CHAPTER SIX: Medical Emergencies
“I didn’t become an EMT to get a
front-row seat to other people’s tragedies. I did it because I knew the world
was bleeding and so was I, and somewhere inside I knew the only way to stop my
own bleeding was to learn how to stop someone else’s.”
- Daniel José Older
Section C:
Other Health Risks
“Safety saves sickness, suffering,
and sadness.”
- Safety saying, circa early 1900s
Energy
The amount of energy available to the body is determined by what food is
ingested and when. Nighttime dinner provides energy for the next
morning. Breakfast becomes afternoon energy. Lunch is utilized at
night.
Foods like nuts, chocolates, and fresh or dried fruits provide sources of
energy that you can snack upon while on
the trail between regular meals. Body heat is made possible only by
metabolizing ingested food. You must eat to live. You cannot cram
down a doughnut and a cup of coffee in the morning and put in a full day on the
trail without feeling the effects of an inadequate fuel supply, as well as
dehydration.
Sheltered from the effects of weather, the adult human body at rest can
maintain its normal temperature of 98.6 degrees for 24 hours at 1,000 to 1,400
calories. Depending on weather and terrain, a hiker can expand from 4,000
to 6,000 calories in the same time period. Unless these calories are
replaced, the body’s energy reserves become depleted. This may not leave
enough energy to maintain a normal body temperature of 98.6 degrees and put you
on a slippery slope to hypothermia.
“Safety brings first aid to the
uninjured.”
- F.S. Hughes
Exhaustion
For short periods the body moves on muscle power fueled by sugars derived from
food (mainly carbohydrates) and water, which are converted by the body to
glycogen. Part of this glycogen is stored in the liver and the rest is
converted into sugar and stored in the muscles for quick use. Hikers
travel first on the energy of muscle sugar until after several minutes of
exertion that causes the heart and lungs to work harder to supply oxygen to the
muscles and bring the body’s fat reserve out of storage. After about a
half hour of hiking the body’s energy comes half from glycogen and half from
fat. Walking for longer periods increases the percentage of energy
utilized from fat. After several miles on the trail a hiker draws almost
90 percent of the needed energy from his supply of body fat.
Walking does not tire a person as much as jogging does. This means
walkers are able to exercise longer to cover the same distance. This
extra exercise time means more calories burned and a higher percentage of these
calories are extracted from body fat. The longer you walk the higher
percentage of your energy comes from fat. Fat has a high energy value,
more than twice that of protein or carbohydrate. For cold weather outings
of short duration ingesting large amounts of fat is not necessary.
However, for prolonged exposure of six months or more to the extreme cold
conditions found in Polar Regions, people should consume a high amount of fat
to provide enough energy to withstand the prolonged periods of cold
weather. A high fat diet allowed the Eskimo to live and thrive in the
arctic. Until this was learned by arctic explorers, many expedition
members perished when their bodies ran out of fat generated energy.
“Maybe this world is another planet’s hell.”
- Aldous Huxley
As your body starts running out of energy; the first visible symptoms of
exhaustion are poor reflex actions, poor control of arms and legs, the need for
frequent and prolonged rest stops, a decreased attention span, along with a
dazed and careless attitude. These are also the same symptoms exhibited
by hypothermia victims.
When you burn muscle sugars, the byproduct of this combustion are heat, lactic
acid, and carbon dioxide. Breathing removes the carbon dioxide through
the lungs. Basic chemistry dissipates the lactic acid and other
detrimental products throughout the whole body and can be flushed out only at a
fixed rate. Short term strenuous muscle activity can produce buildups of
lactic acid and carbon dioxide faster than your body can dissipate them.
When this happens, the body can become oversaturated with detrimental products,
causing muscle failure or exhaustion. This condition lasts until the body
has enough time to systematically flush out the lactic acid buildup and
disperse the carbon dioxide.
At rest, the body can flush out about 30 percent of the lactic acid buildup in
the first five minutes. However, during the next fifteen minutes of rest,
only another 5 percent are removed. The best way to prevent the buildup
of these harmful byproducts is to prevent their formation by traveling
slower. Slower travel also allows for a better appreciation of the
environment while simultaneously reducing the possibility of accidents caused
by fatigue. Without the proper amount of rest, fatigue can be followed by
exhaustion, which paves the way for hypothermia, which can cause
unconsciousness and death very quickly.
To sum up, outdoor recreationists have a limited supply of usable body energy
in the form of carbohydrate, protein, fat and their level of physical
endurance. Eat, drink, and know your physical limits to avoid exhaustion,
hypothermia, and death.
“When the well’s dry, we know the
worth of water.”
- Benjamin Franklin
Dehydration
Even though the average American may drink the advised six to eight cups of
water a day he or she also takes in five or more caffeinated or alcoholic
beverages which are diuretics and cause increased urination that result in a
net loss of water. The result, said Dr. Barbara Levine, director of the
Nutritional Information Center at the New York - Presbyterian / Weill Cornell
Medical Center, is a chronically dehydrated nation.
Many people go to an outdoor event already with a water deficiency, and their
participation in outdoor activities often only worsens their already dehydrated
condition; if they drink the diuretics that are usually associated with outdoor
recreation, such as caffeinated or alcoholic beverages. That is why taking
in sufficient plain water while engaged in outdoor activities is very
important. Always remember that our bodies are more than 70 percent
water.
“Drinking water is like washing out
your insides. The water will cleanse the
system, fill you up, decrease your caloric load and improve the function of all
your tissues.”
- Kevin R. Stone
Outdoor recreationists can lose fluids or body moisture through perspiration,
urination, and additional water loss caused by breathing in cold, dry air and
breathing out your body’s warm moist air. Together these three ways
combined can hasten dehydration that reduces the body’s blood volume.
With less blood volume there is less oxygenated blood available for the
functioning of vital organs, such as the lungs, brain, and heart. Urine
color is an indication of dehydration. The darker the color, the more
dehydrated you are. After you lose more than 10 percent of your body
fluids, you are beyond self help.
Therefore, to stop dehydration before it starts, drink plenty of plain tap
water. Over drink on tap water to be certain you stop dehydration before
it starts at all. Drink one to two cups of water before starting out on a
trek. Drink before you become thirsty. Keep in mind that if you
only drink enough to quench your thirst, it may not be enough water you body
needs and you could still become dehydrated.
“When life places stones in your path, be
the water. A persistent drop of water
will wear away even the hardest stone.”
- Autumn Morning Star
The Israeli Defense Force requires its soldiers to drink water at the start and
during the course of any field operation, even when they are not thirsty.
Their soldiers carry and drink at least three full canteens of water a day
during field exercises. The United States Army requires that their
soldiers drink a full canteen of water every thirty minutes during hot and
humid weather conditions. Active outdoor recreationists should drink at
least one gallon of liquid each day and more if they are involved in strenuous
activity during hot and humid weather. One suggested guideline for hikers
is to drink eight ounces (one cup) of water for each half‑hour of
walking. Expensive sports drinks do not increase athletic performance and
contain many added ingredients that we absorb much slower than tap water.
“I believe that water is the only
drink for a wise man.”
- Henry David Thoreau
While outdoors, don’t drink untreated surface water which might contain Giardia
lamblia, a dangerous intestinal parasite that causes severe gastrointestinal
problems. Because the organism is so widespread, you must consider all
surface water to be contaminated and it must be treated by boiling, filtering,
or chemicals. Many medical authorities now consider iodine in its various
forms to be the best chemical to treat possible Giardia contaminated water.
“Water sustains all.”
- Thales of Miletus
While engaged in outdoor recreation, avoid drinking alcoholic beverages that,
in addition to being diuretics, expand the blood vessels, bringing body heat to
the surface of the skin faster than normal where it is lost by radiation.
In addition, alcohol (as well as some prescription drugs) impair your mind and
may cause you to take risks with life threatening hypothermia as well as
dehydration.
Water is very important to stay alive. You can live without food for two
weeks or more, but under certain weather conditions you can die of dehydration
within three days. As many wise people have stated, “Water is life”!
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