Wilderness Medicine Beyond First Aid 7th Edition
Visit the link below to download the full version of this book:
https://medipdf.com/product/wilderness-medicine-beyond-first-aid-7th-edition/
Click Download Now
Wilderness Medicine
BEYOND FIRST AID
Seventh Edition
WILLIAM W. FORGEY, MD
FALCON
®
GUILFORD, CONNECTICUT
FALCON®
An imprint of Globe Pequot
Falcon and FalconGuides are registered trademarks of Rowman & Littlefield.
Distributed by NATIONAL BOOK NETWORK
Copyright © 1979, 1985, 1989, 1994, 2000, 2012, 2017 by William W. Forgey, M.D.
Illustrations by Robert L. Prince
All rights reserved. No part of this book may be reproduced in any form or by any electronic
or mechanical means, including information storage and retrieval systems, without written
permission from the publisher, except by a reviewer who may quote passages in a review.
British Library Cataloguing-in-Publication Information available
Library of Congress Cataloging-in-Publication Data available
ISBN 978-1-4930-2718-7 (paperback)
ISBN 978-1-4930-2719-4 (e-book)
The author and Rowman & Littlefield assume no liability for accidents happening to, or
injuries sustained by, readers who engage in the activities described in this book.
This book is dedicated to my good friend and fellow wilderness
medicine colleague, Buck Tilton.
He always carries the banner high and leads the way.
This book would not have been possible without the participation of many adventurers on
numerous expeditions that I was part of organizing, especially the young men who lived for
months at a time in the small cabin we built in northern Manitoba, near Churchill, in 1974. I
especially thank Greg Filter and Jim Ross for their one-year stay in 1978, David R. Scott
and Scott E. Power for their 1991–92 expedition, and the many crews in between and
afterward, which provided many additions to this book. I did not realize how diverse the
problems were that could so easily befall the wilderness adventurer until I met these young
men. Their stories are being recorded at www.forgey-cabin.com, which is dedicated to their
participation in this experiential adventure.
CONTENTS
Preface
How to Use This Book
How to Prepare for Remote Wilderness Travel
Mental Preparation
Physical Preparation
The Wilderness Expedition Medical Kit
Improvisation
Chapter 1: Assessment and Stabilization
Assessment and Care
Initial Assessment
Survey the Scene • Check the Airway and Breathing Check
Circulation • Check for Severe Bleeding Check the Cervical Spine
Focused Assessment
The Physical Exam
Vital Signs
Level of Responsiveness • Pulse • Respirations • Skin Signs Blood
Pressure • Temperature
Medical History and Physical Examination
Head • Neck • Chest • Abdomen • Back • Pelvis/Hip • Legs Shoulders
and Arms
Shock
Difficult Respirations
Foreign Body Airway Obstruction
Adult One-Rescuer Cardiopulmonary Resuscitation (CPR)
Adult Two-Rescuer CPR
Rapid Breathing
Cardiac Evaluation and Care
Heart Attack—Myocardial Infarction
Rapid Heart Rate
Tachycardia
Slow Heart Rate
Bradycardia
Chapter 2: Body System Symptoms and Management
Symptom Management
Fever/Chills • Lethargy • Pain • Itch • Hiccups • Headache
Eye
Eye Patch and Bandaging Techniques • Foreign Body Eye Injury
Contact Lenses • Eye Abrasion • Snow Blindness or Ultraviolet Eye
Injury • Conjunctivitis • Iritis • Allergic Conjunctivitis Sties and
Chalazia • Spontaneous Subconjunctival Hemorrhage Blunt Trauma
to the Eye • Glaucoma
Nose
Nasal Congestion • Foreign Body Nose Injury • Nosebleed Nose
Fracture
Ear
Earache • Outer Ear Infection • Middle Ear Infection Foreign Body
Ear Injury • Ruptured Eardrum Temporomandibular Joint (TMJ)
Syndrome
Mouth and Throat
Sore Throat • Infectious Mononucleosis • Mouth Sores • Gum Pain or
Swelling • Mouth Lacerations • Dental Pain • Lost Filling Loose or
Dislodged Tooth • Pulling a Tooth
Chest
Bronchitis/Pneumonia • Pneumothorax • Pulmonary Embolus
Abdomen
Abdominal Pain • Gall Bladder Problems and Appendicitis Vomiting
• Motion Sickness • Diarrhea • Constipation Hemorrhoids • Hernia •
Bladder Infection
Reproductive Organs
Venereal Diseases • Vaginal Discharge and Itching Painful Testicle •
Menstrual Problems • Spontaneous Abortion Ectopic Pregnancy
Poisoning
Plant or Food Poisoning • Petroleum Products Poisoning Ciguatera
Poisoning • Scombroid Poisoning • Puffer Fish Poisoning • Paralytic
Shellfish Poisoning
Managing Diabetes
Water and Waste
Oral Fluid Replacement Therapy • Water Purification Human Waste
Disposal
Chapter 3: Soft Tissue Care and Trauma Management
The Bleeding Wound
Stop the Bleeding • Clean the Wound • Antibiotic Guidelines
Wound Closure Techniques
Tape Closure Techniques • Stapling • Suturing
Special Considerations
Shaving the Wound Area • Bleeding from Suture or Staple Use Scalp
Wounds • Eyebrow and Lip Closure • Mouth and Tongue Lacerations
• Control of Pain • Dressings
Other Types of Wounds
Abrasions • Puncture Wounds • Splinter Removal • Fishhook Removal
• Friction Blisters • Thermal Burns • Human Bites Animal Bites
Finger and Toe Problems
Ingrown Nail • Paronychia (Nail Base Infection) • Felon Blood under
the Nail
Wound Infection and Inflammation
Abscess • Cellulitis
Skin Rash
Fungal Infection • Allergic Dermatitis • Bacterial Skin Rash
Seabather’s Eruption
Chapter 4: Orthopedic Injuries
Concepts of Orthopedic Care
Muscle Pain—No Acute Injury • Muscle Pain—Acute Injury Joint
Pain—No Acute Injury • Joint Pain—Acute Injury Fractures
Diagnosis and Care Protocols
Head • Neck • Spine • Collarbone • Shoulder • Shoulder Blade Upper
Arm Fractures (near the Shoulder) • Upper Arm Fractures (below the
Shoulder) • Elbow Trauma • Forearm Fractures Wrist Fractures and
Dislocations • Thumb Sprains and Fractures Hand Fractures •
Finger Fractures and Sprains • Hip Dislocation and Fracture • Thigh
Fractures • Kneecap Dislocation • Knee Sprains, Dislocations, and
Fractures • Ankle Sprains, Dislocations, and Fractures • Foot
Injuries • Chest Injuries
Chapter 5: Bites and Stings
Bee Stings
Anaphylactic Shock
Snake Bites
Identifying Common North American Poisonous Snakes • Signs and
Symptoms of Pit Viper Bite • Treatment of Pit Viper Bite Neurotoxic
Snake Bites • Treatment of Coral Snake Bite
Insect Bites and Stings
Spider Bites • Ticks • Caterpillar Reactions • Millipede Reactions
Centipede Bites • Mosquitoes • Black Flies • No-See-Ums and Biting
Gnats • Scorpion Stings • Ants/Fire Ants
Aquatic Stings, Cuts, and Rash
Sea Urchin • Jellyfish • Coral Stings • Coral and Barnacle Cuts
Stingray • Catfish • Scorpion Fish • Sponge Rash
Chapter 6: Infectious Disease
Anaplasmosis • Babesiosis • Blastomycosis • Chikungunya Fever,
Cholera • Coccidioidomycosis • Colorado Tick Fever • Dengue
Echinococcus • Ehrlichiosis • Encephalitis • Giardiasis • Hantavirus
Hepatitis A • Hepatitis B • Hepatitis C • Hepatitis D Hepatitis E •
Hepatitis G • Leptospirosis • Lyme Disease Malaria • Meningococcal
Meningitis • Plague • Rabies Relapsing Fever • Rocky Mountain
Spotted Fever Schistosomiasis • STARI • Tapeworms • Tetanus • Tick
Paralysis Trichinosis • Trypanosomiasis, African (African Sleeping
Sickness) • Trypanosomiasis, American (Chagas Disease)
Tuberculosis • Tularemia • Typhoid Fever • Endemic Typhus, Flea-
Borne • Epidemic Typhus, Louse-Borne • West Nile Virus Yellow
Fever, Zika Virus
Chapter 7: Environmental Injuries
Hypothermia
Chronic Hypothermia • Acute Hypothermia Cold Water Submersion
Cold-Stress Injuries
Frostnip • Frostbite • Cold-Induced Bronchospasm Immersion Foot •
Chilblains
Heat-Stress Injuries
Dilutional Hyponatremia • Heat Cramps • Heat Exhaustion Heat
Stroke • Prickly Heat
Lightning
High Altitude Illnesses
Acute Mountain Sickness (AMS) • High Altitude Pulmonary Edema
(HAPE) • High Altitude Cerebral Edema (HACE) Other High
Altitude Conditions
Sawyer®Accident/Evacuation Record
Appendix A: The Wilderness Expedition Medical Kit
Topical Bandaging Module
Non-Rx Oral Medication Module
Rx Oral/Topical Medication Module
Rx Injectable Medication Module
Cardiac Medication Module
(contains Rx and non-Rx components)
Appendix B: International Immunizations and Travel Risk
Assessment
About the Author
PREFACE
This edition marks the thirty-eighth anniversary since the first publication
of Wilderness Medicine in 1979. Recommended therapy in the first edition
was based on a combination of field improvisation techniques and a
modular first aid kit. The kit included multifunctional components to tailor
it more readily to the nature of the trip being undertaken. Over the next
several editions, changes in medical theory and treatment were revised,
including the use of the initial, focused assessment as an entry to treatment
protocols; updates on infectious diseases; totally redesigned modular
medical kit systems; and the incorporation of those medical technological
advances in various disciplines that affected wilderness medicine.
Medicine and its components are hardly static. The effects of change
ripple rapidly into outdoor medicine. Consequently, one advantage this
book has over any other in this field is the use of my website,
www.adventure-media.com/wildernessmedicine7.html. At this site you can
easily access color photographs and updated information concerning many
subjects, such as poisonous reptiles or plants, infectious disease risk maps,
and further sources of information for cross-referencing. Information about
relevant training programs and sources for obtaining the medical supplies
discussed in the book are also included. The updates available on the
website will allow this edition of the book to be kept as current as possible.
Finally, direct e-mail links to me and the other authorities who have agreed
to be part of the site make us easy to reach.
Be sure to check out www.adventure-
media.com/wildernessmedicine7.html often. I’ll look forward to hearing
from you.
This edition of Wilderness Medicine is based on the latest technology that
applies to remote area medicine and delayed transport protocols. This
includes the Practice Guidelines of the Wilderness Medical Society,
published to date in the society journal Wilderness and Environmental
Medicine, the Boy Scouts of America Wilderness First Aid Curriculum,
2017 (for which I am the national task force chairman), and the latest
doctrine from Tactical Combat Casualty Care of the United States
Department of Defense (see
www.naemt.org/education/TCCC/guidelines_curriculum). My referencing
this material and other websites in this book should indicate to the reader
the importance of studying the subject of wilderness first aid and delayed
transport protocols prior to heading into the bush or landing in a self-care
situation.
This book has been written as a cookbook-type of guide on how to
personally manage many significant medical conditions when you must rely
on self-care. The hope of doing so adequately hinges on obtaining the best
foundation possible prior to the event. This requires study, taking
appropriate training courses relating to wilderness first aid, acquiring an
appropriate first aid kit, and having a generous blessing of common sense.
—William W. Forgey, MD, FAWM, CTH®, CCHP-P
Volunteer Clinical Professor of Family Medicine
Indiana University School of Medicine
Crown Point, Indiana
HOW TO USE THIS BOOK
There are four ways to rapidly identify where to find the information you
need.
FIRST
A quick glance through the contents can lead you to the proper chapter and
subject.
SECOND
The Initial Assessment (pages 3–5) and the Focused Assessment (pages 5–
6) not only describe how to perform a physical examination and what to
look for, but these sections also refer you to the page of the book that tells
you what to do if something is wrong.
THIRD
Throughout the book various sections have diagnostic tables with
references to further evaluate or explain treatment options. For problems
that fall into these categories, you can refer directly to the tables indicated
in the list below.
