How to treat a child’s broken tooth during a day hike

Dental injuries on a hike most often occur during a fall.

Sometimes when hiking, dental emergencies occur with children, often as a result of a bad fall but even from something surprising such as biting down wrong on a hard nut in the trail mix.

Among the most common dental injuries is a broken tooth. To treat it, you’ll need drinking water, pain reliever, chewing gum, and a breakable ice pack. Two of the three items are on my recommended list of a first-aid kit’s contents while drinking water is a must on any day hiking trip.

To treat the broken tooth, first have the child rinse his mouth with drinking water to remove any debris and blood. Next, have the child take pain reliever; liquid acetaminophen such Tylenol or liquid ibuprofen is recommended. Hopefully the child has been chewing the gum before the tooth broke; if so, the gum can be shaped to fit around the sensitive nerve exposed by the break. Finally, to reduce pain, break the ice pack so it turns cold and have the child hold it against the cheek on the side of the mouth that the tooth broke; this will reduce any swelling and help relieve pain.

You then should turn back for home. Forcing a child to work through the pain only will make the hike unbearable for them and eventually for you. Once you have cell phone service, contact your dentist for further instructions.

Learn about trail guidebooks available in the Hittin’ the Trail series.

How to avoid trench foot on hike with kids

To avoid trench foot, have children change out of wet socks and shoes.

A rare but potential malady children can suffer during a day hike is trench foot. The problem occurs when feet get wet and remain so for many long hours. The result is numbness with the skin turning blue (or sometimes red). If out on a camping trip, wet feet for several days can lead to gangrene.

Avoiding wet feet is easier than it sounds where children are concerned, for any mud puddle or stream offers a fun place to stomp and splash. Begin by ensuring children wear waterproof shoes or boots. Also have them don wool socks, which better wick moisture from the body than do cotton socks. Next, ask children to walk around puddles and to step over tiny streamlets rather than through them.

Should children’s feet get wet, having them change into a dry pair of socks and hiking boots kept in your backpack is a good idea. At the very least, keep an extra pair in your vehicle, so that once you return from the trail, they can change.

So long as the day is warm, having children take off their socks and boots to air their feet can be helpful as well, especially if their feet sweat. Gently massaging wet feet to encourage circulation also is beneficial.

Should you notice a change in the skin color of a child’s feet after they’ve been wet for a long period, immediately seek medical treatment.

Learn about trail guidebooks available in the Hittin’ the Trail series.

Prepare your feet to avoid injuries on hike

Most hikers will agree that the most important piece of gear and equipment they have for the trail is their own feet. There’s good reason for such an attitude: If your feet are sore, the hike will become a death march rather than a pleasurable activity. This is even truer for children, who lack an adult’s ability to resist physical pain to achieve a goal.

Fortunately, you can take some simple steps with your feet and those of your children to ensure the hike remains enjoyable.

Before the hike:
g Trim toenails – Long toenails will place pressure on the toe as they push against the boot. Toenails shouldn’t catch on socks, either, or they’ll wear a hole in them, which can lead to blisters. Trim straight across the nail rather than round the corners.
g Smooth calluses with a file – Blisters can form under large calluses, resulting in an infection. Calluses usually occur because of ill-fitting shoes.
g Rid inside of hiking boots of lint and small stones – This debris only will rub against your feet as they eliminate the spacing between your sock and hiking boot.
g Replace frayed shoelaces – Ripped laces won’t tie properly, creating pressure points on the top of your feet and preventing the boot from fitting snugly, which can lead to twists and falls.
g Replace the insole – Use a thinner pad if the boot fits too tightly or a thicker pad if the boot fits too loosely.
g Apply baby powder to inside of boot – This helps absorb moisture and keep the foot dry. Excessive moisture from sweat can lead to cold, wet feet.

When putting on boots:
g Wear wool socks – Cotton socks don’t absorb moisture as well. Wool socks also tend to be thicker, providing more cushion.
g Smooth socks around feet – Socks that are bunched up lead to friction and blisters. They also may expose part of the bare foot or leg to the boot, which definitely will be uncomfortable and lead to skin burns.
g Tie laces properly – The laces should ensure that the boot is snug but not tight. If laces dig into the foot, they will be uncomfortable.

Also be sure you know how to treat blisters and have the materials for doing so in your first-aid kit. While the above tips should prevent any problems, being able to address any foot issues during the hike will help tremendously.

Read more about day hiking with children in my Hikes with Tykes guidebooks.

How to set a broken bone during a hiking emergency

Breaking a one during a day hike is a serious injury.
Photo courtesy of Photoree.

While accidents on a hiking trail are rare, they can occur. A broken bone is among the most serious of them. Not only is it painful, if the bone is in the leg the injured party will have to be carried out, slowing you incredibly.

You’re first priority with any broken bone should be to get medical attention. If no blood is flowing to the affected limb, however, you may need to set the bone. Doing so may be the only way to save that arm, leg or finger.

To set a broken bone, first determine if doing so is necessary or wise. Begin by pressing on the skin beneath the break. If it turns white then upon your release it turns pink, blood is circulating in the limb, and no setting is required. However, if it remains white or already is blue, circulation probably has been cut off, especially if there is a lack of a pulse, numbness or tingling in that limb.

If the bone protrudes from the skin, however, do not set it. Immobilize it, instead.

The next step is to align the bone to its normal position. This can be done by pulling the limb in opposite directions on either side of the break. Recheck to see if circulation has returned to below the limb.

Read more about day hiking with children in my Hikes with Tykes guidebooks.

Guidelines for providing first aid during cold weather

Should you need to provide first aid while hiking in cold weather, you’ll want to follow some basic guidelines to ensure that you don’t exacerbate the injury – or put yourself in peril as well.

Among those “rules”:
g Don’t remove your clothing – Though helping an injured person may be easier without gloves on or with a jacket unzipped, this can create problems for you. Gloves taken off might drop into the snow becoming wet, and unlayered protection against the elements exposes you to the cold, as well.
g Perform first aid a warm place – If possible, move the injured person to a place where they can be warm and perform the first aid there. Laying an injured person on the cold ground or removing their clothing in the open only exposes them to the wind and wet.
g Don’t warm by rubbing – This actually can further damage any affected tissue if frostbite occurs. Instead, you want to use the closeness of body warmth or radiant heat to keep a person warm.
g Blankets alone aren’t enough – Use body warmth to keep a person from being cold and wrap the blanket around both of you. If a person has hypothermia, for example, they can’t generate enough heat on their own to rewarm themselves, so a blanket or sleeping bag alone won’t help.
g Loosen constrictive items – Loosening clothing and removing jewelry that restricts circulation is a good idea. Clothing should not be taken off, however, as exposure to the cold can lead to hypothermia.
g Seek medical help immediately – Cold weather injuries such as frostbite and hypothermia require skilled medical professionals working with the patient in a warm, sterile facility. As soon as the injured person is stabilized, get them to a hospital.

Read more about day hiking with children in my Hikes with Tykes guidebooks.

How to make a leg splint during a hiking accident

Make a leg splint the same way that you would make one for a broken
finger. Photo courtesy of van Hilten / Photoree.

Should a leg be injured during a hike, you may need to immobilize it with a splint, especially if a bone has been broken or fractured or a muscle sprained. Immobilizing the leg can help prevent further injury as well as reduce pain, which is vital if the injured party is a child.

A splint is the leg’s equivalent of a sling for an arm. This is where having a small tarp, gauze pads, and full bandage roll in your backpack can prove helpful.

Before placing a leg in a splint, make sure all bleeding has stopped. That typically can be done by applying direct pressure if a gauze pad over any cuts.

If a broken bone, next determine if circulation has been cut off beneath the break. Pale skin below the break suggests there is limited circulation. If this is the case, you will have to set the bone. We’ll save how to do that for another entry and presume the circulation is fine.

Gently slide your tarp (Stronger material, such as cardboard, works better, but we’re improvising, based on what materials you might carry during a hike.) beneath the injured leg. Place gauze pads between the leg and the tarp.

Fold the tarp about the leg, ensuring it is tight enough to prevent the leg from moving (otherwise the bone may shift) yet not so tight that circulation is cut off. Secure the tarp by use the roll of bandages, which can be tied to hold the splint in place.

Seek medical attention immediately.

Find out about trail guidebooks available in the Hittin’ the Trail series.

How to immobilize an arm injured during a hiking trip

Use a sling to immobilize an arm. Photo courtesy of mtsofan / Photoree.

Sometimes when hiking, an injury occurs in which you must immobilize an arm. This might be due to a sprain, a cut or a fracture from a fall or an object (such a rock in a mini avalanche or a tree limb that’s just broke off) hitting it. While such accidents are rare, knowing how to handle them in case they do occur will be extremely helpful in preventing further injury and providing for the person’s comfort, especially if the injured party is a child.

To immobilize an arm, you’ll need to make a sling. This is where carrying a large bandanna or an extra shirt can be helpful. You’ll need a piece of cloth that is about a yard square; a smaller piece will do for small children.

Lay out the cloth flat then fold it in half diagonally so that you have a triangle. Next, slide the injured arm into about the middle of the diagonal cloth. Bring one end of the cloth up around the neck and the other end of the cloth up around the other side of the neck. Tie the ends of the cloth together behind the neck.

The injured arm should be in front of the abdomen, parallel to the ground. Wrap a belt around the body, just above the parallel arm. Cinch the belt tight but ensure that there’s still circulation. If you don’t have a belt, a rope or a pants leg also will work.

Seek medical help immediately.

How to avoid, treat hyponatremia on hike

Hyponatremia is on the rise among desert hikers, such as
those at Grand Canyon National Park.

If hiking in the desert or on an extremely humid day, beware of suffering from hyponatremia. This ailment – a low sodium blood level – has been on the rise, in fact, at Grand Canyon National Park.

Sodium helps regulate the amount of water in and around your body’s cells; when it becomes too low, your cells swell with water, creating a variety of problems such as muscle spasms/cramps, loss of balance, nausea, confusion, fatigue and even death.

In deserts, this typically occurs because the heat causes people to sweat, resulting in a loss of sodium. When hikers drink water to replace the loss fluid, they aren’t replenishing their bodies with salt and other minerals, causing the sodium to become diluted and hence low.

To prevent hyponatremia, imbibe electrolyte drinks and tablets when hiking (sports drinks don’t contain enough electrolytes and so don’t work). Also bring salty food, such as beef jerky and sodium crackers with you. Continue to drink water, however, as your body still requires it in the dry heat.

If suffering hyponatremia, seek medical attention immediately. You will need intravenous fluids, restricted water intake and monitoring.

Read more about day hiking the Grand Canyon in my Hittin’ the Trail: Day Hiking Grand Canyon National Park guidebook.

Avoid eating these poisonous berries

Berries from holly are poisonous.
Illustration courtesy of Wikipedia.

When hiking with young children, it’s tempting for them (and even you!) to pick a plump, delicious-looking berry and plop it in the mouth. Unfortunately, some berries will make children nauseous and others even are poisonous.

Instruct children not to eat any berries (They’re for the animals to eat, after all!). Familiarize yourself with which plants and berries you should avoid.

When on the trail, never eat berries from these plants:
g Castor oil
g Daphne
g English ivy
g Holly
g Lantana
g Mistletoe
g Nightshade
g Virginia creeper
g Yew

Read more about day hiking with children in my guidebook Hikes with Tykes.

How to avoid, treat sore feet during a hike

There’s no more important piece of gear to a hiker than his feet. Once his feet are sore, the hike is over.

Hopefully, your sore feet are due to muscles and connective tissue overstressed by excessive walking or carrying too much weight. Other problems, such as obesity or flat feet, could be the cause, and to resolve those issues, you should see a doctor.

Avoidance
Among the best ways to avoid sore feet is not wearing tight-fitting shoes or that are tied too tightly. This will help eliminate bruising and pain. In addition, wear wool socks that wick sweat away from the feet rather than cotton socks, which become swampy, and can lead to blisters or fungal infections.

Also, carry less gear into your backpack. Usually your knees will the first to buckle under the pressure of excessive weight, but your feet will soon follow.

You also may need to walk a shorter distance. Each of us has our limitations, so there’s no shame in only being able to do a mile. Rest assured, the more frequently you walk what you can handle, the farther you’ll be able to go with each passing week.

Take a look at the quality of the trail as well. Uneven surfaces, especially those with a lot of stone or scree, can quickly wreak havoc with your legs and ultimately your feet. Seek trails with level grades until you build up your leg strength.

Treatment
To treat sore feet on the trail, begin by removing weight from your backpack. Also, change into dry socks if possible. Finally, select a different, easier route if possible.

Once home, try a foot bath by soaking your dogs in warm water mixed with epsom salts. Afterward, stretch your feet, especially with a runner’s stretch. Massaging your feet also can be beneficial; apply gentle thumb pressure to the sore areas and use lotions or oils

Read more about day hiking with children in my guidebook Hikes with Tykes.

How to revive an unconscious child on hike

His an unconscious child does not respond to you calling his name, check
to ensure he is breathing. Photo courtesy of  Peter Griffin.

Re-awakening child may save life

Should a child in your hiking party faint, your ability to re-awaken them may very well save his life. There are any number of reasons why he might lose consciousness, from going into shock to suffering a head injury. By always being safe, you typically can avoid this problem.

Rescue breathing technique
Should you suspect your child of being unconscious, speak loudly to him, using his name, as gently shaking his shoulders.

If he does not respond, tilt his head back and remove any obstructions from his mouth. Check to make sure he is breathing.

Should he not be, begin the rescue breathing technique. For children, keeping their head tilted and chin lifted, pinch the victim’s nose, take a deep breath, and place your mouth over theirs. Give two breaths every three seconds and see if the chest fully rises and falls.

If the victim begins to breathe, continue rescue breaths at rate of 20 per minute, checking for circulation.

Cardiopulmonary resuscitation
Should the child not begin to breathe or stops breathing again, begin cardiopulmonary resuscitation, or CPR. First, find the point on the chest where rib meets the breastbone. Place the middle finger and index finger of one hand there. Put the palm of your second hand next to the two fingers. With one hand only, press the chest down about 1-1/2 inches five times then provide a rescue breath. Continue this cycle of five compressions to one breath until the child begins breathing or you are too exhausted to continue.

Once the child is breathing, place him in a recovery position. This involves rolling him onto his side. Keep the bottom leg extended but bend the top leg at the hip and knee. Their bottom arm should be bent at a right angle with palm facing up. The top arm is bent so that the cheek can rest on the back of the hand.

Immediately seek medical attention by using your mobile phone to call for a rescue, by sending any adults with you for help, or by signaling for help.

Read more about day hiking with children in my guidebook Hikes with Tykes.

Think safety when kids come near water

Children will find water fun, but adults need to be on their
guard to avoid drownings.

Kids love water, and incorporating it into a hike is a great way to turn them on to the pastime. Still, water is very dangerous, so you need to make sure children play it safe.

Avoid trails that wind too close to swift-running rivers, and unless the child is a teenager avoid stream crossings. Before being allowed to go in water, children should know how to swim. Enrolling them in a swimming course is a good idea. They also should know what to do if drowning, and older children should know how to rescue others.

If children wade into streams or lakes, make sure the water is clean. Also carry sandals or an extra pair of sneakers as hidden dangers, like sharp rocks and sticks, can be stuck in the bottom of bodies of water and cut bare feet. Don’t dive into water where rocks clearly line the bottom or stick above the surface. A head easily could hit the rock, leading to a drowning.

To rescue a drowning child, first you must not panic. More than ever, you need a clear head. All too often, a drowning person pulls down their rescuer or a strong current also grabs hold, causing both to die. Next, you’ll need to quickly assess the situation to determine how the child will be saved.

The best of all worlds is when the child is nearby and you can reach out and grab an arm or leg to pull him in. When reaching out, lay down at the water’s edge and spread your legs to give yourself more stability.

If the child is out of reach, you might be able to extend your arm via a strong branch or trekking pole. Lay down at the water’s edge as previously described and shout to the child to grab the object you’re holding out. When the child has a secure grip, pull him in.

Should the child still be out of reach, you may have to get into the water. Be sure that there’s something secure for you to hold onto so you don’t get pulled under. Extend a leg or arm and shout to the child to grab on. When the child securely latches on, pull them toward you. You may then need to provide cardiopulmonary resuscitation, or CPR.

Read more about day hiking with children in my guidebook Hikes with Tykes.

How to avoid, treat altitude sickness in kids

Since air pressure is lower at higher elevations, you will inhale less oxygen in mountainous areas. For most hikers, the problem begins when reaching 8,000 feet above sea level, in which acute mountain sickness can affect both child and adult. More serious and deadlier problems can occur at higher than 12,000 feet, and parents shouldn’t take their children above that level.

Fortunately, few points in North America are that high, so you’ll rarely encounter this issue, unless you’re trying to peakbag the United States’ or Canada’s highest mountains. Children will suffer from altitude sickness more readily than adults. As their bodies are still developing, they simply don’t have the ability to adjust as quickly to changes in oxygen levels as do adults.

To avoid altitude sickness, go at a slow pace that allows time for acclimatization. Limit altitude changes to no more than 2000-3000 feet so long as you’re returning to your starting point.

Signs of altitude sickness include shortness of breath, dehydration, headache, nausea and dizziness. If the child becomes confused, clumsy, vomits and has a dry cough, the condition is serious. Treating altitude sickness requires descending to a lower elevation where there’s more oxygen. In addition, drink extra water to avoid dehydration, and eat light, high-carbohydrate meals. If the condition is serious, get medical attention immediately.

Read more about day hiking with children in my guidebook Hikes with Tykes.

How to treat bleeding children on a hike

Bleeding usually looks worse than it is, but if it isn’t stopped, serious problems can arise. In just two minutes, adults can lose enough blood to die, and the time is even shorter for children. To avoid, following the same safety precautions as for falls and cuts.

To stop bleeding, place the edges of torn skin together while applying direct pressure on the wound. Within a few minutes, usually the blood will clot. Presuming there are no broken bones, lay the person down and raise the affected limb above the heart to limit blood flow to it. Place a sterile gauze pad over the wound and hold it in place by wrapping bandages around the limb.

Check to make sure the dressing isn’t so tight that it restricts blood flow to the rest of the body; if it does, reapply the dressing. Do not use a tourniquet. Once the bleeding has stopped, remove the gauze bandage and dress the wound in clean bandages. Limit movement of the wounded areas as much as possible and treat for shock.

Scalp wounds can be pesky and usually look worse than they are. Stopping the bleeding will be difficult, but the good news is that very little blood loss usually occurs from such a gash. The child probably will need immediate medical attention to stop the bleeding, however.

Read more about day hiking with children in my guidebook Hikes with Tykes.

How to avoid, treat hiking sprains, strains

Sprains occur when a ligament supporting a joint is stretched or torn. Ankles particularly are likely to suffer sprains among hikers. Closely related is a strain, which is when tendons or muscles are torn because they were overstretched.

Avoid sprains and strains by wear hiking boots that provide ankle support.

Symptoms of either a sprain or a strain include pain, tenderness and limited range of motion all in the affected area.

To treat, rest the affected area. If a victim must leave the area, help them walk and carry their backpack for them. Lightly apply the breakable ice pack, or your handkerchief soaked in cold water, over the sprain or strain. Place soft padding, secured with gauze, over the affected area. Elevate the affected area above the heart to reduce swelling and bruising.

Don’t have your children try to “walk it off.” They won’t be able to.

Related articles:
g Treating children's cuts and wounds on hiking trail
g Avoiding and treating child dehydration on the trail
g How to avoid and treat nosebleeds
g How to avoid and treat hiking kids' muscle cramps

Read more about day hiking with children in my guidebook Hikes with Tykes.

Treating children's cuts, wounds on hike

Image courtesy of africa / FreeDigitalPhotos.net

Avoid cuts and wounds by following the same principles of safety to avoid falls. In addition, don’t go off trail through vegetation or climbing on rocks.

To treat a cut or wound, with an antiseptic clean the opening of sand, dirt, gravel and other debris. A cotton swab works well. To irrigate deeper cuts or wounds, a disposable syringe can be used. After drying it, apply an antibiotic ointment and then an adhesive bandage. If a wound, don’t use an adhesive bandage but cover it in gauze dressing and get medical attention immediately.

Never apply insect repellent to cuts or wounds (or to irritated skin, for that matter).

Related articles:
g How to prevent and treat hypothermia in children
g Avoiding and treating child dehydration on the trail
g How to avoid and treat nosebleeds
g How to avoid and treat hiking kids' muscle cramps

Read more about day hiking with children in my guidebook Hikes with Tykes.

How to avoid, treat a child's bruise on hike

If your child has a bruise, then blood vessels under the skin have broken. This could indicate a greater problem, such as a fracture or other internal injury.

To prevent bruises, don’t hike under areas where rocks or tree limbs might fall, and avoid falling yourself.

If you have a bruise, the skin of the affected area will be black and blue, tender, swollen and painful. Reduce swelling by applying a breakable ice pack to the affected area for at least five minutes. Then elevate the bruised area to reduce blood flow to it. If the bruise is extremely large or deep, turn back for the vehicle and get medical attention.

Related articles:
g How to prevent and treat hypothermia in children
g Avoiding and treating child dehydration on the trail
g How to avoid and treat nosebleeds
g How to avoid and treat hiking kids' muscle cramps

Read more about day hiking with children in my guidebook Hikes with Tykes.

Hiking children should carry whistle, ID card

Even those parents who keep a close eye on their children sometimes get distracted enough that their child wanders off and gets lost.

To ensure children can let parents know where they are upon becoming lost, have them wear a safety whistle, attached to a lanyard, around their neck. Tell the child in advance that should they become lost to simply blow on the whistle. The sound of a whistle will travel farther than a shout.

Consider including an ID card on the lanyard, especially if the child is a preschooler or of very young elementary school age. In case the lost child is injured but then found by others, the ID card can be useful in providing important medical information.

The ID card should include the child’s name and date of birth, the parents’ names and their contact information (especially a telephone number), blood type, and any allergies.

Read more about day hiking with children in my guidebook Hikes with Tykes.

Avoid, treat nosebleeds on hikes with kids

To stop a nosebleed, lean the head slightly forward and
punch just above the nostrils. Illustration courtesy of
Wikipedia.

Nosebleeds are not uncommon in children from two to 10 years old, and unless it was caused by a major trauma, such as running into a tree, it’s probably nothing to worry about. The typical reason for child nosebleeds is picking at it, but in the wilds, warm, dry air and rhinitis brought on by minor allergies to local plants can be a cause.

To prevent nosebleeds from occurring, the child should stop irritating the inside of the nose, such as not blowing it forcefully.

You can treat nosebleeds by having children lean their head slightly forward. Pinch just above the nostrils at the bridge of the nose, applying direct pressure for about 10 minutes. Spit out any blood in the mouth rather than swallowing it. To stop major nosebleeds, apply direct pressure as previously described. If that is ineffective, stuff gauze into the nostrils and seek medical attention. Don’t take out the gauze until seeing a medical professional.

Read more about day hiking with children in my guidebook Hikes with Tykes.

Avoiding, treating dehydration on a hike

Make sure children drink water when hiking, as they will dehydrate more
quickly than adults. Photo courtesy of Ken Kistler.

When one has overexerted himself in extremely hot or dry weather or after great exposure to the sun, the body can suddenly dehydrate.

Though dangerous in itself, dehydration can lead to additional problems, such as heat exhaustion, heatstroke and hypothermia.

Drink up
Take note: Children will dehydrate more quickly than adults. After all, a glass with a little water in it will evaporate more quickly than a glass with a lot of water. Likewise, children will use up water more quickly than a full-grown person.

Avoid dehydration by drinking plenty of water. Children need to drink about a quart every two hours of walking and more if the weather is hot, dry or cold and if at a high altitude.

Keep the soft drinks and caffeinated beverages at home. They may temporarily quench thirst, but they won’t adequately replace water the body has lost due to physical exertion. Also, let older kids carry their own canteens or use a hydration system. They’re then more likely to sip water as they need it.

First sign
Parent Rosie M., of Durango, Colo., offers this idea for getting children to drink their water:
“Sometimes kids won’t drink warm water. Fill the canteen half way up with water the night before the hike and place it in the freezer. The next morning, fill the canteen with cold water. Several hours will have to pass before the ice melts, ensuring you have cold water the entire hike.”

Thirst is the first sign of dehydration. The less clear (or more yellow) the urine is, the more dehydrated the body is. Other symptoms include nausea, headache, dizziness, muscle cramps and fatigue.

To treat dehydration, place the victim in the shade. Use sports drinks or packages of electrolyte additives for kids, children, not plain water. Don’t use salt tablets, as they’re difficult to digest.

Read more about day hiking with children in my guidebook Hikes with Tykes.