Survival

Wilderness Injuries

Wild Animals
Insect and Arachnid-Induced Injury and Illness
Plant Injuries
Psychological Stress From Injury

Wild Animals

1. Prevention/Principles
   • Know common species and behavior
   • Avoid provocation and remove threats, e.g., slowly, quietly back away in surprise encounters
   • Stop, stay calm and quiet, and make no sudden moves
   • Break eye contact: do not stare at the animal
   • Stand your ground: do not turn your back on the animal
   • Avoid highly frequented territories, especially those of carnivores
   • Pay heed to warnings of animal's intentions
2. Diagnosis and Treatment: trauma, bites, laceration
3. Wilderness Treatment:
   • ABCs
   • Direct pressure
   • Splint
   • If more than 1hr from treatment
     • Rinse with water safe to drink
     • Can pressure irrigate by filling plastic bag with water, poking hole in base and squeezing bag
     • Then scrub with soap and water or rinse with 1% povidone-iodine solution
   • Prophylactic amoxicillin-clavulanate, 2nd or 3rd gen. cephalosporin
   • Update Td prior to travel

Insect and Arachnid Induced Injuries

1. Principles/Prevention, Diagnosis, Treatment - See Bites

Plant Induced Injuries - See Plant Hazards

Psychological Stress from Injuries

1. Principles
   • Created by any situation that is beyond coping mechanisms of traveling members
     • Traveling stress, inability to meet one's own expectations of performance
     • Lack of control over surroundings, experiencing death or serious injury
     • Pre-travel screening (prior psychiatric hospitalization, known mental illness) may be necessary
2. Diagnosis: panic, anxiety, outbursts of anger, irrational decisions
3. Treatment:
   • Engage in calm, rational discussion with patient
   • Listen to concerns
   • Try behavioral relaxation, Benzodiazepines, or Haldol 5-10mg IM, or Droperidol 5-10mg IM
   • Use guided imagery techniques
   • Involve patient in decisions to degree comfortable
   • Talk patient through technical skills
   • Avoid alcohol and recreational drug use
   • Use Naloxone 0.2-0.4mg IM/IV for narcotic or narcotic analogue overdose
   • Consider Flumazenil 0.1-0.2mg IV for short-term benzodiazepine overdose; be prepared for withdrawal seizures

References

1. Auerbach PS. Wilderness Medicine: Expert Consult, 6th ed. Elsevier-Mosby:Philadelphia, PA, 2012