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Wilderness Medicine

Winter wisdom can save lives

Madigan Public Affairs

Published: 02:43PM November 9th, 2017

301st Maneuver Enhancement Brigade

John Dorman, left, explains backcountry skiing safety, at the Joint Base Lewis-McChord Alpine Club basic alpine course at Mount Rainier National Park March 5.

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“I think people underestimate, they prepare for snow and cold but they don’t always think about the wet and how that can drastically affect how warm your clothes stay.”

Maj. (Dr.) Jillian Franklin

Madigan Army Medical Center, physician and wilderness medicine specialist

Winter is coming. And it can kill.

Being informed and prepared for the weather are the keys to enjoying winter in Washington, safely.

“We have had some injuries that have resulted in lost duty days, lost deployments, potentially a medical board,” said Maj. (Dr.) Jillian Franklin, Madigan Army Medical Center physician and wilderness medicine specialist.

Joint Base Lewis-McChord community members can increase their wilderness knowledge with the help of the Northwest Adventure Center on Lewis North.

This is the place for the JBLM adventurer to find information, classes, guided trips and equipment to get outdoors, prepared with knowledge, skills and the right gear for their chosen activity and level of expertise.

“Make sure if you are going to go on an adventure, you do it the right way,” said Robert Conrad, instructor at the NAC.

Both the NAC’s instructors and Madigan’s wilderness medicine specialists advise following the guidance contained in the 10 essentials list, which includes what to bring on winter adventures.

• Navigation — compass, map, and GPS.

• Sun protection — sunglasses, sunscreen, clothing (that covers arms and legs fully).

• Insulation — extra clothing for layering and survival during extended periods of exposure.

• Illumination — flashlight or headlamp and extra batteries.

• First-aid supplies — first-aid kit with bandages and dressings, cleanser and gloves.

• Fire — lighter or waterproof matches.

• Repair kit and tools — knife, tying, bonding or adhesive equipment.

• Nutrition — high protein, nutrient-rich foods that store well and do not require cooking.

• Hydration — extra water and skills and equipment to obtain and purify more water.

• Emergency shelter — reflective emergency blanket, some form of waterproof covering.

A detailed version of the list can be found widely online including on which provides information to help discover America’s public lands.

These items can be found at most sporting goods retailers. While items like insulation can be pricey, they don’t have to be.

Wool is a great insulator, but polyester holds heat well, too. Conrad advises people to get some workout clothes. Most are polyester and designed to wick moisture away from the body.

This is the failing of cotton — it is a negative insulator, which means it retains moisture and lowers the body’s core temperature. Maj. (Dr.) Owen McGrane, assistant chief of the Department of Emergency Medicine at Madigan and a wilderness medicine specialist put it bluntly, “Cotton kills.”

“I think people underestimate, they prepare for snow and cold but they don’t always think about the wet and how that can drastically affect how warm your clothes stay,” Franklin said.

Another point to keep in mind is that, according to wilderness medicine, within a mile of help is a first-aid situation, and farther is considered a wilderness setting. Even a mile away from help can add a significant amount of time between injury, illness or exposure and response. This makes having gear to sustain life vital.

The 10 essentials can all fit in a small backpack which can live in a vehicle when not in use and be packed along a hiking trail easily.

Adding to these basic items as the amount and complexity of activity increases is a reasonable expectation.

“As soon as you increase that level of risk, you need to financially meet that level with safety,” Conrad said.

An avalanche beacon is one example of an item that is not in every basic pack, but should be considered once the degree of adventure rises.

According to AdventureMed which manages the Advanced Wilderness Life Support certification course at the University of Utah School of Medicine, there have been 116 deaths in Washington since 1950 due to avalanche.

Having the right gear is important but knowing how to use it is paramount. Information and classes can be found free of charge in many places to include the NAC.

“(Madigan sees) usually at least one or two (injuries) a year from people not properly ventilating their heat source inside their tent,” McGrane said.

Get equipped with the gear and skills it takes to enjoy winter in Washington and know that Madigan is ready to care for injury or illness when they happen.