Wilderness First Responder: A Text for the Recognition, Treatment, and Prevention of Wilderness Emergencies / Edition 2

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The Wilderness First Responder is a comprehensive text for the recognition, treatment, and prevention of wilderness emergencies. It's essential reading for wilderness educators, trip leaders, guides, search and rescue groups, and anyone who works or plays far from definitive medical care.

This invaluble resource includes expert, step-by-step instructions, clear illustrations, and "Signs and Symptoms" sidebars designed to help you provide care in the wilderness--whenever you are more than an hour away from an ambulance or a hospital. You'll learn how to conduct a patient assessment, improvise when ideal materials are not at handy, and decide whether or not to evacuate a patient.

Learn how to assess and treat: airway obstructions, cardiac arrest, external and internal bleeding, shock, spine injuries, head injuries, chest injuries, abdominal injuries, fractures and dislocations, athletic injuries, soft-tissue injuries, cold- or heat-induced injuries, altitude sickness, insect bites and stings, diabetic emergencies, poisoning emergencies, allergic reactions and anaphylaxis, and much more.

Buck Tilton, co-founder of the Wilderness Medicine Institute of the National Outdoor Leadership School (NOLS), wrote this book with more than a dozen medical professionals. The book represents more than a century and a half of combined experience in wilderness medicine, rescue, and education. Thouroughly updated and revised, this classic first-ever teaching manual for the "Wilderness First Responder" course is a must-have for anyone venturing into the backcountry.

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Product Details

  • ISBN-13: 9780762728015
  • Publisher: Rowman & Littlefield Publishers, Inc.
  • Publication date: 3/9/2004
  • Edition description: Second edition
  • Edition number: 2
  • Pages: 320
  • Product dimensions: 8.50 (w) x 11.00 (h) x 0.60 (d)

Meet the Author

Buck Tilton is co-founder of the Wilderness Medicine Institute of the National Outdoor Leadership School in Lander, Wyoming, advisor to Western State College's Mountain Rescue Team, co-author of Medicine for the Backcountry, author of Rescue from the Backcountry, Avalanch Safety, Backcountry First Aid, and multiple other books on the outdoors. He is a member of the Outdoor Writers Association of America and a member of the American Medical Writers Association. He resides in Lander, Wyoming.

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Read an Excerpt

It Could Happen to You

After two days of late summer hiking under heavy backpacks into the Bighorn Crags of Idaho, you and three friends near the point on the map where an unnamed lake supposedly abounds with fine fishing and pleasant campsites tucked into the shadows of a dense forest. Clouds that collected over the afternoon start to spill a thin shower, and you stop to put on rain gear. With only a short series of switchbacks separating you from your destination, your group arrives at the scene of an accident. A lone hiker sits against a tree, pack by his side, face wearing a grimace of pain. He complains of lower right leg pain, and the inability to bear weight on the injury. Your patient states he slipped on a wet rock while decending the trail. He wears a cotton T-shirt and shorts, and you note his lower right leg appears bloody and bruised. Occasional shivers disrupt his ability to speak.

Welcome to the world of wilderness medicine!

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Table of Contents

List of Figures xi
Acknowledgments xiii
Section I Introduction
1. Wilderness Emergency Medical Care 3
First Response and Responsibility 3
A Brief History of Wilderness Medicine 4
Wilderness Medicine vs. Urban Medicine 5
Training 5
2. Legal Issues in Wilderness Medicine 7
Civil Law and the WFR 7
Negligence 8
Legal Considerations 8
Legal Protection 9
Section II Patient Assessment and Initial Concerns
3. Patient Assessment 13
Stop! Size up the Scene 13
Stop! Assess the Patient for Immediate Threats to Life 15
Stop! Complete a Focused Exam and Patient History 17
Stop! Document and Report the Event 26
Stop! Monitor the Patient's Condition 26
4. Airway and Breathing 29
Basic Anatomy of the Airway 29
Assessing the Airway 30
Foreign-Body Airway Obstruction: Conscious Adult 31
Rescue Breathing 32
Recovery Position 34
Evacuation Guidelines 34
5. Cardiopulmonary Resuscitation 35
Basic Anatomy of the Heart 35
Cardiac Arrest and CPR 36
Cardiopulmonary Resuscitation 36
Adult One-Rescuer CPR 37
Complications Caused by CPR 38
Criteria for Stopping CPR 38
Special Considerations for the Wilderness 38
Specific Wilderness Situations 39
Evacuation Guidelines 39
6. Bleeding 41
Types of Bleeding 41
Body Response to Bleeding 41
Control of External Bleeding 42
Internal Bleeding 44
Evacuation Guidelines 44
7. Shock 45
Basic Anatomy and Physiology of the Cardiovascular System 45
Shock 46
Types and Causes of Shock 46
Stages of Shock 47
Risk Factors 49
Management of Shock 49
Evacuation Guidelines 50
8. Spine Injuries 51
Basic Anatomy of the Spine 51
Mechanisms of Injury 52
Types of Spinal Cord Injuries 52
General Assessment of the Spine 53
Treatment for Suspected Spinal Injury 53
Lifting and Moving a Patient 54
Special Considerations for the Wilderness 56
The Focused Spine Assessment 57
Evacuation Guidelines 58
Section III Traumatic Injuries
9. Head Injuries 61
Basic Anatomy of the Head 61
Types of Head Injuries 61
Levels of Head Injury 64
Treatment for Serious Head Injury 65
Evacuation Guidelines 65
10. Chest Injuries 67
Basic Anatomy of the Chest and Normal Breathing 67
Types of Chest Injuries 68
General Treatment Guidelines 72
Evacuation Guidelines 72
11. Abdominal Injuries 73
Basic Anatomy of the Abdomen 73
General Abdominal Trauma Assessment 74
Blunt Trauma Assessment and Treatment 75
Penetrating Trauma Assessment and Treatment 75
Evacuation Guidelines 75
12. Fractures 77
Basic Anatomy of the Musculoskeletal System 77
Types of Fractures 77
General Assessment of a Fracture 78
General Principles of Fracture Treatment 78
Specific Treatment for Upper Body Fractures 80
Specific Treatment for Lower Body Fractures 82
Complicated Fractures 85
Evacuation Guidelines 86
13. Dislocations 87
General Assessment and Treatment of Dislocations 88
Specific Treatment for Upper Body Dislocations 88
Specific Treatment for Lower Body Dislocations 90
Long-Term Care for Dislocations 91
Evacuation Guidelines 92
14. Athletic Injuries 93
General Assessment of Athletic Injuries 93
General Treatment of Athletic Injuries 94
Specific Treatment for General Types of Athletic Injuries 95
Specific Treatment for Specific Athletic Injuries 96
Prevention of Athletic Injuries 101
Evacuation Guidelines 101
15. Wilderness Wound Management 103
Basic Anatomy of the Skin 103
Types of Wounds 104
General Wound Management 104
Management of Specific Wounds 105
Evacuation Guidelines for Wounds 108
Wilderness Burn Management 109
Evacuation Guidelines for Burns 110
General Wound Infection Management 111
Evacuation Guidelines for Infected Wounds 111
Section IV Environmental Emergencies
16. Cold-Induced Emergencies 115
Heat Production 115
Heat Loss 116
Hypothermia 116
Frostbite 120
Nonfreezing Cold Injury 122
Evacuation Guidelines 122
17. Heat-Induced Emergencies 123
Dehydration 123
Heat Cramps 124
Heat Exhaustion 124
Heatstroke 124
Hyponatremia 126
Prevention of Heat-Induced Emergencies 126
Evacuation Guidelines 127
18. Altitude Illnesses 129
Acclimatization 129
Acute Mountain Sickness 130
High-Altitude Cerebral Edema 130
High-Altitude Pulmonary Edema 132
Prevention of Altitude Illnesses 132
Evacuation Guidelines 133
19. Immersion and Submersion Incidents 135
Immersion 136
Drowning 136
Near-Drowning 137
Prevention 137
Evacuation Guidelines 137
20. Lightning Injuries 139
Mechanisms of Injury 140
Types of Injuries 140
Management of the Patient 140
Prevention of Lightning Injuries 140
Evacuation Guidelines 141
21. North American Bites and Stings 143
Reptiles 143
Spiders 145
Scorpions 147
Zoonoses 147
Hymenoptera 152
Centipedes 152
Bears 152
Dangerous Marine Life 153
Evacuation Guidelines 155
22. Diving Emergencies 157
Physical Principles of Diving 157
Types of Barotrauma 158
Other Diving Disorders 159
Prevention of Diving Emergencies 160
Evacuation Guidelines 160
Section V Medical Emergencies
23. Cardiac Emergencies 163
Types of Cardiac Emergencies 163
General Treatment for Cardiac Emergencies 165
Evacuation Guidelines 166
24. Respiratory Emergencies 167
Types of Respiratory Emergencies 167
Evacuation Guidelines 170
25. Neurological Emergencies 173
Basic Anatomy of the Brain 173
Unconscious States 173
Types of Neurological Emergencies 174
Evacuation Guidelines 176
26. Diabetic Emergencies 177
Normal Physiology 177
Diabetic Physiology 178
Hyperglycemia 178
Hypoglycemia 178
Diabetics in the Wilderness 179
Prevention of Diabetic Emergencies 179
Evacuation Guidelines 180
27. Poisoning Emergencies 181
Ingested Poisons 181
Treatment for Ingested Poisons 183
Inhaled Poisons 183
Treatment for Inhaled Poisons 184
Absorbed Poisons 184
Injected Poisons 184
General Treatment Guidelines for Poisonings 184
Evacuation Guidelines 184
28. Allergic Reactions and Anaphylaxis 185
Allergic Reactions 185
Anaphylaxis 186
Evacuation Guidelines 188
29. Abdominal Illnesses 189
General Abdominal Illness Assessment 189
Some Types of Abdominal Illnesses 190
General Treatment for Abdominal Illnesses 192
Evacuation Guidelines 192
30. Communicable Diseases and Camp Hygiene 193
Agents of Infection 193
Communication of Disease 194
Some Specific Communicable Diseases 194
Camp Hygiene 195
Principles of Camp Hygiene 198
Section VI Special Emergencies
31. Common Simple Medical Problems 201
Headaches 201
Eye Injuries 202
Ear Injuries 203
Nose Injuries 204
Skin Damage 204
Gastrointestinal Problems 208
Flu-Like Illness 209
Solar Radiation Problems 211
Motion Sickness 212
Dental Problems 213
Other Mouth Problems 214
32. Gender-Specific Emergencies 215
General Assessment Guidelines for Gender-Specific Emergencies 215
Basic Anatomy of the Male Genitalia 215
Male-Specific Emergencies 216
Basic Anatomy of the Female Genitalia 217
Female-Specific Emergencies 217
33. Obstetrical Emergencies 221
Basic Anatomy and Physiology of Pregnancy 221
Obstetrical Emergencies 222
Normal Childbirth 223
Complications of Delivery 226
Evacuation Guidelines 226
34. Psychological and Behavioral Emergencies 229
Normal Responses to Crisis 229
Critical-Incident Stress 230
Basic Psychological Impairment 232
Evacuation Guidelines 233
Section VII Special Concerns
35. Emergency Procedures for Outdoor Groups 237
Trip Plans 237
Evacuation Organization 238
Managing a Lost Person Incident 240
36. Wilderness Transportation of the Sick or Injured 243
Walk-Out/Ski-Out 243
One-Rescuer Carries 243
Two-Rescuer Carries 245
Litters 246
Horse Transports 250
Vehicle Tansports 250
37. Wilderness Medical Kits 253
General Guidelines for Wilderness Medical Kits 253
Specific Considerations for Wilderness Medical Kits 254
A. Oxygen and Mechanical Aids to Breathing 259
Oxygen and Respiration 259
Supplemental Oxygen Safety 259
The Tank 259
The Regulator 259
Oxygen Therapy 260
Airway Maintenance 260
Passive Delivery 261
Positive Pressure Delivery 262
Suction 263
B. Automated External Defibrillation 265
The AED 265
Operational Procedures 265
C. Basic Life Support for Healthcare Providers 267
Adult Two-Rescuer CPR 267
Child and Infant CPR 267
Foreign-Body Airway Obstructions 268
Rescue Breathing for Children and Infants 270
Glossary 271
Bibliography 283
Index 285
About the Author 305
About WMI and NOLS 306
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