Medical gear

1leglance

2007 Expedition Trophy Champion, Overland Certifie
Sterile super glue
and steri strips

I got to use the glue once on a 3/4” deep wound in my wife's upper thigh, when a very sharp knife she was using to cut something held loosely on her lap slipped and badly gouged the top of her leg. The cut looked gruesome...like a cut into a steak as you could see the severed pink muscle cleanly separated by the slice. The glue worked perfectly. Two days later, when we got to go into an urgent care facility, the doc said to leave the glue as is and said it actually skipped the need for stiches.
That is a tough one.....once a wound is closed it is closed for good usually.....so if you are going to close it CLEAN it, CLEAN it really really well....
I actually missed adding a small syrnige with a blunt needle to the list (I am working surgical recovery as I type this)...the pressure washes out dirt and bugs.



For simple pain relief?

In Canada I believe you can buy over the counter a pill that is a combination of methocarbamol and ibuprofen...it seems to be recommended for back and muscle pulls/ pains?, and also buy OTC pain pills with a combination of either codeine and aspirin, or codeine and acetaminophen.

In some US states I think you can still purchase legally, without a prescription, cough syrup with codeine in it....

(Just FYI, I’m not advocating the use or purchase of any of the above)
Anything with a narcotic element is another risky one....will if impact breathing? will it cause you to miss a neuro change? Will it cause nausea?
No one, and I mean no one dies from pain, shock yes, heart attack yes but pure pain is not a killer. I speak as a person who had his left lower leg crushed and the ripped almost off at the hip, I have felt my shattered pelvis grind together and just 3 years ago split my tibia right down the middle like kindling. In all those cases I did pass out from the pain, I did scream from the pain, but it won't kill you.
 

shade

Well-known member
That is a tough one.....once a wound is closed it is closed for good usually.....so if you are going to close it CLEAN it, CLEAN it really really well....
I actually missed adding a small syrnige with a blunt needle to the list (I am working surgical recovery as I type this)...the pressure washes out dirt and bugs.
I carry a 100cc syringe with a fixed plastic tip for that. It works better than a blast from a bike bottle to get bugs out of ears, and is pretty good for flushing eyes & wounds when clean water is scarce.

I was glad to see you stress using pressure dressings over tourniquets. Both have their place, but I've seen many examples of tourniquets applied when they weren't necessary. I think the popularity of devices like the CAT has led to some of the overuse. I don't want someone cranking down a tourniquet on me unless it's needed, and the risk of causing other damage is secondary to the blood loss.
 

Wilbah

Adventurer
Some GREAT info here. I'm not medically certified but SAR trained (which taught me all my limitations which is just as important IMO) and I travel regularly with some who are (docs and EMT's). They convinced me to toss the stitches for super glue. Yes to the irrigation. And spend more time planning and executing the evac than trying to MacGyver medical care.

Good comment on the pain not killing you issue. Forgo the fancy meds. If he or she passes out so be it. People survived getting their legs sawed off during the Civil War with little more than a stick to chew on. But the key was to keep it clean so the infection didnt kill them.
 

1leglance

2007 Expedition Trophy Champion, Overland Certifie
I carry a 100cc syringe with a fixed plastic tip for that. It works better than a blast from a bike bottle to get bugs out of ears, and is pretty good for flushing eyes & wounds when clean water is scarce.

I was glad to see you stress using pressure dressings over tourniquets. Both have their place, but I've seen many examples of tourniquets applied when they weren't necessary. I think the popularity of devices like the CAT has led to some of the overuse. I don't want someone cranking down a tourniquet on me unless it's needed, and the risk of causing other damage is secondary to the blood loss.
On brother, tourniquets can lead to compartment syndrome, nerve damage, and sooo much damage to tissue. It is a last resort and should be loosened to check very frequently.....just like a handgun, when you need it not much else will work, but it is usually something you save till the end.

When I teach I show people how to snip the corner of a ziplock to flush wounds, how to stuff clean clothes into a wound, how to use the stuff they already carry all around them to get things done. If you have the knowledge then you have the tools....they just might not look like what others think of as the proper device :)
 

Pacific Northwest yetti

Expedition Medic
Some solid advice here,

Super glue I am not a fan of, most people don't actually clean the wound well enough prior to using it- or use it wrong. Creating massive voids of infection that can lead to amputation or death.


I agree with the majority of 1leglance, especially with the narcotics, and keeping stuff clean. If you can drink it, you can clean a wound with it. Use pressure, add triple the amount of water you think you need to clean it. It will probably hurt.

Tq's have been used in combat with application times of over 8 hours, and the limb survived, and n nerve damage -well documented. But yes, pretty much only needed for a Arterial bleed, or amputation.

Compartment syndrome, will kill you- but bleeding out will kill you first. Compartment syndrome can be treated. ( usually, with antibiotics and a Fasciotomy )

Loosening it- is insane. That will blow the clot if you were successful in getting it to clot in the first place. We teach direct pressure, TQ now. if you apply it Dont screw with it. As the majority of medicine is doing the same.

People who say they can create a TQ in an emergency have rarely done, or applied one to a screaming writhing bleeding patient. Sure, the theory is sound. But it takes a lot of pressure, and needs a band larger than 1 inch. Pretty easy to break the twigs, or pens, you tried to use with your webbing belt. As the patient has an arterial bleed, and less than 2 minutes until they have no blood left. AND you have to find the parts and equipment you need to build one.

Human heart, 1-2 Liters per minute. 4-5 liters in our body. Missing two liters you pass out, as your brain is not getting enough oxygen saturated O2.
 

Pacific Northwest yetti

Expedition Medic
I carry a 100cc syringe with a fixed plastic tip for that. It works better than a blast from a bike bottle to get bugs out of ears, and is pretty good for flushing eyes & wounds when clean water is scarce.

I was glad to see you stress using pressure dressings over tourniquets. Both have their place, but I've seen many examples of tourniquets applied when they weren't necessary. I think the popularity of devices like the CAT has led to some of the overuse. I don't want someone cranking down a tourniquet on me unless it's needed, and the risk of causing other damage is secondary to the blood loss.
Luckily, if you are not in need of one- you should be able to ask them to not apply it.
 

Paddler Ed

Adventurer
First before you worry about the kit what is your plan for when it all goes wrong? InReach, Spot, Ham, Cell, Smoke Signal.....all the kit in the world won't matter if you can't evac the real emergency
DRS ABC(D)
Danger
Response
Shout for help
Airways
Breathing
Circulation - get it happening with CPR if needed
(Defibrillator)

That Shout could be any of those options above - that is the important part that most people forget, and instead spent 15minutes getting someone bandaged up etc, when that could have been done to get that help just that little bit quicker.
 

Ovrlnd Rd

Adventurer
Great post by 1leglance.

My wife is a herbalist and has quite a bit of wilderness 1st aid training through the school she takes classes from. Unfortunately her own medical condition (severe asthma) prevents her from taking some of the classes to get her WFA certification but she takes the other classes just for the knowledge. My own training - Combat Lifesaver - is 30 years old. If it's life or death I'll do my best but the first thing I'll do is hit the SOS button on my inReach.

Having said that, we have a lot of herbal type, self-made items in our kit. These are generally for our own use (burn powders, sprain/strain salve, minor wound salve, etc) but will utilize them in an emergency situation. For minor 1st aid type things such as bug bites/stings, I'll offer them with the caveat that they're not FDA approved and I'm poor so don't sue me.

Another option for wound washing is to poke a hole in the screw on cap of a water bottle. Simply squeezing the bottle will give you a pressure wash through the hole.
 

BritKLR

Kapitis Indagatoris
People who say they can create a TQ in an emergency have rarely done, or applied one to a screaming writhing bleeding patient. Sure, the theory is sound. But it takes a lot of pressure, and needs a band larger than 1 inch. Pretty easy to break the twigs, or pens, you tried to use with your webbing belt. As the patient has an arterial bleed, and less than 2 minutes until they have no blood left. AND you have to find the parts and equipment you need to build one.
Yep.....but, the bigger challenge after the improvised tourniquet is telling your wife to get the amputated leg and bring it to you so you can wrap it and put it in a cooler for the evac......
 
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