Safety and First Aid
Wilderness First Aid
The Sierra Club and other organizations commonly sponsor wilderness first aid seminars. These are really valuable on a number of levels. It alerts the participants to medical issues that can and have happened in the back-country, and how they can be dealt with. At a seminar that I attended, we received expert instruction on how to deal medical problems one by one, discussed them and then did role-playing exercises to solidify our understanding. I can't recommend such seminars enough.
There is a difference between wilderness first aid and (urban) first responder aid. In the city, a first responder is supposed to deal with a medical emergency until qualified personnel arrives. In many cases, that means knowing not to do “too much.” In the wilderness, no ambulance will come to the rescue. You may be required to do much more. A wilderness first aid seminar will not make you an expert, but it will improve your ability to assess and deal with medical issues in the back-country. A good book about basic wilderness first aid is Wilderness and Travel Medicine by Dr. Eric Weiss.
In the gear section, we mentioned that some experienced thru-hikers carry minimal first aid kits because serious health issues require treatment in town anyway. Of course, if you have special medical needs, carry whatever you need. Beyond this, there are a couple of things that are very helpful, and yet weight nothing. One is wilderness first aid training, and another is the right attitude.
It's better to stay out of trouble, than to need first aid, and that's where attitude comes in. The back-country is probably less dangerous than the city, but mistakes are harder to deal with. Know yourself, and don't push beyond the point where things get out of control. Once, while snowcamping, I got seriously exhausted constructing a snow cave. Anxious to finish, I hadn't paused to drink enough water or eat snacks. In such a state, one's judgment is impaired. I just wanted to press on, skip dinner and get into my sleeping bag. Fortunately, another member of the party, saw the situation, gave me a hand with the shelter, and then insisted that I eat dinner and get rehydrated. Without that intervention, I would have doubtlessly spent a very cold, miserable night and possibly made some even worse mistakes. If you make an error, keep cool and don't compound it.
Serious Problems
Serious problems like a broken bone, are uncommon, but will require getting off the trail. How do you know if you've broken your ankle or just strained it? You may be able to walk on level ground with a broken ankle, but you won't be able to go up or downhill, or at angles without sharp pain. In either case, you'll want to cool your leg in a stream, and then elevate it to avoid swelling. After resting for a few hours or even over-night, wrap your ankle with an ace bandage (not too tightly) and try walking on it again. If you can proceed without sharp pain, it's probably a sprain, and you may be able to go on with your hike. If it's still really painful, then it's a mote point whether its broken or a bad sprain; you'll have to get some help and leave the trail.
If you really have to leave the trail, and you can't do so under your own power, what choices do you have? Yosemite, and perhaps other National Parks as well, have some emergency evac teams available. You would have to get word to them, of course, and this would mean enlisting the help of other hikers or a seasonal Ranger (see your maps for the location of seasonal Ranger stations). There are also horse and mule packers that use the PCT/JMT and they might be able to evacuate you, or at least they could radio out information about your situation. There are also medical evacuation insurance plans that you can purchase, but I have no specific information about how this would work on the JMT. Serious medical problems seem to be uncommon on the JMT as far as I can ascertain.
Minor Medical Problems
Minor problems are much more common, and you should consider how you would deal with these. I carried Ibuprofen and used it morning and evening, mainly as a preventative for painful knees. Follow the intake limits, though, if you use Ibuprofen. I carried aspirin for head-ache too, but didn't need to use it.
Minor burns are a common wilderness injury. Be careful with your stove and with boiling water. Make sure you have enough room to work and walk around your stove. Never sit on the ground next to it—if a pot of boiling water tips over, you could be seriously injured. We usually sat on our bear canisters while cooking and eating. If you use an alcohol stove, remember it burns silently and the flame is invisible except at night.
Naturally, we carried and used sunscreen. Because I already had a pretty good tan, I just used sunscreen on my nose and ears. I wear a wide-brimmed hat which kept the sun off of my face. Those with lighter complexions or more sensitive skin might want to use sunscreen on other exposed body parts. Remember, at high altitude, the Sun's rays are more potent than at sea level.
Cuts and scraps are also common occurrences The main treatment is to keep them clean. I didn't do anything at all about shallow scratches, but anything deeper should be cleaned with water and perhaps alcohol. If it is still bleeding, use pressure to stop it and then use an antibiotic ointment and bandage to cover it. Basically, use the same treatment you'd use at home. The goal is to avoid further infection, and let the healing process go forward.
Most hikers wear shorts, and while the trail is clear, some irritating vegetation might grow off-trail. Nasty things like poison-oak are mostly found at lower elevation, but individuals may be allergic to some things in the Sierras, so pay attention to any skin rashes that appear. If you notice something unusual, clean it with soap and water. If you're carrying an alcohol stove, include a little extra fuel for disinfecting cuts and the like.
Many people experience digestion problems when their diet and/or life-style changes suddenly. Often the first few days on the trail are stressful as your body adjusts to the new demands you are placing on it. If those situations make you gassy, constipated or give you the runs, by all means carry medication to deal with that. For myself, I mix some psyllium with my breakfast, and that seems to help. Eating reconstituted dried beans and lentils make most people a bit gassy. This is amusing for the first few days on the trail, and inevitably leads to jokes about “distant thunder” and so on. After a while, it's just part of the trip. If your partner is a bit gassy, and you're behind him, just don't walk too close! Diarrhea is a more serious issue. If you get a bad case of the runs, you'll lose energy quickly. Carry Imodium or a similar generic product and use it if you get loose bowels.
It's a good idea to carry an elastic Ace bandage. Even if you never need it for your knees or ankles, they have a lot of other uses. A few bandages of various sizes, and some antiseptic ointment will be useful. Carry whatever foot aid items you usually use—moleskin, lambs-wool or whatever. Some long distance runners use duct tape for foot problems saying that it stays in place better than moleskin. Though I didn't have many foot problems, one of my toes consistently got rubbed the wrong way. Perhaps a half-size larger shoe would have prevented this. I used lambs-wool around the sore toe, and that relieved it.
After the Hike