Medicine for the Outdoors: The Essential Guide to First Aid and Medical Emergencies 9780323680561, 0323680569

Table of contents :
Front Cover
Inside front cover
Front matter
Medicine for the Outdoors: The Essential Guide to First Aid and Medical Emergencies Seventh Edition
Copyright
Preface
From Dr. Ali S. Arastu
From Dr. Tate Higgins
Table of Contents
About the authors
PART ONE General Information
How to use this book
Before you go
Be in good health
Be prepared
Common sense
Falls prevention
Rules of the road
Conditioning and acclimatization
Equipment
Trip plans
Medicines
Nutrition
Fluid requirements
Personal hygiene and bodily waste disposal
General injury prevention: Risk factors
Before the activity
During the activity
After the event
Disaster preparedness
Disaster response triage
Duty to assist
General first aid principles
While you are waiting for help to arrive
Assisting a victim of starvation
Medical decision-making
Hand offs
Patient assessmenta structured approach to emergencies in the outdoors
Overview
Primary survey (a search for immediate life threats)
A note on ABC vs. CAB
Airway
Choking
Helmet removal
Breathing
How to assist breathing (mouth-to-mouth)
Circulation
Disability and neurologic status
Logrolling the victim (see Figs. 27 and 28)
Lifting and moving a victim
Expose and environment
The secondary survey
The physical exam
Vital signs by age group
Pulse oximetry
Temperature
History
Ongoing assessment and treatment
PART TWO Major Medical Problems
An approach to the unconscious victim
Drug overdose
Long-term care of an unconscious or gravely disabled person
Chest injury
Broken ribs
Flail chest
Pneumothorax
Bruised lung
Treatment for chest injuries
Serious lung disorders
Asthma
Treatment for severe asthma
Pulmonary embolism
Heart failure (often called “congestive heart failure”)
Chronic obstructive pulmonary disease
Pneumonia
Treatment for pneumonia
Chest pain
Angina pectoris
Heart attack (acute myocardial infarction “AMI” or “MI”)
Treatment for a suspected heart attack
Aortic dissection
Very rapid heart rate
High blood pressure
Noncardiac causes of chest pain
Infection
Pulmonary embolism
Heartburn
Muscle injuries
Costochondritis
Bleeding
Treatment for bleeding
Applying a tourniquet
Internal bleeding
Shock
Head injury
Concussion
Treatment principles for head injuries
Simplified motor score
AVPU
ACDU
Pain control
Lacerations of the scalp
Allergic reaction
Treatment for a severe allergic reaction (anaphylaxis)
Seizure
Treatment for seizure
Fractures and dislocations
Compartment syndrome
Splints and slings
Taping
Specific injuries
Neck
Logrolling the victim (see Figs. 27 and 28)
“Clearing” a cervical spine
Skull and face
Nose
Jaw
Wrist, hand, and finger
Forearm
Elbow
“Nursemaid’s elbow”
Upper arm
Collarbone (clavicle)
Shoulder dislocation
Shoulder separation
Rib
Thoracic and lumbar spine (chest and lower back)
Pelvis
Tailbone (coccyx)
Femur
Hip
Knee and kneecap
Lower leg
Ankle
Toe
Heel
Amputation
Burns
Definitions (Fig. 132)
Treatment for burns
Wet versus dry dressings
Fluid replacement
Antibiotics
Tar burn
Beach tar removal
Burn prevention
Inhalation injuries
Thermal injury
Smoke (chemical) injury
Air quality index for particles
Aspiration injury
Carbon monoxide poisoning
Abdominal pain
General evaluation
Physical examination
Epigastrium
Heart attack (see page 57)
Ulcer (see also page 246)
Gastroenteritis
Heartburn
Pancreatitis
Right upper quadrant
Injured liver
Hepatitis
Gallstones (cholelithiasis)
Pneumonia
Left upper quadrant
Injured spleen
Gastroenteritis
Pancreatitis
Pneumonia
Right lower quadrant
Appendicitis
Kidney stone
Problems of the ovaries and vagina
Colitis
Bowel obstruction
Hernia
Left lower quadrant
Diverticulitis
Colitis
Kidney stone
Problems of the ovaries and vagina
Bowel obstruction
Hernia
Lower abdomen (central)
Abdominal aortic aneurysm
Bladder infection
Colitis
Bowel obstruction
Problems of the ovaries and vagina
Flanks (sides of lower back)
Abdominal aortic aneurysm
Kidney stone
Kidney infection
Pneumonia
Problems of ovaries and vagina
Ovarian infection
Ovulation, ovarian cyst, and torsed (twisted) ovary
Bleeding from the vagina
Vaginitis, vaginal discharge, and vaginal infections
Emergency contraception
Safe sex
Disorders of the kidneys, bladder, and prostate
Bladder infection
Kidney infection
Kidney stone
Blood in the urine
Acute urinary retention
Prostate infection
Problems of the penis and testicles
Painful testicle
Penile discharge
Infection of the foreskin (balanitis)
Safe sex
Emergency childbirth
Complicated deliveries
Shoulder dystocia
Breech delivery
Prolapsed umbilical cord, single arm, or foot
Cellulitis of the breast (mastitis)
Diabetes
Diabetes and SCUBA
Stroke
Infectious diseases
Fever in the returning traveler
Malaria
Yellow fever
Dengue
Chikungunya fever
West nile viral disease
Zika virus disease
Eastern equine encephalitis
Tick bites and prevention
Relapsing fever
Rocky mountain spotted fever
Colorado tick fever
Lyme disease
Ehrlichiosis
Anaplasmosis
African tick-bite fever
Tick paralysis
Babesiosis
Schistosomiasis
Trichinellosis (trichinosis)
Leptospirosis
Tularemia
Typhoid and paratyphoid fevers
Meningococcal disease (including meningitis)
Tetanus
Ebola, lassa, and other viruses that cause “hemorrhagic fevers”
Emerging infectious diseases
COVID-19
Rabies
PART THREE Minor Medical Problems
General symptoms
Fainting
Fatigue
Fever and chills
Cough
Coughing blood
Sore throat
Pneumonia
Pulmonary embolism
Lung cancer
Lung injury
Hiccups (hiccoughs)
Dizziness
Head (including eye, ear, nose, throat, and mouth)
Headache
Tension headache
Migraine headache
Cluster headache
Paroxysmal hemicrania
Sinus headache
Occipital neuralgia
Subarachnoid hemorrhage
Meningitis
Giant cell arteritis
Bell’s palsy
Ear and hearing
Sudden hearing loss
Earache
Ear infection
Referred pain
Injury to the eardrum
Foreign body in the ear
Wax in the ear
Eye
Chemical injury to the eye
Foreign body under the eyelid and scratched cornea; corneal ulcer
Injured eyeball
Bleeding into the eye
Finding a displaced soft contact lens
Removing contact lenses
Subconjunctival hemorrhage
Red eye
Pink eye
Contact lenses
Dry eye
Blepharitis
Snow blindness
Protective eyeglasses (sunglasses)
Sudden vision loss
Vitreous detachment
Injury to the retina
Optic neuritis
Glaucoma
Injured eyelid
Stye and chalazion
Eyelid infection and periorbital cellulitis
Pterygium
Nose
Nosebleed
Broken nose
Foreign body in the nose
Sinusitis
Throat
Sore throat and tonsillitis
Infectious mononucleosis
Food stuck in the throat or esophagus
Common cold
Mouth and teeth (dental)
Fever blisters (cold sores)
Canker (mouth) sores (aphthous ulcers or stomatitis)
Salivary gland infection/inflammation
Black tongue
Sore lips
Toothaches and tooth inflammation/infections
Broken, displaced, or lost tooth
Temporomandibular joint syndrome
Mouth ulcer (canker sore)
Trench mouth
Broken or snagged braces
Upper respiratory disorders
Common cold
Influenza
Bronchitis
Pleuritis
Hay fever
Disorders of the gastrointestinal tract
Diarrhea
General therapy for diarrhea
Fluid replacement
Traveler’s diarrhea
Viral diarrhea
Cryptosporidiosis
Food poisoning
Escherichia coli O157:H7
Giardia lamblia
Other infectious diarrheas
Prevention of infectious diarrhea
General
Food handling and storage
Fruits and vegetables
Meat and seafood
Dairy and sauces
Water and beverages
Dining out
The importance of hand hygiene
Washing dishes and cooking/eating utensils
Botulism
Irritable bowel syndrome
Gluten sensitivity
Constipation
Hemorrhoids, anal fissure, and rectal prolapse
Flatus
Heartburn
Nausea and vomiting
Vomiting blood
Ulcer disease
Therapy
Hepatitis
Skin disorders
Sunburn
Sunscreens
Melanoma
Poison ivy, sumac, and oak (genus toxicodendron)
Other irritating plants
Rashes incurred in the water
Seaweed dermatitis
Swimmer’s itch
Sea bather’s eruption
Soapfish dermatitis
Fish handler’s disease
Seal finger
Hives
Heat rash
Intertrigo
Chafe
Impetigo
Cellulitis, including from methicillin-resistant staphylococcus aureus
Abscess
Ingrown toenail
Fingertip cracks
Paronychia
Felon
Blisters
Basic blister treatment (for intact blisters)
Basic blister draining
Treatment of open and torn blisters
Toe blister
To prevent blisters
Plantar warts
Athlete’s foot, ringworm, and jock itch
Tinea versicolor
Onychomycosis
Good foot care
Diaper rash
Armpit odor
Lice
Scabies
Creeping eruption
Shingles
Herpes simplex virus genital infection
Fever blisters
Minor bruises and wounds
Bruises
Black eye
Blood under the fingernail
Torn fingernail
Puncture wounds
Impaled object
Scrapes
Cuts (lacerations)
Skin flaps and avulsions
Taping a wound closed
Sewing (suturing) a wound closed
Stapling a wound closed
Gluing a wound closed
Dress the wound
Wound infection
Seek medical care
Bandaging techniques
Abscess (boil)
Scalp laceration (cut on the head)
Fishhook removal
Splinter removal
Blisters
Musculoskeletal injuries
Overuse syndromes
Carpal tunnel syndrome
Cyclist’s palsy
Saturday night palsy
Rotator cuff tendinitis
Turf toe
Muscle fatigue
Shin splints
Plantar fasciitis
Torn muscle
Sprains, strains, and tendon rupture
Muscle cramps
Arthritis
Bursitis
Venous thrombosis and thrombophlebitis
Back pain
Mental health (psychiatric) emergencies
Anxiety
Panic
Depression
Delirium
Psychosis
Reaction to an injury or illness (acute stress disorder)
Posttraumatic stress disorder
Attention deficit hyperactivity disorder
PART FOUR Disorders Related to Specific Environments
Injuries and illnesses due to cold
Hypothermia (lowered body temperature)
Prevention of hypothermia
Mild hypothermia
Moderate hypothermia
Severe and profound hypothermia
Rewarming and preparing a hypothermic victim for transport
Cold water immersion
What to do if you fall through the ice
How to assist someone who has fallen through the ice
Winter storm preparedness
Safe sledding
Frostbite
Treatment of frostbite
Stages of frostbite
Wound management after thawing
Prevention of frostbite
Frostnip
Immersion foot (trench foot)
Chilblain (pernio)
Raynaud’s phenomenon
Hives induced by exposure to cold
Snow blindness
Injuries and illnesses due to heat
Burn injuries
Heat-related illness (hyperthermia)
Heat exhaustion and heat stroke
Cooling the victim
Muscle cramps
Heat swelling
Fainting
Hydration, dehydration, and hyponatremia
Hyponatremia
Avoiding heat illness
Wildland fires
High-risk situations
Standard fire encounter principles
What to do when caught in a wildland fire
High altituderelated problems
Prevention of high altitude–related disorders
High-altitude pulmonary edema
High-altitude cerebral edema
Acute mountain sickness
Gamow bag (portable hyperbaric chamber)
Other disorders of high altitude
High-altitude headache
Fluid retention
Visual changes after radial keratotomy
High-altitude flatus expulsion
Altitude throat
High-altitude bronchitis and cough
Snow blindness
Snakebite
Venomous snakes
Signs of envenomation
Pit vipers
Coral snakes
Treatment of snakebite
Avoidance of venomous snakes
Nonvenomous snakes
Gila monster and Mexican beaded lizard
Insect and arthropod bites
Bees, wasps, hornets, and ants
Treatment for insect sting
Avoidance of stinging insects
Spiders
Black widow spider
Treatment for a black widow spider bite
Recluse spiders
Treatment for a brown recluse spider bite
Other spiders
Scorpions
Mosquitoes
Mosquito avoidance
Biting flies
Fleas
Chiggers
Centipedes and millipedes
Ticks
Tick avoidance
Tick removal
Tick bite and red meat allergy
Caterpillars
Beetles
Sucking bugs
Skin infestation by fly larvae
Insect repellents and other protection against insects
Clothing
Screens, bed nets, coils, candles, shields, and traps
Repellents
Leeches
Lightning strike, tornado (cyclone), hurricane (typhoon), flood, earthquake, tidal wave (tsunami), landslide (mudslide), volcano, and snow avalanche
Lightning strike
Lightning avoidance and how to seek safety
Tornado avoidance and how to seek safety
Hurricane: How to seek safety
Flood: How to seek safety
Earthquake: What to do and how to seek safety
Tidal wave: How to seek safety
Landslide: How to seek safety
Volcano
What to do if working or traveling near an active volcano
Snow avalanche
Hazardous aquatic life and aquatic infections
Sharks
Shark avoidance
Barracudas
Moray eels
Sponges
Jellyfish
Coral and barnacle cuts
Sea urchins
Starfish
Cucumbers
Bristleworms
Cone snails (shells)
Stingrays
Avoidance of stingray injuries
Catfish
Scorpionfish
Surgeonfish
Octopuses
Sea snakes
Skin rashes caused by aquatic plants (seaweed dermatitis) or creatures (sea bather’s eruption, swimmer’s itch)
Poisonings from seafood
Scombroid fish poisoning
Pufferfish poisoning
Ciguatera fish poisoning
Paralytic shellfish poisoning
Hallucinatory fish poisoning
Anisakidosis
Underwater diving accidents
Air embolism
Decompression sickness (the “bends”)
Nitrogen narcosis
Ear squeeze
Sinus squeeze
Tooth squeeze
Drowning
Recognizing a victim of drowning
Prevention of drowning
Animal attacks
Animal attacks
General treatment
Special considerations
High-risk wounds to hantavirus
Cat-scratch disease
Rabies
Skunks
Bubonic plague
Murine typhus
Anthrax
Hantavirus pulmonary (lung) syndrome
Avoidance of hazardous animals
Wild plant and mushroom poisoning
Medical history
Treatment for poisonings
Commonly ingested toxic plants and mushrooms
Toxicity of common plants
PART FIVE Miscellaneous Information
Oxygen administration
Precautions
Water disinfection
Motion sickness
Jet lag
In flight
For traveling westward
Before travel
On arrival
For traveling eastward
Before travel
On arrival
Personal safety in an age of conflict, kidnapping, and terrorism
Safe travel
General crime avoidance
Kidnapping and hostage behavior
Proper hostage behavior
Avoiding acts and consequences of terrorism
Piracy
How to lessen the risks associated with pirates
Blast injuries
How to avoid blast injuries
First aid kits
Basic supplies
General supplies to consider
Wound care: Preparations and dressings
Splinting and sling material
Eye medications and dressings
Dental supplies
Topical skin preparations
Nonprescription medications
Prescription medications (select what you feel you might need; the drugs listed are “for example”)
Allergy kit
Forest and mountain environments
Aquatic environments
Physicians abroad
Immunizations
Transport of the injured victim
Lifting and moving techniques
Straight lift
Logrolling the victim (see Figs. 27 and 28)
Carries and litters
Carries
Litters
Helicopters
Ground-to-air distress signals
Lost people
Procedures
Intramuscular injection
Fishhook removal
Splinter removal
Ring removal
Zipper removal
Knots and hitches
Dealing with death
Handling a dead body
Emotional considerations
Obtaining assistance
Appendices
Appendix One: Commonly used drugs (medications) and doses
Drugs and pregnancy
Allergic reaction to a drug
Overview of epinephrine
Overview of metered-dose inhalers, albuterol
Overview of steroids
For relief from a severe allergic reaction
For relief from a mild allergic reaction or hay fever
For relief from severe asthma or chronic obstructive pulmonary disease
For treatment of chest pain (angina)
For treatment of congestive heart failure
For treatment of seizures (epilepsy)
For relief from pain (see also for relief from muscle aches or minor arthritis)
For treatment of opioid overdose
For relief from fever
For relief from muscle aches or minor arthritis
For relief from muscle spasm
For relief from migraine headache
For relief from itching
For relief from toothache
For relief from motion sickness
For relief from nausea and vomiting
For relief from diarrhea
For relief from constipation
For relief from ulcer pain
For relief from indigestion or gas pains
For relief from heartburn (reflux esophagitis)
For relief from nasal congestion
For relief from cough
For relief from sore throat
Cold formulas
Skin medications
Antiseptic ointments, solutions, and scrubs
Anti itch, anti sting
Antifungal cream, lotion, pill, spray, and powder
Antimites
Topical steroids
For sleep
Antibiotics
Appendix Two: Conversion tables
Fahrenheit and centigrade (celsius) temperature conversion
Measures of length
Measures of volume (capacity)
Measures of weight
Conversion between feet and meters
Feet to meters
Appendix Three: Guidelines for prevention of diseases transmitted via human blood and other bodily fluids
Human immunodeficiency virus
Postexposure prophylaxis (PEP)
Preexposure prophylaxis (PrEP)
Appendix Four: Commonly used applications of the SAM splint
General
The concept: The basic bend
Finger splint (for fingertip injuries, broken or dislocated finger, cut finger)
Volar (underneath) wrist splint (for broken wrist, cut wrist, carpal tunnel syndrome)
Thumb spica splint (for navicular [scaphoid] fracture, broken or dislocated thumb, ulnar collateral ligament sprain)
Ulnar gutter splint (for broken or dislocated fourth or fifth finger)
Double layer wrist splint (for sprained or broken wrist, cut wrist)
Upper arm splint (for broken upper arm)
“Sugar tong” splint (for dislocated or broken elbow, forearm, wrist)
Elbow splint (for dislocated or broken elbow)
Adjustable cervical collar (for suspected neck injury)
Anterior dislocation of the shoulder
Ankle stirrup splint (for sprained, broken, or dislocated ankle; for broken lower leg)
Figure-eight ankle splint (for sprained, broken, or dislocated ankle)
Combination ankle stirrup and figure-of-eight splint (for sprained, broken, or dislocated ankle where maximum immobilization is needed)
Single long leg splint (for broken lower leg)
Double long leg splint (for broken lower leg where more immobilization is needed)
Knee immobilizer splint (for knee injuries)
Half-ring splint for femur fracture (for broken femur)
Impaled object protector
Appendix Five: Emergency canine medicine
Glossary (Including Acronyms and Abbreviations)
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Index
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