AY Honors/Backpacking - Advanced/Answer Key

Backpacking - Advanced

Skill Level

3

Year

2012

Version

10.11.2024

Approval authority

North American Division

1

Have the Backpacking honor.

For tips and instruction see Backpacking.

2

Have the Orienteering honor.

For tips and instruction see Orienteering.

3

Have the First Aid honor.

For tips and instruction see First Aid, Standard.

4

Review the prevention and symptoms of, and first aid for:

4a

Sunburn

Sunburn is from over-exposure to the harmful ultraviolet rays of the sun. While the symptoms are usually temporary (such as red skin that is painful to the touch), the skin damage is often permanent and can have serious long-term health effects, including skin cancer.

• There is no such thing as a "healthy tan." Unprotected sun exposure causes premature aging of the skin.
• Sun exposure can cause first and second degree burns.
• Skin cancer usually appears in adulthood, but is caused by sun exposure and sunburns that began as early as childhood. You can help prevent skin cancer by protecting your skin and your children's skin from the harmful rays of the sun.

Factors that make sunburn more likely:

• Infants and children are especially sensitive to the burning effects of the sun.
• People with fair skin are more likely to get sunburn. But even dark and black skin can burn and should be protected.
• The sun's rays are strongest during the hours of 10:00 a.m. to 4:00 p.m. The sun's rays are also stronger at higher altitudes and lower latitudes (closer to the tropics). Reflection off water, sand, or snow can intensify the sun's burning rays.
• Sun lamps can cause severe sunburn.
• Some medications (such as the antibiotic doxycycline) can make you more susceptible to sunburn.

First Aid

• Try taking a cool bath or shower. Or place wet, cold wash cloths on the burn for 10 to 15 minutes, several times a day. You can mix baking soda in the water to help relieve the pain. (Small children may become easily chilled, so keep the water tepid.)
• Apply a soothing lotion to the skin.
• Aloe gel is a common household remedy for sunburns. Aloe contains active compounds that help stop pain and inflammation of the skin.
• An over-the-counter pain medication, such as acetaminophen or ibuprofen may be helpful. DO NOT give aspirin to children.

Do Not

• DO NOT apply petroleum jelly, benzocaine, lidocaine, or butter to the sunburn. They make the symptoms worse and can prevent healing.
• DO NOT wash burned skin with harsh soap.

4b

Blisters

Blister Prevention

When it comes to blisters on the feet, it is always best to avoid them. Blisters are caused when your foot rubs against something repeatedly. Blisters can be avoided by wearing footwear that fits you correctly. Also, be sure to break your footwear in before embarking on a long hike. It also helps to wear two pairs of socks. When you do this, the inner sock moves with your foot and the outer sock moves with your boot. All the rubbing takes place between the two socks rather than between your foot and the sock. This will eventually wear a hole in your sock, but replacing socks is a lot less painful than hiking with a blister.

Blister Treatment

Try not to break the blister open. It is far better if the skin continues to cover the injury, as this will keep out germs and prevent infection. If you must open the blister in order to be able to walk, do it as follows.

• Clean the affected area
• Sterilize a needle
• Pierce the blister in several places around its perimeter to drain the fluid, but try to leave as much of the skin intact as possible.
• Wipe the injury down with rubbing alcohol.

Whether you open the blister or not, you should then treat it as follows:

• Cut a hole a little larger than the blister in a piece of moleskin from your first aid kit, and place the hole over the blister. The thickness of the surrounding moleskin protects the blister from further friction. If you do not have a moleskin, you can do the same thing with an adhesive bandage.
• Cover a large blister with gauze and adhesive tape.
• Be sure to allow the blister to breathe.

4c

Frostbite

Frostbite occurs when ice crystals form in the skin or deeper tissues after exposure to a temperature of 32°F (0°C) or lower. Depending upon the temperature, altitude, and wind speed, the exposure time necessary to produce frostbite varies from a few minutes to several hours.

The areas most commonly affected are the face and extremities. The symptoms of frostbite are progressive. Victims generally incur this injury without being acutely aware of it. Initially, the affected skin reddens and there is an uncomfortable coldness. With continued heat loss, there is a numbness of the affected area due to reduced circulation. As ice crystals form, the frozen extremity appears white, yellow-white, or mottled blue-white, and is cold, hard, and insensitive to touch or pressure. Frostbite is classified as superficial or deep, depending on the extent of tissue involvement.

Superficial Frostbite

In superficial frostbite the surface of the skin will feel hard or rubbery, but the underlying tissue will be soft, allowing it to move over bony ridges. On the exposed skin on the neck and face it is common to first notice patches that are white or waxy in appearance. This is evidence that only the skin and the region just below it are involved. Very little information is available in wilderness first aid training on the appearance of mid and dark toned skin that has been exposed to mild or superficial frostbite. General treatment for superficial frostbite is as follows:

1. Take the victim indoors, or at a minimum, increase their shelter from the elements.
2. Superficial frostbite around the head can typically be reversed quickly by sheltering from the elements with a scarf, hat, or even a gloved hand.
3. Rewarm hands by placing them under the armpits, against the abdomen, or between the legs.
4. Rewarm feet by placing them in the armpit or against the abdomen of the buddy.
5. Gradually rewarm the affected area by warm water immersion, skin-to-skin contact, or hot water bottles.
6. Place hot water bottles into a dry sock/glove to avoid overheating skin.
7. Never rub a frostbite area.

Deep Frostbite

In deep frostbite, the freezing reaches into the deep tissue layers. There are ice crystals in the entire thickness of the extremity. The skin will not move over bony ridges and will feel hard and solid. The objectives of treatment are to protect the frozen areas from further injury, to rapidly thaw the affected area, and to be prepared to respond to circulatory or respiratory difficulties.

1. Carefully assess and treat any other injuries first. Constantly monitor the victim’s pulse and breathing since respiratory and heart problems can develop rapidly. Be prepared to administer CPR if necessary.
2. Do not attempt to thaw the frostbitten area if there is a possibility of refreezing. It is better to leave the part frozen until the victim arrives at a medical treatment facility equipped for long-term care. Refreezing of a thawed extremity causes severe and disabling damage.
3. Treat all victims with injuries to the feet or legs as litter patients. When this is not possible, the victim may walk on the frozen limb, since it has been proven that walking will not lessen the chances of successful treatment as long as the limb has not thawed out.
4. When adequate protection from further cold exposure is available, prepare the victim for rewarming by removing all constricting clothing such as gloves, boots, and socks. Boots and clothing frozen on the body should be thawed by warm-water immersion before removal.
5. Rapidly rewarm frozen areas by immersion in water at 100°F to 105°F (38°C to 41°C). Keep the water warm by adding fresh hot water, but do not pour the water directly on the injured area. Ensure that the frozen area is completely surrounded by water; do not let it rest on the side or bottom of the tub.
6. After rewarming has been completed, pat the area dry with a soft towel. Later it will swell, sting, and burn. Blisters may develop. These should be protected from breaking. Avoid pressure, rubbing, or constriction of the injured area. Keep the skin dry with sterile dressings and place cotton between the toes and fingers to prevent their sticking together.
7. Protect the tissue from additional injury and keep it as clean as possible (use sterile dressings and linen).
8. Try to improve the general morale and comfort of the victim by giving hot, stimulating fluids such as tea or coffee. Do not allow the victim to smoke or use alcoholic beverages while being treated.
9. Transfer to a medical treatment facility as soon as possible. During transportation, slightly elevate the frostbitten area and keep the victim and the injured area warm. Do not allow the injured area to be exposed to the cold.

4d

Hypothermia

Hypothermia is caused by continued exposure to low or rapidly falling temperatures, cold moisture, snow, or ice. Those exposed to low temperatures for extended periods may suffer ill effects, even if they are well protected by clothing, because cold affects the body systems slowly, almost without notice. As the body cools, there are several stages of progressive discomfort and disability. he first symptom is shivering, which is an attempt to generate heat by repeated contractions of surface muscles. This is followed by a feeling of listlessness, indifference, and drowsiness. Unconsciousness can follow quickly. Shock becomes evident as the victim’s eyes assume a glassy stare, respiration becomes slow and shallow, and the pulse is weak or absent. As the body temperature drops even lower, peripheral circulation decreases and the extremities become susceptible to freezing. Finally, death results as the core temperature of the body approaches 80°F (27°C). The steps for treatment of hypothermia are as follows:

1. Carefully observe respiratory effort and heart beat; CPR may be required while the warming process is underway.
2. Rewarm the victim as soon as possible. It may be necessary to treat other injuries before the victim can be moved to a warmer place. Severe bleeding must be controlled and fractures splinted over clothing before the victim is moved.
3. Replace wet or frozen clothing and remove anything that constricts the victim’s arms, legs, or fingers, interfering with circulation.
4. If the victim is inside a warm place and is conscious, the most effective method of warming is immersion in a tub of warm (100° to 105°F or 38° to 41°C) water. The water should be warm to the elbow - never hot. Observe closely for signs of respiratory failure and cardiac arrest (rewarming shock). Rewarming shock can be minimized by warming the body trunk before the limbs to prevent vasodilation in the extremities with subsequent shock due to blood volume shifts.
5. If a tub is not available, apply external heat to both sides of the victim. Natural body heat (skin to skin) from two rescuers is the best method. This is called “buddy warming.” If this is not practical, use hot water bottles or an electric rewarming blanket. Do not place the blanket or bottles next to bare skin, however, and be careful to monitor the temperature of the artificial heat source, since the victim is very susceptible to burn injury. Because the victim is unable to generate adequate body heat, placement under a blanket or in a sleeping bag is not sufficient treatment.
6. If the victim is conscious, give warm liquids to drink. Never give alcoholic beverages or allow the victim to smoke.
7. Dry the victim thoroughly if water is used for rewarming.
8. As soon as possible, transfer the victim to a definitive care facility. Be alert for the signs of respiratory and cardiac arrest during transfer, and keep the victim warm.

4e

Heat Stroke

Heat stroke is a less common but far more serious condition than heat exhaustion, since it carries a 20 percent fatality rate. The main feature of heatstroke is the extremely high body temperature, 105º F (41º C) or higher, that accompanies it. In heat stroke, the victim has a breakdown of the sweating mechanism and is unable to eliminate excessive body heat built up while exercising. If the body temperature rises too high, the brain, kidneys, and liver may be permanently damaged.

Sometimes the victim may have preliminary symptoms, such as headache, nausea, dizziness, or weakness. Breathing will be deep and rapid at first, later shallow and almost absent. Usually the victim will be flushed, very dry, and very hot. The pupils will be constricted (pinpoint) and the pulse fast and strong.

When you provide first aid for heat stroke, remember that this is a true life-and-death emergency. The longer the victim remains overheated, the higher the chances of irreversible body damage or even death occurring. First aid treatment for heat stroke is designed to reduce body heat. Reduce body heat immediately by dousing the body with cold water, or applying wet, cold towels to the whole body. Move the victim to the coolest possible place and remove as much clothing as possible. Maintain an open airway. Place the victim on his/her back, with the head and shoulders slightly raised. If cold packs are available, place them under the arms, around the neck, at the ankles, and in the groin. Expose the victim to a fan or air-conditioner since drafts will promote cooling. Immersing the victim in a cold water bath is also effective. Give the victim (if conscious) cool water to drink. Do not give any hot drinks or stimulants. Get the victim to a medical facility as soon as possible. Cooling measures must be continued while the victim is being transported.

4f

Heat Exhaustion

Heat exhaustion is the most common condition caused by working or exercising in hot spaces. Heat exhaustion produces a serious disruption of blood flow to the brain, heart, and lungs. This causes the victim to experience weakness, dizziness, headache, loss of appetite, and nausea.

Signs and symptoms of heat exhaustion are similar to those of shock: the victim will appear ashen gray; the skin will be cold, moist, and clammy; and the pupils of the eyes may be dilated (enlarged). The vital (blood pressure, temperature, pulse, and respiration) signs usually are normal; however, the victim may have a weak pulse together with rapid and shallow breathing.

Body temperature may be below normal. You should treat heat exhaustion victims as if they were in shock. Loosen the clothing, apply cool wet cloths, move the victim to either a cool or an air-conditioned area, and fan the victim. Do not allow the person to become chilled. If the victim is conscious, administer a solution of 1 teaspoon of salt dissolved in a quart of cool water. If the victim vomits, do not give any more fluids. Transport the victim to a medical facility as soon as possible.

4g

Snake bite

First aid

Snakebite first aid recommendations vary, in part because different snakes have different types of venom. Some have little local effect, but life-threatening systemic effects, in which case containing the venom in the region of the bite by pressure immobilization is highly desirable. Other venoms instigate localized tissue damage around the bitten area, and immobilization may increase the severity of the damage in this area, but also reduce the total area affected; whether this trade-off is desirable remains a point of controversy.

Because snakes vary from one country to another, first aid methods also vary. As always, this article is not a legitimate substitute for professional medical advice. Readers are strongly advised to obtain guidelines from a reputable first aid organization in their own region, and to be wary of homegrown or anecdotal remedies.

However, most first aid guidelines agree on the following:

1. Protect the patient (and others, including yourself) from further bites. While identifying the species is desirable in certain regions, do not risk further bites or delay proper medical treatment by attempting to capture or kill the snake. If the snake has not already fled, carefully remove the victim from the immediate area. If possible, take a photograph of the snake (many cell phones are equipped with cameras). If you do not know what type of snake it is, someone else might be able to identify it from the photo. A poor photo is better than no photo.
2. Keep the victim calm. Acute stress reaction increases blood flow and endangers the patient. Keep people near the patient calm. Panic is infectious and compromises judgment.
3. Call for help to arrange for transport to the nearest hospital emergency room, where antivenin for snakes common to the area will often be available.
4. Make sure to keep the bitten limb in a functional position and below the victim's heart level so as to minimize blood returning to the heart and other organs of the body.
5. Do not give the patient anything to eat or drink. This is especially important with consumable alcohol, a known vasodilator which will speed up the absorption of venom. Do not administer stimulants or pain medications to the victim, unless specifically directed to do so by a physician.
6. Remove any items or clothing which may constrict the bitten limb if it swells (rings, bracelets, watches, footwear, etc.)
7. Keep the victim as still as possible.
8. Do not incise the bitten site.

Many organizations, including the American Medical Association and American Red Cross, recommend washing the bite with soap and water. However, do not attempt to clean the area with any type of chemical. Australian recommendations for snake bite treatment strongly recommend against cleaning the wound. Traces of venom left on the skin/bandages from the strike can be used in combination with a snake bite identification kit to identify the species of snake. This speeds determination of which antivenin to administer in the emergency room.

4h

Cramps

Cramps

There are two basic causes of cramping. One is inadequate oxygenation of muscle, and the other is lack of water or salt. Cramps from poor oxygenation can be improved by rapid deep breathing, and stretching the muscle. Cramps from lack of salt and water can be treated by stretching the muscle, drinking water and eating salt. Pounding on the muscle can increase soreness.

What happens in a cramp is that lactic acid builds up because of normal anaerobic muscle metabolism. When the muscle burns sugar without enough oxygen, it makes lactic acid. The lactic acid finally becomes concentrated enough to trigger the contraction of the muscle. When the muscle lacks salt, the nerves firing the muscle are unable to recharge properly, causing a similar effect.

4i

Dehydration

Dehydration is the depletion of water from the body. It can be prevented by drinking plenty of water, especially during periods of physical exertion. One to five percent dehydration will make you lose your appetite, become sleepy and nauseated, and begin to vomit. As dehydration goes up to 10 percent, dizziness results. You will have headaches, difficulty in breathing, tingling of the legs and arms caused by poor circulation, indistinct speech, and, finally, an inability to walk. Still, 10 percent dehydration generally causes no permanent ill effects. When dehydration exceeds 10 percent, you will become delirious, spastic, almost deaf, and barely able to see. The skin shrivels and becomes numb. At temperatures above 90°F, dehydration over 15 percent is generally fatal. At 85° and less, the body can stand up to 25 percent dehydration. Dehydration is quickly cured by water—in fact, only water can cure it. When you are dehydrated, you don’t have to worry about how much water you drink or how quickly you drink it, or if the water is warm or cool. Cold water, though, will upset the stomach.

4j

Elevation sickness

Altitude sickness can begin in susceptible people at elevations as low as 2400 meters. The early symptoms are drowsiness, feeling unwell, and weakness, especially during exercise. More severe symptoms are headache, poor sleep, persistent rapid pulse, nausea and sometimes vomiting, especially in children. More severe symptoms include pulmonary edema (fluid in the lungs; persistent coughing), confusion, psychosis, hallucination and death.

Victims can sometimes control mild altitude sickness by consciously taking ten to twelve rapid large breaths every five minutes. If overdone, this can blow off too much carbon dioxide and cause tingling in the extremities of the body. The quickest cure is to reduce the victim's altitude if possible. Some mountain rescue groups carry acetazolamide (a prescription drug) to treat mountain sickness, injectable steroids to reduce pulmonary edema, and inflatable pressure vessels to relieve and evacuate severe mountain-sick persons.

Altitude acclimatization has two stages. Overnight, the body can adjust its carbonic acid balance, and substantially improve its performance. Over four to six weeks, the body can grow more blood cells, strengthen the heart and make other tissue changes. Above 5,500 meters, further altitude exposure weakens, rather than strengthening one's acclimation.

5

Learn & demonstrate proper and safe techniques for crossing streams while wearing a loaded backpack.

6

Practice the following safety procedures:

6a

Obtain proper hiking/camping permits for each backpacking adventure

6b

Record your backpacking plans and leave a copy with a responsible point person

7

Plan and take the following:

7a

Two backpacking trips of at least five miles camping out at least one night

7b

Two backpacking trips of at least ten miles camping out at least one night

7c

One backpacking trip, camping out at least two nights, of at least 25 miles

References