WFA in the News

A meeting of the minds of the largest providers of wild med training, an effort spearheaded by Tod Schimelpfenig of the Wilderness Medicine Institute and David Johnson of Wilderness Medical Associates, produced a first draft of minimum requirements and scope of practice for wilderness first aid. Several attempts to produce such a document in the past failed despite the fact that, as Tod says, in his opinion, ". . . the content of the major providers is very consistent." Tod continued: "Conversations with David Johnson, MD, of WMA over the past year, and the actions of the BSA WFA curriculum project led us to sense we are at a tipping point and should move forward on these questions of standard content." Perhaps at last the time has come for a national standard. I have certainly witnessed a few near misses. If you're interested in taking a look at the document, send me a comment with the email address you wish it sent to. And you can read more at www.wildmed.com/blog/is-there-a-standard-in-wilderness-medicine-training/.

H1N1

It may be impossible to avoid contact with H1N1 (the piggy flu) or with at least some flu virus this year. But you can avoid allowing the virus to proliferate enough to cause disease. Keep in mind the pathways for the germs to enter your body are the nose and mouth, and keep in mind these six preventative outdoor and/or indoor steps:
1. Wash your hands often (and if you haven't gotten that message, you are from off-world).
2. Keep your hands off your face unless you are eating or bathing (and wash your hands before eating).
3. Gargle twice a day to rinse out germs that might have entered your mouth. Listerine works fine, but so does warm, salty water.
4. Blow your nose at least once a day. A quick swabbing with salt-water-soaked cotton would be even better.
5. Get enough vitamin C via fresh fruits and veggies and/or supplements.
6. Drink plenty of warm fluids, such as coffee and tea, every day. It's sort of like gargling in reverse. Flu germs in your mouth are flushed into your tummy where they cannot survive.

Bagged Arms Go Numb

A question that comes across my desk semi-often is this: why do my arms go numb from the elbow to the hand after a night in my sleeping bag? The numbness usually can be explained by the fact that people sleep differently in their bags. With less room, they curl their arms at the elbows and often at the wrists as well, especially if they snooze with their hands tucked under their chins. This position, if prolonged, will irritate the median and/or ulnar nerves, and the result is numbness. On the positive side, nothing serious is happening, and soon after the arms are straightened, the numbness goes harmlessly away. If folks had rather avoid the problem, they can try a bigger and/or more insulated bag. Bigger, of course, means more room and less need for elbow flexion. More insulated could mean sleeping warmer with less need to curl up to hold in body heat.

Charlie Houston

On September 27 Charles Houston, MD, slipped away peacefully in his Vermont home at the age of 96. As a pioneering mountaineer, he had few equals. First ascents of Foraker and Nanda Devi were his, and numerous other climbs in Alaska and the Himalayas. A fine writer, Houston's book, K2: The Savage Mountain, chronicling his second expedition to the world's second highest mountain, is a true classic in mountaineering literature. But Charlie Houston contributed most profoundly to the world through his unprecedented research into high altitude medicine. He is indeed credited with the first identification of high altitude pulmonary edema. Houston established and for ten years directed altitude medicine research on Mount Logan in Canada. Much of what we know today and depend upon when we acclimatize to high altitude or treat those who have not acclimatized can be traced to roots on Logan. A classic in wilderness medicine literature, Going Higher: Oxygen, Man, and Mountains, was written by Houston. I remember him best as a kind man who generously answered all my questions when I was young in the field of wild med. I will miss him.

Sprained Ankles

Sprained ankles remain one of the most common wilderness injuiries--and if you're surprised, you haven't been paying close attention. A recent study strongly suggests that severely sprained ankles recover more quickly when the ankle is completely immobilized in a rigid cast that keeps the ankle in the position of function--for a short time. The study does not specific exactly what a "short time" is, but you can read more about it at www.healthline.com/blogs/outdoor_health. In the meantime, we can rest assured that properly applied elastic wraps fall far short of immobilization. Elastic wraps, however, are far better than nothing. And if you've mastered, or at least partially mastered, the art of "immobilizing" a sprained ankle with athletic tape, we can extrapolate and say that a great ankle-taping job, a job often performed by athletic trainers and less often by Wilderness First Responders and WEMTs, will speed healing and promote usefulness far better than an elastic wrap. Sprained ankles are going to remain common for a long time, but we can add even more weight to the skill of taping a sprained ankle in the wilderness.

Two-Step Disinfection

The lapse in blogs, and please forgive me, arose from classes starting back at Central Wyoming College where I teach. I was asked today about two-step water disinfection processes. There are several, but of specific interest this afternoon was the combo of filtering and adding chemicals. Which should you do first? No hard science tells us. Here are some thoughts: If you use your filter first, you'll remove quite a few "things," including larger germs, leaving your chemical with less demand being put on it. Speaking much more practically, it's simple to filter some water, say, out of a lake, and then add a chemical. Not so easy, it is, to collect water, add a chemical, and then, after waiting the appropriate amount of time, use a filter. But throw this into the mix: if your filter has a charcoal (carbon) stage, using the filter second will remove the unused chemical--and its taste and smell.

How to Die

My newest book, How To Die In The Outdoors: 110 Grisly Ways to Croak, can be ordered pre-publication now at www.amazon.com. Here is an excerpt:

"One of America's greatest losses, bison (Bison bison) once flowed like a vast, hairy sea, numbering in the millions, from the Alleghenies to the Sierra Nevada, from southern Texas to the Great Slave Lake in Canada, wandering in search of grass and water. Resembling old world buffaloes, North American bison are a different species distinguished by massive, shaggy heads and shoulders and relatively small hindquarters. A mature bull may reach 6.5 feet in height and weigh in at more than a ton. Unmolested, they are a docile group, what remains of them, not given to harming humans.

Often viewed with pet-like affection by tourists to areas where they are protected, bison are sometimes pressed too closely by humans, arousing their sense of preservation, a survival instinct that has caused bison attacks in parks to outnumber bear attacks by more than four to one. Thundered into by the huge weight and muscle of a bison, you'll go somersaulting, coming to a stop battered, bruised, probably broken, and often dead. In addition, a horn or two will have gored you, in the butt if you’re running away, in the abdomen if you face the charge. Your day will really fall apart if you happen to disturb an old bull whose herd follows nervously after him. In such a case of trampling, depending on the size of the herd, what is left of you may be difficult to recognize and separate from the chips of dung that typically litter bison feeding grounds.

To Live: American bison rarely charge a human unless they approach to within 25 feet or less.