If you or someone in your group suffers a traumatic injury when in the wilderness, it is important to keep your composure. Being able to maintain your composure is critical to the survival of the injured person. The person in your group with the most medical experience should be the one in charge of the treatment of anyone who is injured. If nobody in the group has medical experience, those who have taken first aid and CPR classes through the American Red Cross or another reputable organization should be in charge.

Steps for Treating Life-Threatening Injuries

Once the injured person is in a safe area, it is time to do a head-to-to evaluation of the injured person. To do this, you use the ABCD format. You always go in that exact order. Do not deviate.

• A stands for airway. Make sure the injured person's airway is clear.

• B stands for breathing. Make sure the injured person is breathing. If not, you may need to administer CPR.

• C stands for circulation and C-spine.

• D stands for deadly bleeding.

Once you have performed the initial evaluation, perform a secondary evaluation to find other injuries. Treat all other injuries once the life-threating injury has been treated.

Recognizing and Treating Shock

Shock occurs when the body cannot provide a sufficient blood supply to vital organs. Shock is serious and can lead to death if not treated. If an injured person is in shock, keep the injured person warm by covering them with a blanket or other insulating material. Make sure you also provide insulation from the ground. Treat hypothermia if it exists. If the injured person is conscious, lay them on their back. If they are not conscious, lay them on their side. If a head or chest injury exists, elevate the injured person about 15 degrees to a sitting position. The lower extremities should be elevated 8 to 12 inches unless there is a serious neck, head, abdomen, or chest injury.

Symptoms of shock include:

1. Faintness

2. A weak, rapid pulse

3. Cold, pale, clammy skin

4. Disorientation

5. Restlessness

Bleeding and Hemorrhages

Being able to recognize the type of bleed and how to treat it will be important if someone in your group suffers a traumatic injury. That said, there are three types of bleeds. The most minor is a capillary bleed. Because vessels are close to the surface of the skin, dark red blood tends to ooze from the site.

Next is a venous bleed. A venous bleed can be serious. You can usually identify a venous bleed because of the steady stream of dark red blood. The most serious bleed is an arterial bleed. Blood is typically bright red and spurting. To treat a bleed, you use either direct pressure, pressure points, or a tourniquet. However, you should only rarely use a tourniquet.

Using Direct Pressure

Apply direct pressure immediately to any bleed. You can use your hand or fingers if needed. If you have materials on hand, use a pressure dressing. To apply the dressing, pack the wound with sterile dressing or gauze, then wrap it with a continuous bandage. The bandage should be snug, but not cut off circulation. If blood soaks through the dressing, apply another dressing on top of it. Do not remove the bandage for two days. After two days, you should change it each day. If the injury is on an extremity, elevate the extremity above heart level.

Using Pressure Points

To decrease the amount of blood loss, you can apply pressure to a blood vessel between the heart and wound. Pressure should be applied for ten minutes.

Pressure points on the body from head to toe are the:

1. Carotid artery. There are two carotid arteries in the neck. One is on the left, and the other is on the right.

2. Axillary artery. It is located at the lateral margin of the first rib.

3. Brachial artery. It is located in the upper arm.

4. Femoral artery. It is located in the thigh.

5. Popliteal artery. It is located in the knee and back of the leg.

You should only use a tourniquet if applying pressure, using pressure points, or elevating the extremity have failed to stop the bleeding. Using a tourniquet comes with a high risk of the injured person losing the limb on which the tourniquet is applied, so it should only be used as a last resort. In addition, once you use a tourniquet, you do not remove it.

To make a tourniquet, apply a three to four-inch band two inches above the wound. The band should be between the wound and the heart. Wrap the band around the limb several times, then tie it with a square knot. A stick should be placed in the center of the knot. You can tighten the tourniquet by turning the stick until the bleeding stops. Once the bleeding stops, secure the stick in place. Whenever you use a tourniquet, you should mark the victim's head with a big "T" and make note of the time when it was applied.

Treating Various Injuries

Head Injuries

Symptoms of head injuries include bleeding, a worsening headache, nausea, vomiting, unequal pupils, drowsiness, and unconsciousness. To treat a head injury, first immobilize the neck if you suspect the neck may be injured as well. Treat the injured person for shock and monitor the injured person's mental status. It can help keep notes of time and details of the injured person's status.

Spinal Injuries

Chest Injuries

A chest wound may be an open (gaping) wound or a closed wound. You should cover an open chest wound with a piece of airtight material or plastic with tape on three sides. If the injured person's breathing worsens with the patch on the wound, remove the patch. You should always treat an injured person with a chest wound (open or closed) for shock.

Symptoms of a chest wound include:

1. Pain

2. Cough

3. Shortness of breath

4. Irregular breathing

5. Bluing around the lips and fingers. This is called cyanosis.

6. Anxiety

Abdominal Injuries

Just as with a chest wound, an abdominal injury can be a closed or open wound. If there is an open wound where the intestines are exposed, rinse any dirt and debris away with sterile water mixed with salt. Add one teaspoon of salt to one quart of sterile water. Once the area is cleaned, cover it with a clean, wet bandage to prevent drying. You do not want the intestines to dry out, so the wet bandage is important. Treat the injured person for shock when any type of abdominal injury occurs.

Symptoms of abdominal injuries include:

1. Abdominal wall bruising

2. Pain

3. Bleeding

4. Nausea

5. Drowsiness

6. Vomiting

A fracture is defined as a crack or a break in a bone. That said, there are two basic types of fractures. A closed fracture is when a bone is cracked or broken, but the bone is not protruding through the skin. With an open fracture, you will be able to see bone protruding through the skin. The symptoms and treatments for both types of fractures are listed below.

Closed Fractures

To treat a closed fracture, apply a splint to immobilize the extremity on which the fracture has occurred. The splint should go from the joint above where the fracture has taken place to the joint below where the fracture has taken place. If you do not have a splint, you can improvise by using a stick or branch. Hold the splint in place with a 1-inch wide band of clothing or other material. Monitor the extremity for changes in sensation and circulation. If you are ever unsure about whether a bone is fractured or not, treat it as if it is.

Symptoms of a closed fracture include:

1. Swelling

2. Deformity

3. Pain

4. Inability to bear weight on the injured extremity

Open Fractures

An open fracture has the same symptoms of a closed fracture. The difference is that you will see bone protruding through the skin when there is an open fracture. That said, never try to push bone back into place or handle the bone when treating an open fracture. Instead, rinse dirt and debris away using a mixture of sterile water and salt. Use one teaspoon of salt in a quart of sterile water. Once you have cleaned the open fracture, apply a clean, wet dressing. Wet the dressing using the same solution of sterile water and salt. Do not let the bone ends dry out. Once you have secured the dressing in place, splint the open fracture just like you would a closed fracture.

Treating a Dislocated Shoulder

The first step in treating a dislocated shoulder is administering pain medication. The injured person will need it. Once you have administered pain medication, find a rock or other sturdy surface for the person to lay on. The person should lie on his belly. The injured arm should dangle toward the ground at 90 degrees to the body. When the injured person is situated, tie or tape a 10 to 20-pound weight to the arm so that it pulls the arm to the ground. This allows the muscles to loosen so the bone can slip back into the socket. It takes about 15 to 30 minutes. Once the shoulder is back in its socket, sling the forearm and upper arm so they are close to the body. The injured person should not use the arm or shoulder.

Symptoms of a dislocated shoulder include:

1. A depression below the anterior - or front -- tip

2. Pain

3. Arm rotated slightly outward so that the elbow is head away from the side of the injured person's body

Treating Sprains

A sprain is identified as pain that exists over a joint. Since a sprain presents just like a closed fracture, you should treat any sprain as if it were a closed fracture.

Treating Strains

A strain is identified as pain that exists over a muscle. Treat a strain by applying moist heat. Activity should be kept to a minimum if it makes it worse.

Dust and Dirt in the Eyes

Dust and dirt get blown into the eyes by the wind. The most common area of the eye where the dust and dirt get lodged is right under the eyelid. You can invert the eyelid to try to remove the dust and dirt. If this does not work, rinse the eye with clean water for ten minutes.

Symptoms of dust or dirt in the eye include:

1. Redness in the eye

2. Irritation of the eye

3. Sensitivity to light

4. Pain in the eye

Treating Lacerations and Wounds

Treat all wounds and lacerations by cleaning the area with clean water. Once the wound or laceration is cleaned, apply antibiotic ointment, then apply a clean dressing.