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AN INTRODUCTION TO EXPEDITION MEDICINE

Written by Dr Mark Willis

By their own nature, expeditions are risky endeavours. From uneven terrain and altitude to tropical disease and dangerous wildlife, depending on the environment there can be a lot of variables and potentially dangerous scenarios to consider. If you’ve been on expedition with Secret Compass, you’ll know how important we consider our medical kits. With their unique approaches based on their own personal experiences, our expedition leaders all have their own approaches to safety on expedition and their own medical items they wouldn’t travel without. One thing they all agree on though is that during physical challenges in remote wilderness, there’s nothing more important than the safety of the team.

As Dr Mark Willis outlines in his introduction to expedition medicine in BASE magazine issue #03, prevention is always better than a cure. Having an effective medical kit then ultimately comes down to the right equipment ad the knowledge of how to use it. ‘There’s no point taking intravenous drugs if no one is able to give them,’ he says. Below is an extract from that article with an overview of general expedition medical kit. For more from BASE magazine, be sure to subscribe for free.



The beautiful thing about an expedition is that each adventure is as unique as every person on it.  No two adventures are the same, even if they were to be in the exact same place, at the same time of year and with the same people, they would still be different. I think this is what makes expeditions and adventure travel so exciting and always leaves me wanting more. Being able to look after others as an expedition doctor is only possible if I can look after myself. This often means I need a comprehensive medical kit to treat the full range of illnesses and injuries that may occur. Easier said than done? Yes. If each expedition is unique, then so are the potential medical issues you’re going to face. So how do you create a medical kit for a trip in a remote region, cut off from all medical infrastructure and supplies, and when you can’t be sure what’s going to happen?

First, you should consider the length of your expedition. The duration of your trip or time to a medical facility is going to dictate the quantity of each medical supply you’re going to need. Going to be a maximum of two days away from a re-supply point? Then there’s no need to carry hundreds of tablets if you can only have a maximum eight in a day. The same goes for bandages and dressings.

Second, you should consider the number of expedition members. Try to spread group medical supplies amongst the members to spread the weight. Also, consider the group number when deciding on quantities of medical supplies.

Third, you should consider the experience of expedition members. Taking intravenous drugs to help with emergency situations can have a significant benefit, but only if you have an expedition member that’s confident and competent to use them. The same goes for bandages and splints – don’t carry them if you’re not going to use them.

Third, it’s important to tune your medical kit to the requirements of the specific expedition. One of the most useful ways to construct a medical bag is to think about the environment(s) you will be in. Extreme environments each have their own challenges but, if you pack the right kit, then you can make the adventure that bit more safe and enjoyable. There are certain items of kit that make it into my bag no matter what scenario I’m about to face. Years of expeditions in a wide range of environments have proved that the items listed here are always useful to have at hand.

MEDICAL KIT FOR ALL EXPEDITIONS

Bandages & Slings

A versatile bandage and sling is excellent at providing pain relief and can help aid with the healing of an injured limb or joint. The idea of both is that it provides stability and immobility to encourage healing.

Dressings & Plasters

On an expedition, an infection of any kind can scupper your chances of achieving your goal and leave the person feeling very unwell. Make sure you cover any breaks in the skin with a dressing after giving it a good clean.

Blister Plasters

Your feet are likely going to be vital on your expedition and keeping them healthy is critical. Ensuring you wash your feet every day will help, while blister plasters can be perfect for placing over hot spots. Make sure your boots are well worn to try and stop this happening in the first place.

Women’s Hygiene

Expedition-related stress can play havoc with a woman’s menstrual cycle and menstrual bleeding can happen at any time. Make sure you have some products just in case or consider speaking to your GP about short term hormonal contraceptives to delay your period until after the expedition.

Antibiotics

Consider taking 1-2 courses of oral antibiotics with you on a trip to cover common infections in the chest, skin, and stomach. What you take will largely depend on the geographical location and needs to take in to account any allergies you or the team may have; take advice before travelling.

Painkillers

Multiday expeditions are likely to take its toll on the feet and joints, and it’s a good idea to have a variety of pain killers to hand. Paracetamol is suitable for dull aches and pains, while codeine can be very useful for more severe pain. Ibuprofen has useful anti-inflammatory properties.

Sterile water

Cleaning a wound is only as good as the water you are cleaning it with. Try to use fresh running water or even better carry some sachets sterile water with you.

A selection of meds in the Secret Compass store room, ready for any expedition
Packed and ready to go, this is how an en expedition medical kit might look

Sutures/Steri-strips

Sutures (if somebody knows how to use them) or alternatively steri-strips are great for keeping those small wounds closed, allowing them to heal. Just make sure all cuts are thoroughly cleaned before using them.

Scissors

Cooking, shelter buildings, repairs, and first aid: good scissors can be used for many things on an expedition.

Tape

Like scissors, tape is perfect for multipurpose use. From repairing a tent, to putting the finishing touches to a bandage, or even taping feet to prevent blisters.

Diarrhoea relief 

There’s almost nothing worse than starting with diarrhoea in the hours before summit night – trust me. Anti-diarrhoea tablets such as Immodium could be the differencing between succeeding or staying at base camp.

Laxatives

Altitude and a change in diet can play havoc with your bowels one way or another. Days of not being able to go to the toilet can leave you feeling bloated, uncomfortable and can affect your sleep. Laxatives sort this out.

Anti-sickness

It might be something you’ve eaten or simply the effects of altitude: nausea and vomiting can be debilitating. At best it is uncomfortable, and at worse can leave you severely dehydrated.  There are some great anti-sickness medications available that work by dissolving on your gums.

SPF Sun Screen

Surnburn can cause serious problems on an expedition. Ensure you have enough SPF 30+ (ideally SPF 50) to prevent UVB damage.

Electrolytes & Rehydration Sachets

When in hot environments or working hard we sweat out both water and a whole variety of salts and electrolytes. Therefore it isn’t sufficient enough to replace this fluid by merely drinking water. Electrolyte sachets can replace what’s lost from sweating, vomiting or diarrhoea, keeping our salt and mineral levels stable.

Water Sterilisation Tablets

If your drinking water is not safe and clean, then you’re going to end up in a much worse position, potentially putting your expedition (and life) at risk. Make sure to treat all water adequately, and take your water from a fast running water source.

The full version of this article first appeared in BASE magazine issue #03. To find the complete article and read the rest of the magazine, subscribe online.



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