View Full Version : First aid is a must
Of all the things that are debatable, purifing water, poles, ultra lights and etc. I know now that taking not just scratch and bruise first aid is neccesary but also some FA to address a serious cut. I did it. Never thought I would. 7 miles from the nearest road and no cell phone service which didn't matter anyway. I panicked and got totally lost in basically my own backyard. Was splitting a piece of wood and even though I cut away from myself I managed to stick the blade straight through the top of my thumb and on through the flesh between the thumb and first finger and finally into the tip of the first finger. Amazed at the amount of blood I was spilling I did exactly what they tell you not to do and panicked. I'm just making this a reminder without much discussion. If you've ever caught your kitchen on fire, this is and was about the same feeling. Be prepared. Even if you think your invincible like I do. Not saying I'm not because I am but..............just sayin.
Blissful
12-22-2010, 15:15
Another hiker got a severely infected scratch and had to get off the trail.
Jack Tarlin
12-22-2010, 15:20
Reid:
What a great post. People tend to go extremely minimal now with their First-Aid Kits (as part of the general "Lightweight" thing) and I think in some cases they cut it a bit too fine. Cuts, burns, scrapes, abrasions, falls etc. happen all of the time and sometimes they result in serious injury. Hikers should, at the very least, carry items that will treat, clean, and wrap these kinds of injuries until one can get out of the woods, meaning your "first aid" kit should be more than duct tape, a safety pin, and a razor blade. Oh, and just as important as carrying minimal basic first-aid stuff, it's also wise to know how and when to use it.......most hikers for example don't know how to properly clean,wrap,or treat a wound or sprain, even if they were carrying stuff that would allow them to do so......which most of them don't. But Reid has made a great point......crazy stuff happens, whether to you or someone you're travelling with, and it's almost always a surprise. Be prepared for it so you're in a position to be useful to yourself or to others. Murphy's Law applies big time out there.....when something can go wrong, it will, and usually in the worst possible place or time, so be ready for it, and able to deal with it.
First Aid is a very important skill that many don't bother to learn. These are the same people that always want to borrow your map:)
Even a basic first aid class would be worth attending along with CPR.
This is a good thread topic but likely one that will be overlooked... It seems most consider first aid an after thought and have basically useless first aid kits in an effort to save weight... Mine is big compared to most, but still wouldn't be adiquate to stop a large open wound from bleeding.. I've always told myself that i'd just use a peice of clothing or something to help stop the bleeding. But thinking about this honestly, most fabric i'm wearing or carrying is synthetic and won't do squat to assist in stopping the bleeding other than providing a layer of protection between the wound and my hand when applying preasure. I'll have to rethink my first aid kit and find a good clump of gause to add..
Don I'll except that "knick" at me because I did in fact cut myself, and then procced to get lost. But It wasn't the lack of a map it was because I B-lined it off trail to the nearest road. I found it alright but I had to stay another night, another 6 hrs until daylight. DAJA I couldn't agree more because I would have been the first to overlook it......and have in the past obviously.
Carry a could of rolls of gauze (AKA kling). You can pack an open wound with a roll and use it to wrap and hold compression on a dressing. Fits the ultra light crouds requirements, multi use :)
From experience as an EMT and Paramedic for 34 years.
And the gauze was what I was thinking taking too and some of the tape stuff too. It was too big to just put pressure on. The main cut through my thumb took 14 stitches to sew up and about 5 in my finger. It was a sideways slash because of the way I was holding it so it practically pulled up the flesh like a spiral ham.
Save weight by not taking first aid kit.
Save weight by cutting off fingers.
It's really a win/win here. If you carry enough first aid you have that weight plus the weight of all your digits.
Trailbender
12-22-2010, 16:08
I have duct tape and 2 pads for first aid. I can use a sock or something as a compression bandage if I need to. First aid is more about knowledge than gear, and I got plenty of training thanks to Army medic school. Besides, I carried 40 pounds of just first aid gear when I was in, and I can tell you that any first aid kit you can carry won't be a lot of good for a major injury, and anything you can use that tiny first aid kit for would probably be fine with being ignored or slapping some toilet paper on it. I have carried a first aid kit before, but never seem to be able to justify it when I can think of a thousand ways to make first aid gear out of regular stuff.
Might be nice to have some posts on what people carry for a first aid kit.
Mine kit is very basic. Advil, bandaids, an ace bandage, bacitracin, moleskin, tape. I've never needed the advil, but other hikers have. The moleskin and bacitracin have come in handy.
ShakeyLeggs
12-22-2010, 16:46
As a nurse this topic is very near and ear to my heart.
One of the first things in any situation where you are injured or another is the injured party is to keep calm. Some find that easy to do but many others panic at the first sight of blood. If you get excited at the sight of blood or and injury you need to stop and calm yourself. Make a conscious decision.
The next big thing is to have the knowledge to handle the situation. I HIGHLY recommend everyone take a basic (at the least) first aid course.
As for the first aid kit. Mine is as you would expect a bit more inclusive then needed. But you only need the basics.
Band-aids of all sizes
Quick Clot (http://www.z-medica.com/healthcare/Products.aspx) (For bleeding control)
4” by 4” Gauze pads - for cleaning wounds
4” by 4” Dressing bandages - for wounds, cuts, and abrasions
2” Dressing rolls - for wrapping and bandaging injuries
Antimicrobial hand wipes
Pocket knife
Simple, but important over-the-counter medications that should be kept in a first aid kit and updated regularly (check the expiration dates) include:
Antibiotic ointment - for cuts and scrapes of the skin
Insect sting relief pads Tylenol (Acetaminophen) - pain and fever reducer
Advil (Ibuprophen) - anti-inflammatory for pain, swelling, and fever
Benadryl (Diphenhydramine) - antihistamine for allergic reactions, itching, and runny
nose
Sudafed - a decongestant for stuffy nose (or decongestant nose drops)
Throat lozenges
Also include any med you are prescribed.
If you need more than this your trip is pretty much over anyway.
Quickclot
I've heard that Quick Clot is sort of a last resort solution that more or less cauterizes the wound through chemical burns and should only be used as an absolute last resort. Would it have been of practical use during this guy's situation?
ShakeyLeggs
12-22-2010, 17:12
I've heard that Quick Clot is sort of a last resort solution that more or less cauterizes the wound through chemical burns and should only be used as an absolute last resort. Would it have been of practical use during this guy's situation?
Yea I would only use it for controlling excessive blood loss. Direct pressure or the use of pressure points are what I would and do use before I move on to using Quick Clot.
As for the chemical burns you mentioned, NO. Here is what the manufacturer says about the product;
QUIKCLOT’s third generation of hemostasis products, each specially engineered for use by healthcare professionals, is based on a naturally occurring, inert mineral, kaolinite. Each of the gauze-based hemostasis products is impregnated with kaolin, a white alumina silicate that has been known for decades to activate blood clotting in vitro. When exposed to human plasma, kaolin activates clotting Factors XI and XII, mobilizing the body’s natural coagulation cascade. Known to foster platelet adhesion at the sound site, kaolin contributes to the formation of an active, natural, and stable clot.
When QUIKCLOT hemostatic dressings go into contact with blood in and around a wound, they quickly assimilate the smaller water molecules found in the blood, leaving behind, in the wound, a highly concentrated mix of larger platelets and clotting factor molecules. This process along with kaolin’s key surface chemistry, promote extremely rapid and natural coagulation and prevents severe blood loss.
What about an oz or two of betadine? I was already filthy dirty when I did it.
Llama Legs
12-22-2010, 17:38
I carry a tiny amount of temporary filling material. Available at the drug store. You can fill a tooth or reset a crown. Dental issues lead to a surprising number of wilderness "fails".
fiddlehead
12-22-2010, 18:00
Duct tape, aspirin and needle with dental floss.
It's all many people carry and would've done the trick in the OP's situation.
will1972
12-22-2010, 18:30
Duct tape really can be a lifesaver just never apply to bare flesh. Always cover the wound with something before applying duct tape. Never leave home with out it.
fiddlehead
12-22-2010, 18:34
Duct tape really can be a lifesaver just never apply to bare flesh. Always cover the wound with something before applying duct tape. Never leave home with out it.
Tell that to my brother the plumber who uses it almost daily (he's been a plumber for about 35 years now)
He was just telling his daughter the other day to "put some duct tape on it and quit your whining!"
Reid, my post was in no way meant as a kick at you. I was just saying that there are people who hit the trail prepared and those who do not. Sorry you cut your hand.
Leuko tape is better at sticking to the skin that duct tape. It's the only tape I've found that stays on a hot spot or blister.
Gauze wrap is better for dressing a wound, it holds pressure since it's stretchy. Duct tape won't stick to bloody and sweaty skin.
Reading Churchill's 2010 TJ he tells of one of the group that he was hiking with who cut his hand , including a tendon, and had to leave the trail for surgery. So it can and does happen. Read about it here: http://www.trailjournals.com/entry.cfm?id=332514
mweinstone
12-23-2010, 01:52
i collect and study first aid stuff. i have 50 and 25 person kits hanging as art. and i stuff them with sutchers and iosat radiation pills and tamiflu from canadian pharmasys. i love first aid because it is helping folks, witch i love. i spend thousands of dollars on my first aid hobby.
but...i have never carried a single bandaid or even duct tape hiking. i like to be challenged to use other tecniques to deal out there. hears some things ive learned.
when you cant blot up blood anymore cause your soaked in it, focus on stopping the flow and clotting the dry blood as a way of continueing without dripping. heres how that works in practice.
you gash a knee elbo or arm or leg.stop. elevate. dont wipe or wash. allow to clot.continue walking. now, you will have a ton of blood on you but it will all be dry. dry sterile and sealing the wound. and of course this wont work on a foot, or on your head. those wounds require other ways. but their are lots of things you can do with nothing. like diarehha. rest and hydration work as well as bismuth or imodium. rest and hydration dont allow you to rush off but they work fine. only your comfort level needs to be adjusted. so many of our foods can be used as first aid. we overlook it alot. for instance,any salty food we have helps heat exaustion and stroke. any hot drinks help hypothermia. any citric acid diluted, like even orange juice but lemon is best,helps heartburn and nausea.any honey carried has too many uses to list . from low blood sugar to bug bites to cuts and scrapes.salt can back out ticks as can any heated knife or needle held with a stick.
practice makeing tweezers with a knife and a stick
all the springs provide cold for sprains and bumps better than cold packs
use mud or dirt to remove pioson ivy oils
a few willow leaves acts as asprin
place a folded bandana under your heel to lift it above a blister.
carry alot of advanced first aid gear if you choose to carry any at all. most important is for dog owners to carry skunk soap . a sprayed dog is only second to a bear injured dog.a cell phone is the first gear a wilderness first aid kit requires.
SouthMark
12-23-2010, 10:52
From Gossamer Gear's web site:
I rank possible backcountry injury/illness into three categories:
• You are going to die no matter what you brought
• You are going to live no matter what you brought (though you might be VERY uncomfortable)
•Something you brought will make the difference of you living or dying
Experience shows that very few maladies fall into the third category. Discussions with Search and Rescue (SAR) personnel reveal that most people, when found, had what they needed to be safe. They just didn’t have the knowledge or experience they needed. The classic example is hypothermia, where the first thing that goes is the judgment. Victims are found dead having discarded gear that would have saved them if they knew the symptoms and treatment.
Yea I would only use it for controlling excessive blood loss. Direct pressure or the use of pressure points are what I would and do use before I move on to using Quick Clot.
Thanks for that. what I figured, but good to hear it.
I can think of one item you can carry that meets the "Something you brought will make the difference of you living or dying" criteria, aspirin.
the goat
12-23-2010, 16:41
trail first aid kit = duct tape
For me: tweezers, needle, dental floss, a few bandaids, two 4x4 pads, white medical adhesive tape, moleskin, stretch gauze, neosporin, diphenhydramine (Benadryl), two aspirin, ibuprofen, Allegra (prescription antihistamine I have to take because I'm allergic to pretty much everything), ranitidine (Zantac...acid reducer), and triple duty: hand sanitizer...for sanitizing hands, sanitizing small cuts and scrapes, and starting fires.
wvgrinder
12-24-2010, 12:19
Duct tape, hand sanitizer, needle, floss, black pepper & guaze.
CrumbSnatcher
12-24-2010, 12:27
trail first aid kit = duct tape
this is what i was thinking when you said it:) my dogs first aid kit was top notch though! spared nothin';):cool:
Wise Old Owl
12-24-2010, 12:48
Mine kit is very basic. Advil, bandaids, an ace bandage, bacitracin, moleskin, tape. I've never needed the advil, but other hikers have. The moleskin and bacitracin have come in handy.
The Advil is used on the thirty milers.:D
From Gossamer Gear's web site:
I rank possible backcountry injury/illness into three categories:
• You are going to die no matter what you brought
• You are going to live no matter what you brought (though you might be VERY uncomfortable)
•Something you brought will make the difference of you living or dying
That makes sense I don't question that at all. My reasoning is that I just don't want to feel like that and I wouldn't want anyone else to feel like that either. It was un-nerving to say the least.
Reid, my post was in no way meant as a kick at you. I was just saying that there are people who hit the trail prepared and those who do not. Sorry you cut your hand.
no worries man
BigHodag
12-24-2010, 21:02
I carry a few BZK (Benzalkonium Chloride) prep pads in my kit. BZK kills rabies virus, unlike alcohol or iodine.
I usually get mine at the blood lab where they use them for disinfecting arms. I mention I'm going hiking, the rabies factoid, and would like to take a few along. They usually hand me several at no charge.
Rabies, fowl laryngotracheitis, Seliliki. Forest, and herpes simplex viruses were rapidly inactivated by low concentrations of benzalkonium chloride
Inactivation of Viruses by Benzalkonium Chloride
http://aem.asm.org/cgi/reprint/12/2/132.pdf
Why outfitters like REI & Campmor don't stock these, I'll never know.
Mtn Scout
12-30-2010, 22:28
i use super glue for most cuts. just make sure wound is clean before applying
Jim Adams
12-31-2010, 00:08
TAKE A QUALITY FIRST AID COURSE!!!!!!!! You already have to carry your brain so it really isn't added weight. Most first aid is totally nothing more than common sense. A well trained brain and some duct tape will offer way more first aid than a 5 lb. first aid kit and no idea how to use it or stay calm.
I've been in some deep wilderness, been inside the Arctic Circle on canoe trips, been a white water guide since 1977 and a paramedic since 1978, done 2 AT thru hikes and 1000 miles of PCT......not once did I ever worry about injuries or illness while out there. Not that I didn't care or was reckless just had no worries due to knowledge. A QUALITY FIRST AID COURSE WILL HELP YOU FOR THE REST OF YOUR LIFE! Don't hike dumb...it will catch up to you someday. The self confidence it will give you is worth the peace of mind that it brings.
geek
Excellent post. Especially "stay calm."
Some people get over excited even in suburbia.
Just found this site: http://www.firstaidweb.com/index.php
Online CPR and First Aid training for free. If you want the official certificate it costs you but the classes are free. It's very basic but better than nothing.
I took a NOLS wilderness first aid course and I keep my cpr cert up to date.
You don't have to be a brain surgeon to learn basic first aid and (IMO) it's something everyone should know - it's in the same category as knowing how to change a flat tire.
"Don't hike dumb."
Ha! That really needs to be on a t-shirt. A synthetic t-shirt, of course. :)
Tipi Walter
12-31-2010, 13:12
After reading this thread, it seems the best first aid advice is to never carry and use a knife.
TAKE A QUALITY FIRST AID COURSE!!!!!!!! You already have to carry your brain so it really isn't added weight. Most first aid is totally nothing more than common sense. A well trained brain and some duct tape will offer way more first aid than a 5 lb. first aid kit and no idea how to use it or stay calm. A QUALITY FIRST AID COURSE WILL HELP YOU FOR THE REST OF YOUR LIFE! Don't hike dumb...it will catch up to you someday. The self confidence it will give you is worth the peace of mind that it brings. geek
Amen. If you have training, you can improvise most of what you need from what you are already carrying. Suggest a "wilderness first aid" course if you can find one. What's Google for if not that.
Random tip: can use Aqua Mira to disinfect a dirty wound after irrigation with lots of water - will kill any bacteria it comes into contact with
I've only recently entered the hiking community (done lots of hiking, just not been social about it) and I was rather shocked at how minimalist a lot of folks are with their first aid kit. I'm an EMT and did a stint as a medic in the service, and I spent days agonizing over what I could and couldn't afford to carry from my trauma kit. My full kit approaches 40lbs by itself.
I opted to go with a better than average kit, but with an eye toward weight, and ease of restocking. I figure if I'm more than a day from a road, and I don't think I can last that long with this kit, I'm calling in the Cavalry anyway, because I'm not walking out. Most of this stuff weighs next to nothing. You can pack a hell of a kit in to 10oz. It is a little bulky though.
Dressing:
(6) 2x2 Gauze pads
(2) 4x4 gauze pads
(1) Large roll 'Cling gauze' (doubles as an ace bandage, medical tape, and splint)
Bandaid Assortment
Wound Care:
(1) Small tube neosporin
(1) 1/2oz bottle betadine
(2) 3"x3" QuikClot sponges
(1) small tube superglue
(1) Size 6 Suture needle with 24" of 2/0 suture (sterile)
(1) 1/2oz bottle alcohol hand sanitizer (more useful than prep pads)
Medications:
(100) Ibruprofen (Vitamin I!)
(4) Asprin
(8) Benadryl
(30) Ranitadine
(21) Augmentin (antibiotic)
Blisters:
(10) Second Skin Blister Pads
(2) Strips Mole Foam
(1) Roll Moleskin
Misc:
(1) 4"x36" SAM splint
(1) pair mini shears
(1) pair tweezer
30' Duct Tape
It seems like a lot, but if you don't count the SAM splint (which is bulky but very light) it all fits in to a container the size of a quart paint can, and with the SAM splint, weighs less than 14oz.
As for the QuikClot discussion earlier in this thread, it really is fantastic stuff, I've seen it save a lot of lives overseas. It's great that they've figured out how to make it suitable for civilian use. In its original powder form, it was dangerous if used improperly. It had a tendency to create clots that could go for a walk in your blood stream and kill you quick if the wound was in the right place, or you were careless in its use. Even though it's more idiot proof now, I don't think enough people realize that QuikClot is a last resort even now. If you use it, you are acknowledging that you ARE going to the hospital, and sooner rather than later. It isn't a magic bandaid, and attempting to remove it after the fact could be disastrous.
-Smalls
My first sentence there might get misconstrued as looking down on folks who don't carry a huge kit like mine. It isn't that at all. I simply meant that idea was very foreign to me, and I just couldn't make it work in my own head. To each their own, of course.
-Smalls
Awol1970
01-04-2011, 16:26
I wanna hike with in hollering distance of smalls. :D
How about suggestions for pre-trip first reads, or do you take any type of first aid instructions with you? I just picked up a NOLs Wilderness Medicine book and plan to read through it. Hopefully ill get to take one of their first responder training courses here in the next few months. With all the backpacking my group of friends does, its surprising that none of us really has any medical training, which i really hope to change. I'm just glad that we havent really had to deal with anything major yet (and hope we dont have anything happen!)
G
Green, reading helps, but you really need some hands on training. A First Responder course (usually offered by volunteer fire departments or hospitals) can take ~8 hours a week for 6 weeks or so and do a lot of good for basic first aid.
If you really want some nitty gritty medical training, find a local EMT class. They're usually offered by community colleges or local fire departments. They rarely cost more than $200 or so to attend, but they are quite an investment of time. Most states it's at least 160 hours of instruction. If you aren't planning to test, you might even be able to just audit the class, depending on who's offering it. A lot of the EMT cirriculum isn't much use on the trail, so it would be nice to be able to only go for ~half the classes and come away with some great trail medicine experience.
-Smalls
Trail grasshopper
01-12-2011, 19:00
I did a 40 mile section hike last October. I let my friends talk me into removing some of my socks and the bandaids I was taking.....What did I need the most during the hike? Extra socks and bandaids, of course. I had two good pair hiking socks (one thin pair for sleeping), but I couldn't keep them dry. By mid morning each day, the pair I had on were sweaty and the other pair hadn't had a chance to dry out from the previous day. Well, this caused nasty blisters on my heels. I had moleskin, which I couldn't keep in place and gauze and duct tape, but duct tape wont stay on sweaty feet. Bandaids worked the best and I'll take plenty next time. If I'd taken the extra socks I probably wouldn't have needed the darn bandaids in the first place, but I'll take them, just in case! ; )
I had two good pair hiking socks (one thin pair for sleeping), but I couldn't keep them dry. By mid morning each day, the pair I had on were sweaty and the other pair hadn't had a chance to dry out from the previous day.
to have dry socks in the morning sleep with the wet socks in your bag - for example I typically will put the the socks in my pockets or under my shirt while sleeping - the heat from your body will get them dry by morning
From Gossamer Gear's web site:
I rank possible backcountry injury/illness into three categories:
• You are going to die no matter what you brought
• You are going to live no matter what you brought (though you might be VERY uncomfortable)
•Something you brought will make the difference of you living or dying
Experience shows that very few maladies fall into the third category. Discussions with Search and Rescue (SAR) personnel reveal that most people, when found, had what they needed to be safe. They just didn’t have the knowledge or experience they needed. The classic example is hypothermia, where the first thing that goes is the judgment. Victims are found dead having discarded gear that would have saved them if they knew the symptoms and treatment.
Knowledge in first aid is far more important than a large first aid kit.
One Half
01-27-2011, 13:17
A little heavy. Almost 8 ounces. He is a little heavy on the extra baggies (everything has it's own). My FAK is the only thing I don't worry if I never use it - I still always carry it. He also has a great video on suturing. Yeah, I know, most of the time you never need this but if you ever do or come across someone who does it would be good to be able to do it. He is very common sense.
http://www.youtube.com/watch?v=P60_sELRkqw
http://www.youtube.com/watch?v=7pFHuE8QE6I&feature=related
Also check this guy out. Very similar:
http://www.youtube.com/watch?v=0dboVSTCkuw&feature=player_detailpage
Superglue works great for small cuts. Even a lot hospitals use them now instead of giving stitches.
Superglue is definitely great for cuts and such, but try and find butyl based superglue, rather than the common cyanoacrylate based superglue you find at the hardware store. Standard superglue will work in a pinch, but lemme tell ya, that stuff burns like a sonufagun. It can also cause more prolonged wound inflammation/swelling, which isn't good. The butyl based stuff is readily available as 'vet bond' for a few dollars a tube online.
It also is absolutely not for use on deep puncture wounds, or arterial bleeding, as bad bad things can arise from either of those applications.
-Smalls