Chapter 4: Safety Practices in Outdoor Recreation

What should one do when faced with a medical emergency situation?

Panic is the worst enemy of any emergency situation. It even makes a bad
situation worse, as this spreads to others as well. It does not allow one to think. In fact,
it even hinders or interferes with the rational thinking and causes confusion. So, the first
thing to do in an emergency situation is to stay calm. Then, try to remember and apply
the DRSABC action plan
DANGER – always check first the danger and source of injury. Make sure the
surroundings are safe and out of danger, otherwise, you will also allow yourself to be a
victim.
RESPONSIVENESS – can the casualty hear your voice? Can they open and close their
eyes? Are there any movements? Do they respond to touch?
SEND – send for help or shout for help
AIRWAY – is the person’s airway clear? If the person is not responding and is
unconscious, check airway by opening the mouth and having a look inside. Tilting the
head back with the chin facing up will clear an airway.
BREATHING – make sure that the victim is breathing by looking at breathing signs,
listening to exhales, and feeling air coming out of the mouth or nose.
CPR (Cardiopulmonary resuscitation) – if an adult is unconscious, no pulse, and not
breathing, perform the CPR until the emergency personnel or medics arrive.

How is cardiopulmonary resuscitation administered?

Cardiopulmonary resuscitation (CPR) is a lifesaving technique that is
administered when breathing and heartbeat of a person stopped, such as during a heart
attack and drowning.
CPR involves the CAB process that stands for compression (restoration of blood
circulation), airway (clearing of airway), and breathing (breathe for the person).
In administering first aid, it is important to know when to use CPR. If there is no
breathing and no pulse is felt, administer the CPR cycle – 30 compressions, then two
breaths until help arrives. In administering CPR or compression, the following must be
done:
1. Put the person on his or her back on a firm surface.
2. Locate hand position for compression by drawing an imaginary line from armpit
to center chest for hand placement.
3. Place heel of one hand on the lower part of the breastbone.
4. Put other hand over the first, interlacing your fingers for support.
5. With straight arms and shoulder positioned over the victim’s chest, push down on
the victim’s chest. For adult victims, push it down for at least 2 inches or 5 cm
deep.
6. Give 30 compressions in 18 seconds or less (rate of 100 compressions in one
minute) and let chest rise completely between compressions.
7. After 30 compressions, give two rescue breaths.
8. Repeat cycle until help arrives or when there are signs of movement.
 In checking for pulse of the victim, put two fingers on the center of the neck then
slide fingers down to the side of the victim’s neck up to the nudge between muscles.
When pulse is felt but no signs of breathing, administer one rescue breathing every
five seconds and recheck pulse every two minutes. In rescue breathing, do the
following:
1. Gently tilt the victim’s forehead back with one hand.
2. Tilt victim’s chin using the other hand; this will open the victim’s airway.
3. Pinch nose close then cover the victim’s mouth with your mouth. Blow life-giving
air to the victim. Watch for the chest rise; if it does not rise then reposition and
perform the rescue breathing all over again.

FIRST AID OF COMMON EMERGENCISS IN OUTDOOR ACTIVITIES

What are the common medical injuries encountered in outdoor recreation and
what first aid treatment should be administered?
The term first aid refers to administration of care to prevent deterioration of the
victim, to aid recovery, and to preserve life. Generally, first aid entails some simple but
often life-saving ways that most people can be trained to perform with minimal
equipment. On a technical level, it is not identified as medical treatment and should not
be compared to what a trained medical profession might do. First aid, as they say, is a
combination of simple procedures and an application of some common sense.
Common Injuries and Illnesses in the Outdoors
A. Cuts, scraps, and punctures
Wounds, cuts, and lacerations can be caused anywhere from rock climbing, cutting self
from a knife, and stumbling
To treat minor cuts, scrapes, and punctures:
 Clean, cuts with soap and water then apply antibiotic cream then cover with
sterile bandage and secure using medical tape.
 If bleeding, apply direct pressure using clean cloth to the injury.
 If wound is on the arm or leg, raise limb above the heart to help slow down
bleeding.
 Do not apply tourniquet unless the bleeding is sever and does not stop even with
direct pressure.
Emergency personnel must be called immediately if:
 Severe bleeding or bleeding does not stop despite pressure
 You suspect there is internal bleeding (inflammation and severe pain the area)
 There is an abdominal or chest wound
 Blood sprouts out of wound.

B. Sprains, strains and fractures

Many things can cause a sprain, strain, or fracture while doing an outdoor activity.
One may fall or twist an ankle while trekking or miscalculate a movement while rowing a
canoe. Most often it is the ankle, wrist, or finger that suffers from sprain and the
hamstring for strains. Sprains, strains, and fractures are definitely painful and may
bruise or swell.
 Sprains are injuries that involve the stretching or tearing of the ligament. This
usually occurs when a joint is overextended from its usual range of motion. Strain is the
twisting or pulling of a muscle tendon. This usually happens when a muscle is stretched
and suddenly contracts such as when one is running or jumping. Fracture involves the
breaking of a bone.
Doctors usually categorize strains and sprains according to severity. Grade I
category is mild that involves minor tearing of a ligament or muscle. Grade II
classification involves the partial tearing of the ligament or muscle. Grade III refers to
severe injury that involves the complete tearing of the ligament or muscle.
Grades I and II categorizes may be treated with rest, ice pack, compression, and
elevation (RICE). This means having victim rest the injured or painful part, then applying
ice pack, compressing or wrapping with bandage or athletic tape, and finally elevating
the injured area above heart level o minimize swelling. Grade II injuries, however, may
need further immobilization to hasten the healing process.
In using the bandage, do the figure-eight pattern. Wrap the bandage diagonally
across the top then around the ankle and foot as if making the number eight, moves to
the heel then toward the calf. The wrap covers entire foot and ends several inches
above the ankle. Fasten the bandage with a clip or secure with tape.
For fracture, immediately call medical help if the following occurs:
 One suspect’s injury to the person’s head, neck, or back.
 Bone is sticking out of the skin.
 Bleeding does not stop after several minutes of firm pressure.
 Blood spurts from the wound.
While waiting for the medical help, do the following first aid:
 Immobilize the area of injury until help arrives or until the person is brought to the
hospital.
 Make sure to clean and dress cuts before splinting.
 If bleeding, apply pressure to wound with clean until bleeding stops. If bone is
pushing through the skin, do not touch.
 Gently tape the dislocated area or fracture to a rolled-up newspaper, ruler, or a
rolled piece of clothing with first aid tape. Avoid moving the injured limb and
never force it or even try to twist it back into place.

C. Concussions
Concussion is a traumatic brain injury that is often caused by a blow or bump to the
head or body. Cuts and bruises may be seen on the head or face. Some lose
consciousness or forget what happened before the injury; others do not.
 Treat cuts
 Apply ice or compress if no ice is available
 Rest until symptoms disappear.
 Watch out for symptoms that need emergency action
Call immediate help if the following occurs:
 One vomits repeatedly
 The pupils become unequal
 One looks agitated or confused
  One is unconscious or passes out
 One feels very drowsy
 There is pain in the neck after the fall or knocked out.
 There is slurred speech.
 One experience seizure

D. Blister
Blister are a result of ill-fitting footwear. It is especially seen among hikers and trekkers.
Blisters can be painful and may cause discomfort. Treat blisters with the following:
 Placed a piece of adhesive over affected area
 Doughnut-shaped moleskin helps when blisters are at the bottom of foot.
 If blisters have popped, wash area with soap and water then put antibiotic cream.
 If it is absolutely necessary, drain a blister with a sterilized needle into the side of
the blister. Apply with antibacterial solution and cover with gauze dressing and
tape.

E. Burns or Scalds
Burns or scalds are injuries on the skin caused by hot liquid or heat.
 If still on fire, stop burning immediately through the “stop, drop, and roll” method.
Then remove the flamed material from the person. However, if the clothing sticks
to the skin, do not pull it out but cut or tear around it.
 Take off constrictive clothing immediately (belts, jewelry, and tight clothing) as
burns can swell quickly.
 If first degree burn (top layer skin affected)
o Put affected area under running water or immerse in cool (not ice) water
until pain subsides. If no running water is available then apply compress.
o Cover with sterile, non-adhesive bandage, or clean cloth.
o Do not apply butter or ointments, which can cause infection.
 For second degree burn (affecting 3 layers of skin)
o Immerse in cool water for 10 to 15 minutes; apply compress if running
water is not available.
o Do not apply ice, it can lower body temperature and may cause further
damage.
o Do not break blister or apply butter or ointment cause infection.
o Protect burn with sterile, nonstick bandage, and secure with gauze of
tape.
o To prevent shock, let the person lie flat and elevate feet for about 12
inches high and elevate burn area about heart level (if possible) and cover
the person with coat or blanket.
o Wait for emergency personnel/

For burns, immediately call medical help if the following occurs:

 Burn penetrates all layer of sin
 Skin is charred looking, with white, brown, or black patches.
 Burn blister is larger than two inches or oozes
 Hands, feet, face or genitals are burned.
 The person is an infant or senior