Seniors Hiking In The Woods

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Volume 27 Number 5

By Paul MacMillan, AEMT

More and more seniors are hiking in the woods, which is simply a “walk in the woods.” You will find seniors walking along rugged trails, along riverbanks, through meadows, or on boardwalks over wetlands. You can find seniors recreating almost anywhere in the wilderness.

To look at the prevention side of things as a senior that plays out in the woods, there are a few things you should do before you go for your hike. I would like to review some of these simple steps to keep you safe and make your hike enjoyable.

If you are on medications, make sure you pack any medications that are needed for that day’ activity and extra medication in case something delays you from returning home at the appointed time. If you have special conditions that a first responder may need to know in order to provide you with the best possible care, wear a medical bracelet, necklace, or carry this vital information in your wallet. Program emergency contact information into your cell phone. Many first responders will check cell phones for the notation “ICE” (In Case of Emergency). Leave your family or friends an itinerary of when and where you are hiking, and when you plan to return.

When you head out, wear comfortable and appropriate footwear for your hike. Senior’s hiking shoes should have excellent ankle support, be lightweight, and, if possible, have non-skid soles. Have a well-supplied backpack to meet the needs of your hike. Make sure you pack it with the essentials: water, light snacks, a map and compass, a signaling device (whistle, or mirror), light source (headlamp, or flashlight), matches, cell phone, rain gear, extra pair of socks, a SOLO WFA map, and of course, your medications. If you have balance, knee, or back problems, I also recommended that you use a walking stick or trekking poles.

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MASS CASUALTY INCIDENT (MCI) and Triage

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ISSN-1059-6518

MASS CASUALTY INCIDENT – 2014

Aka Triage – Are you hurt?

By Paul MacMillan, AEMT

Cover photo courtesy Dundar Sahin and AKUT

I have been asked to write an article on triage and Mass Casualty Incidents (MCI). You might ask why are we writing an article on triage and MCI? Given the world we now live in, it is a good time to review these topics. With mass casualty incidents happening more frequently in schools, malls, political gatherings, and on mass transit systems it is important to know how to respond to save lives. Often when we teach these topics it is at the end of the course and we quickly cover them because of time constraints.

There is a wealth of data on these topics. You might recall one of the most famous studies. It focused on the Avianca, Flight 52, plane crash in Cove Neck, New York. It happened on a foggy and windy night on January 25, 1990. A number of volunteer fire and rescue units responded to this incident where 8 out of the 9 crew members of the aircraft were killed and 65 out of 149 passengers were killed. You may recall that during this event there was a huge problem with all the responders’ vehicles and equipment parked on either side of a narrow road which made it impossible for ambulances to get to the scene or turn around. This incident has changed how we now stage resources at MCIs.

Unfortunately, we have a wealth of data on triage and evacuation coming from the Iraqi and Afghanistan war. For example the battlefield injury survival rate for U.S. military personnel in Iraq reached 90%. This was 10 points higher than what was seen in the 1991 Persian Gulf War. Maj. Gen. George W. Weightman, commander of the Army Medical Department’s Center and School at Fort Sam Houston in San Antonio, Texas, cited a number of things that have changed in treating battlefield injuries which have improved survival. These include improved trauma care moments after the injury and a large number of soldiers trained as combat lifesavers.

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Update and Summary of Tickborne Diseases in North America

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Volume 27 Number 5

 

In previous editions of the WMNL, articles have been written on the various tickborne diseases. Over the past few years several important changes have occurred, and there have been several more illnesses added to the list.

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– Leading insect vectorborne diseases in USA.

– 95% of all insect vectorborne illnesses in USA.

– Second only to mosquitoes worldwide in causing and spreading disease.

– Ticks are little cesspools.

– Lyme Disease is the #1 tickborne illness.

– Anaplasmosis (HGA) is the #2 tickborne illness.

Here is the current list of tickborne diseases seen in North America:

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Viruses

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Volume 27 Number 4

What is a Virus?

What is a pandemic?

Why do we care?

By Frank Hubbell, DO

Illustrations by T.B.R. Walsh

There are currently a lot of concerns about infectious disease and the risk of another worldwide pandemic. This is being driven by the current Ebola scare. Over the course of human history, there have been many pandemics that did have a major impact on human populations and history itself.

In our most recent history, there was and still is, the Human Immunodeficiency Virus (HIV) pandemic. When HIV was first described in the mid 1980’s, there was a great outcry that it was the next great pandemic. Experts at the time estimated that it would kill upwards to 20% of the world population in 10 years and a much higher percentage in developing nations. HIV never became as serious as estimated because of dedication to good research, medical science, and excellent education. Today HIV remains a very serious illness, but it is very well understood, and excellent antiviral medications have been developed. As a result, it is under good control, at least in developed nations.

The last major, true worldwide pandemic was the Spanish Flu Pandemic in 1918.

From 1918-1919 the Spanish Flu raced around the globe, the worst influenza pandemic to date. Caused by an H1N1 flu virus, it was responsible for more than 500,000 U.S. deaths, as compared to 50,000 US servicemen who died in WWWI the previous two years. The worldwide death estimates range from 20 million to 100 million.

This Spanish Flu pandemic occurred before the invention of antibiotics. Antibiotics are essential in treating the secondary bacterial infections that often kill flu-weakened patients. So, that number would most likely be much lower today with the use of antibiotics to treat the potentially life-threatening secondary respiratory infections and pneumonias.

 

Major Worldwide Pandemics: (only the largest pandemics are noted.)

Date                        Number of Deaths and Location                                    Cause

165-180                  30% of Europe, Asia, and North Africa                               Smallpox

541-542                  40% of the European population                                          Bubonic plague

1346-1350              30%-70% of the European population                                Plague

1629-1631              280,000 deaths worldwide                                                    Plague

1665-1666              100,000 deaths in England,(Great Plague of London)    Plague

1816-1826              >100,000 deaths in Europe and Asia                                   Cholera #1 epidemic

1829-1851              >100,000 – Asia, Europe, and North America                   Cholera #2 epidemic

1852-1860              1,000,000 deaths in Russia                                                   Cholera #3 epidemic

1875                         40,000 deaths in Fiji                                                               measles

1889-1890             1,000,000 deaths world from influenza                              influenza

1899-1923              >800,000 Europe, Asia, Africa                                             Cholera #6 epidemic

1918-1920              75,000,000 deaths worldwide – the Spanish flu               influenza

1957-1958              2,000,000 deaths worldwide – the Asian flu                      influenza

1968-1969              1,000,000 deaths worldwide – the Hong Kong flu           influenza

1960 – now            >30,000,000 deaths from HIV/AIDS pandemic             HIV/AIDS

2009-2010             14,286 deaths from viral influenza                                      influenza

2013-2014            6,000+ deaths from Ebola virus                                    Ebola virus

 

In regard to pandemics, smallpox is no longer a threat, declared eliminated as of 1974 through the efforts of worldwide vaccination programs. A similar program is currently being undertaken by Rotary International in an attempt to eliminate the poliovirus as well.

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