| Outside magazine, June 1995|
In the world of wilderness first aid, Bill "Doc" Forgey wrote the book. In fact, the Merrillville, Indiana-based physician has penned or contributed to a daypack-load of them, most recently the fourth edition of his most complete handbook, Wilderness Medicine (from ICS Books, 800-541-7323). Here are his remedies for a few of North America's nastier summer surprises.
Ticks. Since these wicked arachnids can transmit any of a half-dozen fairly serious ills, the backcountry traveler should dress to repel: Wear long sleeves, long pants, and gaiters, and tuck in clothing. "In the old days, we used to just make everybody do a nightly tick check," says Forgey. But Lyme disease, which can be spread by immature ticks smaller than a pinhead, makes a 0.5 percent permethrin spray a necessity. Brands such as Sawyer Per-methrin are available in most camping shops at about $6 for two full-body applications. "If you let it dry on your clothes overnight, you won't be able to get rid of it for 14 days," says Forgey. "And it kills ticks." Should you nevertheless find one with its head buried in your flesh, Forgey suggests using tweezers to grab your skin on either side of the tick's head, and then pinching. Then wash the bite with antiseptic soap. If you can't get the whole head out, or if you develop a fever or muscle aches, get to a doctor.
Stinging Insects. Chances are that the extent of your trouble will be a pinprick of pain. If a stinger is left behind, just scrape it off the skin with the edge of a credit card, to avoid squeezing more venom into the bite, and wash the area with cold water, to help relieve the discomfort. If it itches or swells, pop an antihistamine. "The thing to worry about here," cautions Forgey, "is anaphylaxis." Your doctor can tell you if you're prone to this systemic freak-out, which kills about 200 bee-sting victims in the United States every year, and can prescribe preloaded syringes of the drug epinephrine to take on the trail. Watch for difficult breathing, welts combined with a husky voice (a sign of swelling in the upper airway), and shock symptoms, such as an increased heart rate. If any of these occur, keep the victim sitting upright and get him or her to an emergency room.
Snakes. "The most important item in your snakebite kit," says Forgey, "is your car key." If you or a companion gets fanged, don't panic--of the 8,000 or so venomous snakebites in North America each year, fewer than a dozen are fatal, and in fact 25 percent contain no venom at all. If you're in the unfortunate 75 percent, you have about 90 minutes (less for small children and those who are already sick) before the toxic effects start kicking in. Don't apply tourniquets, electricity, or ice, and don't cut and suck; these TV-western "remedies" only cause more tissue damage. Instead, Forgey recommends packing a small suction device called the Sawyer Extractor (about $10, from most outdoor shops), which can safely suck out more than a third of the venom. Remove jewelry or clothing that might cause problems if a bitten limb swells. Then take the victim for help. "The snakes we have on this continent are designed by nature to kill rodents, not people," says Forgey. "So just think: Are you a mouse or a man?"