The survival instinct was alive and well in 2011. With Mother Earth clearly in an apocalyptic mood, people found ways, often against seemingly impossible odds, to survive earthquakes, volcano eruptions, hurricanes, tornados and tsunamis. Tales of wilderness survival – stories involving the injured or lost hiker who braved the elements long enough to talk about it another day — were also well represented.  To pick SOL’s Top Seven Survival Stories of 2011, we turned to Dr. Chris Van Tilburg, editor of Wilderness Medicine magazine and a long-time member of Oregon’s Hood River Crag Rats Search and Rescue Team.

Excerpt from A Comprehensive Guide to Wilderness & Travel Medicine, 3rd Edition, by Dr. Eric A. Weiss.

If a person who has diabetes becomes confused, weak, or unconscious for no apparent reason, he may be suffering from insulin shock (low blood sugar) or diabetic ketoacidosis (high blood sugar).

INSULIN SHOCK (LOW BLOOD SUGAR)

If a person with diabetes takes too much insulin or fails to eat enough food to match his insulin level or his level of exercise, a rapid drop in blood sugar can occur. Symptoms may come on very rapidly and include an altered level of consciousness, ranging from slurred speech, bizarre behaviour, and loss of coordination, to seizures and unconsciousness.

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By Buck Tilton

When bullets and arrows start filling the autumn air, we know a few of them will strike a hunter and fewer still non-hunters. Everyone knows the danger of a loaded gun, but gunshot wounds during hunting season—at least gunshot wounds to and from hunters—are on the decline, says the US Forest Service, probably due to mandatory hunter safety courses. While this is not a time to be less than perfectly careful with a firearm — with new hunters hitting the field each year — statistically, depending on where and how you hunt, there may be dangers greater than a rifle or a bow.

Excerpt from A Comprehensive Guide to Wilderness and Travel Medicine, by Eric A. Weiss, M.D.

Lightning kills more people every year in the United States than all other natural disasters combined. Carrying or wearing metal objects, such as an ice axe, umbrella, backpack frame, or even a hairpin, increases the chances of being hit.

To calculate the approximate distance in miles from a flash of lightning, count in seconds from the time you see the flash to when you hear the thunder, then divide by five.

Prevention

Excerpt from A Comprehensive Guide to Wilderness and Travel Medicine, by Dr. Eric A. Weiss.

Head trauma and brain injury can result from direct impact or from the shearing forces produced by rapid deceleration. When your head hits a hard object such as a boulder, the impact can fracture the skull, bruise the brain, or cause severe bleeding inside the brain from damaged blood vessels. Shearing forces from sudden deceleration of the brain against the inside of the skull can also tear blood vessels on the surface of the brain, leading to an expanding blood clot and pressure on the brain (intracranial pressure).

Excerpted from A Comprehensive Guide to Wilderness & Travel Medicine, 3rd Ed., by Eric A. Weiss, M.D.

Shock is a life-threatening condition in which blood flow to the tissues of the body is inadequate and cells are deprived of oxygen. Any serious injury or illness can produce shock. Examples are severe bleeding (either external or internal), thigh (femur) or pelvis fractures, major burns, dehydration, heart failure, severe allergic reactions, or spinal cord injuries with paralysis.

By Buck Tilton

When the earthquake of 12 January 2010 ended, much of Port-au-Prince lay in ruins and the lives of a quarter million human inhabitants had suddenly and violently ended. Then the hurricane hit, and then the deadly cholera epidemic. Haiti, poorest nation of the Western Hemisphere, has yet to recover. In an area just a little smaller than Maryland, an estimated 9.7 million people struggle for basic health and without hope for much more than that.

Cardiopulmonary Resuscitation (CPR)

New guidelines by the American Heart Association recommend that the three steps of cardiopulmonary resuscitation (CPR) be rearranged. The new first step is doing chest compressions instead of doing mouth-to-mouth breathing. The new guidelines apply to adults, children, and infants, but exclude newborns.

When to Stop CPR

By Chris Van Tilburg, M.D.

The Wilderness Medical Society (WMS) recently published recommendations that guides carry epinephrine in outdoor education settings, according to a consensus statement in Wilderness and Environmental Medicine. The reason: allergic shock, called anaphylaxis, can be deadly in minutes. But, the practice of letting lay, non-medical guides use prescription medicine on clients is fraught with difficulties, and some potentially deadly effects.

A Word About Anaphylaxis