Let’s Talk: First Aid

First aid is one of those things I always knew was important, but it took me a while to really learn just how useful it is. Being able to swim was something that was always really important to my Mom, so she put me in swimming lessons as a kid and later signed me up for lifeguarding courses when I turned 14. I did junior lifeguarding until I was 16, when I completed my National Lifeguard course and was certified for 4 years. First aid is a major component of this course and it is something that has served me well ever since. I’ve done several variations of first aid courses for work and guiding ever since and I think it is so worthwhile to invest time in learning basic first aid. Even if you don’t have a formal certification, being able to recognize symptoms and treat simple emergencies is a huge asset in the outdoors.

I was employed for 2 summers as a lifeguard at age 18, other than that I’ve never had any formal capacity as a first aider. Yet, since then I’ve treated a seizure, heat exhaustion, heat stroke, a broken arm, injured knees, and any number of cuts, scrapes, and blisters. I never leave my first aid kit at home, and I’ve been surprised by how often I’ve needed it. You can be resourceful in the wilderness, but I’ve never regretted carrying along a few extra first aid items (and you will definitely regret if you need them and don’t have it). I think the most important thing is knowing what to bring and how to recognize symptoms.

First Aid Training

Let’s start with training. The easiest way to learn is to do a formal course. There are 3 basic first aid courses: Emergency, Standard, and Wilderness First Aid. Having done them all at least once, I think Standard First Aid is the best bang for your buck. I don’t like Emergency First Aid, it’s only a 1 day course and it covers very little outside of CPR and AED. While these are good skills to have, I don’t think they are the most practical. I’m much less likely to need CPR and much more likely to need to bandage a broken wrist, so I find Standard First Aid more practical (plus you learn CPR/AED in all 3 courses).

Standard First Aid is generally a 2 day course and covers diagnosing and treating all different kinds of ailments, which is why I think it’s more useful. Treating heat stroke was the most life threatening thing I’ve ever done and I was able to diagnose it incredibly quickly, to the benefit of the individual (read about that experience here). Even for simple things, diagnosis can make a big difference. I was once 3 days into the wilderness and had a frightened hiker approach me with heartburn, I gave him pepto-bismal and it resolved in no time (somehow he’d never heard of heartburn – he described his symptoms and Emily immediately diagnosed it as heartburn since she gets it a lot, while I sang the pepto-bismal rhyme and he looked at us like we had 3 heads). So in my opinion, Standard First Aid is more practical than Emergency.

Wilderness First Aid sounds like it would be the most applicable for outdoor adventure (and it is), but it’s also the most expensive and has the biggest time commitment (2 long days or 3 shorter days). In my opinion, Wilderness First Aid is glorified Standard First Aid. It covers the same material, but from the perspective of someone in the wilderness with limited resources. So you practice splinting with sticks, homemade stretchers, and hypothermia wraps, but it’s not substantially different. Though once you have Wilderness First Aid, it’s half the work to re-certify it every 3 years (just a day), so I try and keep mine up to date. So if financial is a concern, I’d recommend Standard First Aid as the best course.

An idea of what “technical” means

Understanding Your Abilities

The second part of first aid is knowing what to bring with you and keeping a cool head in an emergency. If you panic, your patient will panic, so my approach has always been to be reassuring while asking lots of questions. Honestly, the presence of a first aid kit and care from someone who seems like they might be able to help is often reassurance enough for the patient. The other important thing is knowing when to call for help and doing so immediately. For example, you can probably handle small cuts and scrapes yourself, as well as mild dehydration. When my friend broke her wrist on a hike, I was able to wrap it for her to make her comfortable enough to walk back to the car on her own.

Dehydration is one of the more dangerous problems you can encounter, so being able to recognize it is important so that you can self treat. When I did the North Coast Trail, on the third day, me and Emily were both feeling really low and when Emily started to complain of an upset stomach, I immediately made the whole group stop hiking and we took a break while we both chugged a litre of electrolytes. While Emily’s energy remained low, our quick action prevented it from getting worse and we were able to finish the day in good spirits, with no injuries. In contrast, when my friend got heat stroke on the trail to Assiniboine, I didn’t know she was feeling bad until it was really too late. Her muscles started cramping, she couldn’t stand, and she even started losing feeling in her legs – all of these symptoms occurred within 15 minutes of her stopping to say she felt sick. In this case, I immediately made an SOS to emergency services on my inreach and spent 3 hours rehydrating her while waiting for help. Don’t try and be a hero; sometimes professionals and a quick extraction are needed and you are much wiser to make the call in those scenarios. Read my post on personal safety for more about communication devices and preparedness.

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What to Bring

And the last thing I want to highlight is the more practical side of what to bring with you. Lots of places sell small first aid kits and most people opt for a tiny one to throw in their backpack. I wouldn’t say my first aid kit is large, but it is more sizable than what most people bring. Sometimes I lament the extra weight, but I always bring it. REI has a pretty comprehensive list of what to bring, which you can view here. Personally, I like to bring band-aids in varying sizes, a blister kit, sutures, antibacterial wipes, dressings, compression gauze, a tensile bandage, surgical scissors, triangle bandage, tweezers, safety pins, medical tape, polysporin, and latex gloves. I also bring electrolytes, advil or tylenol, pepto-bismal, and an emergency blanket and bivvy sack. Depending where I’m going, sometimes I throw in a small bottle of aloe and in the winter I will add hand warmers. One thing I don’t have is a sam splint, which I’ve been considering adding because it’s on a lot of first aid kit lists, but I’m not convinced I couldn’t just use a stick or a hiking pole in an emergency.

Your first aid kit is only meant to complement your 10 essentials, so make sure you also have extra clothes, food and water, as these can also help in a first aid emergency. If someone in your party is injured and it takes you longer to hike back – you don’t want to further endanger yourselves by not having other essentials, like a headlamp. I always remind myself to pack for the hike that goes wrong rather than the hike that goes right. I bring my insulated seat cushion on most hikes as well, because it can make a big difference to your comfort if you’re stuck sitting on the cold ground for hours waiting for help.

To conclude, my biggest recommendation is to get a first aid kit and learn what to do with it. Learning how to diagnose symptoms and how to treat them can make someone feel a lot more comfortable in an emergency, and may even save your life or the life of a friend. Stay safe out there!

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Mount Assiniboine Backpacking Trip: Part II

We had a pretty solid start to our trip on Day 1 (Part I), but things went downhill really fast on Day 2. It’s hard to write about, but backcountry safety and emergency preparedness in the wilderness are so important to me, so I think it’s really important to share when things go wrong. More people than ever have been exploring the backcountry during the pandemic and search and rescue tasks have been way up. Social media has exposed a lot of very beautiful locations, but people don’t always share the challenges that often come along with those experiences. I don’t want to give a false idea of what multi-day thru-hikes are like, so I think it’s really important to share the good along with the bad. In general, my entire 6 day trip to Assiniboine was extremely challenging, but Day 2 was probably one of the worst days I’ve ever had in the backcountry.

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On Day 2 we had to go 14km to get to our campsite at Magog Lake. We departed shortly after 8am and it was about 1km to the lake. There’s a short uphill section that takes you partway up the mountainside and from there, it’s another 6km of relatively flat terrain that runs parallel to the lake. The trail traverses in and out of the trees, so we had a pretty good time because large parts of the trail were shaded, and the parts that weren’t shaded offered absolutely gorgeous views of Marvel Lake and the glacier covered mountains at the end of the lake. From the trail, we could just see the tip of Mount Assiniboine peaking out from behind the mountains.

Once the trail reaches the end of the lake, it starts to ascend up to Wonder Pass via a series of switchbacks. We knew the switchbacks would be challenging in the heat, so we planned a nice break before starting them. It was around 11am, so we decided to wait to have lunch and instead has some snacks. I was feeling a little tired, so I mixed myself some electrolytes to help prepare for the climb. We hit a river right before starting the ascent, so we all topped up our bladders and bottles.

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I was feeling good as we started the switchbacks, but I was also worried about the others, particularly Lien, who drinks a lot of water on a normal day, much less a really hot one. I told everyone to say if they felt the least bit dizzy or nauseous and that we would stop. But one mistake I think I made was that as we climbed up the switchbacks, I was at the head of the group. We probably should have put a slower hiker at the front, but the trail goes in and out of the trees, so we were stopping for short breaks at every single shady section of the trail, so I didn’t think much of it.

I was one shady section ahead of the group taking a break when the guys called up to me that our other companion, whose name I’ve left out for privacy reasons, was feeling tired and wanted a quick break. I walked back down the trail to see her sitting on the ground leaning against her pack with her eyes closed. This was a bad sign for me and indicated to me that she probably already had heat exhaustion. I quickly mixed her a half litre of electrolytes to try and perk up her energy. The guys seemed pretty sure she’d come around quickly, but honestly for me it was a really bad omen. I’ve had first aid training since I was 16 and have treated 2 other cases of heat exhaustion in the past (1 of which resulted in a seizure), so I just had a really bad feeling.

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What I wasn’t prepared for though was how quickly our companion’s health went downhill. Within minutes she was fully lying down on the trail while I continued to give her electrolytes and Brandon gave her energy chews. She kept saying she just needed a few minutes to rest up, but I was not reassured by the fact that she was lying down and knew she was likely already dehydrated and needed more than a few minutes of rest. I booted up my Inreach on the side as a precaution, but the guys wanted to give her more time. This is not unreasonable as you definitely don’t want to call for emergency assistance unless you’re sure you need it.

But shortly after that things really deteriorated and she started having severe muscle cramps in her arms and legs. At first I thought she was having a seizure, but then recognized it as heat cramps and immediately made the SOS call. This is something I hoped never to have to do when I purchased my Inreach, but of course, I also purchased it for this exact scenario. While I was making the call the guys removed her shoes and socks and anything that was creating tightness and started massaging her legs, feet, and arms. This definitely helped with the pain of the cramps, but I knew that in the long term she needed hydration. I poured water over her face and torso to try and cool her down and kept feeding her electrolytes, hoping she would not pass out because I needed to keep giving her water.

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As we gave first aid, I noticed the SOS had still not sent. It often takes my inreach about 20 minutes to send messages, especially in the trees like where we were, but I didn’t want to wait for it, so Brandon offered to run it up the trail to try and get the message through. It stressed me out for us to split up, but we needed help and I had wilderness first aid training and Brandon was fast, so it made the most sense. He took his water and left. It felt like he was gone forever, during which I mostly continued to feed her electrolytes until she complained it was too much and asked me to switch to water. At that point, I started drinking the electrolytes myself because I was starting to get tired too. Lien continued to massage her limbs. She had initially been frantic because she couldn’t feel her legs or arms, but overtime, she started to regain feeling and fortunately, still never passed out. Eventually she became cold from all the water I poured on her, so I changed her into dry clothes and we put an emergency blanket under her to insulate against the cold ground.

I don’t know what the official diagnosis was for her condition, but I believe it was heat stroke, which can only be treated with medical help. The fact that she had such severe cramping and lost feeling in her limbs likely suggests that her body was starting to shut down and was taking energy away from her limbs to preserve her body’s core functions. I’m not a professional, so perhaps it wasn’t as extreme as heat stroke, but I don’t doubt she needed more help than we were able to provide on that mountain.

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The sun was on the move and our shade was disappearing, so I put up my tarp to shield us all from it. Her pain had subsided so me and Lien quickly ate some food to keep up our own strength and then kept giving her water. There wasn’t much else I could do for her aside from try to replenish her fluids. Thankfully Brandon returned, having finally got the SOS to go through. He was immediately inundated with messages from Emergency Services looking for more details. Fortunately the Inreach had found the satellite and we were now able to message from our location. I’m sure the technicians were frustrated with us because it takes forever to type using the text pick on the Inreach and we gave them pretty limited info to try and get the messages out as fast as possible. They asked if we could move at all, to which I responded no, and I told them we’d wait at this location and to look for a yellow tarp. Lien tied his red ground sheet to the trees as well to make us more visible.

Once I finished the trip, I learned Inreach had called both Seth and my Mom, who were listed as my emergency contacts. They couldn’t originally get a hold of Seth, who had our entire trip plan, but the main thing they first asked my Mom was about my level of experience and whether she thought I had sent the SOS accidentally. The reason they wondered is because the GPS location showed we were directly on the trail. Mom told them she thought it was unlikely it was an accident and to please send help. By then we had got more messages through and Inreach reassured my Mom they were already on the way.

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They definitely were on the way. Shortly after Brandon returned and less than an hour after the message had gone through, a helicopter circled our location and sirened at us to let us know they’d seen us. They told us after it was really easy to find us having our exact GPS location and with the tarp. They flew off and returned some time later with a guy on longline. He landed about 15metres down the trail from us and Lien accompanied him to our location. He asked our companion some questions and we filled him in on what had occurred. During this, Brandon had departed again to go back to the water source to refill our bladders and Lien began packing up the backpacks for departure. A second S&R guy was flown in on longline and they assessed whether they could bring our companion out lying down or sitting up. They decided lying down would be best for the extraction and then to transfer her to the helicopter to sit on the way to the hospital. At this point she was looking better. She was actually keeping her eyes open and giving longer responses, plus she needed to go to the bathroom twice. S&R never actually gave her any first aid on the ground and instead transferred her to hospital to go on saline.

They told us we had taken the right actions in putting up the tarp, cooling her down, and giving her lots of water and electrolytes. They took her out via longline lying down and then took Lien out by longline sitting up. They waited for Brandon to return before taking Lien so we could plan what to do next. They did indicate they would take us all via longline if we needed it, but that it wasn’t preferred as the helicopter wasn’t big enough. They needed to take Lien so he could go to the hospital, but it made no sense for them to take me and Brandon too, so we had to decide whether to go back or continue on. I felt that we should go back. We had been through something traumatic and I wanted to know she was okay after having given her first aid for 3 hours. But Brandon pointed out there was really nothing more we could do for her and we were more than a day from either trailhead, so we should just go on.

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So we went on. I still feel a bit guilty about it, but I’m also glad that at least the trip wasn’t over for everyone. In the back of my mind though I was concerned about me and Brandon also getting heat exhaustion. Brandon had already climbed the pass once with the Inreach and I was tired from the stress of attending to the incident. One of the eeriest parts of the day was the fact that we hadn’t seen a single person besides S&R. It made us feel like we were the only people crazy enough to be out hiking, but we encountered lots of other people at Assiniboine who were day hiking up to the pass and thru-hiking in the opposite direction, so it was just a coincidence we were the only ones hiking through the pass that day.

Before moving anywhere we finally sat down and ate our lunch to get some energy back. After that we took it really slow. We crawled at a snail’s pace through the sunny sections and took a break every time we encountered shade. There was limited shade in Wonder Pass, but was it ever gorgeous! I felt like we weren’t able to properly enjoy it, but we still got some lovely photos. We debated camping in the pass since it was an extenuating circumstance, but there was so little shade to be found we ultimately decided to press on. Though we did find a single tree up there and took a break.

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It was approaching 6pm when we left the pass. The top of the pass marks both the Alberta-BC border and the transition between Banff National Park and Mount Assiniboine Provincial Park. It was a relief to finally start moving downhill and we walked through a beautiful larch forest that I’m sure is super scenic in the fall. We descended past a waterfall and down to some meadows where we re-filled our bottles from the stream. In total Brandon drank a whopping 7L of water on this day!

It was still late June, so I was surprised by the amount of wildflowers we saw on the trip! We saw lots of buttercups and Indian Paintbrush, as well as the Alberta Wild Rose, forget-me-nots, and lots of other white and purple flowers I can’t identify. Eventually we arrived at Gog Lake, which still had some small bergy bits floating in it. I wanted to go for a swim in it, but it’s surrounded by wetland, so I settled for a dunk in freezing Magog Creek instead. It was only knee deep and my feet immediately started to go numb, so I quickly washed myself down before crawling back out.

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We were pretty exhausted at this point, but we continued on through the meadows and couldn’t help exclaiming at the beauty of the park. We finally hit the Naiset Huts and were disappointed to learn it was still another 2km to the Magog Lake campsite. It was finally starting to cool off now though and the sun was lower in the sky, we continued along the edge of Magog Lake and were treated to the most gorgeous views of the lake. Every step hurt and when we finally rolled into the campsite it was 8pm – almost 12 hours after we had started! We were greeted by the Ranger who directed us to the shadiest campsite remaining (not very shady). But we didn’t care and trudged our way out to site number 40 at the back of a little meadow.

I have lots to write about the campsite, but this post is getting long, so I’ll save it for the next entry. We set up camp as quick as possible and I got dinner going while Brandon filtered water. We scarfed down our dinner and sent messages out to Lien and Seth to let them know we’d made it to the campsite and check on our companion. She was still in the hospital, but doing better. After that we pretty much hit the sack immediately. Unfortunately sleep was elusive. There was too much to process from the day, I just lay in bed for hours with my brain spinning. At one point I got up to pee and I could barely open my eyes or move my body I was so tired, but my mind just would not go to sleep. Eventually I drifted off late in the night with no alarms set for the next day. Click for Part III.

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