First aid for Cape Town hikers
Call Wilderness Search and Rescue first. These notes are while you wait.
Heat exhaustion and stroke
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
- Move to shade immediately — stop all activity
- Remove excess clothing and loosen anything tight
- Wet the skin and fan to promote cooling
- Give water in small sips if the person is conscious
- Place cold, wet cloths on the neck, armpits, and groin
- 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
Heat stroke is life-threatening. When in doubt, call Wilderness Search and Rescue.
Snakebite
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
- Keep the person calm and as still as possible — movement spreads venom faster
- Remove rings, watches, or tight clothing near the bite before swelling starts
- Keep the bitten limb at or below heart level
- Note the snake's colour and markings if it is safe to do so
- 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
Cape cobra bites can be fatal within hours. Antivenom must be given at a hospital. Call immediately.
Hypothermia
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
- Get the person out of the wind and rain
- Remove all wet clothing
- Insulate from the ground — use a pack, sleeping mat, or extra layers
- Cover the head and neck — most heat is lost there
- Place warm (not hot) packs in the armpits and groin if available
- Give warm, sweet drinks if the person is fully conscious and able to swallow
- 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
Rewarm slowly. Rapid rewarming can cause cardiac arrest. Keep them still and warm until help arrives.
Twisted ankle or fracture
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
- Stop moving immediately
- Sit or lie down and elevate the leg if possible
- Pad the injury with spare clothing — do not attempt to straighten
- If the person cannot bear weight at all, call WSAR
- 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
If you cannot tell whether it is a sprain or fracture, treat it as a fracture.
Rockfall injury
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
- Move everyone out of the rockfall zone first
- Call WSAR immediately if any head or spinal injury is suspected
- Control bleeding with firm, direct pressure using a clean cloth
- Keep the person still, warm, and calm
- 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
Head injuries can deteriorate quickly with no outward change. When in doubt, call.
Lost on the mountain
Signs
- Landmarks do not match your map or description
- The path has disappeared
- Daylight is fading
What to do
- Stop — do not keep walking when you are uncertain of your position
- Call WSAR if you have signal: 021 937 0300
- If no signal, try 112 — it works on any network without airtime
- Stay put — a stationary person is much easier to find
- Signal your position: three whistle blasts, flash a headlamp, reflect sunlight with a phone screen
- 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
Most call-outs are for hikers who kept moving after getting lost. Stay put and make noise.