Get Out!

Fear Factor

If you find yourself in one of these wilderness quandaries, should you relax or run for help?

By Christopher Van Tilburg May 17, 2010 Published in the June 2010 issue of Portland Monthly

Christopher Van Tilburg, MD, is a wilderness doctor and Crag Rats Search and Rescue member.

I found a tick on my daughter. Should I burn it out?

On a scale of 1-10 (Relax to Run): 3

FIRST, CHECK TO SEE if it’s actually attached: those ubiquitous arthropods will wander around the skin for about two hours before burrowing in. If the critter has already chomped, don’t whip out the flamethrower. Instead, gently pull out the tick with tweezers. If the body pops off, see your doc. We have tools to safely remove the tick, and we can provide antibiotics for infections such as Lyme disease (which is, fortunately, rare in this part of the country).


Halfway through our hike on Mount Adams, my buddy tripped over his Tevas and smacked his head on a rock. No blood, but he looks a little out of it. Should I be worried?

On a scale of 1-10 (Relax to Run): 8

EVEN A SMALL RAP on your noggin can cause brain bleeding, a potentially fatal condition. If your buddy blacked out, be worried. Watch for confusion, unequal pupil size, vomiting, fluid leaking from the ears or nose, or repetitive language. If the stun clears in two hours, it may be a mild concussion, and you can evacuate slowly with your friend. If he’s still sounding like a stuck CD after two hours—or if he has any other symptoms—it’s time for tough love: leave your bud with provisions and shelter, climb the nearest ridge, and call 911.


I’m hiking in the Wallowas, drinking tons of water, but I’m still dizzy. Is it heatstroke?

On a scale of 1-10 (Relax to Run): 6

IF YOUR URINE is profuse and colorless, probably not. You’ve got the opposite problem: hyperhydration, or water intoxication. Consuming too much water and not enough salt while exerting yourself can create a critical depletion of electrolytes, those pesky little things required for brain function. Drinking a three-liter CamelBak over two hours can make you foggy. The fix: replace the salt by sucking down a sport drink, an energy bar, or a salt tablet. If your sensorium is still fuzzy, get help ASAP.

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