ISSN-1059-6518
The Backpack or Traveling Pharmacy
By Frank Hubbell, DO
A group of long time friends, three couples and various children, were always coming up with new adventures to share. One of the couples loves to sail and suggested that they should all get together and rent a sailboat for a couple of days and go for an ocean voyage. Over the next several months that idea for a great vacation grew, as did their enthusiasm. They eventually were able to rent a sailboat along with its captain in the US Virgin Islands for their Great Adventure. The ship could accommodate all ten of them for a grand week of cruising on the great blue Caribbean sea.
Off they went to the Caribbean and for the first three days all went well. In the evening of the forth day, several of the younger kids began to feel sick with scratchy, burning throats, itchy eyes, runny noses, and upset stomachs. Because they were all in such close quarters the adults decided that the kids were either coming down with colds or allergies. Over the next several hours their conditions worsened and two of the kids began to complain of a sensation of shortness of breath accompanied by wheezing. At the same time several of the adults confessed that they were also beginning to fell sick, with similar symptoms. One of the adults complained of a burning, peppery taste in her mouth. Obviously, they were all getting progressively alarmed.
After sailing all day, the group was now anchored in a nice little hurricane hole on a remote uninhabited island. They would have to wait until morning to head for the nearest port, about four hours away once under sail.
A call was placed to the US Coast Guard who after listening to all the symptoms, thought it might be scombroid poisoning from eating fish that was not properly stored and refrigerated. They explained that it was a form of histamine overdose from eating the fish, in this case mahi mahi, and they needed to treat everyone onboard with antihistamines plus anyone who was wheezing would also need use a rescue inhaler, a bronchodilator such as albuterol.
There were no pharmacists, nurses, EMTs, or docs on board. The group needed to figure this out themselves. They decided to gather all the medications that each of them had brought and see what they had that might be of help. What would have helped the most was good old fashioned KNOW HOW. By the way, no internet service was available, just advice from the Coast Guard via their marine radio that the Captain was required to have on board the boat. (And no, the boat was not the USS Minnow on a 3-hour tour.)
This article highlights standard information that is taught to EMTs. The medications mentioned are ones they can and will commonly use in providing emergency medical care. Some of these medications are over-the-counter meds while others are prescription meds. The following section covers the basic pharmacological aspects of EMT training.
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Whatever happened to Mercurochrome?
/in First Aid Kits, Infection, Medications/by WMN EditorsISSN-1059-6518
Volume 28 Number 1
By Paul MacMillan, AEMT
Those of you under the age of 30 will have no recollection of this tincture. From its discovery in the early part of the 20th century as a treatment for urinary tract infections, Mercurochrome soon found its way into operating rooms as an antiseptic. Ultimately, the compound was produced commercially and became available to the general public who embraced it enthusiastically. Few households did not have this antiseptic in their medicine chests. Shortly after, a cousin, Merthiolate was introduced as an alternative, and it followed the same path as Mercurochrome.
So, what was the issue with Mercurochrome and Merthiolate? Mercurochrome or merbromin is a compound containing mercury and bromine while Merthiolate, a trade name for thimerosal, is a mixture of mercury and sodium. The percentage of mercury was very small; however its presence did raise concerns. These compounds work by killing much of the disease-causing bacteria by denaturing enzymes and other proteins to block the metabolism of the microbes through breaking the chemical bonds of the proteins.
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Termites Can Hurt You (at least indirectly)
/in Bandaging, Head, Musculoskeletal, Scalp, Trauma/by WMN EditorsISSN-1059-6518
Volume 27 Number 6
By Paul MacMillan, AEMT
I had the great pleasure of traveling with Frank Hubbell to Zambia in July to teach a Wilderness First Responder class with him to a group of aspiring missionaries. For years we have been teaching this course at the Overland base overlooking the Zambezi River in Livingston. This summer we were very fortunate to be teaching this class during a special occasion. Halfway through teaching this program, Chief Makuni, who is the tribal chief of all the villages around Overland Missions, was hosting the Chiefs’ Council, a time when all sixty (60) chiefs from Zambia come to a series of four-day events which include eating and talking and also enjoying the different cultural dances and music from the many tribes.
You might be asking why this article is in the SOLO Wilderness Newsletter…. On the second day of the activities, Chief Makuni held a huge celebration of music, dancing, and singing. Dr. Frank, to his total surprise, was one of the honored guests at this celebration, and I was fortunate enough to be able to tag along. As an honored guest Frank was invited to have lunch with all the chiefs.
At the end of the cultural celebration, we all walked up to the area where people were going to be served lunch. It was a bright, beautiful day. Our WFR students, along with the Overland Missions’ staff, were the people who would be serving the chiefs and their delegations. Their delegations included their family members and their security people. There were a large number of police and military people carrying automatic weapons protecting the chiefs and their families.
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Medications That an EMT Can Administer or Help Administer
/in Antihistamines, Asprin, First Aid Kits, Medical Response, Medications, NSAIDs, OTC, Oxygen, Pain control, Travel Medicine/by WMN EditorsISSN-1059-6518
The Backpack or Traveling Pharmacy
By Frank Hubbell, DO
A group of long time friends, three couples and various children, were always coming up with new adventures to share. One of the couples loves to sail and suggested that they should all get together and rent a sailboat for a couple of days and go for an ocean voyage. Over the next several months that idea for a great vacation grew, as did their enthusiasm. They eventually were able to rent a sailboat along with its captain in the US Virgin Islands for their Great Adventure. The ship could accommodate all ten of them for a grand week of cruising on the great blue Caribbean sea.
Off they went to the Caribbean and for the first three days all went well. In the evening of the forth day, several of the younger kids began to feel sick with scratchy, burning throats, itchy eyes, runny noses, and upset stomachs. Because they were all in such close quarters the adults decided that the kids were either coming down with colds or allergies. Over the next several hours their conditions worsened and two of the kids began to complain of a sensation of shortness of breath accompanied by wheezing. At the same time several of the adults confessed that they were also beginning to fell sick, with similar symptoms. One of the adults complained of a burning, peppery taste in her mouth. Obviously, they were all getting progressively alarmed.
After sailing all day, the group was now anchored in a nice little hurricane hole on a remote uninhabited island. They would have to wait until morning to head for the nearest port, about four hours away once under sail.
A call was placed to the US Coast Guard who after listening to all the symptoms, thought it might be scombroid poisoning from eating fish that was not properly stored and refrigerated. They explained that it was a form of histamine overdose from eating the fish, in this case mahi mahi, and they needed to treat everyone onboard with antihistamines plus anyone who was wheezing would also need use a rescue inhaler, a bronchodilator such as albuterol.
There were no pharmacists, nurses, EMTs, or docs on board. The group needed to figure this out themselves. They decided to gather all the medications that each of them had brought and see what they had that might be of help. What would have helped the most was good old fashioned KNOW HOW. By the way, no internet service was available, just advice from the Coast Guard via their marine radio that the Captain was required to have on board the boat. (And no, the boat was not the USS Minnow on a 3-hour tour.)
This article highlights standard information that is taught to EMTs. The medications mentioned are ones they can and will commonly use in providing emergency medical care. Some of these medications are over-the-counter meds while others are prescription meds. The following section covers the basic pharmacological aspects of EMT training.
Read more
Scene Size-up
/in Heat related Injuries, Medical Response, Mountain rescue, Patient Assessment/by WMN EditorsISSN-1059-6518
Volume 27 Number 5
We have asked several members of the SOLO staff who also work in remote settings to write up occasional first-hand experiences where some point or principle of wilderness medicine was underscored, relearned, or re-enforced.
We are calling these new segments “Reports From the Field,” and you will see them periodically as a new addition to the newsletter.
Our first Report comes from SOLO instructor Lee Lang who is a Protection Ranger at Yosemite National Park.
Scene Size-up Starts Sooner than Later:
By Lee Lang
Scene size-up should start as soon as you begin responding, and those first decisions may be just as critical as your later ones.
The Grand Canyon of the Tuolomne for most people is generally a four-day hike. The typical hiker starts in Tuolomne Meadows, Yosemite National Park, and hikes down the canyon, exiting via the Pate Valley trail in White Wolf, a grueling 10-mile hike with more than 4000 feet of climbing. In mid-July the temperatures in Pate Valley can easily reach 104 F. The Pate Valley trail sees sun for most of the day, and the lower half to two-thirds of the trail is treeless and dark granite. The upper portion commonly meanders through high ground cover ensuring little air movement. Even though it is several thousand feet higher in elevation, on this July afternoon the temperature was in the mid-90s. I was several miles out from White Wolf on road patrol when I was dispatched:
Mike 52 – We have a report of 23-yr-old female near Hardin Lake. The RP reports that she is unresponsive, hot, dry, and pink. The RP states the hiker walked out of Pate Valley, and the patient drank very little fluid throughout the day.
A flurry of radio traffic ensues, and the decisions made are critical. I arrive at the trail head in several minutes and prepare for my 2.5 mile hasty approach. I know that a Park Medic is responding to the helitack base and is preparing to spool-up for a short-haul operation. A second ranger is en-route to the trail head but will be 20-30 minutes behind me. A ground SAR team, including a paramedic, is also being assembled but will be nearly an hour and a half behind.
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