1st aid

[dustin harwood]

anyone looking for a great first aid package for your paddling crew, check out this link:

http://www.narescue.com/Product1.aspx?U ... duct_ID=97

it has almost everything you could possibly use for a casualty on the water, except a c-spine collar for neck injuries. you can find that at this link:

http://www.narescue.com/ACE-Cervical-Collar-P65C7.aspx

If your interested in this kit, but need info on the use of anything in this kit, pm me and i'll give you the skinny on how to use it like a special forces medic! i think this would be a great addition, i've noticed a lot of rescue systems for getting people out of the water, but what if you get them out and they're really hurt!? especially if your miles from the nearest phone or road.

[dustin harwood]

for you experienced paddlers, could you give me your input on this outfit, is it too much to carry, too much to carry versus the possibility of using it, etc...

[RIORESIDENT]

I carry a similar one for multi-day trips. I havn't had mine long, and havn't used it, but its nice to know you have the equipment if its needed.

here is a link to the one i carry.

http://www.galls.com/style.html?assort= ... tyle=TK059

[Arthur Bowie]

That's a pretty expensive kit, which is fine if you know how to use the stuff in it. The type and length of trip is a big factor in deciding what is approiate medical gear.

The most important medical gear is what you have in head, it's what you know and what you have practiced. If you can go in $200 or $300 steps, that first step would be to take the 2 or 3 day Wilderness First Aid training by SOLO.

The courses ACC has sponsored in the past have had modules added to make the training paddling specific, Tom Burroughs -OzarkTom- is nearly readly to start the next round of those courses any time now.

Anyway, I think it is much better to get the training first and then start building your kit to match your level of training and the type of trips you expect to support.

[Zach]

That would seem to be overkill for almost anyone except a guide leading a large group.
After taking a wilderness first aid course a few years ago, I find I take less and less first aid gear.

Just a small clear make-up bag with a variety of bandaids and gauze pads, ducktape, athletic tape, a ziplock with anti-inflammetories and tums, some small scissors, some antibiotic ointment, a knife, and not much else.

A plastic injector for cleaning wounds would probably be good too.

After having some training I think most people wouldn't need any of the sam splints (which are really heavy), and even with wilderness first aid course one probably wouldn't feel qualified to use a neck collar (though wilderness first responder courses will cover this). A lot of the other gear used improperly could lead to major injuries; the cases where a tourniquet are needed are slim to none, and if used wrong could lead to a lost limb.

With a small first aid kit I can take it even on the shortest trips, which I wouldn't with a large one.

And the extra gear can be improvised. As long as your not a professional who may see regular broken bones, I for one could live with ripping apart a backpack or gutting the outfitting from my boat for splints, carrying slings, etc.

As Arthur already said, take a course. I would feel more comfortable dealing with a major injury with the shirt off my back, some ducktape, and a few sticks after taking a course than a backpack full of gear without a course

[dustin harwood]

thanks for the tips guys, but as far as classes go, i've got some of the most advanced medical training the army has to offer. since im in a recon unit, they cross train us in a lot of fields because we're usually so far away from other friendly units. It all seems complicated, but most things are easy to learn. and while usually overkill paddling on a river, a tourniqete can be safely left on for up to 8 hours and still have a good chance of saving the limb. but like i said, i carry a bag similar to the on i suggested in the field, and im well qualified to use everything therein. but thanks for the tips on size and what would be overkill on the river

[Trismegistus]

One critical component seems to be missing -- suture materials. Most of the time I'm reaching for my emergency pak I'm reaching in to get something to clean and repair a wound -- a couple of forhead gashes, a badly cut foot, a sharp knife in the leg, a puncture wound in an arm, etc. Thus I carry a few sanitary napkins -- can really absorb a lot of blood and water from a wound --, betadine, Avitene coagulent, syringe with local anesthetic -- both short (Carbocaine) and long-acting (Marcaine), needle holder, scissors and some non-wicking Gore-tex suture. Tri-Ointment and dressing material complete the service. On the river you're far more likely to need to close a laceration and than place a nasopharyngeal tube -- and at least in closing a laceration you don't run the risk of perforating someone's sinus or the thin lining of bone that often separates the posterior wall of the nose from the brain.

[Zach]

Butterfly bandaids work great as well for wound closure.
Only problem is they need to stay dry, which on the river would mean covering with second skin or liquid bandage.
If you can keep them dry you often won't need stitches.

[dustin harwood]

great tip guys. both the sutures and the butterflies are something i never really thought of. they would surely be something to be added to any first aid package

[dustin harwood]

another good bandage that i'd like to bring attention to is the clotting bandages. these things work amazingly. there are some in the kit RIORESIDENT advertises above. or you can buy them at this site

http://www.narescue.com

they come in all different sizes and shapes (at wildly varying costs.) all you do is put it on a wound that wont stop bleeding for 2 minutes. after 2 minutes, simply keed the bandage in place and cover with onther bandage to hold in place. i saw a demo of these on a pig where they cut the femoral artery in half, then applied the bandage, which stopped the bleeding in less than a minute.

[Don Harwood]

Yes, skin tears are about the most common injury in the river environment.
So, we definitely need FA for that.

[RandyJ]

Isn't there medical-grade "super glue" for closing wounds now? Anyone out there have knowledge on this?

[Trismegistus]

Yup we use "superglue" all the time here in the office for wound closure and we use the "medical grade" stuff i.e. "2-octyl-cyanoacrylate." This compound supposedly causes less skin irritation than the butyl-based stuff you buy at Target. But it also be more expensive because it says "medical" on the tube and really doesn't work that much better. The best way to approximate and seal the laceration -- dry as possible, approximate the edges, quick dab dry again, brush with "glue" and then immediately wet for an "instant set" -- water is the "hardener".

FYI: The medical community tends to frown upon folks using "superglue" to close lacerations. First they'll tell you "tissue adhesive" or "medical grade superglue" is seemingly critical to prevent inflammation and scarring, etc. Second, we've all seen these messed up glue covered wounds that are a nightmare to clean up -- the stuff is not made to used liberally or deep within a wound -- use sparingly, keep it on the outer dermis, etc. And third, a wound must be cleansed before closing -- very important -- or you're just setting yourself up for infections, tetanus, etc.

[Eric Esche]

out of curiousity, how does pepper work as an clotting agent/coagulant? My grandmother used to use it on farm emergencies and I've seen it used maybe a dozen times on construction sites with fairly good results even with near amputations from saws. Just curious. I had it used on me when my ring finger was smashed very flat and the doctors didn't complain about it contaminating the wound site when it was cleaned and sutured. They said it might have even saved my finger, but that was a LONG time ago, say 1960.

Murphy's law, I didn't have any handy two weeks ago when I openned up my knuckles on a trussplate and bled profusely. I bleed pretty freely now after having been taking a 325mg aspirin a day for the last nine years since a MI and am rather thin skinned, so this is a practical question for me.

Thanks, Eric

[dustin harwood]

i've also heard a lot about pepper being used as a clotting agent. although i've only seen it a few times on minor wounds, the stories i've heard sound convincing. i've always heard cayenne works the best, then black pepper.