Arcturus Primitive Skills Institute

medical emergency

11/28/25 From Shoulder Dislocation to Restoration: The Cunningham Method in Motion

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A dislocated shoulder is a painful and often alarming injury, but in many cases, it can be treated effectively without surgery. Among the various reduction techniques, the Cunningham method stands out for its simplicity, gentleness, and reliance on the body’s natural relaxation response. This technique uses traction, muscle relaxation, and massage—particularly of the trapezius, deltoid, and biceps muscles—to guide the shoulder back into place. I was fortunate enough to learn this skill when I went through Wilderness First Responder training.
 
Understanding the Dislocation
Most shoulder dislocations are anterior, meaning the head of the humerus (upper arm bone) slips forward out of the socket. This can happen during falls, sports injuries, or sudden arm movements. The key to successful reduction is relaxing the surrounding muscles, which are often in spasm due to pain and trauma.
 
The Cunningham Technique: Step-by-Step
This method is ideal for cooperative patients and does not require sedation or forceful manipulation. Here’s how it works:
1. Positioning the Patient
• Sit the patient upright in a chair with a straight back.
• The affected arm should be adducted (resting close to the body), with the elbow bent at 90 degrees and the forearm resting on the patient’s lap or gently supported by the practitioner’s arm.
2. Establishing Calm and Comfort
• The practitioner should reassure the patient and encourage deep, slow breathing.
• A calm environment is essential. Muscle tension is the enemy of reduction.
3. Gentle Traction
• Without pulling, allow the natural weight of the practitioner’s arm (if their right shoulder is dislocated, reach across with your right hand and hook it gently in the bend of their elbow. Have them place their right hand on your right shoulder; opposite for a left shoulder dislocation) to provide light downward traction.
• No jerking or sudden movements—just steady, passive support.
4. Targeted Muscle Massage
• Begin massaging the trapezius (upper shoulder/neck area) using circular motions.
• Move to the deltoid (shoulder cap) and then to the biceps, especially the biceps brachii.
• Use a kneading motion: thumb in front, fingers behind the arm, applying firm but comfortable pressure.
• This massage helps relieve muscle spasm, which is often the main barrier to reduction.
5. The Moment of Reduction
• As the muscles relax, the humeral head may slip back into the socket without a dramatic “pop.”
• Watch for subtle signs: the shoulder contour normalizes, and the patient may feel sudden relief.
 
Why This Works
The Cunningham technique leverages the body’s own mechanics. By relaxing the muscles that are pulling the humeral head out of place, and applying gentle traction, the joint can realign naturally. It avoids the risks of forceful manipulation and is especially useful in settings without access to sedation or advanced equipment.
 
Aftercare
Once the shoulder is reduced:
• Immobilize the arm in a sling.
• Apply ice to reduce swelling.
• Refer for follow-up imaging to confirm reduction and rule out fractures.
• Begin rehabilitation within days to restore strength and prevent recurrence.
 
Why You Should Have This Knowledge
In a world where help might be hours—or days—away, knowing how to perform a shoulder reduction like the Cunningham Method can be the difference between a manageable injury and a full-blown emergency. This technique doesn’t require sedation, special tools, or brute strength—just calm, confidence, and a basic understanding of anatomy. That makes it a perfect fit for wilderness medics, preppers, outdoor guides, and anyone building a serious preparedness plan. Pair this knowledge with a compact sling, a cold pack, and a laminated instruction card, and you’ve got a shoulder rescue system that fits in your backpack. When the trail gets rough and the stakes are high, it’s not just about what you carry—its about what you know. And this is knowledge worth carrying.
 
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Heat Stroke vs. Heat Exhaustion: Can You Spot the Signs Before It’s Too Late?

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It’s July 1, 2025, and summer is officially here. In West Michigan, we’ve already endured two major heat waves, with temperatures soaring into the low to mid-90s.
 
During my June 20–22 Basic 101 course, I stressed an important core principle: hydrate, stay shaded, and cool down often. I even hung a tarp over our meeting area to protect students from the intense sun. Why? Because I was actively working to prevent Heat Exhaustion—and more critically, Heat Stroke.
 
But do you know the difference between the two? And more importantly, can you recognize the signs before it’s too late?
 
Heat Exhaustion vs. Heat Stroke: What You Need to Know
Both conditions are dangerous responses to extreme heat, but they differ significantly in severity and treatment. Heat Exhaustion is the body’s warning sign that it’s overheating. It typically begins with dehydration from heavy sweating, salt loss, and prolonged exposure to high temperatures.
 
If not treated, it can quickly progress to Heat Stroke—a medical emergency in which the body’s internal temperature control fails, potentially leading to brain damage, organ failure, or even death.
 
At Arcturus Primitive Skills Institute, we teach our students how to monitor and regulate core body temperature, because failing to do so in extreme conditions can have serious consequences.
 
Key Differences Between Heat Exhaustion and Heat Stroke:
Category: Heat Exhaustion vs Heat Stroke
Severity: Moderate; can be treated on-site vs Critical; requires emergency medical attention
Sweating: Heavy, continuous vs None; skin becomes hot and dry
Body Temp: Below 104°F vs Above 104°F
Mental State Fatigued but conscious vs Confused, disoriented, may lose consciousness
Pulse Rapid and weak vs Rapid and strong
 
Symptoms to Watch For:
Heat Exhaustion
• Excessive sweating
• Thirst and dehydration
• Dizziness or fainting
• Nausea and possible vomiting
• Muscle cramps
• Cool, clammy, pale skin
• Weakness and fatigue
• Headache
• Body temperature at or below 103°F
• Rapid, weak pulse
Heat Stroke
• Severe or pounding headache
• Confusion or altered mental status
• Absence of sweating
• Red, hot, dry skin
• Body temperature above 104°F
• Nausea and vomiting
• Rapid, strong pulse
• Short, shallow breathing
• Loss of consciousness
• Possible seizures in extreme cases
 
Treatment Protocols:
Treating Heat Exhaustion
• Move to a shaded or air-conditioned area
• Remove excess clothing
• Rehydrate with water or electrolyte-rich fluids like Gatorade
• Apply cool, damp cloths to the neck, head, and underarms
• Take a cool shower if possible
Treating Heat Stroke
• Call 911 immediately
• Relocate the person to a cooler area
• Remove clothing to aid cooling
• Apply cold compresses or ice packs to the neck, groin, and armpits
• Lay the person down and monitor closely for changes in consciousness
 
Summer in Michigan is no joke. Stay prepared, stay hydrated, and don’t ignore the signs of heat-related illness. When things cool off, come visit me in the wild. 

Battling the Freeze: Essential Tips for the Prevention and Treatment of Frostbite

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Frostbite is nature’s brutal way of reminding you who’s boss. When temperatures plummet and you’re exposed to the biting cold for too long, your skin and the tissues beneath can literally freeze solid. It’s the extremities—fingers, toes, ears, and nose—that take the worst hit. Initially, your skin turns ice-cold and red, then goes numb, hard, and pale as it progresses. The more severe the frostbite, the deeper it bites, tearing through muscles, nerves, and blood vessels, sometimes leading to permanent damage or even amputation. From a mild stinging sensation to skin turning a sinister shade of purple or black, frostbite is relentless. Dressing in layers, covering every inch of skin, and seeking warmth as quickly as possible are essential to stave off this icy menace. Once frostbite sets in, immediate medical help is your only lifeline.

Remember the colors red, white, and blue? They’re not just about patriotism—they’re your body waving the white flag to the cold.

Red: The early stage, known as frostnip, where your skin turns red and cold. You’ll feel pain, numbness, and that dreaded pins and needles sensation, especially in your hands and feet. Time to escape the cold, find heat, and seek shelter.

White (and early blue): This is superficial or second stage frostbite. Your skin turns white and stiff, like wax, with the tissue freezing underneath. Strangely, your skin might feel hot at this point. Your body’s sending out distress signals—get warm now!

Blue: Deep frostbite is the real deal. Both superficial and deep tissues are frozen. Your skin turns blue and splotchy, circulation is clogged up, and you’ll start getting blisters. Ignore it, and your skin will turn black and die, leading to potential amputation.

Immersion foot (trench foot): Think WWI. When feet are stuck in water below 60°F for too long, it wrecks the nerves, leaving lasting damage.

So how do you stave off these icy attacks? Get out of the cold, find shelter, find heat, and strip off those wet clothes and shoes. Start rewarming—slowly. It’s gonna hurt, but it’s necessary. Too fast, and you risk stopping your heart. For frostbite, soak the affected area in warm water (not above 103°F) for 30 minutes, replacing the water as needed. Skin should turn red again. Give Ibuprofen for pain and to help blood flow. Whatever you do, don’t let the tissue refreeze—that’s a one-way ticket to more damage. And no rubbing frozen skin!

Remember, it’s a cold, cruel world out there. Stay warm, stay vigilant.

 

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