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Care
in remote regions, far from medical care,
identifying potential problems early on
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can help prenullent minor ailments from
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becoming serious emergencies.
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A
t home, coping with being sick is usually pretty straightforward: visit the pharmacy, take nullronullem: GENERAL AnullDOnullINAL nullAIN
the day off work and have a long nap until you feel better. If an illness persists, you might
Watch for:
make a trip to your doctor’s office or a walk-in medical clinic, and in dire situations, there
• An elevated pulse while at rest.
is always the local hospital with a 24-hour emergency department.
• Constant abdominal pain in anyone who is
Things get a lot more interesting when travelling in remote settings or in countries with a less-
pregnant.
developed medical infrastructure. In these situations, a hospital could be hours, days or even
• Constant, unrelieved pain aggravated by
weeks away. Your ability to recognize early signs and symptoms of potentially serious problems
movement and touch.
can enable you or your travel companions to leave the field and receive medical care before things
• Persistent fever.
become much worse. Being able to identify these red flags can also help you to determine when a
Urgency: Moderate to high. Anyone experi-
condition isn’t serious and doesn’t require evacuation.
encing significant abdominal pain with an
In the examples below, a situation that is low urgency means that once a warning sign has been
unknown cause that doesn’t go away within 24
observed, you should be fairly concerned and start a safe, controlled trip to reach medical help within
hours should visit a medical clinic. This becomes
a couple of days. In a moderately urgent situation, you’ll need to speed things up a little and try to
highly urgent if the person seems pale with cool,
obtain medical attention within 24 hours. If the situation is highly urgentt— he equivalent of a 911
clammy skin, if her heart and breathing rates
calla— ll options for evacuation, including by plane or helicopter, should be considered in order to get
are elevated while at rest or if she becomes con-
medical care as quickly as possible.
fused, disoriented or loses consciousness.
It’s important to remember that any time you see a change in a person’s consciousness—con-
fusion, disorientation or loss of consciousness—this is very serious and the situation should be nullronullem: EAR nullAIN
considered highly urgent. Even your friend who had too many margaritas should be considered an
Watch for:
emergency case if you can’t wake him up.
• Fever.
Similarly, a fever that persists is always a reason to get medical help within a day or two. If it’s
• Severe pain.
accompanied by an injury or pain, the situation is more urgent. As always, if there’s a change in
• Ongoing dizziness.
consciousness…you know the drill!
Urgency: Moderate, but highly urgent if there
Below are some common medical conditions you could encounter while travelling and import-
is a change in consciousness.
ant signs to watch for. They will alert you to the fact that things are taking a turn for the worse and
that you need to get proper medical care.
nullronullem: N OSEnullLEED
Watch for:
nullronullem: SUNnullURN • Elevated heart rate when at rest.
• Profuse bleeding.
Watch for:
Urgency: High. Evacuation should begin
Urgency: Low, but if the nosebleed is the
• A drop in body temperature (hypothermia)
immediately. If there is a change in conscious-
result of a head injury that causes a change in
identified by constant shivering, confusion
ness (she becomes confused, disoriented or
consciousness or uncharacteristic behaviour,
or disorientation.
loses consciousness), this is a major emergency.
or if the person develops a fever, or if there
• Fever: Elevated temperature indicating an All available resources (air evacuation, ground
are signs of shock (clammy, cool skin and ele-
infection. transport, etc.) must be considered to get the
vated heart and breathing rates), the level of
Urgency: Low to moderate. Consider a safe person help as quickly as possible.
urgency is high.
and controlled evacuation for medical care
within a couple of days, faster (within 24
nullronullem: nullOnullITING
nullronullem: COUGHnullCOnullnullON COLDnull
hours) if it’s not possible to keep the person
Watch for:
OR OTHER RESnullIRATORY INnullECTION
warm, or if he is running a fever.
• Vomiting that continues, leaving a person atch W for:
unable to keep food or fluids down. • Significant difficulty swallowing.
nullronullem: DIARRHEA
• Difficulty breathing because the airway is
• Persistent fever.
(def_i ned as a completely liquid bowel movement) partly blocked.
• Bloody sputum (coughed-up mucous).
Watch for: • Evidence of blood in the vomit (this may
• Persistent chest pain.
• Dehydration: If you’re losing fluid faster that look like coffee grounds).
• Difficulty breathing.
you can drink it, you’re losing the battle. Urgency: Moderate to high. If a person can-
Urgency: Moderate (high if there is difficulty
• Non-stop continuation of the condition for not retain food or fluids because of vomiting,
breathing).
more than 24 hours. he should get medical help within the next 24 MIKE WEBSTER is a paramedic and the Canadian
• The presence of blood (semi-digested blood hours. If breathing is affected, or if there is a
Executive Director of ilderness W Medical Associates, an
has a tar-like consistency).
international organization dedicated to the education
change in consciousness or signs of hypother-
and research of medicine and first aid in remote and
• A persistent fever. mia, this is a major emergency. unconventional settings.
48 : verge winter 2010
v.null i.2
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