Oct. 15, 2001 -- Before 38-year-old Los Angeles architect Andrew Alper went backpacking in the Sierra, he knew full well that crossing the creek at Convict Canyon would be a hazardous undertaking. Trail information had warned that the fast-moving stream was dangerous; several bridges had already been washed away. Yet Alper and his three companions decided to cross the creek -- carefully.
Despite their caution, something went wrong. The group was moving quickly, hoping to outrun an approaching storm. Alper lost his footing in the rushing water, and, as his foot buckled, he felt his knee give way with a painful wrench. He stumbled across the creek to the opposite bank, where his knee quickly became swollen and the pain grew more intense.
Fortunately, the four hikers had their wits about them. Alper's friends fashioned a walking stick for him, then took most of the stuff out of his backpack and divided it among their own packs. "One person stayed with me while I hobbled along the trail, and the other two went down to get the car ready," says Alper. "We got caught in the rain, but not for too long."
Alper and his friends were fairly experienced hikers, and their reactions were swift and decisive. But many people heading outdoors for a getaway might find themselves unsure of what to do in the same situation. The new "reality" television program Survivor, in which 16 people volunteer to be shipped off to a remote area to fend for themselves for several weeks, has got average Americans musing about how well they might do in similar circumstances. Should I bandage a gash with a banana leaf? Wrestle a snake to the ground? How would I survive in the outdoors?
While most people who venture outdoors will make it home unscathed, being prepared is the best way to make sure that any mishaps remain minor. "It's when people don't have maps, adequate clothing, and water that they get into real trouble," says Scott Votey, MD, an associate professor of internal and emergency medicine at the University of California Los Angeles Medical School.
The Right Stuff: What to Bring
Surprisingly, it's not the people who go on long trips in the wilderness who get into medical emergencies. "Almost universally, the people we end up having to rescue are day hikers who didn't prepare well because they thought they'd be out for only a few hours," says Buck Tilton, EMT-W (wilderness emergency medical technician), director of curriculum and development at the Wilderness Medicine Institute of the National Outdoor Leadership School (NOLS).
Tilton recommends these 10 essentials for any outdoor excursion:
- an extra layer of clothing (in case of cold)
- a waterproof jacket or shell (in case of rain)
- plenty of water or a filter to disinfect stream water
- sun protection (hats, sunscreen)
- insect repellent
- adequate food and water
- first aid kit (buy one made for outdoor trips, says Tilton, otherwise you'll end up with one that's two small or too big)
Stopping Problems Before They Start: Prepare and Prevent
Before you head out, familiarize yourself with the route you'll be taking. Talk to park rangers or anyone else who can alert you to potential areas to avoid -- creeks that are about to spill over their banks or places where the trail is unstable. Always tell someone exactly where you are going and when you are expected back.
If the altitude is new to you or the temperature is something that you're not used to (especially heat), take time to acclimate your body one to two weeks before the hike with proper physical training and adequate hydration. Once you're there, avoid dehydration by drinking clean filtered water frequently. Don't go for more than 30 minutes without sipping some fluid, advises Bill Forgey, MD president of the Wilderness Medical Society.
But remember, even water from a crystal-clear stream should be filtered with an EPA-approved filter. Keeping your hands clean can also help ensure you don't suffer a trailside stomachache. No room for soap in your day pack? No problem. "I'm very impressed with the data on the new hand sanitizing gels sold in outdoor stores, which kill more bacteria than soap and water," says Tilton.
It sounds obvious, but avoiding trips and tumbles on the trail can be as simple as looking often at the ground, says Forgey. Sure, it's tempting to gaze out at an inspiring vista as you hike, but staying aware of your foot placement can keep an ankle sprain from putting a damper on your hike. Hiking boots (rather than plain sneakers or even running shoes) can also help support your ankles.
Dress in light-colored, loose-fitting layers, so that no matter what the weather, you'll be comfortable and protected. Bring a hat; it can provide heat retention or sun protection, as needed, says Tilton. Long pants can keep mosquitoes and ticks from making a meal out of you.
What to Do When Something Goes Wrong
OK, so you've got a real problem. What should you do? Here is some advice from the outdoor experts on how to handle a few common outdoor emergencies in true Survivor style. (Too bad you can't win a million dollars for your efforts.)
Feeling weak, confused, nauseated? Got a headache and a rapid pulse? You could have heat exhaustion. "You may feel like you've come down with an instant case of the flu," says Tilton. If your core temperature rises to an even more dangerous level, you could be stricken with heat stroke, a potentially life-threatening condition. If you think you have heat exhaustion, remove any clothes made from heat-retentive synthetic fabrics like nylon. Drink water, wet your skin, and have a companion fan you. If you return to feeling normal, says Tilton, it's OK to continue on your way. If not, get help immediately.
If a snake bites you, don't bother grabbing the snakebite kit. "They really don't work," says Votey. Instead, to slow the influx of venom, keep the bitten limb still and lie down flat. It's best to have medical care come to the person who has been bitten, but if you're alone and can't find anyone to help you, you'll have to get yourself out to treatment. According to Votey, you should see a doctor at once for any bite from a poisonous snake (whether or not there are symptoms) or any bite that causes pain, swelling, or tingling . People with symptom-free bites from clearly nonpoisonous snakes do not need to be rushed to the ER. If you have any doubts, though, go.
If you're allergic to bee stings, always carry injectable epinephrine, which is available by prescription from your doctor. After the bee has stung you, it may have left the stinger behind, and removing the splinter-like tail will help quell the reaction. Either pluck it out with your fingers, says Forgey, or use a knife blade (or other firm, sharp-edged item) to gently scrape the skin surface and pull out the stinger. If you've got one, take an antihistamine pill (like Benadryl) to help minimize the swelling and reaction.
If, like Alper, you think you've sprained your knee or ankle, do what Alper's party did. They took some weight out of his pack, fashioned a walking stick so that he'd hobble with more balance, and then helped him get out safely. What about a quick call to 911 on a cell phone? Not so fast. Only call for help when you feel you absolutely cannot make it on your own. When you make an SOS call, "you put other people at risk and, also, depending on how long you have to wait, put yourself at greater risk for hypothermia or other dangers," says Forgey. If it's your ankle that's sprained, keep your boot laced up to prevent further swelling. When you return to civilization, treat the sprain with RICE --rest, ice, compression, and elevation.
Ultimately, Andrew Alper didn't need to see a doctor about his knee. Probably because of his friends' help the walking stick, hiking out didn't make his injury worse. After a few days of practicing RICE, he was feeling fine again. "None of us on the trip were trained in first aid, but we used common sense," says Alper. "That, I think, made all the difference."