BROKEN BONES
Anything can happen in the wilderness, including broken and fractured bones. And despite what you’ve seen in the movies, such injuries are not something a person with no medical training should tackle in the woods 

“The best thing to do, especially if you’re near a trail, is to wait for someone that can go for help,” said Dr. Jess Daniels, an emergency physician at Washington Regional Medical Center in Fayetteville. 

“If you do have to move the person, you can use a stick or tent pole [anything long and rigid] to splint the bone.” 

A splint of this nature can be improvised with pack straps or strips of clothing until it can be properly set by an orthopedic surgeon. The purpose of this is not to set the bone, but to prevent it from being jostled, which may cause further injury to surrounding muscles and nerves.

Daniels’ best precautionary advice is to travel with a companion and not to take unnecessary risks. He also recommends letting someone know the destination and expected whereabouts at all times during the trek. And under no circumstances should you go into the wild without a cell phone.

“Keep a cell phone with you,” Daniels said. “Even if you don’t have service, most phones include a built-in emergency signal.” —BH 

LOST

Jim Gifford, veteran outdoorsman and former Ouachita Mountain Hikers board member, has simple advice for any would-be hiker.

“Pay attention so you don’t get lost in the first place,” he said.

Don’t completely rely on GPS to get you through a hike. Gifford brings a printed map with him, even on trails he’s already hiked many times. He also said a good watch is important; knowing your pace can help you estimate how far on a map you’ve traveled.

Keeping sight of trailblazers, or “confidence markers,” is another way to know you’re still on the right path and provides reference points if you need to double back. The sun isn’t always a great helper with direction, especially when it’s directly overhead or, obviously, if the sky is cloudy. If you haven’t made it home before dark, the stars are a better directional tool. 

“If you know the Big Dipper, then you can find the North Star,” Gifford said. “The two stars farthest from the handle of the Big Dipper point to the North Star, which is the tip of the handle of the Little Dipper. The North Star is always due north.”

If you find yourself lost, use the map to navigate to landmarks. Look for highways and towns nearby or ridges and peaks where you can get some elevation, look out over the land and get your bearings. If you can spot a creek, follow its flow; it will probably lead to some sort of civilization. 

Visit the Arkansas Trails Council (arkansastrailscouncil.com) for maps. Sharpen your navigation skills via a group hike with Ouachita Mountain Hikers (omhikers.net). —SB

FALLS
Falling from a deer stand or while rock climbing is serious business, said Mike Hillis, emergency medicine physician at Mercy Hospital in Fort Smith and medical director at Sebastian County EMS and Rescue. The best cure for most outdoors-related medical emergencies is prevention, and that particularly applies here. 

Wear an appropriate and well-fitted climbing harness on the deer stand or the mountain and a helmet when rock climbing. It is better not to hunt or climb alone, but if you do, let someone know where you’ll be and when to send help if you don’t return. Remember to carry an adequate first-aid kit, preferably one that contains a tourniquet and SAM splint.

In the event of a fall, assess and stabilize the injured. Look for signs of bleeding and apply a pressure bandage to the area. If there is severe bleeding that could be life-threatening, apply a tourniquet. Check for deformities in the extremities. If deformities are noted, install a splint to avoid further injury to soft tissues, muscles or vessels. 

Falls resulting in extreme back pain, loss of feeling or movement in any extremities, unnatural or twisted neck or back positioning, impaired breathing or loss of bowel or bladder control could indicate a spinal cord injury. Spinal cord injury victims should not be moved. —LC

FOOD 
The Arkansas woods provide edible native plants to sustain you. But they’re home to plants that could kill you as well.  

Edible plants in Arkansas include clover, dandelion, chickweed, wild asparagus, redbud flowers, chicory, alfalfa, fireweed, wood sorrel, henbit, curly dock and wild black cherries (but not the pits). Even pine bark and most native grasses are edible. Plants to avoid include nightshade, rhododendron, wisteria, holly, dogwood and, of course, poison ivy.

The U.S. Army Survival Manual offers a universal edibility test that can help determine which plants are safe to consume in an emergency. Make sure your sample plant is free of insects or worms and separate it into parts: leaves, roots, stems and, if present, buds and flowers. Many plants have both edible and nonedible parts. 

First, crush different plant parts and rub on the inside of your wrist or elbow. Wait 15 minutes. If it produces a burning sensation, bumps or rash, it won’t be good to eat.

Next, try a taste test. Place a portion of the crushed parts in your mouth and wait 15 minutes. If you experience any burning, tingling or numbness, spit out the plant and rinse your mouth with water. 

If a plant passes these tests, chew your sample for 15 minutes without swallowing. If it passes the chew test, swallow and wait. Induce vomiting if nausea results. If it doesn’t, you’ve found a safe food source. —MC

CAPSIZED
Dealing with a capsize begins with proper preparation, the difference between a mishap and a tragedy. Wear your personal flotation device (life jacket). It doesn’t matter how well you can swim, anything can happen once you exit the boat. If the air and water temperatures combined are below 120° F, carry a change of clothes in a dry bag. 

Once flipped, try not to panic; capsizing happens all the time and it’s critical to remain calm. Remember nose and toes as both should be pointed toward the sky. Ensure your feet are downriver and your butt is as high in the water as possible. If you hit something midstream, take care not to lean upriver as that could cause your boat to fill with water and become pinned. 

Locate your boat. Is it above or below you? If above, take care to avoid being pinned between it and obstacles in the water, and if below, try to keep it in view. After you’ve assessed the situation (Am I OK? What’s just downriver that could make this worse? Is help coming?) begin swimming aggressively toward safety. It’s tempting to try and stand, but don’t do it until the water is no more than knee deep. Foot entrapment causes many river drownings every year. 

For more, visit arkansascanoeclub.com. —LC

FIRE
Lost or stranded in the wilderness, the ability to start a fire without a match is paramount. Marcal Young, scout executive for the Quapaw Area Council of Boy Scouts of America, shared tips from the BSA handbook on starting a fire by friction:

• Fashion a spindle, bow, hand block and fire block from dry, soft wood such as yucca, elm, red cedar, basswood or cottonwood, all found in Arkansas. In the edge of the fire board, whittle a V-shaped cut leading to a depression in the top of the board. 

• The spindle should be 12-18 inches long, rounded at one end and tapered at the other.

• Whittle a depression that will fit over the rounded end of the spindle and string your bow with a length of cord, shoestring or guyline.

• Gather dry, shredded bark for tinder. Place it under the notch in the fire board and kneel down with one foot on the board to keep it steady. Twist your bowstring tightly around the spindle once, then hold the spindle upright with the hand block. 

• Twirl the spindle with long strokes of the bow while maintaining pressure on the spindle with the hand block. Repeat until you get an ember and heavy smoke.

• Breathe gently into the tinder until you get a flame, then remove the fire board and add more small kindling. —MC

HYPOTHERMIA
Hypothermia, one of the most pervasive threats in the outdoors, is where the body loses heat faster than it can produce it. Symptoms begin with shivering and can quickly progress to slurred speech, shallow breathing, weak pulse, clumsiness, confusion and death.

If hypothermia sets in, first concentrate on maintaining a positive outlook, said Mike Hillis, emergency medicine physician at Mercy Hospital in Fort Smith and medical director at Sebastian County EMS and Rescue. If you’re unable to find a warm area to recover, at least seek shelter from the wind. Remove wet clothing. If you’re prepared with hot liquids, drink them, and apply hand warmers to the groin and armpit areas. 

Be prepared for cold weather conditions by wearing layers of wool, poly, fleece or Capilene clothing rather than cotton, which loses most of its insulating value when wet. Avoid alcohol consumption in cold weather as the feeling of warmth it provides comes from the dilation of superficial blood vessels, which actually increases heat loss. For other tips, see ozarksar.com. —LC

HEAT
Arkansas summers are brutal, and prolonged exposure to the sun and heat can be dangerous. Preparation goes a long way, including loose, breathable clothing to prevent heat from being trapped against the body. 

Initial signs of distress include cramps, nausea and/or muscle twitches. Heat exhaustion is typified by profuse sweating, nausea and pallor, perhaps accompanied by a headache, dizziness or lightheadedness. In addition to providing hydration, spray water on or fan the skin to provide additional airflow to accelerate evaporative cooling.

“Get to a shady area,” said Dr. Mark Wiggins of St. Bernards Medical Center in Jonesboro. ”If you’re hiking and there’s no immediate foliage available, it would be wise to generate something to get out of the direct sunlight.” 

Heat stroke (sometimes called sun stroke) is when the body’s ability to regulate heat has altogether collapsed. It is a true emergency. 

“That’s where you see the patient becoming confused, a little belligerent, or even uncooperative, and they may even be unconscious at that point,” Wiggins said. —BH

DESPERADOES

Brothers Wendell and Donnie Blankenship were on a backwoods trail in the Flatiron Wilderness of the Ouachita National Forest. Emerging from a trailhead at a primitive campsite, they suddenly met a couple of foul-tempered, pistol-packing men with a female companion. The trio seemed none too pleased to see the unexpected hikers. The armed campers grabbed nearby rifles and met the approaching hikers with queries as to their business there. The Blankenships attempted to explain they were out enjoying a beautiful day which only aggravated one of the gun-toting fellows, who kept complaining of a pounding headache.

Thinking fast, Donnie grabbed for his wallet, pausing mid-reach as the rifles turned his way. Moving more gently, he explained, “I’ve got BC Powders.” Guns lowered, he fetched one of the aspirin, handing it to the agitated gunman. His suffering antagonist knocked back the pain reliever and almost immediately, the atmosphere changed with the previously suspicious campers offering the newcomers a drink of cool water. Satisfied the hikers proved no threat to their hideout, the Blankenship brothers continued on their merry way. 

Only later did they learn of Chevie Kehoe and his sidekick Daniel Lewis Lee were on the lam for the suspected killing of gun dealer William Mueller, his wife and daughter just prior to the encounter in February 1995. —RL

GUNSHOT
Knowing how to help yourself or another person who has been injured by a bullet or buckshot is good practice if you plan to enjoy the outdoors during hunting season. 

“Gun safety is the first step in preventing these accidents, but even with every precaution, with hundreds of folks out there during hunting season, we do see many injuries,” said Dr. Sangeeth Samuel, medical director of the Emergency Department for Baptist Health Medical Center-Arkadelphia.

Taking time to learn CPR (heart.org/en/cpr) and Stop the Bleed techniques (bleedingcontrol.org) could save a life. While waiting for medical help to arrive, keep in mind the general rule of CPR and consider the ABCs—airway, breathing and circulation. 

“If the injury in any way affects the individual’s airway, this is the first step to help them. The ability to breathe is paramount. If there is anything impeding this, it needs to be addressed before anything else.”

Apply pressure and try to slow bleeding that’s visible. Internal bleeding may be present without any immediate outward signals, which is a big reason to seek medical attention as soon as possible. 

“Sometimes wounds that don’t look bad initially can have delayed and progressive symptoms. Delaying treatment could end up with poor outcomes,” Samuel said. “Obviously, any injury to the head and neck is very serious, but wounds to the torso, pelvis and even your legs can be deceiving. The damage caused internally may be a lot worse than the external wound would indicate.” —SB

SNAKE BITE
The Natural State has four species of venomous snakes: rattlesnake, copperhead, cottonmouth and coral snake. Dr. Lee Johnson, an emergency medical physician at Baptist Health Hospital in Fort Smith, said his emergency department will treat on average about 10 venomous snake bites per summer.

“Most snakes won’t seek you out to bite you, but they will if you step on them,” Johnson said.

Contrary to what you’ve seen in old Westerns, making an incision around a bite and sucking out the poison doesn’t do anything, nor does applying a tourniquet, immersing the bite area in ice or applying an electric shock. Most of what to do is of the common-sense variety, like getting away from the snake so as not to get bitten again, staying calm and not trying to capture the offending reptile. 

Hollywood also tells us snakebite means you have only minutes to live without anti-venom but that’s also not reality. Hiking back to the car (or at least to a cell signal) is generally OK, but take care not to get your heart rate up. 

In 20 years as a physician, Johnson has seen one case he considered life-threatening and that person recovered. But, he said, you still should take the matter seriously. 

“If you’re certain you’ve been bitten by a poisonous snake, 100 percent come to the emergency department,” said Johnson. —BH

BEARS
Bears rarely attack humans, but as long as people visit their habitat, encounters—and therefore attacks—are a possibility.

Here’s what you should know if you come across a bear in the wild, courtesy of the University of Arkansas Cooperative Extension Service:

• Stay calm and stand your ground. Try to intimidate the bear by shouting and making noise. If that doesn’t work, hit it with sticks or rocks. Don’t try to outrun a bear; it’s a race you won’t win.
• An encounter with a female and her cubs is an especially dangerous situation. Stand your ground and slowly back away without making direct eye contact. Never approach lone cubs. Turn around and head back the way you came.
• In the extremely unlikely event of an attack, fight back as aggressively as possible with any means available. Strike the bear in the eyes and snout.  
• Bear spray can help if applied at close range to the face or eyes, but when applied to clothes, tents or campsites it is not a deterrent. In fact, it has been proven to attract bears. —MC