Water is our Wilderness

Walking the docks of our marina, we saw many jellyfish around the sailboats, all shape and sizes.  We saw one with a beautiful long tail called a War O'war.  Oh you do not want to get in these waters now.  With the water so warm and the temperature so high, this is when most people and dogs are jumping into the water to cool off.

The next day a friend had gotten stung by a jellyfish by Redfish Island, but they had no vinegar on board.   She was stung on her rib cage.  So she just drank lots of alcohol to numb the pain until they returned to shore.

Here are some Helpful facts from Judith Klein, MD that I had just watched after seeing all the jellyfish in the marina.  For an hour she talks about dealing with injuries in the wilderness called Into the Wild, Backcountry Medicine 101 found on ItunesU.

Jellyfish and Man O'war stings

    Local Symptoms

1. stinging/ pain
2. itching
3. raised tentacle marks

             System-wide symptoms (worst case, most venomous Box jellyfish)

1. vomiting
2. shock
3. paralysis

    Treatment

1. decontamination (with sea water not fresh)
2. remove tentacles (wear gloves, tweezers, use your Boatus card to brush it off)
3. douse with vinegar for 30 seconds (vinegar (4-6% acetic acid) inhibits nematocyst discharge, baking soda and seawater paste for man o'wars)
4. pain control, over the counter pills and soak for 20 minutes water between 104 and 113 F after vinegar
5. antivenin, on the beaches in Australia for Box jellyfish stings (can kill in 20-30 minutes)

All others sea creations stings

• Treatment

1. spine removal (in hospital if in torso or upper leg)
2. immerse in hot water (30-60 minutes)
3. wash with soap and water
4. observe for serious symptoms for 4 hours

KEEP IT SIMPLE (AAABBCCC)

• Assess the scene
• Airways
• Alert help
• Breathing
• Barriers
• Circulation
• Cervical Spine
• Cover up

   Heat Production created by

1. Basal metabolic rate (running the human machine)
2. shivering
3. physical activity

   Heat Loss caused by

1. radiation (60% of all heat loss)
2. evaporation (sweat/lungs)
3. conduction (5-25x greater when wet)
4. convection (wind)

Hypothermia is when heat loss is greater than heat production

• Predisposing factors

1. starvation
2. dehydration
3. low oxygen/ altitude
4. alcohol
5. fatigue

     Treatment

• stop heat loss

1. shelter against cold and wind
2. remove wet clothing

• increase heat production

1. blanket/ sleeping bag
2. warm water bottles at groin/neck/armpits or warm human
3. warm drinks if able
4. fuel/ food
5. oxygen if at altitude

      Evacuate gently

Heat Exhaustion/ Stroke (weak, cold, clammy, headache progress quickly to stroke)

  A. Contributing reasons why so hot

1. dehydration
2. elderly/children
3. humidity
4. exercise
5. medications
6. not acclimatized to heat

  B. Treatment

1. shade
2. ice bags (neck, armpits, groin /cool water immersion)
3. wipe sweat off to allow for more sweating
4. fan
5. cool oral liquids