Outdoor first aid

Backpackers who enjoy hiking in the wild should learn and master some basic rescue and distress-signalling knowledge.

Below are some of the most basic techniques for signalling for help, self-rescue and mutual rescue. (The hand-drawn illustrations and the accompanying first-aid tips were provided by the Health and Rescue Training Centre of the Beijing Red Cross.)

It's even better to attend a first-aid training course run by the local Red Cross or a similar organisation before you set off.

With advances in technology, modern distress equipment such as beacons, radios and satellite phones has become increasingly widespread. If you can, bring such equipment. If you don't have it, there's no need to panic. Remembering a few simple signalling methods can be a great help.

1. Fire signals: The most common way to signal for help outdoors. Light three fires in a row, spaced roughly equal distances apart. During the day, produce smoke by covering the fire with damp leaves or similar material. Take great care to prevent fires, especially in forests.

2. Light signals: During the day, a reflector can send a very effective signal. Any reflective object will do, such as metal, glass or spectacles. It is simple, easy and carries no risk. To use it, point one hand in the direction you want to signal, and with the other hand hold the reflector to catch the sunlight, gradually angling the reflected beam towards the target. At night, use a torch or other light source to send signals. The international mountain-rescue distress signal is to flash a light six times a minute, pause for one minute, then repeat.

3. Ground markers: On open ground such as grass, beaches or snowfields, you can create ground markers. Cut out a shape in a grassy meadow, tread a pattern into snow, or arrange branches, stones or seaweed into shapes to convey messages. Remember these three words: SOS (distress), HELP (assistance), LOST (lost).

We hope you will put safety first on your adventures and always act within your abilities. If you unfortunately get lost in the wilds and long attempts to signal for help fail, with no options left, look for a stream and follow it downstream, overcoming obstacles as you go. Keep going, and you will certainly reach people.

Prevention: Develop good hygiene habits. Avoid eating food that looks unhygienic or unclean. Do not eat wild vegetables or fruit casually in the wild, and never pick and eat wild mushrooms at random.

Symptoms: Diarrhoea, nausea, convulsions, and even unconsciousness.

First aid: First move the patient to fresh, well-ventilated air and keep them warm. If the food was eaten recently, try to bring up as much of it as possible (the simplest way is to press the back of the throat). Then wash the stomach with clean water or soapy water, and get the patient to hospital as quickly as possible.

For mild poisoning causing diarrhoea and vomiting, drinking salt-sugar water is enough to replace the fluids the body has lost.

Prevention: When walking or camping in the wild, it is best to wear long trousers and stay alert along the way.

Symptoms: Severe pain at the wound, redness and swelling, nausea, vomiting, blurred vision, drooling, sweating, and even difficulty breathing.

First aid: First, have the injured person lie flat and stay calm. Fear can speed up the heartbeat and spread the venom through the body faster. Immediately slow the blood flow to the injured area. Bites are usually on the legs, so tie a rope or piece of clothing tightly above the wound. Rinse the wound with clean water and draw out the poisoned blood, ideally with several people taking turns (anyone with mouth ulcers must not take part). Apply external snake antivenom and cover the wound with gauze, without raising the wound above heart level. Give internal snake antivenom and get the patient to hospital as soon as possible. (If the snake has been killed, be sure to bring its body, especially the head, to the hospital so doctors can treat the injury according to its toxicity.)

Symptoms: Usually only localised redness, swelling and pain, with few systemic symptoms. However, when stung by a swarm of bees, systemic symptoms such as dizziness, nausea and vomiting may occur. In severe cases, shock, coma or even death is possible.

First aid: For honeybee stings, apply a weakly alkaline solution (such as 3% ammonia water or soapy water) to the area. You can also dab the area with Hong Hua oil, Fengyoujing or Hua Lu Shui (floral water). For wasp stings, neutralise the venom with a weakly acidic solution such as vinegar, and immediately remove the stinger with a fine needle. If systemic symptoms are severe, go to hospital promptly.

First, loosen the drowning person's collar and quickly clear any foreign matter from the mouth and nose to keep the airway open. Then hold the person head-down and pat their back so that water in the airways and lungs drains out. Do not do this for too long. If the drowning person has stopped breathing, begin artificial respiration immediately.

Artificial respiration and chest compressions are also applicable to unconsciousness and shock caused by other reasons.

Backpackers sometimes get a few knocks and scrapes on hiking trips. Although serious accidents are unlikely, it is very important to know what to do if someone is hurt along the way.

Uncontrolled bleeding can be life-threatening, so stopping blood loss is the first step in trauma first aid.

For heavy bleeding, you must stop the flow by pressing the corresponding artery. First-aid training teaches you how to locate arteries precisely with your fingers, and first-aid guides published by local emergency centres cover this in more detail. Due to space constraints, only the following key points are listed here. Although simple, they are very effective.

For minor injuries, press gauze, a clean handkerchief or a piece of clothing over the wound to stop the bleeding.

The carotid artery is the body's main blood supply channel. It sits slightly above the collarbone and is easy to feel. For heavy bleeding in the head or upper limbs, pressing here is enough.

Located slightly inward from the midpoint of the inguinal ligament, where the pulse is very strong. For heavy bleeding in the lower limb, press outward and upward with both thumbs to stop the flow.

Used to stop bleeding in the wrist and hand.

For bleeding in the upper limb, turn the web of your other hand (between thumb and index finger) upward and pinch the artery two-thirds of the way up the upper arm.

Use your thumb and index finger to press the base of the bleeding finger on both sides.

This is also a very effective way to stop bleeding. If you don't have a proper tourniquet, you can use rope, rubber bands or clothing instead. Tie it tightly above the bleeding site (on the arm or thigh) to slow blood loss. Do not tie it too tightly, and be sure to loosen it for a few minutes every half hour to prevent muscle cell death.

Dressing protects the wound from infection and also helps stop bleeding. Do not wrap it too tightly or too loosely.

Use medical gauze and bandages for dressing if possible. If you use a handkerchief or clothing instead, make sure it is clean.

For a typical limb fracture, you can use tree branches or wooden boards to splint and dress the injury, depending on the situation. The aim is to keep the fracture stable and prevent further movement that could worsen the injury.

At altitudes above 3,000 metres, air pressure and oxygen levels are low. Most people will experience headache, dizziness, palpitations and shortness of breath. Severe cases may bring loss of appetite, nausea, vomiting, insomnia, fatigue, abdominal bloating and chest tightness, and there is a risk of complications that can be life-threatening.

Nosebleeds are common at high altitude. Sit down and lean your head forward so blood does not run down your throat. Pinch the lower part of the bridge of your nose (do not pinch the nostril wings). Release every 10 minutes and repeat several times until the bleeding stops.

Travellers who live at lower altitudes have poor tolerance to low oxygen. On reaching areas above 1,500 metres, such as Kunming (1,880 metres), mild altitude sickness is likely, so be mentally prepared.

In high temperatures, a headache, dizziness, hot and flushed skin, or a racing pulse are all signs of heatstroke, and you should rest in a cool, shaded place as soon as possible. For a heatstroke victim who has lost consciousness, rescuers can help cool them down: move them to a shaded area and lay them flat; remove their outer clothing; cover them with clothes soaked in cool water; once their body temperature returns to normal, remove the wet clothes, dry the skin, and keep fanning them. If they are dehydrated, give them plenty of lightly salted water, then lay them flat with their feet raised.

Sunburned skin becomes red, itchy and soft, and may even blister. Move to a shady place as soon as possible, gently wipe the sunburned skin with a soft cloth dipped in cool water, and drink water to replenish fluids.

Moving an injured person must be done with great care. Self-guided travellers do not have professional carrying equipment, but depending on the nature of the injury and the surroundings, they can use the following bare-handed carrying methods.

1. Supporting: Suitable for injured people with minor conditions who can stand and walk.

2. Piggyback: Suitable for conscious, lightweight injured people who can stand but cannot walk unaided. Do not use this method for people with breathing difficulties, such as asthma sufferers, or for people with chest injuries.

3. Cradling: Suitable for a single rescuer carrying the injured person.

4. Two-person chair carry: Suitable for conscious injured people who can cooperate with the rescuers. This method requires two rescuers working together.

A person with a spinal injury should not be moved lightly. If moving is unavoidable, several people must work together, lifting the casualty flat and keeping the body steady, especially the head and neck. For long-distance transport, always use a stretcher or a improvised substitute.