Be Prepared For A Medical Emergency In The Woods

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It is a crisp fall morning. Overnight, a light dusting of snow has fallen. Perfect for the first day of bear season you think.

The old group has assembled coming from near and far to partake in this yearly tradition. The drive is off to a great start and the gang, like a well-oiled machine, starts its first push through the laurel hollering as they have dozens of times before.

An hour later, the drivers begin to merge with the sitters, a little more dog-eared and humbled by the brush. As the group reassembles, an older member is notably missing. After a brief search, the gentleman is found on the ground unconscious. What happened? A fall? A heart attack?

Situations like this unfortunately play out yearly in Penns Woods. In these circumstances, one needs to rapidly assess the situation, formulate a plan and act. Would you know how to react in this situation to possibly save this gentleman's life?

Just as we go through our preseason rituals such as sighting our rifle or placing stands, we should review some basic first aid and at least mentally prepare for the unthinkable.  While we are often limited in interventions in the field, it is often the most simple steps and equipment that are the most overlooked and most important.

Anyone can put together a small first aid kit to carry in the field or at least keep in their vehicle. This should include an assortment of bandages, gauze, medical tape, supplies to make a rudimentary splint for possible broken bones, and an assortment of medications.

These medications can range from those of convenience such as hydrocortisone cream or diphenhydramine for minor allergic reactions or ibuprofen for headaches to life-saving medications like aspirin, which research has shown to reduce the risk of death during a heart attack (325 mg dose).

Another consideration to include would be a high quality tourniquet such as a CAT tourniquet. However, if you choose to carry one you must be confident and take time to educate yourself in its proper use.  The best thing about building a first aid kit is that you can customize your kit to what you feel you need, ranging from the most basic to very advanced.

You can also simply buy a pre-assembled kit and add accessories you feel may be lacking.

First aid can be practiced and perfected during the off seasons just like shooting your bow or tying your favorite fly pattern. Besides self education and practicing with the equipment you carry, courses may also be offered in your area to better hone your skills.

One course I would recommend is Stop the Bleed (www.bleedingcontrol.org), which covers severe bleeding and management. Another course is the American Heart Association’s CPR/AED or “Hands-Only” courses which can be taken in person or online (cpr.heart.org). You can also contact your local EMS agency for information for similar or more advanced classes nearby. 

In such a situation as the one described here earlier, it is important to first assess the area to confirm the scene is safe to approach. It may seem like common sense, but in an emergency, people often can miss important details that may put their own lives at stake.

Once you have determined the scene is clear to approach, evaluate if you’re able to get the person to respond to you. If alone, immediately call for help and dial 911. If with others, direct someone else to complete this task. If the person is not responding or simply moaning/gasping, it is best to start CPR.

Recent research has shown that compressions are more important to survival than giving the person rescue breaths. The American Heart Association recommends “Hands Only” CPR in adults and teenagers especially if the person was seen suddenly collapsing.  

To perform properly, make sure the person is on their back on a firm surface. Place one hand over the other in the center of the person's chest. Lock your elbows and push hard and fast, allowing the chest to completely recoil to its resting position between each compression.

The ideal rate and depth of chest compressions should be 100 times per minute and 2 inches respectively. Research has shown that high-quality chest compressions increase the chance of survival. Remember to take turns with other bystanders that are present every few minutes. Quality of compressions can greatly decrease if fatigue sets in.

Any delays from checking pulses or for rescue breathing (unless properly trained in this technique) can be detrimental to the person.  Continue CPR until help arrives. If you have access to an AED (automatic external defibrillator), use it!

One should also consider if the person has other health issues such as diabetes. Low blood sugars should be thought of as a potential cause. Low blood sugars can cause a wide range of symptoms including tremor, sweating, confusion, strange behaviors, trouble speaking, loss of consciousness or even seizures.

Always check for a medical bracelet or necklace that may indicate a serious health issue such as diabetes. If hunting in a group, I recommend that at least one person should be aware of other members serious health issues. Alternatively consider carrying a card in your wallet with medical diagnoses and medications. This can be essential to EMS providers when they arrive.

Preparation is the best defense against calamity. The proper mindset in a situation such as the one described above comes from knowing you have the right equipment for the situation and are confident in its utilization. How you or others respond in a medical emergency can certainly mean the difference between life and death.

A major health issue can strike at any moment not only in the dense forest of Pennsylvania, but anywhere where our pursuits led us outdoors and away from nearby medical aid. It is our job not to ignore this risk, but to embrace it as part of our routine preparation for outdoor endeavors.

With some preparation and practice, basic medical skills and the right equipment in the backcountry may just save a life—that of a friend, family member or even your own.

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This article was originally published in Pennsylvania Outdoor News (Volume 15, Number 23), and republished here with permission.

Kyle Yebernetsky MD is an emergency medicine resident in central Pennsylvania.

The Author disclaims any liability from injury that may result from the use, proper or improper, of the information contained in this article. All the information in this article comes directly from highly trained professionals in emergency medicine, but does not guarantee that information contained herein is complete, safe, or accurate, nor should it be considered a substitute for your good judgement and common sense.

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