Surviving A Wilderness Emergency 5

This is the thirteenth post based upon educational sessions and syllabus material presented at the Wilderness Medical Society Annual Meeting & 25th Anniversary held in Snowmass, Colorado from July 25-30. It’s based upon an excellent presentation given by Peter Kummerfeldt, who is President and Chief Instructor for OutdoorSafe, Inc. of Colorado Springs, Colorado. In his presentation, Peter wisely made the point that the information provided was designed for educational use only and would not be a substitute for specific training or experience. When going into the outdoors it is the reader's responsibility to have the proper knowledge, experience and equipment to travel safely.

FIRE

There are at least seven good reasons for building a fire: for warmth, for melting snow, for purifying water, for drying clothing, for signaling, for cooking and for your mental comfort. Having a fire is a great morale builder.

Select a safe site close, but not too close, to your shelter. Clear away any vegetation or snow from the fire site and make sure that you are not building the fire below snow-laden branches that will dump into the fire as the snow warms. Before you strike the first match, be certain that you have all needed materials on hand.

In order to create a fire you need three things: heat source, fuel to burn, and sufficient oxygen. Without each component in the right proportion, the fire will not ignite or sustain. Carry plenty of wind- and waterproof matches in a waterproof match case. As a back up, carry a cigarette lighter and a metal match in your kit. Good fire starting aids include Vaseline-soaked cotton balls, chemical fire cubes and a piece of candle. Birch bark and pitch wood (also know as lighter wood or fat wood) are two excellent natural fire starting materials that can be gathered and carried in your pack or pocket. These aids can make the difference between getting a fire going quickly and not getting one going at all -- particularly during inclement weather. Dry grass, pine needles, leaves, wood shavings and twigs make good tinder. The dead lower branches of trees that are protected by the overhanging limbs are usually dry and make good firewood. Look for standing dead trees. Wet wood can be split with a knife, exposing the dry heartwood. Always remove the soaked bark from a piece of wood before placing the wood on the fire. Compared to an ax, a small handsaw is much safer and more energy efficient to use than is an ax.

After you have ignited the tinder, add the larger pieces of kindling and
then the larger pieces of wood. A fire built in either a tee-pee or log cabin shape works best.

WATER AND FOOD

Drink a minimum of three to four quarts of water each day to prevent dehydration. Body water that is lost through waste elimination, sweating and breathing must be replaced or your bodily functions will begin to fail. In dry and/or hot climates, as many as two gallons of water must be consumed each day to prevent dehydration. In cold environments and when traveling at high altitude, lack of water in your body can become a major problem.

Thirst is a notoriously unreliable way to judge how much water your body needs. Thirst may diminish when you are nauseated, tired, or (paradoxically) dehydrated. Your body may be in tremendous need of water but not providing you with the appropriate signal of thirst. The first indication that your body needs more water may be a headache. You can also check the color of your urine -- a change from clear or light-colored to darker yellow indicates that you are becoming or are already dehydrated and need to drink more water.

Whenever possible, purify (disinfect) your water by boiling, adding chemicals, or filtration. However, in the absence of full disinfection capability, in a time of moderate to severe need, drinking unpurified water, and preventing dehydration, may be better than not drinking the water and suffering the more immediate effects of dehydration. You may certainly acquire infectious diarrhea, but the premise is that the short term “save” is necessary.

In addition to open water sources (streams and ponds), there are
many other sources. Snow and ice can be used. Melt snow or ice in a plastic water bag placed between the layers of your clothing or by placing the snow in a pot over the fire. A cloth bag filled with snow may be hung to the side of the fire where the radiant heat will melt the snow. As the snow melts, the water drips from the lowest point of the bag, where it can be collected in a container. Eating snow or ice is not a good idea if you are cold and possibly hypothermic.

Laying a piece of waterproof material on the ground to capture rainwater and then draining the water into a container can be very effective. In a desert environment, you may need to use a transpiration bag or a vegetation bag to gather water.

Despite what your stomach tells you, you can survive for many days without food. Trying to live off of the land by trapping animals and gathering wild edible plants is very difficult and usually results in the survivor expending more energy than is replaced by the food that is gathered. Cold temperatures and heavy physical activity increase the need for food. However, even in a winter survival situation, a person can survive for a long time without food as long as he or she has appropriate clothing, and can build a shelter and a fire. In a survival situation, increase the quantity of carbohydrate in your diet (carbohydrate-centric nutrition bars, candy, etc.) Avoid meat products, such as jerky, for which digestion consumes relatively large amounts of body water.

SIGNALS AND RESCUE

First aid for injuries, shelter, fire and water will be your primary needs when lost or trapped by bad weather or darkness. Organizing resources and protecting yourself from further harm is the next step. Then, you must decide if you should sit tight and wait for rescue or attempt to make your own way out. Staying where you are and waiting for rescue is usually the best option if you are lost, injured or if you will further endanger your life by moving or leaving the area.

If the weather improves, you are in good physical and emotional condition and you know where you are, you may be able to rescue yourself. If you need help, there are signals that can be used to identify your position and your condition to others. Remember that three of anything is generally recognized as a signal for help. For instance, three shots or three whistle blasts can alert others that you are in trouble and need help. On the other hand, three fires in a triangle are unnecessary. Gather large quantities of green vegetation and place them near your fire. When an aircraft approaches, pile the green vegetation on top of the fire so that columns of white smoke will result.

Searches for missing persons will usually be conducted using both ground search teams and aircraft. Be prepared to signal either group. Remember, a person is very difficult to see from the air unless he or she does something to draw attention. To attract the attention of an aerial searcher, use your signal mirror or, as previously mentioned, add green vegetation to your fire. In areas where fires could damage timber, the smoke from your fire may be noted by a fire lookout tower or by a forester and hopefully be investigated. The light from your campfire is a very effective signal at night. In some instances, searchers use night vision enhancing equipment and other thermal detecting equipment to locate the survivor.

Tramping out the letters “SOS,” “LOST,” or “HELP” in the snow, or laying rocks or logs out in a large X, V, N or Y pattern is intended to draw the attention of searchers. These internationally recognized emergency signal letters should be large as possible, with straight sides and sharp angles and be situated where they can be easily seen from the air. Whistles are effective devices when trying to attract the attention of nearby ground search teams. The human voice, which is not very loud and easily exhausted, is the weakest signaling device; a person can essentially blow a whistle all day long.

Electronic beacons are very useful when one’s ability to attract the attention of rescuers has not proven successful. Most of these devices are GPS-enabled such that when they are activated, search and rescue personnel can identify both the identity of the user and his location. When help is a long way, off carrying a beacon makes a lot of sense.

If you have “filed a flight plan,” e.g., told someone where you were going and when you expected to return, the searchers will have a much easier time finding you. Bad weather conditions and the remoteness of your position may delay your rescue. Do not surrender hope - the rescuers will come! Your job is to keep yourself alive until they get there! Until your “flight plan” expires and someone becomes sufficiently worried about you to initiate the rescue process, there may not be concern for your safety. Once the rescue effort is underway, the rescuers will investigate any sign of your whereabouts – a wisp of smoke, a flash from a mirror, the sound of a whistle, etc.

Always remember, “A positive mental attitude is more valuable than a day pack full of equipment.”

Tags: survival, outdoor survival, wilderness survival, wilderness medicine, outdoor medicine, healthline

Labels: outdoor survival, survival, wilderness survival

Permalink | 0 Comments| Email Post

Post your comment

Electrolyte Additives for Hydration

The current issue of the journal Wilderness & Environmental Medicine, published by the Wilderness Medical Society, has a number of very interesting articles of significance to the layperson outdoor medicine enthusiast.

"Effects of an Electrolyte Additive on Hydration and Drinking Behavior During Wildfire Suppression," by John S. Cuddy and his colleagues (WEM volume 19, pages 172-180, 2008), describes a study designed to compare the effects of a water plus electrolyte solution versus plain water on changes in drinking behaviors, hydration status, and body temperatures during wildfire suppression activities. In this particular study, eight participants consumed plain water, and eight participants consumed water plus an electrolyte additive (Elete by Mineral Resources, Ogden, Utah) that contained magnesium, sodium, chloride, potassium and sulfate. The participants were provided specially outfitted backpack hydration systems with three-liter capacity from CamelBak (Petaluma, California).

During the measurement period, the participants were monitored for volume of fluid consumed, body weight, core, and skin temperatures. Work output was measured, as was the environmental temperature. The results indicated that all things being equal, the major difference noted between the water group and the water plus electrolytes group was that a remarkably lower fluid consumption (approximately 3.3 liters per day) was noted in the water plus electrolytes group. This suggests that supplementing water with electrolytes might reduce the amount of fluid necessary to transport and consume during extended activity. This would minimize excessive weight, which in and of itself might contribute to a lessening of fatigue.

In this study, the amount of fluid consumed was at the discretion of the participant, so was presumably driven by thirst. It would be very interesting to replicate this study in other situations where rehydration is important, such as high altitude travel, competitive sports, and recreational sports. It would be important to control for as many variables as possible, such as beverage temperature, taste, food intake, and so forth. It would also be useful to determine if this information has any applicability in a survival situation.

Tags: electrolyte additive, hydration, wildfire, wilderness medicine, outdoor medicine, healthline

Labels: electrolyes, fluid and electrolytes, fluid replacement, hydration, rehydration

Permalink | 0 Comments| Email Post

Post your comment

Sunlight and Vitamin D

Being in the outdoors has traditionally meant significant exposure to sunlight, and therefore to ultraviolet radiation, forms of which cause sunburn and skin cancers. It has long been taught that exposure to sunlight is necessary to maintain an adequate amount of vitamin D in the body. This concept has recently been challenged.

In November of 2008, the American Academy of Dermatology recommended "that an adequate amount of vitamin D should be obtained from a healthy diet that includes foods naturally rich in vitamin D, foods/beverages fortified with vitamin D, and/or vitamin D supplements; it should not be obtained from unprotected exposure to ultraviolet UV radiation."

The obvious reason why unprotected exposure should be avoided is to help reduce ultraviolet radiation-related cancers. In this modern age, where vitamin supplementation and a balanced diet are frequently possible, this makes great sense. For impoverished individuals, some afflicted by starvation, vitamin deficiencies (vitamin D deficiency can cause, among other problems, rickets) may preclude this approach.

Currently, the National Academy of Sciences has published guidelines for minimal intake levels of vitamin D, based upon age:

Birth to 13 years - 5 micrograms (mcg) = 200 International Units (IU)
14 to 50 years - 5 mcg (200 IU), including during pregnancy and lactation
51-70 years - 10 mcg (400 IU)
71+ years - 15 mcg (600 IU)

Risk factors for vitamin D deficiency include dark skin, elders, and photosensitive individuals. Such persons might need to take greater minimal amounts of vitamin D.

Many of us would benefit from rational vitamin and mineral supplementation, under the advice of a nutritionist or other informed health care practitioner.

image courtesy of www.tantalk.com

Tags: vitamin D, sunlight, ultraviolet, wilderness medicine, outdoor medicine, healthline

Labels: skin cancer, sunlight, ultraviolet, vitamin D

Permalink | 0 Comments| Email Post

Post your comment

Surviving A Wilderness Emergency 4

This is the twelfth post based upon educational sessions and syllabus material presented at the Wilderness Medical Society Annual Meeting & 25th Anniversary held in Snowmass, Colorado from July 25-30. It’s based upon an excellent presentation given by Peter Kummerfeldt, who is President and Chief Instructor for OutdoorSafe, Inc. of Colorado Springs, Colorado. In his presentation, Peter wisely made the point that the information provided was designed for educational use only and would not be a substitute for specific training or experience. When going into the outdoors it is the reader's responsibility to have the proper knowledge, experience and equipment to travel safely.

SURVIVAL AND FIRST AID KITS

Everyone should carry a personal survival kit when he or she is in the field. The contents of the kit may be adjusted according to the time of year, expected weather, area through which you are traveling, and personal needs. Pack the kit in a belt pouch, fanny pack or daypack and carry it with you no matter how short a trip that is planned. If you become lost, the survival kit you left back at camp or in your car cannot help you.

When assembling the kit, plan for a worst-case scenario. Every survival kit should include the following:

1. waterproof, windproof shelter material (2 or 3 large orange, industrial strength garbage bags)
2. REI matches in a watertight container
3. a second method (e.g., metal match) for starting a fire (metal match)
4. one or two match cases or filled with Vaseline-soaked cotton balls
5. a good glass signal mirror
6. a whistle

Many other useful pieces of equipment can be added to the kit depending on your particular needs. These could include a knife, spare compass, water purification (disinfection) tablets, flashlight, candle, parachute cord, metal cup, and first aid supplies. In addition to the equipment you carry for emergency purposes only, the kit should also include extra clothing to keep you warm and dry. One or more one-quart water containers must be included. Baked, rather than extruded, carbohydrate food bars work well for emergency food. Avoid meat products, because protein requires a lot of water to digest. Ensure that an identity card or tag is included in your equipment. If you are unconscious, rescuers can still determine who you are and contact your family for further information relative to any
health issues.

One of the most important pieces of survival equipment to include in your kit is a photograph of a “loved one.” The desire to be reunited with that person(s) is a very powerful motivator in a survival situation. Take a first aid class and learn specifically which items you should have in your first aid kit. At a minimum, include adhesive bandage strips, aspirin (or similar pain killer), lip balm, sunscreen, prescription medications, and spare eyeglasses.

Be prepared. You may never need your survival or first aid kit, but if you do, having it with you and knowing how to use the equipment increases your confidence and could save your life.

SHELTER

In most situations, protection from the rain, snow, wind and low temperatures will be your most immediate need. While fire will be very beneficial, it may not be necessary if you are wearing sufficient clothing and can construct an effective shelter. Your first shelter will be a combination of the clothes you are wearing and the waterproof, windproof material you take out of your survival kit to wrap up in or crawl underneath.

People often wait until the very last minute to begin building an emergency shelter. The need for an emergency shelter in which to spend the night or sit out a storm may only become apparent as the sun is about to set or the storm about to break. Furthermore, by the time a shelter is needed the survivor is often already dehydrated, hypothermic, and possible injured.

Being able to construct a text-book survival shelter depends upon the physical ability of the survivor, amount of time available, natural resources on hand, and availability of cutting tools (saws, axes and knives).

Survivors must carry the materials, such as tarps or heavy duty plastic bags, that they need to quickly protect themselves. DO not count on thin, plastic “space blankets” to provide you the protection you need. They are difficult to open, may require two hands to hold them around you, are sometimes too small for an average adult, very noisy (making it difficult to hear approaching aircraft or searchers), and easily torn when slightly damaged. Immediate action shelters such as these will may only keep you warm and dry while you evaluate your situation and plan your next step.

Huddling under the protective lower limbs of a large tree may be a good place to wait out a sudden rain shower or snowstorm. Look for a sheltered location with plenty of natural materials to build a more permanent shelter. Stay away from areas where rock fall, snow slides or flash floods may happen. Situate your shelter out of low places where cold air gathers. Look for a level spot that is large enough for you to lie down in comfortably.

A lean-to made from a tarp or from tree limbs and boughs is simple to construct and when used with a fire in front, makes a snug shelter. Hanging an aluminized “space blanket,” silver side down, on the inside of the roof of the lean-to will reflect radiant heat from the fire down onto you. Never sleep directly on the ground. Instead, build up a thick layer of boughs, leaves, pine needles or other duff to sleep on and insulate you from the cold ground. Lacking a sleeping bag, fill the interior of the shelter with other dry vegetation and crawl into it, pulling some of the vegetation around you.

Under colder conditions, where more protection is needed, a debris hut should be built. Using tree limbs and branches, build a framework that is just larger than you, then cover the structure with a thick layer of boughs, leaves or other vegetation. Fill the interior of the shelter with similar vegetation and crawl in. Seal the door after you enter and pull the “vegetation sleeping bag” around you.

Under snowy, winter conditions a snow trench provides good protection. Using a shovel, a snowshoe, a ski tip, or if all else fails, your boots, dig a trench in the snow slightly longer and wider than you. Build roof supports using skis or ski poles, snowshoes, branches or boughs, then cover the roof supports with snow. Line the inside of the shelter with vegetation and seal the door with a mat of boughs or a snow block.

When extremely cold conditions are experienced, a thermal shelter is appropriate. Scrape the snow away from the ground and build a framework over the exposed area. Cover the framework with a tarp or similar material. Then cover the entire structure with a layer of boughs or other branches. Next, pile on a minimum of ten inches of snow. Crawl inside and seal the door behind you with a plug of snow or a woven mat of branches. The heat released by the ground combined with the heat given off by the human body, and possibly a candle, will raise the internal temperature of the shelter, regardless of the outside air temperature.

To be continued...

Tags: survival, outdoor survival, wilderness survival, wilderness medicine, outdoor medicine, healthline

Labels: outdoor survival, survival, wilderness survival

Permalink | 1 Comments| Email Post

Post your comment

Thank You to Val Jones, M.D. for Grand Rounds

Thank you to Val Jones, M.D. of medpageTODAY for including my post about cold water immersion in this week's Grand Rounds. Grand Rounds is a weekly compilation of health care posts from around the web compiled by a host, who goes to great lengths to make the collection informative and entertaining. On this momentous day of inauguration of a new President of the United States, we all hope and pray that Barack Obama and his administration will be effective, successful and truly attuned to the most important issues of the health of our nation's people, the environment, and the health and welfare of all people around the globe.

Labels: Grand Rounds, medpageTODAY, Val Jones

Permalink | 0 Comments| Email Post

Post your comment

Vitamins E and C in the Prevention of Cardiovascular Disease

By now, most of you have probably figured out that I am not confining my posts to wilderness and outdoor medicine in the strictest sense. In recognition of the fact that medicine is multi-disciplinary in nature, and that many interrelationships are worthy of exploration, I am always on the lookout for new information and new associations. Such is the case with this brief discussion of an article entitled, "Vitamins E and C in the Prevention of Cardiovascular Disease in Men: The Physician's Health Study II Randomized Controlled Trial," authored by Howard D. Sesso et. al. in the Journal of the American Medical Association (downloaded from www.jama.com on November 10, 2008).

Many of us try to maintain good health in part by taking vitamin supplements, including vitamins E and C. The putative benefits of these two vitamins as supplements is in their antioxidant capacity, for the purpose of reducing cardiovascular disease. Many of my healthy, active and outdoor-minded colleagues take these supplements regularly, and some even believe that they improve their performances under situations of physical stress, including brisk exercise and when suffering viral illnesses. However, no one has heretofore had data to support the utility of vitamin E or C supplementation to reduce cardiovascular disease.

The investigators enrolled 14,641 U.S. male doctors in this study, which began in 1997 and concluded in in 2007. The enrollees were 50 years of age or older, and 754 of them (5.1%) had known pre-existing cardiovascular disease. The supplements were 400 international units of vitamin E ingested every other day, and 500 milligrams of vitamin C taken daily. The study was a randomized, double-blind, placebo-controlled trial, which means that until the completion of the study, no one knew which enrollee was taking real vitamins and which enrollee was taking the placebo products.

The conclusions of the study were that in this study group, neither vitamin E nor vitamin C supplementation reduced the risk of major cardiovascular events (such as heart attack or stroke). This was true for each vitamin alone and when they were taken in combination. The investigators noted an increase in hemorrhagic (bleeding) stroke in the vitamin E group.

The investigators looked for adverse effects from these vitamins, such as bleeding, diarrhea, nausea, fatigue, skin rashes, headache, etc. No increase in these parameters was noted in the active vitamin groups.

The take-home message is that we need more studies like this, to look at many, if not all, of the vitamin and mineral supplements that are taken for suspected, but not proven benefit. We may find that these supplements not only do not improve our health, but might had a deleterious effect(s). There are is no end of theories about how various substances, allopathic and naturopathic, might improve our health, but most of them are just that - theories. Supra-normal quantities of chemicals, be they vitamins or otherwise, that go beyond our established nutritional needs, should be proven useful before their ingestion is adopted as necessary or desirable.

I see large handfuls of vitamin pills popped by my peers and friends on the trail, under the assumption that if a little is good, a lot must be better. Not necessarily true!

photo courtesy of www.mizar5.com

Tags: vitamin C, vitamin E, cardiovascular disease, wilderness medicine, outdoor medicine, healthline

Labels: cardiovascular disease, heart disease, Vitamin C, Vitamin E

Permalink | 0 Comments| Email Post

Post your comment

Airplane in the Hudson and Cold Water Boot Camp

We're all familiar with the US Airways plane that was guided to a safe landing in the Hudson River after taking off from LaGuardia Airport yesterday. The passengers were rescued quickly, but more than a few were reported to have suffered from immersion hypothermia. I was asked by Associated Press to comment on what might have happened had the immersion been prolonged. While answering the question, I mentioned an excellent educational offering about cold water immersion and survival that has recently come into existence.

Cold Water Boot Camp is an educational program and website featuring Dr. Gordon Giesbrecht, affectionately (and respectfully) known as "Dr. Popsicle." I just had the opportunity to review the DVD of the same name. It is an excellent tool for teaching and outreach.

Consider:

MYTH - Most people believe that they don't need a lifejacket "if they are close to shore," or "because they can swim" and that "they can put a lifejacket on in the water if they need it."

FACT - In 90% of drownings, a life jacket was not worn. Research has demonstrated that in cold water, under 59 degrees Fahrenheit, the risk of drowning increases by 500%, and many of those drownings occur within 6 feet of safety.

Cold Water Boot Camp takes nine hardy volunteers from Canada and puts them into cold water to learn what happens. Dr. Giesbrecht is the instructor, and his style is highly informative and entertaining. The DVD contains a full 30 minute program as well as a 10 minute classroom version, as well as some public service announcements.

As it was explained to me, Cold Water Boot Camp was created to help change the traditional thinking about accidental immersion into cold water. I highly recommend it for student groups, outdoor groups, or for any individual interested in personal safety related to cold water, in educating others about the same. This is a tremendous safety initiative.

For the purpose of understanding a few principles of what happens to people who are immersed in cold water, be advised that a sudden plunge into cold water causes the victim to hyperventilate, which may lead to confusion, muscle spasm, and loss of consciousness. The cold water rapidly cools muscles and the victim loses the ability to swim or tread water. Muscles and nerves may become ineffective within 10 minutes. Over the ensuing hour, shivering occurs and then ceases. Anyone pulled from cold water should be presumed to be hypothermic. In terms of survival, the aphorism is that when a person is plunged into very cold water (32° F or 0° C), he or she has 1 minute to control breathing (e.g., to stop hyperventilating from the “gasp reflex”), 10 minutes of purposeful movement before the muscles are numb and not responsive, one hour before hypothermia leads to unconsciousness, and two hours until profound hypothermia causes death.

Kudos to the pilot of the airplane, the passengers for their orderly behavior in the face of a potential disaster, and to all the rescuers and medical personnel who assisted the victims.

Tags: cold water, Cold Water Boot Camp, hypothermia, wilderness medicine, outdoor medicine, healthline

Labels: cold water, Cold Water Boot Camp, drowning, Hudson River, hypothermia, plane crash, US Airways

Permalink | 1 Comments| Email Post

Post your comment

Surviving A Wilderness Emergency 3

This is the eleventh post based upon educational sessions and syllabus material presented at the Wilderness Medical Society Annual Meeting & 25th Anniversary held in Snowmass, Colorado from July 25-30. It’s based upon an excellent presentation given by Peter Kummerfeldt, who is President and Chief Instructor for OutdoorSafe, Inc. of Colorado Springs, Colorado. In his presentation, Peter wisely made the point that the information provided was designed for educational use only and would not be a substitute for specific training or experience. When going into the outdoors it is the reader's responsibility to have the proper knowledge, experience and equipment to travel safely.

BASIC SURVIVAL RULES

There are nine basic rules for surviving a wilderness emergency that will help you return to safety:

1. Always tell someone where you are going and when you plan to return. If you change plans and move from one area to another, tell someone. Knowing where to begin a search will significantly reduce the time it takes the searchers to find you.

2. Never travel alone. Many of the illnesses (hypothermia, in particular) that outdoor users experience occur without the victim becoming aware of the onset. Accidents happen in the outdoors that lead to injury. In an emergency, the assistance of a partner to care for you and then to seek help could save your life.

3. Carry two compasses and a map of the area and know how to use them. Use one compass to navigate. The second compass serves two purposes. First, it can be used if your primary compass becomes lost or broken. Secondly, it may be used for confirmation. Many panicked people prefer to rely on an innate homing instinct rather than use their compass. They therefore believe that their compass is broken when it indicates a direction that does not correspond with their instincts. Two compasses, both pointing in the same direction, increase the chance that you will believe the compasses and follow the correct heading back to camp or to one of the pre-selected boundaries.

4. Wear clothing that will keep you warm and dry. Loss of body heat because of exposure to the elements, especially wind, precipitation and low temperatures, must be prevented or hypothermia will result. The weather can change very quickly. Select clothing that will keep you warm and dry when you spend an unexpected night out, or when you are inactive. Layers work best. The innermost layer must move water away from your skin. Synthetic fabrics accomplish this better than do natural fibers. Cotton holds moisture against the skin and conducts heat away from the body, so don’t use it in a cold, wet environment.

The next layer, the insulation layer, must trap “dead air” around your body and insulate you from the cold. Pile, fleece and wool work well for this purpose. The outermost layer of clothing serves as a barrier and must protect the inner layers from wind and from moisture penetration. The head and neck are the most critical areas of the body to protect, so keep them covered. Unprotected hands are easily injured and quickly lose dexterity when exposed to cold temperatures. Stiff fingers make it difficult to strike a match, aim a signal mirror, tie a knot, zip a zipper etc. Carry mittens and a pair of light leather gloves. Also carry at least one extra layer of insulated clothing to put on when the temperature drops. “Dress to survive, not to arrive!”

5. Always carry a survival kit. You will not be able to “improvise” what you need to survive.

6. Plan your outing so that you can return to your camp or your vehicle before it gets dark. Always carry one or more flashlights so that you can return safely after dark should that become necessary.

7. Drink enough liquid to keep your urine light colored. Dehydration seriously reduces the body's ability to function properly, especially its ability to stay warm, and greatly increases the possibility of other medical problems.

8. Practice survival skills before you have to use them in an emergency. Learn how to build a fire using the equipment you carry in your survival kit. Practice erecting an emergency shelter. Experiment with your signal mirror until you can quickly reflect a beam of sunlight to any point on the horizon.

9. Do not count on anybody else being around when you get in trouble. You must be able to do all the tasks needed to keep yourself alive until rescue arrives.

To be continued…

Tags: survival, outdoor survival, wilderness survival, wilderness medicine, outdoor medicine, healthline

Labels: outdoor survival, survival, wilderness survival

Permalink | 0 Comments| Email Post

Post your comment

Winter Accidents

I was fortunate to spend a few days with my family in the Sierra Nevada over the Christmas Holiday and enjoy terrific fresh powder. We skied at Squaw Valley and Sugar Bowl until I had to beg for mercy for my tired old legs.

As much fun as we had, there were others who suffered tragic endings in the same environment. A young man was caught in an avalanche on Christmas Day in the Red Dog area of Squaw Valley ski resort. He was later found by search dogs dead and buried under several feet of snow. The unwitnessed slide occurred in a heavily wooded and steep area, so the precise details of what triggered the avalanche are not known. In a separate incident, also on Christmas Day, a woman and her son were struck by an oncoming Union Pacific Railroad train during a snowstorm. They were hiking along the train tracks, presumably mistaking it for a trail, when the train overtook them. They attempted to escape, but were not successful. The woman was killed and the son seriously injured.

First and foremost, our condolences go out to all of the victims and their families. These tragic events were certainly unintended and unforeseen.

To assist others who might find themselves in similar circumstance to those that preceded the accidents, here is some advice:

Snow Avalanche

1. Be prepared for the most harsh environmental conditions you might expect to encounter. To the best extent possible, become familiar with the setting and possible survival scenarios, particularly should you become stranded or lost. If you will be traveling in avalanche country, consider taking a level 1 avalanche certification course recognized by the American Avalanche Association or other reputable organization. Do not assume that you are completely safe within a ski area, even within bounds, during avalanche conditions. While the patrollers may have made the area as safe as they could using controlled avalanche release, when the snowfall is heavy, avalanche conditions may reoccur, and it is impossible to trigger every conceivable area of dangerous snow over an entire large ski area.
2. If you are traveling in snow country, you should know how to avoid being caught in an avalanche, and consider carrying an avalanche rescue beacon (transceiver) that operates on the frequency of 457 kilohertz (kHz). The signal carries 100 to 150 ft (30 to 46 m) and is received by the rescuers’ units. In avalanche country, also carry a shovel and a collapsible probe pole. Consider wearing an AvaLung or an ABS Avalanche Airbag System. A new technology for locating an avalanche victim is the RECCO® harmonic radar-based detector.

Train Avoidance

1. Do not walk, bike, or snowmobile on train tracks, particularly in the winter when rapid escape from an oncoming train may be difficult or impossible. The plows used to break through deep snowpack are enormous, and the visibility of the persons operating the trains may be severely diminished during times of heavy snowfall.
2. Wear brightly colored clothing whenever possible if someone's ability to spot you might save your life.
3. Always expect a train coming from any direction and on any track. You may not hear quieter trains approaching, particularly in times of high winds.
4. Never take a shortcut across a train track. Always cross at a designated crossing when the signal indicates that it is safe to cross. Do not expect a train to stop for you at a crossing. A train moving 55 miles per hour may require up to a mile in distance to be able to stop.

photo by Mark LLanuza at www.flickr.com

Tags: avalanche, plow train, winter safety, wilderness medicine, outdoor medicine, healthline

Labels: accident, avalanche, plow train, train

Permalink | 0 Comments| Email Post

Post your comment

Rescue Missions for Avalanche Victims

I'm working now with a group of Stanford students on the design of a unique avalanche rescue device that will hopefully bring a new approach to solving the problem of how to find and save persons buried under the surface after a snow avalanche. In order for us to do our work properly, it's important to be aware of some facts that describe the situation of victims buried beneath the snow.

In an article in the journal High Altitude Medicine & Biology (Volume 9, Number 3, 2008, pages 229-233) published by the International Society for Mountain Medicine, Matthias Hohlrieder and colleagues described "Rescue Missions for Totally Buried Avalanche Victims: Conclusions from 12 Years of Experience." The purpose of their data collection on the circumstances of avalanches was to bring evidence-based information to the rescuers who are tasked with finding and rescuing victims in such extreme and highly emotional circumstances.

Utilizing information complied by the Austrian Mountain Rescue Service, Tyrol, they were able to identify 109 totally buried persons over a 12-year period, 56 of the persons skiing off-piste and 53 in the backcountry. These persons were rescued or recovered; 18.3% of them survived to hospital discharge. Notable is the fact that the median depth of burial was 1.25 meters (4.1 feet), which may not seem very deep, but is obviously a depth from which a person cannot self-extricate. The median duration of burial time prior to recovery was 85 minutes, so clearly, it is still necessary to postulate ways to find and extricate the victims more rapidly, or provide them an alternative method of breathing.

The majority of rescue missions were performed under dangerous avalanche conditions, which speaks to the reason for the primary event and also to the need to find these persons quickly and to extricate them rapidly, to minimize the risks to both victims and rescuers. The probability of surivial was highest when the victims were located visually and lowest when they were located by transceiver - probably a function of how quickly they can be reached. Survival did not differ between those found by rescue dogs and those located with avalanche probes.

We will be taking this information into account as we continue to work on finding a new approach(es) to facilitating avalanche rescue via device design.

Tags: avalanche victims, avalanche, snow burial, wilderness medicine, outdoor medicine, healthline

Labels: avalanche, search and rescue, snow avalanche

Permalink | 0 Comments| Email Post

Post your comment

Surviving A Wilderness Emergency 2

This is the tenth post based upon educational sessions and syllabus material presented at the Wilderness Medical Society Annual Meeting & 25th Anniversary held in Snowmass, Colorado from July 25-30. It’s based upon an excellent presentation given by Peter Kummerfeldt, who is President and Chief Instructor for OutdoorSafe, Inc. of Colorado Springs, Colorado. In his presentation, Peter wisely made the point that the information provided was designed for educational use only and would not be a substitute for specific training or experience. When going into the outdoors it is the reader's responsibility to have the proper knowledge, experience and equipment to travel safely.

Everybody should carry and know how to use a map. Many kinds of maps are available and can be obtained from county, state or provincial agencies, the US Forest Service and other sources. The most useful maps, called topographic maps, may be purchased at many sporting goods outlets; some book stores or ordered directly from the US Geological Service (888-ASK-USGS.) Topographic maps show both man-made features (drawn in black or red) and natural features (drawn in green for vegetation and blue for water). Contour lines, lines drawn on a map joining points of equal elevation above sea level, are drawn in brown and show the altitude and the terrain features of the land mass covered by the map.

You will find other useful information in the marginal information of the map. The scale enables the user to measure the distance between two points on the map. The declination diagram shows the difference between True and Magnetic North. The date the map was printed - remember changes take place over time that may not be reflected on the map. Map symbols enable the user to interpret the information shown. Remember, unless shown otherwise, north is always at the top of the map.

Also consider using A Global Positioning System (GPS) receiver. These devices can be extremely useful navigation devices in the backcountry. GPS receivers enable the user to mark a departure point then hike all day long and at the end of the day return to that departure point regardless of the weather conditions or darkness. These devices should not replace the need to carry a compass but when used in conjunction with an orienteering compass and a USGS topographic map take all the worry out of becoming lost!

Basic navigation skills are taught to enable outdoor users to relocate themselves after becoming disoriented and make their way back to safety. Orienteering clubs, mountaineering equipment shops and other recreation programs offer additional wilderness navigation training that is designed to refine navigation skills and increase one's confidence in the ability to travel the back country without getting lost.

To be continued…

Tags: survival, outdoor survival, wilderness survival, wilderness medicine, outdoor medicine, healthline

Labels: outdoor survival, survival, wilderness survival

Permalink | 0 Comments| Email Post

Post your comment