Table of Contents
Preface x
How to Use This Book xii
How to Prepare for Remote Wilderness Travel xiv
Mental Preparation xiv
Physical Preparation xv
The Wilderness Expedition Medical Kit xvi
Improvisation xviii
Chapter 1 Assessment and Stabilization 1
Assessment and Care 1
Initial Assessment 3
Survey the Scene
Check the Airway and Breathing
Check Circulation
Check for Severe Bleeding
Check the Cervical Spine
Focused Assessment 5
The Physical Exam
Vital Signs 6
Level of Responsiveness
Pulse
Respirations
Skin Signs
Blood Pressure
Temperature
Medical History and Physical Examination 8
Head
Neck
Chest
Abdomen
Back
Pelvis/Hip
Legs Shoulders and Arms
Shock 10
Difficult Respirations 12
Foreign Body Airway Obstruction 13
Adult One-Rescuer Cardiopulmonary Resuscitation (CPR) 14
Adult Two-Rescuer CPR 17
Rapid Breathing 17
Cardiac Evaluation and Care 18
Heart Attack-Myocardial Infarction
Rapid Heart Rate 21
Tachycardia
Slow Heart Rate 22
Bradycardia
Chapter 2 Body System Symptoms and Management 24
Symptom Management 24
Fever/Chills
Lethargy
Pain
Itch
Hiccups
Headache
Eye 33
Eye Patch and Bandaging Techniques
Foreign Body Eye Injury Contact Lenses
Eye Abrasion
Snow Blindness or Ultraviolet
Eye Injury
Conjunctivitis
Iritis
Allergic Conjunctivitis
Sties and Chalazia
Spontaneous Subconjunctival Hemorrhage
Blunt Trauma to the Eye
Glaucoma
Nose 48
Nasal Congestion
Foreign Body Nose Injury
Nosebleed Nose Fracture
Ear 50
Earache
Outer Ear Infection
Middle Ear Infection
Foreign Body Ear Injury
Ruptured Eardrum
Temporomandibular Joint (TMJ) Syndrome
Mouth and Throat 56
Sore Throat
Infectious Mononucleosis
Mouth Sores
Gum Pain or Swelling
Mouth Lacerations
Dental Pain
Lost Filling Loose or Dislodged Tooth
Pulling a Tooth
Chest 64
Bronchitis/Pneumonia
Pneumothorax
Pulmonary Embolus
Abdomen 67
Abdominal Pain
Gall Bladder Problems and Appendicitis Vomiting
Motion Sickness
Diarrhea
Constipation Hemorrhoids
Hernia
Bladder Infection
Reproductive Organs 79
Venereal Diseases
Vaginal Discharge and Itching
Painful Testicle
Menstrual Problems
Spontaneous Abortion
Ectopic Pregnancy
Poisoning 84
Plant or Food Poisoning
Petroleum Products Poisoning Ciguatera Poisoning
Scombroid Poisoning
Puffer Fish Poisoning
Paralytic Shellfish Poisoning
Managing Diabetes 87
Water and Waste 88
Oral Fluid Replacement Therapy
Water Purification Human Waste Disposal
Chapter 3 Soft Tissue Care and Trauma Management 96
The Bleeding Wound 97
Stop the Bleeding
Clean the Wound
Antibiotic Guidelines
Wound Closure Techniques 105
Tape Closure Techniques
Stapling
Suturing
Special Considerations 110
Shaving the Wound Area
Bleeding from Suture or Staple Use Scalp Wounds
Eyebrow and Lip Closure
Mouth and Tongue Lacerations
Control of Pain
Dressings
Other Types of Wounds 112
Abrasions
Puncture Wounds
Splinter Removal
Fishhook Removal
Friction Blisters
Thermal Burns
Human Bites Animal Bites
Finger and Toe Problems 124
Ingrown Nail
Paronychia (Nail Base Infection)
Felon Blood under the Nail
Wound Infection and Inflammation 127
Abscess
Cellulitis
Skin Rash 129
Fungal Infection
Allergic Dermatitis
Bacterial Skin Rash
Seabather's Eruption
Chapter 4 Orthopedic Injuries 133
Concepts of Orthopedic Care 134
Muscle Pain-No Acute Injury
Muscle Pain-Acute Injury Joint Pain-No Acute Injury
Joint Pain-Acute Injury Fractures
Diagnosis and Care Protocols 142
Head
Neck
Spine
Collarbone
Shoulder
Shoulder Blade Upper Arm Fractures (near the Shoulder)
Upper Arm Fractures (below the Shoulder)
Elbow Trauma
Forearm Fractures Wrist Fractures and Dislocations
Thumb Sprains and Fractures Hand Fractures
Finger Fractures and Sprains
Hip Dislocation and Fracture
Thigh Fractures
Kneecap Dislocation
Knee Sprains, Dislocations, and Fractures
Ankle Sprains, Dislocations, and Fractures
Foot Injuries
Chest Injuries
Chapter 5 Bites and Stings 170
Bee Stings 171
Anaphylactic Shock
Snake Bites 173
Identifying Common North American Poisonous Snakes
Signs and Symptoms of Pit Viper Bite
Treatment of Pit Viper Bite Neurotoxic Snake Bites
Treatment of Coral Snake Bite
Insect Bites and Stings 177
Spider Bites
Ticks
Caterpillar Reactions
Millipede Reactions Centipede Bites
Mosquitoes
Black Flies
No-See-Ums and Biting Gnats
Scorpion Stings
Ants/Fire Ants
Aquatic Stings, Cuts, and Rash 184
Sea Urchin
Jellyfish
Coral Stings
Coral and Barnacle Cuts Stingray
Catfish
Scorpion Fish
Sponge Rash 184
Chapter 6 Infectious Disease 188
Anaplasmosis
Babesiosis
Blastomycosis
Chikungunya Fever
Cholera
Coccidioidomycosis
Colorado Tick Fever
Dengue Echinococcus
Ehrlichiosis
Encephalitis
Giardiasis
Hantavirus Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D
Hepatitis E
Hepatitis G
Leptospirosis
Lyme Disease Malaria
Meningococcal Meningitis
Plague
Rabies
Relapsing Fever
Rocky Mountain Spotted Fever Schistosomiasis
Stari
Tapeworms
Tetanus
Tick Paralysis Trichinosis
Trypanosomiasis
African (African Sleeping Sickness)
Trypanosomiasis, American (Chagas Disease) Tuberculosis
Tularemia
Typhoid Fever
Endemic Typhus, Flea-Borne
Epidemic Typhus, Louse-Borne
West Nile Virus Yellow Fever, Zika Virus
Chapter 7 Environmental Injuries 216
Hypothermia 217
Chronic Hypothermia
Acute Hypothermia
Cold Water Submersion
Cold-Stress Injuries 221
Frostnip
Frostbite
Cold-Induced Bronchospasm Immersion Foot
Chilblains
Heat-Stress Injuries 225
Dilutional Hyponatremia
Heat Cramps
Heat Exhaustion
Heat Stroke
Prickly Heat
Lightning 231
High Altitude Illnesses 234
Acute Mountain Sickness (AMS)
High Altitude Pulmonary
Edema (HAPE)
High Altitude Cerebral Edema (HACE)
Other High Altitude Conditions
Sawyer® Accident/Evacuation Record 240
Appendix A The Wilderness Expedition Medical Kit 241
Topical Bandaging Module 244
Non-Rx Oral Medication Module 250
Rx Oral/Topical Medication Module 252
Rx Injectable Medication Module 258
Cardiac Medication Module (contains Rx and non-Rx components) 260
Appendix B International Immunizations and Travel Risk Assessment 262
Clinical Reference Index 264
About the Author 282
