Injured or ill in a remote area?

PARAMEDICS GO BUSH WITH AMBULANCE VICTORIA'S NEW REMOTE AREA RESPONSE            

The last few years have seen Ambulance Victoria up-skilling specialist paramedics across the state for responding into remote and wilderness environments. Wilderness Response Paramedics are trained to assist in medical emergencies in Victoria’s bush and alpine areas and can provide patient care over protracted periods in challenging locations. We had the privilege of being introduced to this service by Andy Oates (paramedic with Ambulance Victoria) and volunteer with our Bush Search and Rescue (BSAR) team (photo above) at the recent Bushwalking Victoria Leadership Forum. 

They respond as part of a multi-agency team which typically sees members from Victoria Police (VicPol), Victoria State Emergency Service (SES), County Fire Authority (CFA), or the Department of Land, Environment, Water, and Planning (DELWP) co-respond.

The team is able to access areas that are otherwise inaccessible. Wilderness Response Paramedics then assess and manage a patient until extrication can be arranged either by ground or air.

This month (June 2019) saw the rollout of this service extended to a group of paramedics working in the metropolitan region. There are now more than 90 trained responders throughout the Victoria. A number of the paramedics involved in the program have a BSAR background. Note that VicPol is the ‘Lead Agency’ in any Search and Rescue incident in Victoria and that the new Ambulance Victoria program is aimed at giving its paramedics the capacity to safely provide a high level of medical support for an injured or ill patient once located. More information about Ambulance Victoria Services here. 

Bushwalkers are most grateful for this service in the unlikely event of an incident whilst on a remote bushwalk - thank you Ambulance Victoria! 

Finding Maps for Bushwalking in Victoria

Where to start when looking for maps?

Bushwalkers need accurate, up-to-date maps. Whether planning or leading a walk, or just walking with a few friends in the bush, good maps enable walkers to safely navigate their intended route. They also open new possibilities both during the walk planning and on the track. So, where are these good maps found? We asked map expert, Andrew Robinson from the Koonung Bushwalking Club, to put together a guide for us. 

Paper or digital maps?

Using both is best. The paper map provides the 'big picture', can be annotated during planning and is 'weatherproof'. A mapping GPS or Smartphone will, at the very least, provide an accurate position. Put both together and you have a well-equipped walker who is unlikely to be 'mislaid'. Both paper and digital maps are discussed below.

A word about scales

Large scale maps are a must; a good scale is 1:25,000, i.e. 4cm on the map = 1km on the ground. 1:50,000 (2cm = 1km ) is borderline, sometimes lacking sufficient detail for walkers, while 1:100,000 (1cm = 1km) is really only a detailed road map.

Some Smartphone apps

There are a large number of mapping apps, many linked to websites. For bushwalking, maps should be saved offline into the Smartphone itself, rather than continually accessing the internet via a mobile signal. I will mention just a few free apps.
Avenza maps is linked to a map store containing about a million maps worldwide. It can also display custom maps from other sources and is used by many mapping organisations. You can use your phone's built-in GPS to track your location on any map, plot tracks, add photos and much more.
Maps.me is your worldwide street directory with lots of additional information.

Terra Map is a good, easy app for plotting your track on a walk.

Map sources

1. Vicmap

Vicmap is the Victorian Government mapping agency. It is part of the Department of Environment, Land, Water and Planning. It produces over 10,000 separate map sheets using 3 scales covering the entire state. These are:

• Vicmap Topographic 1:25,000, A0 sheet
• Vicmap Topographic 1:30,000, A4 sheet
• Vicmap Topographic 1:30,000, A3 sheet
  (1:30,000 maps contain the same detail as 1:25,000, but are designed for easy printing on A4 or A3)
• Vicmap Topographic 1:50,000, A0 sheet
• Vicmap Topographic 1:100,000, A0 sheet

These maps are updated every 18 months to two years.

The maps are available either online or via the Vicmap Viewer Smartphone app. This app allows you to purchase, download, store and copy Vicmaps to the Avenza map app. Remember, only 3 custom maps (including Vicmaps) can be loaded into the Avenza free version at any time. So the Vicmap Viewer app is handy storage for the maps.
Vicmap mainly prints 1:50,000 paper maps and only a few 1:25,000. As all the map files are PDF’s, you can print any map you want; the 1:30,000 maps are especially handy here.

If a large number of Vicmaps are required, they can be purchased through a value-added reseller. Memory-map is one such reseller that has all Vicmaps. There are limitations. You must use memory-map software for viewing and printing the maps, but the cost savings can be considerable. Memory-map works on both your desktop and through a Smartphone app. Maps are downloaded as you need them or can be fully downloaded from the memory-map digital map store.

2. Spatial Vision

A number of areas of interest to walkers are covered by Spatial Vision’s Outdoor recreation guides. Most of these maps are at a scale of 1:50,000 and are packed with detail. Wilsons Promontory, The Grampians and Bogong Alpine area are just a few. The maps can be purchased as paper or are also available in a georeferenced form through the Avenza app map shop. Spatial Vision also produces the Vicmap books, covering Victoria at a scale of 1:50,000. These are used by the CFA and emergency services.

3. Meridian

Popular walking places, such as the Brisbane Ranges, Lerderderg and Werribee Georges, Hattah-Kulkyne and others are covered by Meridian’s Victoria Parks Guides. The maps can be purchased as paper or are also available in a georeferenced form through the Avenza app map shop.

4. OpenStreetMap

OpenStreetMap is a free editable map of the world maintained by over two million volunteers. These maps form the basis of the maps used in many Smartphone mapping apps. Many areas are mapped in great detail including the accurate plotting of walking tracks. Occasionally, one may come across a remote area where the mapping is incomplete. Printing of these maps can be done through a number of websites. Inkatlas is one such site which is free, easy to use and you can add your own track plots too. It can print in black/white and A4 multipage so expensive printing is not required.

5. Google and Apple maps

These online maps are primarily road maps but can show some tracks in some areas. Both are available as apps for a Smartphone and Google maps are readily opened on a desktop.

6. Melway

This much-loved street directory does show minor roads and some walking tracks. In some areas, the tracks are incomplete or inaccurately marked. There is also an online version.

7. Parks Victoria

Parks Vic visitor guides often contain good information on visitor facilities, walks and a good sketch map of the park. Many of the maps are also available in a georeferenced form through the Avenza app map shop for free. So you can print a copy and have the map available on your mobile too.

8. Rooftop and Hayman maps

These maps can be only obtained through map resellers. See list below. The Forest Activities Map series are the ones for walkers at a scale of 1:50,000 with more detailed insert maps of some areas. They cover some popular walking areas.

9. Google Earth

Don’t forget this superb resource. Once you have decided on your walk route, you can visualise it on Google Earth. Check out every twist and turn you intend to walk. If you don’t have the program on your desktop or smartphone, you can use the web version.

10. Local Organisations

Don’t forget local organisations. Councils, alpine resort managements etc. often produce excellent maps and track notes of walks in their areas.

11. Map Resellers

ABC Maps – shop and online

Maps, Books and Travel Guides – online only

MapWorks – shop and online

Melbourne Map Centre – online only

The above list is not exhaustive, but can start you on the way to finding quality, up-to-date maps for your next walk.

Links and sources accurate as on 20 May, 2019. Link validity and link content are subject to change. 

A Bushwalker's Guide to Pain-free Walking!

Top tips for preventing and managing injuries.

We asked Lauren Campbell, physiotherapist, and director at The Optimal Health Lab to give us some advice on avoiding and dealing with common ankle and knee injuries often suffered by bushwalkers. Here are her top tips:

Appropriate footwear

With such a rapidly growing footwear market, the numerous brands, models, and designs of walking shoes can be overwhelming! How do we even know we are in the best shoes for our feet? As everyday consumers we are not expected to know it all, so here are a few tips to help with your choice:

• All shoes have different purposes – for instance for tennis, running, climbing or bushwalking.
• Different shoes for different feet – shoes range from lightweight and neutral to heavy and more structured. Your type and choice will depend on your specific body type and individual needs, previous injury history, current pain/discomfort, etc.
• Fit and function – The length, width, and depth are incredibly important. A factor often overlooked is function. Function determines how the shoe moves with your foot during gait and how it may assist your gait - for example, how much it may support or resist certain movements (such as pronation)
• Injury risk – Ill-fitting footwear that does not address the above factors, could increase your risk of injury. Adequate support and cushioning, good sole grip, and fit and function, are always important considerations when choosing appropriate footwear.

The best way to ensure a good fit is to have your shoes fitted by a trained shoe store attendant or to see a podiatrist who has knowledge in the area. 

Ankle Sprains

Ever had that niggle in your ankle that never quite went away? And all it took was a slight twist? That niggle could actually be a little more serious than you think.

Ankles are incredibly important and complex joints. They have a big role as they form the connection between our leg bones and foot bones. They are held together by an intricate array of ligaments and supported by tendons and muscles. An ankle sprain or twist can cause disruption and damage to any of these structures, and often go unnoticed for a while.

Noticeable symptoms of damage may include pain, swelling, stiffness, bruising and inability to walk. If left untreated, our body ‘glues’ things back together in the way it knows how, but that is often not the best way. Our ankles may become weaker and more flexible, which makes it easier for an injury to occur again.

It is thought that these injuries and their symptoms are progressive. This is where rehab is crucial. Your recent major ankle sprain may have been avoided entirely if the last couple of little ones were addressed early. Your biomechanics - the way your body moves and functions - could also be contributing to your overall risk or reason for sprains.

As the saying goes, prevention is the best cure, so book an appointment with your podiatrist for a thorough biomechanical assessment to reduce your risk of ankle problems.

Knee pain – why up is better than down hills

Bushwalkers often present to physiotherapists with soreness on descending hills but are bemused/ confused that they can ascend hills with less pain. This is why this is a common presentation to our clinic and what factors may be involved.

When you are descending hills or walking downstairs, it requires your knee joint to perform a mini single leg squat to lower the other leg to the next step and/or patch of a walking trail. This single leg squat movement is stressful on some structures on the front of your knee, like Hoffa’s fat pad, and for the cartilage which lines the back of your patella (knee cap). It can also require your knee to bend at a larger angle than you are prepared for, which can put a strain on any structures within the knee joint itself. This could include any meniscal injury and/or any osteoarthritis in your knee compartments. Conversely, when ascending a hill, there isn’t the degree of stressors on internal or frontal knee structures, simply because you don’t need to perform a single leg squat with every step.

So what factors are involved in reducing pain around knees when heading downhill… because it’s certainly not all bad news and we don’t want you to despair… there are answers and help available.

Muscle strength is an important factor. With enough muscle strength supporting your knee complex, your knee structures are not stressed to a painful level. These muscle groups include your thigh, hamstring, glute and calf muscles. Strengthening these muscles at home and/or through some gym work or pilates may be part of your knee pain management plan.

Sourcing appropriate footwear for walking and considering your ankle stability and foot anatomy can ensure that your foot lands in the evenest way possible on the ground. Lastly, and most importantly, if you have had previous injuries or are experiencing pain when walking/climbing, you need an effective diagnosis and treatment plan from an experienced physiotherapist on the exact cause of your pain. A physiotherapist's aim is to keep you moving rather than removing you from all activity when dealing with knee pain. There are numerous benefits to bushwalking and we want to keep you on the tracks and trails.

Bushwalking in Extreme Weather

Extreme Heat

Bushwalking in hot and humid weather interferes with the normal body cooling process of evaporation from the lungs and skin and may lead to heat exhaustion. If this state is not recognized and treated promptly it may progress to the more serious and potentially fatal condition of heat stroke in which the body temperature rises due to failure of the heat-regulating center in the brain.

Prevention

• When walking in hot weather, drink plenty of water
• Avoid activity in the hottest part of the day by planning to rise early, take a midday siesta or reduce the distance to be covered during the day
• Plan mid-summer trips near watercourses and do not overextend the party
• Wear a hat and avoid sunburn
• Drink plenty of water before commencing the day's walking

Recognition

Early symptoms are thirst, muscle cramps, and weakness, headache, feeling hot, faint, giddy and nauseous. The victim develops rapid pulse and breathing accompanied by excessive sweating. As the dehydration becomes more severe, the skin becomes hot and dry, with headache, nausea, vomiting and mental disturbance common prior to collapse and unconsciousness.

Treatment

• Assist the victim to rest in a cool and shaded area.
• Remove unnecessary clothing, sponge with cool water and fan the victim.
• Give frequent cool drinks.
• Gently stretch any cramped muscles.
• In extreme cases immerse the victim in water or if this is not possible, cover with a wet sheet or tent.
• Where Heat Exhaustion has developed into Heat Stroke, the condition is potentially fatal, and the first aider must act urgently to call emergency services.

Extreme Cold

The gradual onset of the effect of exposure to extreme cold may be overlooked in the early stages. When the body loses heat faster than it can create it and the core temperature is lowered, the condition is known as hypothermia. It is responsible for several deaths each year in Australia.

Prevention

• Carry and wear suitable clothing to ensure you always have adequate protection from the cold particularly when combined with wet and windy conditions (ref clothing)
• Ensure a regular intake of food (high calorie) and drink. Do not drink alcohol which accelerates heat loss.
• On overnight walks be self-sufficient and do not rely on reaching mountain huts for shelter.
• Avoid physical exhaustion by walking within your party's capabilities.
• Take particular care when walking with more susceptible people, such as young children, slightly built, weak or less fit individuals.
• Take into account that long stops or immobilisation due to injury increase susceptibility.
• Be aware of the early signs of hypothermia.

Recognition

Treatment

The basic principles of first aid and resuscitation apply, in addition to the following measures to prevent further body cooling.

• STOP IMMEDIATELY
• Protect the victim from the cold environment by finding a nearby or improvised shelter from the wind and the wet, and insulating the body from the ground.
• Put on extra layers of clothing and a sleeping bag if available, remembering to cover the head.
• Enclose in a waterproof layer, such as a large plastic garbage bag pack liner, bivvy bag, ground sheet or safety blanket.
• Huddle together to warm the victim by body heat from other party members.
• DO NOT attempt to restore body heat by massage, warming beside a fire or hot water bottles. External heating that is too rapid may actually cause the core temperature of the victim to drop.
• Give warm sweet drinks and easily digestible food if conscious.DO NOT give victim alcohol, cigarettes, coffee, tea or hot drinks.
• Ensure other party members are adequately clothed and not in similar danger.

Electrical Storms

Prevention

Check weather conditions with the Bureau of Meteorology before commencing your walk. Wherever possible, do not go out when thunderstorms are predicted.

Take Action

Avoid high ground, isolated objects such as a tree in a clearing, overhanging cliffs or caves. If possible, insulate yourself from the ground by sitting on your pack. Members of a party may sit together but should not be in contact.