First aid for Cape Town hikers

Signs

• Hot, red, or clammy skin
• Confusion, dizziness, or headache
• Rapid or shallow breathing
• Nausea or vomiting
• Loss of consciousness in severe cases

What to do

1. Move to shade immediately — stop all activity
2. Remove excess clothing and loosen anything tight
3. Wet the skin and fan to promote cooling
4. Give water in small sips if the person is conscious
5. Place cold, wet cloths on the neck, armpits, and groin
6. If no improvement within 15 minutes, or the person is confused — call WSAR

Do not

• Do not give food
• Do not allow them to walk if confused

Signs

• One or two small puncture marks
• Pain, redness, or swelling around the bite
• Nausea, dizziness, or sweating
• Drooping eyelids or difficulty swallowing in severe cases

What to do

1. Keep the person calm and as still as possible — movement spreads venom faster
2. Remove rings, watches, or tight clothing near the bite before swelling starts
3. Keep the bitten limb at or below heart level
4. Note the snake's colour and markings if it is safe to do so
5. Call WSAR immediately — do not wait for symptoms

Do not

• Do not cut the bite or try to suck out venom
• Do not apply a tourniquet
• Do not apply ice
• Do not give alcohol or pain killers

Signs

• Uncontrolled, intense shivering
• Confusion, slurred speech, or poor decision-making
• Stumbling or poor coordination
• Pale or blue-tinged skin
• Shivering that has stopped — this is a danger sign, not recovery

What to do

1. Get the person out of the wind and rain
2. Remove all wet clothing
3. Insulate from the ground — use a pack, sleeping mat, or extra layers
4. Cover the head and neck — most heat is lost there
5. Place warm (not hot) packs in the armpits and groin if available
6. Give warm, sweet drinks if the person is fully conscious and able to swallow
7. Call WSAR

Do not

• Do not give alcohol
• Do not rub the limbs vigorously
• Do not put the person in a hot bath or against a fire
• Do not assume they are fine because shivering has stopped

Signs

• Pain and tenderness around the ankle or along the bone
• Swelling or bruising
• Unable to bear weight, or significant pain when trying

What to do

1. Stop moving immediately
2. Sit or lie down and elevate the leg if possible
3. Pad the injury with spare clothing — do not attempt to straighten
4. If the person cannot bear weight at all, call WSAR
5. If they can bear some weight, assist them out slowly — improvise a splint from sticks and clothing

Do not

• Do not remove the boot if the ankle is badly swollen — it provides compression and support
• Do not attempt to straighten a suspected fracture

Signs

• Visible wound or bleeding
• Head injury: confusion, unequal pupils, nausea after impact
• Suspected spinal injury: neck or back pain after a fall or impact

What to do

1. Move everyone out of the rockfall zone first
2. Call WSAR immediately if any head or spinal injury is suspected
3. Control bleeding with firm, direct pressure using a clean cloth
4. Keep the person still, warm, and calm
5. Do not remove a helmet if one is being worn

Do not

• Do not move someone with a suspected spinal injury unless they are in immediate danger
• Do not give food or water to someone with a head injury

Signs

• Landmarks do not match your map or description
• The path has disappeared
• Daylight is fading

What to do

1. Stop — do not keep walking when you are uncertain of your position
2. Call WSAR if you have signal: 021 937 0300
3. If no signal, try 112 — it works on any network without airtime
4. Stay put — a stationary person is much easier to find
5. Signal your position: three whistle blasts, flash a headlamp, reflect sunlight with a phone screen
6. Get out of wind and conserve warmth while you wait

Do not

• Do not keep walking downhill hoping to find a path — in the dark, this can take you off a cliff face
• Do not separate from the group