First Aid Kit Q.

[felixXJ]

By the way, that was a BK9 I was working with at the time. I know Clifford Stamp did his his best to break one (he succeeded) but I'd never be able to break it. I digress though from topic.

Sutures are a useful skill and so is the use of hemostats. EMS is not always < an hour away. I'll likely to be able to get some good antibiotics as well for inclusion.

 

[k-spar]

I should've been more clear, that my comment wasn't directed at you, but at home stitching. I know a doctor who uses superglue on himself and his family, so I naturally just follow suit. I imagine that the problem here would be the glue somehow sealing in an infection that the body would otherwise more easily reject?

yeah, infection is the worry. This can work, but only after being certain to FULLY CLEAN the wound. Use high pressure irrigation. It is best if it has a breathable bandage which can be replaced often though, and continue to make sure the wound is clean. I recommend adding an irrigation syringe to your kit for this purpose. Infections in the backcountry are bad news.

 

[k-spar]

Sutures are a useful skill and so is the use of hemostats. EMS is not always < an hour away. I'll likely to be able to get some good antibiotics as well for inclusion.

I'd get antibiotics as well, but you can use steri-strips as sutures often, if they aren't sticking use tincture of benzoate to stick it. Suturing is a good skill though, if you know how to do it--I don't.

 

[nemoaz]

yeah, infection is the worry. This can work, but only after being certain to FULLY CLEAN the wound. Use high pressure irrigation.

Respectfully, Sir, there is much more to cleaning a wound than this. I was a paramedic, ER nurse, and military medic. I have the skills and have closed minor wounds in the past... in clinical settings with the ability to monitor the patient (even if it was by follow up by another medic). Surgeons have sterile equipment and antibiotics yet they still often require additional surgerical interventions or different antibiotics.

Just because Rambo sewed himself up with dental floss doesn't mean that you should. Leave the wound open, dress it with appropriate gauze and antiobiotics, and remove the exudate from the wounds and dress the wound again with clean gauze as often as possible given your probably limited amount of dressing material. The scar may be ugly, but you will have a better chance of living.

Guys with first aid level knowledge of medicine have NO BUSINESS closing a wound.

 

[k-spar]

Respectfully, Sir, there is much more to cleaning a wound than this. I was a paramedic, ER nurse, and military medic. I have the skills and have closed minor wounds in the past... in clinical settings with the ability to monitor the patient (even if it was by follow up by another medic). Surgeons have sterile equipment and antibiotics yet they still often require additional surgerical interventions or different antibiotics.

Just because Rambo sewed himself up with dental floss doesn't mean that you should. Leave the wound open, dress it with appropriate gauze and antiobiotics, and remove the exudate from the wounds and dress the wound again with clean gauze as often as possible given your probably limited amount of dressing material. The scar may be ugly, but you will have a better chance of living.

Guys with first aid level knowledge of medicine have NO BUSINESS closing a wound.

Sorry, I was misinformed. Is high pressure irrigation pretty much as good as you can do for cleaning wounds in a wilderness situation?

 

[Inferno]

Pretty much, yeah. The tough part is getting access to sterile syringes and saline; carrying any amount of liquid that you can't drink seems wasteful to me, so see if you can get an MD/RN friend to get a few saline flushes for you-- they're basically 10cc syringes pre-filled with normal saline (NS). Just attach an 18G or 16G needle/cath and make sure to use everything-- don't save it, bacteria can grow like crazy in NS. I used to pack a couple syringes, needles, and a 250 or 500 bag, but it would never get used or be too much for what I needed at the time. So, bottom line, flush it then cover with dry sterile dressings and try to keep it clean. If you have to cross water and the wound isn't healed yet, try a Tegaderm dressing. It's basically a big piece of sterile tape that will seal everything out (and in). I'm with Nemoaz on the suture issue, I wouldn't suggest it no matter how many raw chicken legs you've practiced on...

 

[felixXJ]

Celox and dressing will do what I need in any conceivable situation. If 2 old surgeons wanted to teach you, what would you do?

 

[SpookyPistolero]

Just to add to the thread for those that are worried about cleaning out a wound, there are cans of sterile saline spray for just this purpose, so you don't have to worry about carrying around syringes.

http://www.allegromedical.com/wound-care-c541/wound-wash-saline-210-ml-p172296.html

I've no experience with that particular product, it's just an example. Any pharmacy should have something comparable in the first aid aisle.

 

[k-spar]

Thanks for the answer. In my Wilderness First Responder course I was told to carry an irrigation syringe in my kit, and use water which was purified and drinkable. Not as good as saline, but sometimes you don't have it.

Another option is to fill a sterile rubber glove or non-lubed condom with drinkable water, tie it off, and poke a small hole in it and use that to shoot water at a higher pressure.

Again--sorry about suggesting superglue was a viable method of wound-closing. I was told it would technically be fine if the wound was clean but you can't be sure, so don't do it. You should have a dressing which you can remove and clean.

 

[Inferno]

Well, if the wound is clean and you use crazy glue to seal it, the idea is to join the skin and not get any inside the actual wound; I'd rather glue it than use a dry sterile dressing if I had to cross water or go through someplace really muddy. All depends on the situation! On a side note, I keep a tube handy for sealing cuts when I am working on projects, and have never had an infection as a result of gluing something shut right then & there... knock on wood!

 

[maxkimber]

I have two small children, and we went to a friends house and my daughter was stung by a bee and we had nothing of our own (luckily she wasn't allergic). Since then, we bought a small tackle box and stocked it accordingly. Now whenever we go out we take the tackle box. We use the same box for all our first aid needs inside and outside the house - that enables us to use, rotate, and replenish the stock, vs. just keeping a kit where ointments get out of date, band-aids don't stick, etc. Obviously, not the best set-up for hiking or camping, but works great where you have your vehicle.

 

[nemoaz]

Well, if the wound is clean and you use crazy glue to seal it, the idea is to join the skin and not get any inside the actual wound; I'd rather glue it than use a dry sterile dressing if I had to cross water or go through someplace really muddy.

Sure, if the wound is clean, it would be good to seal it. How did you get it clean? Povidone-Iodine and mechanical scrubbing? No? Just irrigating a wound does NOTHING to kill microbes. Closing the wound then gives them the chance to kill you. Sterile saline is better for irrigation because you won't be introducing any new microbes to the wound... but it does nothing to kill what got in there during the traumatic injury that caused the wound to begin with.

Even Rambo was knew enough to cauterize the wound prior to closing it. Still not recommended BTW.