16. Wilderness first aid training and Lyme prevention

In today’s podcast, Sarah examines the importance of adequate training in wilderness first aid skills. She speaks with expert Michael Crawford, an instructor at Slipstream Wilderness First Aid in Victoria, BC. Michael points out some of the differences between regular first aid and wilderness first aid. Anyone performing first aid on a patient in a wilderness setting will likely need to care for them for a longer period of time than in a city situation. It is also important to know and differentiate between which health issues need to be addressed immediately and those that can wait.
In the courses, he emphasizes the importance of prevention to avoid potential health risks. Michael advises outdoor leaders to teach participants a daily tick checking routine in order to reduce their risk of contracting Lyme disease. This training includes knowing what ticks look like at different stages of their life cycle and where they are more likely to attach on humans.
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Michael also teaches about when to include Lyme disease as a differential diagnosis, which would make it one of the possible explanations for signs and symptoms a person may be experiencing. He points out that for those who have symptoms involving multiple systems, Lyme disease should be on their radar as a possible cause. Michael teaches how to safely remove a tick and keep it for future testing. He points out that a history of previous travel should be considered, pointing out that a person may have contracted an illness from previous travel but develop symptoms at a later date. He talks about the decision making behind medical evacuation from a trip which can include preventing the long term morbidity of Lyme disease.
“The first thing I do is prevention…teaching these outdoor leaders to teach daily tick checks, which significantly reduce the risk of tick-borne illness.”
Michael points out that his students spend a lot of time outdoors, and are often very interested in learning about ticks and Lyme disease. He explains that some of his students have contracted Lyme disease themselves, or know someone that has. Did you know that ticks love to climb up? Michael explains how knowing tick behaviour helps us to defend ourselves against these stealthy critters. It is important to remove ticks properly so that the tick’s saliva (and pathogens in their saliva) do not transfer into our body. Michael explains how to keep a tick for testing, pointing out that it is much easier to detect borrelia (the Lyme bacteria) in a tick than it is to test a person for Lyme disease. Sarah reminds us of an earlier podcast, where Justin Wood of Geneticks (a private Canadian lab) talks about the testing he provides for Lyme bacteria and other tick-borne pathogens. In that podcast, Justin also let us know that ticks do not need to be alive to be tested.
“Tick-borne illnesses are going to be generally a part of differential diagnosis, so all the different things that could be wrong with somebody with the kind of symptoms that they’re presenting.”
Michael takes us behind some of the decision making behind medical evacuation from the wilderness, pointing out that many factors must be taken into account before that decision is made. He wraps up by urging people to learn more about Lyme disease, and to follow the science. He recognizes that technical language can be a barrier to understanding science, and calls for terminology that the majority of people can relate to. Thank you Michael for teaching outdoor leaders and enthusiasts how to stay safe in the outdoors!
