First Aid & Field Medicine

[ColoradoPacific]

We all love to get out in the Great Beyond and have fun, but occasionally nature conspires against us and things can go awry. When you are hundreds of miles from the nearest hospital or urgent care center (or only 2 miles, but it's rough terrain), do you have the skills and equipment to ensure a bad day doesn't end in tragedy?

I'll break this thread down into FOUR major topics.

1. FIRST AID SUPPLIES (what to take and how to use it)
2. EMERGENCY TRAUMA CARE (for when a band-aid and some Motrin won't cut it)
3. IMPROVISED MEDICAL CARE (things you can get away with if you have to)
4. PLANNING AHEAD (certifications, classes, special considerations)

After the major topics, I will cover a few specific scenarios and how to treat them in the field.

1) FIRST AID SUPPLIES
It should go without saying that every car should have a basic first aid kit stored somewhere that is easily accessible. But the further "out there" you like to go, the more you should really evaluate what kind of medical supplies you want or need to have.

Basic Kit
This is essentially your boo-boo kit. Minor cuts and scrapes.

• Assorted self-adhesive bandages
• Butterfly bandages
• ACE wraps (compression wrap)
• Iodine
• Alcohol prep pads
• Tweezers
• Ibuprofen or other NSAID (Non-Steroidal Anti-Inflammatory)
• Neosporin (or similar ointment)
• Burn Cream
• Cortizone (or similar anti-itch)
• Sewing needles (NOT for sutures!!! We will get to that)
• Mylar emergency blanket

If you don't already carry those things, in suitable amounts for you and regular passengers, then this should be your first step. You can buy pre-packed kits just about anywhere, or build your own and pick the brands and quantities you prefer (Ninja Turtle band-aids, anyone??).

Intermediate Kit
These supplies are for treating major, but not life-threatening injuries. Trips and falls, slipping with a can opener, axe swing misses and hits your shin, etc

• Hemostatic agent (gauze, sponges, and granules/powder are all available)
  • QuickClot is one of the most common brands, and can be found at most sporting goods stores
• Large gauze, wraps, and tape (to control major bleeding in conjunction with hemostatics)
• Splints
  • Flexible metal style for fingers
  • Inflatable or rigid splints for arms & legs
  • These can take up a lot of space, and can be jury-rigged with other items. Most people don't even bother.
• Sterile gloves (latex or non-latex, depending on allergies)
• Hand sanitizer
  • Use BEFORE tending to open wounds
  • Use AFTER coming into contact with any bodily fluids
  • Sanitize your hands before and after, even if you wear gloves!
• Soft bristle brush (the free toothbrushes from the dentist's office are great)
  • Used to gently clean large particles out of a wound (dirt, sand, etc)
• Clean water supply
  • You should already have plenty of drinking water
  • Do NOT use unfiltered water to flush out (irrigate) a wound. This can lead to serious bacterial and parasitic infections.
• CPR mask
  • There are several different types, the collapsible or semi-rigid ones provide the best seal and the most protection
• Scissors
  • Any quality scissors will do, but EMT shears from a reputable manufacturer are the best option
  • EMT shears are specifically designed to quickly cut through clothing without accidentally stabbing the patient
  • The good ones can cut a penny in half and still be sharp enough to cut bandages and clothing

Advanced Kit
These are for grave injuries that require immediate and skilled attention. You should not try to utilize these supplies or methods without proper training!

• Suture set
  • Assorted Hemostats (usually a couple straight ones and a curved one will suffice)
  • Scalpel handle and replaceable blades
  • Silk thread
• Tourniquet
  • Thanks to tactical needs, we now have the CAT Tourniquet, which can (with practice) be self-applied in about 30 seconds.
  • Ensure that your tourniquet will fit arms and legs, or carry multiple sizes
• IV kit & saline solution
  • This can be used to help recover from massive blood loss or to treat severe dehydration
  • You can also use a heated or cooled IV to treat hypothermia or heat stroke, respectively
  • Supplies for this can be difficult to come by in some places. You may have to get creative, which is fine, as long as the saline and hookup are STERILE!!!

2) EMERGENCY TRAUMA CARE

 

[Kelly]

I picked up one of these...


http://store.doomandbloom.net/medical-and-dental-kits/stomp-supreme-trauma-survival-bag/

It's bulky and heavy, so I only take it on more remote trips. I'm still searching for "the ideal" smaller kit.

 

[Disco_Berty]

I carry an intermediate kit, put together by myself with advice from a Doctor who works for me. I volunteered to be one of the first aiders at work and as such get up to 3 days training each year. It really is surprising just how quickly you forget what you have learned when you do not use it regularly.

I have also asked my local gun range to set up a specific training day on dealing with gun shot injury, but nothing has yet been arranged. Hopefully they will set something up next year.

@Reconnoiter - nice set up. I would love something like this, but definitely out of my skill range for the moment.

When I had just turned 18 - many moons ago now, I came upon a van that had hit a tree. The driver was bleeding from his ears, noise and mouth. He had not been wearing a seat belt. All I remember was how impotent I felt not knowing what to do. In the end I just sat with him and tried to comfort him (despite him being unconscious). Nothing I felt I could do except continue to ensure his airway was open and ensure he was breathing whilst I waited for the ambulance to arrive. The other thing I remember was that I was the only person to stop and provide help. Many just had a good look at what was happening and then drove on. Remembering that feeling of impotence made me want to ensure that I could better deal with next time. Also, having four kids and being able to cope with whatever stupid act they do that results in needing me to patch them up with confidence

 

[Kelly]

Although not current, I was trained as an EMT, and I like having the right tools.

Re: Gun Shot/Knife Wounds. This is the best kit I've found...

(knife & gun not included ;-)

http://store.doomandbloom.net/bleeding-control-products/gunshot-wound-kit/

 

[expeditionnorth]

great article

I carry one of these


attended this class at the VT ORW in 2011, it was an eye opener

 

[Kelly]

great article

I carry one of these


attended this class at the VT ORW in 2011, it was an eye opener

I took some Wilderness Medical Training as part of Ski Patrol. It's a whole 'nother level.

 

[VCeXpedition]

I took a 4 day Wilderness Advanced First Aid course (WAFA) and have developed a decent kit in hopes that I'll never have to use more than the Motrin and band aids but I guess I may know what to do in a pinch.
I've used the training a couple times but nothing too serious but glad I had at least some training.

 

[Kelly]

I took a 4 day Wilderness Advanced First Aid course (WAFA) and have developed a decent kit in hopes that I'll never have to use more than the Motrin and band aids but I guess I may know what to do in a pinch.
I've used the training a couple times but nothing too serious but glad I had at least some training.

Copy that! The most common maladies in remote locations, are anaphylaxis, upper respiratory infection, and diarrhea. I carry Benadryl, Mucinex DM, and Imodium. For trauma, I've got blood stoppers, SAM Splints, C-Spine Collars, Pharyngeal airways, and the SOS button on my InReach :-)

P.S. There's also altitude sickness, but unless you're willing to haul Oxygen around, your best bet is to descend.

 

[Kelly]

great article

I carry one of these


attended this class at the VT ORW in 2011, it was an eye opener

The books are really important to have with you. Especially for those of us who don't administer medical aid on a regular basis. This is a permanent fixture in my rig...

 

[Rogue Beardsman]

Nice! I keep a pretty well stocked kit in my rig that a put together after taking a WEMT course a few years ago. I don't need to use it much, but when I need it I have it. I also think that any bit of training one can get makes a big difference. If your going to learn to do damage, you need to learn to fix it. That's regardless of the activity. If you're out shooting, hiking, weight lifting, middle of nowhere expeditions you need to consider the risk and prepare accordingly.

 

[Plisken]

The OP has a solid list that is very well broken down. I would add that it is VERY important to re-inventory your medical kit before every trip to the outdoors regardless of which level of kit you are taking. This not only allows for restocking used items but also confirms the readiness of your kit. Package seals age and open causing contents to dry out; tubes of gels and creams can expire or explode from heat, medications you carry expire. My worst experience was when a bottle of iodine leaked and soaked everything else in my kit causing some melting of packaging as well as the air tight container everything was in. It was a small basic kit as described above that sat behind my passenger seat. I have no idea how long it sat in that state but now I always check all of my kits before a trip.

 

[Jason Mainville]

Another point worth making, just because you have the gear DOES NOT MEAN YOU KNOW HOW IT IS USED! Don't know how to suture? maybe shouldn't pack a suture kit. You can make a situation worse by using items you do not how to use properly. That being said, there isn't anything keeping you from seeking out the training to be able to use the gear you have.

 

[Crusty Overland]

What I have stocked in my rig. A full EMT kit. And yes I am currently studying for my EMT certification.
- Alex
-Crusty Overland
- ig: crusty_rustys_restoration

 

[Bouncer]

there isn't anything keeping you from seeking out the training to be able to use the gear you have

I beg to differ. Finances and time restraints are both fairly large things that can keep a person from seeking training. I know for me EMT classes were 4 hours a day for 6 months and cost upwards $1500 after book, equipment, and uniform. Granted that's a dedicated class for full EMT, but even weekend crash courses for emergency medicine or suturing can be rather pricy... I guess that's why we have youtube and chicken breast to practice on (sutures).

 

[El Solis]

Bouncer,
Exactly my position on training which is why I am going to start getting the First Aid section up to speed with training videos and holding free in person classes. Will you get a certificate? Nope. Does anyone check for that in an emergency before letting you care for them? Nope. Better to know a little than nothing at all. If anyone has topics they want to hear about please let me know. I’ll be covering the basics of first aid/trauma first.

 

[Jason Mainville]

Bouncer,
Those constraints are individual, and can only be assessed by the person. I was meaning there are many different classes, offered to people of all skill sets. I know many that want to learn but do not because they are not aware classes and training programs exist.

 

[Bouncer]

Bouncer,
Exactly my position on training which is why I am going to start getting the First Aid section up to speed with training videos and holding free in person classes. Will you get a certificate? Nope. Does anyone check for that in an emergency before letting you care for them? Nope. Better to know a little than nothing at all. If anyone has topics they want to hear about please let me know. I’ll be covering the basics of first aid/trauma first.

How important it is to secure C-spine in the event of a roll over or other accident. I have seen too many instances where people just jump up and start moving from adrenaline only to make thinks much worse for them selves. Does not seem like many people carry collars in their bags. When not flexed they lay flat, take very little room, and weigh almost nothing

 

[El Solis]

Securing the C spine is an evolving practice. Some places still require it for all trauma patients while others have very specific criteria. Current consensus is that if the person can get themselves out (self extricate) then no collar needed. As for the collar, you have to weigh how long they will be in the collar vs the benefits. If the patient is going to be in the collar for more than an hour (same with a backboard) then you should secure the c spine in a different manner. Also, if you don’t know how to properly apply a C collar you can cause more harm than good. It is rare to have full neurological function and a significant C spine injury. I carry one, just for disclosure, but would only use it if there was apparent neuro injury and/or I needed to move the Pt from a dangerous situation to where care was going to be provided.

 

[Road]

We all love to get out in the Great Beyond and have fun, but occasionally nature conspires against us and things can go awry. When you are hundreds of miles from the nearest hospital or urgent care center (or only 2 miles, but it's rough terrain), do you have the skills and equipment to ensure a bad day doesn't end in tragedy?

I'll break this thread down into FOUR major topics.

1. FIRST AID SUPPLIES (what to take and how to use it)
2. EMERGENCY TRAUMA CARE (for when a band-aid and some Motrin won't cut it)
3. IMPROVISED MEDICAL CARE (things you can get away with if you have to)
4. PLANNING AHEAD (certifications, classes, special considerations)

After the major topics, I will cover a few specific scenarios and how to treat them in the field.

What happened to topics 2, 3, and 4 - are they still coming?