Outdoor Injuries

Those of you with no interest in numbers may choose to read no further. If you're still reading, these stats come from Wilderness and Environmental Medicine (the official publication of the Wilderness Medical Society), 19, 91-98 (2008)--and you're going to learn about the number of outdoor injuries in 2004 and 2005. During those 2 years, an estimated 212,708 injuries were sustained in outdoor activities and treated in hospitals. Sounds like a lot, yes, but the stats include just about any activity you can think of including skiing, horsepacking, skydiving, and snowmobiling. Lower limbs were involved in 27% of the injuries, upper limbs in 25%, and the head and neck in 23.3%. The most common diagnoses were fractures (27.4%) and strains or sprains (23.9%). Males were injured in 68.2% of the accidents. The most dangerous activity? Snowboarding, with a whopping 53,996 estimated annual injuries. Second was sledding, which includes sliding down snowy hillsides on tubes and disks (22,780 annual injuries), and third was hiking (13,448) which included anyone out for a walk anywhere outdoors. Short version: It's statistically much safer on ground than snow. For more info, check out www.wms.org.

Bleached Water

Someone recently asked if he could use household bleach to disinfect water on the trail. The short answer is "yes." Here's more info: Household bleach typically runs about 5% chlorine. We know that 0.1 ml to 0.2 ml of 5% chlorine bleach added to a liter of water will disinfect it, if you wait about a half hour, killing everything except Cryptosporidium (and it may take an hour or more to kill Giardia). A problem arises in measuring bleach into a water bottle. You can use a measured dropper, one that tells you how much fluid is being dropped, and that's the only way to be sure of your measurement. Others guess at the amount, using a non-measured dropper and estimating that a standard "drop" will be about 0.04 ml. Guessers often add 8 drops of bleach per liter of water in an attempt to be safe rather than sorry. The result is water tasting nastily of bleach, but it won't hurt you. Frankly, even though bleach is cheap, I'd rather use a product that guarantees safe water, such as chlorine dioxide tablets (www.rei.com/product/736898).

HAFE

The Outdoor Retailer Show in Salt Lake City was another highlight of my year, added to greatly by the presence of the awesome trio from Celtic--Kurt, Brian, and Bill. (Celtic, an advertising and public relations firm, designed and maintains this site. Check them out at www.celticinc.com). The people with problems who stopped by the first aid station were as I suspected (see the previous post), and dehydration was especially rampant, a reminder to keep your urine clear or lightly yellow in color.
Someone asked about intestinal gas at higher altitudes. High Altitude Flatus Expulsions (HAFE) is a real and discomforting, though rarely serious, problem for those arriving at upper elevations of Earth. Air in your tummy expands like air trapped in a plastic bag. The products Beano and Gas-X have been shown to help alleviate the discomfort. You and your tentmate might both appreciate the alleviation.

Outdoor Retailer

I leave in a few days for the Outdoor Retailer Show in Salt Lake City, my 34th stint in the First Aid Station. After thousands of OR patients, most of them non-serious, I know what I'll see: People forgetting some of the basics of a healthy life. They'll wear pretty shoes that rub them the wrong way, they'll dehydrate, they'll fail to get enough rest, and they'll eat way too much and/or something strange to their digestive systems. But, on the other helping hand, it's sort of like job security for me.
I'll be signing free copies of my new book (Knots You Need, totally non-medical) on Aug 8 at 4PM and Aug 9 at 5PM. If you can't drop by, you can always order (and pay for) a copy (www.globepequot.com), and if you do, I thank you.

Season of the Snake

Definitely, there is something unsettling about getting bitten by a venomous snake (or, hey, any snake). But you know one of the most important things you can do, should it happen to you, is stay calm (whether you're the bitten or the rescuer). Someone recently--and creatively--asked could he take a Benadryl (www.benadryl.com) or another antihistamine. Benadryl does have a mild sedative effect. It can help you sleep. I don't, however, think it would help. The over the counter tabs are not strong enough unless you took enough to be dangerous. And if you were able to chemically alter the patient's level of consciousness, you really would not want to. LOC gives evidence of how the patient is handling the emergency. The only definitive treatment for snakebite remains antivenom. Do what you can, non-chemically, to keep the bitten calm--and find a doctor.

Picaridin

Could be the name of a Knight Templar, but picaridin is an insect repellent, available in the U. S. only relatively recently, although it has been on store shelves in Asia, Europe, and Australia for far longer. It is derived from a substance known as piperidine and was first developed by the people who make Bayer. The EPA has approved it for anyone three years old and up. Less irritating than DEET, and with no indication of any toxicity whatsoever, it works about as well, in the only study done so far, as six percent DEET--which means you have to apply it more often than DEET. I just returned from a trip into Theodore Roosevelt National Park, ND (I love the Badlands) where mosquitoes were moderately nagging problems, as usual, at dawn and dusk. I used picaridin (www.cutterinsectrepellent.com) and found it not only much more pleasant to use that DEET but satisfyingly effective in the conditions on the trail and in camp.

Back from Alaska

Winter camping in June: There's nothing like it. Temps at night reached, at the lowest, 5 above 0, and the mercury rose at midday to 50 F and more. It was a jungle, without insects, while the snow and ice beneath our tent was estimated to be 4500 feet thick (yep, nearly a mile). Almost everyone who climbs Denali gets off an airplane that landed on the Southeast Fork of the Kahiltna Glacier at about 7300 feet elevation--a few feet from the ranger tent where I was working (and sometimes just relaxing). They also almost all leave the mountain there, except for two young Japanese climbers who, this year, disappeared and failed to reappear after ten days of intensive searching--bringing the historical total to 100 dead on Denali. But two others were found, and, with other patients, I had a chance to splint arms, patch wounds, inspect and pontificate on frostbite, melt a ton of snow for water, and wax poetical on what is absolutely one of the most beautiful spots on this planet. Not a bad summer vacation.