Wilderness Medicine

I think I can speak for most landscape photographers, the majority of us got into the art of making photos because of the love of nature and wilderness. Most activities in nature have a degree of risks. Landscape photography is no exception.

You are probably taking steps to reduce some of the risks, such as packing warm clothing, flashlights for the dark, and carrying water for those long hikes.

Fortunately, most of the locations we visit aren’t too far from civilization, and given the popularity of these locations, we often aren’t alone. If an emergency were to occur, chances are we would be helped. However, one can never be over-prepared for an emergency, especially when backpacking into remote locations. Being prepared and knowing what to do in an emergency or even urgency, could mean the difference between reducing risks of further harm, even death.

In case of a medical emergency, you could be a first responder to a person in your group or anyone you encounter. If you are alone, You must rely on your knowledge and abilities.

This article is not a substitute for proper training in wilderness medicine or first aid. Rather it is meant to function as a starter guide into basic wilderness first aid, more importantly, to get photographers thinking about what essentials are needed for each trip and what the risks are.

I encourage anyone who is interested in learning more about wilderness first aid, to visit the following websites for courses and resources

https://www.nols.edu/en/courses/

https://www.redcross.org/content/dam/redcross/atg/PDFs/ Take_a_Class/WRFA_ERG_9781584806295.pdf

https://www.backpacker.com/skills/first-aid

https://www.rei.com/learn/expert-advice/wilderness-first-aid- basics.html

Due to the depth of the topic, this article will be divided into two sections, the second part will be posted at a future date.

in the first section, we will cover the following:

  1. Basic Essentials
  2. Hydration
  3. Tick Bites
  4. Spider bites
  5. Poison plants
  6. Snake Bites

In part 2 of the article, we will cover the rest of the topics:

5. 6. 7. 8. 9. 10.

Blisters
Burns
Wounds and Infections knee and ankle injuries Hypothermia
Altitude sickness

Basic Essentials of hiking in wilderness other than your camera and tripod!

The basic essentials may differ from one trip to the other, based on the location, environment, temperature extremes, and terrain. The essentials for most environments are the following:

– hat
– sunscreen

– insect repellent
– boots
– long pants and sleeves, extra clothing – rain gear
– Map of the area

– https://www.gaiagps.com/
– Compass
– flashlight with extra batteries
– sunglasses
– pocket knife
– matches in a waterproof container or fire starter (or both)
– First Aid kit.
– water and water filtration systems. these can be purchased

through REI or Amazon.
– Duct tape
– Ground insulation for overnight stays.

Hydration

If you are thirsty, you are partially already dehydrated. You should drink to prevent thirst, not to quench it. Proper hydration is essential for the function of your joints, muscles, gastrointestinal system, circulation, kidney function, and mentation, all of which are crucial when hiking. Proper hydration can prevent electrolyte imbalances, such as low or high sodium (both can occur), also known as hyponatremia and hypernatremia respectively. Sodium irregularities can lead to neurological and cardiac conditions, which can be life-threatening.

Mild dehydration is something that most of us have experienced, dry lips and mild thirst. More severe dehydration can lead to fatigue, muscle aches and cramps, irritability, frustration, and brain fog, which all can lead to poor decision making.

– Heat cramps: brief but painful involuntary muscle spasms. they usually occur in the muscles being used during the exercise and are the result of insufficient fluid intake.

– Heat Exhaustion: difficulty breathing, headache, feeling hot on the head and neck, dizziness, heat cramps, chills, nausea, irritability, vomiting, extreme weakness or fatigue

– Heatstroke: Rapid and shallow breathing, rapid heartbeat, unusually high or low blood pressure, lack of sweating, mental confusion and disorientation, unconsciousness, physical collapse

In the event of heat exhaustion, stop the activity, move into a cool environment under a shade, remove excess clothing and drink hydrating liquids slowly, to prevent rapid electrolyte shifts, which can lead to nausea and vomiting and further neurological conditions. Avoid using medications such as Tylenol or Ibuprofen to reduce temperature. Seek immediate medical care when possible this is a medical emergency. The above measures canoe life-saving. It is always a great idea to have snacks that also contain potassium, such as nuts, banana, dried fruits. Potassium can also be lost through heavy sweating, which is also essential in cardiac and musculoskeletal function. Low potassium (hypokalemia) can lead to heart rhythm problems, as well as muscle cramps. Always avoid caffeinated and sugary drinks as they can actually lead to further dehydration. Sugary drinks such as Gatorade can lead to diarrhea through osmotic effect. If that is all you have available, it can be life-saving, but if you have a choice between water and Gatorade, always pick water.

Tick Bite

Although most tick bites are harmless, Proper handling of tick bites can prevent complications such as Lyme disease or Rocky Mountain Spotted Fever (RMSF), now reported under a new category called Spotted Fever Rickettsiosis (SFR). Lyme disease is endemic to the north-east and parts of California’s central coast. SFR is endemic to south-eastern states. The peak months for both are in the warmer months of the year, May through August. Before you go out, know where to expect ticks. Ticks generally live in grassy, brushy and wooded areas, on animals, such as deer. Key is prevention. You can reduce your risks of tick bites by treating your clothing with Permethrin 0.5%. It can be used to treat boots, clothing and camping gear. You can also purchase clothing items previously treated with permethrin. When possible, avoid contact with ticks by walking gin the center of trails. After returning from the hikes, checking your clothing items, remove all clothing items and check your body. Examine gear and pets. The longer the tick stays on your body, the higher the risk of transmitting the disease. Generally, 24 hours or more of the tick embedded in the skin is required to transmit the disease, therefore it is essential to find the tick and remove properly.

In the event of finding an attached tick, remove the tick as soon as you notice it by grasping it with tweezers, as close to the skin as possible, pulling it straight out. If you aren’t sure how long the tick has been attached, seek medical care. Avoid applying petroleum jelly, fingernail polish, r a hot match to the end of the tick. These home remedies do not work, they also are likely to kill the tick while it’s embedded in the skin, increasing the risk of transmitting the infection. Avoid twisting the tweezer, as this will break off the body of the tick, leaning the head behind, making it much more difficult to remove. Wash the bite area and your hand with soap and water after removing the bug. Save the tick by placing it in a small container filled with rubbing alcohol, this way

your doctor can send this to a lab for assessment and identification of the tick. Watch for early signs of infection, such as rash, fever, body aches in the days and weeks following the bite.

For more information, visit the links below.

RMSF https://www.cdc.gov/rmsf/index.html

Lyme disease https://www.cdc.gov/lyme/index.html

Preventing tick bites https://www.cdc.gov/ticks/avoid/on_people.html

Spider Bites

  • –  2 Central punctums (as opposed to one with an insect bite)
  • –  Seek medical care if pain is severe, difficulty breathing, upset stomach.
  • –  Although rare in nature, it is important to identify them for

proper treatment
– Two common poisonous spiders in the US

– Brown Recluse: Most commonly found in the midwestern and southern states of the US; Bite causes a stinging sensation with localized pain, small white blister develops.

– Black widow: Found throughout North America, more common in southern and western states. It usually causes two puncture sites. The venom is a neurotoxin and produces pain at the bite area, then spreads to the chest, abdomen and entire body. It can cause body aches and gastrointestinal upset.

– Possible spider bite symptoms:

– itching, rash, pain, muscle cramps, reddish to purple color or blister, sweating, difficulty breathing, nausea and vomiting, fever, chills, restlessness.

– In case of a bite, stay calm. Identify the type of spider if possible.

  • –  wash the bite area with soap and water.
  • –  Apply a cloth dampened with cold water or filled with ice to the

bite area to reduce the swelling.

  • –  Elevate bite area if possible
  • –  Do not attempt to remove the venom
  • –  Immediately seek professional medical carePoisonous PlantsThey grow in wooded or marshy areas throughout North America. The plants aren’t really poisonous. They have a sticky, long-lasting oil called urushiol that causes an itchy, blistering rash after it comes into contact with skin. The reaction is delayed, often hours to one day after exposure. This is called delayed hypersensitivity reaction. The rash can peak within a week but can last as long as 3 weeks. The three main poisonous plants that you may encounter are Poison Ivy, Poison Oak, and Poison Sumac.

Poison Ivy

– Two types of Poison Ivy: Western Poison Ivy (ground vine only) and Eastern Poison Ivy ( ground and climbing vines)

  • –  Leaves are always grouped in threes
  • –  Pointed leaves
  • –  Staggered stems

Poison Ivy in the summer

Poison Ivy in the fall

Variation of Poison Ivy

Poison Oak

– Two types: Atlantic Poison Oak (ground vine and small shrub) and Pacific Poison Oak (ground and climbing vine and shrub)

  • –  Leaves are always grouped in threes
  • –  Rounded leaves
  • –  Staggered stems

Poison Sumac

– One type, found only in very wet environments, in the east coast

  • –  Pointed leaves
  • –  Small trees, not in vines
  • –  Leaves grouped up to 13
  • –  Rare in the mountains
  • –  Often grow near lower-lying wetlands

Exposure Prevention is key. Once the oil is exposed to skin, it causes a delayed hypersensitivity reaction, resulting in rash and blisters at the sites of exposure within hours to 24 hours later. The rash doesn’t usually spread unless urushiol is still in contact with your skin.

Clothes can keep you safe. Keep your skin covered. Wear long-sleeved shirts, long pants, gloves, and closed shoes if you’re in an area where these plants grow. If you think you’ve come into contact with these plants, be sure to handle the clothing items with care, with gloves, and wash them at the hottest temperature.

If you think you’ve been exposed to the plants on your skin, wash the area as soon as possible with warm water and soap, apply calamine lotion and hydrocortisone cream. If water and soap

aren’t available, alcohol wipes can remove the oils. Keep the areas cool, dry and clean to prevent secondary skin infections. Antihistamine tablets and creams will NOT help with the itching, so be sure to carry Hydrocortisone cream if you travel in these areas. Severe reactions may require much stronger steroid creams and even oral steroids. Seek medical care if your rash is moderate to severe.

Best of 2019

Long Exposure Photography

What is long exposure photography and why I do long exposure photography?

By definition, any photograph made with a shutter speed of 1 second or longer could be considered long exposure photography. This varies from one photographer to the next. Some consider 0.25 sec long, some 0.5. Ultra long exposure photography, although there is no clear definition, is a long enough exposure which smooths out the movements. In my experience, anything longer than 30 seconds is considered ultra long exposure. Never the less, This yields a photo that records the passage of time in one single frame. the resultant photograph can only have an impact if the subject has an element of stillness and movements. For a long exposure photograph to be successful, it needs to have mainly two elements:

  1. a subject that is static, such as rocks, or trees
  2. an element of constant movement such as water, clouds, people, etc.
Standard Exposure

Standard Exposure

Long Exposure

Long Exposure

 

 

 

 

 

 

 

 

 

 

Long exposure photography can turn a very chaotic subject such as the sea with harsh waves into a minimalistic, serene, dream-like scene that has mystery, that you normally can not see under normal circumstances. It is an abstract world that you can only create with your camera.

Long exposure photography with a large format camera is more challenging than with a digital camera, which is the reason why I like it. The calculation for a correct exposure for various films changes based on the respective reciprocity failures. The development of black and white film also is different for each film and also changes with long exposure.

The best time to photograph in my experience is overcast days, as the exposure is uniform due to the diffused lighting, there are no harsh lights and shadows, which can adversely affect the exposure and development of the film. Dark shadows on a sunny day, despite metering correctly, will yield a very dark, almost complete black shadows without any details due to effects of long exposure and tricky development. For the same reason, the highlights can often become over-exposed.

I typically carry a B+W 6 stop screw mount ND filter and a Lee 10 stop ND filter but I find that the 6 stop is what I utilize most often, As a 10 stop ND filter with the addition of reciprocity failure time can lead to very long exposure times which can increase the risk for failures. When it comes to black and white film, I often use Kodak Tmax 100 due to higher resistance to reciprocity failure than Ilford Delta 100. To put it into perspective, a 1-sec exposure for Kodak Tmax 100 with 6 stop ND filter yields a 1 minute and 30-second exposure, as opposed to 8 minutes and 14 seconds for Ilford Delta 100 in the same situation with the same 6 stop ND filter. As one can imagine, the Delta 100 exposures can easily add up in darker situations.

Black and White Long Exposure

Black and White Long Exposure

I also use Fuji Velvia 100 on overcast days as it is very stable with long exposure. One must be cautious on sunny days as you can easily have over-exposed highlights with long exposure.

For the exposure calculation I use an app called Reciprocity Timer which simplifies the task. It has a database of popular films which allows the addition of different filters.

To meter the scene, I typically meter as I normally would, then plug time exposure time into reciprocity timer, add the 6 stop ND filter, and use the exposure time given by the app. I have found that the only time my exposure has not been accurate is on sunny days with harsh lighting.

As stated earlier, there are many challenges with long exposure photography with a large format camera. On a recent trip, I discovered that wind, despite having a sturdy tripod, can still create movement, not by shaking the camera, but the movement of the film inside the film holder through the opening of the dark slide. This creates a partially out of focus photograph. One half of the photo is in focus which isn’t objected tot he wind. the portion of the film that is adjacent to the dark slide opening, is subjected to movements, thus leading to a blurred foreground in a vertical orientation. The film can also shift creating an out of focus capture. As I thought about this further, I came up with two fixes. In order to prevent wind entering the film holder, one can place a piece of masking tape on the opening after removing the dark slide and prior to exposure, or one can make a custom dark slide, long enough to place in the opening just after removing the actual dark slide. To fix the shifting film, one can tap on the film holder a few times to assure it doesn’t move during exposure. Removing the film holder from the Ziplock bag also allows any shrinking and expansion of the film sot hat it doesn’t occur during exposure.

Focused Top Half

Focused Top Half

Out of Focus Foreground

Out of Focus Foreground

 

 

 

 

 

 

 

 

 

 

As I continue to learn this process myself, the biggest advice I can offer is trial and error. I recommend experimentation with your favorite film, with only one filter, such as a 6 stop ND filter which results in long enough exposure to yield the desired effect without leading to very very long exposures. Develop a technique that is consistent.

 

Name: Gevork Mosesi

Location: San Diego, CA

I began my photographic journey in the mid 1990’s with the legendary Canon AE-1 which still works till this day. In 2011, I rekindled my love for analog photography, leaving digital photography. I have not looked back since. I primarily use a 4×5 large format camera to make my photographs. I also utilize a 6×17 panoramic camera in the right setting. This format allows for a slower workflow which makes me more aware of the landscape, giving me full control of the image making process, ultimately avoiding multiple unnecessary digital exposures. Most of my work is from the landscapes of the Southwest.

Gallery: Gevork Mosesi

Website: http://www.gmosesi.com/