Our good friend and JMT stalwart John Ladd had a hike-ending injury and successful self-rescue this week. You can follow the play by play on the thread at the JMT FB page.

John is very interested in contacting SAR folks about his ordeal as he prepares to write it up. Find John through messaging on FB, or check out the JMT FB Group.

https://www.facebook.com/groups/JohnMuirTrail/?fref=nf

Sounds like he took a fall. I'll be taking more Vicodin along when I go on my next trip! Hope he posts his writeup soon.

Steve,

That is a question I had: Can you take a class II controlled substance as part of your first aid kit? If so, do you ask your PMD before trips for a limited dose?

SD

With prescriptions, why not? And yes, I get the occasional Rx for trips as necessary.

you have been reading too much about the opioid crisis.

if you are a responsible person, and your MD is not an illegal Rx-mill, then yes you can do this. The vast majority of patients and providers use such drugs judiciously and properly.

As for those wackos who buy a street corner rice-grain size piece of carfentanyl and die, that's different.

Opioids: I just keep my old supplies around -- knee surgery, shoulder surgery, dental implant -- all the doctors prescribe way more than I ever need.

As a Sierra Club Outings leader - wishing to be protect my hikers to the best of my ability, I found three constraints.

1) Sierra Club - don't carry pharmaceuticals - for legal reasons.
2) St. Johns First Aid Certification - don't carry pharmaceuticals - for legal reasons.
3) Doctor prescribed drugs - don't carry them either - for legal reasons.

So, I needed to set a worst-case boundary. At the time I was leading trips where a miss-step could easily lead to a broken extremity with no possibility of chopper extraction until after dawn the next day.

So I carried a splint, to help prevent further permanent damage. My doctor (D.) at the time gave me samples of Tramadol, which is a non-masking pain-killer. Which means vital signs are not affected, so that the professionals could see the real situation - or something like that. The stress of staying overnight on the trail could also be dealt with by a small sample of Valium. I also carried samples of Klonapin for the very rare anxiety attack. That little yellow pill is magic.

So, in several cases, I indicated to the "victim" that if they wished to take some medication, they should look in a particular pocket of my pack. I didn't directly provide it, and Dr. D didn't prescribe it and a hiker benefited.

I expect to be torn apart by the the multiple legitimate doctors on this site. However, I've witnessed a young lady go from vagus disaster to normal in 10 minutes with a simple Klonapin dosage.

Perhaps we should start a new thread here...

You are setting yourself up for a potential lawsuit or worse. Never hand out samples of your personal medication to anyone, even in an emergency. Why?

First, you are not a doctor, second you don't know the person's medical history, third you don't know possible bad interactions with other drugs the person might be taking and fourth, you are probably breaking the law. Keep your samples in your pack or don't carry them at all.

When I was in SAR we could not give a rescued person any medication unless we had a direct order from a physician. On my first SAR mission the victim with a broken pelvis (screaming) was given a shot of Demerol by one of our team, who happened to be a local surgical nurse. The order was given by radio by a doctor nearby who was with us as a team member on the mountain (the North Palisade). We could not even give aspirin without a doctor's legitimate order or even suggest it to a victim.

Any doctors knowledgeable with current laws might want to chime in on this one. This should be interesting.

the replies that Steve and I had made pertained to using our own pills to treat ourselves.

As for giving pills to others, if I (a physician) encountered a seriously injured person on the mountain and I was carrying my usual supply of antibiotics, Diamox, pain pills, and others, I could offer them. All it takes is a history (listen to the patient) and limited physical exam to make it legal in an emergency not done "legally" in the office. Greater need of the injured person overrides other concerns. I would think any good samaritan clause would allow that. There are plenty of prescribing situations back at sea level that do not begin to meet this standard. Think internet prescribing, for example.

Um, anyone contacted John at the JMT FB page?

John Ladd posted this afternoon that he hopes to post his writeup by mid-week.

A few years ago I was hiking with Bob R, and we came upon a "day" hiker who had been out on the trail about 36 hours. He reported his back "went out" at or near the summit, and he was struggling down slowly. I offered him one (or maybe it was two) Vicodin tablets, and he was really happy to accept it.

He made it down safely on his own. The pain meds helped.