Ma and Pa Medical Section. Overview

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1 Ma and Pa Medical Section Overview Medical Issues Health and safety are essential to a successful trek experience. Please pay special attention to the following information and instructions: Medical Specialists Each trek group is required to have emergency healthcare professionals with them throughout the Trek; specifically: a minimum of two medical personnel (doctor, registered nurse or EMT) for the first hundred participants and one for each additional 100 people. The medical staff will be prepared with all the necessary medical equipment, medicine, shelter, transportation, release forms and communication needed to handle any medical emergencies. Medical Information During the registration process, each participant will be required to complete a personal medical information form which includes any special medical conditions or medication needs. That information is held by the medical specialists for reference. Medical information about each youth assigned to your trek family, will be given to you before the trek so you can be advised ahead of time of any unique medical situations. First Aid Kits You should provide a basic first aid kit as part of your family equipment. Carrying container / bag (to hold your first aid kit) Bandage scissors A few alcohol swabs (or alcohol wipes) A few pieces of moleskin A few bandaids A few sterile gauze (2x2 inch) A few sterile non-stick pads ( telfa pad or generic) Tape Tweezers (with a fine tip) Small container of Vaseline Neosporin Ointment (generic is triple antibiotic ointment) Consecrated oil used by the Priesthood Ibuprofen Medicines The medical staff will have the following medicines if needed (we are providing these): Benadryl (generic is diphenhydramine) Imodium (generic is loperamide) Tylenol (generic is acetaminophen) Acid Controller (Tums or antacid) Anxiety medicines Severe allergy medicines Hay fever medicines Antibiotics Other medicines as needed

2 Water Use and Guidelines Only drink water that is provided for you on the handcarts and at the designated drinking water spigots on the trail and the campground. Never drink rainwater, stream water, lake water, pond water or water from puddles or creeks. Serious sickness can occur from drinking impure water. Giardia is a common parasite found in impure water; it can cause flulike symptoms and cramps. Dehydration This is one of the most commonly encountered medical issues along the trail. Each handcart should carry 5 gallons of Gatorade and 5 gallons of water and have the opportunity to refill as necessary. It is important for the whole train of carts to stop frequently for water breaks. This is particularly important for the young women. They don't seem to want to drink enough water. Watch for signs of dehydration. (If you are thirsty you are already dehydrated). Drink enough water to avoid dehydration. Dehydration and heat exhaustion often go hand-in-hand, so make sure water goes inside the body, but also keep the outside body cooled down with wet bandanas around the neck and/or by using a spray bottle. Food The stake will provide all water, gatorade, meals, and snacks. Please do not feel that you need to bring any food or drinks. The medical staff will carry extra energy foods such as trail mix, nutrition bars, or similar food items for participants who appear to be overly stressed because they are hungry. Prevention Prevent Dehydration: Drink to prevent thirst, not to quench it. It is important to have plenty of water, Gatorade, or the equivalent. The goal is to not have any medical interventions (IV Fluid Rehydration). The trail boss will stop the group periodically for water breaks. When it is really hot, groups may refill their water jugs (5 gallon containers) two to three times during the day. Spray bottles are a good way to help participants cool off. Avoid carbonated, caffeinated, and highly sweetened drinks. Adequate water will be available to trek participants at points along the trail and in camping areas. All participants should bring a personal water container (bottle) to constantly refill during the trek, even refilling many times each day. Diet: The trek experience is physically challenging. Trek participants need nutritious, well balanced meals and snacks to maintain strength. Fasting during the trek is not recommended. This will help prevent dehydration. Proper Clothing: Pioneer style clothing is good for more than one reason - it helps set the mood and provides protection. First, make sure that the trek clothing is appropriate for the weather conditions that your group might face. Generally, groups are encouraged to wear cotton (or cotton-polyester blends) fabrics. Lightweight, long-sleeved blouses and mid-calf to boot-length skirts with bloomers underneath for modesty are suggested for the girls. Light-weight, long-sleeved shirts and pants that are comfortable and loose fitting are recommended for the boys. Shoes should be walking/hiking type shoes (good sturdy styles) that are well broken in. It is suggested that trekkers wear appropriate socks as well. (For good shoes and socks refer to the additional handout available on the stake website). This can help to reduce the likelihood of blisters. Large brimmed hats and sunbonnets help protect from sun and insects. This

3 prevents excessive sweating which can lead to dehydration if not properly managed through drinking plenty of water. Remember to have participants drink even when they are not pulling handcarts. If you suspect severe dehydration, please see the medical team Prevent Trail Sickness: Avoid physical exhaustion and dehydration. Symptoms include headache pain, flu-like symptoms, dizziness, depression and fatigue. Drink water throughout the day and if it is hot, make sure everyone gets some Gatorade. Prevent Blisters: Blisters can ruin the trek experience for some people. It is important that individual trek participants, take preventative measures to make sure their feet are adequately protected. Pre-trek hikes are the best prevention for tougher feet and fewer blisters. Remember to bring plenty of extra socks to change daily and if socks get wet. Do not allow trekkers in your group to walk with wet socks or wet shoes, as blisters will form easily under these conditions. If you feel a hot spot forming on your foot, stop right away and treat it before it becomes a blister. See treatment below in the first-aid section. It is a good idea to have a daily foot inspection to identify blisters and see that they are treated. Prevent Chafing: Decrease the amount of friction to skin. Stay dry. Wet skin can make chafing worse. Can apply talcum and alum powders to areas that get the sweatiest. Powders can help wick moisture away from the skin. Change out of wet or sweaty clothes. Lubricate. Apply petroleum jelly, body glide, or a similar product, to hot spots. To reduce nipple chafing, petroleum jelly, patches, or tape can be placed on nipples to reduce friction. Dress right. (See proper clothing above). Compression shorts, such as those worn by cyclists, may help reduce thigh chafing and could be worn under Trek clothing. Lastly, choose exercise garments and bras that have smooth seams to avoid rubbing. Prevent Sunburns: Use Sunscreen! Encourage the youth in your group to reapply every two hours. Wear long sleeves and hats. Prevent Ticks or Bug Bites: Use a repellent with DEET (on skin or clothing) and/or permethrin (on clothing and gear). Repellent containing 20% DEET can be applied to skin and can protect up to seven hours. Do not get repellent in eyes or mouth. May use permethrin to treat boots, clothing and camping gear. Perform daily tick checks. Have a partner check your back and hair. Places to look include under arms and in and around ears, waist band including belly button, back of knees, in and around all head and body hair, between the legs. Check your clothing and gear for ticks (and spiders). Remove any that may be found. Wear long pants/long sleeved shirts and tuck shirt into pants and tuck pants into socks. Wear light-colored clothes to make it easier to detect and remove ticks. Mosquito bites can also cause serious illness such as West Nile Virus. Prevent bites from mosquitos by applying insect repellent. Prevent Spider Bites: Wear long pants and sleeves. Use insect repellent. Be careful where you place your hands. Bite happen often while sleeping so check your sleeping bag prior to getting in it. Roll it up tight after using to prevent insects from getting in. Prevent Snake Bites: Encourage all participants to stay on the main trail and do not allow them to wander off. If you see a snake, remain calm and do not panic. Stay at least five feet from the snake. Give the snake plenty of space. Back up slowly and look for alternate route. Do not try to harass as this increases the chance the snake will bite you. Usually, the snake is simply moving through the area, sunning itself or looking for a place to hide. If you leave the snake alone, it will leave you alone. Alert

4 people to the snake's location. Advise them to use caution and to respect the snake. Rocky, talus slopes are the places where you'll most likely encounter rattlesnakes. A snake's camouflage allows it to blend into its surroundings. They're tough to see. Watch where you step and watch where you place your hands when you sit down. Pay attention in brush, wood piles, and rocks. Prevent Allergies: Ensure medical team is aware of any severe allergies. Communicate with food team if needed for severe food allergies. Those with seasonal allergies should be taking prescribed medications daily such as Loratadine, Allegra or Zyrtec as prevention. Prevent Heatstroke: Stay hydrated and rest if needed. Heatstroke may be caused by strenuous activity in the heat or by being in a hot place for too long. Heatstroke can occur without any previous heat-related condition, such as heat exhaustion. Heatstroke signs and symptoms include: Changes in mental status or behavior, (confusion, agitation, slurred speech) Hot, dry skin or heavy sweating Flushed skin Rapid breathing Nausea and vomiting Rapid pulse Headache Fainting, which may be the first sign in older adults Fever of 104 F (40 C) or greater Prevent Heat Exhaustion: Stay hydrated and rest if needed. Symptoms range in severity from mild heat cramps to heat exhaustion to potentially life-threatening heatstroke. Heat exhaustion can begin suddenly, usually after working or playing in the heat, perspiring heavily or being dehydrated. Heat exhaustion signs and symptoms include: Faintness or dizziness Heavy sweating often accompanied by cold, clammy skin Weak, rapid pulse Muscle cramps Nausea or vomiting Headache Pale or flushed face Weakness or fatigue Prevent Hypothermia: Be prepared for cold temperatures and wet conditions. It can get cold in the middle of the night when temperatures cool in the desert. Make sure that each participant knows to bring some warm clothing for sleeping, including a lightweight beanie to cover their head. Hypothermia is often caused by exposure to cold weather or immersion in a cold body of water. Increased risk person is also exhausted or dehydrated. Signs and symptoms of hypothermia usually develop slowly and may include: Shivering, though this may stop as body temperature drops Slurred speech or mumbling Clumsiness or lack of coordination Confusion or memory loss Weak pulse Slow, shallow breathing Drowsiness or very low energy Loss of consciousness

5 First Aid Treatment We are recommending that all Mas and Pas treat minor injuries themselves, so that the medical team does not become overloaded with injuries/medical conditions. The following sections describe simple first aid treatment that you can perform yourself. The sections also describe what should be referred to the medical staff and when to know it s something to refer. With all conditions, if you feel uncomfortable with the issue, or if you have any questions, either large or small, please refer to the medical staff. That s why they re on the trek. Our goal is to allow the medical staff to be available for all moderate and serious injuries and not be burdened with too many minor issues. Blisters Treatment: Small Blisters (small in size or blisters with very little fluid) Cover with moleskin, padding, or other dressing. Apply Vaseline or other friction reducing salve over the dressing. It is not necessary to open small blisters. If they open on their own, wash with soap and water (or use alcohol wipe) and cover with clean bandage. Medium - Large Blisters These are best referred to the medical staff. If you want to treat yourself, wipe area with alcohol and sterilize a pin (or use a sterile needle). Prick the blister near the edge and press out the liquid. Protect the wound from pressure and keep it clean with a sterile bandage. Some bandages need to be wrapped around the appendage if it will move with walking. Chafing Treatment: Gently clean the chafed area with water and dry it thoroughly. After cleaning the area, apply a substance like petroleum jelly. If the area is very painful, swollen, bleeding, or crusted, Trek Medical team may recommend a medicated ointment. Give your skin some time to heal from chafing before being active again if possible. Continued friction will only make it worse so stop the friction areas. Clean skin and pat dry or allow to air dry. Apply a thin layer of Vaseline or lubricant or Calmoseptine ointment to reddened or irritated skin 2-4 times daily. Antibiotic ointment may be needed if the area becomes infected. If you have any participant with a questionable chafing condition, refer to the medical staff. Sunburn Treatment: If any skin reddening starts to happen, cover the area immediately. Cool area with cold, damp towel on skin for minutes a few times every day. Gently pat dry and slather a moisturizing cream or lotion that contains aloe vera or soy to soothe the skin. Severe burns may use hydrocortisone cream to the area for a couple days. Drink extra water and juice and watch for signs of dehydration. Ibuprofen may be taken for discomfort and to decrease swelling. Do not pop any blisters that may form. Wear clothing that covers and protects any sunburned areas while it heals. For mild sunburns, use the above treatment. For moderate to severe sunburns, consult the medical staff. Splinter Treatment: Wash your hands and the skin around the splinter thoroughly with warm water. You can disinfect the affected area with soap and water or use an antibacterial wash. Disinfect tweezers or needles with alcohol. If available, use a magnifying glass and good lighting. Using the needle, break and lift the skin flap that rests over the splinter. This can help you more easily grab the splinter and remove it more quickly. Once you ve exposed the splinter s tip, grasp it with your tweezers. Gently pull out the splinter at the same angle that it entered the skin. If the tip of the splinter breaks off, you may need to try re-grasping it with tweezers. Remove splinters that entered the skin horizontally and are fully exposed by opening the skin with a sterile needle and flicking it out. Allow area to bleed a little then wash area again with soap and water and apply bandage. Allergies/Allergic Reaction Treatment: Mild seasonal allergies treat with OTC Benadryl, Claritin, Allegra or Zyrtec (or generics of these medicines). For severe allergies contact the medical team.

6 Treatment of Cuts: Small cuts - Wash with soap and water. Apply clean bandage for pressure and to stop bleeding. Apply a small amount of antibiotic ointment. Apply a sterile non-stick pad with tape or wrap with bandage. Large Cuts- Apply direct pressure with clean bandage to stop any immediate bleeding and see medical team immediately. Puncture Wound Treatment: A puncture wound doesn't usually cause excessive bleeding. Often the wound seems to close almost instantly. But this doesn't mean treatment isn't necessary. A puncture wound such as from stepping on a nail can be dangerous because of the risk of infection. Wash your hands. Stop the bleeding. Apply gentle pressure with a bandage or clean cloth. Clean the wound. If dirt or debris remains in the wound after washing, use tweezers cleaned with alcohol to remove the particles. If debris still remains, see the medical staff. Apply an antibiotic cream. Cover the wound. Bandages can help keep the wound clean and keep harmful bacteria out. Change the dressing. Do this at least once a day or whenever the bandage becomes wet or dirty.watch for signs of infection. See a medical team if the wound won t stop bleeding after a few minutes of direct pressure, isn't healing, or has any redness, increasing pain, drainage, warmth or swelling. Let the medical know of anything bigger than a puncture wound. Foreign Object in Eye Treatment: Wash your hands with soap and water. Seat the person in a welllighted area. Gently examine the eye to find the object. Pull the lower lid down and ask the person to look up. Then hold the upper lid while the person looks down. Try to flush the object out of eye with a gentle stream of clean, warm water. If this doesn t work, then call the medical team. Nosebleed Treatment: Lean the person forward and have them pinch the nose (5-10 minutes). If more than 20 minutes have passed and nose is still bleeding, blow nose then start pressure again. You may apply a nasal decongestant (Affrin Nasal Spray) and a cotton ball and gently place it up the nose to constrict the vessels. Have the cotton ball remain in place for 20 minutes before removing. Avoid using the much older method of tilting the head backwards. This has been found to the opposite of what is needed. If the nose continues to bleed after all of these treatments, call the medical team. Diarrhea Treatment: Drink lots of fluids. Eat a light diet such as the BRAT diet if available (bananas, rice, apple sauce, and toast). Consider Gatorade if necessary. Anti-diarrhea medication such as Imodium (generic is Loperamide) or Lomotil (generic is diphenoxylate / atropine) may be considered for those without a fever or bloody/mucus diarrhea. Pepto-Bismol may also be tried. Do not give Pepto-Bismol to children or teenagers ages years who may have the flu or chickenpox due to risk of Reye syndrome. Refer to medical team if any questions. Tick Removal Treatment: Smaller Ticks - Scrape the tick with blade or credit card edge, being careful not to cut yourself. Remove an attached tick with fine-tipped tweezers as soon as it is noticed. Clean the area around the bite, and use a sterile needle to carefully lift or scrape the head from the skin. Wash the wound & your hands with soap & water after removing a tick. Apply antibiotic ointment to help reduce the chance of tick disease or infection. Watch for rash or illness over the next few weeks after a tick removal. ** If the head accidently breaks off and remains in skin, refer to the medical staff. Larger Ticks Refer to the medical staff. Spider Bite Treatment: Lie down and rest if needed. Keep calm. Keep bite below heart if suspect poisonous. Remove constricting watches, clothing or jewelry as the area may swell.treat for shock if needed. (Allergic reaction can happen). Contact the medical team immediately if you suspect a black

7 widow bite or an allergy to bees. (Black Widow bite typically won t kill you, just make you very sick, Brown recluse/hobo may cause skin destruction). If the spider is found, bring it with you to the medical team. Bee Sting Treatment: See the medical team. If the medical team isn t immediately available, try and remove the stinger as quickly as possible without regard to method. Snake Bite Treatment: Call medical team immediately. Lie down and rest. Keep calm and quiet. Heat Exhaustion Treatment: Move the person out of the heat and into a shady or air-conditioned place. Lay the person down and elevate the legs and feet slightly. Remove tight or heavy clothing. Have the person drink cool water or Gatorade. Cool the person by spraying or sponging with cool water and fanning. Monitor the person carefully. Alert the medical staff. Heat Stroke Treatment: Alert the medical staff immediately. Move the person out of the heat and cool him or her by whatever means available, for example: Sponge with cool water, fan while misting with cool water, place ice packs or cool wet towels on the neck, armpits and groin, cover with cool damp sheets. Let the person drink cool water or other beverage without caffeine, if he or she is able. Hypothermia Treatment: Contact the medical team immediately. Gently move the person out of the cold. If going indoors isn't possible, protect the person from the wind, especially around the neck and head. Insulate the individual from the cold ground. Gently remove wet clothing. Replace wet clothes with warm, dry coats or blankets. If further warming is needed, do so gradually. Offer the person warm drinks. Hyperventilation (Panic Attack) Treatment: Hyperventilation is excessive breathing, normally caused by extreme anxiety, and can happen at the same time as a panic attack. Reassure the person and calm them to help reduce anxiety. Have the person sit down and try these strategies: Breathe through pursed lips as if blowing out a candle. Cover the mouth and one nostril and breathe only through the other nostril. Breathe slowly, taking 1 breath every 5 seconds. Take deep, slow breaths from the abdomen ("belly breathing"). Breathe into a paper bag. Call medical team if: 1. The person's symptoms don't get better after several minutes, symptoms get worse or the person is in pain. (i.e. Chest pain, including pain that is crushing, squeezing, feels like a heavy weight on the chest, or is sharp and stabbing, especially if it is worse with deep breaths.) 2. Difficulty breathing. 3. Racing heartbeat. 4. Fevers or chills.

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