Wilderness First Aid Basics

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A violent allergic reaction to a drug or insect sting can cause shock. So can injury to the spinal cord.

Once shock starts, it may be difficult to reverse. If it is not stopped or reversed, the casualty will die.

PREVENTING SHOCK

Since the problem is basically one of oxygen shortage to the cells, you must be sure that the casualty is breathing with maximum efficiency. Since low blood pressure is a factor, you must be sure no more blood is lost. Raising the legs increases return of blood to the heart. Keeping the casualty warm is especially critical because the skin, with a decreased blood supply, is more vulnerable to injury from cold. Rough handling increases shock. So does pain. And reassurance has been shown to have a positive effect on blood pressure and certainly on the casualty's survival attitude. The first-aider should not be fooled into thinking there is no shock problem if shock does not appear immediately after blood loss. The body compensates in so many ways for the initial blood loss that pressure may be maintained for a time. With continuing loss, shock may appear rapidly.

Dehydration is not usually a factor in urban first aid. In the wilderness, however, it affects us more than we think. Dehydration is what occurs when the body loses more water than it takes in.

DEHYDRATION CAUSES

Because of the cold, very dry air of the north, especially in winter, evaporation is very rapid, and a person who is working hard outdoors for several days with little opportunity to drink may become severely dehydrated, and may show signs and symptoms similar to shock. But dehydration by itself is not usually the main problem, for almost everyone, if they can, will eventually satisfy his thirst with the needed fluids. The combination of dehydration and other conditions, though, may be a real problem.

Suppose, for example, an active hunter has lost 5 percent of his total blood volume by dehydration. The body will compensate-much as it does in shock-by reducing blood flow to the skin. This makes the skin colder and more likely to be frostbitten. Suppose the hunter is injured and loses blood. Since his blood volume is already decreased, it takes less blood loss to produce shock. Suppose that same hunter had a chest injury or a respiratory infection. Because the body fluids have become more viscous (thicker and stickier) from dehydration, it is harder for the hunter to cough up the fluids which accumulate in the lungs.

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