BREAKING NEWS — The American Red Cross and American Heart Association today announced changes to guidelines for administering first aid. Among the most noteworthy revisions are new and updated recommendations for the treatment of bleeding; recognition of stroke; recovery position; anaphylaxis (severe allergic reaction); use of aspirin with heart attacks; and treatment of hypoglycemia (low blood sugar) in diabetics.  Read the rest of this entry »

Understanding how our bodies create, maintain and lose heat is key to preventing hypothermia. By taking a few proactive measures to make sure that the body is able to optimize heat generation and maintenance, outdoor ventures in cool and cold climates can be safer and more comfortable.

The body produces heat by metabolizing the energy in the food we eat, making it important to remain well fed and hydrated before, during and after participating in activities in cold environments. Ensuring regular consumption of calories throughout activity as well as eating meals with a balance of carbohydrates, fats and proteins will provide adequate energy to keep the internal furnace burning. Proper hydration supports consistent blood volume and regular circulation of blood throughout the body and ensures that this warmth travels to the extremities and skin.

In order to retain the heat generated by the body, it is important to wear proper clothing for the environment. Using a layering system that includes nonrestrictive, dry materials will allow for a clothing system that can be adjusted throughout the activity depending on the conditions and level of exertion. The goal is to stay warm without sweating in order to avoid the resulting chill of evaporative cooling. Individuals should add and remove layers consistently to achieve warmth without sweating.

Recognizing the symptoms

Mild hypothermia occurs when the core body temperature decreases. Individuals experiencing mild hypothermia can present with signs that include violent shivering, pale, cool skin and a series of changes often referred to as the “umbles”: stumbles, grumbles, mumbles, and fumbles. Early recognition of these symptoms in ourselves and our group members is key to treating hypothermia in its mild phase. 

A patient with mild hypothermia can be treated as follows:

  • Protect from the cold: Exchange wet or damp clothes for dry layers and provide additional protection to the patient by placing them in a warmer environment (car, tent, house, sleeping bag).
  • Refuel the furnace: Provide food with simple sugars and carbohydrates. Warm, sugary drinks are a good option for fast acting calories.
  • Gentle exercise: Once a patient is safely able to get up and move around, light exercise can help further enhance the body’s heat production.

Additional Information: All CWS wilderness medicine courses including Wilderness First Aid and Wilderness First Responder provide detailed information on the body’s response to cold and cold injuries.

Many years ago, I found myself on a camping trip hunkered down on a foam mat trying to find safety from the storm overhead. To this day, I still have memories of my hair standing up on end, the smell of ozone and the rattle of metal objects during that storm. Since that storm, I have found myself in far too many thunderstorms while traveling in remote environments. Some of the storms were closer than others, but each inspiring awe, fear and a good dose of respect.


The most challenging part about being in a lightning storm is the lack of predictability of the strikes. Lightning is random; it can strike in the same place twice, does not always hit the tallest object, and can travel horizontally from storms striking a location with blue skies overhead. This unpredictability combined with the violence of the lightning should produce respect and caution in even the most well traveled adventurer.

Lighting can strike people in two ways – direct strikes and through a ground current. Direct strikes occur when the lightning passes through the body of the person being hit, producing both entrance and exit wounds. Ground currents are strikes from an electrical charge caused by a near by strike that travels through the ground and are responsible for the majority of lightning produced injuries.

The best prevention is to not be outside when a lightning storm hits, however this is not practical for people the recreate outside. Knowing local weather patterns can provide some knowledge of when to travel and, more importantly, when not to travel in lightning prone areas. Learning to read weather to predict the arrival of the cumulonimbus clouds (tall clouds that produce lightning) provides the ability to move towards a safer location prior to the arrival of a storm. In settings where visibility is limited by a mountain or cliff, having and using a barometer to detect changes in the atmospheric pressure allows for warning that a storm is approaching.

You can track the progress of the storm toward or away from you by counting the time between the flash of lightning and the boom of thunder. The storm is one mile away for every five seconds between the light and the noise. If the count between the flash and the boom is getting smaller the storm is moving closer; if the count is getting longer the storm is moving farther away.

If you find yourself in a thunderstorm there are a few things you can do to reduce your risk exposure. If you are close enough to hear the thunder you are close enough to get struck. Start by getting to a “safer” location: summits, ridges, hilltops, and bodies of water are all less desirable than valleys and low-lying areas. Find a low-lying area ideally with a group of trees that are a similar height; avoid being under or near a lone tree. Next, reduce your exposure to ground currents by insulating yourself from the ground by crouching, kneeling or sitting (preference is in that order) on a sleeping pad or backpack in order to limit your contact with the ground.

Lightning injuries are caused by the heat, electrical charge and concussive force of the lightning. Injuries include cardiac or respiratory arrest, loss of hearing and/or vision, burns, and nervous system dysfunction. Many of the injuries can be stabilized with first aid and early high quality CPR for individuals who do not have a pulse and are not breathing or not breathing normally. Regardless of the severity of injury, anyone who is suspected of being struck by lighting should be evacuated to a hospital for further evaluation.

Even with wilderness medicine training and an appropriately stocked first aid kit, the best first aid is always prevention. When spending time outdoors this summer, be sure to keep an eye on the sky to watch for the build up of cumulonimbus clouds. Understand the local weather patterns and have a plan for how to get yourself to a less exposed place if the storm continues to build.

The only good snake is a dead snake. At least, that’s what my high school friend said the time we went backpacking and he chopped a garter snake in half with a machete. He wiped the blade in the grass while the tiny, non-venomous, non-constricting snake writhed—the last twitches of a non-threat neutralized.

Most snakes are harmless to humans, but developing a healthy fear of them kept our ancestors from getting squeezed to death or suffering a painful—and occasionally lethal—bite. But we may want to fight this ingrained phobia. (I mean, who needs it anyway since some of us spend the weekend tucked safely in our condos watching Snake Man of Appalachia?) And we should definitely rethink our urge to kill these reptiles—if only because they help keep us safe from another scary biter: the tick. That’s right, a recent study finds that snakes help halt the spread of Lyme disease.
The science is pretty simple. The three species of bacteria (genus Borrelia) that carry Lyme disease tend to live in small rodents. When a tick sucks an infected rodent’s blood, it too becomes infected. And if that itty-bitty tick should someday sink its mouth parts into, say … you or your beloved pet, there’s a chance it’ll slip its new host a shot of that same bacteria. The result? A health condition that causes fever, headaches, depression, joint pain, and heart and central nervous system damage.
But what could help stop this chain of infections? A healthy dose of rodent-loving rattlesnakes! A single timber rattler eats 2,500 to 4,500 ticks a year, according to a new study conducted by Edward Kabay, a recently graduated master’s student in conservation biology at the University of Maryland. (Kabay presented these findings last week at the 98th Annual Meeting of the Ecological Society of America.) When a snake catches a field mouse infected with Lyme, it gobbles up everything: the messenger (the tick), the message-sender (the mouse), and the message itself (the bacteria).
“Snakes have very strong digestive juices, capable of digesting bone, hair, and tissue,” Kabay tells me. “Anything with a soft exoskeleton is going to get dissolved with the rest of the meal.”
Since not every Lyme-carrying tick infects a person, Kabay says we can’t really say how many human cases of the disease rattlesnakes prevent each year. But removing these predators from the ecosystem could literally come back to bite us.
Unfortunately, when it comes to these reptiles, many humans still invoke the edict of kill-or-be-killed. Six states across the south and southwest still sanction snake roundups that encourage hunters to turn in snakes for cash. (To catch the reptiles, hunters sometimes spray gasoline into burrows made by tortoises. Such dens are a common hideout for snakes as well as more than 350 other species, ranging from insects to small mammals, that often die as a result.) Meanwhile in the east, timber rattlesnakes are endangered in six states and threatened in five others due to habitat loss, unregulated collection, and indiscriminate killing.
I get being afraid of venom, what with the nausea, diarrhea, drop in blood pressure, and sensation that Hades himself is trying to bust through your skin. But of the 7,000 to 8,000 people struck by venomous snakes each year in the United States, only about 6 actually die from bites. (Side note: Please don’t call snakes poisonous. They’re venomous, and yes, there is a difference.)
And some vipers, like rattlesnakes, try not to waste their weapon on the likes of us, a trait I can’t help but admire. In fact, I’ll go as far saying rattlesnakes are rather considerate creatures. What other animal sits there and shakes a maraca until you go away? So the next time you hear that ancient rhythm coming from beneath a brush pile or rock outcrop, do us all a favor and get out of its way. Because who knows, the next tick it eats might be destined for you!

GREAT FALLS, VA – Center for Wilderness Safety will be offering a Wilderness First Aid (WFA) course exclusively for women. WFA training is imperative for people who are looking to experience outdoor adventure, safely, giving you the knowledge and confidence to assess and manage medical emergencies when there is no help nearby. Wilderness First Aid will expand your awareness of potential hazards in the backcountry.

September 26 & 27, 2015
Great Falls, VA
Cost: $185 (includes textbook & all course materials)
Read the rest of this entry »

The Body’s Response to Stressful Situations

Imagine hiking along a trail, coming over a ridge, and coming face to face with a large bear. Uh oh! Your life is on the line and whatever happens in the next few moments will determine if you live or die. Fortunately, your body has a built in response to help ensure you have a chance. It is called the stress response, also known as fight or flight. This is a response that has been with us for thousands of years and is responsible for the fact that, as a species, we still exist. Let’s look at exactly what happens when you encounter a bear, or any kind of stressful event. Read the rest of this entry »

There is a great number of skills and training that can assist in trip safety. Everything from: Navigation Courses, Avalanche Safety, Belay Training, and Leave No Trace Trainer Courses. These skills can all help ensure maximum comfort and safety on your next adventure.

One essential course that is beneficial for all adventure goers is a Wilderness First Aid course. As with many types of training there are several levels including: Wilderness First Aid, Wilderness First Responder, and Wilderness EMT. The appropriate level needed depends on what you intend on doing.

Why is Wilderness First Aid important? It teaches you the same essential life saving skills a basic first aid course would with an emphasis on how to put those skills into practice in remote settings. In the backcountry we don’t always have the resources we would in the front country (i.e. supplies, cell service, etc.)

In the backcountry we also face weather, terrain, and time issues. If a person becomes injured or ill in the backcountry, it could take hours, if not days to get them the help they need. While inclement weather and/or treacherous terrain play a huge role in longer evacuations, having training in Wilderness First Aid can make the difference in the overall outcome of the patient. Wilderness First Aid training provides tools necessary for patient assessment, and keeping them comfortable until help arrives or you’re able to get them out.

Additionally, you’ll learn how to properly treat blisters and burns as well as some great first aid kit suggestions like the ones below!

  • Replace items that have been depleted from use. Also replace expired items like ointments and over the counter medications.
  • Include a writing utensil and paper for recording vitals, patient information, directions, and other important incident information.
  • Consider adding items that are hard to improvise. Such as a syringe for irrigating wounds or gloves, in which a pair is needed for each patient.
  • Try to include items that serve multiple purposes like cloth bandages, medical tape, and cord. Those items can all be used in a multitude of incidents.

By Michael Morse

People have different thresholds for coping with things that frighten, confuse, or worry them. Objectivity is imperative at an emotional scene; people need somebody to take charge and lead them out of the jungle that has invaded their space.

An emergency scene can be returned to order simply by not participating in the nuttiness. The trick is to calmly, and non-judgmentally try to make things better by finding out what is wrong, solving the problem and getting the right resources to the scene.

Here are five scenes that could easily get out of control, and how to handle them: Read the rest of this entry »

Sterling, VA – The Center for Wilderness Safety (CWS), a nationally recognized program offering wilderness and remote medical training as well as American Red Cross health and safety training, will be a contributing sponsor for the 2010 Mid-Atlantic Student Wilderness Medicine Conference in Philadelphia, PA. The Conference is an exciting opportunity for medical students and health care professionals to learn about and gain hands-on experience treating patients in extreme environments.

The two-day conference in April will consist of lectures and workshops lead by nationally recognized physicians and experts on a variety of topics. Demonstrations featuring some of the latest technology being used in the field will also be offered. Students are invited to submit abstracts from their own research in wilderness or disaster medicine for poster presentations. This is an excellent opportunity for both students and health professionals to expand their knowledge and network with other like-minded professionals in the field.

Four members of the CWS staff, including Sean Keener, the new program director of CWS, will be attending the 2010 Conference. Sean has attended many similar wilderness medicine and risk management conferences around the US and is looking forward to getting a different prospective on what students are interested in learning and what new programs CWS can develop to bridge the gap between medical students, health-care professionals, and the relatively new field of wilderness & remote medicine.

Stay tuned for updates from our staff as more information becomes available. You can follow CWS on Twitter at (@CWSonline) and the Wilderness Medicine Conference at (@phillywildmed).

More information is available at

Chewable aspirin is absorbed faster and is more effective than regular aspirin that is either swallowed whole or chewed and then swallowed, a new study shows. This “seemingly quite simple finding” could lead to improvements in the care of heart attack patients, researchers say.

Sean Nordt, MD, of the University of California, San Diego, and colleagues, gave three different types of aspirin to 14 people between ages of 20 and 61. One group was given regular solid aspirin tablets and told to swallow the pills whole. Another was given regular aspirin tablets and told to chew the pills before swallowing. A third group was given chewable aspirin tablets, and swallowing occurred during chewing.

The researchers then measured levels of aspirin in the blood; researchers say the chewable aspirin consistently showed the greatest and fastest absorption rates. The findings are being presented at the annual meeting of the Society for Academic Medicine in New Orleans. Researchers say the study was done because current guidelines recommend chewing to increase absorption, but evidence that that’s best is scant.

Thirteen of the 14 participants were men; the mean age was 31. Over the course of the study, each participant ingested each form of aspirin; 1,950 milligrams of aspirin (the equivalent of six regular aspirin tablets) was administered every time. Measurements of blood showed clearly that aspirin was absorbed fastest when administered in chewable form and swallowed. “This supports the recommendation to use chewable [aspirin] formulation in the treatment of ACS,” the researchers say. ACS refers to “acute coronary syndrome,” the general medical term meaning heart attack or sudden onset of angina.

Current guidelines call for giving heart attack patients one aspirin tablet and for them to chew it to speed up its anti-blood-clotting properties.

Aspirin works within 15 minutes to prevent the formation of blood clots in people with known coronary artery disease. One adult-strength aspirin contains 325 milligrams. The current study suggests that 325 milligrams of chewable aspirin would be preferred in the setting of a heart attack or sudden onset of angina ( chest pain). However, aspirin should still be taken under these circumstances if the chewable form is unavailable.

Aspirin use in patients with heart disease is common. People with known coronary disease often are told to take a “baby” aspirin (81 milligrams) daily to reduce their risk of heart attack of stroke.

Want to learn more? Take a Red Cross CPR class and learn to save a life!
Visit the Center for Wilderness Safety’s website at
and sign up for an American Red Cross course today!

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