Every party on the hills should carry a first aid pack. This should contain as a minimum: plasters (for blisters and cuts); lint or gauze (for dressings etc); Antiseptic cream for burns, cuts etc; aspirin for headaches and pain) and a selection of bandages.

Salt is a very useful commodity in mountains and may sometimes relieve cramps. A solution of salt makes a good dressing for cuts, burns and sprains.

Treatment

Medical treatment is obviously best left in the hands of a doctor or someone highly skilled in First Aid but, if an accident does occur, it may be necessary for an unskilled person to give immediate first aid before a rescue party can be summoned. Every mountaineer should therefore learn at least the rudiments of First Aid. The notes below are intended purely as a simple guide for the layman faced with a mountain accident.

General Principles

• Check the airway. Check it frequently and keep it clear.
• Stop any bleeding and apply dressing to open wounds.
• Do not move the patient unless you are quite sure that there is no injury to the spine.
• Treat for shock. Keep warm and relieve pain.
• Immobilize broken limbs to relieve pain and prevent further damage.
• Do not experiment. When in doubt, do as little Fist Aid as possible since an unskilled person can do considerable damage by applying the wrong treatment.

Shock

Shock is present in almost all cases of accident. The symptoms are pallor, weak and rapid pulse, cold, clammy skin, and a hunger for air. Make the patient comfortable and insulate him from the cold ground. Reassure him, allay anxiety and relieve pain. NEVER overheat a shocked patient.

Burns and Scalds

Use a dry sterile dressing on the wound and treat the patient for pain and shock. Leave any adhering clothing on a burn. Remove hot wet clothing from a scald.

Cuts and Wounds

Cut away clothing to make sure there is no dangerous bleeding if it is suspected. Stop any bleeding by applying direct pressure on the wound with a clean dressing or pad and then bandage.

Sprained, Twisted and Dislocated Ankles

In general, do not remove boot – it forms an excellent splint and sufficient relief from swelling can usually be obtained by loosening the laces. If boot is removed apply cold compress and bandage firmly to limit swelling.

Cramp

Massage the affected part and apply warmth. It may some-times be relieved by drinking a salt solution or eating a few grains.

Frostbite

Early or superficial frostbite is best treated by applying body warmth or breathing on the cold parts until sensation returns. The warm skin of the crutch or the armpit is good or if possible immersing the part in warm water. Once a frostbitten part has been re-warmed, keep it warm. DO NOT RUB. Treatment of deep or established frostbite should be delayed until hospital treatment can be given. Protect the parts from rubbing or banging for the tissue is devitalised and will readily tear.

Snakebite

There are few poisonous snake. The commonest symptoms are fright and fear of death. Reaaurance is vital. Death from Snake bite is rare. Keep the patient at rest. Immobilise the bitten part as for a fracture and apply a firm bandage on the heart side of the bite. Administer analgesia (e.g. aspirin).

Fractures

Fractures must be immobilized before the patient is carried down on a stretcher, but if you have no experience or training in First Aid, it is probably better not to try to immobilize a fracture before the Rescue Party arrives, unless it is causing the patient extreme pain. Do not try to straighten a broken limb.

Arm.    Bandage the upper arm to the chest (If splints are available, first bandage these to the arm), and either put the forearm in a sling or bandage it also to the chest, whichever is the more comfortable for the patient.

Leg.    Bandage the injured leg to the sound one at the ankles, knees and hips, padding well between the knees, or bandage the leg to a splint (or ice axe) if available. Avoid moving the injured leg and do not try to straighten.

Collar Bone.    Place the hand near the other collar bone and bandage the whole shoulder and arm to the chest.

Spine.    On no account move the patient. A spinal injury is often difficult to diagnose, but signs are pain in the back or numbness in the legs. If in the slightest doubt, treat as a spinal injury, and do not move until you have plenty of helpers and a proper stretcher.

Neck.    Carefully lay the patient flat on his back. Place a pair of boots, one on each side of the head, with the soles facing outwards and the uppers crossing under the nape of the neck. Narrow triangular bandages can then be tied firmly round the boots and head across the forehead and chin.

Jaw.    Support the jaw with the hand, then bandage. Don’t allow the patient to lie back or he will choke as he cannot swallow.

Head Injuries

Check the airway frequently and keep it clear. Stop any bleeding by applying a sterile pad and bandaging firmly, then place the patient in the recovery position.

Unconscious Patient

Do not administer drinks or morphia. Make sure breathing is not obstructed and remove any dentures. Turn the patient on his side in the coma position to prevent the tongue falling back and obstructing the airway and to help the drainage of secretions.

Heat Exhaustion

Reduce temperature by moving into cool shade, using cold water and/ or helping respiration by increasing air movement – fanning. Apply preventive action – i.e. the giving of salt in solution.

Exposure (Hypothermia)

Exposure is caused by exhaustion and a severe chilling of the body surface, usually in windy and wet conditions. This is one of the most common reasons for rescue calls in mountains and must be guarded against continually. It is defined as a lowering of the temperature of human body below the arbitrarily chosen level of 35 C(95 F) and the result of severe chilling of the body surface causing a progressive fall in body temperature and leading to various symptoms.

Signs and Symptoms:

• Complaints of cold, tiredness, cramp.
• Mental and physical lethargy. Lack of understanding of simple questions and directions.
• Slurring of speech.
• Irrational or violent behavior.
• Abnormality of vision.
• Collapse and coma.

These may not all be present nor in the order given.

All cases should be treated immediately, for mild cases can rapidly become very serious. Suspect others, and yourself, of being mild cases and protect the party from being reduced to the same condition.

Prevention:

• Wear good clothing including windproof and waterproof garments.
• Avoid getting overtired.
• Do not go too long without energy giving foods.
• If any member of a party is becoming tired, cold and wet, the group should go down into a more sheltered area.

Treatment:

STOP. Provide shelter from the elements causing exposure. having found a sheltered spot, put up a tent or use the emergency bivouac provided by rucksack and polythene bag. Give the patient prolonged rest.

• Immediately insulate the patient from further heat loss. Insulation from the cold ground is particularly important. Cover for head, face and neck is a great help.
• Place the patient in a horizontal position and if possible place a warm companion alongside him.
• Warm food and warm sugary drinks are valuable if the patient is conscious (e.g. sugar, glucose, condensed milk).
• Anxiety and mental stress is often an important contributory factor. Be cheerful and encouraging.
• If there is no breathing in severe cases, mouth to mouth resuscitation should be given until normal breathing is obtained.
• DO NOT rub the patient to restore circulation.
• DO NOT allow further exertion and thereby use up essential energy.
• DO NOT give alcohol.

If in any doubt send for help but prompt action, good equipment and good leadership will provide the important safeguards against exposure.