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Old 05-28-2014   #21
Boulder, Colorado
Paddling Since: 1999
Join Date: Aug 2009
Posts: 21
Devils advocate and food for thought:
to the Medic, RN, EMT, ER doc, Optometrist, Gynecologist or whomever bringing med equipment and meds....theres liability for whatever you bring- be willing to backup your knowledge and experience for using such cool apparatuses....or even for having them along for "possible" use and maybe -not- using them..... someone might point a finger as to why you didn't use this or do that when you had it to use.
I know we all have the best interests and intentions in mind, but in a rotten situation that gets worse by administering drugs a person is allergic to (who knew?), or a splint that's applied and not rechecked for placement or CMS and the person risks losing a limb now due to a 12 hr wait for overnight evac, or....or....or....
Good Samaritan law does not cover what one might think....esp when you have specific medical knowledge and esp med equipment along that can be used or -not- used.
Then enter the mourning, angry , grief stricken family member who just knew something would go wrong 'out there' and whose brother happens to be a lawyer.....and is going to question everything down to the brand of oatmeal you had at breakfast let alone what qualified you to do or not do or administer what you did....and if you made the rotten situation into a life/limb situation.
There is a liability and responsibility that goes along with carrying the kit that folks might not always look at.
I'm sure the docs are pretty aware with the $$$ paid yearly in malpractice ins.
Just sayin......

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Old 05-28-2014   #22
Caspar, California
Paddling Since: 1980
Join Date: May 2014
Posts: 6
That, unfortunately, seems to be a prevailing attitude worldwide. I have seen people turn their backs on the suffering of fellow (wo)men. It is something I have never done and hopefully never will do.

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Old 05-29-2014   #23
whip's Avatar
Salida, Colorado
Join Date: Oct 2003
Posts: 516
SAT phone. If you got it you wont need it. But you might fly some other party's critical ill or injured member out. We did daily dressing changes sometimes x 2 on a foot injury for 2 weeks don't underestimate how much material and bacitracin you could go through.
No amount of money is worth your free time!
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Old 05-29-2014   #24
The Old Troll
David Miller's Avatar
Gypsum, Colorado
Paddling Since: 2000
Join Date: May 2010
Posts: 458
No one has discussed dental emergencies. What do you need to treat an abscess or a tooth that splits in two. Fillings can fall out and expose some very sensitive nerves. I'd be interested in what first aid items you folks carry to treat these types of emergencies.
Why does Pluto walk on all fours, drink from a dog bowl, and get treated like...a dog, while Goofy drives a car, wears clothing, and speaks in English?
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Old 05-29-2014   #25
lhowemt's Avatar
at my house, Montana
Paddling Since: 2020
Join Date: Apr 2007
Posts: 4,347
Two items from the drug store. One is a fillimg repair and the other is a pain application. Sorry I don't have details in feont of me. There was a thread a while back that mentioned this and someone had some seriois repair stuff with. I asked my SIL dentist and.she recommended against the stuff because it could affect permanent tepair. So I have the OTC stuff.

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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 05-29-2014   #26
Las Vegas, Nevada
Paddling Since: 2013
Join Date: Feb 2014
Posts: 97
I do have a small cadre of dental items in addition to the floss, toothbrush & toothpaste that I carry with me. I have my own first aid kit that also doubles as the kit I take backpacking with items I know I may need or use (I won't bore anyone with what is in the full kit). For dental care I have a tube of Orajel, Dental Wax (in case I need to pack something that becomes exposed), along with a temporary crown cement and applicator. I would think an abscess or a serious dental emergency could result in evacuation. If an abscess ruptures it could be very bad. I usually also have some percocet for pain related issues and some antibiotics. Keep in mind I would not give out the script stuff to others, it has my name on it and I am not willing to take the liability.
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Old 05-29-2014   #27
Denver, Colorado
Join Date: Aug 2009
Posts: 106
Originally Posted by GCHiker4887 View Post
Keep in mind I would not give out the script stuff to others, it has my name on it and I am not willing to take the liability.
Not to mention the felony, which one can only hope LE would never hear about and a prosecutor would have the good sense not to pursue.
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Old 05-29-2014   #28
Belgrade, Montana
Paddling Since: 1992
Join Date: May 2014
Posts: 6
I have an extensive medical kit that lives in a couple of ammo cans. Includes, suture supplies, IV solutions, antibiotics, Zofran, etc... No advanced airway stuff, though.

Let me start by saying that I treat most everything with ibuprofen and beer. But, on our trip this past spring, one of our boatmen got a puncture wound to the finger that became VERY angry and ugly within one day. Had it not been for 5 days of Keflex and Epsom salt soaks, we may very possibly have had to evacuate him. As it was, it cleared up within 3-4 days. Very happy patient.

As for coloradogem's cautionary post: I think these are real concerns, indeed. However, it is well established and accepted that "Wilderness Medicine" involves a quite different set of rules. And someone correct me if I am wrong, but the liabilities and restrictions of wilderness medicine are less stringent, and therefore the "provider" is less susceptible to litigation. (Though I'm sure there are lawyers out there that would work hard to dispute this.)

For example: a basic EMT would never attempt to reduce a dislocated shoulder while working on an ambulance, but all Wilderness EMT courses that I know of (and have taught), specifically address and instruct basic wilderness EMT's in how to reduce this dislocation. After all, if you are more than a couple of hours away from an ER, you - and certainly the patient - would want to try to reduce that shoulder. (It is worth noting that I have actually done this - twice - in the backcountry. Fortunately, both incidents had very positive outcomes, and we were able to avoid a very involved evacuation of the patient.)

In wilderness medicine the risk vs reward for treatments of emergency situations are definitely different. The prospect of evacuation is a very big deal. As a paramedic, I have a well-defined scope of practice. But that scope expands in the backcountry.

As a doctor, I trust that you would bring along any supplies that you think you may need - and reasonably be able to use in that environment.

Still, I think Ibuprofen and beer works best for most everything. If it's really bad - break out the whiskey.

Have a great trip!!
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Old 05-29-2014   #29
Caspar, California
Paddling Since: 1980
Join Date: May 2014
Posts: 6
Before we went downriver where my wife and daughter were students with Sundance on the Rogue, the instructors asked me to give them a tutorial on atraumatic reduction of a dislocated shoulder. On Day 2, while doing ender pirouettes in the ender hole below Upper Black Bar Falls, I came down with a high brace and immediately recognized, while upside down, under water, that I'd dislocated my right shoulder. I popped out of my boat and swam over to the support raft where Judo and the Glotti brothers were waiting to try out their new found skills. I had to yell at them to pull like they meant it, my humeral head popped back in and I spent the rest of the trip with my arm in my life vest. It has never given me trouble again these past 30 odd years.
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Old 05-29-2014   #30
Old Guy in a PFD
Tucson, Arizona
Paddling Since: 1967
Join Date: Feb 2013
Posts: 1,022
I agree with the ibuprofen and beer treatment plan.

On a trip a lady managed to fall into a very HOT firepan, and although she was instantly extricated, she had some serious "sun burn". Given her intoxication level the doctor who happened to be along declined to dig into his medical bag for pain relief until the next morning. The victim was not in serious pain until morning when he did treat her for that. As to the outcome, she proudly wore the moniker "firepan Carol" forever after.

I went on a single trip with another outfitter who carried Morphine in their kit, even though there was normally no doctor along, and no one was trained to administer it. They also did not have the means to treat an adverse reaction to Morphine. The morphine was badly outdated, and I always wondered if they would have decided to treat "firepan Carol" with that morphine and what the outcome would have been.

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