Improvising First Aid

I am sure that most of us routinely have access to some sort of FAK, hopefully compatible with our training. Within it most likely there are meds of various sorts, bandaids and sterile dressings, etc.,but nothing too terribly bulky or heavy.

This means that when faced with a really serious injury, we will need to improvise -a bandanna becomes part of a tourniquet- a belt or duct tape holds a dressing in place, etc.

What improvisations come to mind when you contemplate dealing with various serious situations when you are not in quick communication with 911? What are your tips and tricks which will be generally useful?
Sometimes even fully equipped SAR teams run out of supplies. I once took off my pants to complete splint padding (I had a second pair in my pack)....

Saran wrap for burns and sucking chest wounds.

You can never have too many triangular bandages, they can be used for so many things.

Don't leave duct tape on too long, it will take skin off with it.

Shirts and cut poles for a stretcher. Run the poles through the bottom and then the sleeves; you can add several shirts if needed. A poncho also makes a good litter.

Any cloth is usable as a pressure bandage. Stop the bleeding and worry about infection later.

One reason I like bandannas ; they make pretty good triangular bandages.

While Montanero is of course correct about duct tape taking skin off, it's probably the single most useful improvisational first aid tool imaginable for traumatic injury.

How long is too long for duct tape? How effective is adhesive tape as a substitute for duct tape./ you should have one or the other handy (most likely D tape...0.

I do use duct tape for such things, you just have to be aware that you can't yank it off. I have never measured it, but I have experienced the skin removal after a couple of days of the duct tape being stuck to the skin on the bottom of a person's foot.

The plastic pkg that battle dressings, triangular bandages, other medical supplies come in have usefulness on sucking chest wounds, insulation, etc.

Super Glue!!!

I agree with the duct tape comments. We once used it, cut into butterfly strips, to close an eyebrow/eyelid laceration. As to difficulty removing it: it pretty much sloughed off when we got to the trail head 2 days later. One of our party was an eye surgeon! He's never seen anything work better, leaving absolutely no scar. We're sold.

Other than that, we're always wearing something that could be cut up for a pressure bandage, etc., if we had to.

I disagree with the super glue unless you're absolutely sure you disinfected the cut. Same disagreement as to suturing in the field. Unless you're willing to risk infection, you don't want to totally seal up a laceration. You need a bit of leakage/draining. Butterfly strips are the way we go.

Not sure about super glue. I don't believe it is recommended in any first aid manual that I am aware of. For that matter, a suitably tight bandage has always stopped the bleeding, in my experience. So, why use it?

Superglue has been used to close a wound; in a wilderness setting, it's best not to close a wound since an open would is less likely to get infected.

Jeanette Isabelle

Emphasis added.

Butterfly strips are fairly easy to apply and remove, and they don't seal the wound so that infection can set in. Clean/flush the wound, apply butterfly strips, apply bandage as appropriate and then make a decision as to evacuating. IMO if a wound is serious enough that you're applying butterfly strips and are concerned about infection, odds are better than even that the hike is over. You need to find an ER/hospital/medical clinic as appropriate.

Plastic bags for wound irrigation. Fill the bag, poke a little hole and squeeze. It gives the force you need to clean out a wound.

True enough. The question is whether it is an advisable procedure, even in an improvisational setting . I doubt that it is a good idea. Staunch the blood flow with something less permanent,like a pressure dressing.

By the same token, whiskey has been consumed for snakebite. The victim survived, but that doesn't mean that "booze for bites" is a good idea....Very likely, survival occurred in spite of the treatment, not because of it.

It´s not a good idea especially in an improvised setting. It´s an even worse idea if you could reach a doctor within a couple of hours.
Done right it may increase the risk of infection. Not done right it may impede healing by itself. Either way if the wound needed sutures, the doctor wont do it after the superglue treatment.
Many of the successful applications I heard didn´t need closing the wound in the first place.
Technical grade superglue may also contain toxic traces and iritate the tissue.


Probably it was an experienced snake which saved the venom for something meal-sized. In that case treatment for the venom might not have been neccessary anyway.

What is the effect of alcohol on blood that would make it beneficial following a snakebite? I see no direct or indirect benefit at all. It's great in old movies where the hero drinks and smokes to excess as part of his character, but in real life?

It does not have any benefit, and that was the point. Somewhere in the past someone took a drink after they were bitten, and they didn't die. As Max stated, many snakes will not waste the precious resource of their venom on something they do not plan to eat and are just trying to scare you away. So many snake bites are not injected with venom. Correlation is causation in the minds of most, so they determined that alcohol is good for snake bite. At the very least, it may calm someone down and slow down their heart rate, which may slow the spread of some of the venoms.

Quite a few "remedies" for snakebite, especially are actually detrimental, rather than beneficial. this included the traditional "cut and suck" procedure which was recommended in my youth - not so today.

Since a good proportion of bites are not loaded with venom, it can be worthwhile to see if there is evidence of envenomation (swelling, discoloration, etc). Mr. Snake may have realized he had better uses for his juice than wasting it on something non-edible. This probably accounts for the prevalence of so many bogus snake bite remedies.

Alcohol helps to dilate periphal blood vessels and increases the blood flow there. It also increases lymph flow a little. That helps to distribute the venom faster. I´d consider that to be a direct benefit to the snake if it actually injected venom.
A real life snakebite victim should neither smoke nor drink alcohol.

I thought one of the most valuable parts of Wilderness First Responder class was the improvisational training. There are no real rules to improvisation, of course, and in theory anyone can just jump right into it. But it's really useful to work with people and to practice a few times in different scenarios, with different equipment, etc. It gets your mind going in the right direction, and you pick up ideas and techniques. The mindset is more important than the techniques.

Also, improvisational practice is just a lot of fun -- both for the pretend victims and for the pretend rescuers.

The most rewarding and successful first aide course i ever taught was given to an Explorer Post with a definite outdoors slant. As extra credit (since this went well beyond Red Cross training) they brought their packs to class and we spent some time running through different scenarios, using the resources they were likely to have handy. The instructor learned just as much as the students. This was before the time of Wilderness First Responder courses.

A month or so later I was teamed up with one of those students and Real Life gave us both a final exam - we encountered a victim with all sorts of problems (his fractures had fractures, etc). He survived our care, and in fact later became a member of our unit, so I claim a passing grade.

I'm surprised no one has mentioned old school foam sleeping pads (ensolite or similar). These are one of the best items for improvised first aid.

The "jelly roll splint" is a classic for a leg injury: Take two pads, put them cross ways under the injured leg. Adjust the overlap of the pads to get the proper length for the leg. For patient comfort it is usually best to put a small wad of clothing under the knee so it is flexed slightly. Start from both sides and roll the ends of the pads towards the leg. The idea is to end up with the leg cradled between two rolls of pad. Then secure with cravats, webbing, or whatever. This has been used successfully many times for everything from a blown knee to a full on leg fracture. It is comfortable for the patient, and provides padding and insulation, and it is easy to monitor the leg for swelling.

A single pad can be used for a shorter splint. Or the pad can be cut up to make a reasonably good C-collar. Or can be cut to provide padding inside some other splint. Or used as padding in a rigid stokes type litter. Or....other uses are limited only by your creativity.

Note that more modern inflatable sleeping pads don't work very well in this application. Although I carry an inflatable pad for sleeping, I also almost always have a foam pad along as well.

One of the best uses I've seen was when I was once backpacking in the Talkeetna Mountains, and met a NOLS group with an injured woman. NOLS does very long backpacks in that area, stopping at isolated lakes for resupply by floatplane. The woman had blown out her knee. Rather than calling for imediate extraction, the group had splinted her leg with a jelly roll, adjusted slightly loose so she had some flex in the knee, and could still hike, albeit slowly. They distributed her gear to the rest of the group, and were slowly making their way to the next resupply point, where the woman could be evacuated. A great example of self sufficiency and self rescue, in my opinion.

"Or the pad can be cut up to make a reasonably good C-collar."

i've had to do ust that a couple of times - works great. you are absolutely correct about the value of foam pads.

How about inflatable pads designed to be separated and reassembled into pneumatic splints? Just a thought....

Here is a novel way of closing a wound that has more tension than butterfly strips. Duct tape sutures.
https://paddling.com/learn/picture-this-duct-tape-rx/

I realize that Superglue is not as good as duct Tape- after all, nothing is as good as duct tape.

On the other hand, the original question was improvised first aid when not able to get immediately to ER.

Superglue can temporarily stop bleeding in small to major wounds; at least long enough to get to professionals.

Fast, no needles, stop bleeding.

I would never substitute superglue for an ER visit, but have used it for paper-cuts and other small scrapes. It even forms its own scab.

The Mayo Clinic uses a form of superglue in place of stitches on some wounds.
Reference http://mayoclinichealthsystem.org/hometo...r-first-aid-kit

Super glue sold at retail can cause an allergic reaction in some folks, something I'm told is much less common in surgical super glue.

I'm much more likely to use steri-strips (regular or the field-expedient duct tape variety) than super glue to close a wound.