Natural phenomena have medical considerations, such as broken bones, lacerations, crush wounds, hypothermia, drowning, and others discussed throughout this book. Because it can be lifesaving, it’s very important to know how to seek safety and behave during a severe weather event or natural disaster. Lightning strike Lightning strikes the earth at least 100 times per second during an estimated 3000 thunderstorms per day. Fortunately, the odds…

Bees, wasps, hornets, and ants Honeybees, bumblebees, wasps, hornets, and yellow jackets each possesses a stinger, which is used to introduce venom into the victim. Most stings occur on the head, neck, arms, and legs. “Killer bees” are an Africanized race of honeybees created by interbreeding of the African honeybee Apis mellifera scutellata (originally brought for experiments into Brazil) with common European honeybees. The hazard from…

Venomous snakes Snake bites are an enormous problem worldwide, leading to death and disfigurement. A global agenda will hopefully encourage production of improved region- and snake-specific antivenoms. Two types of venomous snakes are indigenous to the United States: pit vipers (rattlesnake, cottonmouth [water moccasin], copperhead) and coral snakes. Their distributions are as follows: Northeast: Cottonmouth, copperhead, timber rattlesnake Southeast: Cottonmouth, copperhead, eastern diamondback rattlesnake, pygmy rattlesnake,…

Altitudes of 8000 to 14,000 ft (2438 to 4267 m) are attained regularly by skiers, hikers, and climbers in the continental United States. Outside the United States, mountain climbers can reach altitudes of up to 29,032 ft (8849 m) (Mount Everest height updated 2020). Appendix 2 (see page 503) lists common conversion numbers from feet. Most difficulties at high altitude are a direct result of the…

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Burn injuries See page 128. Heat-related illness (hyperthermia) Human core temperature is maintained at 98.6°F (37°C), with little variation from individual to individual. Heat is generated by all of the metabolic processes that contribute to life, from the blink of an eyelid to the running of a marathon and must be shed constantly to avoid a condition of overheating. The resting person generates enough heat (60…

Hypothermia (lowered body temperature) The body generates heat through metabolic processes that can be maximized with involuntary shivering to roughly five times the basal level (up to 10 times with maximum exercise). However, shivering is abolished after a few hours of exposure, because of exhaustion and depletion of muscle energy supplies. When a victim loses the ability to shiver, the cooling process becomes quite rapid. Skin,…

The wilderness experience can be quite stressful, and a member of the party might behave in an unusual fashion. This can be directly related to the events at hand or reflect an underlying mental health disorder. It’s imperative that someone recognize warning signs early and evacuate anyone who cannot retain mental stability, to avoid placing the impaired individual and their traveling companions at risk for injury.…

Overuse syndromes Whenever a muscle is overused—that is, exercised past its state of conditioning—there is actual destruction of the muscle tissue and generation of lactic acid. Given a reasonable rest period, the products of metabolism are carried away in the circulation and the muscle tissue regenerates to a healthy, sometimes even stronger, condition. However, if the exercise has been vigorous and unrelenting, the participant might suffer…

Bruises A bruise is a collection of blood that develops in soft tissue (muscle, skin, or fat), caused by a direct blow to the body part, a tearing motion (such as a twisted ankle), or spontaneous bleeding (ruptured or leaking blood vessel). With trauma, tiny blood vessels are torn or crushed and leak blood into the tissue, so that it rapidly becomes discolored. Pain and swelling…

Sunburn The solar radiation that strikes the earth includes 50% visible light (wavelength 400 to 760 nanometers [nm]), 40% infrared (760 to 1700 nm), and 10% ultraviolet (10 to 400 nm) ( Fig. 163 ). Energetic rays (e.g., cosmic rays, gamma rays, and x-rays) with wavelengths shorter than 10 nm do not penetrate to the earth’s surface to any significant degree. Sunburn is a cutaneous photosensitivity…

Diarrhea Although diarrhea is included here in the “minor problems” section, severe diarrhea can be devastating. Diarrhea can be due to a number of causes, including viral infection (most common), bacterial infection, protozoal infection (such as the protozoan Cyclospora cayetanensis , which can contaminate fresh berries, or Cryptosporidium species, which are waterborne), food poisoning from toxin(s), unusual parasites, inflammatory bowel disease, allergies, and anxiety. It is…

Common cold Most “colds” are upper respiratory tract infections caused by one of a host (at least 200) of viruses. It is not true that exposure to a cold climate (“catching a chill”) causes a cold. Symptoms include runny nose, cough, sore throat, headache, muscle aches, fever, fatigue, weakness, and occasional nausea with vomiting and/or diarrhea. Unfortunately, there is no cure for the common cold. The…

Headache In general, particularly worrisome headaches include a single headache that is the “first” or “worst” of a person’s life; headache with a fever that is not explained by an obvious illness; headache with vomiting that is not explained by an obvious illness; headache associated with a neurologic sign, such as weakness or altered speech; headache associated with altered mental status; headache associated with neck pain…

Fainting Fainting is defined as sudden brief (usually less than 1 minute) loss of consciousness not associated with a head injury. The medical term for fainting is “syncope.” The term for feeling like you are going to faint, but remaining conscious, is “presyncope.” There are innumerable causes of fainting, but most episodes are associated with decreased blood flow (oxygen and/or glucose) to the brain. This might…

Wilderness enthusiasts and travelers are exposed to numerous pathogens, vectors (carriers, such as mosquitoes or ticks) and diseases that are not indigenous to their home, placing them at risk of exposure to infectious diseases. This section addresses some of the more common and worrisome infectious diseases associated with travel and outdoor activities. Information regarding these infectious diseases, including recognition, prevention and treatment, is based on what…

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When a woman is ready to give birth, the contractions of labor are usually intense and uninterrupted, or separated by intervals of less than 3 to 5 minutes. If the child to be born is not the woman’s first, labor can progress very quickly, so do not wait until the last minute to set up. On the other hand, do not deliver a baby in the…

Painful testicle If a male complains of a painful testicle, examine both testicles. Look for discoloration or swelling. If a testicle has been injured by a blow, provide support with an improvised jockstrap and apply cold packs. If a testicle suddenly becomes painful, particularly in an adolescent, and appears swollen and/or discolored, usually without a penile discharge, it might be twisted, or “torsed.” If a painful…