Expedition Medicine for The Medically Uninformed
    By Adrian Owen M.D.
   

Next time you’re planning an under-funded, stupidly dangerous expedition and can’t afford a doctor to come along for the ride, just look over these guidelines for wilderness medicine. It might even up your chances of survival. If Stanley had known some of these medical precautions, a great many more of his crew might have lived to say hello to Dr. Livingston.

   
         
     
When bites get infected like these, it can spell trouble in the tropics.
 
   
  • Sanitation

Most wilderness medicine is common sense, starting with basic sanitation. The majority of problems on any trek are due to dehydration and if you’re throwing up or having diarrhoea at regular intervals, it’ll just speed up the process of dehydration. Wash your hands before and after preparing food. Keep your toilet away from the water supply, and if this isn’t possible make it down stream. If you have any guides, cooks or porters tell them to do the same.

  • Safe Water

Purify all water obtained from streams. No matter how much you want a drink, iodine’s cheap and it takes less than an hour to work.

  • Forward Planning

Identify the route you’re planning to take and the possible hazards you may experience. If you’re going to be at altitude, give yourself time to acclimatize prior to the trek.

  • Know Your Group

If any of the group members have a pre-existing medical condition make sure they have the necessary medications and know how to treat it.

  • Medicine

Obviously most drugs should only be taken with prior medical advice, but there are some drugs that are always useful and can be bought in most developing countries before going into the wilderness. Below is a brief list of drugs and their doses.

     

Problem

Drug

Dose

Wound healing

Ascorbic Acid

50mg

Wound healing

Zinc Sulphate

15-45mg 3 times per day

Wound Infection

Flucloxicillin

500mg 4 times per day

Cold Sore

Aciclovir

5% cream 5x/day for 5 days

Nausea/Vomiting

Metoclopramide

10mg up to 3 times per day

Nausea/Vomiting

Cyclizine

50mg up to 3 times per day

Nausea/Vomiting

Prochlorperizine

10mg up to 3 times per day

Diarrhoea

Loperimide

2mg up to 8 times per day

Dehydration

Electrolyte Rehydration Solution

In 200ml of cooled boiled water

Throat or chest infection

Amoxicillin

500mg 3 times per day

   
  • Wound Care

In the tropics skin infections are a big worry as it’s almost impossible to keep wounds clean or dry, which is always the aim of wound care. Any coral cut also needs to be treated promptly as Coral Seas are full of bacteria. Blisters and ulcers due to poor fitting footware are a regular problem and need to be treated immediately as a group member who can’t walk will slow the whole group down.

-Clean all wounds out with clean water and remove any debris, then sterilise (this is another great use for iodine), and finally cover with a clean dry dressing.

-If you feel like a budding surgeon and want to stitch a wound up then it needs to be completely clean. If it isn’t and the dressing won’t hold it, consider putting strong gaffer tape on either side of the wound and stitching those together with a running stitch. By doing this, you can then clean the wound out regularly and close the wound after.

-Super glue is brilliant for small cuts to the face, put a thin line on either side of the wound then hold it together until it sticks, don’t put it in the actual wound!

   
                       
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