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#253816 - 11/25/12 10:10 PM Re: how do I choose the right first aid kit? [Re: picard120]
JPickett Offline
Enthusiast

Registered: 08/03/12
Posts: 264
Loc: Missouri
"think about trying to splint a busted bone only to move it and have a bone splinter cut a artery!!!"
This is why you splint a broken limb in the position you find it.
Don't move it any more than you must to get the splint on.

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#253835 - 11/26/12 01:31 AM Re: how do I choose the right first aid kit? [Re: JPickett]
AKSAR Offline
Veteran

Registered: 08/31/11
Posts: 1233
Loc: Alaska
Originally Posted By: JPickett
"think about trying to splint a busted bone only to move it and have a bone splinter cut a artery!!!"
This is why you splint a broken limb in the position you find it.
Don't move it any more than you must to get the splint on.

Severly deforemed and angulated fractures often pinch off blood vessels, compromising circulation to the limb distal to the fracture. What is generally taught these days in WFR and WFA classes is to attempt to use very gentle traction to move the broken limb into (more or less) normal anatomical position, prior to splinting. This is generally more comfortable for the patient and has better outcomes, particularly if transport to a hospital is delayed. However, if you meet resistance when you try to traction into position, or the movement causes extreme pain, then splint in the position found.

Splints should immobilize the joint above and below the fracture. For example, for a broken forearm, you might want to use a SAM splint to imobilize the the wrist and forearm, then support the splint with a "sling and swathe" to also immobilize the elbow. Splints should be well padded and easy to adjust to account for swelling. Check CSM (circulation, sensation, and movement) distal to the fracture both before and after splinting. Frequently check CSM distal to the injury, since swelling can cut off circulation after splinting. If over time you find CSM is becoming compromised, then you need to adjust the splint to maintain circulation.
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#253849 - 11/26/12 03:49 PM Re: how do I choose the right first aid kit? [Re: Lono]
MDinana Offline
Pooh-Bah

Registered: 03/08/07
Posts: 2208
Loc: Beer&Cheese country
Originally Posted By: Lono


It all depends. CPR for example - CPR on a coronary 15 miles up the trails is a losing cause; CPR on a hiker struck by lightning however will save his life more often than not. So don't throw that arrow out of your quiver.

I carry about a pound and a half of dedicated first aid supplies, based on what I need in the event a Scout goes down - I can't in good conscience treat them with an AMK 0.9 and band aids. Its the first aid supplies that I also carry that are improvised from my hiking gear that can make the difference long term - the neck collar traced on my blue pad, ready to cut out and wrap around his neck to help immobilize his spine; the rest of the blue rest pad to use to pad his arm or leg fracture; clothing to cushion splints; my hiking poles for splint materials; warmth, warmth, warmth, to stave off the effects of shock. That sort of thing. Add it all up, you can and should carry a lot more than whatever fits in your little bag with the first aid cross on it.

It depends on what you know, or what you're ready to treat.

Sorry, I had to get rid of the wall o' text.

In theory, I agree - lightening and cold water drownings sometimes do come back. But overall, nearly pointless. Like I said, even if you get them around, it's going to be a PITA to get them out of the back country.

If I was responsible for a bunch of scouts, I might take more. Or more likely, break the kit into modules that I spread around and make part of the troop-level equipment.

Like others say, a class, and make your own. Then carry it around for a bunch of hikes and see what you see.

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#253859 - 11/26/12 06:46 PM Re: how do I choose the right first aid kit? [Re: picard120]
TeacherRO Offline
Carpal Tunnel

Registered: 03/11/05
Posts: 2574
A few things I've added to my commercial kits:
Exam gloves
Tiny fauxton type lights
SPF chapstick
folding knife - small, but locking

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#253866 - 11/26/12 09:40 PM Re: how do I choose the right first aid kit? [Re: hikermor]
ILBob Offline
Old Hand

Registered: 02/05/10
Posts: 776
Loc: Northern IL
I am of the opinion that most purchased first aid kits are gimmicks. Figure out what you use as far as first aid stuff goes and buy some of that. Add some things you rarely if ever use like some blood stopping pads.

My personal favorite for stopping bleeding is either a hanky or a towel of some sort. You probably already carry one in your pack for the more common uses so no need to add extra crap. I have a clean hanky and a pack towel in a baggy in both my fanny pack and my day pack.

Duct tape or electrical tape works every bit as good as white adhesive tape. I have some of both wrapped around a pill bottle that I keep my fire kit in.

I am not a fan of carrying stuff that one may not even know how to use effectively.

Irrigating a wound does not require anything other than a water bottle that you already have.

IMO, sterility on the first aid products is highly overrated. The environment you are in is not sterile so while clean is a good idea, sterile bandages probably don't serve a necessary purpose.
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Warning - I am not an expert on anything having to do with this forum, but that won't stop me from saying what I think. smile

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#253867 - 11/26/12 09:55 PM Re: how do I choose the right first aid kit? [Re: MDinana]
ILBob Offline
Old Hand

Registered: 02/05/10
Posts: 776
Loc: Northern IL
Originally Posted By: MDinana


In theory, I agree - lightening and cold water drownings sometimes do come back. But overall, nearly pointless. Like I said, even if you get them around, it's going to be a PITA to get them out of the back country.

If I was responsible for a bunch of scouts, I might take more. Or more likely, break the kit into modules that I spread around and make part of the troop-level equipment.

Like others say, a class, and make your own. Then carry it around for a bunch of hikes and see what you see.

A volunteer fireman I know who is an EMT and has been one almost as long as IL has had them told me a few years ago he had never personally seen anyone come back with CPR and no one else on his small department had either. AEDs do work well though if you can get it done very quickly. Usually you only have a few minutes where they are going to do much good. But they are just too heavy to cart around.

The reaility is that most people cannot sustain CPR for more than a few minutes anyway. It is just physically too taxing to the rescuer.
_________________________
Warning - I am not an expert on anything having to do with this forum, but that won't stop me from saying what I think. smile

Bob

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#253871 - 11/26/12 10:39 PM Re: how do I choose the right first aid kit? [Re: ILBob]
hikermor Offline
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 7705
Loc: southern Cal
This is something that is not emphasized in most CPR classes. My CERT trainer, a highly experienced fire captain, said he had witnessed seven truly successful recoveries - the patient eventually walked out of the hospital - spread over 300 incidents. Personally, I am 0 for 2, but I am glad I have the capability to render aid. CPR is way ahead of back pressure- arm lift, its predecessor in emergency resuscitation.
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#253879 - 11/26/12 11:42 PM Re: how do I choose the right first aid kit? [Re: picard120]
Lono Offline
Old Hand

Registered: 10/19/06
Posts: 1013
Loc: Pacific NW, USA
Personally I'm 2 for 3, so perhaps more optimistic than most. But personal stats are meaningless. WFR told us to try CPR resuscitation on lightning victims, so yes, I'm going to max out on trying to bring them back if ever I encounter a lightning victim. Also I would put the entire CPR effort into context. I performed CPR on my wife - no issues with that, that was one of my success stories. I hang out with Scouts, I hike with them, counsel their merit badges, counsel their eagle projects, watch them grow up, know their parents - there is nothing that could keep me - short of two broken arms - from a vigorous if fruitless effort to rally all available scouts to save the life of one of our friends lying in front of us. Damned if I'm going to quote the known survival rate to a grieving parent and abandon hope before even beginning.

Statisically speaking the specific experiences of highly experienced FD folks may or may not map to actual survivability across very large populations, or even to very specific contexts like lightning strikes. I think that's where WFA / NOLS advice comes from about lightning victims, in the wilderness context, and not in urban or rural survival rates. As I understand the fire rescue stats, AEDs have really given survival a bump in the stats, and for good reason; and CPR education and training have helped too, in urban-suburban contexts where the EMTs are arriving within minutes and not 20-30 minutes after. And the focus on compression only resuscitation may also give an overall bump, if only because it restores a bit more circulation while shorting the patient on oxygen a bit, as long as EMTs arrive with their panopoly of drugs. Those drugs give the patient the best odds.

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#253889 - 11/27/12 02:31 AM Re: how do I choose the right first aid kit? [Re: ]
hikermor Offline
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 7705
Loc: southern Cal
Originally Posted By: IzzyJG99

You blew smoke up their bums. There were actual devices all around towns and cities that looked like horns. You'd grab one and light the tobacco in it and then use it to blow smoke up their rump. This was back in the 17th to 19th centuries, I believe.

...Yep. We've come a long, long way.



ETS is an incredible source of information. Never ceases to amaze..... BTW, what was the success rate?


Edited by hikermor (11/27/12 02:32 AM)
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#253892 - 11/27/12 04:56 AM Re: how do I choose the right first aid kit? [Re: Lono]
Arney Offline
Pooh-Bah

Registered: 09/15/05
Posts: 2485
Loc: California
Originally Posted By: Lono
And the focus on compression only resuscitation may also give an overall bump, if only because it restores a bit more circulation while shorting the patient on oxygen a bit...

First responders are generally at a disadvantage from the get-go because some time has already passed between when a cardiac arrest happens and when they show up and begin CPR. Every second counts.

However, a large prospective observational study published in 2010 by the folks in Phoenix who were among the vanguard of advocating compression-only CPR observed that among adult cardiac arrest victims outside of a medical setting who had a layperson perform CPR (traditional and compression-only) survived to hospital discharge 7.8% and 13.3% of the time, respectively. Unfortunately, out of the 4,400 cardiac arrest victims they tracked over 5 years, 2,900 victims did not get any CPR at all (at least by lay bystanders).

We might presume that there could've been another 200-300 "saves" over that time if all of them had received CPR of some sort.

Edit: actually, on second thought, that's an overestimation. About 5% of victims who did not get any CPR survived to hospital discharge so more bystander CPR would not save that many. So maybe half of my original estimate that with compression-only CPR. Still, if that saves someone you love, even one more save is significant.


Edited by Arney (11/27/12 05:15 AM)

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