HIKING RELATED MEDICAL PROBLEMS

STOP

SAFETY FIRST

TAKE STOCK

OPTIONS

PLAN AND PROCEED

NEVER HESITATE

TO CALL

911

TweezersAntibacterial OintmentBandaids, various sizes

Gauze padsTape, paper or cloth

Moleskin, corn padsHand Sanitizer and/or WipesSplint (SAM)ACE Bandage

FIRST-AID KIT

Aspirin/Tylenol/Ibuprofen

Personal Medications

Pepto-Bismol/Imodium

Blood Pressure Anti-anginaInhalersMigraine MedsEye drops

Antihistamine (diphenhydramine/Benadryl)

MEDICATIONS

SPRAINS ANDFRACTURES

FRACTURE: Break or crack in a boneRapid swelling, deformity

SPRAIN: Stretching or tearing of ligaments/tendons/musclesCan be hard to distinguish from a fracture

TREATMENT: IbuprofenSplinting Elevation

SPLINTING: Check circulationUnless circulation at risk or so deformed you cannot splintSPLINT THE INJURY IN THE POSITION YOU FIND ITPad the injured areaTry to immobilize the joint above and below

“Walk out if able”

BLISTERS

BLISTERS: Fluid filled areas arising from shearing forces on skinHOT SPOTS: Reddened areas of shearing without separation and fluid

TREATMENT:Don’t drain blister unless it is too big to cover (nickel size)Dress with a “donut” of moleskin or corn pad Place a puff of cotton, blister pad, or dollop of ointment in middleEarly “Hot Spots” can be treated with bandaid or change of socks

PREVENTION: Break in your boots slowlyWear clean and soft socksConsider a sock linerCheck for hot spots, and

aggressively treat them

LACERATIONS AND ABRASIONS

STOP THE BLEEDING: Direct pressure with kerchief or gauze pad (5-30 minutes)

WASH AND IRRIGATE: Irrigate with water (200cc)Clean with antiseptic pad/hand sanitizer

PUNCTURE: Remove foreign material whenever possible

DRESSING: Apply antibiotic ointment, cover and tape with a protective dressing

FOLLOW-UP: Medical visit if a deep puncture, retained material, or gaping woundWound can be stitched or repaired up to 12 hours after injury

PREVENTION: Active hikers should have a current Tetanus booster every 10 years

CARE OF LACERATIONS, PUNCTURES, AND ABRASIONS

Punctures

Agave:Sap is toxic: Saponin compoundTip is toxic: CaOxalate crystalsBacterial and Fungal coatingCan cause pain/swelling for weeks

Cactus:Spines and GlochidsBarbed/tenacious, chemical coatBacterial and Fungal coatingCan cause irritation and infection

Treatment:Remove spines • Tweezers (80%) • Duct tape (65%) • Glue (70%)• Tweezers+glue (95%)• Friction not effective

Treatment:Wash skin and wound ASAPTopical antimicrobial ointment

if puncture wound(5% infection rate: Staph, tetanus, fungi)

Ibuprofen/antihistamineTopical pain reliever (lidocaine)See Doctor if increasing redness

pain, or swelling

BITES AND STINGS

SCORPION STINGS

Over 11, 000 stings/year in ArizonaMost are Bark Scorpion and Centuroides

Toxins are proteins that attack the Nervous system and immune systemSYMPTOMS: Local pain, swelling, redness

Muscle twitching/spasmDifficulty breathing/SweatingMuscle weakness/incoordinationVomiting/urination/defecation

TREATMENT: IMMEDIATE RETURNMEDICAL EVAL IF “RED FLAG SYMPTOMS”Wash the area Apply ice or cold waterIbuprofen and antihistamines (Benadryl)Antitoxin “ANASCORP” (within 6 hours)

RATTLER BITES250 per year in Arizona, 4-8 fatalities, 50% disability

Venom is proteins and enzymes that attack the blood

SYMPTOMS: Sweating, nausea, dizzinessPain, bruising, blistering Difficulty breathingMuscle twitches and spasms

TREATMENT: IMMEDIATE RETURNNO ice or medicationsGently wash the area of biteKeep below heart and immobilizeRemove rings, watches, tight clothesNO SUCTIONINGIf more than one hour from help:

ACE wrap 2-4 inches above biteloose enough to put a finger under

SEEK EMERGENCY ROOM CARE“Crofab” within 6 hours

Remember: a dead snake can still give avenomous bite for up to 4 hours

HEADTRAUMA

HEAD TRAUMA

NO LOSS OF CONSCIOUSNESS: Rarely associated with severe injuryIf alert and NO Red Flag symptoms:

MAY CONTINUE HIKING

“RED FLAG” SYMPTOMS: Increasingly severe headacheNausea/VomitingConfusionAmnesiaSeizure or weakness

BRIEF LOSS OF CONSCIOUSNESS (< 2 MINUTES): MUST TERMINATE THE HIKE AND SEEK MEDICAL CARE If hiker is alert with NO RED FLAGS they can be walked out

PROLONGED UNCONSCIOUSNESS (> 2 MINUTES): CALL 911 FOR EVACUATIONImmobilize the neck

RED FLAG SYMPTOMS: CALL 911 FOR EVACUATION

A Hiker on a hot day can easily sweat 1+ liters/hourBright sun alone can raise body temperature 3 degreesEven mild dehydration can raise body temperature

INCREASED RISK: ElderlyOverweightDeconditionedDiabeticsMedicines:

Diuretics, Beta-blockers,AntidepressantsAntihistamines

TREATMENT:Move hiker to a cooler, shady spot

(or make shade with a tarp)Pour water on head and clothing

and fan the hiker (evaporative cooling)Ice in water-bottle (neck, axilla, groin)Rehydrate aggressively

(electrolyte solution or 1 tsp salt/liter)

CALL 911 FOR EVACUATION IF:SIGNS OF HEAT STROKE

CONFUSIONNO SWEATING

UNABLE TO STANDLOSS OF CONSCIOUSNESS

PREVENTION=HYDRATIONPre-, During, and Post-

CRAMPS

PUFFY HANDSAND FEET

MUSCLECRAMPS

CAUSES: Overuse/fatigueDehydrationUphill/downhillLoss of sodium, potassium,

calcium, or magnesium Inadequate carbohydratesMedicines: Blood pressure

Cholesterol-loweringInhalers (albuterol)Diuretics

PREVENTION: StretchingPre- and post-exercise hydrationSalty snacksElectrolyte solutions (Hammer, Nuun)Complex carbohydratesVitamin B-complex, Vit E, Magnesium

TREATMENT: Rest: typically last < 3 mins Stretch the affected muscleHydrate with electrolytesGENTLE massage to relax muscleEat some carbohydrate

TREATMENT PEARLS: Topicals (Theraworx) don’t work (Mag)Quinine FDA CONTRAINDICATEDMustard, pickle juice, cherry juice, pepper,

capsaicin, lemon/lime juice DO HELP“Hot Shot”: 1.7 oz bottle of cinnamon, capsaicin, ginger, lime

available at REI, Amazon, pharmacies

PUFFY HANDSAND FEET

WHY?NOT related to electrolytesNOT related to hydration status“Heat-related Edema”Lymph fluid affected by gravityBlood vessels are leakyMuscle use and heat dilate vesselsTight pack straps, boot laces

PREVENTION/TREATMENT:Hike with poles Wiggle fingers and toes regularlyElevate when you have the chanceRemove boots and socks if stopped > 10 minsLoosen pack straps, lacesConcern if persists for > 2 hrs post-activity

SUNBURN

SUNBURN RISKS:AZ has second highest rate of skin cancer in the worldAZ melanoma cases have increased 20% since 2010High altitude, low latitude, year-round sunshineProlonged low-level sun = limited, intense sunClouds, Winter sun NOT protectiveDark skin NOT protective (equivalent to SPF 7)Both UVA and UVB can cause skin damage and cancer

SUNSCREEN/PREVENTION:SPF: Sun Protection Factor (recommend 30 +)

No observed benefit of SPF > 50“Broad Spectrum”: both UVA and UVB coverageMost people apply 50% less than they shouldReapply every two hours, don’t forget lipsSprays and towelettes are effective, but should be applied

with four sprays or wipes in all areasLook for “Water-Resistant” (40 or 80 minutes)

THE CHOKING HIKER