MODULE 8 SAFETY PRACTICES IN OUTDOOR RECREATION

Learning Objectives
At the end of the session the learners are expected to;
1. Identify common injuries and illness in the outdoors
2. be aware of how to treat common injuries and illness in the outdoors
3. Determine the safety practices in outdoor recreation.

FIRST AID OF COMMON EMERGENCIES IN OUTDOOR ACTIVITIES

What are the common medical injuries encountered in outdoor recreation and what first aid treatment should be
administered?

The term first aid refers to administration of care to prevent deterioration of the victim, to aid recovery, and
to preserve life. Generally, first aid entails some simple but often life-saving ways that most people can be trained to
perform with minimal equipment. On a technical level, it is not identified as medical treatment and should not be
compared to what a trained medical profession might do. First aid, as they say, is a combination of simple procedures
and an application of some common sense.

COMMON INJURIES AND ILLNESSES IN THE OUTDOORS

A. Cuts, scrapes, and punctures

Wounds, cuts, and lacerations can be caused anywhere from rock climbing, cutting self from a knife, and
stumbling.

To treat cuts, scrapes, and punctures:

 Clean cuts with soap and water then apply antibiotic cream then cover with sterile bandage and secure using
medical tape.
 If bleeding, apply direct pressure using clean cloth to injury.
 If wound is on the arm of leg, raise limb above the heart to help slow down bleeding.
 Do not apply tourniquet unless the bleeding is severe and does not stop even with direct pressure.

Emergency personnel must be called immediately if:

 Severe bleeding or bleeding does not stop despite pressure.
 You suspect there is internal bleeding (inflammation and severe pain the area).
 There is an abdominal or chest wound.
 Blood spurts out of wound.

B. Sprains, strains, and fractures

Many things can cause a sprain, strain, or fracture while doing an outdoor activity. One may fall or twist an
ankle while trekking or miscalculate a movement while rowing a canoe. Most often it is the ankle, wrist, or finger that
suffers from sprain and the hamstring for strains.

Sprains are injuries that involve the stretching or tearing of the ligament. This usually occurs when a joint is
overextended from its usual range of motion. Strain is the twisting or pulling of a muscle or tendon. This usually happens
when a muscle is stretched and suddenly contracts such as when one is running or jumping. Fracture involves the
breaking of a bone.
For Fracture, immediately call medical help if the following occurs:

 One suspects injury to the person’s head, neck, or back.

 Bone is sticking out of the skin.
 Bleeding does not stop after several minutes of firm pressure.
 Blood spurts from the wound.

While waiting for the medical help, do the following first aid:

 Immobilize the area of injury until help arrives or until the person is brought to the hospital.
 Make sure to clean and dress cuts before splinting.
 If bleeding, apply pressure to wound with clean cloth until bleeding stops. If bone is pushing through the skin, do
not touch.
 Gently tape the dislocated area or fracture to a rolled-up newspaper, ruler, or a rolled piece of clothing with first
aid tape. Avoid moving the injured limb and never force it or even try to twist it back into place.

C. Concussions

Concussion is a traumatic brain injury that is often caused by a blow or bump to the head or body. Cuts and
bruises may be seen on the head or face. Some consciousness or forget what happened before the injury; others do not.

 Treat cuts.
 Apply ice or compress if no ice is available.
 Rest until symptoms disappear.
 Watch out symptoms that need emergency action.

Call immediate medical help if the following occurs:

 One vomits repeatedly.

 The pupils become unequal.
 One looks is unconscious or passed out.
 One feels very drowsy.
 There is pain in the neck after the fall of knocked out.
 There is slurred speech.
 One experience seizure.

D. Blister

Blisters are a result of ill-fitting footwear. It is especially seen among hikers and trekkers. Blisters can be painful
and may cause discomfort. Treat blisters with the following;

 Place a piece of adhesive over affected area.

 Doughnut-shaped moleskin helps when blisters are at the bottom of foot.
 If blisters have popped, wash area with soap and water the put antibiotic cream
 If it is absolutely necessary drain a blister with a sterilized needle into the side of the blister. Apply with
antibacterial solution and cover with gauze dressing and tape.
E. Burns and Scalds

Burns or Scalds are injuries on the skin caused by hot liquid of heat.

 If still on fire, stop burning immediately through the “stop, drop, and roll” method. Then remove the flamed
material from the person. However, if the clothing sticks to the skin, do not pull it out but cut or tear around it.
 Take off constrictive clothing immediately (belts, jewelry, and tight clothing) as burns can swell quickly.
 If first degree burn (top layer skin affected)
 Put affected area under running water or immerse in cool (not ice) water until pain subsides. If no
running water is available then apply compress.
 Cover with sterile, non-adhesive bandage, or clean cloth.
 Do not apply buffer or ointments, which can cause infection.
 For second degree burn ( affecting top 2 layers of the skin )
 Immerse in cool water for 10-15 minutes, apply compress if running water is not available.
 Do not break blister or apply butter of ointment causing infection.
 Protect burn with sterile, nonstick bandage, and secure with gauze of tape.
 To prevent shock, let the person lie flat and elevate feet for about 12 inches high and elevate burn area
about heart level (if possible) and cover the person with coat or blanket.
 Wait for emergency personnel.

For burns, immediately call medical help if the following occurs:

 Burn penetrates all layers of the skin.

 Skin is charred looking, with white, brown, or black patches.
 Burn blister is larger than two inches or oozes.
 The person is an infant or a senior.

What are the common illnesses or sickness experienced in outdoor recreation and what first aid
treatment should be administered?

1. Fever

Check temperature first. If the temperature is 38 C or 100.4 F or below then is considered a low-grade or no
fever and does not require you to do anything much except to let the person drink a lot of fluids and rest. Unless the
person feels uncomfortable then an over-the-counter medicine may be given, such as paracetamol, ibuprofen, or
acetaminophen. However, always check if the patient has allergies to the medicines. Aspirin must not be administered
to anyone below 18.

If the fever is 102 F or 38.8 C or higher, have the patient take oral medicines. Give a sponge bath to lower the
temperature and increase fluid intake of the patient. Light clothes should be worn as overdressing will make
temperature go higher. In case the person chills cover the patient with blankets until chills go away.

Emergency should be sought when the person is:

 Unresponsive;
 Having difficulty breathing or is wheezing;
 Has lips turning bluish;
 Seems confused; and
 Observes sudden onset of rashes.
2. Headache

Headache are often experienced in trekking or hiking due to lack of eye protection from the sunrays, tension in
the neck, dehydration, swelling of brain tissue due to excessive sweating over a period of days, and consumption of large
amounts of water taking salt tablets.

Over-the-counter medicines may be taken such as paracetamol, ibuprofen, or aspirin to prevent further
discomfort. However, one should also observe the source of problem as it may just be a symptom of something else.

3. Altitude/Mountain sickness

Altitude sickness happens because the rate of the ascent altitudes outpaces the body’s ability to adjust to those
altitudes. In other words, the body was not able to acclimatize to high altitude and was not able to be increase
ventilation to compensate for the low level of oxygen in higher altitude. Triggering factors may be ascending too quickly,
overexertion in ascent, inadequate fluid intake, hypothermia, and alcohol consumption.

Altitude sickness may range from mild to life-threatening situations. High altitude pulmonary edema or HAPE
and the high altitude cerebral edema or HACE are life-threatening. In HAPE, fluids accumulated in the lungs and makes
breathing extremely difficult. These come quickly and if untreated, can lead to respiratory collapse and ultimately death.
HACE refers to the build up of fluid in the brain causing swelling and changes the person’s mental state. He or she loses
coordination, becomes comatose, and then dies.

Emergency treatment should be sought when the person has HAPE and exhibits the following progression of
symptoms:

 Shortness of breath at rest or experiences tightness of chest.

 Gurgling or rattling breaths.
 Cough with frothy or pink sputum.
 Lips of fingernails turn bluish or grayish.
 Respiratory failure.
 Drowsiness.

Onset of HAPE can be gradual or sudden. HAPE typically occurs after more than one day spent at high altitude.
High altitude cerebral edema (HACE) can begin up with the group.

 A person developing HACE begins having trouble keeping up with the group.
 Walking and coordination become impaired.
 As the brain continues to swell, lethargy and then comatose will develop.

First aid for this illness:

 If symptoms are severe, immediately descend 1,500 to 2,000 feet with minimal exertion as possible. Keep going
down until symptoms go away.
 If symptoms are mild, the person should not go any higher until symptoms are completely gone.
 Treat symptoms, give the person oxygen if available, keep him warm, have him rest, give him plenty of liquids,
and give him pain relievers.
4. Hyperthermia

Hyperthermia is a condition where the body produces or absorbs heat more than it can dissipate. This may be
caused by an increase in air temperature, solar or reflected radiation, poor ventilation in clothing, low fitness level, and
excess bulk or the reduced ratio skin area to body mass. People suffering from hyperthermia experiences heat cramps,
heat stroke, or heat exhaustion.

a. Heat Cramps

Heat cramps usually happen during heavy activity in hot environments. They are painful, involuntary muscle
spasms which are more intense than the typical nighttime leg cramp where the muscles affected includes the calves
arms, abdominal wall, and back. This happens when the muscles accumulate excessive lactic acid or a loss of fluid and
electrolyte through perspiration. What must be done?

 Cool down and replenish loss electrolyte through clear sports drink.
 Gently stretch and massage affected muscle group.
 Do not resume the strenuous activity and rest until cramps go away.
 Take salt pill with water at the start of specific muscle pain.

b. Heat Exhaustion

When the water is not sufficient for the body’s demand in a particular outdoor activity, the body becomes
dehydrated and salt-depleted. This results in nausea, faintness, a weak rapid pulse and/or cold and sweaty skin. This
case requires first aid similar to what is administered in case of heat cramps.

c. Heat Stroke

Heat stroke is the most serious degree of hyperthermia.

Emergency should be sought when the person:

 Losses consciousness;
 Becomes disoriented;
 Pulse rate suddenly becomes fast;
 Has warm. Red, dry skin, and body temperature above 103 F; and
 Reduced sweating.

Do the following first aid while help is on the way:

 Remove the person from the heat exposure and cool him/her by whatever means available, such as putting
damp sheets; spraying with cold water; and applying cold wet cloth or ice packs to the armpit, neck, and groin,
Fan air to increase cooling.
 Do not give the person anything to drink if the person is not alert or is vomiting.
 Treat the symptoms. If with seizures, keep the person safe from injury. If vomiting, turn the person on the side
to keep airway open.

5. Hypothermia

Hypothermia occurs when the body chills faster than body’s ability to produce heat due to exposure to cold,
wet, and /or windy weather. Not taking enough –production food and not having proper clothing speeds up
hypothermia. This generally occurs in temperatures or less than 35 C.
 Symptoms include numbness, uncontrollable shivering that muscles begins to stiffen and become
uncoordinated, skin turns bluish, pulse and respiration slow down, and victim does not respond or becomes
unconscious.

First aid must be administered quickly:

 Move the person to a sheltered area and restore warmth slowly.

 Remove wet clothes and replace with dry clothes.
 Wrap the blankets or sleeping bags.
 Exhale warm air near the vicinity of the patient’s mouth and nose.
 Note that rapid warming can cause heart arrhythmia so it is advised not to immerse the person in warm water.
Warm person’s trunk first-not the hands and feet- as warming extremities first can cause shock.
 Find ways for the victim to stay conscious.
 Begin CPR if necessary and continue until emergency personnel arrive.

Emergency should be sought when the person:

 Shows confusion, memory loss, or slurred speech;

 Body temperature drops below 35 C (95 F);
 Shallow breathing.

6. Diving-Related sicknesses

a. Barotrauma

Barotrauma is a serious injury that can occur because of pressure differences between the body’s air-filled
cavities and the water. If one is having trouble equalizing the ear and the air trapped in the middle ear cannot escape,
the resulting ruptured eardrum would be consider to be a form of barotrauma. Not only can the ears be affected, so can
the eyes, the lungs, the paranasal sinuses, the skin, the brain, the teeth, and other body parts.

Majority of cases of ear pain forces the diver to abort the dive. Symptoms are often resolved shortly after the
diver reaches the surface.

Emergency should be sought when the person shows disorientation, vomits, and hearing loss, which shows
ruptured eardrum. Rush to the nearest medical facility immediately.

b. Decompression sickness

Decompression sickness or DCS is a serious deep water diving related injury. It happens when divers fail to
follow prescribed dive profiles, and it can also happen after a rapid ascent. During a dive, nitrogen bubbles from inside
one’s body, including the bloodstream. If the bubbles remain, pain and tissue damage occur.

Emergency should be sought when the symptoms appear rapidly and the person exhibits the following:

 Unconscious
 Dizziness
 Trouble breathing
 Abnormal walk or weakness

AQUATIC HAZARDS
 The underwater is such a wonderful place to explore. However it can be home also to some aquatic creatures
that may pose some hazards to people. Some aquatic hazards are as follows:

1. Jellyfish/Portuguese Man-of-War/Fire Corals

People stung by jellyfish, Portuguese man-of-war, or fire corals will experience swelling, burning, and severe
pain. When stung, one must:

 Get the person first out of the water

 To stop the stinging:
a. Wash the area with seawater (not fresh water) to deactivate stinging cells.
b. Rinse the area with vinegar for at least 30 seconds. If vinegar is not available, a solution of baking soda can be
used. This will be deactivated the stinging cells.
c. Next, soak the area in hot water for at least 20 minutes if possible. Cold packs can be used instead if the area
cannot be soaked in hot water.
d. To relieve itching and swelling, use mild hydrocortisone cream or oral antihistamine.

Bring to the nearest medical facility if the person exhibits severe allergic reaction or if the stings covers more
than half an arm or leg. If the sting also come from a box jellyfish, then the person needs to be brought to the
hospital immediately. The victim may suffer from intense pain and experience swelling. Box jellyfish sting can be
fatal.

2. Sea Urchin/Weever Fish

 Sea urchin puncture and weever fish stings are treated in a similar way.
 Remove large spines carefully with tweezers.
 Scrub wound with soap and rinse with fresh water.
 Do not close the wound with tape.

Call for urgent medical attention if severe allergic reactions are observed.

3. Stingray

You should immediately call a lifeguard and seek speedy medical help as there is no antidote for stingray
venom. While waiting for ambulance, do the following first aid:

 To control pain, immerse the affected area in hot water (as hot as can be tolerated without burning skin) for 30-
90 minutes.
 Any large spines should be carefully removed from wound using tweezers (avoid touching the spine with bare
hands). Spines embedded in or near joints or tendons must be assessed and spines may need to be surgically
removed.
 Clean wound using soap and fresh water, do not cover wound.

ENVIRONMENTAL HAZARDS
 The mountains and the wilderness have so much to offer to people to enjoy and these include some animals
and plants which might impose some hazards to people. It is important to know how to deal with the injuries they cause
to people as this may save lives.

1. Poison Ivy/Poison Oak/Poison Sumac/Wood Nettle

Poison ivy, poison oak, and poison sumac are plants that can cause an itchy rash upon contact. These plants
have a substance called the urushiol which causes the rash. The rash usually disappears in one to three weeks. The
following are what should be done when one gets in contact with this rash-causing substance:

 If the plants left some stinging hairs, they have to be removed fast as this is how the poison enters the body.
Various methods are used in removing them such as duct tape (placing it on the area and logically the hairs will
stick to the tape) or tweezers. The important thing to remember is not to rub them, as this will further spread
the substance.
 Wash exposed area with soap and warm water. Washing it within 10 minutes upon contact can significantly
reduce chances of allergic reaction.
 Remove contaminated clothing, as the oil of the plant can continue to spread from clothing.
 Ease the itching discomfort by applying cool compress for 15-30 minutes.
 If itchiness makes it difficult to sleep, give oral antihistamine.

2. Leeches

Leeches or locally called “limatik” are common sights in the Philippine forest. Hikers usually come across a
leech already clinging and sucking blood on their skin. Pulling it out is not advisable as it regurgitates (or “vomit
back”) the blood it has ingested or may worsen the wound. It is important to note that leeches when full just
leave or fall-off on their own. Usually applying alcohol-based solution or flame (through lighter or match stick) is
a faster way for leech to fall off. Washing the wound it has left is the only thing to do.

However, when leech enters the mouth, throat, or nose it will difficult to just remove it. Local mountaineers
suggest gargling with alcohol-based drink and it will usually do the trick. The most difficult part is when the leech
enters the eyes. Some hikers say they were able to remove the leech by using tweezers. Others just leave it until
the leech leaves on its own. The safest way is to let medical personnel to remove it.

It can be an emergency case if there is a generalized itching in the whole body for a person bitten by leech.
If rashes, sweating, dizziness, fever, and difficulty of breathing happen, this means that the person has an
allergic reaction to the leech and medical attention must be sought immediately. Antihistamine may serve as
first aid.

3. Snake Bites

The mere sight of snake would likely scare people and make them panic. Snake are part of the natural
environment and we have to learn of respecting them. However, snakes, just like other animals, attack as part of
their defense instinct. Not all snake are venomous, in fact, according to World Health Organization (“Venomous
snakes” 2010) of the 3000 species of snake, only 600 are venomous. As a general rule, venomous snakes have a
triangular shaped heads and elliptical eyes (like the cat’s eye), instead of the rounded heads of most non-
venomous snakes and round eyes. Most venomous snakes also have a color pattern while non-venomous have
one solid color. Of course, there is always an exception to this general description. The first important thing to
notice when one is bitten by a snake is to remember how the snake looked like. This information will be helpful.
 ACTIVITY 1
Search the internet. Look for pictures/illustrations showing
injuries and illnesses related to mountaineering.
Write down the proper remedy for each chosen
injuries and illnesses.

ACTIVITY 2
Search an article on common injuries
and illnesses encountered during
outdoor activities.