Do you know what to do if your friend has collided with the snowmobile and the skin tone turns grey and pale and he or she feels cold but sweaty and feeble? If you get white patches on your skin in very cold temperatures? Or if someone in your company sprains an ancle or gets an open wound? Be prepared with basic first aid knowledge in case of an accident.

Mikael Nyman teaches first aid and mountain safety, he is an outdoor guide and loves adventures just as much as you and I. Right now his biggest passion is exploring and climbing abandoned mines. In this article, Mikael will give you advice and recommendations on what you need to know and how to act if an accident should occur in the outdoors.

According to Mikael, the most common accidents that occur during outdoor activities are sprained ancles and fall injuries as well as overuse injuries and common blisters. When snowmobiling, the most frequent injuries are from colliding or from turning over with the machine. The seriousness of the injury depends mostly on speed and terrain.

First aid

Knowledge on how to act in case of an accident is crucial for all of your outdoor adventures. Invest your time in a first aid course to be well prepared on how to react and get help.

  • Your navigation skills will be important if there is an accident on the mountain. Navigation is not about direct first aid, but it will very important to know where you are and to give an exact position to the medics. They will need to know your coordinates and terrain references. The more exact information they have, the more time will be saved. And time is often crucial in serious accidents, says Mikael.

STOP guides you in a crisis

The STOP rule will help you to think rationally if somebody is hurt on the mountain or in the forest. Mikael explains that STOP stands for Stop, Think, Orient and Plan.

  1. Stop. Stop what you do instead of rushing into the situation. Take a few seconds to stop and assess the situation in front of you.
  2. Think. What has happened? Which equipment is available and which opportunities can you make use of in order to deal with what has happened.
  3. Orient. Orient yourself. Where are you and what does the environment and the situation look like?
  4. Plan. Make a plan for taking care of the injured person and potential evacuation.

Once you have gone through the steps in STOP then you should take care of the person according to the DRSABCDE process. The first aid course will include more knowledge on this and if you have taken the course you will know that this process ensures that you do the life saving actions in the right order:

D: danger

R: response

S: send for help

C: catastrophic bleeding

A: airway

B: breathing

C: circulation

D: disability

E: exposure & examination

Mikael points out that knowledge is key and that it is more important to take a course and then invest in equipment, compared to just getting a health care kit that you don’t know how to use.

Alert when you suspect internal bleeding

Internal bleeding is difficult to treat on location. Examples of these kinds of accidents are collisions or more severe snowmobile accidents.

  • If you suspect an internal bleeding, you need to evacuate as soon as possible. Signs of internal bleedings are coldsweat on grey and pale skin, fainting sensations, anxiety, thirst, initial high pulse and rapid, shallow breathing. Evaluate what has happened and if the accident might have caused an internal bleeding, Mikael recommends.
  • Make sure the injured person lies on flat ground, well protected from cold. Avoid giving the person liquid. Alert medic care and evacuate as soon as possible.

The cold is dangerous in all seasons

Regardless the season, low temperatures are always dangerous.

  • Always stay dry, well fed, warm and happy. If you are hungry and thirsty and feel tired from physical exercise or poor sleep, you will be more sensitive to cold temperatures. Also have in mind that windy days are a lot colder than a calm day, regardless of the temperature, says Mikael.

There are different kinds of hypothermia, i.e. when our body temperature is too low. One kind of hypothermia is when we are cooled down very quickly, e.g. when we fall into a hole in the ice. This is acute hypothermia. On the mountain we are exposed to chronic hypothermia because we are slowly cooled down during a long period of time.

  • Pay attention to chronic hypothermia. Maybe you are out on a multiday adventure, probably sleeping poorly and not getting enough energy. As time goes by we feel colder and colder. At first, we get short tempered, we don’t feel like talking to the rest of the group. After a while we don’t even want to take part in the activities. This is a signal to your friends that they need to give you some energy and make sure you get up and move around. If they don’t pay attention, you will feel more apathic and if it goes very far you will become unconscious, Mikael explains.

Local frostbites often occur when your skin is directly exposed to the cold in the winter. Hence, look out for each other and observe each other’s faces. If white patches appear, hold your hand against the affected area to heal. 

White patches are the first signs of frostbites but if you pay attention to these and make them disappear you can continue with your adventure. If the white patch is left untreated it will develop into a texture that feels like wax. Then it is recommended that you interrupt your outdoor activity. 

  • Don’t expose any skin during the winter, and plan for cold temperatures. It is dangerous to get sweaty and cold, so dress in layers, Mikael recommends.
  • Wear spacious clothes and shoes. Local frostbites develop when your gear is too tight. I have seen many frostbitten toes and fingers and the consequences will be with you throughout your entire life and it should be taken seriously. If you cannot feel your toes and fingers because they are cold, immediately pause whatever you are doing and adjust your layering to get warm.

First aid in case of sprains

Sprains can be treated immediately by applying a compression wrap.

  • I use a high quality elastic wrap. Wrap it tightly from the foot, or hand, towards the heart. Have it applied for about 20 minutes, then remove and apply again but slightly lighter. A sprain is an injury that you want to keep functional, hence it is important to apply the compression wrap straight away. Time will matter if you want to be able to walk despite a sprained ancle. If you wait for too long the area will be swollen and the wrap will have no effect, Mikael says.
  • Bring poles when going on hikes, these will alleviate your injury and you will be able to move with less pain.

Be careful of open wounds

Common injuries from accidents outdoors are open wounds. What you need to do depends on the wound.

  • If the open wound is over body joints, in your face or if a child is involved, then I would generally recommend evacuation, says Mikael.

Open wounds should be cleaned with water and soap. Put a band aid on small wounds, or a stripe to facilitate healing. If you are on a longer outdoor adventure, you need to take extra care. Clean the wound often and change band aid or wound pad.

Pay attention to blood poisoning, or sepsis. This might occur very suddenly with symptoms such as chills, high fever, difficulties breathing, confusion, diarrhea and vomiting. Weak muscles, stomach pain and pain in your back muscles are also common symptoms.

Avoid blisters

Blisters are open wounds that many people have experienced. Blisters can be avoided. Take these precautionary actions before your next outdoor adventure:

  1. Cut your nails. They should be just the right length: not too long and not too short.
  2. Keep your feet clean and change socks a few times per day. Rinse and let dry on your backpack if you are out on a hike. Clean your feet in any creek or river you pass by.
  3. When you stop for energy, take off your shoes and your socks and let your feet rest.
  4. Make sure you have tried the shoes on at home before long hikes. You should have 1 cm space in your shoes.
  5. Avoid cotton. Merino wool is better!
  6. If you feel a blister developing, make a stop and put on tape. It should be a breathable make and it is great if it is elastic too.
  7. If you have already developed a blister, put on a tape or bandaid specifically made for blisters. Avoid bursting the blister. If you really need to burst the blister, make sure you disinfect the needle by holding it in an open flame for a while. This is to avoid infection.