First aid in the field

[Fish_monger]

Im prepping for a 10 day back country trip with a buddy. At best, we’re probably 6 hours from medical attention so I thought it would be appropriate to bring a stocked first aid kit.

I picked up a “MyMedic” kit based on a recommendation from a friend. I’d love to take a first aid course but that’s off the table with COVID this year.

Most of the things in this kit are self explanatory. However, there are half a dozen items that I feel completely under qualified to handle. Mostly:

Chest seal
Quikclot
Trauma dressing
RAT tourniquet
Nasopharyngeal airway

Are these things an ametuer should be prepared to use? any resources recommended to learn proper application?

 

[HoneyDew]

SkinnyMedic

My channel is for those situations where you may be the first responder. You will see the majority of videos are medical / trauma related but you will also s...

www.youtube.com

Enjoy

 

[Theringworm]

If I were backpacking for 10 days, no wya I am carrying half of that stuff. I would dump the following:

Scissors
Thermometer
Nasopharyngeal airway
Light stick
Metal instrument pack (tweezers, scissors. Scalpels)
CPR shield
All of the wrapping for big items that don’t need to be wrapped (I.e. tourniquet)

Quickclot, Trauma dressing, Tourniquet, and Chest seal are all easy to use and you can find online instructions if you have no idea how to use them. Google and YouTube are your friend.

 

[FlyGuy]

Man, this is probably really bad advice, but I don’t carry much. Some bandaids, some Leuko tape, gauze, a very small amount of antibiotic cream, plastic gloves, wipes, tweezers (WTX/NM has an ocean of needly things that are just dying to get into your skin), small fingernail clippers, Tylenol, and some old left over prescription pain meds.




You can’t cheat the mountain

 

[Wumbo]

Do you have a list of the items in the kit? First off, ditch the thermometer and the penlight. I think there is more you can cut as well.

Chest Seal: Normally the chest cavity is a closed system and this allows the lungs to inflate and deflate properly. In the event of a penetrating injury this can temporarily patch this closed system and it has a vent in order to allow excess gas to escape. Apply to entry and exit wounds in chest, relatively simple.

Quikclot: is a hemostatic agent, a compound that helps clotting, it is either in a mixture or a dressing impregnated with it. Apply directly to wounds with bleeding you cannot control with regular bandages and direct pressure.

Trauma dressing: apply to wounds you cannot control with regular bandages in conjunction w/ direct pressure.

RAT tourniquet: google and practice application - good for major bleeding on extremities, apply above wound and do not apply over joints. tighten until bleeding stops

Nasopharyngeal airway: I recommend removing this. You are unlikely to find a backcountry utilization for this and it is contraindicated to use with facial trauma.

 

[Fish_monger]

Do you have a list of the items in the kit? First off, ditch the thermometer and the penlight. I think there is more you can cut as well.

Chest Seal: Normally the chest cavity is a closed system and this allows the lungs to inflate and deflate properly. In the event of a penetrating injury this can temporarily patch this closed system and it has a vent in order to allow excess gas to escape. Apply to entry and exit wounds in chest, relatively simple.

Quikclot: is a hemostatic agent, a compound that helps clotting, it is either in a mixture or a dressing impregnated with it. Apply directly to wounds with bleeding you cannot control with regular bandages and direct pressure.

Trauma dressing: apply to wounds you cannot control with regular bandages in conjunction w/ direct pressure.

RAT tourniquet: google and practice application - good for major bleeding on extremities, apply above wound and do not apply over joints. tighten until bleeding stops

Nasopharyngeal airway: I recommend removing this. You are unlikely to find a backcountry utilization for this and it is contraindicated to use with facial trauma.

Really appreciate the help. I’ve been in YouTube for the last hour watching videos. Im seeing a lot on information on HOW to apply, but I’m really looking for WHEN to apply.

 

[Wumbo]

Really appreciate the help. I’ve been in YouTube for the last hour watching videos. Im seeing a lot on information on HOW to apply, but I’m really looking for WHEN to apply.

You're asking the right questions. Putting on a tourniquet, quikclot, or naso airway isnt benign and you should try standard bleeding control or other interventions first

 

[Warmsy]

Do you have a list of the items in the kit? First off, ditch the thermometer and the penlight. I think there is more you can cut as well.

Chest Seal: Normally the chest cavity is a closed system and this allows the lungs to inflate and deflate properly. In the event of a penetrating injury this can temporarily patch this closed system and it has a vent in order to allow excess gas to escape. Apply to entry and exit wounds in chest, relatively simple.

Quikclot: is a hemostatic agent, a compound that helps clotting, it is either in a mixture or a dressing impregnated with it. Apply directly to wounds with bleeding you cannot control with regular bandages and direct pressure.

Trauma dressing: apply to wounds you cannot control with regular bandages in conjunction w/ direct pressure.

RAT tourniquet: google and practice application - good for major bleeding on extremities, apply above wound and do not apply over joints. tighten until bleeding stops

Nasopharyngeal airway: I recommend removing this. You are unlikely to find a backcountry utilization for this and it is contraindicated to use with facial trauma.

Chest seal is a one- way valve for a sucking chest wounds. It will gargle and hiss. Inn the case iif a pneumothorax (air in the chest cavity), you must relieve the air by jamming a needle just under the collarbone. You will know because their trachea will not be centered on their neck and difficulty breathing.

Hemo thorax (blood in the chest cavity) requires a penrose drain about mid ribcage, towards the back. This can occur from many different injuries, and a little more difficult to diagnose.

Quikclot: dump a bunch on there, usually groin, armpit, neck trauma, and apply pressure as much pressure as you can.

Yeah, if you need to intubate someone 6 hours from a hospital, they're probably going to die.

In my training I was always told that a person administering care without certifications, can be charged criminally if the patient dies. Obviously, who gives a shit iif your best friend is hurt? Try training some of these techniques with hunting/ hiking partners.

I used to be able to find the military classroom coursework online, the US Navy hospital corpsman and field medical service school would be great jumping- off points iif you can find them.

Good luck!

 

[justinspicher]

Med kit, maybe when the elk start shooting back I’ll put more thought into this, otherwise my small boo boo kit is what goes.

 

[firecog]

I would recommend a different tourniquet such as the SOFTT-W

SOF® Tactical Tourniquet – TacMed Solutions™

*The newest SOF® Tourniquet is available and you can find it directly here!*Among tourniquet brands, the SOF® Tactical Tourniquet is one of the top performing medical tourniquets currently available. It is the tourniquet of choice for many of the world's most elite and experienced warriors who...

www.tacmedsolutions.com

 

[Fred]

Some really good responses to your question. Thought I add to also take a big dose of "Be careful" especially that far back in.

 

[cacklercrazy]

Man, this is probably really bad advice, but I don’t carry much. Some bandaids, some Leuko tape, gauze, a very small amount of antibiotic cream, plastic gloves, wipes, tweezers (WTX/NM has an ocean of needly things that are just dying to get into your skin), small fingernail clippers, Tylenol, and some old left over prescription pain meds.




You can’t cheat the mountain

Sounds like a lot of us and your probably right bad ideas on a weak med kit. It's weight we're always pushing the light weight idea. Not the safe way.

 

[Warmsy]

There ought to be a [sub forum] for backcountry medicine and trauma. I imagine there are folks frequenting this site that have up-to-date training and knowledge that could save lives and help prepare us for the worst case scenario.

I'm surprised that so many of us focusing on the minutia of gear, equipment, ecology, and life- sustaining delicious meat and are barely responding to this thread.

Hunters are regarded as the most knowledgeable and self- sufficient folks out there. Medical trauma training is accessible. I'd be happy to contribute to a project on this forum securing information and training programs to educate us.

 

[Sb23]

I would take:

Israeli dressing
4-6" ace wrap
Chest seals
quick clot.
Sam splint.
2 pieces of nonstick gauze dressings,
2 pieces of 4x4 gauze.
tylenol, ibuprofen, aspirin, tums, zofran, Benadryl, pepto bismol tablets. narcs if you have any.
CAT tourniquet.
Steri strips and bandaids.


Everything else you don't need. You don't want to suture in the field. Closing a dirty wound would greatly increase the risk of infection without properly cleaning it. You don't need a scapel, burn dressing, trauma shears, gloves, ect.

That list is what I pack.

 

[Marbles]

Short version, based on what you have, bring:
tourniquet
chest seal
quick clot
trauma dressing
triangular bandage
space blanket
Ibuprofen AND Tylenol

Everything else is fluff. If it will not save a life, or enable self rescue, why carry it. Ditch the pouch and use a 1 qt Ziploc.

Probably to late for this trip, but get you Wilderness First-aid, or even better, Wilderness First Responder.

More complicated version, and ignoring recommending other products.

In the US, Good Samaritan laws give a lot of protection. The short version is, so long as there is no compensation for you assistance the standard you are held to is gross negligence (i.e. not doing anything obviously harmful) instead of the standard of negligence (i.e. not doing anything that a reasonable person would not do). It is a little more complex, but anyone interested can read into it.

Personally, I would leave the chest seal, trauma dressing, and tourniquet. With tape (if you carry duck tape or such) and a space blanket you can fabricate a chest seal (or a trash bag for that matter). You can use a space blanket to cover a burn and minimize fluid loss and hypothermia (talking large burns). A triangular bandage can be a pressure dressing (especially if combined with an item of clothing) as well as a sling and a tourniquet when combined with a stick. Some things depend on personal skill and designed one trick ponies are easier to use than improvised solutions and most people will screw up an improvised tourniquet causing more harm than they do good. So what I do may not be correct for you.

Sutures require skill to prevent scaring and knowledge to keep from creating a bad infection as well as to identify other potential complications. If you need sutures, just get to a professional. You have about 24 hours before it can no longer be closed successfully to do that in. If anyone wants to learn more about suturing look up Practical Plastic Surgery for Nonsurgeons, this is a free book. You would still need to be able to assess for injured tendons and other things that would cause even an ED doc to refer a patient to orthopedics or surgery.

Tylenol and ibuprofen can be used together and I would carry both. The combination might be the difference between walking out and needing someone to come get you. Just take each in accordance with the label.

Just use clean drinking water and wash wounds with large amounts of it. Alcohol and all other antiseptics cause harm and delay healing. Ideally use pressure when you wash it, a syringe works, but if you use a hydration bladder you can also just sit/kneel on it to get a pressurized stream. There is not evidence (at least last I checked) to show that sterile water irrigation results in fewer infections than tap water.

 

[def90]

I would trade the quickclot for combat gauze, doctors/surgeons prefer to deal with cleaning gauze out if a wound than a mass of quickclot. It’s also easier to apply and pack a wound with combat gauze than to deal with quickclot and gauze at the same time.

Take a TCCC (aka “Stop the bleed”) class so that you know how to properly use this stuff, as in how to pack a wound with gauze, use a pressure bandage to stop bleeding and how to use the tourniquet.

As for my kit I go with CATs tourniquet, combat gauze, regular gauze, compression bandage, nasal airway deal, chest seal, and a few random bandaids. Everything fits in my Hill People Gear recon chest pack along with my carry gun, elk calls, wind checker and some random snacks for the day.

 

[Jn78]

In my training I was always told that a person administering care without certifications, can be charged criminally if the patient dies.

Of course, this is not legal advice, but the likelihood of a Good Samaritan being charged criminally is tremendously low as long as that person is acting in good faith and attempting to render aid. If law enforcement exercised their discretion in a very unusually poor manner, I guess they could charge the Good Samaritan. Also, if the first aid was rendered in a reckless manner, which caused death, the Good Samaritan could be charged. For example, if the Good Samaritan was drunk and used a dull machete to do a field tracheotomy to treat someone who simply had he wind knocked out of them and they died, sure, that could be filed. But, by and large, the criminal justice system allows us to help each other.

 

[Wumbo]

Short version, based on what you have, bring:
tourniquet
chest seal
quick clot
trauma dressing
triangular bandage
space blanket
Ibuprofen AND Tylenol

Everything else is fluff. If it will not save a life, or enable self rescue, why carry it. Ditch the pouch and use a 1 qt Ziploc.

Probably to late for this trip, but get you Wilderness First-aid, or even better, Wilderness First Responder.

More complicated version, and ignoring recommending other products.

In the US, Good Samaritan laws give a lot of protection. The short version is, so long as there is no compensation for you assistance the standard you are held to is gross negligence (i.e. not doing anything obviously harmful) instead of the standard of negligence (i.e. not doing anything that a reasonable person would not do). It is a little more complex, but anyone interested can read into it.

Personally, I would leave the chest seal, trauma dressing, and tourniquet. With tape (if you carry duck tape or such) and a space blanket you can fabricate a chest seal (or a trash bag for that matter). You can use a space blanket to cover a burn and minimize fluid loss and hypothermia (talking large burns). A triangular bandage can be a pressure dressing (especially if combined with an item of clothing) as well as a sling and a tourniquet when combined with a stick. Some things depend on personal skill and designed one trick ponies are easier to use than improvised solutions and most people will screw up an improvised tourniquet causing more harm than they do good. So what I do may not be correct for you.

Sutures require skill to prevent scaring and knowledge to keep from creating a bad infection as well as to identify other potential complications. If you need sutures, just get to a professional. You have about 24 hours before it can no longer be closed successfully to do that in. If anyone wants to learn more about suturing look up Practical Plastic Surgery for Nonsurgeons, this is a free book. You would still need to be able to assess for injured tendons and other things that would cause even an ED doc to refer a patient to orthopedics or surgery.

Tylenol and ibuprofen can be used together and I would carry both. The combination might be the difference between walking out and needing someone to come get you. Just take each in accordance with the label.

Just use clean drinking water and wash wounds with large amounts of it. Alcohol and all other antiseptics cause harm and delay healing. Ideally use pressure when you wash it, a syringe works, but if you use a hydration bladder you can also just sit/kneel on it to get a pressurized stream. There is not evidence (at least last I checked) to show that sterile water irrigation results in fewer infections than tap water.

Very well said. One of my pet peeves is people using antiseptics instead of clean water for irrigating wounds when there is no evidence for their use. Your point about sutures is spot on.

One point I wanted to emphasize was that you were right to put a disclaimer on your improvised tourniquet advice. Recently had a patient in the ER, following a saw accident, that we struggled to control his bleeding with a commercial tourniquet and I cannot imagine myself improvising a proper tourniquet for that scenario in the field. I'd imagine you would have to have a very specific improvisation in mind with lots of practice and forethought to have mouse's fart of a chance to make it back to safety with a bleed that truly required a tourniquet.

 

[Wumbo]

Chest seal is a one- way valve for a sucking chest wounds. It will gargle and hiss. Inn the case iif a pneumothorax (air in the chest cavity), you must relieve the air by jamming a needle just under the collarbone. You will know because their trachea will not be centered on their neck and difficulty breathing.

Hemo thorax (blood in the chest cavity) requires a penrose drain about mid ribcage, towards the back. This can occur from many different injuries, and a little more difficult to diagnose.

Quikclot: dump a bunch on there, usually groin, armpit, neck trauma, and apply pressure as much pressure as you can.

Yeah, if you need to intubate someone 6 hours from a hospital, they're probably going to die.

In my training I was always told that a person administering care without certifications, can be charged criminally if the patient dies. Obviously, who gives a shit iif your best friend is hurt? Try training some of these techniques with hunting/ hiking partners.

I used to be able to find the military classroom coursework online, the US Navy hospital corpsman and field medical service school would be great jumping- off points iif you can find them.

Good luck!

Suggesting needle decompression or penrose drains for bystander first aid sounds dangerous

 

[def90]

Suggesting needle decompression or penrose drains for bystander first aid sounds dangerous

Yeah, the instructor in my TCCC class basically said that anyone that has not been medically trained to put a decompression needle in to someones chest should in no situation ever do it.