Oh dear, I just chopped my leg! (scenario)

[ScottC]

OK so here's the scenario

Your on an overnight camp and have to chop up some firewood with your axe.
While chopping you misjudge the swing and you end up with a rather large cut in your leg with blood going everywhere.

You take out your first aid kit and......

??????
???
?????

What equipment should you have with you to accomodate such an accident?
what do you do?

[TheViking]

Hi...

'Butterfly' sutures....... and knowledge to sew such a wound. :wink: :biggthump Off course it depends, how deep the wound is. Very deep = sutures. Not so deep = maybe a big bandage would be enough...
In my opinion.... :biggthump

[Adi007]

Currently I have shell dressings for that job ... but depending on the cut these can really just be something to soak up blood until no more remains. Shell dressing are OK but if I got it bad enough it could be major bad news.

Over a year ago I chopped the back of my hand with an axe (actually, I raised my hand and caught it on the blade) and went right to the moving parts above the knuckle of my left hand. Long story short, this was treated at home and the results were just a scar (that's moved to below the knuckle now for some reason).

From this I'd say the following:

- Don't underestimate how far a little blood goes ...
- Make sure you have quality first aid gear ... i went into the first aid box for a dressing and found that the bandage was wrapped around it and I had to unwrap the whole thing (dropping the absorbent pad on the floor in the process). This was wrapped and sealed up like this from new - a silly way in my opinion
- Elevate and apply compression. Know pressure points to slow down major bleeding
- Drink plenty to replenish lost fluids.
- Stay calm!

I have heard of a product called QuikClot that seems really promising but never tried it :shock: so I can't comment on it but it seems good.

With this type of injury, prevention is much, much better than cure!

[ScottC]

Aha but your going to have to slow down the flow of blood first surely? Would you use a torniquet or what? What if you do it too tight and your circulation stops??

[ScottC]

Hi...

'Butterfly' sutures....... and knowledge to sew such a wound. :wink: :biggthump Off course it depends, how deep the wound is. Very deep = sutures. Not so deep = maybe a big bandage would be enough...
In my opinion.... :biggthump

Aha but your going to have to slow down the flow of blood first surely? Would you use a torniquet or what? What if you do it too tight and your circulation stops??

[TheViking]

A deep wound where the arterie, is hit there must be tight pressure on. A headscarf or the like, would be good. Wrap it to a ball and press hard on the wound to stop the blood from flowing. And try to get the wound over heart-height. :wink:

[SquirrelBoy]

OK so here's the scenario

Your on an overnight camp and have to chop up some firewood with your axe.
While chopping you misjudge the swing and you end up with a rather large cut in your leg with blood going everywhere.

You take out your first aid kit and......

????

Faint, probably... :rolmao:

[Adi007]

With a sharp tool, unless you hit a largish pipe of the red stuff, you might be surprised how little blood there is initially.

[ScottC]

initially...

[Adi007]

initially...

Well, yeah ... overall though, unless you hit something big, cut for cut, a sharp tool cut bleeds less than a blunt or jagged tool. However, big, sharp tools like axes alow you to get enthusiastic and do real damage.

[Stew]

Aha but your going to have to slow down the flow of blood first surely? Would you use a torniquet or what? What if you do it too tight and your circulation stops??

Recently, I (very stupidly) cut my thumb knuckle to the bone with my LM Wave saw. I refused to go to hospital for stitches as I didn't want to spoil the weekend. It just so happened that one of our friends coming away with us is an A & E nurse so she sorted it out. She made me put pressure on the cut but once she had put the first steri-strip on I didn't need to put pressure on any more because that was enough to stop any more flow.
I was amazed!
Obviously this was only a small scale cut (Inch 'n' half long) and I doubt it would work for anything much bigger!

[Martyn]

Aha but your going to have to slow down the flow of blood first surely? Would you use a torniquet or what?

Use only with EXTREME caution. If you tourniquet a limb, you will cut off the blood supply to everything distal to the tourniquet - goodbye limb!

If you suspect you've severed a major artery (you'll know it if you have, trust me), then a tourniquet may be the only way to stop you bleeding to death, but it may cost you a limb in the process.

Firm, direct, localised pressure is the way to go in most cases, and as others have mentioned, elevate the limb. Then get to hospital ASAP.

On an aside, if you're heading into the woods with sharps big enough to do some real damage (ie. and axe or a billhook), then a large bloodstopper bandage or military type field dressing in your FAK, is a really good idea.

[Adi007]

Martyn, any good field dressings available that you'd recommend, or jsut the standard military field dressing?

Also, any experience of QuikClot?

[PC2K]

i t bought a "isreali bandage", the emgency bandage. http://www.firstcareproducts.com/ the cilivlian version not to long ago. Haven't used it fortunaly, but it looks good on the picture's i have seen and the reviews about it. This things is semi vacum packed, but is still very big compaired to my dutch army field dressing. The pressure bar and closure bar look much easier to use than the dutch filed dressing, which i did tryed out, the bandage on the filed dressing is very thin and doesn;t want to stay spread.

if i just planted an axe in my leg or arm thats proberbly the thing i will grabe. And than go to the hospital right away.

[Martyn]

Martyn, any good field dressings available that you'd recommend, or jsut the standard military field dressing?

Also, any experience of QuikClot?

Nothing particularly Adi, just a general all purpose bloodstopper - that's a bandage with a big wad of absorbent material to cover the wound. There's nothing magical about dressing a wound at this point, all you need is big wads of sterile absorbant stuff, with a metod of tightly attaching it. The military bandages are as good as any I suppose. But if you're interested in tyhe commercially available civillian stuff, a good place to look for all your med supplies is SP Services ( http://www.999supplies.com ), we use em at work for some things and they do outfit emergency services personnel/vehoicles etc.

This looks cool...
http://www.999supplies.com/product_i...oducts_id/2558

I like the method of applying pressure, though it's not a dressing I've personally used, or could recommend in any way, but it looks to be a gpood solution, if a little fancy.

Sorry, I've never heard of QuikClot.

[ChrisKavanaugh]

http://www.usuhs.mil/uao/Release03-05.pdf Go to www.equipped.org and do a basic search for quikclot. We have several inputs from paramedics and a retired military doctor. Briefly, the agent becomes hot after contact with water and causes severe burns.It was a tossup if the wound was life threatening enough to warrant that additional injury. I submit another set of protocols: Your camped out and preparing to chop wood for the fire. Reaching for the Granfors Bruk/Wetterling you pause, recall reading this thread and shiver at the thought. You take a deep breath, scratch various body parts, regrip your axe and cut with extreme caution and deliberation.

[Viking]

1. Keep calm
2. Put and field dressing on the wound and keep pressure on it (aleays carry a field dressing on you) if you do not have a field dressing put your hand on the wound and keep it under pressure and then use a pice of clot or something that will keep a pressure on the wound.
3. Pick up your cell phone and if you are badly hurt call an ambulance and tell where you are or tell them to meet you on the nearest road or other place wher thy can get to. If the wound is not critical call someone you know and tell them what happend and where you are and what you are going to do (walk back stay the night). The make sure you call back every hour or so just to let them know you are ok.

If you dont have the knowledge to fix wounds made from an axe, dont bring the axe with you out in the wilderness.

[Adi007]

Your camped out and preparing to chop wood for the fire. Reaching for the Granfors Bruk/Wetterling you pause, recall reading this thread and shiver at the thought. You take a deep breath, scratch various body parts, regrip your axe and cut with extreme caution and deliberation.

:biggthump

[Steve K]

Viking is right.

If you are only on an overnight the chances are that you are not far from help and so it's probably best to use it.

Dressing your own wounds can be quite tricky for even the most experienced first aider(try dressing your dominant hand for example) and you may not always make the most sound judgements.

Pressure, Elevate, seek medical aid.

The shortest FA course I heard:

"If their not breathing, breath for them,
If their hearts not beating, pump it for them,
If its bleeding, plug it,
If ist burnt, cool it
and if its broken, keep it still."

Keep it simple and you won't forget

[MartiniDave]

As well as all the excellent advice above remember that prevention IS better than cure. Learn to use your cutting tools in a safe manner, and practice with them initially where you can get help quickly.

Don't forget the old first-aid standby of wadding up triangular bandages to help stem blood flow. Also consider getting some formal first aid training.

Dave

[leon-1]

1. Keep calm
2. Put and field dressing on the wound and keep pressure on it (aleays carry a field dressing on you) if you do not have a field dressing put your hand on the wound and keep it under pressure and then use a pice of clot or something that will keep a pressure on the wound.
3. Pick up your cell phone and if you are badly hurt call an ambulance and tell where you are or tell them to meet you on the nearest road or other place wher thy can get to. If the wound is not critical call someone you know and tell them what happend and where you are and what you are going to do (walk back stay the night). The make sure you call back every hour or so just to let them know you are ok.

I am with the viking on this, there was a mention of a field dressing being used, the issue field dressings are designed to be able to open them so that you do not contaminate the surface of the absorbant pad.

There is also a specific way that the dressing is bound onto the limb, you work the binding or bandage around the dressing so that you cover the dressing as well as just above and below the dressing itself, this gives compression over a larger area reducing the the blood flow and reducing the tourniquet effect (one area of compression which is narrow) as well as semi-sealing the edges of the dressing.

In all the dressing (which allows the blood to clot), with the compression provided by the bandageing on the dressing (slowing the blood flow) should do the job, but you can also lie down and elevate the limb above your heart level (rest it on your daysack or a log basically anything that will raise your leg by around 12 to 18 inches).

If it is not arterial, whilst you are down there put on a cup of tea and try to relax, if you smoke have a cigarette, it will help you relax and the tea will help to replace lost fluids and sugars.

If it continues to bleed heavilly get help, use your phone, whistle anything to attract attention to your location, but stay calm.

[TheViking]

Hi... :biggthump

I have something to add. In Rambo (think it was no. 2) he opens a bullet and puts the gunpowder in the wound. I've been told that this was wrong. (And hurts like sh*t)

In 24 hours (if you've seen season 3) the young guy takes a hot ironpiece and 'stops the bleeding' by burning the wound in his hand. Everybody should know that it's wrong and yet I haven't seen any 1. aid book who has mentioned this. I'm not a doctor, but burning the wound only makes it worse, in my mind. :wink:

[MartiniDave]

As someone who has loaded literally thousands of rifle and pistol cartridges I'm telling you there aint no way you'll pull a bullet without at least 2 pairs of pliers. We used special kit for that job, teeth just won't do it. I don't want to think about what might be in the burnt powder either!

Dave

[TheViking]

Hi...

In the survival manual made by Garth Hattingh, he explains that if you need tinder, you can open a bullet and take the powder from there... But does this mean that there's no way this is possible without a pair of pliers? (by the way, I think it's a horrible and dangerous way to do it, because gunpowder is a very unstabil substance!) If someone is even going to open a bullet, they must have military experience. :biggthump

[leon-1]

The process of placeing a red hot bar onto an open wound is called cauterization, it can be used to seal off what medical people tend to refer to as "open Vessels".

Due to the fact the tool used to do it is sterile (because of the heat) it is not unlikely that it could be used, but I would have thought that the pain from doing it would more than likely make you pass out.

Now you have a burn injury and burns are highly susceptible to infection, on this you would need to talk to a medical proffessional. I know that cauterization is still used in a medical/controlled enviroment, but to what extent is another matter.

And the Rambo films should be taken with a pinch of salt at the best of times, there are far too many effects from primary and secondary projectile injuries to think that this would sort out the problem on its own. :-)

[TheViking]

Hi...

As said i'm not a doctor, but you're right. Burning a wound will only give you both a burn and a bleeding wound to deal with. And the burn will tap water from your body and you will also waste precious energy in healing such a big wound again. But I don't know anything about how doctors burn wounds or projectile wounds. No, stick to the good old thumb......... You always have it with you and it can stop a bleeding...! :wink: :biggthump :-)

[den]

I think it’s worth mentioning how dangerous a tourniquet can be. If not used correctly the whole limb can be lost.
I personally would only use one if the other methods has failed (Direct pressure, pressure points)and the casualty has a good chance dieing if one was not used.
If you are using a one remember to slowly release the tourniquet every 15 minutes so blood can reticulate the limb. I was always told to take it off slowly as a quick rush of blood to the wound could knock the clot off.
I’d go for direct pressure to the wound by whatever means .elevate if this fails apply pressure to the appropriate pressure point until bleeding slows. Stay calm. Get help. Job done.
Cheers
Den :-P

[frog71_uk]

When I did my first aid training, I was told that a tourniquet should only be
applied as a very last resort, i.e. very specifically when no one else is around that can go and alert medics for you. If someone else is around, send them and maintain pressure. If not, apply the tourniquet, and importantly write down the time you applied it, and leave this info visible on your "patient" FAO medics. (on a piece of paper pinned to his / her shirt, or in blood on his / her forehead if you have no paper). Then go and get help after covering the person with a blanket, jacket ... and, it may sound daft, but pay good notice to your location so you can give clear indications to the rescue team.

We were told very clearly NEVER EVER to release the tourniquet, as the toxins that accumulate in the limb while the tourniquet is applied have the potential to poison the victim if released in the bloodstream. This means that yes the limb may be lost, the alternative being blood poisoning (death).

Guys, this is what I was taught, I am no expert and never had to put it in practice (thank God). If there are any doctors reading this and I am wrong, please correct me.

In fact, the only advice I would like to give is this: take a first aid course: it's cheap, it's very interesting, and you never know ... they say that a good number of people could be saved each year if people knew the basic of first aid - at least enough to raise alert and keep people alive while the specialists arrive ...

Anyway, enough preaching :roll:
http://www.redcross.org.uk/subsectio...21625709883027

Cheers

[ScottC]

Ok let's change the scenario abit

Your deep in the wilderness miles away from civilisation and the same thing happens with the axe.

You have no phone and no other means of getting help, to get out it would take a arduous 3 day hike and seeing as you had an axe imbedded in your leg a few minutes ago that seems pretty impossible, you have not cut an artery but you are losing blood fast

You are in an area surrounded by mossy vegetation which you use as a dressing (your FAK has only small bandages)

At night you get a fever and the next day you realise your wound has been infected.....Dun Dun Duuuuuuunnnn!!

What Now????
What would you use instead of moss if it was available??
What kit would you take so you can make sure that such a scenario never arrives??
How would you prevent infection??

[leon-1]

The team medics in the armed forces are taught that if a tourniquet is used the subject will almost certainly lose whatever limb it has been used on from somewhere around six inches above the tourniquets application, and that the tourniquet is only to be used as a last resort and that the tourniquet is BANNED in the whole of Western Europe (this last one could be a scare tactic so that it is only used as a last resort).

Once again the medical pro's on here could probably inform better.