M. W. D. Forgey - Wilderness Medicine: Beyond First Aid

William W. Forgey, MD, FAWM, CCHP-P, CTH , was elected a Fellow of the Explorers Club in 1975 and is a Fellow of the Academy of Wilderness Medicine. He holds a Certified Correctional Health Care ProfessionalPhysician ranking by the National Commission on Correctional Health Care, and was awarded the Certificate in Travel Health by the International Society of Travel Medicine. He is a volunteer Clinical Professor of Family Medicine, Indiana University School of Medicine, a National Committee member of the Boy Scouts of America, and a member of the Scientific Advisory Committee and member of the Board of Directors of the International Association for Medical Assistance to Travellers. He is the chairman of the BSA Wilderness First Aid Task Force.

He is the author of Basic Illustrated Wilderness First Aid (2016), Campfire Stories (second edition; 2011), Campfire Tales (third edition; 2011), Basic Essentials Wilderness First Aid (second edition; 2007), all published by FalconGuides, Globe Pequot. He has authored over thirty books. This is the seventh edition of Wilderness Medicine, which has been in continuous print since 1979 and has sold over 150,000 copies.

Dr. Forgey is a past president of the Wilderness Medical Society, and is currently the chairman of the Global Health Committee for the society (www.wms.org). He is currently the advisor of Medical Student Missions (www.medicalstudentmissions.org), and has lead over thirty medical service projects with lay and professional volunteers to rural Haiti. Persons wishing to contact Dr. Forgey may do so through either of the above websites.

FALCON

An imprint of Globe Pequot

Falcon and FalconGuides are registered trademarks of Rowman & Littlefield.

Distributed by NATIONAL BOOK NETWORK

Copyright 1979, 1985, 1989, 1994, 2000, 2012, 2017 by William W. Forgey, M.D.

Illustrations by Robert L. Prince

All rights reserved. No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without written permission from the publisher, except by a reviewer who may quote passages in a review.

British Library Cataloguing-in-Publication Information available

Library of Congress Cataloging-in-Publication Data available

ISBN 978-1-4930-2718-7 (paperback)
ISBN 978-1-4930-2719-4 (e-book)

The author and Rowman & Littlefield assume no liability for accidents happening to, or injuries sustained by, readers who engage in the activities described in this book.

This book is dedicated to my good friend and fellow wilderness medicine colleague, Buck Tilton.
He always carries the banner high and leads the way.

This book would not have been possible without the participation of many adventurers on numerous expeditions that I was part of organizing, especially the young men who lived for months at a time in the small cabin we built in northern Manitoba, near Churchill, in 1974. I especially thank Greg Filter and Jim Ross for their one-year stay in 1978, David R. Scott and Scott E. Power for their 199192 expedition, and the many crews in between and afterward, which provided many additions to this book. I did not realize how diverse the problems were that could so easily befall the wilderness adventurer until I met these young men. Their stories are being recorded at www.forgey-cabin.com, which is dedicated to their participation in this experiential adventure.

This edition marks the thirty-eighth anniversary since the first publication of Wilderness Medicine in 1979. Recommended therapy in the first edition was based on a combination of field improvisation techniques and a modular first aid kit. The kit included multifunctional components to tailor it more readily to the nature of the trip being undertaken. Over the next several editions, changes in medical theory and treatment were revised, including the use of the initial, focused assessment as an entry to treatment protocols; updates on infectious diseases; totally redesigned modular medical kit systems; and the incorporation of those medical technological advances in various disciplines that affected wilderness medicine.

Medicine and its components are hardly static. The effects of change ripple rapidly into outdoor medicine. Consequently, one advantage this book has over any other in this field is the use of my website, www.adventure-media.com/wildernessmedicine7.html. At this site you can easily access color photographs and updated information concerning many subjects, such as poisonous reptiles or plants, infectious disease risk maps, and further sources of information for cross-referencing. Information about relevant training programs and sources for obtaining the medical supplies discussed in the book are also included. The updates available on the website will allow this edition of the book to be kept as current as possible. Finally, direct e-mail links to me and the other authorities who have agreed to be part of the site make us easy to reach.

Be sure to check out www.adventure-media.com/wildernessmedicine7.html often. Ill look forward to hearing from you.

This edition of Wilderness Medicine is based on the latest technology that applies to remote area medicine and delayed transport protocols. This includes the Practice Guidelines of the Wilderness Medical Society, published to date in the society journal Wilderness and Environmental Medicine, the Boy Scouts of America Wilderness First Aid Curriculum, 2017 (for which I am the national task force chairman), and the latest doctrine from Tactical Combat Casualty Care of the United States Department of Defense (see www.naemt.org/education/TCCC/guidelines_curriculum). My referencing this material and other websites in this book should indicate to the reader the importance of studying the subject of wilderness first aid and delayed transport protocols prior to heading into the bush or landing in a self-care situation.

This book has been written as a cookbook-type of guide on how to personally manage many significant medical conditions when you must rely on self-care. The hope of doing so adequately hinges on obtaining the best foundation possible prior to the event. This requires study, taking appropriate training courses relating to wilderness first aid, acquiring an appropriate first aid kit, and having a generous blessing of common sense.

William W. Forgey, MD, FAWM, CTH , CCHP-P
Volunteer Clinical Professor of Family Medicine
Indiana University School of Medicine
Crown Point, Indiana

There are four ways to rapidly identify where to find the information you need.

FIRST

A quick glance through the contents can lead you to the proper chapter and subject.

SECOND

The Initial Assessment (pages 35) and the Focused Assessment (pages 56) not only describe how to perform a physical examination and what to look for, but these sections also refer you to the page of the book that tells you what to do if something is wrong.

THIRD

Throughout the book various sections have diagnostic tables with references to further evaluate or explain treatment options. For problems that fall into these categories, you can refer directly to the tables indicated in the list below.

FOURTH

The Clinical Reference Index, starting on page 264, provides a comprehensive cross-reference between symptoms, conditions, and treatments. Subjects are listed using both medical jargon and vernacular descriptions.