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Wilderness Survival and Emergency Care

Carderock, MD April 25, 2009

I. Splints: 1. The concept: secure the bones or joints medial AND distal to the particular joint or bone. 2. Before splinting: Always check for CMS (capillary flow, motor control, and sensation under fingernails (To make sure there is no loss of CMS after you intervened and make you liable for lawsuit). 3. After splinting: Check for CMS again. 4. SAM splinting board is a bendable, reusable & lightweight 2 x 4. To increase its strength and rigidity, try making more little “V-shaped” or “T shaped bends” along the board. i. Improvisation: To make a basin, Bend the SAM board into a circular ring and place a waterproof fabric or plastic bag over it. 5. Examples: i. Traction splint: femur fractures that are not open or penetrate the skin. Basically, you want to lengthen the leg and prevent the splintered ends of the fracture from injuring nearby vessels & nerves. You can often use hiking poles as splints. The splint should be longer than the leg. ii. Forearm splint w/ sling: position the wrist and hand in slight dorsiflexion (or the most natural position for a relaxed wrist). Then, use a sling to secure the forearm in an elevated position. The sling will be a triangular piece of cloth. Make sure there is a knot tie at the 90o angle of the triangle. The knot will be placed behind the elbow to cushion and secure it. Have the 2 wings of the sling in front of the person and elevate the forearm (and fracture site) above the heart, so that blood is flowing back to the heart instead of towards the limb. Tie the two ends of the cloth splint on one side of the neck but never directly behind it, where a pressure point might be located. iii. Cervical neck splint: use the SAM splinting board. Make sure there is an indentation for the chin.

II. Carrying injured people: 1. One rescuer - Face the patient & bend their knees. Cross your hands, grab their wrists, and make sure your hands are turned with the palm side facing down. Step on their feet. Squat down with your back straight and chin pointed upwards slightly. Pull the person off the ground and turn to the
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2. 3. 4.

smplog / wilderness side of your top hand. Make sure the person is lying high up on your back. For tall patients, it’s ok to let their feet drag. Two rescuers - Have the patient in between. Three rescuers - One person on each side and a third person going down in between the legs of the injured person. Carry the patient on your shoulders and on their back. E.g. for an abdominal evisceration. Four rescuers w/ a litter - 2 long branches with a poncho or fabric wrapped across it. The 2 people at the patient’s feet should lift first. E.g. for a leg fracture.

III. Important supplies: 1. Water-proof, magnesium matches with striker. Flashlight. Compass. Sharp knife. Ropes. Whistle. Black plastic bag. Vaseline gauze. Always check and make sure your equipment works before going out into the field.

IV. Water: 1. Bring some water, which will delay the effects of dehydration and the consequences of having to drink un-sanitized water. 2. Most water sources (streams, ponds, rivers etc ) are OK to drink. It might give you bacteria or other pathogens, but you will die of dehydration within 3 days, while drinking bad water will only affect you after weeks. 3. Try iodine tablets before your trip to determine if you can handle its unique taste. 4. If you are running low on water, don’t eat any more of the food (will cause you to dehydrate even more). 5. Water-gathering strategies: i. Tie a t-shirt or cloth around your legs early in the morning. Then, walk around the fields and try to soak up as much dew moisture from the leaves and plants as possible into the t-shirt. Squeeze it out to get your water. ii. Bring plastic zip-lock bags with you on the trip. Crush fresh leaves and seal them inside the bag. Leave it out in the sun and gather the condensation found on the sides of the bag. iii. In a snowy environment & inside your shelter: you can dig a trench and slight slope that leads to your cup. Your body heat will conveniently melt the ice underneath you. iv. In a snowy environment & outside your shelter: On a sunny day, spread out a black, plastic bag that you can place over a pit. Then, use the heat-collecting abilities of the black bag to melt any ice that is placed on top of it. v. Filtering mud or muddy water: Gather the mud in a sock and swing the sock in a circular motion to draw the water out from the mud (via centrifugal motion). Setup a 3-tier, filtration system made of cloths. Place your cup underneath it. Make sure to have some charcoal on the last cloth as an extra filter. Squeeze that water out from the sock and onto the top filter, and let gravity do its job.

V. Survival: 1. The rule of threes: a. Can’t live without oxygen for > 3 minutes. b. Can’t live without water for > 3 days. c. Can’t live without food for > 2-3 weeks. 2. Make sure to carry vital tools and items on you. You never know if you will be separated from your bag.
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3/22 http://smplog. The fire might burn along the roots and come up above ground somewhere else.pbworks. At the center of the pit. You don’t want to wait until you’ve checked the entire body. Pitch can be gathered from where the branches meet the trunk. look for the “halo effect’. VII. and not be able to determine where the bleeding is from. Second round body exam: start at the head (look for brain injury). First round body exam: circulation and hemorrhage. Compression is always the most important 1st step. 2. 6. Diagnosis: 1. dry twigs ¾ or almost all around the tinder (start-up fuel). ii. neck. Make sure there are no roots in the soil underneath the pit. Hemorrhages: 1. even dirty clothes to provide extra layers. Determine if it’s from inside or outside the ear. You can bleed out in less than 3 minutes. Angling the point of contact will also help direct the sparks towards the tinder. Fluffed-up cotton balls are good tinder for fires. gauge the flame’s size and add more or larger twigs accordingly. 4. you can use anything else. Cover up the pit with leaves and debris. Adding Vaseline will make it burn longer. VIII. 7. chest (pneumothorax).Airway. circulation. face & mouth. abdomen. To determine if there is CSF in the fluid. After putting out the fire. try a “log-cabin” system of piling the fuel around the fire. 3. where the red blood is pushed out to the periphery and the clear CSF is in the center of the stain (forming a ring). 8. Twigs from the birch tree. stick your hand into the fire pit dirt to determine if it is still hot (and can potentially start a new fire). When the cotton catches on fire. fast/shallow pulse.8/20/2010 smplog / wilderness 3. 4. etc ) 2. check your hands to see if there is bleeding from that area. Look for fallen. setup a tepee of small. Also make sure there is no debris inside the ring. fingernail-plate capillary perfusion takes more than 30 sec. Fire-starting: 1. Trace-less fire: The idea is to minimize your impact on the environment.com/wilderness . condition of the patient for transport. Tourniquets are useful and can stay on an extremity region for up to 6 hours straight. Using a flint and striker: move the flint stone in an upward motion while holding the striker still. etc 3. Fluids from inside the ear can be blood. Then. 4. Paper (creates a strong smell). Bleeding around the ear: i. 3. Then. rotting trees. iii. Signs: pale face. treat that problem or area first before moving to the next area. breathing. Assess the situation (any immediate danger. Apply a clean dressing right over the wound as soon as possible. Bleeding can potentially be the most critical problem after an accident. It will increase the likelihood of being rescued. Never wander too far from where you got lost or were last seen. After each body region. CSF or a combination. VI. shallow breathing. Use the soil removed from the pit to build a ring of dirt around the pit with a radius of 2-ft. 5. ABC . Dig a shallow fire pit. 2. and legs. ii. Other sources of fuel: dry leaves. i. If there is any region with a problem.

3. Leaves and snow provide good insulation by creating dead air space. The concept: Create a flashing. XI. 5. sun and your fingers that airplanes can see. smplog / wilderness If there are plenty of people in the rescue team. Orient the mirror facing the sun and next to your face. tops of boulders. The Site: choose an area of higher elevation. In the desert or snowy environment: dig down into the sand or ice for 2 feet to escape the extreme temp. Pelvic hemorrhages: very dangerous and require immediate attention.8/20/2010 5. 2. Mirror signaling: 1. you do not even need a tourniquet. Try to apply compression by tying a jacket or shirt around the hip region with the knot in front.g. It should feel secure and slightly tight. 3. try to make yourself look really big and make a lot of noise. First. If you see a bear approaching. Then add thinner branches on top to fill in the bigger gaps. Poncho-tent: tie the poncho’s four corners to stakes and then pitch a short stick into the middle to keep it up. Dig a trench around the poncho. 6. You can lose one liter of blood into the thigh’s extravascular region. because their instincts are to chase after moving objects. Wild Animals: 1. 3. etc 2. without noticing any swelling. so the reflected light passes in between the space of the 2 fingers and beyond the fingers on either side. Slowly. bright light using the mirror. flashing pattern. Shelter: 1. play dead. Someone can just apply compression manually. X. Cats like to pounce from a higher place e. Buy a compass that has a mirror attached to it. slightly but quickly rotate the mirror back and forth. The “wall” is first made up of bigger branches or cut pieces. so that water will not enter the area under the tent. Lean-to: a shelter with only one slanted side. to create an intermittent. 4. pull on the sleeves to increase compression and stop the bleeding. Finally. http://smplog. 2.com/wilderness 4/22 . IX. Then. Never turn your back to the animal and try to run away. If you see a cat approaching.pbworks. add leaves on top of that and inside the shelter for insulation. trees. tie a long pole or branch horizontally onto 2 nearby trees. which will serve as “the slit” from which the reflected light will shine through. Form the peace sign with the other hand.

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