By Dr. Phil Petersen

It’s spring and summer is coming. It’s the time when we are leaving town and getting out into nature. The further from town, the better! The places we go to refresh and recharge.

While we are far away from the noise and bustle of civilization, we are also far from help. Mishaps in the back country may loom much larger than the same event happening in town. Getting help or getting out may take hours to days. Communication may be difficult or non-existent. You are basically on your own.

If you go to a wilderness medicine conference it is likely that more than three quarters of the time will be spent on safety and preparation. Much more time than on dealing with disaster. The reason is that we are much better off staying out of trouble than getting out of trouble.

We should start by looking at ourselves. What is our level of fitness? What medical issues do we have? Just about all of us can do car camping at a remote campground with tent or camper. Those who can carry a heavy backpack over a wilderness mountain pass are fewer in number. People with significant heart or lung issues may not tolerate high altitudes. Immune suppressed individuals should not travel to areas where tuberculosis is endemic. Do we have allergies, for example, to wasps? The list of strengths and weaknesses to be considered goes on and on.

Then we need to look at where we are going and what we will be doing. Look at what conditions we will be expecting, but also what conditions are not expected, but possible. We need to prepare for the conditions that may show up unexpectedly. For example, summer thunderstorms in the mountains often cause winter conditions and induce hypothermia. Or worse, lightning injuries. On the other end of the spectrum, hot weather may cause heat exhaustion or heat stroke if we don’t take sufficient water on a hike. Wherever we go, we should have sufficient knowledge of the area, or a combination of maps, compass and/or gps so we don’t get lost.

Once we are far from help, it becomes much more important that we avoid unnecessary risk. We tend to take potentially dangerous things into the backcountry. Axes, knives, firearms, four wheelers (and, yes, alcohol) are on the list that goes on and on. We should know the how to use each of our backcountry tools safely and use them in that way. Every piece of equipment we take with us on our nature adventures should be tested and practiced with at home before taking it to the wilderness. At home, it won’t really matter if it doesn’t work or if don’t know how to use it yet.

Even with preparation and safety precautions, sometimes things happen. There are some instances where fast action will save a life. If there is significant bleeding, you have to stop it. Almost always direct pressure can stop bleeding. Rarely, a tourniquet may be required, but you would need to be aware that we may lose the limb to save the life.

A hypothermic person is bleeding body heat. You need to stop the heat loss. Get out of the water, out of the wet clothes, and out of the wind. Into a dry wrap, and potentially with another warm person. And the hypothermic person needs fuel to make heat. Hot coffee doesn’t do it.

Lightning strike victims may die because their respiratory center is temporarily shut down. If you can give artificial respirations, they will often start breathing again and survive.

A wasp allergic hiker who is stung will need the epinephrine injection, which he should be carrying. All of the other people in the group should know where epi pen is and how to use it.

There are many backcountry medical emergencies that cannot be managed on scene. In these cases we need to be looking at how to get a person to medical care. Sometimes a person can walk out with assistance. We learn how to make stretchers out of material we have on scene, but in reality it is very difficult to carry a grown individual to safety. Satellite utilizing devices can call for help, but they require exposure to the southern sky and may not work in a canyon or under a dense forest canopy. If there are two uninjured, one can go for help while the other stays. The worst situation is if there is only one other person and the impossible decision to stay or to leave the injured friend and go to get help.

So this summer, get out there and enjoy nature. Think before you go and prepare with clothing for all possible weather, safety equipment as appropriate, and a basic first aid kit. And most of all, avoid mishaps if you can, but if one happens, keep your wits about you.