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Old 05-20-2014   #11
Old Guy in a PFD
Tucson, Arizona
Paddling Since: 1967
Join Date: Feb 2013
Posts: 1,022
I wouldn't dare presume to tell a doctor what he should bring on a canyon trip. I mean, he's the Doc, right?

I will presume to tell him he can expect dirty conditions; think camping without water for a week. The Colorado river often looks and acts more like chocolate milk, what with all the sediment in it. And, it's cold; even 150 miles downriver it will cause hypothermia in just a few minutes for someone who isn't protected. The air temp can be 110, the river can be 55, so the shock factor is a consideration.
You can expect critters that bite; from rattlesnakes and scorpions to the little purple wasp thingys and fuzzy spiders that I understand hurt like the dickens if they get you.
If something happens you can expect to be on your own for anything from several hours to days; that's how long it can take to get word out and get a chopper into you.
The other posters hit it right; a cut or scratch that gets infected is the devil to get and keep clean, and a major pain to deal with.
And expect the irritation factor to be high; there are plenty of ways to get a rash, or itch or something that doesn't require evacuation, but will make people a major pain to live with. Lots of potions, and lotions and salves and balms will help.

And expect to be paid for your services in beer.

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Old 05-20-2014   #12
Old Guy in a PFD
Tucson, Arizona
Paddling Since: 1967
Join Date: Feb 2013
Posts: 1,022
and something else to consider;
The river rules state that if a thing absolutely positively must be kept dry and clean, it will not.

Pack your stuff as if you were expecting it to be dropped, kicked, stepped on, dunked, and super heated, cause it will. The doctor who went on most of our trips used a big ammo can lined with plastic, the contents water proofed, and packed carefully. There's probably something better now, but keep in mind whatever you use will be fully tested as to it's ability to keep stuff dry and not squashed.

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Old 05-20-2014   #13
Wavester's Avatar
NorCal, California
Paddling Since: 91
Join Date: Jul 2010
Posts: 330
In addition to the usual meds like Epi and Benadryl, Zofran, and a broad spectrum antibiotic I have seen and done suturing and splinting or casting fractures on the GC. All the BLS stuff the NPS recommends as well.
We brought IV solution last year for an August trip for rehydration as well. Hopefully the only thing you treat is sunburn and blisters.
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Old 05-20-2014   #14
GAtoCSU's Avatar
Eagle, Colorado
Paddling Since: 1994
Join Date: Apr 2005
Posts: 696
What are you going to do with a BVM? I don't know the statistics, but I would presume that any respiratory arrest even in the canyon has a very high likelihood of a fatal outcome. I once thought bringing airway equipment into the wilderness would be a good idea, but I've since changed my mind. I carry a basic mask with a 1 way valve if it comes to it, but I won't be running a code long enough in the wilderness to need a BVM, king tube, LMA, etc.

Basic stuff like sunscreen, epi pen x several, benadryl, imodium, zofran odt, cipro, ibuprofen, LMX for suturing, dermabond for blister repairs, and PO opiates are about all that one needs to do a decent job out there. Steri strips, 4x4's, and cobain for dressings.

Invest in a satellite phone to call a friend if needed.

I'm an EM resident.
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Old 05-20-2014   #15
Join Date: Jul 2006
Posts: 332
Staple gun and ring cutter
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Old 05-20-2014   #16
lhowemt's Avatar
at my house, Montana
Paddling Since: 2020
Join Date: Apr 2007
Posts: 4,345
Originally Posted by oarboatman View Post
ring cutter
Yes! Plus lots of sterile saline flush/irrigation and epsom salts for cleaning.
I am a river, babe - I've got plenty of time, I don't know where I'm going, I'm just following the lines..... - "We are water" by Shaye
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Old 05-20-2014   #17
Redmond, Oregon
Paddling Since: 1973
Join Date: Jan 2013
Posts: 1,031
I'm ready to get beat up.

Manuka honey.

While the definitive long tern treatment for serious burns is still excision etc there is some evidence that in the short term, prior to transport to advanced care, Manuka may be better than Silvadene.

One study claimed some, repeat some, effectiveness of a Manuka related MediHoney against MRSA.

Side effects of honey is that it is sweet.
Oral is recommended along with topical. Of course, more individual study is needed.

Manuka Honey Effective Against Antibiotic Resistant MRSA
Researchers at the University of Technology Sydney have shown that medical-grade manuka honey, also known as Medihoney, improves the effectiveness of antibiotics. It can prevent bacteria from becoming resistant to the medications. Medihoney is a highly-absorbent seaweed soaked in special, sterilized manuka honey.
- - - -

PLOS ONE: Synergism between Medihoney and Rifampicin against Methicillin-Resistant Staphylococcus aureus (MRSA)
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Old 05-21-2014   #18
Barnburner's Avatar
Reno, Nevada
Paddling Since: 1999
Join Date: May 2011
Posts: 13
With regards to the BVM, myself and my pals are all 20+ year medics. We'd rather be able to ventilate someone with room air vs no air at least as a shot. Statistically sure, your probably right, the chances of a successful resuscitation is slim, although we will give whomever the best shot possible. If that means an opa and bag and or dropping a tube then so be it. A least we can say we tried.
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Old 05-28-2014   #19
Denver, Colorado
Join Date: Aug 2009
Posts: 106
I expect every member of the party to bring their own sunscreen, lotion, lip balm, soap, hand sanitizer, antiseptic ointment, and bandaids. I expect them all to be able to treat their own blisters, sunburn, minor burns/cuts/scrapes, splinters, and bug bites. I am a big fan of Superglue for cuts/cracks, and the flexible kind is even better. It is sold as adhesive for fake fingernails, in the cosmetics aisle. I think everyone should have their own bottle of it. On trips with kids, sometimes I hand everyone in the party a small bottle of hand sanitizer. Party favor.

As a boat captain, my enhanced kit includes all of the above plus a snake bite kit, more extensive bandages, screw top ice bag, a few rolls of cloth athletic tape, a couple of curved steel finger splints, toenail clippers, scissors, extra tweezers, an X-acto blade (not for surgery but in case something has to be lanced or dug out beyond what a needle will do), latex gloves, Quick Clot, antiseptic wipes, Cetaphil or baby shampoo for wound care, and a glucagon injector pen (my sibling is a type I diabetic and could go unconscious due to insulin shock).

When I am lucky enough to have a doctor along on a trip, I would hope that he/she would be able to bring along things the layman cannot get: a local anesthetic such as Lidocaine, sutures, oral antibiotics, high grade topical antibiotic ointment, and some better-than-OTC painkillers. That plus medical knowledge/training, of course. Come to think of it, I should probably just carry sutures anyway.
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Old 05-28-2014   #20
Caspar, California
Paddling Since: 1980
Join Date: May 2014
Posts: 6
thanks Ridecat,

My thinking exactly. As an ER Doc with wilderness experience, I expect everyone to have the basics to deal with minor problems. I conceive of my role as serious, hopefully not life-threatening situations requiring my intervention and my kit will reflect that. I plan on relaying the same mention to my fellow river rats.

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