Wilderness and Rescue Medicine 7th Edition Jeffrey Isaac, PA-C and David E. Johnson, MD

Seventh EDITION Wilderness and Rescue MEDICINE Jeffrey Isaac, PA-C David E. Johnson, MD Wilderness Medical Associates International

Wilderness Medical Associates International 1 Forest Avenue

Portland, ME 04101 www.wildmed.com

Copyright © 2019 by Wilderness Medical Associates International. All rights reserved. No part of the material protected by this copyright notice may be reproduced or utilized in any form, electronic or mechanical, including photocopying, record- ing, or by any information storage and retrieval system, without written permission from the copyright owner. Wilderness and Rescue Medicine, Seventh Edition is an independent publication and has not been authorized, sponsored, or otherwise approved by the owners of the trademarks or service marks referenced in this product. The procedures and protocols in this book are based on the most current recommendations of responsible medical sources. Wilderness Medical Associates International makes no guarantee as to, and assumes no responsibility for, the correctness, sufficiency, or completeness of all such information or recommendations. Other or additional safety measures may be required under particular circumstances. This textbook is intended solely as a guide to the appropriate procedures to be employed when rendering emergency care to the sick and injured. It is not intended as a statement of the standards of care required in any particular situation, because circumstances and the patient’s physical condition can vary widely from one emergency to another. Nor is it intended that this textbook shall in any way advise emergency personnel concerning legal authority to perform the activities or procedures discussed. Such local determinations should be made only with the aid of legal counsel. Some images in this book feature people posed to illustrate a point or technique, or people whose image is captured in a public domain photograph. These people do not necessarily endorse or represent WMAI or the authors of this book. Additional illustration and photographic credits appear on page 268, which constitutes a continuation of the copyright page. Library of Congress Cataloging-in-Publication Data Isaac, Jeff. Wilderness and rescue medicine / Jeffrey Isaac, David E. Johnson.—7th ed. p. ; cm. Includes bibliographical references and index. ISBN: 978-0-9834300-8-7 1. Outdoor medical emergencies. 2. First aid in illness and injury. I. Johnson, David E., M.D. II. Title. [DNLM: 1. First Aid— methods. 2. Emergency Treatment—methods. 3. Rescue Work—methods. WA 292] RC88.9.O95I83 2012 617.1’0262—dc23 2011025588 6048 Printed in the United States of America 16 15 14 13 12 10 9 8 7 6 5 4 3 2 Production Credits Cover Image: Josh Kling Printing and Binding: J.S. McCarthy Printers Cover Printing: J.S. McCarthy Printers Designed and Edited by: Laura Lee