When I was a boy, I watched Mount St. Helens explode from the front yard of the family home. It was both thrilling and terrifying. The Toutle River overflowed Interstate 5, and school was canceled due to ash fallout. Hurricane Katrina, the Spring floods that devastated Northeastern states, and now Hurricane Earl — which at the time of this post was threatening to hammer much of the Eastern Seaboard — prove that natural disasters can hit close to home. So, everyone should prepare a 72-hour emergency kit for Mother Nature’s worst.
ESSENTIALS
Ideally you need two kits: a large plastic bin for home and a small portable kit for your car. A good disaster kit has 5 components: water, food, first aid kit, extra clothing and bedding, and survival gear.
WATER, HYDRATION & FOOD
You’ll need a gallon of water per person per day, and a method of purification, in case you refill from a tainted municipal source. The simplest, easiest water storage is gallon jugs of commercially bottled water. I keep a supply of chlorine dioxide purification tablets, which I find lighter and more compact than a filter or ultraviolet light pen. Non-perishable food should be no-cook, ready-to-eat canned or dry goods with a good source of protein and carbohydrates. Simple, heat-and-eat meals are great, but you’ll need to add a small camp stove and fuel to your kit.
FIRST AID
For first aid supplies, I like the Fundamentals for home because it has enough components for multiple people for many days, with room for extra medications and tools. A combo kit, like the S.O.L. 3, which comes with essential first aid, survival and repair tools, is ideal for the car, when time and space are in short supply.
Select a kit with enough supplies to cover all the members in your household for a minimum of three days
CLOTHING, BEDDING & SHELTER
Have a spare sleeping bag, or a lightweight bivvy, which is always a mainstay in my SAR pack, car kit, and household bin. Toss in an old raincoat, fleece sweater, a hat, and gloves for everyone in your household.
SURVIVAL
Survival supplies are of paramount importance. Start with a personal survival kit that includes a whistle, fire starter, signal mirror, cord, wire, compass and other essentials. Include a headlamp with extra batteries, a pocket tool like a Leatherman Juice, hand sanitizer and body wipes for personal hygiene, insect repellent, sunscreen of SPF 25, and a battery operated AM/FM radio.
OTHER CONSIDERATIONS — PERSONAL NECESSITIES
Don’t forget personal items like spare prescription glasses; extra prescription medicine; baby formula and diapers, if required; hygiene sundries; family documents, like photo ID and passports stowed in a waterproof travel case; and access to cash and credit cards. Make a list of emergency contacts and emergency utility shutoff valves in your house.
LAST BUT NOT LEAST…
Toss in instructions! Even the most skilled benefit from reminders, such as Dr. Weiss’ excellent Comprehensive Guide to Wilderness & Travel Medicine 3rd Edition, which includes life-saving tips on how to improvise treatments when you don’t have ready access to professional medical care — a common occurrence following a major disaster.
Storing the whole shebang is pretty simple. For your home kit, get a large waterproof plastic bin like a Rubbermaid Action Packer. Make sure everyone in your household knows the location. Rotate the food and water out every 6 to 12 months as expiration dates recommend. Add an empty backpack to the bin so you can grab gear in a jiffy. For your car, stash the gear in a soft kit in the trunk or under a seat. In your car, you should always carry repair tools too, including: a jack, spare tire, jumper cables, extra oil, a flat repair kit, basic tools, a tow strap, duct tape, and a small folding saw.
Check expiration dates on your kit's food and water supplies every six to 12 months
Let’s hope the natural world will calm down for a while. But when the seas heave, the winds blow, and the earth rattles, access to a complete disaster kit will make life easier and safer.
Chris Van Tilburg, M.D., is the editor of WMS’s Wilderness Medicine and the author of eight books on the outdoors. His most recent book is Mountain Rescue Doctor. Van Tilburg is also a member of Hood River Crag Rats Search & Rescue Team. He lives in Bend, Oregon.
I’ve been chomped by a tick multiple times, as have most people who regularly tramp in the outdoors. It’s creepy — the tick drops onto your skin, burrows in painlessly, and sucks. Its anticoagulant can cause tick paralysis, and these arthropods carry all sorts of infections: Colorado Tick Fever (a virus), Rocky Mountain Spotted Fever (parasite), Tularemia (a bacteria), and the more commonly known Lyme Disease.
Lyme Disease can be scary. Lyme Disease is caused by an inoculation of the bacteria Borrelia burgdorferi. Ticks around the world carry it: In North America it’s transmitted by deer ticks (Ixodes scapularis) and the Western black legged tick (Ixodes pacificus). It was first identified in Old Lyme, Connecticut, after a group of kids complained of having a strange pain in their joints and an odd rash. So one might think, No problem — bacteria can be killed by antibiotics. But, there is a problem: Lyme is hard to kill and it can turn chronic. A single bite from a Lyme-carrying tick can require years of treatment and recovery.
THE REAL SCOPE OF LYME DISEASE
Lyme Disease is a widespread, global disease that is poorly understood. According to the CDC, in 2007 there were 27,000 cases in the U.S. and, because of the sometimes-vague symptoms, it may be dramatically underreported. While West Nile Virus, Dengue Fever, and even Swine Flu have gotten press lately, they account for much less illness. For example, in 2007, there were only 3,600 imported cases of West Nile Virus.
HOW TO PROTECT YOURSELF
Outdoor adventurers should follow standard insect, tick and arthropod preventions when traveling in the backcountry or abroad. Ticks don’t jump or fly, they drop or fall onto humans from trees or grasses. So, long sleeve shirts and long pants tucked into socks is a great start.
Insect repellents, including ones containing DEET like Tender’s Ben’s 100® pump and Ben’s® 30 wipes, work well at warding off Ticks. For people looking for a DEET-free alternative, repellents like Natrapel® 8-hour, which contains 20% of the active ingredient Picaridin, provide protection that’s as effective as DEET. Insecticides with Permethrin also work, and can be sprayed on clothing or impregnated into the fibers of garments.
When in tick country, remember to check your entire body after the day’s hike. Often you have two or three hours before a tick burrows. If it does, your chance of getting Lyme is low if you remove the bugger right away.
HOW TO SAFELY REMOVE A TICK
Once burrowed, ticks are tricky to remove. Don’t try those old wives tales like fingernail polish or a match. The best technique is to use tick or splinter-removal forceps, grabbing as close as possible to the head, and pulling the tick out with slow, gentle pressure. Sometimes I’ve had to wiggle the head gently to unclasp the tick’s pinchers. Unfortunately, many people sever the body from the head. I’ve had to dig out many tick heads in the emergency room. Like all wounds, clean thoroughly with soap and water.
RECOGNIZING THE SIGNS OF LYME DISEASE – WHAT TO LOOK FOR
How do you know if you have Lyme Disease? First, you will see a circular rash that looks like a target or bull’s eye called erythema migrans, which slowly enlarges. Then, the Lyme bacteria can spread to your body causing fever, fatigue, malaise, muscle and joint aches, headaches and swollen glands. Some patients have these symptoms for several months or years. That’s the big problem with Lyme Disease: It affects multiple parts of the body and may be difficult to diagnose if the initial symptoms go unnoticed. The symptoms can take anywhere between three days to one month or longer to emerge. Twenty percent of people who do not receive treatment develop severe complications within weeks or months after the bite, ranging from heart and neurological problems to severe attacks of arthritis.
If you think you need treatment, see your doctor and let him or her know that you have been bitten by a tick. Antibiotics are the mainstay of treatment, but don’t try to treat yourself at home with an old prescription in your medicine cabinet – treatment requires a specific antibiotic, like Doxycycline, with a longer course than typical.
For more information on avoiding bug-borne diseases, visit www.tendercorp.com.
Christopher Van Tilburg, MD, is the editor of Wilderness Medicine and the author of eight books on safety in the outdoors. His most recent book, Mountain Rescue Doctor: Wilderness Medicine in the Extremes of Nature, is now available in paperback.
Oh Noooo! …Tips for Treating & Avoiding Travelers’ Diarrhea
By Christopher Van Tilburg, MD
After an all-night flight to Santiago, Chile, last year, I passed out a pack of AMK’s Fresh Bath Travel Wipes to everyone in our group right before hitting the tarmac. It was rejuvenating.And, the antibacterial properties actually do more than refresh, they function to prevent the most common travel related illness – travelers’ diarrhea.
The Risk of Travelers Diarrhea (TD) is higher than malaria: it is the most common affliction when heading overseas. According to the Centers for Disease Control, TD affects 30-50% of all travelers to high-risk areas. That’s 50,000 people per day and 10 million per year. TD is essentially food poisoning, which occurs when consuming food or water that is contaminated by bacteria, parasites, or viruses. It gets on your food or hands, and then down your gullet. (more…)
HYPOTHERMIA: THE COLD HARD FACTS ABOUT WINTER’S DEADLY KILLER
By Christopher Van Tilburg, M.D.
Rescue mission for a lost snowboarder: a bitter-cold, raging midnight storm high above timberline. That was the scene of my first search and rescue call to Oregon’s Mount Hood as a young doctor. After another team located the snowboarder, I scurried from the tempestuous black night to the ski patrol room, where I examined a shivering, huddling young man. He clutched a blanket draped over soaked ski clothes, and held a steaming cup of hot chocolate, too scalding to drink. Fortunately, the snowboarder had been found. But from across the room I could see he suffered from hypothermia and dehydration.
RECOGNIZING THE SYMPTOMS
Hypothermia is a cooling of the body’s core temperature. Every year 600 people in the U.S. die from hypothermia, according to the Centers for Disease Control and Prevention. Mild hypothermia begins with shivering and progresses to lethargy. Moderate hypothermia is dangerous: one has slurred speech, poor concentration, and a staggered gait. Severe hypothermia is a critical condition: the heart, lungs and other organs start to shut down, and extreme mental status changes occur such as the inability to talk coherently, walk properly, or even process thoughts. Bizarre behavior like paradoxical undressing — when a person discards articles of clothing, even though doing so hinders their chances for survival — can occur when the brain gets confused. A well-known example of this condition involved the CNET reporter James Kim. After being stranded for several days with his family in a remote forested area of southwestern Oregon, Kim set off on his own to find help. He was later found in the snow, having succumbed to hypothermia. Media reports said he had removed several pieces of clothing, including his pants. Paradoxical Undressing not only speeds death but it can also put an entire group at risk, because the person suffering from it will inevitably require more attention and resources – at a time when both may be in short supply. Death by hypothermia doesn’t occur instantly, but it does occur rapidly. And often it is the hypothermic person’s partner who notices a problem first.
IMPROVING YOUR CHANCES OF SURVIVAL
Exemplified by snow burial studies, we know that with today’s fleece and nylon-laminate clothing and a well-built emergency shelter, a person can spend an unexpected night in the winter mountain wilderness, even in below freezing temperatures. But beyond one night without proper clothing, food, water and shelter, your odds of survival plummet even if the thermometer doesn’t. And once you get hypothermic, the basic tasks of survival become difficult to complete.
Before you head into the wilds, always make sure you have enough food, water and clothing for an unexpected night out. And carry the tools to build an emergency shelter such as a shovel to dig a snow cave and a space blanket like the Heatsheets Emergency Survival Blanket to act as a covering.
TREATING HYPOTHERMIA
If you do notice even mild hypothermia—you are more likely to see it in your partner—treat it immediately. Change into dry clothing and put on all extra layers. Insulate yourself from the ground. Chemical heat packs do help, if you place them on your torso. Drink lukewarm fluids and eat a snack: calories and fluids are important to generate internal heat, no matter if they are hot or cold. Seek shelter right away and try to keep active. If you can, build a fire. Make sure you pack a survival kit, with a reliable fire starter and signaling mirror for alerting rescue craft. Above all, get help and evacuate from the backcountry as soon as you can.
Also, watch for coexisting frostbite — when your skin actually freezes — which usually occurs on the face, nose, fingers and toes. To prevent frostbite, make sure that all exposed skin is covered and you have proper boots, socks, gloves and a hat. Frostbite is treated by immediate evacuation then rapid re-warming, usually with 40-degree water or fluids. But be extra cautious if you re-warm an extremity in the backcountry to make doubly sure it doesn’t refreeze, which can cause worse damage than walking out with a frozen finger or toe.
To treat the snowboarder in the ski patrol room, I had his friends help him change in to dry clothes then covered him with dry blankets. And I gave him two large cups of lukewarm hot chocolate, which he guzzled down with gusto and perked up. I checked him for frostbite and we fed him whatever snacks we could find. He finally warmed up and we sent him down the mountain.
Chris Van Tilburg, MD, is the editor of Wilderness Medicine Magazine and is also a member of Crag Rats Mountain Rescue, in Hood River, Oregon. Started in 1927, Crag Rats is the oldest mountain rescue unit in the nation.
Avalanches typically kill more people in the mountains in the West than any other natural disaster, and the winter of 2007-2008 was particularly grim. Last year 36 people died – the worst on record.Two of those people were killed by avalanches off of house roofs, one was killed in a ski area and thirty-three were killed doing their thing in the backcountry — snowboarding, skiing, climbing or riding a snowmobile.
I am often asked why this past year was so bad and the short answer is that dangerous conditions existed virtually everywhere and they existed for extended periods of time.Typically one or two geographic areas will have bad avalanche conditions and the rest of the country will have relatively stable conditions, but that was not the case in 2007-2008.
Although there were many complex reasons for the spate of avalanche fatalities this past season, the weather – specifically, an unusual snowfall pattern — played a major role. In general terms, most mountainous areas started with relatively light snow fall and cold temperatures.These conditions produced a weak faceted snow layer that could not support the additional weight that was piled on top it by a subsequent series of large snow storms.The weak basal layer was analogous to the strength of potato chips; the big storm layers to the weight of a brick.Obviously potato chips have a hard time holding up a brick and so the basal layers collapsed and avalanches occurred.
The freakish weather wasn’t the only reason for the uptick in Avalanche deaths. Last winter, more people were out in the backcountry because the powder happened to be awesome just about everywhere.Technology exacerbated the situation. Because our skis, boards and snowmobiles are much better than they were just a few years ago it’s now easier and more tempting to get into steep avalanche-prone terrain.
WHAT YOU CAN DO TO AVOID AN AVALANCHE
There is only one absolutely certain way to avoid being caught in an avalanche and that is to avoid all avalanche terrain.Avalanches can only occur on slopes steeper than about 30 degrees, so if a person stays on slopes flatter than 30 degrees they are almost guaranteed to never get caught in an avalanche.But that’s easier said than done. Western mountain ranges all have an abundance of slopes steeper than 30 degrees and much of the best backcountry skiing, boarding and snowmobile riding occurs there.So if you choose to go into terrain steeper than 30 degrees – and most of us do – then you can only reduce your risk, you cannot eliminate it.
The most effective way to reduce your risk is to have the tools and skills necessary to identify avalanche terrain, assess snow stability, and carry out a fast and effective rescue if things go bad.
When you go out, along with bringing your dedication to following low-risk travel protocols, you must have a slope meter to determine slope steepness, an avalanche probe and know how to use it, a shovel, extra food, water and clothes, an emergency bivvy or blanket, and a good first aid kit.But the most important tool you can have is avalanche awareness skills. And the best way to develop those skills is to routinely read and/or listen to your local avalanche advisory provided your area has one, take an avalanche class (for information look on avalanche.org or go to your local outdoor shop), read books like the Avalanche Handbook and Staying Alive in Avalanche Terrain, watch videos like Think Like An Avalanche (available from Black Diamond mail order) and check out the Forest Service National Avalanche Center website at .fsavalanche.com.
There are no shortcuts; it takes time to learn how to assess avalanche danger and how to make reasonable decisions based on your assessment. I urge everyone who goes into the backcountry to take the time and make the commitment to develop your skills so you know when to say “go” and when to say “no”.
(The NAC coordinates all the Forest Service Backcountry Avalanche Centers in the US, facilitates research, and manages the Forest Service Military Artillery for Avalanche Control Program, among its other duties)
In October, a solo climberon Washington’s 12,276-foot Mount Adams fell on Suksdorf Ridge, and broke his ankle. It’s just what every climber fears: being alone on a high mountain with a disastrous injury. Unable to walk, he dragged himself down the snowfields. After five days and nights, he was found at 6,200 feet suffering from frostbite and dehydration. He survived on creek water and an eclectic mix of creepy crawlers: ants, centipedes, spiders, mushrooms, and berries.
Sooner or later, if you spend time outdoors, you may find yourself without food or water on a wilderness outing; hopefully it’s just a short distance to your car and you are uninjured. But in survival mode, if you are lost and injured, you may need to eat and drink from the wilds.
You can live several weeks without food. But you won’t last much past five to seven days without water, even fewer if you are in the desert or at high altitude. Finding water is a paramount priority.
Drinking from creeks, like the Mount Adams climber, is probably a risk worth taking in prolonged survival situations. Yes, you can get protozoa infections like Giardia and Cryptosporidium, as well as bacteria and viruses. However, it takes just one day for you to begin to become incapacitated from dehydration.
When you find a source, ideally you should have a means to purify water before drinking. That means boiling, filtering, or chemical treatment. I carry water purification tablets for emergencies: they are compact, light, and easy to use.
Remember, when in the mountains, eating snow can cause hypothermia, because you need to use vital calories to melt it in your mouth first. So you should carry a lightweight backpacking stove to melt water. When in the desert, locating water can be extremely difficult, so if you find a source, consider staying put until you are rescued. If you do get a gastrointestinal infection from drinking backcountry water, see your doctor A.S.A.P.
As for food, if you can’t identify it, don’t eat it. You can get seriously ill from toxins and infections. My friend Greg Davenport, a survival expert, said critters with eight or more legs like centipedes and millipedes are often toxic. He recommends sticking to insects, which have some nutrition, but not much. A typical 100 gm (3.5 ounce) serving of fish, for example, yields 22 g protein, 1g fat and 0g carbos. The same weight of crickets yields 13 g protein, 6 g fat, and 5 g carbos. But that’s a big pile of crickets to scrounge for.
Wild plants—leaves, roots, bark, nuts, seeds, and berries— can be energizing or deadly. Use caution: even a small bite can cause stomach pain, nausea, vomiting, diarrhea, and rashes. Mushrooms can kill you. Davenport said aggregate berries, like thimbleberries, raspberries, and blackberries, are generally safe to eat. Purple, blue and black berries, such as wild huckleberries and cranberries, are 90% edible. Red berries are about 50% edible, so it’s probably best to avoid those, as well as any berry white, green or yellow, which are not edible.
Remember: always take enough water and food (an extra bottle of water and a few extra energy bars) to spend at least one unexpected night in the wilderness. And stash some water purification tablets in your survival kit.
