Wearing a wide-brimmed hat, visor, or baseball cap will help keep the sun off your face. Although you may not have an obvious lobster-red sunburn, even a subtle burn will make sleeping difficult, keep you from hydrating (as the body is repairing the damage), and make you feel achy all over. Pain relievers will help you feel better and make sleep come a little easier when a sunburn is keeping you awake. Drink enough liquids to help your body heal. Lotions will help soothe burns and relieve the infernal itching that comes with peeling sunburn.
Note that hiking on snow doubles the amount of radiation being aimed at your body. It’s not unusual to get burns on your palms, the roof of your mouth, under your chin, or other less noticeable places from reflected light. Make sure to apply sunscreen everywhere vulnerable.
Snow blindness is a painful, often debilitating condition where the cornea of the eye becomes inflamed; put simply, it is sunburn of the eyes. Once afflicted, the condition takes several days to go away. The victim will experience severe headaches, sleeplessness, and general fatigue. There’s not much one can do to expedite healing, other than staying in a dark room and keeping up a steady dose of ibuprofen. I will say this several times in this book: do not skimp on good eye protection. Make sure your glasses are large enough to cover the entire area around your eyes, including the sides and bottom. Lenses must block out 95%–100% of all UVA and UVB radiation. Prevention of snow blindness is easy; recovery is not.
Heat Exhaustion
Heat exhaustion occurs when the body works up excessive heat that it cannot effectively dissipate. Dehydration is the first symptom of heat exhaustion; most cases are triggered by exertion in hot, dry environments. A victim will have cool and clammy skin, weakness, nausea, and may even faint. In extreme cases (known as heat stroke), the pulse will be rapid and the victim may become seriously disoriented.
Cooling the victim down and providing fluids are important steps in reversing this condition. Cease any strenuous activity, and rest, preferably with the feet elevated. Work on cooling the face, head, and body. Find shelter in the shade, or set up a tent (with the doors open) to provide shade if you are above tree line. Many cases of heat exhaustion occur when there is snow on the ground; use it to your advantage to help cool the victim. Once the person feels better and can hold down liquids, assess the situation. Unless the person is feeling 100%, descend and try for your summit another day.
Frostbite
Frostbite is a painful and serious condition in which the blood vessels in the body freeze and crystallize, causing damage to body tissue and circulation. Injury from frostbite can cause permanent impairments and, in severe cases, loss of appendages. Most frostbite will occur on the nose, ears, fingers, and toes. When the body gets cold, it prioritizes the areas close to the heart, leaving body regions distant from the core vulnerable to the cold. Initial symptoms include a bluish discoloration of the skin, sharp pain, numbness, and a burning sensation. If caught in the early stages (considered frostnip), warming the injured body part will prevent further damage. Note that frostbite rarely appears without hypothermia, so make sure to treat your victim for all conditions.
Conditions change drastically once above tree line.
In severe cases, the skin will become blue or black, and hideous blisters may swell up. Never rub or try to massage frostbitten skin; this will only further damage tissue. Only a slow and painful thawing of the injury in lukewarm water will regain sensation. In these cases, evacuate the victim and seek medical attention. If the foot is severely frostbitten, do not attempt to thaw it in the field; once rewarmed, it will be too painful to walk on.
Note that women are more prone to frostbite than men. Poor circulation, diabetes, or overly tight clothing and footwear can also promote frostbite. Alcohol should also be avoided in cold conditions, as it can dehydrate a body and make the limbs less sensitive to the warning signs of frostbite as it develops.
Fractures, Sprains, and Broken Bones
Twisted ankles and sprained wrists are among the most common injuries in the mountains. Any swollen or bruised limb should be tended to immediately. SAM splints (soft aluminum splints lined with foam) or inflatable splints are lightweight and can be used to set and immobilize injuries. In a pinch, you can use hiking poles, sleeping pads, or an ice ax to set an injured limb. Anti-inflammatory medicines should be taken by the injured hiker, and evacuation should begin as soon as possible.
Shock
Shock occurs whenever the body experiences a sudden loss of blood pressure. Normally, blood loss from an injury causes this sensation, but people can incur shock (in the medical term) from witnessing a disturbing event or from sheer panic. Loss of blood pressure can disrupt the circulatory system and, if prolonged, can cause permanent damage to vital organs or death. A victim of shock may display any of the following symptoms: confusion, rapid pulse, clammy skin, dull or distant eyes, and rapid breathing. Additionally, the victim may feel nauseous, weak, and frightened. If shock occurs, do everything you can to keep the person warm. If they are conscious, provide liquids. Talk to the victims and reassure them that they are not alone. Be calm and help ease them by tactfully apprising them of the situation. Seek medical attention if victims experience shock—and always in the case of blood loss.
Panic
Mountains can be intimidating places, and for good reasons. No matter how experienced the hiker, the bottom line is that Mother Nature holds the trump card when it comes to control. Storms, stress, exposure to heights, witnessing an accident, or unexpected illnesses can induce panic. A panicked individual can “lock up,” both physically and mentally. Fear can literally make one weak in the knees and impair balance and judgment, often in the places where concentration and focus are imperative. If you begin to panic, focus on taking at least five deep breaths. Remember, your body is reacting to a perceived risk—one that must be dealt with using logical thought. If you are on tricky terrain, breathe deeply and flex your fingers slowly a few times—assure your body that your mind still has control. Figure out your safest option and follow through with confidence. This advice is easy to dispense from the comfort of my warm office, but it’s a bit more difficult to execute in the heat of the moment. My own experience has been that when you control your breathing, you control your mind, and thus control your body.
If you are with companions who begin to panic, talk to them calmly and reassure them of their options in simple, supportive language. Offer suggestions in a positive tone. Once the moment of panic is over (for example, a tricky move has been accomplished), continue to be reassuring and positive. Panic is one of those ailments that is really all in the head—which proves that mountain climbing is just as much about mental strength as it is powerful legs and lungs.
Suggested First-Aid Kit
Every hiker should carry an individual first-aid kit. In addition, groups heading into the backcountry should also carry a group kit with extra supplies or individual-specific drugs. Keep in mind that preexisting conditions should be known before heading into the backcountry and appropriate medical treatments should be included in your kit. Here is sample list of what every basic first-aid kit should have:
Adhesive bandages (Band-Aids or similar brand): Minimum of 10 standard 1-inch bandages
Butterfly bandages: to serve as temporary stitches for minor wounds
Sterile pads: at least two medium and two large pads for larger wounds
Antibiotic ointment packets or tubes (Neosporin or similar brand): to help wounds heal
Roller bandages: to wrap around wounds and hold dressings in place
Medical tape: to secure dressings or to tape up fingers and hands when climbing
Moleskin: used to pad blisters or as a blister preventative
Alcohol pads: used to clean small wounds. For large wounds, use soap and water with a syringe (alcohol will damage exposed tissues). Make sure to replace these pads in your kit every six months, as they can dry out even when left in