View Full Version : What does a decent first aid kit really need ?
In light of Warthog1981's recent injury with an axe I've been thinking about the bits and pieces that I usually have in my first aid kits.
The little one in my day pack would have struggled to deal properly with that type of wound and I'm seriously thinking of adding a large field dressing to the kit.
Any other *musthaves* that ought to be in it ?
cheers,
Toddy
Rothley Bill
03-01-2009, 23:08
A large field dressing as you mentioned very useful. There is no need to go over the top or to take anything you are not sure about using, as it could make things worse :(
I carry a small dressing, large dressing, plasters, blister kit, Saline and a cool pack for taking the heat out of burns, cos we are not always near to a stream or river and you can use it for a number of possible injuries. amongst various other things that live in the kit like safety pins, steristrips et al.
Scots_Charles_River
03-01-2009, 23:13
Wrap your sannys in cellophane, to use for that type of wound ! Or a collpased lung
Nick
warthog1981
03-01-2009, 23:29
All you need is a cotton handkerchief and a sock and a bandage to stop it falling off ;)
But a large field dressing would have been ideal :D
Here's what I carry,an why.
A selection of different size plasters all waterproof, Most accidents are cuts and grazes.
1 metre of strip plaster ,not waterproof. Some accidents need more than a small plaster.
A cooling burn pad for large burns and some small burnpads ,also cooling . Most burns are to the fingers
A field dressing for big cuts.
A triangular bandage for broken or sprained arms,Also doubles as an extra wound dressing.
An eye bandage for eyes and as a small dressing
A tampon for pierce wounds.
Two small bandages for breaks and sprains,also (again a small dressing).
Tweezers for splinters.
A tick remover.
Painkillers
Anti-inflammatories.
Immodium
A tube of savlon
Anti histamines.
Blister cream and pads.
It seems like a lot to carry but any one of them can save a lot of pain and grief.
On the top of my first aid kit is an instruction leaflet just in case I'm unconcious.
Not as much as people think.
If you are within a day's walk of help your first aid need only be very basic.
A large sterile field dressing is arguably unnecessary as the wound is far from sterile before it goes on.
A clean sock, scarf or torn off bit of cloth is ample to press on the wound. When you get to A+E, the wound will be properly cleaned before closure.
I also stopped carrying sachets of saline/antiseptic on the same basis. Wound/ eye irrigation can be done with boiled water from my canteen in the field before A+E do it properly.
For any sizeable wound problem you need way more irrigation than you would carry in a first aid kit. I like the idea of the burns pack if you are away from water, but that's rarely the case in this part of the world.
I carry:
Plasters, alcohol wipes and gaffa tape for blisters, small cuts and splintage.
Scalpel blades and sterile needles for blisters, splinters, nail haematomas (and possible heroics)
The drugs I carry are limited to minor ailments or lifesaving.
Painkillers
Antihistamines
Antacids
Antidiarrhoea
Aspirin
Pottasium permanganate (quick decontamination of lots of water)
I think that's it, I'll check it to see if I've forgotten anything. It all fits in the side pocket of my small possibles pouch.
Of course for a multi-day trip, this changes completely depending on the environment.
Man I type slowly!
What happened to you Warthog?
With a bit of creativity, gaffa tape replaces:
triangular bandage
crepe bandage
blister dressings
warthog1981
03-01-2009, 23:55
if you look at the Scottish New Year meet up thread you can see what I did shep :o
Ouch.
Like you posted though. Cotton hankerchief, sock etc. then get yourself to A+E. No real need for a field dressing if you're not too far from home.
Carry what you want but without training you are just peeing in the wind as has been said before on several threads regarding FAK's recently. Only carry your own medication or that of family members in your party, use your training and call for help.
MartinK9
04-01-2009, 01:19
if you look at the Scottish New Year meet up thread you can see what I did shep :o
:yikes: Owww that looks sore, hope you get well soon
MancsMan
04-01-2009, 09:48
Small bottle of Oil of Cloves, if you have ever lost a filling, cracked tooth while miles from the nearest dentist you will understand why.........
John Fenna
04-01-2009, 11:28
if you look at the Scottish New Year meet up thread you can see what I did shep :o
Oh boy - I bet that stung!
I carry a Web-tex medic pouch - the belt order one - filed with the kind of stuff you find in the 1st aid kits sold by the St Johns website.
A larger version - rucksack medics side pocket is in the van, a smaller one in my work bag, a mini one in my man bag, a micro one on my belt in camp, a "cuts" specific one in my workshop and a simplified but large one in my wifes car...
I just renewed the contents of them all all some items go past a "best before" date and I do not fancy being sued by some "get rich quick" lawyer type if some one whose life I save decides that the infection they got in a cut was due to my using an out of date dressing....
The refurb cost about £100.00....:(
its always worth having super glue for sealing small cuts. and as i only found out yesterday, super glue and cotton mixed together create an extreme exothermic reaction. that is, if you pour super glue onto cotton wool you can start a fire.
its always worth having super glue for sealing small cuts. and as i only found out yesterday, super glue and cotton mixed together create an extreme exothermic reaction. that is, if you pour super glue onto cotton wool you can start a fire.
A note aside:
'Superglue' used in hospital to close wounds is different than the one you buy in a DIY store!
The DIY version should not be used to glue wounds.
:eek:
Scots_Charles_River
04-01-2009, 13:58
So a staple gun for that type of wound ?
If far away from help, that was the premis on my last course for every scenario, stemming blood and keeping shock at bay would the answer. Knowledge, as others have said helps more, a collins gem or other aide-memoire helps.
Nick
A note aside:
'Superglue' used in hospital to close wounds is different than the one you buy in a DIY store!
The DIY version should not be used to glue wounds.
:eek:
Actually one of the types found in hospital is practically identical. There are also a few around that are not based on cyanoacrylate though.
I once heard that cyanoacrylate was originally developed by the US military in the 70's specifically as a wound closure, I don't know if that's fact though.
Anyway, I would not advocate closing or sealing any wounds in the field on a short trip as you are likely to be sealing more in than you are out.
its always worth having super glue for sealing small cuts. and as i only found out yesterday, super glue and cotton mixed together create an extreme exothermic reaction. that is, if you pour super glue onto cotton wool you can start a fire.
Don't use household superglue please:rolleyes:
John Fenna
04-01-2009, 16:16
super glue and cotton mixed together create an extreme exothermic reaction. that is, if you pour super glue onto cotton wool you can start a fire.
Just tried this with £1 shop Super glue on pure cotton cottonwool.
It not even get warm!
rancid badger
04-01-2009, 16:31
In light of Warthog1981's recent injury with an axe I've been thinking about the bits and pieces that I usually have in my first aid kits.
The little one in my day pack would have struggled to deal properly with that type of wound and I'm seriously thinking of adding a large field dressing to the kit.
Any other *musthaves* that ought to be in it ?
cheers,
Toddy
I ALWAYS carry at least one, f.f.d. or army issue field dressing, in a pocket if I'm out and about with edged tools. These are excellent, as they are of a size that is just about right and fully waterproof too. This is in addition, to a small kit which goes with even a swiss army knife. If I'm out with the family or a small group, I carry several, in my kit.
I must echo rik_uk3 in both his post's in this thread by the way!
cheers
R.B.
In light of Warthog1981's recent injury with an axe...
There is no portable medical kit capable of fixing that. You'd need a tourniquet, a sat phone, GPS and a handful of morphine jabs.
If possible, and if you MUST use glue, try and get hold of something like Dermabond, its the pukka stuff
Not as much as people think.
If you are within a day's walk of help your first aid need only be very basic.
[...]
I carry:
Plasters, alcohol wipes and gaffa tape for blisters, small cuts and splintage.
Scalpel blades and sterile needles for blisters, splinters, nail haematomas (and possible heroics)
[...]
Of course for a multi-day trip, this changes completely depending on the environment.
Shep, watch out with needles for nail haematomas! The best trick is to heat a paperclip and press it through the nail; the blood will immediately cool off the paperclip and because it's blunt it will not pierce the oh so sensible skin under your nails.
Shep, watch out with needles for nail haematomas! The best trick is to heat a paperclip and press it through the nail; the blood will immediately cool off the paperclip and because it's blunt it will not pierce the oh so sensible skin under your nails.
True and a good point, the paperclip works well and A+Es have a gadget which is a cross between a paperclip and a soldering iron. I'm just obsessed with everything being multi-purpose when it comes to my recreation kit!
It's easy enough with a needle. You use a drilling action and stop as soon as you hit paydirt. I haven't hurt anyone yet...
If possible, and if you MUST use glue, try and get hold of something like Dermabond, its the pukka stuff
i did notice on the cyanoacrylate MSDS sheet that it polymerizes flesh! which could obviously be horrible, but maybe it would help to cauterize a serious wound?
i think i'll look out for the pukka stuff though. :o
w00dsmoke
04-01-2009, 20:08
I think this is a must have:
http://www.dentanurse.com/
Unfortunatley I've had to use this kit 3 or 4 times over the years and it really has saved the day by returning things almost to normality until you get to a dentist. I've replaced fillings, fixed collapsed crowns (during last years Loch Chon meet up I collapsed a crown and had to use it then!). Forget the travel kits with syringes unless you really are going abroad then take this kit too as this is better!
squantrill
04-01-2009, 21:16
I remember my old kayak instructors first aid kit on multi day excursions!! it was a strip of paracetamol!!
Mmm well I am first aid trained and I just take along a big cotton thinggy for wrapping up arms legs and head! a few plasters and iodine both for water and wounds. and paracetamol..Im working on the assumption that with a mobile phone and the closeness of help where I go that it is not a problem. If I was to go further afield I would check what I took with me and proabably add a few more bits and pieces.. but I try to 'K I S S'..
Can you use sanitary towels instead of wound dressings? I think I read that somewhere - sterile, absorbent and cheap.
I am quite amazed at the amount of stuff being carried!
Unfortunately, the first thing we need to specify is the purpose of the first aid kit: for the car? the pocket? the house?
If we assume 'the pocket', we need to keep things small otherwise we are very unlikely to carry it at all. And, as we all know, it's no use if we leave it at home. I would argue that the following are essential and you can add stuff as you wish, remembering to keep it small:
Shell dressing (large pad of cotton wool, strips of material, safety pins all included)
Various plasters
Pencil and paper (gaffa tape wrapped around pencil)
And that's it! Remember that this is a FIRST AID KIT - to administer first aid until casualty can get to hospital and see someone who knows what they are doing.
The military shell dressing can be used for small as well as large wounds (cut/tear it to size), the safety pins can be used for improvising a sling with the casualty's own clothes, the strips of material connected to the pad can be removed and used for other stuff (small bandages, splint ties, etc)
Plasters are great for nicks and cuts. You don't need antiseptics now - just flush with the water that you're carrying or use a salt solution with your cooking salt that you've probably got in our bag somewhere (nick a sachet from a cafe!).
Burns? Cool water.
Blisters? Gaffa tape.
Etc, etc. By improvising
We talk a lot about carrying knowledge instead of kit - do a St Johns course and learn the basics.
I have a kit in the car which has all the extras but for wandering around, keep it really simple.
If we are starting to look at expedition first aid kits, we're getting into a whole different ball game...
Looking on the firstaid.com site, they list one of the most important items in a FAK is a mobile phone, I for one agree with them.
One major drawback to carrying too much gear is panic/anxiety, all first aiders, Nurses, Doctors will go through some level of panic, with experience and training these emotions are controlled, but for some, having a mass of kit in front of them could lead to confusion, and you can't afford to be confused in a first aid situation; you need to be keeping things in a very orderly fashion and above all, simple
My big worry when I read threads like this is the lack of training and the kit people are carrying which is very often way over the top
Do the training
Practise what you have been taught on a regular basis
Keep your kit as simple as possible
Don't think you know it all, trust me, you don't
Update your skills/knowledge as and when you can
Remember, your a first aider, not George Clooney from ER
warthog1981
05-01-2009, 13:58
Hence the reasoning for the clean cotton handkerchief and a sock fast clean and always at hand simple Ive had enough nicks and cuts to not panic and just patch it up till some one more savvy than me can take a proper look at it :D
I should point out i always carry two handkerchiefs one for my nose and one is my first aid kit
Cheers Russ
Can you use sanitary towels instead of wound dressings? I think I read that somewhere - sterile, absorbent and cheap.
Yes you can - they are not sterile, but they do work very well. Don't go for any that are perfumed or anything though! Also, be aware of how much liquid they can absorb - remember to be on the lookout for shock, it is easily missed until too late if you can't see a pudle of blood!
Melonfish
05-02-2009, 14:55
am i the only one to carry an FFD? heh, odd but incredibly useful. i have a small one thats always in a us Compass/alice pouch. it can be webbed anywhere.
brill for large cuts or monster bleeders and of course can be tied off. i also keep a space blanket in the same pouch because those things are fantastic.
also Eye drops, the type you can squeeze the lot out if need be (eyewash)
anybody use that spray on plaster stuff for small cuts? is it any good?
I agree entirely with Rik- mostly it is what is in your head, not your FAK that will make a difference.
I carry very little- plasters and compeed for comfort, cling film or a wound dressing for more serious stuff. Those special tweezers for sheep ticks, they work !
I have however bought some Quick Clot ( would put in a link but I do not know how- you can find it via any search engine) from Cabelas in the US as I could not find a UK supplier. It occurred to me that serious blood loss was actually relatively likely to occur ( I hope not) and one of these is light, takes up little space and might make a difference. I hope it never gets used, like all First Aid.
Think about what might happen, and what you need to do to keep someone alive till the cavalry arrive- as in most UK situations you will be waiting for them, and you simply have to keep the patient alive and as happy as can be until you hand over to the experts.
Bigbear
Frankly, I'm amazed at some of the advice here so I'm going to go for a big old post and then we'll all have a pint at the end. :)
First and foremost, first-aid is a misused term. Strictly, it's 'Simple emergency medical care procedures intended for lay rescuers to perform before emergency medical professionals are available.' This basically means "make sure they don't die". If all you want to do is make sure someone doesn't die, then sure, carry a few dressings, a yard of muslin and a mobile phone. Take a look at a WWII first aid kit, it really had naff all in it, even though the chances of a traumatic injury were far higher than we have out in the wilds. This is real "patch 'em up and ship 'em out" territory.
The next level up from that is "make sure they don't die and have the best chance of making a full recovery". Sure you can treat a burn with cold water, but if you've just slipped over and put your hand in a fire and you run that in a stream for a bit, then not only do you run the risk of getting lovely bacteria in your wound, but that wound is not going to heal anything like as good as if you applied a burn dressing or burn gel. Application of anti-septics and the use of gloved or at least clean hands would be awfully useful here too. If you want to cut plasters or tape with your knife that you've been using to cut all manner of stuff, then you go ahead, I'm going to carry scissors. I carry steristrips, because they give the best chance of a deep cut healing back to normal. I always carry a survival bag. My mate (mountain rescue) also carries a sleeping bag and bothi, even on a day trek.
This is basically where the RNLI first aid stops and we carry a first aid kit the size of a suitcase and are trained to use it. Yes, it's so big because we could come up against all sorts of problems, but we really are into keeping people alive and getting them to hospital or helicopters with the best chance of survival, not about trying to treat them at sea.
OK, so that's first aid, but in reality what we as campers, hikers, trekker and bushscrafters carry are 'medical kits'. We're not merely concerned with keeping people alive, we're interested in treating what we can. We don't want to have to take people to hospital or home if we can help it. If you've ever had a minor strain then you'll know it's actually quite painful unless you're strapped up when it's really quite ok. A good ankle strapping allowed me to finish a charity walk. I would have been gutted without that opportunity. Cuts, stings, strains, blisters, blood blisters, sun burn, ticks, splinters, minor pain and inflammation and other injuries can all be managed with very light weight kit. Yes, you can walk in pain for five days on a splinter and it go septic when you get home, but I'll carry tweezers. Yes, I can use my left thumb because my right one has blood under the nail, but a paper clip will sort that out. Yes, I can guess if someone has a fever, but a head strip thermometer weighs nothing. I'll take immodium rather than battle with diarrhoea and consequential dehydration.
Further along the line are things that just plain make people comfortable. If I'm trekking, I don't like guts ache, so I carry antacids. I don't like dry lips, so I carry lip balm and I don't like pain, so I carry pain killers.
I choose my first aid kit contents based on what I'm going to be doing, how long I'm going to be doing it for, the environment, the weather, how far I am from civilisation, who else I've got to look after and what level of care I want to give* and what I'm qualified to administer**.
* The level of care I want to give is generally. Don't die. Don't call the emergency services unless I have to, especially if they are voluntary. Get myself home (or back to civilisation or camp) if I can. Don't go home unless I need to. Be comfortable whilst I'm out. But equally, don't carry so much that I can't carry something else useful which I'm more likely to need or want. I don't carry a neck brace, for instance.
** Corollary: always take a nurse
There is a very big difference between a pocket kit for a day hike in along the coast path and a five day camping trip on Dartmoor with a group of school kids. I don't light fires when I'm hiking, so I don't carry burn stuff. None of the kids have angina, so I don't carry glyceryl trinitrate spray.
There is also a difference between what you have in a day sack and what you have at camp. You don't need to carry all of it all the time.
So the answer to the question "what belongs in first decent first aid kit" is all about what could go wrong and how much you want to let that spoil your trip. And the mere fact that it was asked with the qualifier "decent" implies it wants to be somewhat more than emergency patch up.
Remember, if you're in a party and someone needs to go home, they'll be taking someone perfectly healthy with them and if that can be avoided, then all the better for two people.
And finally, just because you have not injured yourself before and you consider yourself very careful, doesn't mean it won't happen to you or someone you're with. That is the nature of accidents. It can be high impact stuff, even if it's very low risk.
Now, who fancies a pint?
Now that's a good idea :D thanks for the post, lots of common sense and practical advice.
I know that I 'need' antihistamines, I know I 'need' something to clean and potentially cover bites, cuts, grazes, burns and the like.
I know I have damaged ligaments in my ankle so a strapping bandage is always in my pack.
But I also knew that apart from doing as Russ did, I had nothing that would dress a wound such as his and keep it clean and stable until we got him to hospital........a shemagh maybe ? :dunno:
I think I'm going to add some field dressings to my out and about F.A. kit
The rest is pretty standard but 'decent' enough.
Does anyone in the know have pros or cons for one of those self adhesive bandages ? It occurs to me that that would have held the whole thing stable over the hankie until he got to hospital. They stick to themselves, not to the skin, they get used for folks with leg ulcers and the like.
Lot of really good responses to this thread; cheers folks,
atb,
Toddy
Wilderbeast
05-02-2009, 16:37
it must be said that i've got a good bit of training in this area so I don't feel the need to carry too much, therefore I carry:
FFD's x2
Savlon (miracle cream)
Plasters
Aspirin
tweasers and a needle
alcohol gel-hand cleaner and NOT FOR cleaning wounds!! !!!
with and ffd you've got the packaging for sucking wounds (how in bushcraft i've no idea!!) and also stuff for splints and bandages!!!
Does anyone in the know have pros or cons for one of those self adhesive bandages ? It occurs to me that that would have held the whole thing stable over the hankie until he got to hospital. They stick to themselves, not to the skin, they get used for folks with leg ulcers and the like.
I am not familiar with this accident, so I'm sorry if this doesn't fit. They strike me as something less versatile than non-adhesive bandages which don't stick to skin, ulcers or leg hair (for those of us that have it) either. I do carry Micropore tape though.
The drill for major blood loss is direct pressure, raise the wound, get them on the ground and get them assistance. You want to apply a dressing under pressure and then if that fills up, just apply another one on top and get the thing bandaged on*. I'm not going to advise anyone to use a tourniquet without instruction, but, well, you know ;) if it's life and death, just don't forget the 'T' and the time on the forehead.
* If the second fills, start again.
Go and buy the DK First Aid Manual and you'll feel a lot more confident.
I've done quite a few F A courses over the years, but somehow, practical though they are, they kind of miss the place with some of our activities.
I mean, so far this year Russ has had two injuries that needed hospital attention, caused by a sickle and an axe :rolleyes: Neither are usual injuries covered in first aid courses, but I'm confident enough to know how to stabilise them until I could get him or anyone else to A & E.
I do feel though that 'appropriate' materials kept to hand might not be a bad idea for the future.......if he can cut himself like that, heaven alone knows what I can do to myself :eek:
From there it seemed a good idea to revise my F A kit contents while I was at it.
I'm not a fan of Savlon, it brings my skin up in the same kind of rash as that caused by zinc oxide plasters, but I do like the Compeed plasters, for both burns and blisters they are excellent :approve:
I'm half tempted to see if we can persuade Sniper to organise a bushcraft first aid course north of the border like the ones that Smarty and other folks do down south.
cheers,
Toddy
it must be said that i've got a good bit of training in this area so I don't feel the need to carry too much, therefore I carry:
FFD's x2
Savlon (miracle cream)
Plasters
Aspirin
tweasers and a needle
alcohol gel-hand cleaner and cleaning wounds!!
Very similar to my pocket kit which also has a hay fever tablet and blister plasters in it as well as a foil blanket. Are there any dos and don'ts to purchasing alcohol gel for this purpose? I normally carry wipes.
I've done quite a few F A courses over the years, but somehow, practical though they are, they kind of miss the place with some of our activities.
I mean, so far this year Russ has had two injuries that needed hospital attention, caused by a sickle and an axe :rolleyes: Neither are usual injuries covered in first aid courses, but I'm confident enough to know how to stabilise them until I could get him or anyone else to A & E.
You should have been on the first aid course I was on. We had dummies with wounds that squirted blood and everything. :D :D :D
Shambling Shaman
05-02-2009, 17:44
Just see this thread, Have not read all the post, but field dressing are good how ever some are very absorbent and can draw blood out so look for the more modern type and not the old MOD ones, There was a sharp rise on server puncher wounds on the hill due to people relining on there walking poles on down hill legs if it snaps one impaled walker lot of MRT had to rethink FAK contents
Sorry if this has been said :)
Something that's new to the RNLI kit for which I've not had training yet are tourniquets and Israeli Pressure Dressings. They are very good, I hear.
Are there any dos and don'ts to purchasing alcohol gel for this purpose? I normally carry wipes.
Should not be used at first aid level! The wipes that are HSE approved are alcohol free. Using alcohol wipes or alcohol gel would be outside of your FAW training. (If you have more advanced training PM me and I'll discuss it with you).
Shambling Shaman
05-02-2009, 18:40
Israeli Pressure Dressings. They are very good, I hear.
Yes very good the ones Iv seen are very versiatile
Wilderbeast
05-02-2009, 18:46
Should not be used at first aid level! The wipes that are HSE approved are alcohol free. Using alcohol wipes or alcohol gel would be outside of your FAW training. (If you have more advanced training PM me and I'll discuss it with you).
oh, o.k won't ever do that then, never used alcohol gel for cleaning wounds just got told it would work :rolleyes: :rolleyes: another rumor then!! With the exception of savlon, what else could you use for cleaning wounds??:You_Rock_
also my FA training has always been military style which is actually really useful because they teach you all the things you can do with an FFD
Wilderbeast
05-02-2009, 19:04
Should not be used at first aid level! The wipes that are HSE approved are alcohol free. Using alcohol wipes or alcohol gel would be outside of your FAW training. (If you have more advanced training PM me and I'll discuss it with you).
that was an accident waiting to happen ! cheers alex
bloody pub chat grumble grumble :banghead: :banghead: :banghead:
He' s left the building
05-02-2009, 19:18
Anyone using any blade/axe/knife in a remote location should have at least one of these: http://www.spservices.co.uk/product_info.php/cPath/91_253/products_id/2562 (disclaimer: I have no link with this supplier except as a very happy customer!)
I advise buying at least two, that way you can rip one open and practise with it.
No safety pins required, as you'll see if you practice with one!
He' s left the building
05-02-2009, 19:21
Israeli Pressure Dressings.
See my post above! :)
Does anyone in the know have pros or cons for one of those self adhesive bandages ? It occurs to me that that would have held the whole thing stable over the hankie until he got to hospital. They stick to themselves, not to the skin, they get used for folks with leg ulcers and the like.
These are actually really quite handy, they don't stick to skin/wounds and don't often twang your hair, which really is the least of your worries! They don't unwind or loosen, which normal bandages can have a habit of doing when applied by novices, especially when the patient then has to trek to safety! Micropore on bandages also has a habit of unsticking if the affected limb (assuming it's a limb being bandaged) is not kept still. One thing to watch out for when applying a self-adhesive bandage is that it's even more important to not applying it too tightly, as it will not loosen barely at all, unlike a normal one. Therefore, hold the bandage with the roll on the outside, and don't pull it round, unroll it around affected area without creating any more tension in the bandage.
Having said all this, a normal bandage will do the trick very well 98% of the time, with just a bit more micropore than normal!
Something that's new to the RNLI kit for which I've not had training yet are tourniquets and Israeli Pressure Dressings. They are very good, I hear.
Note of caution: tourniquets should never under any circumstances be used :nono: by anyone other than those people who have had recent (therefore current) specific training in their use, improper use can cause severe complications :yuck: , and be just as deadly as not using them at all, so if you are not trained in them then leave well alone.
Anyone using any blade/axe/knife in a remote location should have at least one of these: http://www.spservices.co.uk/product_info.php/cPath/91_253/products_id/2562 (disclaimer: I have no link with this supplier except as a very happy customer!)
I advise buying at least two, that way you can rip one open and practise with it.
No safety pins required, as you'll see if you practice with one!
This is the optimal gadget for applying pressure to a wound.
http://upload.wikimedia.org/wikipedia/en/thumb/f/fa/Hand.svg/496px-Hand.svg.png
It allows pressure directly on the bleeding point with little or no tourniquet effect. There are few circumstances within civilian first-aid when the time can't be taken to use it properly. The purpose of military field dressings is to allow the casualty and medic to keep moving once it's been applied. Something you should not do unless you absolutely have to.
These are actually really quite handy, they don't stick to skin/wounds and don't often twang your hair, which really is the least of your worries! They don't unwind or loosen, which normal bandages can have a habit of doing when applied by novices, especially when the patient then has to trek to safety! Micropore on bandages also has a habit of unsticking if the affected limb (assuming it's a limb being bandaged) is not kept still. One thing to watch out for when applying a self-adhesive bandage is that it's even more important to not applying it too tightly, as it will not loosen barely at all, unlike a normal one. Therefore, hold the bandage with the roll on the outside, and don't pull it round, unroll it around affected area without creating any more tension in the bandage.
Having said all this, a normal bandage will do the trick very well 98% of the time, with just a bit more micropore than normal!
Adhesive bandages are designed to apply pressure, but will do so circumferentially and risk acting like a tourniquet. Direct-pressure wins again I'm afraid. Once the bleeding is stopped or well-controlled, a crepe bandage is best for light pressure to hold padding on.
It allows pressure directly on the bleeding point with little or no tourniquet effect. There are few circumstances within civilian first-aid when the time can't be taken to use it properly. The purpose of military field dressings is to allow the casualty and medic to keep moving once it's been applied. Something you should not do unless you absolutely have to.
Adhesive bandages are designed to apply pressure, but will do so circumferentially and risk acting like a tourniquet. Direct-pressure wins again I'm afraid. Once the bleeding is stopped or well-controlled, a crepe bandage is best for light pressure to hold padding on.
Correct. Tourniquets are bad and should never be used unless you have been specifically trained. Most people already take their hands with them, so why bother taking an extra bit of kit?
Israeli bandages are fine if you are on your own and might need to treat yourself, but most of the time that does not happen. Keep it simple guys! A large HSE FA dressing or a No. 4 ambulance dressing is usually best and take up hardly any room. You would be amazed what you can treat with one of those and a triangular bandage. Most of the time there is no need to take much else (unless you have a fetish for it or actually need a proper medic with you!).
Alex
Sorry to double post, but if anyone in the South West wants to meet up some time, I'd be happy to go through some medical improvisation techniques with them. Thinking outside the box and confidence can do wonders!
I might also show the 150+ injuries that can be treated with just triangular bandages...
He' s left the building
07-02-2009, 22:05
Once the bleeding is stopped or well-controlled, a crepe bandage is best for light pressure to hold padding on.
The dressing in my link above is simply a pad with a crepe bandage attached, no tourniquet effect just light pressure (depending on how tight the crepe is wrapped obviously).
Military forces use quick-clot and similar products and operational soldiers are supplied with two tourniquets as routine (again, obviously with the correct training), I'm not saying we should do the same.
I'm not suggesting anything unusual here, it's just a dressing with a crepe attached. Anyone out in the woods/hills using a blade/axe/knife should have a dressing and a crepe bandage, either separate items as Alex suggests or the military type combined item (as I suggest).
What if you have a careless moment whilst carving and your blade slips deep into your inner arm/thigh, you sever your femoral artery and lose consciousness before you are found? You won't be applying pressure by hand for long?
I'm not suggesting anything unusual here, it's just a dressing with a crepe attached. Anyone out in the woods/hills using a blade/axe/knife should have a dressing and a crepe bandage, either separate items as Alex suggests or the military type combined item (as I suggest).
Fair enough. It's just important for the many readers of this thread not to think of any of these combined dressings as a substitute for direct pressure, and that if they are used in an attempt at haemostasis, they will tourniquet the limb. They should be reserved for a wound that is already under control.
What if you have a careless moment whilst carving and your blade slips deep into your inner arm/thigh, you sever your femoral artery and lose consciousness before you are found? You won't be applying pressure by hand for long?
If you're alone and you lose enough blood to pass out (about 40% of your volume, or 2l in an adult male) you are in deep doodoo whatever fancy dressing you have. For the best way to avoid getting to that stage see above.:)
Sapper1
I hope that the tampon you carry for puncture wounds would not be used for a penetrating chest puncture wound, that would be lethal, and bad for most other penetrating wounds if your intention is to insert it into the wound.
Shep
Again I hope the needle you carry for blisters as you put it, is not to burst or pierce the blister, again this would be a bad thing opening the area up to infection and also reducing the ability for the bodies own healing system to do it's thing. You are quite correct though in the first instance a suitably clean hand (preferably latex gloved though) is the perfect tool for applying direct pressure.
Bigbear
If you have "Quick Clot" you may use it on yourself if you wish to, but must never under any circumstance use it on anyone else, it could have dire consequences. It is used by US field medics and there are trials ongoing in some US hospitals, however it is not used over here and to use it on a third party is asking for serious trouble.
Boops
If you cut your femoral artery in a careless moment as you describe, whilst in a remote area and by yourself or with someone with little or no first aid knowledge or skills the action needed is very simple. Stand up and put your head between your knees and kiss your **** goodbye. Even with a signal for your mobile phone to call the emergency services you just ain't gonna survive it, far too severe a wound. You would be lucky to survive under normal circumstances with that type of wound at home even with the emergency services getting to you within 15 minutes.
I'll debate the blister point with you. You're right that the medical hard-and-fast is that a blister roof is in itself a sterile dressing. However, it also goes that if a blister impairs movement of a finger etc. it gets deroofed and dressed.
Out and about, I find that if I don't deflate blisters, the top just gets ripped off anyway. So if one's in the way (and going to get more friction) I decompress them.
I use a technique which was taught me by my Dad that I've never seen in any of my subsequent training! Clean the skin with alcohol and enter to one side of the blister and come up under it. You can decompress it without rupturing the nice cover. Then apply a dressing that presses on it a little. Sometimes they stay down and heal very quickly, occasionally they reaccumulate. I've never had an infection.
Caveat. While most of my advice comes from proper training and experience, this last bit is, I confess, purely anecdotal.
The fluid inside the blister is the body's very own medication, and should be kept where it is needed, at the site of the damage ie blister. If you burst it even though you have cleansed the skin you have still made an opening even a small one where germs, which are much smaller than a needle point, can get in. A common place for blisters is the heel and by simply applying a dressing, any friction to the skin which is what made it in the first place, is alleviated. The technique shown to you by your dad but you have never seen since is quite simply not the correct treatment for blisters, it's that simple, he may well have shown you his way of dealing with them, but if it involves bursting them or piercing them then it is not the correct treatment for them I can assure you. Many things have been taught in days gone by for example treating a burn by putting butter on it, but that is probably about the worst thing you can do, but for many years a helluva lot of folks thought this was the correct way cos their mother or granny had taught them this. Ask any doctor, medic, or check in any first aid manual for the correct way to deal with blisters, you will see I am correct, regardless of what you have been shown in the past and by whom, and I mean no disrespect to your dad or anyone else. Has your proper training, as you put it, ever shown you to treat a blister by puncturing it, no by your own admission, so please accept that what I am saying is right, I can assure you it is absolutely correct and valid.
Graham_S
08-02-2009, 01:26
My first aid kit has a small mirror in it. on the way to the moot a couple of years ago I got a wound on my forehead. how do you check the wound you can't see?
Also a petzl e+lite lives in there. Chances are when the worst happens it'll happen at the worst time, and I don't want to be scrabbling around looking for a torch and my first aid kit.
traderran
08-02-2009, 01:51
If you can find them. The Air Force individual kit is great and easy to pack.
The fluid inside the blister is the body's very own medication ...
In support ... on the charity walks I do, the St Johns guys specifically advise not puncturing blister you are going to walk on for both comfort and healing reasons. I personally apply Compede with micropore over for extra hold and carry on.
As I wrote. It is the standard medical advice to keep blisters where possible. Sometimes, however, it isn't possible. In my experience, decompressing them can work well. There is constant debate on this in burns, where more of my experience lies, but it seems to be equally contentious with friction blisters.
There is some work to support my suggestion, which also has some other interesting points about blister prevention:
The abstract can be read here (http://www.ncbi.nlm.nih.gov/pubmed/8570998?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pu bmed.Pubmed_ResultsPanel.Pubme d_DiscoveryPanel.Pubmed_Discov ery_RA&linkpos=1&log$=relatedreviews&logdbfrom=pubmed)
John Fenna
08-02-2009, 10:10
French medics on the Marathon des Sables rip any flesh off a blister and then dress it...sadists or their SOP?
Do they do that for all nationalities, or just the Brits?
What I would love is for someone to write a sort of idiots guide for dealing with cuts.
I've got a few students who are medical professionals (A surgeon, a paramedic and a GP) who have offered to give me some advice but there's always a language barrier there.
If anyone could give a simple, point by point, technique for dealing with cuts I would be eternally grateful.
What I would love is for someone to write a sort of idiots guide for dealing with cuts.
I've got a few students who are medical professionals (A surgeon, a paramedic and a GP) who have offered to give me some advice but there's always a language barrier there.
If anyone could give a simple, point by point, technique for dealing with cuts I would be eternally grateful.
I'd be happy to do this. What did you have in mind?
Alex
sandbender
08-02-2009, 14:53
My first aid kit has a small mirror.....torch and my first aid kit.
Lots of good advice here, Graham's point about the mirror and torch is a good one, I have a WW2 steel heliograph in my belt pouch which although it has never been used for signaling it once made it much easier to remove a insect that had clambered inside the orbit of my eye :eek:
A small mirror is also useful for inspecting your appearance before heading back to civilization :)
He' s left the building
08-02-2009, 14:59
Boops
If you cut your femoral artery in a careless moment as you describe, whilst in a remote area and by yourself or with someone with little or no first aid knowledge or skills the action needed is very simple. Stand up and put your head between your knees and kiss your **** goodbye. Even with a signal for your mobile phone to call the emergency services you just ain't gonna survive it, far too severe a wound. You would be lucky to survive under normal circumstances with that type of wound at home even with the emergency services getting to you within 15 minutes.
That's quite a fatalist attitude! Which thankfully I do not share!
I have a very good friend who ruptured his aorta due to trauma sustained in an 'impact event' (ie he fell from a very great height) but he survived (he lost his left leg and sustained multiple fractures but he survived).
As an EMT, I have dealt with bleeding femoral arteries on several occasions, nearly all survived.
A possible injury to a bushcrafter is damage to the radial artery (in the wrist) or other major blood vessels in the fingers/arms. Less life-threatening than a blown aorta or femoral, but life-threatening nonetheless.
The point I'm trying to make is that by purchasing, practising with, then carrying, a cheap, lightweight, easily available military-type dressing (or as Alex suggests a No4 dressing and separate crepe bandage) a person may be able to save someone (themselves or someone else) from bleeding to death.
My suggestion is in direct response to this thread which the OP specifically relates to a severe laceration caused by an edged tool.
Almost everyone reading this is into using edged tools, usually in remote settings. Without 'getting into the weeds' of casualty treatment protocols I still insist that it is a good idea to carry a compression/pressure (ie military-type) dressing.
Band-aids were developed for miltary use and are now commonplace, I think the medical items currently being used in combat-zones will be commonplace in the future.
:)
He' s left the building
08-02-2009, 14:59
double post, oops :)
He' s left the building
08-02-2009, 15:08
I have however bought some Quick Clot ( would put in a link but I do not know how- you can find it via any search engine) from Cabelas in the US as I could not find a UK supplier.
If you get this stuff in your eye or inhale it then you will be sorry, if you survive inhaling it anyways :)
It is also available in the form of a dressing (containing the clotting agent within the fabric, ensuring you won't inhale it), but this sort of stuff is best left to those who've had the appropriate training. It also has a use-by date.
I'd be happy to do this. What did you have in mind?
Alex
Something along the lines of what to clean what with (hands, wound, skin around it) or not.
Then about covering/dressing it.
Basically I'd be interested in making a good job of patching up little cuts and keeping big ones clean and tidy for someone else to fix :)
Wilderbeast
08-02-2009, 15:17
it's so weird all this talk of life threatening injuries on a bushcraft forum, I hadn't realised these injuries were so common, I thought with the correct training and respect which EVERYONE who wields a knife or axe should know these injuries were extremely rare??!
Something along the lines of what to clean what with (hands, wound, skin around it) or not.
Then about covering/dressing it.
Basically I'd be interested in making a good job of patching up little cuts and keeping big ones clean and tidy for someone else to fix :)
OK. If I was to put together a few easy to understand PDFs or something, is there anything anyone else would like to see in them?
Alex
sandbender
08-02-2009, 15:28
OK. If I was to put together a few easy to understand PDFs or something, is there anything anyone else would like to see in them?
Alex
Yes I'd be keen to see them Alex
Cheers
it's so weird all this talk of life threatening injuries on a bushcraft forum, I hadn't realised these injuries were so common, I thought with the correct training and respect which EVERYONE who wields a knife or axe should know these injuries were extremely rare??!
Yeah. Low Risk, but High Impact. Bit like car accidents. Seat belts and air bags in cars hardly ever gets activated, but if you have an accident, you sure as hell want them!
I use a technique which was taught me by my Dad that I've never seen in any of my subsequent training! Clean the skin with alcohol and enter to one side of the blister and come up under it. You can decompress it without rupturing the nice cover. Then apply a dressing that presses on it a little. Sometimes they stay down and heal very quickly, occasionally they reaccumulate. I've never had an infection.
Caveat. While most of my advice comes from proper training and experience, this last bit is, I confess, purely anecdotal.
Hiya Shep,
Not anecdotal for me. I haven't had to do it for a while, but I've taken care of a few blisters doing just that. Carefully draining the blister from the side and not ripping the skin often allowed the area to dry out and the skin reattach (sorry, not an experienced first aid bod so I don't know all the right terms! :) ). Only thing to watch for was during the initial healing the skin was still quite mobile and could rip away with light rubbing. So a simple dressing was needed to protect the area from direct pressure and movement.
Hope this helps (and I still need to book a refresher! Damn, another thing to remember to do!).
Nigel.
EDIT:
Just seen the posts following Shep's. Just to clarify my post I accept it's better to leave blisters alone and would only pierce if it hindered movement or was likely to rupture on it's own. Also I've only ever done this with friction blisters. Always left burns well alone.
Only thing to watch for was during the initial healing the skin was still quite mobile and could rip away with light rubbing. So a simple dressing was needed to protect the area from direct pressure and movement.
From long distance (100k) walking experience I have found that no matter how carefully you drain or otherwise loosen then top layer and no matter how you dress it, it will come off. My advice is to leave the blister intact and apply Compede with micropore support.
However, prevention is better than cure and my two top tips are to wear loop pile socks and to check "warm spots" when you feel them coming and slap a Compede on before they become blisters.
Don't buy cheap blister plasters, they are rubbish.
I've seen a recommendation of wearing women's nylon "pop" socks to reduce friction and prevent blisters. Any takers?
Shall we start a new thread for blisters and socks rather than hijack this one?
He' s left the building
08-02-2009, 20:05
Keep the blister info on here I think.
Most 'injuries' outdoors tend to be blisters, sprains, gastro-intestinal illnesses and lacerations/abrasions (cuts and grazes).
Focusing on what is a likely injury therefore suggests our kit should enable us to deal with blisters, immobilise/support joints, assist hygiene and dress minor/major bleeds.
I agree with Boops on this one.
Boops
Not fatalist in the least, you described a severed femoral artery followed by unconciousness due to shock whilst out in the wilds, and where the femoral artery is severed the body, will bleed out very quickly, within minutes in fact without proper treatment, and just applying a dressing on it's own would in my experience be insufficient to stem the flow without additional pressure. Also to complicate matters the severed artery will most likely retract from the site making it even more difficult, plus the pressure behind it makes it extremely difficult to stem the flow. In town or somewhere easily got to by road you have a chance that a professional can get to you with the right equipment to deal with the bleed but just as important they can also get a line in, to keep the fluids up, thereby reducing the effects of clinical shock. Out in the woods where they may need to search for you, even with a grid reference, will unfortunately, take some considerable time, depending on location possibly hours. Even with medivac or air ambulance, getting it airborne and searching for someone in the woods does not bode well for a quick result in finding you. Far longer I reckon than you would have whilst spewing blood from an arterial bleed, I am unfortunately speaking from experience. Although tourniques are actively banned for untrained folks, I am fortunate enough to know how to use them and have recently updated on this, in this scenario I feel this might be the only course of action, unfortunately there are very few out there can use one safely, and without causing more damage.
Nigeltm
The fluid inside the blister is the bodies own medication which is naturally designed to repair and protect the tissue, by bursting the blister you are removing the very thing the wound needs most to heal itself. If you take the example of inhalation of hot gases or drinking bleach or some such, which will cause the airway to block because of blistering and swelling of the throat therefore the airway, medics do not burst the blisters to get air into the lungs, instead they insert an airway which keeps an open passage for air to get in. I think you would agree that this is much more serious than a restriction of movement to the fingers, so if they don't burst them to save a life then you certainly shouldn't burst them to free up a little movement in the digits, probably better to stop the cause and rest the parts concerned before continuing.
Also bear in mind cooling a blister with cold water when it first starts to form, is a way of reducing the blistering effect.
He' s left the building
08-02-2009, 23:12
Stopping a catastrophic bleed is far more important than getting IV access. In some cases by administering fluids you may cause harm by increasing blood pressure, which often does not help in some cases of head injury (depressed fracture), and may also disrupt any clotting process for major bleeds (by blowing off the slowly forming clot).
I am in no way suggesting we use equipment such as tourniquets or clotting agents, etc without adequate training, I am merely again suggesting that a pressure dressing is an appropriate first aid item to keep handy when people and edged tools get together.
I am willing to be corrected on anything I have said by someone who is either a HPC registered paramedic or a surgeon :)
Your absolutely right in that the bleed takes priority over the IV but once the bleeding has been controlled the IV is the next priority for treatment and crucial to the casualties survival. I am only pointing out that the scenario that you gave in your first post was an extreme scenario, in which there is a very high possibility of the casualty not surviving is all. In that scenario then it may be one of the very very rare occasions where a tournique might be used by a properly trained person. I also would think that a surgeon would not be the best person to advise on this scenario as most surgeons will testify, their first aid skills are not usually very current or practised, as their job is normally done inside an OT with their tools and supporting staff around them and not in a wood somewhere with nothing but a small FAK to hand. I am trained to IHDC level, and part of my job is training not only first aiders but also first aid trainers for the British Red Cross, I also train others in Rescus support and oxygen therapy, Moving and handling of casualties, Trauma management and major incident management to name but a few relevant skills, plus I am a duty officer for the Red Cross emergency response management & implementation team for my area and for the UK, therefore I am fairly confident in my level of skills and current knowledge and protocols in first aid procedures without being either a surgeon or a paramedic to be able to speak with some authority on the subject. I apologies if my post has in some way offended you, I can assure you it was not in any way meant to, I am only endeavouring to correct wrong information and answer any queries arising from this thread, perhaps I should leave it to those better qualified?
phaserrifle
09-02-2009, 00:14
I find that some plasters of various sizes or some plaster tape (basicaly a long plaster you cut to size) are both very useful. most injuries are minor cuts. I also carry a roll of zinc oxide tape, to hold plasters on better. I also have a small bandage for larger cuts, or cuts in odd places where the plaster won't stay put (eg the palm of my hand), a small tube of savlon and a pair of scissors. that's all I realy need for most stuff, It covers minor cuts, and the plaster tape can be used to protect blisters, till I can get back to camp, and some more suitable matiriels (explained below)
admittedly I also bought a larger kit (life venture mountain kit) which has more of the same, plus some proper blister plasters, burn cream, skullache pills, larger bandages, gloves, steri-strips and a small roll of gaffa tape amongst other things. the advantage of this one is that as I often go on camps with scouts, the larger supply of minor injuries gear is useful, as you can guarentee someone else will do themselves a mischeif, and not have an FAK with them. the major injuries stuff is only intended for me to use on myself, or for someone else to use, as I am not a qualified first aider.
He' s left the building
09-02-2009, 17:57
I apologies if my post has in some way offended you, I can assure you it was not in any way meant to, I am only endeavouring to correct wrong information and answer any queries arising from this thread...
No offence taken Sniper :)
I'm just a bit wary of taking medical advice from forums if people haven't stated their qualifications, lots of urban myths, etc.
My EMT status is well out-of-date but I still have access to doctors and surgeons, etc in my day job and it is them I get feedback from, ie 'if the first responders had done XYZ then we would have got a casualty in a better condition...' all a surgeon wants from pre-hospital emergency care staff is an immobilised casualty whose bleeding has been controlled and whose body tissues are still perfused with sufficient oxygen to make surgery worthwile.
Way OTT for this thread, suffice to say that if you stick an axe/machete into the back your hand then your immediate first aid actions must be quick and decisive, preferably involving a big dressing! Also worthwhile pointing out that a large dressing will go on a small wound or a large one, but a small dressing will only go on a small wound?
When I was providing medical support to gap-year expeditions, we could guarantee lifting at least one of them in the first few days with 'machete rash' :) With that and vehicle accidents, urchins in the foot, tree branches in the eyes and diorrahoya (however you spell the sh#ts?!!) it was almost a full-time job!
Cheers :)
primitiveliver
09-02-2009, 19:01
I always make sure to have at least one Quickclot package on me. It is really great for large injuries.
http://www.quickclot.com/
I always make sure to have at least one Quickclot package on me. It is really great for large injuries
And really bad if used incorrectly.
Boops
I agree with you that a lot of advise given, even with the best of intentions are often way off the mark and in some cases downright dangerous. Also giving advice on forums is not always taken but as you say it's difficult to know what the background is of the folks giving it.
I've read some really good stuff from the USA about "Quick Clot" and some bad stuff about wounds being burned by it, as I understand it, the trials are still ongoing before a definitive decision is made about it's use over there. I do know that it is only being sanctioned for very severe bleeds by those using it, and not for any smaller and less dangerous wounds, of which most cuts are. Certainly it is not advised over here, in fact it is actively discouraged until the test results are in, as only then will the UK look at it for introduction and use in Britain.
primitiveliver
10-02-2009, 05:37
If you bleed to death or nearly to death I am not sure burning around the wound should be your first concern. I am not saying it is the only thing I carry and frankly I have never need it for myself. However if you are back county with a large bleeding wound Quick Clot will stop it. I am not sure that Quick Clot is all that controversial here in the USA. If you go to their website you will find that they are starting to market to the average Joe. From taking to people it seams either you know about it or you don't. And if you do you know, then you what the product can do good and bad. There is another product called Celox’s, which is like Quick Clot. I have not had a chance to do my home work on it yet. But I here it is safer and easier to use.
http://www.celoxmedical.com/
http://www.quickclot.com/
Neither are advised by JRCALC. I think the forces might be using them, but nothing civilian that I have come accross. For the moment, I would not advise either (but if you have to then from what I have read Celox looks safer).
Alex
nige7whit
13-02-2009, 22:11
I have, in the past, used commercial superglue to close quite serious (bleeding annoyingly) cuts on myself, mainly fingers, but also thigh.
My First Aid kit has lots of stuff... 6 x field dressings, single use bag/valve/mask, OP airways, 5 sizes (2 of each), Sphygmomanometer and stethoscope, blood sugar monitor, foil blanket, Tuff-Cut shears x2, lots of medical gloves, digital thermometer, flashlights, forceps, burn gel, cling film, alcohol hand rub, hi-vis sleeved waistcoat, heavy duty rubber gloves, a few plasters, and some headache tablets. (and the car, that it lives in).
its always worth having super glue for sealing small cuts. and as i only found out yesterday, super glue and cotton mixed together create an extreme exothermic reaction. that is, if you pour super glue onto cotton wool you can start a fire.
British Red
13-02-2009, 23:33
In light of Warthog1981's recent injury with an axe I've been thinking about the bits and pieces that I usually have in my first aid kits.
The little one in my day pack would have struggled to deal properly with that type of wound and I'm seriously thinking of adding a large field dressing to the kit.
Any other *musthaves* that ought to be in it ?
cheers,
Toddy
Okay, my take and I think, a few points that have been mentioned that are worthy of emphasis
Firstly the point is well made that the kit I need at home, work and "in the field" vary.
My field medical kit serves two purposes. To deal with serious injuries and preserve life until I can obtain qualified assistance. However it also has the purpose to deal with minor problems sufficiently well that I do not need to bring the trip to a premature end. For me at least it is important that I can do both of these things and know the difference.
So what do I plan for.
1) Blisters. Its been covered in a variety of ways on this thread but clearly it needs thinking about. My main purpose is to cushion the area and protect it. I personally like the gel based "second skin" material covered with a large dressing
2) Eyes. Sparks, splinters, branch whips etc. TWO eyes dressings. Why? If you have to cover an injured eye, the other will still move and the eyes move together aggravating the injury. If it is safe and practical its useful to be able to cover both eyes. Either two eye dressings or one of the new "headband" type that covers both eyes is useful. I also like to carry the sealed ampoules of sterile water to irrigate an eye - I've seen a tiny spark spit in an eye whilst cooking. Having one to hand offered quick, safe relief.
3) Cuts - sterisrips, plasters (large), zinc oxide tape, antiseptic etc. I like to have a wound wash liquid to flush cuts with. For decent sized cuts TWO medium (No 8) dressings. One can be used as a pad for the other in a palm cut. both can be used around a protruding object etc. FFD for sure on longer trips and a triangular bandage for elevating slings, support slings, head dressings etc.
4) Guts. Immodium to stop severe upset stomach. Some sachets of doiralyte are much more palatable than whomped up salt in water.
5) Bites, stings, splinters. Needle, tweezers, antihistamine tablets, topical bite relief, Tick hooks are a must
6) Burns Cling film and water gel (dressing or sachet). Water gel is mainly for the normal "hot billy can" moments and is no substitute for proper cooling but it does give relief for small but painful burns
Clearly theres some more stuff in my kit (personal meds, pain relief etc.) but hopefully thats an insight into the general type of stuff I carry (and why)
Red
Red that sounds to me like a good stocked and well thought out level of stuff for the individual. It has a good mix of general use items and I doubt you would need much more than you have got there. I would suggest adding another triangular, extremely useful for fracture immobilisation cos of the width thereby reducing pressure ridges, also a space blanket lightweight and very handy for helping keeping a casualty warm, and lastly paracetamol for pain relief. I personally do not carry eye dressings except in my big kit, I instead carry a couple of small dressings which can be used for eye injuries but also other types as well, and I carry a roll of finger bandage and applicator as it makes dressing a finger so much easier and latex gloves for hygiene plus some safety pins.
If you bleed to death or nearly to death I am not sure burning around the wound should be your first concern. I am not saying it is the only thing I carry and frankly I have never need it for myself. However if you are back county with a large bleeding wound Quick Clot will stop it. I am not sure that Quick Clot is all that controversial here in the USA. If you go to their website you will find that they are starting to market to the average Joe. From taking to people it seams either you know about it or you don't. And if you do you know, then you what the product can do good and bad. There is another product called Celox’s, which is like Quick Clot. I have not had a chance to do my home work on it yet. But I here it is safer and easier to use.
In the US "Quick Clot" is more acceptable but until the trials are completed to the satisfaction of the Brit health authorities then it won't be allowed here so the burn factor is no real concern, however as I understand it when used by folks for more minor cuts the resulting tissue damage is far worse than the original wound, and that is one of the reasons, and IIRC there was some controversy over allergic reactions when first introduced for testing, and although this original setback problem was addressed by the manufacturers there is still some other concerns. Exactly the nature of these other concerns I'm afraid I'm not sure.
British Red
14-02-2009, 00:41
Red that sounds to me like a good stocked and well thought out level of stuff for the individual. It has a good mix of general use items and I doubt you would need much more than you have got there. I would suggest adding another triangular, extremely useful for fracture immobilisation cos of the width thereby reducing pressure ridges, also a space blanket lightweight and very handy for helping keeping a casualty warm, and lastly paracetamol for pain relief. I personally do not carry eye dressings except in my big kit, I instead carry a couple of small dressings which can be used for eye injuries but also other types as well, and I carry a roll of finger bandage and applicator as it makes dressing a finger so much easier and latex gloves for hygiene plus some safety pins.
Oh theres a good few more bits - gloves of course plus a disposable resus shield on me. a vast variety of safety pins (including latching nappy pins) - although they are more likely to be used on a bust zip etc.. Duct tape is in the bag too but more likely for a boot sole :)
There are a few little wrinkles I have found useful - wound wash in a squirty bottle for example (pointy top type) - good for clearing dirt etc.
For pain relief I think its useful to have anti inflamatory as well as analgesia but that thats a personal choice. I find a good old crepe bandage very handy too for the odd light sprain.
Tubigauze is great stuff but I find the applicator bulky so it lives at home - excellent for nicked fingers I agree!
I also find a few "lemsip direct" as a useful addition to the normal OTC pills and potions.
I do try to keep my weekend FAK to "paperback" sized - more than that and it becomes an encumberance so I ahd to sacrifice the second triangular - usually have a bandana or scarf if needed though
Red
Best not to use commercial super glue on wounds, not good, get something like Dermabond.
Also be carefull with the Imodium, its not always a good idea to just use it if your not sure what is causing your problem, if possible keep hydrated and let nature take its course.
sandbender
15-02-2009, 09:29
Best not to use commercial super glue on wounds, not good, get something like Dermabond.
rik_uk3 do you have links to pages which discuss the differences? I have read that although commercial superglues and dermabond are chemically different, that chemical difference only serves to make dermabond more flexible not less toxic.
Any info you can post would be appreciated, thanks.
:)
rik_uk3 do you have links to pages which discuss the differences? I have read that although commercial superglues and dermabond are chemically different, that chemical difference only serves to make dermabond more flexible not less toxic.
Any info you can post would be appreciated, thanks.
:)
Just do a quick google
I carry Dermabond by choice, standard superglue can create heat which is not good for skin tissue. Any glue should really be a last resort to be honest, for one thing you may be sealing debris etc in the wound.
Lots of people use super glue so use it if you want, I won't though.
MartinK9
15-02-2009, 12:55
Neither are advised by JRCALC. I think the forces might be using them, but nothing civilian that I have come accross. For the moment, I would not advise either (but if you have to then from what I have read Celox looks safer).
Alex
UK Forces get issued it when entering either of the current theatres of Operation; they also recieve training on its use
I have a couple of confusions from Ray Mears's recommendations from Essential Bushcraft.
sterile liquids, for wound irrigation with a 20cc syringe with green cannula or steripods
What would the green cannula bit be all about?
Topical antiseptic such as Povidone Iodine in the form of an Aqueous Betadine solution for bites, small lesions and minor cuts
Not Savlon then? I know people have opinions here, so what is a good topical antiseptic?
I have a couple of confusions from Ray Mears's recommendations from Essential Bushcraft.
What would the green cannula bit be all about?
Not Savlon then? I know people have opinions here, so what is a good topical antiseptic?
Green is 18g, but not sure why he mentions it. A canular is invasive and certainly not first aid. It must never be used by someone who has not been trained to use one.
I'd avoid Savlon. Can be a bit nasty. Tisept is very good. If you are doing stuff in the UK though, there should not really be a need to use antiseptic, as you should never be that far away from help. Personally I'd rather people avoided putting stuff in wounds unless they really have to (read that as they have proper training and they are days from help) as it can often cause more problems then it solves. Lots of clean water or saline is the way forward.
Alex
In what sense can Savlon be nasty?
Can cause allergic reactions and I did read a report about it causing anaphylaxis.
Can cause allergic reactions and I did read a report about it causing anaphylaxis.
Bugger! That is nasty!
Ok, Saline seems very useful for irrigation. Is it possible to do this as a DIY thing in the field (e.g. salt dissolved in pure water) or is it not a sensible thing to do.
Ok, Saline seems very useful for irrigation. Is it possible to do this as a DIY thing in the field (e.g. salt dissolved in pure water) or is it not a sensible thing to do.
Depends how long you want to wait for it. Steripods cost tens of pence and are also squirtable.
Ok, Saline seems very useful for irrigation. Is it possible to do this as a DIY thing in the field (e.g. salt dissolved in pure water) or is it not a sensible thing to do.
You can just use sterile water to irrigate, saline is great, but its not the end of the world if you don't have it to hand.
He' s left the building
16-02-2009, 13:54
Guys, can I suggest that you don't get hung-up about cleaning wounds.
This thread is about sticking an axe into the back of your hand, it will be squirting claret and stopping this blood loss is the aim of the game.
As Alex has advised, clean minor wounds with saline/tisept solution, don't bother with large wounds as they are self-cleaning and you would need immediate medical treatment anyways (which would involve debridement and cleaning by qualified medical staff in a medical facility).
Advice for remote areas is outside the remit of this thread/forum, as expeditions to truly remote areas are supported as part of their medical plan.
Boop's top tips:
#1. Avoid sticking axes into any part of your anatomy.
#2. Carry a big dressing if you can't avoid Point # 1 :)
My First Aid Kit:
- Gaffer tape
- Toilet paper - can also be used to wipe behinds.
My First Aid Kit:
- Gaffer tape
- Toilet paper - can also be used to wipe behinds.
A man after my own heart.:lmao: True field First Aid....
forestwalker
12-03-2009, 04:42
Just do a quick google
I carry Dermabond by choice, standard superglue can create heat which is not good for skin tissue. Any glue should really be a last resort to be honest, for one thing you may be sealing debris etc in the wound.
Lots of people use super glue so use it if you want, I won't though.
There is also the issue that while it breaks down (as it does in the body) it releases formaldehyde. The medical preparations (2-ocyl cyanoacrylate IIRC) have a longer carbon chain, and will therefore break down slower, generting lower tissue concentrations of formaldehyde.
There is also the issue that while it breaks down (as it does in the body) it releases formaldehyde.
That doesn't sound good!
Just bumping this excellent thread.
My First aid kit is my Insurance policy , I really don't want to 'claim' on it , but i know i need the best one i can afford.
Can i ask a question of the Directly mediacally trained guys , now that some more time and i guess field reports have circulated , what are the current views on CELOX?? for addressing deep T**** arterial bleeds??
CELOX is now carried by some ambulance services and I have heard very good reports. Never used it in anger myself, but I have spoken to those who have and they say very good stuff. Still a bit expensive if you have to buy it yourself, but cheaper then death or HemCon!
Hope this helps
ForgeCorvus
25-09-2009, 22:41
So, basically
Big holes= stop the claret (with a pad not a cord), get the professionals out
Small holes= stop the claret, clean and cover
Extra joints in the limbs= Immoblise and get the Pros out
Burns= cool and cover (I was told its a get the Pros job if they're palm-sized or bigger...is that right?)
Blisters(friction)= pad (don't burst), dress if/when they burst
KO=Pro job
Don't put anything in any holes (no glue, cream or other stuff) as it makes the Pros job harder
That about it?
So, a good to decent kit should have:-
Phone
Torch
Mirror
Gloves and/or hand cleaner
Big pad (or two)
Small pads
Bandages (Field dressings are pad and bandage)
Tri- bandage (or two)
Plasters, Tape(micropore,surgical or whatever)
Cotton wool
Saline (I'm assuming the sterile squeezy things)
Sissors (which are not used for anything else)
Basic tablets (painkillers, anti-his and something for the trots)
Tick remover (I'm a fan of the lttle crowbar like hooks, no moving parts, cost pence and weigh nowt)
Anything that you need (epi-pen, prescribed meds, etc)
That sort of it?
BTW, if you're out on the moors or somewhere like, would a smoker be any use to make you easier to spot (assuming that Heli-extraction is likely)
bushblade
26-09-2009, 11:07
I have a couple of confusions from Ray Mears's recommendations from Essential Bushcraft.
What would the green cannula bit be all about?
Not Savlon then? I know people have opinions here, so what is a good topical antiseptic?
The green canula he attatches to the syringe to use as kind of a squirt gun to irrigate wounds, an alternative to steripods.
The betadine (no longer available in the uk, search for videne) is just 10% povidone iodine, can be mixed 8-16 drops per litre for purifying drinking water or mix it 10ml (approx 200 drops, or quite possibly the whole bottle!) to 1litre of water for wound irrigation.
An alternative and more compact option to mixing up one litre is to carry a few rolled up zip lock bags that each hold 200ml; fill each with water, add 40 drops of povidone iodine, wait for the contact time then puncture a hole in the corner of the bag with a knife or safety pin and squeeze the bag to expel the liquid under pressure at the wound site.
Just going back to the blisters, I think the general rule and what people have done FOR THEMSELVES AND FOUND IT WORKS FOR THEM should be understood by all. If you want the text book answer then it is packing around with a ring bandage or moleskin, etc etc. Personally, I put a stitch through large blisters. I haven't had one for a long time, but when I was a yoof in training, I got a large blister on my heel and the Doc put a stitch through the blister from one edge to the other and then placed a sterile dressing over it. A piece of tubagrip held the lot in place so it didn't ruck up in my boot and create further problems.
The piece of thread left running through the blister acted as a sort of wick, and this helped the fluid to be released from the blister. The dressing soaked that fluid up and also added an element of comfort and I was told to pull the thread through just a millimetre or so a few times a day so that it didn't get stuck and if the wound got a little sore to remove the thread. When I removed the thread, I continued dressing it and within a few days the skin had reattached itself and it was as if I had never had a blister.
Now, this is how I deal with my own blisters. I use a needle and thread that I sterilise in boiling water. It is my foot at the end of the day and I will deal with the consequences of treating my own blisters in this way, although I have never had a problem yet. These days, I'd slap a load of iodine on it to boot! If a blister is all that stands in the way of me completing a fun weekend out, then I'l dress it and move on. Bear in mind that this is for friction blisters only, a burn would be treated with a damp sterile dressing and off to hospital.
My first aid kit contains:
First Aid aide memoire
Tweezers
Scissors
Toe nail scissors (pliers-style)
Small packet of tissues
Bottle antibacterial handgel (50ml)
Sun cream
Insect repellent
Mycil foot powder
Vaseline (49g)
Painkillers
Imodium
Army field dressing (2)
Compeed medium blister plasters (8)
Gauze dressing (90cm x 3m)
Zinc Oxide plaster tape (2.5cm x 8m)
Dressing strip (6cm x 1m)
Assorted plasters
Pack finger bandages (6)
Masterplast antiseptic wipes (4)
Tube Daktarin athlete's foot cream (30g)
Tube Germolene antiseptic cream (30g)
Eye drops (10ml)
Assorted safety pins (6)
Latex gloves (10 pairs)
All packed into an Eagle Creek Half-Cube pouch. Weight: 1.25kg