First Aid & Survival

Tissue freezing in extremities exposed to severe cold, most often fingers, toes, and the face. Early frostnip is reversible with rewarming; deeper frostbite needs evacuation rather than field rewarming.

1. Prevent: Keep extremities insulated and dry, and protect exposed skin from wind chill. Loosen boots, gloves, and gaiters if they're constricting circulation -- tight footwear is one of the most common causes.
2. Recognize: Numbness and tingling that progresses to skin that's hard, waxy, and pale or white. Frostnip is superficial and still soft to the touch; true frostbite feels solid all the way through.
3. Treat: Get out of the wind and dry the area. Frostnip rewarms with body heat or skin contact. Leave deep frostbite alone in the field -- don't rub it, rewarm it near a fire, or walk on thawed feet -- and evacuate instead, since refreezing does more damage than the original freeze.

Overheating from exertion in hot conditions, ranging from heat exhaustion (heavy sweating, weakness, nausea) to heat stroke, where the body stops sweating and core temperature climbs to dangerous levels.

1. Prevent: Drink before you're thirsty, replace electrolytes on long, hot days, pace climbs to avoid overheating, and rest in shade when it's available.
2. Recognize: Heat exhaustion looks like heavy sweating, weakness, headache, and nausea. Heat stroke is the emergency version -- hot, flushed or dry skin, confusion, and sweating that stops even though the patient is still overheating.
3. Treat: Move the patient to shade, remove excess layers, and have them rest and rehydrate for heat exhaustion. Treat heat stroke as a medical emergency: cool the body aggressively with wet cloth and airflow, and evacuate immediately rather than waiting to see if it passes.

A drop in core body temperature from cold, wet, and wind exposure, starting with shivering and clumsiness and progressing to confusion and loss of coordination. Treated in the field with a hypothermia wrap and evacuation.

1. Prevent: Stay dry, layer before you're cold rather than after, and keep eating and drinking -- a body that's run out of fuel can't generate enough heat to stay warm.
2. Recognize stages: Mild hypothermia shivers and fumbles simple tasks. Moderate hypothermia stops shivering and starts slurring words or acting confused. Severe hypothermia is unresponsive, with a weak or absent pulse -- treat it as a life-threatening emergency.
3. Treat: Get the patient dry, out of the wind, and into a hypothermia wrap. Handle them gently and keep them horizontal -- in moderate to severe cases, rough movement can trigger cardiac arrest. Evacuate rather than waiting for them to warm up on their own.

A layered cocoon of insulation, a vapor barrier, and a windproof outer shell built around a chilled patient in the field, stopping further heat loss while the party arranges evacuation.

1. Build it: Insulate the patient from the ground first, then layer dry insulation, a vapor barrier (a bivy sack or even a garbage bag), and a windproof shell around their whole body, leaving the face clear.
2. Add heat: Warm water bottles wrapped in clothing at the armpits, neck, and groin help with mild to moderate cases. Sweet, warm drinks and food work too, but only if the patient is alert enough to swallow safely.
3. Handle gently: Move a cold patient as little and as gently as possible. Rough handling or rubbing cold limbs can trigger a dangerous heart rhythm as chilled blood from the extremities reaches the core all at once.

Cover built from whatever is on hand, a tarp, an emergency bivy, branches, or a dug-out snow shelter, to get a party through an unplanned night out or wait out a storm.

1. Prioritize: Block wind first, insulate from the ground second, and worry about overhead cover last -- a windbreak with dry ground insulation keeps a party warmer than an open shelter with nothing underneath them.
2. Look for options: Rock overhangs, tree wells, and root holes need the least building. Without natural cover, a tarp lean-to or a dug-in snow trench both go up fast with materials most parties already carry.
3. Insulate underneath: Pile branches, packs, rope, or anything dry between bodies and the ground -- the ground pulls heat away faster than the air does, regardless of what kind of shelter is overhead.

A makeshift brace built from whatever is on hand -- trekking poles, pack stays, clothing for padding -- to immobilize a suspected fracture until the patient can be carried or walked out.

1. Build it: Pad a rigid material against the limb and immobilize the joints above and below the injury, not just the injury itself, so the bone ends can't shift.
2. Secure it: Wrap snugly enough to hold the limb still without cutting off circulation. Straps or cordage work better than anything that can't be loosened quickly.
3. Check it: Confirm the patient can still feel and move fingers or toes past the splint, and recheck circulation periodically -- loosen and re-wrap if the limb goes numb, cold, or changes color.

Standard ways to attract attention when overdue or in trouble: three of anything (whistle blasts, flashes, shouts) repeated as the recognized distress signal, plus a mirror or bright fabric for ground-to-air visibility.

1. Use the pattern: Three of anything -- whistle blasts, flashes, shouts, fire flare-ups -- spaced evenly and repeated reads as distress, where random or single signals get written off as noise.
2. Stack your signals: Combine a whistle with a signal mirror, a headlamp, or bright clothing or a tarp laid out in the open. Searchers in the air rely on contrast and movement more than sound.
3. Conserve resources: Save battery, flares, and energy for when rescuers are actually close -- aircraft overhead, a search party in earshot -- rather than signaling continuously from the start.

Stop, Think, Observe, Plan: the standard first response to realizing you're lost, meant to interrupt the urge to keep moving and making the situation worse before working out an actual way back.

1. Stop: Resist the urge to keep walking in search of something familiar -- that's how a small navigation error turns into a long search.
2. Think: Work out how you got here: your last known position, how long it's been since you were sure of your route, and what's left in your pack for food, water, and daylight.
3. Observe: Take stock of terrain, weather, and remaining light. Look for landmarks, trail signs, or high ground that might confirm your position before committing to a direction.
4. Plan: Decide between retracing your route, staying put and signaling for help, or building an improvised shelter for the night -- then commit to it rather than second-guessing once you've started.