First Aid for hikers and expeditions

How to give First Aid

When you’re hiking through regions where professional care is difficult to reach it is important to be trained in the basics first aid. Along with a good first aid kit this section should help to prepare you for most emergencies. Jake and I have both been trained to basic medical standards and we highly recommend you get the same training before heading off your journey’s. Even a simple First Aid course might mean the difference between life and death.

This post is part of our ongoing list of hiking skills and gear you’ll need when you hit the trails.

Enjoy and share your thoughts with us.

Mouth to Mouth Resuscitation

Humans can stop breathing for many reasons including, a heart attack, drowning, electric shocks and suffocation. Diagnosing a heart attack can be hard if you’re medically trained, but some signs to look out ofr include a blue-grey tint to the skin, particularly the face, and no ‘rise and fall’ chest movement. If the affected person hasstopped breathing, mouth-to-mouth resuscitation will need to be performed. The method you use will be different for different situations, as shown below:

Adults

Mouth to Mouth

What do you do when the heart stops? Don’t panic, it can forced back into motion again using CPR. This involves a series of chest compressions combined with the ventilation techniques descirbed above.

• Open the patient’s mouth and if necessary remove blockages from the airway carefully using your finger as a hook.
• Next, two fingers under the patient’s chin and a hand on the forehead, then carefully moving tilt the person’s head back.
• Using your thumb and forefinger, pinch their nostrils closed, breathe in and place your mouth on theirs.
• Breathe hard, forcing their chest to rise.
• Remove your mouth to allow the chest to fall.
• Turn your head away as the patient exhales, and take a deep breath.
• Give 10 breaths in quick succession and then check for a pulse. If you can’t find one, then give CPR.
• Continue method at 10 breaths per minute.

Mouth to Nose

If the patient has facial injuries taht prevent mouth tho mouth resuscitation, use this next methond

• Use steps 1-2 from above.
• Use your hand ot hold the persons mouth closed, take a deep breath and place your mouth around the person’s nose.
• Breathe into their nostrils quite forcefully until the chest rises.
• Remove your hand and mouth to allow the air to escape.
• As before, turn your head away and take a deep breath in readiness for the next step.
• Continue at 10 breaths per minute.

Sometimes you’ll come across facial injuries that make mouth to mouth resusication ineffective until treated. For example, puncture woulds to the cheeks will air to escape and need to be sealed. Plastic wrappers can be used as a way of sealing facial and chest wounds.

Children

Mouth to Mouth and Nose for a Baby (under 1 year)

• Open the child’s mouth and using your pinky finger gently remove any blockages with a finger.
• Place your mouth around the baby’s nose and mouth.
• Gently blow air into the baby’s lungs whilst watching its chest. Be gentle! Children’s lungs are far smaller than an adult’s and breathing in a full breath could cause damage.
• As soon as the chest rises, stop and let the air escape.
• Repeat to give one breath every 3 seconds.
• After 20 breaths check the pulse.
• If the heartbeat is lower that 60 bpm then start CPR, and if it is above this then continue ventilation until help arrives.

Mouth to Mouth for a Child (over 1 year of age)

• Use steps one 1-2 from mouth to mouth for adults.
• Blow gently into their lungs until you see their chest rise. Pay the same consideration as you would to a child under one year old and don’t blow too hard or long.
• Stop, and let the air escape.
• Repeat to give one breath every 3 seconds.
• After 20 breaths check the pulse.
• If absent, start CPR, and if present continue mouth to mouth until help arrives.

Cardio-Pulmonary Resuscitation

Adults

• Give two breaths as described above.
• Position the heel of your hand slightly above where the breast bone and the ribs meet.
• Interlock your fingers with your other hand.
• Keep your arms straight and press down firmly, then release but keeping your hands in the same position.
• Repeat 15 times.

Note: CPR is physically demanding and, where possible, should be carried out by two people. The two aid givers should swap roles over 15 compressions.

Children

Baby (under 1 year of age)

• Ensure the baby is on a firm surface.
• Place two fingers slightly below the nipple line in the middle of the chest.
• Press down and release 5 times, at a rate of twice per second.
• Continue mouth to mouth for one breath as described above.
• Repeat steps 3-4 until help arrives.
• If a pulse appears and is above 60 bpm stop the chest compressions but continue ventilation.

Child (over 1 year)

• Place one hand slightly above where the breast bone and ribs meet.
• Use the heel of your hand to press down firmly and release.
• Repeat 5 times at a rate of 2 per second.
• Blow air into the lungs once, as described above.
• Repeat steps 3-4 until help arrives.
• If a pulse is present stop compressions but continue ventilation.

Severe Bleeding

A severed

Even a small cut to an artery can result in huge blood due to the pressure. Suffering from extensive blood loss can lead to shock, unconsciousness or even death. Anything more than a litre of blood from an ajdult and a third of a litre from aa child is considered harmful and the injured person is at risking fyding.

The following steps should be used to treat severe bleeding from a limb:

• If conscious, get the person to lay down and try to raise the injured limb, as the elevation will cause a reduced blood flow to the area. This slows down blood loss.
• Press either a clean dressing or, if unavailable, a clean item of clothing, frimly against the wound and maintain the pressure.
• Remove derbis such as glass and metal from the injury site before applying pressure.
• Place a clean dressing over the wound and then apply a bandage to the entire limb.
• Do not remove the dresssing if it becomes soaked in blood. Apply a second dressing, up to a maximum of three, and mantain pressure for a further 10 mintues.
• Seek medical attention if bleeding does not stop.

Head Injury

Head injuries can be hard to spot and in many cases there might not be a visible wound. When this happens you’re going to have to look for other signs that indicate a head injury. Just because you can’t see an injury site, take care as serious head injuries can be fatal. may not always be obvious. Other signs to look for when you suspect a head wound:

• Blood or a straw-coloured liquid seeping from the ear (the latter is a good indication of a fractured skull)
• Unconsciousness
• Dizziness
• Nausea
• Headache

Applythe following treatment to visible head injureis:

• if the wound is open, attempt to pull flaps of skin back in place. In the past, I’ve stitched my own injuries with an emergency first aid kit, but only do this if you have a strong stomach, confident or the fix is one of last resort.
• Press a clean dressing firmly on the wound.
• Use a binding, or some other item like a belt to secure the dressing in place.
• If the person is conscious lay the down but raise their head and shoulders.
• If they have fluid leaking from an ear, secure a dressing over it and tilt the person’s head to allow free drainage.
• Severe head injuries cna be lethal. Seek medical attention as soon as possible.

Chest Injuries – Punctures

• Reduce the flow of blood bythe wound by covering with a palm.
• Dress the would and then seal with a piece of plastic sheet.
• Tie off with either a binding or belt to form an airtight seal.
• if you’re at a high altitude, descend ASAP as thin air make breathing difffiucl;t and could lead to complications

Internal Bleeding

Internal bleeding is an injury that can be easily missed. When blood vessels are ruptured blood can leak into cavities within the body. This type of injury can be caused by a fracture or even a fairly minor sprain. In some cases, a blow to the body is strong enough to rupture a blood vessel but not the skin.

Some of the signs you should watch out for:

• Contant pain in the affected area
• Cold, clammy skin
• Fainting
• Loss of colour
• Nausea
• Dizziness
• Dilated pupils
• Being out of breath
• An irregular pulse
• Swelling or bruising at the site

Treatment for internal bleeding:

• Seek professional medical treatment immediately
• No drinkgs for the injuted person.

Dislocations

A dislocation is where one or more bones at a joint are removed from its socket. Most commment sites of dislocations include, the shoulder, finger, thumb or jaw (which can be incredibly painful). A disclotion can be recognised by:

• Swelling
• Out of place bones
• Pain and tenderness
• Change in skin colour

To treat, follow these instructions:

• Apply a splint to the joint to prevent movement
• Keep the injured area elevated, if possible
• Do not attempt relocate the joint.

Fractured Forearm

• If the person can hold the arm across their chest then apply a splint and help position it with a wide sling. The person’s fingers should be positioned above their elbow so that the arm forms a ‘V’ shape.
• If the injury prevents the arm from being bent, splint it in the straight position then using a binding, scarf, belt,, ect to secure it to the side of the body.
• Seek medical help.

Other Fractures

A fracture can be either a broken or cracked bone and there are two types you need to know about; simple and compound. A simple fracture does not break the skin. If left untreated the sharp edges of the broken bone and peirce the skin and developo into a compound fracture (which is where the bone pierces the skin)

A compound fracutre can serious bleeding and presents a high risk of infection and other complications. Signs of a compound fracture include:

• Pain and tenderness
• Difficulty moving
• Difficulty breathing
• Swelling
• Bruising
• Change in skin colour

Treatment for a compound fracture:

• Reduce, or stop any bleeding.
• Cover any open wound with a clean dressing, but do not apply any pressure to the injury.
• Secure the injured limb to a solid part of the body. Use a sling to support fractured arms. If you don’t have a triangualr bandage available, use a piece of clothing to form the sling.
• Watch for signs of shock.
• Warmth is essential, put the person in a sleeping bag if possible.
• Apply a splint (see below).

The Splint

A splint is a method of keeping movement in a fractured bone to a minimum. They are easy to fit, and these steps are simple to follow:

• Simple or compound: check the suspected fracture sight to assess whether it’s simple or compound.
• Blodop flow: does the patient have circulation above and below the fracture? Are they able to move fingers toes (if appropriate)?
• Apply clean dressings to control bleeding.
• Administer pain medication if necessary.
• Apply a splint (which should be placed both above and below the injury).
• To reduce the risk of further damage to the injury site, prepare the splint on an uninjured body part, and then transfer it to the injured area. In addition, this will reduce the amount of pain associated with splinting a fracture limb.
• Be creative when making splints. Sticks, ski poles, tent poles or other similar objects can be used.
• Fastenings can be made from belts, rope, bootlaces, bandages, tape and strips of clothing. Slings can be made from triangular bandages, sheets, and ropes.
• Apply the splint in a way that it does not interfere with circulation – not too tight.
• If you’re in a cold climate, and the fracture is simple with no signs of decreased circulation, pack ice/snow around the wound to hlep reduce swelling and pain. Don’t apply ice directly to the skin, your patient won’t thank you!
• Every 15 minutes after the splint has been applied, check the injury site to ensure that swelling inside the splint has not cut off the circulation.
• Where possible, elevate the injured part to reduce/minimise swelling.
• If you feel the injury is severe, seek medical help. In the case of a broken toe, or finger, it’s possible to go on with your journey once first aid has been applied.

Anyone who has suffered from a broken bone should have a full evaluation once they returen home. Misaligned bones can leads to complications further down the line.

What to avoid:

• Unless necessary, moving the person as this can lead to secondary injuries including damage to internal organs.
• Applying pressure to a compound fracture to stop bleeding – it may cause extreme pain and can move bones.