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Ask a Pro: How Do I Alleviate Medical Issues in the Backcountry?

Traci Salisbury | Oboz Ambassador

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Backcountry travel is one of the most inspiring ways you can see the outdoors. Day hiking is wonderful, but once you have a few successful nights sleeping in your tent out amongst the stars and away from all urban influence, you will be hooked. With backcountry travel comes added personal responsibility. Oftentimes you will be miles out, away from definitive care, and need to recognize and begin to treat basic medical situations before they become larger issues. Below is a short list of common medical problems that can occur during your adventure travels and how to troubleshoot them on the fly. Keep in mind these can all occur on a simple day hike as well!  

Blisters

Blisters are the bane of all hikers’ existence. A blister is a small pocket of fluid that gets trapped in the upper layer of skin due to forceful rubbing.  Blisters are not typically a medical emergency, but left untreated, then can surely make your backcountry trip a terrible experience.

Signs/Symptoms: 

  • A red spot (also known as a “hot spot”) forming in places on the body where excessive friction is taking place—think back of the heel or in between toes
  • A visible bubble elevated on the skin surface
  • Often accompanied by pain at the sight of the wound, swelling, and redness.

Treatment in the field:

  • If it is a hot spot, medical tape on top of the hot spot is sufficient     
  • Apply a doughnut of moleskin to the affected area; place the hole of the doughnut on top of the blister. This will take direct pressure off the blister itself

Plan ahead and prepare:

  • Allow adequate break-in time for your hiking boots before your backpacking trip
  • Keep your feet dry and change socks often
  • Catch and treat blisters early

Dehydration

Dehydration occurs when your body loses more fluid than it takes in. If your body does not have enough fluids, it will have trouble carrying out normal bodily functions. At home, this could mean an afternoon slump at the office and a visit to the water cooler. On a four-day trip in the desert, dehydration can turn dangerous very fast.

Signs/Symptoms

  • Excessive thirst
  • Darker than normal urine
  • Headache
  • Muscle cramps
  • Dry mouth
  • Lethargy, irritability (more severe)

Treatment in the field:

  • Stop often for water breaks and pace yourself
  • Eat snacks that contain water and salt—think fruit or salty nuts/chips
  • Get plenty of rest each night of your trip
  • If you are on a hot and sunny trip, consider taking a siesta during the hottest part of the day and hiking your miles in the morning and early evening

Plan ahead and prepare:

  • Study your route and know when and where your water refill spots will be
  • Carry a water treatment option as well as a backup. At Wildland Trekking, we carry Aqua Mira and gravity filters on all backcountry trips
  • Pack salty snacks, fresh fruit for day one (maybe day two), and oral rehydration salts for emergent situations
  • Pre-hydrate before your trip even begins

Mountain Sickness

Also known as acute mountain sickness or altitude sickness, this condition arises from a rapid exposure to a high altitude. Higher than normal elevation gains and lower levels of oxygen can leave your body feeling depleted and off kilter.

Signs/Symptoms

  • Lethargy/malaise (not feeling like yourself)
  • Dizziness
  • Headache
  • Nausea/vomiting
  • Trouble sleeping at elevation
  • Loss of appetite

Treatment in the field:

  • Stop ascending until symptoms clear up
  • Drink plenty of water
  • Use an OTC pain medication for headache
  • Use Diamox, a medication used to aid the symptoms of altitude sickness

Plan ahead and prepare:

  • If possible, train for your trip at higher elevation to get used to it
  • Educate yourself on the more severe versions of altitude sickness—HACE and HAPE.
  • Plan extra days into your trip to acclimate to large changes in elevation

Fractures

Broken bones and dislocations can be a very serious occurrence on a multi-day backpacking trip. Fractures in the backcountry are most common in the ankle, wrist, or leg usually caused by a fall. If a fracture happens, the main goal is to immobilize the injury via splinting it. 

Signs/Symptoms

  • Obvious deformity of the bone(s) that took the fall
  • Pain and swelling at the injury site
  • Changes in range of motion
  • Inability to bear weight/put pressure on it
  • Crepitus (sound of bone rubbing on bone)

Treatment in the field:

  • Assess the injury—look, listen, and feel
  • Splint the injury in a position of comfort; use a rigid component such as a SAM splint or stick
  • Make sure the splint immobilizes the joint above and below the injury site
  • Make a plan to evacuate the injured party rapidly

Plan ahead and prepare:

  • Carry adequate first aid supplies to splint a fracture—SAM splint, ACE wrap, and padding.
  • Learn how to build a basic wilderness splint
  • Navigate uneven terrain carefully

FrostNip/Frostbite

Frostnip is the precursor to frostbite. Frostnip is a result of vasoconstriction and is a non-freezing cold injury. At this stage, the tissue is not yet frozen, however, if left untreated, it can escalate into frostbite. When frostbite occurs, the tissue is frozen and is in need of careful re-warming by a trained medical professional.

Signs/Symptoms (frostnip):

  • Tingling/stinging of the affected area
  • Deep cold feeling around the area
  • Discoloration (red, white, or yellowish)
  • Unlike frostbite, skin remains pliable and soft

Treatment in the field:

  • Move inside your tent/sleeping bag and put on warm dry layers of clothing
  • Try to re-warm the area using warm water, the key to re-warming is gradual
  • Use OTC pain medication for pain/discomfort

Plan ahead and prepare:

  • Pack extra protective layers for exposed skin—i.e. a balaclava, hat, scarves
  • Limit your time in the elements, if possible
  • Bring plenty of winter socks to change often during your trip
  • Drink warm drinks
  • Gain experience in warm weather backcountry travel before you attempt winter backcountry trips

All of these tips and pointers are helpful, yet not exhaustive by any means.  I highly suggest educating yourself on some basic Wilderness First Aid before heading out on longer trips away from definitive medical care. The National Outdoor Leadership School (NOLS) offers comprehensive courses that vary in length and depth. I recertify my Wilderness First Responder every two years to keep up with the evolving curriculum.

Traci Salisbury

Name: Traci Salisbury

Hometown: Salt Lake City, Utah

Where I’ve Been: I have many memorable great hikes, and one of my favorite is completing California's Lost Coast Trail with my best friend. There was also the time I led Wildland Trekking clients on a 6-day llama trekking trip into the backcountry of Yellowstone during a rogue September snowstorm.

Why I Hike: The beauty and the mystery. The first time I camped out west, in Colorado at 9,000 feet, the view of the Milky Way was something I had never seen before when I was growing up on the east coast.

Lead The Way: I'm a guide with Wildland Trekking and I live #vanlife; my home is a converted Chevy E250 van.

 I solo hike and explore with others; my favorite memories are formed around camaraderie and a shared experience. 

Ambassador Focus: #protip

Find Me:

Instagram: @wildlandtrekking

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