The ‘burrito wrap’ and the ‘taco ice bath’ – with wilderness medicine, prevention is better than cure

In the latest Australian Prescriber podcast Dr Justin Coleman chats with Dr Charmaine Tate, Chief Medical Officer of the New Zealand Defence Force. They cover some of the recent updates in the Therapeutic Guidelines Wilderness Medicine. The latest edition includes some unusual sounding techniques.  The ‘burrito wrap’ for hypothermia is a concept of a vapour barrier on the outside of a sleeping bag and a source of heat on the inside. The ‘taco ice bath’ is for heat-related illness.

This podcast is relevant not only for health professionals but also for hikers, trampers, guides, divers, climbers and all-round adventure seekers to better prepare for their next wilderness experience.

The conversation goes from bites and stings to overheating and freezing. It also covers altitude sickness, diving injuries, drowning and lightning strikes.

The latest edition emphasises prevention. It gives recommendations around good preparation and provides basic principles for the management of emergencies.

“These problems are rare. Most people really enjoy their time in the wilderness. The focus on prevention and preparation is to ensure that, even if an unlikely problem occurs, that you're best prepared to manage it,” says Dr Tate.

Bites and stings from scorpions, millipedes, caterpillars, leeches and ticks are not uncommon in the bush. While most of these bites do not affect more than the area around the bite, the guidelines do highlight some of the more unusual effects that can occur. For example, you can develop an allergy to meat after a tick bite.

“People may not think a trip in the bush could be the cause of a strange health problem. Tell your doctor where you’ve been if your problem started after a recent bush trip,” she says.

The guidelines include practical ways to spot problems early and remember what to do in an emergency.  

“In cold-related illness, watch out for the ‘umbles’. Fumbles, mumbles, grumbles and stumbles could mean a problem is on its way,” says Dr Tate.

“Things get worse slowly in the cold. Picking up signs that a person is cooling down is important. If you spot this early, you can stop them from getting colder. That’s much easier than warming them up later,” she says.

Listen to this podcast: Episode 135 Therapeutic Guidelines Wilderness Medicine