First aid for wounds

Pretty sure it's ice, I think immobilize is through rest, compress, and elevate.

I was taught to practice HIRICE, the HI being hydrate and ibuprofen
 
I was an Army medic for 20 years and have done a lot of wound treatment including suturing in a field as well as an E R type environment and my rule was if I could clean and debred the wound and stop the bleeding in the field just as good as in the E R without other issues I would do probably do it if evacuation was not possible. Other issues are nerve and tendon damage which should be determined by checking touch and motion especially on extremities. If complications indicated not closing the wound I would use wet dressings and work on evacuation.
Now it has been 21 years since I practiced this tail gate medicine and I would bow to the new breed as long as we don;t throw common sense out the window and so far that has not happened in this thread.
 
mkhop said:
I was an Army medic for 20 years and have done a lot of wound treatment including suturing in a field as well as an E R type environment and my rule was if I could clean and debred the wound and stop the bleeding in the field just as good as in the E R without other issues I would do probably do it if evacuation was not possible. Other issues are nerve and tendon damage which should be determined by checking touch and motion especially on extremities. If complications indicated not closing the wound I would use wet dressings and work on evacuation.
Now it has been 21 years since I practiced this tail gate medicine and I would bow to the new breed as long as we don;t throw common sense out the window and so far that has not happened in this thread.
Click to expand...

Nice! Great post, I agree with you totally.:thumbup:

Good point on assesing nerve damage. I didnt mention that, and its important.:thumbup:
 
Something I forgot to share....If treating shock by elevating legs, take into consideration abot the inter-cranial pressure associated with a head injury. You elevate the legs, it will raise ICP which is not a good thing.

Actually Trendlenberg is really not used anymore.(elevation of legs) I heard that from a very good source. First Ive heard of it.
 
J - Signs of blood poisoning, still waiting for it.....How do I know when a cut, dressed in the field, isn't recovering appropriately.

The question is asked because of the sceneraio where a wound, non-life threatening, was incurred, but taken care of in the field and a decision was made not to evacuate patient or kill the field trip. However, what are the warning signs to suggest that the previous judgement should be revisted. How long does one wait before re-evaluating condition of a dressed wound?

How do I discriminate between the decision - 'time to get out of dodge' and 'lets give it one more day'

I know these are toughies and incident-specific, however, I'd love to here some suggestions. Also want to keep this thread growing.
 
Sorr Pict, I mustve missed the question.:o

Blood poisoning-sepsis

Signs you should watch for is fever, chills, tachycardia, N&V, feeling seriously ill. Mental status changes, decreased urine output.

Severe sepsis occurs when sepsis leads to organ dysfunction, low blood pressure, or insufficient blood flow to one or more organs. Sepsis can lead to septic shock, multiple organ failure and death.

Wounds, and pts status should be evaluated every 24hrs, when you are changing dressings.

Hope this explains it, sorry for the delay bro.:thumbup:
 
Also watch for milky discharge and steaking. Also, it helps to be able to tell the usual trauma irritation and bruising from infection and necroyourshitisabouttofalloff.
 
way good thread man. :bigthumb:

you guys all told me my hand was gunna fall off after I stitched it. I can s ttt tt yy llll typpppp pppp ppppppee weeel.
 
This may be a late addition but I think it will mesh well with this thread...

My wife's main outdoor activity is horseback riding ( and yes she is the that horse is my baby kind of person) and about a year ago her horse was seriously injured. I'm talking a gash that I could stick all four fingers into all the way to the back knuckle. Having been in the Marine Corps for five years I knew enough to recognise that there was no arterial bleeding so instead of rushing to the vet I put in a call.

The vet's instructions were as follows. Stall the horse. Clean the wound twice a day with iodine( or betadine) solution. She recommended half water because the betadine sold at the farm supply is already diluted. After cleaning I was told to cold hose 10 minutes making sure the water was coming out of the wound clear, then to pack the wound with "Wonder Dust" and leave uncovered. Keep in mind this was done twice a day.

Long story short the horse doesn't even have a scar and this wound was horizontal to the ground and about 7/8's of the way up the front leg of the horse so it was in a place that every time she moved the wound opened.

The reason I told this story is to give meaning to my recommendation of Wonder Dust as a First Aide Kit essential. It's a cheap form of Quick Clot that is readily available at the local tack or farm store. It comes in a plastic bottle about the size of a Coca Cola can with a spout on the top. I treated this horse for over two weeks with less than one bottle so a little goes a long way and I know from vet's advice and personal experience that it works on people as well as animals.

As far as killing infection, her wound was already oozing pus when I found her ( it happened while I was at work) and the combination of betadine and wonder dust completely stopped the bleeding (within minutes) and pus with in a day or so.

David
 
Wow! Great post man. Thats really interesting. Im gonna look into that stuff. Safe for people?
 
I used it on myself on a small but deep slice and it worked just fine, no ill effects. I didn't even have to cover it with anything. Just washed the cut a little with water from the hose put about a half teaspoon in my palm and mashed it on the cut.

The stuff looks like graphite powder (it's pretty fine) and it clots into a "scab" very quickly on slow bleeding cuts. I would guess it would have to be used in conjuntion with a temporary tourniquit or even pressure point manipulation to have any effect on arterial bleeding though.

David
 
This is great stuff guys. I think everything I've read so far has been right on the money info. Lacerations, sutures, fractures.... Haha I live for this stuff. I'm EMT certified working in the ER of a level 1 trauma center hospital near my house and currently applying to med schools with hopes of becoming a trauma surgeon. Lets just say I love emergency medicine haha. J williams you sure seem to know your stuff! I am impressed. The only thing I'm iffy on is when you said "Actually Trendlenberg is really not used anymore.(elevation of legs) I heard that from a very good source. First Ive heard of it. "
I literally just went through EMT school and I was taught to use it for shock, unless obviously there is a chance for lower extremity or pelvis fractures. I don't know if it's taught differently somewhere else, but that's what I was told to do. Who knows. I wanna hear more crazy scenarios and see if I can answer them hahaha. Sorry, I love this stuff.
 
How exactly do you use Crazy glue for closing a wound? I'd imagine it's got to be a small cut and you wash it first right? Do you pinch the wound closed, apply the glue and hold it closed until it dries? Not sure how this works. Do you just leave it like that until the glue falls off?

Any risk of poisoning from the glue?

Sorry for all the questions
 
THis might be a late post on a couple of things, but I figured it's better to chime in late than never...J williams is an expert on this stuff and he seems to have covered all the basis...Tredellenburg (or feet elevated position) is still used in medical emergencies that indicate a decrease in blood pressure or in a truama emergency that would indicate a signifcant loss of blood volume, as charectarized by tachycardia (elevated heartrate) and low blood pressure (detected by lack of a radial pulse in the wrist) provided as J said there is no suspicion of a head injury...ie: if someone falls oout of a tree stand and is bleeding profusely there is a poss of a head injury..which might cause pressure on the brain..we don't want to shunt more blood that way and increase that pressure..however someone is swinging an axe and gets a local injury to the leg by severing there femoral artery...than in addition to trating the bleed we might elevate the legs to help all the remaing blood to get to the brain.
Also in regards to sepsis a decrease in blood pressure in conjunction with an elevated heartrate is a pretty serious indication that one is approaching the septic shock spectrum.. If you don't carry ablood pressure cuff with you you want to try and feel for a radial (or wrist pulse),
I don't know if roug guaging of blood pressure is really an appropiate diagnostic tool for non medical people but it might be helpful in some situations so here 'goes
If you do not have a blood pressure cuff in the field (which I imagine most people wont) a quick way and very rough to guage a systolic (or top number of a blood pressure) is as follows.

if you can detect a radial (or wrist pulse) than the top number is at least 80 or above..80 is not great but we're not sweating it yet

if no radial pulse is present you go to the femoral pulse in the leg (this would indicate 70 or above) 70 or less is where I'm starting to raise my eyebrows and thinking about the fastes way to get out of dodge.

if no femoral pulse is detected there is a good chance to person is unconcious otr will be shortly..that your going to move on to a carotid (or neck pulse) which would indicate 60 or higher...if no carotid pulse is present...the Fit has hit the shan so to speak...

Also just a basic idea which has saved me allot of grief.. if someone has an elevated heartrate (a weak or undetectable radia pulse) is cool and clammy and moist there is a distinct chance they are suffering from low blood pressure either by itswelf, or as the result of an imjury or an underlying medical condition..have them lay down...thuis will save them from passing out and getting injured or worse... just my 2 bits Thanks.
 
Remember to watch for signs of shock with all injuries.

SIGNS AND SYMPTOMS OF SHOCK : confused behavior, very fast or very slow pulse rate, very fast or very slow breathing, trembling and weakness in the arms or legs, cool and moist skin, pale or bluish skin, lips and fingernails and enlarged pupils.



Anticipate that shock will follow ANY injury and to take measures to prevent it before it happens.


Putting a victim in a lying-down position improves circulation.

If the victim is not suspected of having head or neck injuries, or leg fractures, elevate the legs.

If you suspect head or neck injuries, keep the victim lying flat. If the victim vomits, turn on their side.

If victim is experiencing trouble breathing, place them in a semi-reclining position. Maintain the victim's body temperature, but do not overheat.


Shock will almost certainly follow a bad cut or a broken bone. It can happen very rapidly. Treat the bleeding first, then treat for shock.
 
good stuff on shock. :thumbup:

Rielly - I agree 100% with what you stated. The comment I made about trendelenberg came from a scenario with a header from 20ft onto concrete. I wasnt on the call, but you know how calls get kicked around at lunch etc.. Well, we got to talking with one of the new guys, talking about higher risk of bad juju with the shock from bleeding out or the TBIs ICP. I am concerned with the TBI, and keeping ICP down first, and then minimizing the shock as well as you can, which of course you cant elevate this pts legs due to the other injury. One of the guys made a comment about Trendelenberg not being used all that much anymore. This is a guy who is also head of a very well renouned hospitals EMS system, and also works for us. No slouch. But that comment did have my head spinnin. Thats why I threw it out here to see if I could get any feedback on it. Thanks bro, im glad my initial impression of the comment was accurate with yours. :thumbup:
 
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