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Wilderness Medical Society - snowmass 2005 (Page 122)

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Wilderness Medical Society - snowmass 2005
INTRODUCTION
More people heading to the wilderness with kids in tow. Activities vary between
families. Simple sports like hiking, camping, or trail biking are popular. With small kids,
backpacking or trailer biking are possible. With teens, the sky is literally the limit. This
overview describes basic afflictions to children.

DIFFERENCES BETWEEN KIDS AND PARENTS
Children are different from adults in a variety of anatomic and physiologic ways.
·
Smaller size makes them more at risk for problems such as animal envenomation or
dehydration.
·
They have less developed immune system.
·
Kids' growing bones allow fractures to heal more readily. Often fractures are more
stable and less severe such as with a greenstick or buckle fracture. On the contrary,
growth plate fractures are potentially debilitating.
·
Thermoregulation is generally less efficient than an adult's. Key features include:
o
Kids generate more heat with exercise,
o
have a lower cardiac output that decreases capacity to shunt heat from core to
periphery,
o
gain heat or loose heat rapidly with larger surface area to mass ratio,
o
acclimatize slowly,
o
sweat less for cooling,
o
have less subcutaneous fat for insulation,
o
have inefficient shivering mechanism for generating heat,
o
and have less developed behavioral response to cold and heat.
GENERAL EXPECTATIONS
INFANTS: SHORT, SIMPLE, AND SUNNY. Since they can't walk, infants are
mostly restricted to baby joggers, baby-carrying backpacks, or mountain bike trailers.
They require lots of gear: diapers, extra clothes, bottles, and binkys. And they require
naps, usually two a day. Fortunately, they are easily entertained by any toy that makes
noise or can be put in their mouth. The key: go in good weather and don't make your first
outings too complicated or too lengthy. Short, simple, and sunny are your main
parameters for infants.
TODDLERS AND PRESCHOOLERS: EASY, SLOW, AND FLEXIBLE.
Toddlers are quite different from infants. As all parents know, they are constantly active
and require close supervision. Toddlers also have equipment that doesn't necessarily go
on the top of an SUV like diapers, spill-proof cups, and, of course, snacks--lots of them.
Toddlers need to have some sense of exploration to satisfy their curiosity, but you need
keep them from getting stuck in a patch of poison oak or from stepping into huge mud
puddle. They tend to need food, but can be picky eaters. They tend to need a daily nap,
but greatly resist one. They are too big to be carried for a long time, but may insist on it.
At any given time, usually when they need to eat or sleep, they can metamorphose into a
Tasmanian Devil. Sound tough?
This is an important stage for outdoor families. You want trips to be fun, but they
shouldn't be so difficult that it becomes a huge chore to go anywhere. When our kids

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