First Aid Facts
Ice Baths Do's and Don'ts
A number of people have been asking about ice baths lately. The general theory behind this cold therapy is that the exposure to cold helps to combat the microtrauma (small tears) in muscle fibers and soreness caused by intense or repetitive exercise. The ice bath is thought to constrict blood vessels, flush waste products and reduce swelling and tissue breakdown. Subsequently, as the tissue warms and the increased blood flow speeds circulation, the healing process is jump-started. The advantage of an ice bath submersion is that a large area of intertwined musculature can be treated, rather than limiting the cold therapy to a concentrated area with a localized ice pack.
So, should ice baths be one of these routine activities to help you gain an advantage on your competition? It depends on whom you ask. The research to date is inconclusive, and in asking elite coaches, you are likely to receive a varying degree of significance placed on the practice. However, most agree that while ice baths may not be gauranteed to help, it generally can't hurt. My personal recommendation is to treat this much like any other part of your training program: experiment with ice baths at a period in your season when you are not approaching a key race and see how your body responds.
Given this is uncharted territory, here are some general guidelines to ice bathing:
- Do: Be conservative with water temperature as you get started. Most rehabilitation specialists recommend a water temperature between 54-60°F. Consider starting a bit higher and inch this downward a degree or two each exposure.
- Do: Recognize that each individual will have his or her own cold threshold. Play within your personal comfort zone, and consider investing in booties (toe warmers made of wetsuit material) as your toes are likely the most sensitive body part to be submerged.
- Don't: Overexpose! At the recommended temperature range above, 6-8 minutes should be sufficient. Unless supervised or you have history with ice baths, do not exceed 10 minutes.
- Don't: Assume colder is better. Spending a prolonged period of time in water colder than 54°F could be dangerous.
- Do: Be aware that moving water is colder water. Much like the wind chill created when you ride, if there are jets in your ice bath and the water that is warmed at the skin's surface gets pushed away, the resulting impact of the water will be cooler than measured by the thermometer.
- Don't: Assume 54-60°F or bust. Cool water (say 60-75°F) can still be beneficial - as can active recovery (very light exercise to facilitate blood flow to musculature).
- Do: Seek to simplify. Building a personal ice bath daily can be a daunting task. Look for a gym that has a cold plunge, or if you live close to a river, lake, or the ocean, keep tabs on the current water temperature.
- Don't: Rush to take a warm shower immediately after the ice bath. The residual cooling effect and gradual warming are ideal. Consider initial warming options of a sweatshirt, blanket and/or warm drink... but DO take the shower if you are unable to warm yourself.
How about some whiskey to kill the pain of your toothache? Actually, your best bet is to take the ice and instead of pouring whiskey on it put between your thumbs and index fingers. The cold, rubbing sensation travels on the same pathway to the brain as tooth pain, and by icing your hand, you override the signals from your mouth. Rubbing an ice cube on people's hands remedied tooth pain in 50 percent of people. Call a dentist as soon as possible, and save the whiskey for later.
Keep Cuts Closed
It's true that you can use instant adhesives to close a cut, but we don't recommend it. Still, we know some of you are going to try this, so be sure to start by thoroughly flushing out any debris with water. Hold the wound edges firmly together, and spread a thin layer of glue on the closed wound. It will take several layers do the trick. Allow each layer to dry before applying the next one. You will need to use nail polish remover later to remove the glue, otherwise; you'll injure yourself further trying to rip the glue off.
We strongly encourage packing and using wound closure strips instead, which are cleaner and less time consuming. We also emphasize that it's never wise to close a gash longer than half an inch. Doing so just begs for an infection.
If someone is injured by lightning and does not have a heart beat, immediate CPR is essential since many victims (80% in fact) can be revived with timely CPR. As with any serious injury, keep an eye out for the onset of shock too. Impaired eyesight, balance, and hearing are commonplace among lightning victims. Seek professional medical care as soon as possible.
Generic Insect Bites and Stings
Some arthropods are merely annoying while others can become deadly. Of all deaths due to venomous stings and bites, most are caused by arthropods, not snakes or other reptiles. The pain inflicted is a result of either the venom that has been injected, or a stinger that has been inserted into your skin. Only bees leave their stingers in your skin (see specific section below). Wasps, hornets, and yellow jackets do not leave their stingers in your skin. Caterpillars have hollow, venom-filled hairs on their bodies, which may break off in the skin. Place tape over the sting area to remove them. Ants, spiders, scorpions, centipedes and millipedes are also potentially dangerous.
General Relief From a Bite or Sting:
- Use a cold/ice pack and apply it to the afflicted area to reduce immediate swelling.
- Apply a pain relieving cream (i.e. calamine lotion, ozonol, etc.) or a baking soda paste to the bite or sting.
- Try rubbing some aloe vera lotion or gel to the affected area surrounding the bite or sting.
For all bites and stings, do the following:
- Use a cold/ice pack and apply it to the afflicted area to reduce immediate swelling.
- Apply a pain relieving cream (i.e. calamine lotion, ozonol, etc.) to the bite or sting.
- Try rubbing some aloe vera lotion or gel to the affected area surrounding the bite or sting.
- Seek out medical attention immediately if you experience a severe allergic reaction.
Any of the following allergic reactions require the immediate attention of a physician:
- Skin around the bite or sting is red, hot, painful, or swollen indicating a possible infection.
- Swelling around or of the eyes, lips, or throat
- Visible hives (red, itchy, spots)
- Dizziness, lightheadedness or confusion
- Breathing difficulties
- Abdominal cramping or nausea/vomiting
- Fainting or loss of consciousness
- Irregular heartbeat
Last but not least, use these precautionary tips and you just might avoid being bitten or stung altogether:
- Ask the local inhabitants about the local venomous or harmful anthropods.
- Hang clothes up instead of lying on the floor of your tent or other dwelling.
- Make a habit of checking latrines, bedding, shoes, clothing, before use.
- Apply insect repellent every few hours when in insect or spider-infested areas.
- Skin-So-Soft bath oils (by Avon) are excellent for repelling insects.
- Be sure to wash off insect repellent when returning indoors again.
- Avoid the outdoors during the dusk hours this is when mosquitoes are most prevalent.
- Burn the anti-mosquito candles or coils when outdoors in the evening.
- Do not wear perfume, aftershave, cologne, or any scented skin or hair products when outside. The sweet scents will attract insects.
- Wear white or any light-colored clothing to avoid bee stings (avoid yellows and reds as they attract insects).
- Avoid wearing flower-printed patterns, as bees are usually attracted to these types of patterns and colors.
- Wear shoes or sandals when walking through grassy or wooded areas to avoid being stung by insects or spiders.
- Wear socks when possible and pull them up to cover more of your lower legs.
- Wear gloves and tuck pants into socks when working in places where spiders may be lurking.
Arachnid (Spider) Treatment
If you are bitten by either of the following arachnids, consult a physician immediately! These are the most common dangerous spiders:
- Black Widow. Identified by the shiny black body and a red hourglass or red marking on the abdomen.
- Brown Recluse. Identified as a small light brown spider with a dark brown violin on the head/back.
The most dangerous scorpions in the U.S. are found in Arizona and small potions of New Mexico. Other dangerous scorpions are found in Mexico, Central America, South America, the Mediterranean region, North Africa, South Africa, and India.
- Do not give morphine, morphine derivatives, or Demerol.
- Use ice packs or cold compresses to relieve the pain and slow the spread of venom. Avoid freezing the skin.
- Consult a physician immediately unless specific knowledge of the scorpion is known.
- In the case of more marked symptoms, medical treatment must be given as quickly as possible. There is antiserum for scorpion venom. Treatment must be overseen by a doctor.
Centipede and Millipede Treatment
Centipede bites are painful but not life-threatening. Millipedes secrete a toxin which causes burning and itching, but is also not life-threatening.
- Wash the skin thoroughly.
- Follow general relief steps below and watch for allergic reactions.
- Consult a physician immediately.
- Follow general relief steps below and watch for allergic reactions.
Bee Sting Treatment
Once stung, you must remove the stinger to avoid infection. A bee stinger is small and barbed and has a venom sack attached that can continue to pump venom into your system for 20 minutes after you have been stung. It can also release a hormone into the air that will make other bees in the area more aggressive and apt to sting also. Needless to say, it is imperative to remove the stinger as quickly as possible. When removing the stinger, try to avoid pulling at the top part where the venom sacs are located. It is best if you can get a grip on the lower part, closest to your skin. If the venom sacs are popped, the amount of venom pumping into the skin will increase. Follow these steps immediately after a sting:
- First try pulling the stinger out with your fingers - this is generally the quickest method. If you are not able to remove it with your fingers, as quickly as possible use either tweezers, or a stiff, flat object, such as a credit card, and pull or scrape out the stinger.
- As long as you aren't showing any signs of an allergic reaction (see symptoms under Insect Bites and Stings section), wash the area gently with soap and water, if available. If you are not near soap and water, see if someone has a first aid kit. If so you can use an alcohol swab to sterilize the sting area.
- Now add a cold compresses to the area to reduce the swelling. Either a washcloth run under cold water, or a baggie full of ice will work for a compress. If pain subsists, use a pain reliever such as aspirin, ibuprofen (Advil), or acetaminophen (Tylenol). Take an oral antihistamine (like Benadryl) to alleviate itching and inflammation.
Removing A Tick
When walking in the woods and fields, you must take precautions against a small, disgusting, little bloodsucking insect called a tick. Tick season usually begins in early spring and will continue through until late fall. Although ticks are generally not dangerous, in some parts of the country they are now known to carry a bacterial infection Borrelia Burgdorferi, or Lyme Disease.
Not all ticks are dangerous but the known carriers of Lyme disease are Deer ticks, which aptly named, are often found on deer. Hunters must be particularly careful to check the carcass. Ticks can also be found in your own back yard, near wood piles, stone fences, or any place that rodents might nest.
Naturally you will need to remove a tick if you find one on yourself. A tick will bury it's head under your skin in order to drink blood so it is very important to remove the head as well as the body. The head, if left under the skin, will cause an infection. You also must be sure that you get it out alive. An injured or dying tick will regurgitate your blood back into your blood system - along with all of the bacteria and germs the tick was carrying.
Remember those guidelines as you continue following these directions:
- Do not panic. This is not a life threatening situation at this point, but if you panic it could be.
- Make sure you have easy access to the spot in which the tick is located. If need be, have someone help you hold hair out of the way, or fashion something to hold hair out of the way for you. You must have a clear view of what you are doing.
- Use tweezers to remove the tick. Sterilze the tweezers by using rubbing alcohol or running them through a flame several times. If using the flame method make sure they are cool before using them for tick removal.
- If you have no access to tweezers, it is best to use a paper towel, napkin or tissue. Do not grab the tick with your bare hands!
- While grasping the tick as close to the head as you can get, start pulling back away from your skin, but be gentle. The object here is to get the tick to let go, on it's own.
- Do not squeeze the tick, just use enough pressure to hold onto it. Keep a steady pressure on the tick, and if need be jiggle it slightly.
- Do not rotate the tick or you will separate the head from the body. You may have to keep the pressure up for 30 seconds to a minute or two, in order to convince the tick it no longer wishes to be attached to your skin.
- Last resort: If after several minutes the tick still will not let go, drop a small drop of rubbing alcohol on the tick. Repeat this step once a minute for up to 10 minutes. But be careful, using too much alcohol can sometimes cause the tick to regurgitate.
Once the tick has been removed, make sure that you have the head. If not, we would recommend you see a doctor at this point. Assuming the head and body are intact, we also recommend the following actions:
- Do not dispose of the tick. Place it in a ziplock baggy or other sealed container so that it can be checked for Lyme Disease.
- Treat the removal area with a disinfectant, and keep it clean and dry.
- Write the date of the bite on your calendar. If you have contracted Lyme Disease a rash will appear any time within 24 hours upto one month from the time you were bitten. The rash will have a bulls-eye, and along with the rash, you may get flu like symptoms, a headache, muscle aches, loss of appetite, fever and fatigue. It is important that you tell your doctor that you were bitten (and the date) since many doctors have never seen Lyme Disease.
If Lyme disease is treated early with antibiotics there are generally no lasting problems, if untreated it can cause permanent nervous system damage and in some cases even death. Early symptoms include: fatigue, headache, fever, chills, muscle pains, and joint aches. If you remove the tick within the first 36 hours, your odds of contracting Lyme disease are slim (less than 4%).
Finally, here are a few measures you can take that might prevent you from being bitten in the first place:
- Wear light colored clothing with long pants and long sleeves. The light colored clothing will contrast to the dark color of the tick making them easy to spot.
- If at all possible wear boots and tuck your pant legs into your boots.
- Also before you leave the area, check yourself and even your pets for any ticks.
- Carry tweezers or a knife that has a set of tweezers enclosed every time you go out. It also would not hurt to carry a small ziplock bag.
- There are several commercial tick repellents on the market. There are clothing treatments that seem to be quite effective in killing ticks. You apply this to your clothing and it will even last through several washings. Also there are some insect repellants being made now, that are also work for ticks. Be sure to follow any instructions on the labels of these, particularly regarding children.
This tiny larva of the harvest mite, commonly called a chigger, is essentially invisible without a magnifying glass, but its bite produces an agonizingly itchy red welt. Found east of the Rockies, these parasites are a seasonal plague throughout the Southeast and Plains in early summer, when they latch onto hikers who brush against low shrubs, grasses, and especially berry patches (which attract birds, rodents, and other potential hosts). The simplest way to give these pests the slip is to wear long pants and then tuck deet- or permethrin-treated cuffs inside your socks. Also, skip sandals or shoes with mesh ventilation where chiggers can enter, and avoid thick undergrowth by staying on trails.
Polar explorers, rejoice: Antarctica is the only place on earth without this insect's all-too-familiar whine. For the rest of us, unfortunately, these buzzing, biting flies thrive wherever there's standing water - from the Alaskan tundra to Southwest desert washes to Florida's salt marshes. Some species bite at dawn and dusk; others prefer midday. When mosquito season arrives (typically spring and early summer), you can find some relief on shoreline and ridge-top locations, where breezes keep the bugs at bay, or by walking in the rain. Also, wear colors that blend in with your backdrop - mosquitoes recognize contrasts of light and dark - and consider a headnet if extra-thick swarms are testing your sanity.
Essentially the mosquito's smaller, evil cousin, the pest flourishes wherever it can breed in unpolluted moving water - think streams, not swamps. Also called buffalo gnats because of their humpbacks, black flies are especially thick in pristine northern locales such as Maine and Michigan's Upper Peninsula. Unlike the mosquito, which use its needlelike proboscis to suck blood, a black fly gnaws a hole in your skin (especially around your head) and sips the blood that pools there. Avoid this unappealing fate by covering all exposed skin with light-colored clothing, and skip shirts with buttonholes (also known as black-fly portals). Mornings, late afternoons, and cloudy days are when they're at their peskiest. If you're in the right place at the wrong time, wait for a chillier day - or consider a nighttime hike.
More plant injuries are caused by poison ivy, poison sumac, and poison oak than all other varieties of plants combined. Other injurious plants include some grasses, shrubs, and vines. In some species the whole plant is poisonous and in others, only certain parts are poisonous, such as the limbs, flowers, fruits, berries, leaves, bark, roots, seeds, bulbs, and pods. In poison ivy and oak, the whole plant is poisonous - especially the leaves and stems.
Contact poisoning may result in a variety of symptoms depending upon the amount of exposure to the plant, the presence or absence of allergic sensitivity, and the body part exposed. These symptoms may include:
- Redness and swelling of exposed area
- Burning sensation on exposed area
- Rash (immediate or delayed for up to 72 hours)
Vomiting or diarrhea may occur if the poisonous portion of the plant has been eaten. In this event, professional medical attention should be sought immediately and the following steps should be taken:
- Thoroughly wash the exposed area with soap and water or alcohol.
- Wash only the exposed area to avoid spreading the poison to other parts of the body.
- Wash the area several times using a fresh solution each time.
- Do not dress the area. Containing the moisture only makes the condition worse.
- Remove any contaminated clothing and do not re-use until laundered.
- If you are treating someone other than yourself, thoroughly wash your hands after treatment to avoid spreading the poison to yourself or others.
- Seek professional medical attention depending on the severity of the symptoms.
Once again, an ounce of prevention is worth a pound of cure. There is no cream or spray that will protect you from poisonous plants - the only effective prevention is avoidance. You know the mantra "leaves of three, let it be." That adage does not guide you from plants that disguise themselves by changing colors, growning vines, or mimicing harmless plants. Take the following precautions:
- Ask the locals about poisonous plants in the area.
- Wear appropriate clothing and footwear at all times.
- Avoid touching unfamiliar plants or allowing them to touch you.
- Avoid touching the face or genitals with unwashed hands.
- Don't use unfamiliar plants for fuel or cooking materials.
- Stand upwind from burning brush that includes poison ivy or oak. Do not inhale the smoke or allow it to touch your skin.
Human Body Parasites
Millions of parasites, including mites, worms, bacteria, fungi, and viruses are eating your flesh right now - whether you know it or not. It's a nasty thought but humans are subject to infestation by more than 1,000 types of parasites even in the safety of our own homes. Virtually all parts of our bodies will host some type of parasite within our lifetimes. These freeloaders can go completely unnoticed or be extremely harmful.
Parasitic infestation of humans has reached epidemic proportions in some parts of the world, including North America. Yep - this represents a major health challenge that is often overlooked by medical professionals. There is a tendency to only treat the symptoms: chronic fatigue, skin rashes, muscle and joint pain, weakened immune system, forgetfulness, food allergies, colitis, water retention and many others, without considering that parasites may be the root cause of health problems.
Parasites use humans as their hosts, enjoying the nutrients we provide and leaving us with their waste products in return.
There are three particulary common types of parasites in America. The first being a species of hookworm, aptly named Necator Americanus or American Murderer. These ugly creatures attach themselves to the intestinal walls feasting on the hosts tissue and blood, causing iron deficiency anemia.
Tapeworms are huge parasites that may be more than 30 feet long and are capable of producing a million plus eggs a day. Tapeworms consume so much food that the host may actually be hungry all the time, yet may appear obese because of tapeworm-induced water retention.
Pinworms are extremely common intestinal parasites - difficult to avoid as their eggs are often airborne. Once pinworms are snugly ensconced inside their human host, they crawl outside the anus at night, causing severe itching, and then lay their eggs on bedding or sleep wear.
One thing to remember about parasites: Although most of them lack a brain as we know it, they are highly developed survival machines. They focus all their energies on eating and reproducing. Getting rid of them is difficult.
Whereas some parasites are harmful to us, others actually perform a service. One example is the relatively harmless tooth amoeba. Undaunted by toothpaste and the toothbrush, they feast on microscopic bits of food or other organic material.
Another service parasite is the dust mite. Although they can cause allergies, dust mites operate as a sort of clean up crew for our skin. They march about on our skin and scalps all day, scarfing up dead skin cells. They coexist with Demodex Folliculorum, the rather ordinary eyebrow mite, which lives in human hair.
Combine the invisible guests such as worms and bacteria with visible ones like fleas, ticks, mosquitoes, lice and flies -- all of whom feed on human blood or tissue -- and it's easy to get a little paranoid about being host to an army of parasites.
What to do if you suspect that you suffer from an infestation of harmful parasites? (Remember, experts say that more than 85 per cent of us are.) The first thing to remember is; don't panic and run out to buy a bagful of remedies that may be useless. Removing parasites takes time and patience. There are a number of books available that provide useful information that will help you and your health care provider make wise decisions. Check out The Essentials of Medical Parasitology by Thomas J. Brooks. Animals Parasitic in Man by Geoffrey Lapage. Medical Parasitology by Markell and Voge, and just for fun, consider Furtive Fauna by Roger Knutson. On the Web, search for writings by Dr. Ross Anderson, N.D., Dr. Peter Wina, Dr. Frank Nova, and Dr. Hazel Parcels.
One additional way you can keep parasites away is to strengthen your own immune system. Eliminate sugar, saturated fat, junk food, white flour, yeast, alcohol, tobacco and caffeine. Avoid eating meat that is not well done. Educate yourself about proper food handling and storage practices. Drink plenty of pure water and consider a moderate exercise program.
Use an antibacterial soap when washing your hands. Clean surfaces in your home with a mixture of 1/4 cup liquid laundry detergent (not dishwashing detergent) and 4 tablespoons chlorine bleach per gallon of water. Use rubber gloves and keep the area well ventilated.
Treating Snake Bites
The best advice is to relax. Most bites come from pit vipers, like rattlers, and getting excited actually increases the rare chance of death. First, sit down and calm yourself. Next, wash the wound. If bitten on the arm or leg, keep it level with your heart, and remove jewelry in case of swelling, which happens in 75 percent of pit-viper bites. Walk out slowly and seek medical attention. If you're deep in wilderness, arrange an air evacuation. The more lethal coral snakes inject neurotoxins. If you're butten by one, apply pressure and immobilize the wound. Wrap from the bite up toward your heart, as tight as you would bind a sprained ankle. Splint the appendage and get to a hospital. As for snakebite kits, don't bother packing one. No kits remove enough venom to change the outcome of a bite.
Identifying Coral and King Snakes
Coral snakes are probably the easiest to properly identify, they are small (usually no more than about 30 inches long, sometimes up to 40 inches), thin, brightly colored, and have small heads. A coral snake's red and yellow stripes are next to each other, while the nonvenomous king snake, milk snakes, and other harmless mimics have red and yellow stripes are separated by a black band. Here are two good mnemonics to remember the difference between venomous snakes and nonvenomous mimics:
Red touches yellow, kill a fellow
Red touches black, venom lack.
Another mnemonic is to think of a traffic light. If red is adjacent to yellow, stop!
Drinking Water Disinfection
When the home water supply is interrupted by natural or other disaster, limited amounts of water could be obtained by draining your hot water tank or melting ice cubes. For larger quantities of water, well water is usually the preferred source of drinking water but if a well is not available, river or lake water must be used. As a general rule, one should always avoid water sources that have floating substances, like scum, moss or any kind of film or water with a dark color or an odor.
In all of Western Europe and most other developed countries you can drink safely from any public water supply. In many (but not all) developing countries, the water supply contains bacteria that causes diarrhea. Water to be used for drinking, cooking, making any prepared drink (including the ice cube in the drink), or brushing the teeth should be properly disinfected. While hardened travelers may adjust to impure water over weeks or months, most travelers avoid problems by buying most or all of their water.
When disinfection is necessary, examine the physical condition of the water. Disinfectants are less effective in cloudy water. Murky or colored water should be filtered through clean cloths or allowed to settle before drawing off the clean water for disinfection. Water prepared for disinfection should be stored in clean, tightly covered containers that will not corrode.
The following pathogens are found in water and most result in gastrointestinal illness (i.e. diarrhea, vomiting, cramps):
- Parasites (tiny worms and other such nasty creatures) ranging in size from 2 to 15 microns. Parasites include Protozoans such as Giardiasis (6-10 microns) and Cryptosporidium (4-6 microns in diameter), which cause diarrhea, stomach cramps, upset stomach, etc. All parasites can be eliminated by micro filtering the water.
- Bacteria (smaller than parasites but larger than viruses) ranging in size from 0.5-5.0 microns in length. Bacteria include E. Coli, dysentery, cholera and typhoid. The E Coli bacteria are what cause 40% of travelers' diarrhea. All bacteria are killed by boiling, iodine or chlorine treatments. The filter size for bacteria should be 0.2 microns.
- Viruses (micro organisms) are smaller than 0.1 micron. Viruses include hepatitis, polio and meningitis). Viruses invade and then multiply within your cells - making them difficult to treat. These are the most problematic when treating water. Viruses can be killed by boiling, iodine, or chlorine treatments in the water but the best defense is to get the correct vaccinations before you begin traveling.
There are three primary methods by which small quantities of water can be effectively disinfected: boiling, chemical treatment, and filtration. Of the chemical treatments, chlorine is generally more effective than iodine and both disinfectants work much better in warmer water. Chlorine and iodine are generally effective in protecting against some, but not all parasites. These chemical methods therefore should only be used to treat well water (as opposed to surface water sources such as rivers, lakes, and springs). Well water is less likely to contain some of the harmful parasites.
Vigorous boiling for one minute will kill any disease-causing micro organisms present in water including parasitic cysts, bacteria and viruses. Note that at altitudes above one mile, water must be boiled for three minutes. The problem with this method is the time and energy source required since fuel, both heavy and bulky, is sometimes difficult to obtain in a post-disaster situation.
Boiled water will have a flat taste which can be improved by aeration (i.e. pouring it back and forth from one container to another) or by allowing it to stand for a few hours, or by adding a small pinch of salt for each quart of water boiled.
Iodine is easy and effective in 20 minutes. Iodine does not neutralize cryptosporidium (a diarrhea causing protozoan). Iodine used for water purification is commonly added to water as a solution, in crystallized form, or in tablets. The addition of vitamin C, in the form of a pill or in flavored drink powders, precipitates much of the iodine out of solution, so it should not be added until the iodine has had sufficient time to work. When purifying cold water (32° F- 41° F), iodine takes longer to purify because the chemical reaction is slower. Iodine should not be used for extended periods of time, meaning several months. It also should not be used by pregnant women or anyone with a thyroid condition.
One form of iodine is tincture of Iodine. This is the common household iodine found in a medicine cabinet or first aid kit. Using an eye dropper, add five drops of 2 percent United States Pharmacopeia (U.S.P.) tincture of iodine to each quart of clear water. For cloudy water add ten drops and let the solution stand for at least 30 minutes when the water temperature is at least 25°C (77°F). Increase the standing time for colder water: (e.g., for each 10° less than 25°C (77°F), allow the water to stand for double the time before drinking it. If dining in a foreign restaurant you may add two or three drops per glass of water, stir, and wait a few minutes. This is unscientific but seems to work.
A second form of iodine is the iodine tablet. Commercially prepared iodine tablets containing the necessary dosage for drinking water disinfection can be purchased at drug and sporting goods stores. The two most popular iodine treatments in the U.S. are Potable Aqua and Polar Pure. They should be used as directed. If directions are not available, use one tablet for each quart of water to be purified.
A third form of iodine is crystalline iodine (found at some chemical companies and sporting goods stores). First make a saturated solution by placing 4-8 grams of crystalline iodine into a 1-2 oz container (our 2 oz mini droppers work great) and fill with water. Shake the bottle vigorously for 1 minute. Allow several additional minutes for the iodine to maximally dissolve in the available water. Some crystals should always be visible; if they totally dissolve, then more crystals should be added to the container to insure that iodine saturation of the stock solution has been achieved. Then add 13 ml (approximately 260 drops) of saturated iodine solution to add to water (just the solution and not the crystals). In cloudy water, add 26 ml (approximately 520 drops) of saturated solution per Liter or Quart. Allow the solution to stand 20 minutes before drinking the disinfected water when the water temperature is 20-25°C (68-77°F). Increase the standing time with colder water. For each 10° less than 25°C (77°F), allow the water to stand for double the time before drinking. The crystalline form stores well indefinitely and new batches of the saturated solution can be made from a small amount of crystals each time you take a trip. Warning: crystalline iodine at 4-8 grams is a lethal dose if accidentally swallowed in a single dose. Keep out of the reach of children.
Silver ion is another form of water disinfectant and is available in tablet form. These tablets are expensive, running about $20 for a packet of forty tablets which purifies forty liters. However, silver is an alternative for those who don't want to, or can't use iodine. A concern with using silver is the possible deposition and accumulation of silver compounds in various body tissues leading to a rare condition called argyria that results in a permanent, disfiguring, bluish-gray pigmentation of the skin, eyes, and mucous membranes.
Chlorine dioxide is an iodine and chlorine free disinfectant that kills parasite, bacteria, and viruses. The small size, portability and long shelf life of the kit represents a breakthrough in technology allowing this highly effective treatment method to be carried and used by individuals around the globe.
The unique formula works by releasing nascent oxygen, a highly active form of oxygen, which is a strong oxidant and a powerful germicidal agent. Chlorine dioxide has been used by municipal water treatment plants at very low concentrations to kill a variety of waterborne pathogens since the late 1940s. Unlike free chlorine (familiar as household bleach) or other halogen chemicals (such as iodine), chlorine dioxide does not create potentially harmful by-products, but the jury is still out as to if it is a potentially harmful reactant.
Treatment time for viruses and bacteria is 15-20 min, and treatment time for protozoa (cysts) is 30 minutes to 4 hours in temperatures ranging from 20-4° (the colder the water the longer the treatment time). At treatment times over one hour in length, it's actually lighter to carry a filter than the tabs or drops. One hour is around the break even point, and treatment times of less than an hour generally result in a reduction in weight carried if one uses tabs or drops. It may be good to use a filter in the winter that is capable of filtering protozoa. That said, I don't know anyone that has waited over an hour, and tests have shown treatment times to be much less than what is reported by manufacturers or the EPA (most likely due to liability). For my own liability, you should use these products as directed by the manufacturer.
According to the EPA's Alternative Disinfectants and Oxidants Guidance Manua', Chlorite and chlorate are produced in varying ratios as byproducts during chlorine dioxide treatment and subsequent degradation. The primary concern with chlorite and chlorate is oxidative damage to red blood cells. According to the Chlorate and Chlorite Drinking-water study conducted by WHO, IARC (1991) has concluded that chlorite is not classifiable as to its carcinogenicity to humans. That same study shows that chlorine dioxide has been shown to impair neurobehavioural and neurological development in rats exposed perinatally. Experimental studies with rats and monkeys exposed to chlorine dioxide in drinking-water have shown some evidence of thyroid toxicity; however, because of the studies' limitations, it is difficult to drawn firm conclusions. A more recent study conducted by a Canadian Committee on Drinking Water resulted in similar findings. A third study, called Toxicological Review of Chlorine Dioxide and Chlorite was conducted by the EPA, also came to the same conclusion. On the other hand, the EPA regulates chlorite concentrations in drinking water to 1 mg/L, and lists the long term health effects as Anemia in adults, and nervous system effects in infants & young children. They probably do this to err on the safe side.
From the EPA chapter on Chlorine Dioxide, found that even under the most favorable conditions (i.e., at a pH of 8.5), required doses to achieve 2-log Cryptosporidium inactivation requiring doses of more than 3.0 mg/L with a 60 minute detention time. At neutral pH levels, the required doses may be more than 20 mg/L. The EPA maximum contaminant level for Chlorine Dioxide is 0.8 mg/L, so a dose of 3.0 mg/L of chlorine dioxide that would inactivate crypto in the most favorable conditions may be potentially harmful. The EPA warns that some infants, young children, and fetuses of pregnant women who drink water containing chlorine dioxide in excess of the maximum residual disinfectant level could experience nervous system effects. Some people who drink water containing chlorine dioxide well in excess of the MRDL for many years may experience anemia.
Compare with a maximum contaminant level of 4.0 mg/L for chlorine. While chlorine dioxide may be somewhat more effective as a biocide than chlorine, it is even easier to take a harmful dose to yourself. Excessive amounts of chlorine dioxide may result in anemia, while excessive amounts of chlorine may result in an upset stomach. Which, in addition to it's higher cost, is the reason chlorine dioxide is used to a lesser degree in public water systems.
It should be noted that the EPA and other regulations apply to municipal treatment plants, not personal water treatment systems. It should also be noted that lots of people use Aquamira/Pristine and no one is dropping dead. I have seen no indication that a healthy adult using it for a short period of time would suffer any ill effects. Still, in light of the regulations that apply to ClO2-treated water consumed on a regular basis, it seems reasonable to suggest that anyone considering using ClO2 for an extended period, or anyone with an underlying medical condition (including pregnancy or blood disorders) might want to get medical advice specific to their situation. For anyone who is looking for a threshold that is known to be safe, a report commissioned and used by Mountain Equipment Co-op in Canada advises limiting intake of water treated with Pristine/Aquamira to 1.5L/day for no longer than three months, and to only use the regular dose. It also advises people with thyroid problems, anemia, or other blood illnesses to use of treatment methods, and says that women who are or are trying to become pregnant should not be exposed to it.
Chlorine tablets or drops kill bacteria, viruses, and some parasites (not including Cryptosporidium), but the wait time is 30 minutes for bacteria and four hours for parasites. It is commonly used as a household or swimming pool disinfectant. Some people who use water containing chlorine well in excess of the maximum residual disinfectant level could experience irritating effects to their eyes and nose. Some people who drink water containing chlorine well in excess of the maximum residual disinfectant level could experience stomach discomfort. Chlorine (available in several forms) should be used as a last resort. It is less stable than iodine and has some associated cancer risks. Chlorine tablets containing the necessary dosage for drinking water disinfection can be purchased from drug and sporting goods stores and should be used as directed. If directions are not available, use one tablet for each quart of water to be purified.
Common household bleach will also disinfect water. Use as directed on the label. If directions are not written on the label, look for the percentage of available chlorine listed and use the information in the following tabulation as a guide. (If strength is unknown, add ten drops per quart of water. Double amount of chlorine for cloudy or colored water or water that is extremely cold.)
Available Chlorine Drops per Quart of Clear Water 1%
The treated water should be mixed thoroughly and allowed to stand, preferably covered, for 30 minutes. The water should have a slight chlorine odor; if not, repeat the dosage and allow the water to stand for an additional 15 minutes. If the treated water has too strong a chlorine taste, it can be minimized by allowing the water to stand exposed to the air for a few hours or by aeration (pouring it from one clean container to another several times).
Granular calcium hypochlorite is a two-step disinfecting process. First, add and dissolve one heaping teaspoon of high-test granular calcium hypochlorite (approximately 1/4 ounce) for each two gallons of water. This creates a chlorine solution. Then, add the chlorine solution in the ratio of one part of chlorine solution to each 100 parts of water to be treated. This is roughly equal to adding 16 ounces of stock chlorine to each 12.5 gallons of water to be disinfected. To remove any objectionable chlorine odor, aerate the water as described above.
MIOX systems use a salt solution to create mixed oxidants, primarily chlorine. Chlorine has a low to moderate effectiveness in killing Giardia, and a high effectiveness in killing bacteria and viruses.
Filtering cleans water mechanically. Filters will remove parasites and bacteria, but even the finest filters will not filter out all viruses so they should be used in conjunction with chemical treatments. Only filters that contain a chemical disinfectant matrix will be effective against some viruses. In the process of cleaning the water, they can become blocked so it is important to clean the filter regularly. Make sure you know how to do this before you leave home. In the long run you will save money by filtering, instead of buying water. Filters vary in their effectiveness, and no type clears all viruses. If you decide to use a filter, look for two things: an absolute pore size of 1 micron or smaller, and an assurance that the product has passed EPA testing. Filters designed to remove Crypto will have any of the following four messages on a package label: (1) Reverse osmosis (with or without NSF testing), (2) Absolute pore size of 1 micron or smaller (with or without NSF testing), (3) Tested and certified by NSF Standard 53 or NSF Standard 58 for cyst removal, (4) Tested and certified by NSF Standard 53 or NSF Standard 58 for cyst reduction.
An ultraviolet light purifier bombards water with UV rays, causing the nucleic acids in DNA to break their bonds and pair incorrectly. This causes the DNA to either be unreadable or misread, and that in turn causes the parasite, bacteria, or virus to be unable to carry out their normal functions or reproduce correctly. It works in less than a minute and doesn't leave a chemical aftertaste. It is expensive upfront, but it may pay off over time. UV is fast, light-weight, but is dependent on batteries, the size of the opening of the bottle, and the turbidity (cloudiness) of the water. Often times, you still have to filter the water to reduce turbidity so that the UV rays can adequately penetrate the entire bottle. The worst part of UV treatments is that you are not killing the bacteria, protozoa, or viruses; you are only mutating the organisms DNA to the point that it can't replicate, and then you're ingesting it live. There is no evidence to the degree that lack of pathogen reproductive ability reduces harm if ingested. UV may prove to be an effective method in pathogen reduction in back-country water, but there is a lack of independent testing data available on specific systems.
Summary of Methods (in order of effectiveness):
- Boiling: an excellent, yet somewhat impractical method requiring considerable time and fuel. It is the only method that is 100% effective in removing all pathogens. Water should be brought to a rolling boil for 1 minute. At altitudes greater than 6,562 feet (greater than 2000 meters), you should boil water for 3 minutes.
- Chemical treatments: are dependent on contact time, disinfectant concentration, water temperature, water turbidity (cloudiness), water pH, and many other factors can impact the effectiveness of chemical disinfection. They also often have health associated risks. Iodine is extremely effective but cannot be used by everyone. Silver is excellent but expensive. Chlorine is less effective and produces a bad flavor. Chlorine dioxide (ClO2) is effective against all pathogens, but protozoa can take 30 minutes to 4 hours to treat depending on water temperature.
- Filters: A good filter is fast and produces good tasting water. Filtration can be used as a pathogen reduction method against most microorganisms, depending on the pore size of the filter, amount of the contaminant, particle size of the contaminant, and charge of the contaminant particle. According to the CDC, filters designed to remove Crypto will have any of the following four messages on a package label: (1) Reverse osmosis (with or without NSF testing), (2) Absolute pore size of 1 micron or smaller (with or without NSF testing), (3) Tested and certified by NSF Standard 53 or NSF Standard 58 for cyst removal, (4) Tested and certified by NSF Standard 53 or NSF Standard 58 for cyst reduction.
For more information, read Alternative Disinfectants and Oxidants Guidance Manual from the EPA. Also, consider that the majority (some say 99.9%+) of bacteria in natural stream and lake waters (let alone stock tanks) exist in the biofilm mode of growth where microorganisms are associated with suspended particles or agglomerated with each other, then a germicide that can effectively penetrate these "slime layers" is going to have a higher probability of neutralizing the pathogenicity of these bacteria. Also consider that an increasing number of waterborne intestinal illnesses are resulting from bacteria (despite the increasing hype about viruses and protozoa) such as Enterococci (common in areas where stock animals are allowed). For more information, be sure to read Efficacy of Chemical Water Technologies in the Backcountry by Erica McKenzie and Dr. Ryan Jordan, which discusses the impact of biofilms on purification and compares the efficacy of Aquamira to other chemical treatment methods, including iodine and MSR Miox. Bleach was not included in that experiment, but another study showed that biofilms exposed to chlorine bleach for 60 min are reported to still have live cells. Unless you use a harsh chemical like chlorine dioxide, a filter should be used to remove any biofilms. The bigger the biofilm the harder it is for a chemical to penetrate, but the easier it is to get caught in a filter.
These are difficult and very personal choices but all things considered, we agree with the CDC and would choose the filter/chemical treatment combination. We feel this combination provides the safest, best flavored water in a reasonable amount of time, and at the most affordable price. Bleach and iodine are the most affordable and safest options when it comes to choosing a chemical treatment. Iodine can also be used to disinfect cuts and wounds, and the vitamin C powder used to neutralize its taste can be used independently. Here is a table from the CDC that compares viable options for backcountry and travel use.
Dehydration is not a climate-dependent condition, as some would assume. Your body can dehydrate just as easily in an Arctic winter as it can in a Sahara afternoon. Physical exertion produces sweat, even in the cold and the vapor clouds you see when you exhale represent precious moisture leaving our bodies. The basic consideration is that one must increase water intake proportionately as energy is expended. In hot climates the need for water doubles or triples. Hikers may require a gallon or more per day as they sweat and produce water and water vapor. Conversely, shivering in the cold also burns energy and requires greater hydration. At a minimum the body requires 2 to 3 liters of fluid per day. Survival time in a temperate climate is about a week. In hot zones, it shrinks to as little as a few hours.
The next time your lips feel dry or chapped, drink several glasses of water and see what happens. Your lips, as semi-mucous-membranes, provide excellent representation of the hydrating effect. Internally, this is how our cells, tissues, and organs also react to proper hydration.
Remember that thirst is an unreliable indicator of dehydration. Although a sip of liquid might quench your thirst it will not improve your internal water deficit. You may not even notice your thirst depending on your circumstances and stress level. A better barometer is your urine color. If it's always very yellow, you're probably a couple of quarts low on water. A general rule to live by for good health is this: drink enough water to ensure at least two almost clear eliminations per day.
To conserve fluid, breathe through your nose and stop talking. Stay in the shade and avoid unnecessary exertion. Don't eat - digestion requires water. Don not drink seawater, urine, alcohol, or caffeine (diuretics take more moisture than they give).
Basic symptoms of dehydration are: disorientation, low blood pressure, kidney failure, and ultimately, death. Losing even 5% of your body weight through dehydration will prompt the symptoms of severe dehydration: waves of nausea will begin, your movements will slow down dramatically, your speech will slur, and you'll become unable to walk. Dehydration to this degree can be fatal. As a final note, in cold temperatures a sip of whiskey or hot beverage may seem like a good idea but remember that both alcoholic and caffeinated beverages (including cocoa, tea, and coffee) have an extremely dehydrating effect on the body.
Hot & Cold Temperature Injuries
Humans are homeotherms, meaning our bodies try to maintain constant body temperature regardless of the surrounding climate. The body consists of an inner hot core, surrounded by a cooler outer shell. The core consists of the brain and other vital organs contained within the skull, chest, and abdomen. The shell is what is left: the skin, fat, muscle, and limbs. The shell acts as a buffer between the core and the outside world, protecting the organs from any catastrophic change in temperature.
The maintenance of proper internal body temperature is the most important factor in determining your survival. Even in extreme cold or heat, the core temperature will seldom vary more than two degrees either side of 98.4°F (36.8°C), with the shell just a few degrees cooler. If your core temperature rises above 109°F (42.7°C) or falls below 84°F (28.8°C), it's check out time for you. Your body generates both energy and heat as it burns fuel. When you start to shiver, your body is telling you that it is losing heat faster than it is being replaced. The shivering reflex works your muscles and increases heat production by burning more fuel. If your core temperature continues to drop however, shivering will not be enough to keep you warm and the situation could be fatal.
The body has a thermostat, located in a bit of nerve tissue at the base of the brain. This controls the production or dissipation of heat and monitors all parts of the body in order to maintain a constant temperature. In the state of hypothermia, the body thermostat responds by ordering heat to be drawn from the extremities into the core. Your hands and feet will start to stiffen. As the core temperature drops, the body also draws heat from the head. When this happens, circulation slows down, and the victim doesn't get the oxygen or sugar the brain needs: the sugar the brain ordinarily feeds on is being burned to produce heat. As the brain begins to slow down, the body stops shivering, and irrational behavior begins. That is a definite danger sign, but it is hard to recognize in yourself because you will simply lose the will to help yourself. You stop shivering and you stop worrying - in fact, you are dying and couldn't care less! At this point, your body loses its ability to reheat itself. Even if you have a sleeping bag to crawl into, you will continue to cool off. Your pulse gets irregular; drowsiness becomes semi-consciousness, which then turns into unconsciousness. The only hope at that point is the exposure to heat from an external source - a fire, hot drinks, another body. In fact, one of the most effective ways of rewarming a hypothermia victim is to zip them up in a sleeping bag with another person whose body temperature is still normal. Fortunately, in many desperate situations, a warm body would probably be a lot easier to find than a fire or a hot drink. Who knew a lovely cuddle could save a life?
This discussion applies to all types of burns. From sunburns to heat burns. Self applied first aid is generally adequate for treating first- and second-degree burns smaller than a quarter on a child or smaller than a silver dollar on an adult. See a doctor for larger burns, any burn on children under one year old, and anyone over the age of 60.
It is important to properly determined the severity of any burn. First-degree burns affect only the skin's surface and tend to appear red. Sunburns are usually first-degree burns. Although first-degree burns can cause great pain, they seldom result in lasting problems or require medical attention.
Second-degree burns probe deeper into the skin and result in blistering or splitting of the skin's layers. Very severe sunburns and scalding are common instances of second-degree burns. Like first-degree burns, second-degree burns rarely cause lasting problems or scarring. The pain can be intense, but usually subsides in 24 hours. For an adult, these burns can usually be treated at home providing the burn is no larger than the size of the patient's hand.
Third-degree burns destroy all layers of the skin and extend into deeper tissues. These burns are actually painless because the nerve endings have been destroyed. Third-degree burns result in scarring, infection, and fluid loss, and should be seen by a doctor immediately. Skin grafts are often needed to repair these deep burns.
Contrary to popular belief, you should NOT apply any ointments, antiseptics, sprays or home remedies (such as butter, oil, honey, potato peelings, milk, mustard, yoghurt, or toothpaste) to a new burn. For proper treatments, follow these steps:
- Immediately cool the area with cold water or a cold compress (not a frozen compress which can cause frostbite). If pain subsists, use a pain reliever such as aspirin, ibuprofen (Advil), or acetaminophen (Tylenol).
- Wait 24 hours after the burn before washing your injury gently with soap and water or a mild Betadine solution once a day.
- If the skin is red but blister-free, loosely cover the area with sterile gauze (or a clean bandana) to slow the skin's loss of moisture. If the skin is blistered or blackened, fighting infection is key; after washing the burn, swab with antibiotic ointment and then bandage it with gauze.
- Two or three days after you burn, break off a fresh piece of aloe and use the plant's natural healing moisture, or squeeze on an over-the-counter aloe cream. Avoid aloe cream that contains alcohol, which will sting and dry the skin.
- Once the skin has begun to heal and after it has scabbed over, vitamin E can be used to help prevent scarring. Blisters are nature's own best bandage, so leave them alone. If a blister pops, clean the area with soap and water, then smooth on a little antibiotic ointment and cover.
From mid-morning to mid-afternoon, as much as 90% of the suns ultraviolet light reflects off the snow giving you a double whammy of damaging UV rays. It's not that the reflected rays are more hazardous, it's that you're getting hit with direct and indirect rays at the same time - and from all angles. To protect yourself, wear wrap around sunglasses or goggles, a brimmed hat, sunscreen with SPF 30 or higher, and a generously applied SPF lip balm. Be sure to apply sunscreen to the insides of your nostrils and under your chin to block the reflecting rays. Keep your mouth closed as much as possible and breathe through your nose to avoid sunburn to the roof of your mouth. Yes, those reflecting rays actually make it in there. Strange as it sounds, it is doubly painful.
Frostnip occurs when the first layer of skin freezes, creating pale blotches on the affected area. If unchecked, the condition deepens into frostbite, in which multiple layers of skin freeze. Frostbite turns the flesh white and makes it feel solid to the touch. It often causes permanent tissue damage, and in rare cases requires amutation.
- Wear a facemask or apply a skin-protection sunscreen to exposed skin.
- Don't constrict blood flow by cinching cuffs too tightly, wearing elastic bands around the wrists or ankles, or hiking in snug boots.
- Drink plenty of water; staying well hydrated helps circulation.
- Regularly inspect your partner's face and ears for white spots, and vice versa.
- Carry chemical heat packs for fast warmth.
- Pain and subsequent numbness are the first signs of frostnip; stop and get warm before it becomes more serious.
- Never rub or massage frozen extremities. Rough treatment of embedded ice crystals can injure the skin even more.
- Do not warm frozen parts close to a fire or directly against chemical heat packs; numb skin cannot detect excessive heat.
- Sip warm liquids, but skip caffeine and alcohol, which slow the body's ability to warm itself.
- Thaw by placing the affected area against warm skin (under your arms; on your partner's belly).
- Get to a hospital. If a quick evacuation isn't an option, keep moving, even on frozen feet, if it means getting to medical care faster.
- Don't thaw frostbitten areas if there's any chance they will refreeze, which can cause further damage.
- If there's no danger of refreezing, immerse the injured area in warm water (100 to 105 F or hot-tub temperature) for 20 to 30 minutes; keep the limb moving underwater to stimulate circulation.
- Take painkillers; thawing frostbite is extremely painful.
- Once warmed, frostbitten areas usually swell up and develop blisters. Wash and cover the injured area to prevent infection until medical help can be obtained.