Wilderness 911?

By Christine Gorman

I endured a bit of gentle teasing from friends and co-workers two weeks ago when I told them I was taking a weekend course in wilderness first aid. "Getting ready for Y2K?" they wanted to know. "What's next, survivalist camp?" Well, no. But I do like to escape Manhattan's concrete canyons every now and again to go tramping through nearby state parks. It's not exactly isolated backcountry, but then neither is medical help just a phone call away.

The first thing I learned in the class, which was offered through Stonehearth Open Learning Opportunities, of Conway, N.H., in conjunction with my local hiking club, was to adjust my definition of wilderness conditions. Any activity taking place more than an hour away from medical attention--whether it's hiking all day or sailing a mile offshore--can quickly feel as if it's in a remote wilderness when an accident occurs. As Dr. Frank Hubbell, one of the founders of SOLO, notes, "When you get to a trailhead, you have to start thinking like a pioneer."

Why the emphasis on time? Doctors have identified a "golden hour" after heart attacks, accidents and other emergencies in which they can do the most to preserve life and limb. The purpose of giving first aid is to reduce further harm until medical help arrives, which in urban areas is usually within 15 to 30 minutes. Indeed, Red Cross instructors now tell their students that if they're alone when they need to give someone cardiopulmonary resuscitation and a phone is at hand, they should call 911 first, then start administering CPR.

Practicing wilderness first aid ensures that at least some of the benefits of treating within the golden hour are not lost. In urban first aid, for example, you're taught to splint a suspected sprain, strain or fracture as close as you can to the position you found it in. Under wilderness conditions, you need to be alert to the possibility that nerves or the blood supply in the affected limb may have been cut off, requiring you to pull gently and straighten it out before splinting to restore circulation and sensation. Otherwise, the accident victim could permanently lose use of that arm or leg. As a rule, if you're not seriously injured and you know your way back and can move under your own power, it's better to hike out than wait for rescue.

As in any good first-aid class, my teachers stressed prevention. Scrambling up a rocky trail in tennis shoes is asking for a sprained ankle. Make sure to carry plenty of food, water and extra clothes, even if you're just out for the afternoon. A sudden change in the weather or a broken leg could turn your pleasant stroll into a very uncomfortable night outdoors; take along something to insulate you from the ground and prevent hypothermia.

That's just for starters. Two of the more accessible books on the subject are Country First Aid and Extended Care by Buck Tilton of the Wilderness Medical Institute in Pitkin, Colo. (Globe Pequot Press; $4.95), and Medicine for the Back Country by Tilton and SOLO's Hubbell (ICS Books; $14.95).

Although I hope I never have to use what I learned on the trail, at least now I feel more confident about inviting my niece and nephews along. I also plan to get recertified for CPR. There are still 2 1/2 months before the year 2000.

For more information, visit time.com/personal or www.stonehearth.com You can e-mail Christine at gorman@time.com