Third-degree, or full-thickness burns, are the most serious, resulting from contact with hot liquids or solids, flame, chemicals, or electricity. The skin becomes dry and leathery; charred blood vessels are often visible. The skin is a mixture of colors: white (waxy- pearly), dark (khaki-mahogany), and charred. The patient feels little or no pain, because the nerve endings have been destroyed. Hair pulls out easily with no pain. The burn extends through all dermal layers and can involve subcutaneous layers, muscles, organs, and bone. Third-degree burns are considered minor if they occur on less than 2 percent of the body surface. Moderate burns involve 2 to 10 per- cent of the body surface. Third-degree burns are classified as critical if they occur on more than 10 percent of the total body surface, if there is any involvement of the face, hands, feet, or genital area, or if the burns are caused by chemicals or electricity. Third-degree burns that cover large areas usually require skin grafting and take months or years to heal completely; small areas require weeks.

Second-degree burns result from contact with hot liquids or solids, flash or fame contact with clothing, direct fame from fires, and contact with chemical substances. The skin appears moist and mottled, and it ranges in color from white to cherry red. The burned area is extremely painful. The epidermis and dermal layers of skin are usually burned, and damage may result to some fat domes of the subcutaneous (fatty tissue lust under the skin) layer. Second-degree burns are considered minor if they involve less than 15 percent of the body surface in adults and less than 10 percent in children. Fifteen to 30 percent of adult body surface and 10 to 20 percent of a child's body surface indicates a moderate second degree burn. The burn is also considered moderate if it involves the face, hands, feet, or genital area. A second-degree burn is considered critical if it involves more than 30 percent of the total body surface in an adult and 20 percent in a child. Healing of a minor second-degree burn usually requires five to twenty-one days. If infection occurs, healing time is extended to over thirty-five days, and the burn is con- sidered third-degree.

First-degree burns are caused by a flash, a flame, or the sun. They are the most common and the most minor of all burns. The skin surface is dry; no blisters or swelling occur. The skin is reddened and extremely painful, but the epidermal layer is the only one affected. First-degree burns heal in two to five days with no scarring. Peeling of the outer epidermal layer usually occurs, and some temporary discoloration may result.

Cricothyrotomy consists of the insertion of a knife through the cricothyroid membrane. A horizontal incision of less than one-half inch is usually performed. The handle of the knife is inserted into the incision and rotated 90" to maintain the patency of the opening, but it is usually necessary to insert a tubular device such as a small leg, 4 mm internal diameter) endotracheal tube or metal cannula. This may be attached to a bag-valve or other such device for providing positive-pressure ventilation with high oxygen concentrations. This should only be performed by a trained & qualified person.

• Look for the signs of respiratory distress, which include: • Nasal flaring: the nostrils open wide during inhalation. • Tracheal tugging: the Adam's apple is pulled upward during inhalation. • Retraction of intercostals muscles (those between the ribs) during inhalation. • Use of the diaphragm and neck muscles to assist in inhalation. • Use of the abdominal muscles during exhalation. • Cyanosis (bluish discoloration of the skin and mucous membranes). • And Hands grasping at the throat & Neck (classic)

because we are warm-blooded animals, our bodies perform best when we maintain 98.6°. However if it is hot outside, then it is difficult for our bodies to keep that temperature. People who are prone to getting hot easily are subject to a number of problems. • You should always drink plenty of water because as your temperature rises, you will begin to lose water and could become dehydrated. • Wear good protective clothing such as a hat; a thin, light-colored, long-sleeve shirt; and a pair of pants. These items will offer you more protection than shorts and a t-shirt.

Prevention of exhaustion involves a lot of common sense. • First and foremost, know your limits. • It helps to be in shape and use your fuel efficiently. That's where conditioning comes in. • Be prepared with the right clothing and equipment. • Continue to fuel up the entire time that you are exercising. • Choose foods with sugar for quick energy and carbohydrates for a more sustained fuel source. • Water is also necessary for expending any energy and prevents dehydration.

if you're planning for a long hike you'd better take the moleskin along. Because no matter how careful you are, chances are you will get a blister. With good preparation, blisters can be easily remedied or avoided so that you can continue to enjoy your hike in the great outdoors. • When a blister does occur, cut a piece of moleskin that is large enough to cover the blister evenly on all sides by at least a quarter of an inch. • Then cut a small hole in the middle to make room to expose the blister. • Make sure you've got clean socks.

The most common serious illness related to altitude is high altitude pulmonary edema (HAPE). This condition is excess fluid in the lungs caused by ascending elevation too quickly. HAPE is the number-one cause of high-altitude deaths. One of the first signs you may notice is shortness of breath. But for the type of hiking that most of us are doing, deaths are rare. If you think you or your companions are experiencing altitude sickness, the best cure is simply to descend elevation.

220 minus your age (30) = 190 Minus your resting heart rate (62 beats per minute) = 128 multiply by 60% = 76.8 Add resting heart rate = 138.8 Divide by 6 = 23 (beats every 10 seconds)

Cardiovascular fitness can ultimately improve your ability to complete a long hike. This fitness is the ability of your heart and lungs to maintain movement over a sustained period of time at a certain level of intensity. If you can comfortably carry on a conversation, then you are probably working at the right intensity. If you can sing a song, then you are probably not working hard enough. And if you are gasping for air, then you are probably working too hard. To regulate your heart rate more accurately, you'll need to find your target heart rate. Once you know this, then you can determine how hard your heart is really working.

Ticks can be rather unpleasant on their own, but Lyme disease can make you hate them even more. Although cases of Lyme disease have risen, the condition is still very rare. If you are bitten by a tick, wait for signs of a fever or rash within four weeks of when you were bitten. Your physician can administer a blood test in order to make a definite diagnosis.

Walking outdoors is much more dangerous than walking on a sidewalk. The ground is usually uneven and covered with rocks, roots and puddles. Sprains and fractures are the most common injuries encountered in the outdoors. Prevention comes down to being careful and wearing boots with some ankle support. If a sprain occurs, do whatever you can to keep the area from moving. Remember RICE: R est I ce C ompression E levation If you don't feel better after a few days there is probably something more serious going on and you should see your physician.

• First and foremost, don't panic. • One of the best methods is an extractor you can buy at an outdoors store. • Select the right sized suction cup, attach it to the syringe, then put it over the bite with the plunger fully extended. • Push the plunger in as it begins to suck to your skin. • Leave it there for about five minutes and then remove the plunger. • Wipe any venom away. • Keep the injured part at the same level or below the rest of the body.

Here are some general guidelines to follow when putting your medical kit together. • Various band-aids, gauze and medical tape. • SAM Splint for sprains and fractures. • Elastic bandage or ACE bandage. • Bring extra medication in case your hike goes longer than expected.

• Poison ivy and poison oak symptoms can range from an itchy rash to overall body hives. • Mild cases will have an itchy rash with blisters and sometimes get a little crusty. • Keep the area clean with soap and water. • You should probably also treat it with cortisone cream and Benadryl to prevent itching. • If your case is more serious you should seek your physician for treatment.

Clean water is essential for good health. But in the outdoors safe water may not be so easy to come by. Three ways to make it safe are: • Boil it: This will kill any germ or virus. • Filtration: Filters are convenient and easy to use. • Chemical Treatment: Tablets and drops can be added.

a long hiking trip is just that: walking for a very long time in the outdoors. And that is, in fact, the best way to train for it. • Seek opportunities to walk such as going to the store, taking the dog for a walk, or spending some time with a friend. • Try taking the stairs instead of the elevator. This is great work to prepare for any climbing you may do on your trip. Keep in mind that the better condition you are in, the better you'll feel, and therefore the more fun you'll have.

Hypothermia is not an illness that strikes only mountaineers. Some people can become sick from hypothermia in temperatures in the low 50s. Prevention is the best medicine. • Wear a synthetic pile or wool sweater. These materials keep you warm even when wet. In addition, the synthetic materials dry very quickly. • The worst material is cotton, which loses all of its warmth when wet. • If wind or rain is a factor, make sure to bring a shell along. • And if you expect temperatures below 40 or so, you should probably consider taking a down parka with you.