Trail Med : From Common Ailments to SOS

Bumps, Bruises, Helicopter Evacuations Oh My !

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” Health is the soul that animates all the enjoyments of life, 

which fade and are tasteless without it ” ∼ Seneca

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Given my trail name of Doc (the combat type, not the card-carrying doctor type), I would be remiss if I didn’t chime in on the medical side of things in this epic community of ours. With over twenty years in emergency and tactical medicine, I have dealt with everything from headaches and bee stings to amputations and mass fatalities both on the civilian and military side. It’s been a wild ride for sure! People always ask, “What’s the worst you’ve seen!?” Impossible question to answer, it’s really all a blur, although truthfully there are many that stand out. No doom and gloom here though! This post is to get us all thinking about preparedness on our treks. Remember that the best medicine is always prevention. If your mindset isn’t in the right space, you will fail, and the easiest way to end the glorious thru-hike you’ve saved and trained for is a preventable medical issue. Let’s get into the first installment in our medical training, shall we?

Look familiar? Common items here we may or may not have to some extent. Honestly though, how much thought do we give to things we don’t like, that we don’t want to happen? Hope is never a strategy, let’s think a little larger, a little smarter. Yes, these items are useful, especially an over-the-counter NSAID, perhaps take a maintenance dose short term on the trail to keep swelling and inflammation down if you know your prone to problems. As always consult your primary care physician if you have any pre-existing conditions this could affect.

How about our most valuable trail asset? Our feet! One problem there and it’s game over. One thing I can take to the bank from my time in the army is feet preparation. I’d be inclined to think this could be the majority of cases that take people off the trail. They think ok, sure, they may be sore and it can be uncomfortable, but they don’t realize the magnitude major blisters can have. Do me a favor and look up military road march blisters, you’ll never think the same about your feet again.  Carry your kit, all of it, and for a respectable distance. This is where we make those shakedown miles count. Find those hot spots, remember not every foot works with every boot or trail runner. Now, get some tape down, cut moleskin to fit those places, try it out. An additional tip can be to wear dress socks under your regular socks, keeps the friction down a tad more, and every bit helps. Toe socks may be good for some as well but I can’t speak to that, haven’t used ’em. How do they do? Leave a comment or two.                                                                                                                                                                                                                                                                                                          

Fall down go boom? Remember the last wipe out you did looking at a navigation app in motion, or moving quickly in low light to make up some time or miles? No bueno, right? Serious falls, however, account for a good portion of trail rescues and recoveries. With trees and rocks aplenty, punctures and lacerations can be an ugly beast. Know how to use gauze to create a pressure dressing and add those items to your first aid kit. How about serious arterial bleeding? Contrary to popular belief, direct pressure and elevation will only slow it down. See one real arterial bleed in your life and you’ll realize what we’re working with. Combat tourniquets aren’t just for gun shot wounds, they work for all penetrating trauma and or amputations. Place them high on a long bone (upper arm, or upper leg) and cinch down until the bright red bleeding stops. I will stress, this is life and death only, know how to identify a true arterial bleed, and remember you may have minutes or less to act to save someones life or your own. A tourniquet on a non-serious wound can cause irreversible damage.

This of course is a major problem and needs a med-evac immediately. Tourniquets are ultra light and easy to store and use, no reason at all one shouldn’t be in your kit, your vehicle and your home at all times. Have the means for emergency communication such as your phone or appropriate GPS device that has SOS capabilities, many these days do. Garmin’s track record for rescues is impressive, you can even see a world map of all the places they have responded to SOS signals from their various devices.

Speaking of survival, how about temperature control? A likely secondary common reason for trail evacuation or misfortune is not being aware and prepared for the temperatures you will experience day and night along with the variables that play into that with elevation. Understanding how layering works when it comes to clothing is key. Have a secondary plan though for contingencies. Carry an emergency blanket or bivy. They are packed small and light and can give you those precious few degrees that may make all the difference in a survival situation, also many are brightly colored which can be a dual function when being used as signal device. The environment not only can come at us with the elements, but life as well. Study and know the local flora and fauna, big and small and how to mitigate risks associated with them. Avoid contact is the name of the game, and to avoid something sketchy you’ve got to know what it is your looking at. In the end we could write a book on this stuff, but you and I have better things to do, like plan and prep for that next adventure, and to up our preparedness game. If you have any questions feel free to leave a comment and we can chat it out some, otherwise let’s prevent so we don’t have to be behind the curve. Action is always faster than reaction. Cheers, your Doc on the trail, out.