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Dirty First Aid

6K views 24 replies 12 participants last post by  GAtoCSU 
#1 ·
Dirty First Aid Series - Part I - Unsponsored

We all love to kayak, sure. It has some things we love and some we hate. First Aid often becomes the elephant in the room.

When was the last time you or your peers did a course or a workshop? Do you keep ‘up to speed’ on developments?

In this series I am pleased to offer a ‘dirty’ First Aid approach. This is suited to kayakers and river users. Using a ‘find it fix it’ approach to incident care and management.
 
#3 ·
Was hoping there was some good info on using duct tape and a wet dirty sweat soaked piece of sleeve from an under armor shirt to stop the bleeding from a puncture wound from a stick that got lodged close to a big artery near ones arm pit while rolling a kayak. Then dealing with a 45 minute uphill climb through the bush and poison ivy to a dirt road, with maybe one bar of cell service, on a rainy day with no sat phone reception. Only to hike another half mile to hitch hike to the town and make it to the ER by dark.. Not saying this happened to me..but I will always keep duct tape on my paddle if this happens again to someone I know.
 
#5 ·
You can get s staple gun to close wounds for about $15 on line. I wouldn't use it unless you were bleeding pretty heavy or something was really hanging open. Puncture wounds have a higher risk of infection. Heavy bleeding and lots of water greatly lowers risk of infection. Duct tape is awesome in some areas (where you can wrap) harder in others, like a cheek.

There are some techniques to reduce a shoulder. Not always easy without sedation but when your on an isolated river, could make a huge difference. Many videos on how to do this and that's one of the most likely injuries to happen on the river.
 
#6 ·
I always prefer to have a couple of medically-trained personnel on the trip if possible. I'm CPR certified (and have had to use it), and an uncle of mine who often comes with us is a surgeon (an oral surgeon, but he can still do stitches or set an I.V. when needed, and we've had to do that as well).

Here's the most important tips from my experience:

Stock your first-aid kit with anything you might need (I.V. kits, suture material, pain pills, fever suppressants, bandages, rubbing alcohol and such like), and make sure you know how to use everything in it (the most advanced first-aid kit is useless if you don't know what's in it or how to use it). Pack the kit with the possibility of needing to change out bandages for a week after someone is hurt on the first day of your trip.

Be smart. Most emergencies can be avoided in the first place if you are cautious. Drink plenty of water (no, beer doesn't count), wear a hat and sun screen, and keep an eye on kids to be sure they are doing the same. Know the physical limits of everyone in your group.

Practice beforehand. It always seemed repetitious and unnecessary as a boy scout to review the same first-aid or knot-tying stuff over and over again, but it pays off when you have to set up a rescue line or splint a leg in a real emergency.

In short, with a bit of precaution, you shouldn't need to use your first-aid kits, but make sure you know what to do if there is a freak accident.
 
#9 · (Edited)
Here's the most important tips from my experience:

Stock your first-aid kit with anything you might need (I.V. kits, suture material, pain pills, fever suppressants, bandages, rubbing alcohol and such like),..


... Pack the kit with the possibility of needing to change out bandages for a week after someone is hurt on the first day of your trip.
Hey Morbald, Like your thinkin but, I can't fit all that in my kayak. What do you think are the top 10 items needed in a first aid kit? How do you carry them? Where do you carry them? As a kayaker these are the things that plague us before every trip.
 
#8 ·
Right on unsponsored. Thanks for providing content. Like flyingdutchman, I"d like to see you take on how you improvise. I all my years duct tape and super glue have mcgyvered me out of all kinds of evils.

keep it up!
 
#13 ·
My kit is stocked with a lean towards controlling bleeding with many compresses and gauze and triangular bandages. I have a sam splint and a CPR mask too. Alcohol wipes, antibiotic ointment, pen and paper, swiss army knife w/ scissors. While we don't discuss it much before hand, I've found in the limited times we've had to break them out we always have what we need between all our kits.

Hmmm, thinking about discussing first aid a little more during safety/orientation speeches before launch.

Second the thought that none of it is any good if you don't know how to use it.
 
#17 ·
Just to comment on a few things in here...

1. I don't carry IV's on the river. There's no reason to do this. You have to carry so many different supplies on a river to have an IV, keep it in place, flushes, IV meds, blunt tip needles, etc to make it worth while.

2. If you're looking for pain control and you have a DEA license, you could always do intranasal fentanyl or IM fentanyl if you had to. Intransal devices are slick and you don't have to carry around needles. Again, no reason for an IV

3. Lidocaine with epi. Under the right hands, this can be a god send. I have carried a 22 gauge spinal needle, 10cc syringe, and 10 cc's of lido with epi on rivers before. With these three things, I can do anatomical nerve blocks, hematoma blocks (Fracture pain relief), and even do glenoid injections to facilitate shoulder dislocations. Again, this is if you're either an ED doc or an anesthesia guy.

4. EpiPen: Great for anaphylaxis if you are actually dealing with anaphylaxis. This shouldn't be used for isolated hives, and if your patient is over 40 you should really consider if this is a necessary treatment as you could cause more harm than good if you're not treating true anaphylaxis. I carry one myself, but would ONLY use it in an airway emergency or angioedema from anaphylaxis.

5. Epipen: This is not used in code situations. IM epi isn't a code drug. The dose is wrong, the delivery is wrong, etc. Code drugs in the wilderness are not something I plan on doing and really haven't been shown to increase survival, even when given in the ED or by EMS.

Food for thought from your neighborhood ED doc.

Scott
 
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