

Identification

Poison Ivy: "Leaves of three, let it be." Three leaflets per stem.

Poison Oak: Similar to poison ivy with oak-like leaves, grows as shrub or vine.

Poison Sumac: Woody shrub with 7-13 smooth-edged leaflets arranged in pairs.

Treatment

If exposed, wash the area immediately with soap and water. Remove contaminated clothing. Apply cool compresses. Use calamine lotion or hydrocortisone cream for itching. Seek medical attention if the rash is severe or covers large areas of the body.

Snake Bites

Most snake bites in North America are from non-venomous species. However, venomous snakes include rattlesnakes, copperheads, cottonmouths (water moccasins), and coral snakes.

Prevention

Watch where you step and reach. Wear boots and long pants. Use trekking poles to probe ahead in tall grass. Be extra cautious around rocks, logs, and in areas with rodent activity.

Treatment

If bitten, stay calm and keep the affected limb immobilized below heart level. Remove jewelry and tight clothing before swelling occurs. Do not apply ice, cut the wound, or attempt to suck out venom. Mark the edge of swelling with a pen and note the time. Seek emergency medical care immediately.

Conclusion

Being prepared for wilderness emergencies is essential for any landscape photographer venturing into remote locations. This knowledge, combined with proper equipment and training, can make the difference in emergency situations. Stay tuned for Part 2, where we'll cover additional wilderness first aid topics.

Remember: This article is not a substitute for proper wilderness medicine training. Take a certified course to be fully prepared.