Wilderness Medicine SMP

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Note: Once I get permission, I will upload the instructional videos up to youtube and link it to this site.

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 forCMS (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 boardis 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 90 o 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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5. If there are plenty of people in the rescue team, you do not even need a tourniquet. Someone can just apply compression manually.6. Pelvic hemorrhages: very dangerous and require immediate attention. You can lose one liter of blood into the thighs extravascular region, without

noticing any swelling. Try to apply compression by tying a jacket or shirt around the hip region with the knot in front. Slowly, pull on the sleeves to

increase compression and stop the bleeding. It should feel secure and slightly tight.

IX. Wild Animals:

1. Cats like to pounce from a higher place e.g. trees, tops of boulders, etc

2. If you see a cat approaching, try to make yourself look really big and make a lot of noise. Never turn your back to the animal and try to run away,

because their instincts are to chase after moving objects.

3. If you see a bear approaching, play dead.

X. Shelter:

1. Leaves and snow provide good insulation by creating dead air space.

2. The Site: choose an area of higher elevation.

3. Lean-to: a shelter with only one slanted side. First, tie a long pole or branch horizontally onto 2 nearby trees. The wall is first made up of bigger

branches or cut pieces. Then add thinner branches on top to fill in the bigger gaps. Finally, add leaves on top of that and inside the shelter for

insulation.

4. Poncho-tent: tie the ponchos four corners to stakes and then pitch a short stick into the middle to keep it up. Dig a trench around the poncho, so that

water will not enter the area under the tent.

5. In the desert or snowy environment: dig down into the sand or ice for 2 feet to escape the extreme temp.

XI. Mirror signaling:

1. Buy a compass that has a mirror attached to it.

2. The concept: Create a flashing, bright light using the mirror, sun and your fingers that airplanes can see.

3. Orient the mirror facing the sun and next to your face. Form the peace sign with the other hand, which will serve as the slit from which the reflected

light will shine through. Then, slightly but quickly rotate the mirror back and forth, so the reflected light passes in between the space of the 2 fingersand beyond the fingers on either side, to create an intermittent, flashing pattern.




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Wilderness Medicine SMP