Equipped to Provide First Aid

Posted by: hikermor

Equipped to Provide First Aid - 05/19/19 04:59 PM

This new thread is inspired by the current "customizing your medical Kit" - the total assemblage is significantly more than a standard FAK.

For one, I keep band aids (typically for those messy boo-boos) right at hand in my wallet. This saves time and drama when dealing with the typical bloody scratch. Sometimes you don't even need that - just a few minutes o direct pressure will stop the bleeding.

At the other extreme, I keep a bandanna, usually red, handy in a pocket, so that when confronted with a spurting arterial bleed, I can immediately work on stopping the flow, while the FAK is brought into action.

My FAK has the usual sterile dressings, tape, and bandages. I am a real fan of compression bandages, but beyond that are the various items that might be employed in improvising FA items - especially splints, which are usually too bulky to be included in a FAK of reasonable size.. A splint can be my hiking staff, a rolled up magazine, a handy pine sapling - you name it. Sooner or later, one will face situations where improvisation is required. Duct tape is your friend...

Most important is the skill and training received in a good training course. Can you properly bandage, conduct an adequate patient survey that will catch the underlying more serious condition as well as the more obvious wound? Can the victim return to normal activity or should they see a doctor (or ER)?

Most of the time, we encounter minor scratches needing only minimal treatment. What counts is identifying the more serious injuries, stabilizing the victim (s), and getting them on their way to more definitive care. How will you transport the victim?? That is a whole other story...
Posted by: chaosmagnet

Re: Equipped to Provide First Aid - 05/19/19 08:49 PM

On the training front, one of the more useful things I've learned is how to tell when a situation is best handled by professionals; sometimes it isn't obvious. In the last few years I've rolled up on several car wrecks and about four falls in public where being able to rapidly survey the injured person and determine if they need further care has been helpful.

The most memorable of these had me pulling over at the scene of a moments-previous low-speed car vs. bicycle collision. Neither the driver nor the bicyclist seemed inclined to call for help, and there were no visible injuries beyond one minor scrape.

I spent about sixty seconds working to evaluate the bicyclist. He was disoriented, had the "stumbles, fumbles, mumbles and grumbles" and was definitely not hypothermic. When I announced that I was calling for an ambulance the bicyclist complained that he didn't want one. I responded, "Buddy, you are going to GET. IN. An ambulance." While I have no legal or moral power to require strangers to submit to medical care, the injured bicyclist didn't know that, and meekly entered the ambulance when it arrived.
Posted by: Russ

Re: Equipped to Provide First Aid - 05/19/19 10:45 PM

...disoriented, had the "stumbles, fumbles, mumbles and grumbles" ...

So were you thinking shock, concussion or both?
Posted by: chaosmagnet

Re: Equipped to Provide First Aid - 05/20/19 03:06 PM

Based on the MOI and how he was acting, it sure looked like a possible concussion to me. Fortunately, this was half a mile from the fire station and not part of a larger scale emergency that might have saturated first responders, so it was a slam dunk for me to call.

It looked to me like the driver and others at the scene meant well but just werenít thinking about what to do next, since the bicyclist was on his feet and just had the one visible minor scrape.
Posted by: WesleyH

Re: Equipped to Provide First Aid - 06/09/19 11:42 AM

In a case like this, closed head injuries are always a big risk. The can rapidly escalate the severity of the situation.

In an emergent situation, a couple of things to LOOK FOR:

-If a patient had a Loss of Consciousness, (as evidenced by self report or witness report) It merits a trip to the ER as the only way to really clear someone is an MRI or CT scan.

-Assess level of consciousness, what is their level of orientation? Do they know who they are, what the date and time is, Who is the president, etc. Are their pupils Equal Round and Reactive? If one pupil is significantly larger or smaller than the other, It merits a trip to the ER. If they are disoriented, the need to go.

-Are they able to move all their limbs? Are their grip strengths and foot strengths intact and roughly equal?

-Similarly, If there is any visible head trauma, they need to go to the ER.

But in the case of the bicyclist there is also a good chance for a spinal cord injury.


Posted by: chaosmagnet

Re: Equipped to Provide First Aid - 06/09/19 01:03 PM

Good stuff WesleyH.

As someone who isnít a medical professional, in an urban/suburban situation with readily available ambulance service, as soon as I see one thing that merits a professional response I will call.
Posted by: WesleyH

Re: Equipped to Provide First Aid - 06/19/19 04:56 AM

It is a shame that the cost of education, even as a basic EMT has gone up so much. When I first took the original 81 hour EMT class in '75, It didn't cost me anything save the price of the book.

A few years later, after I had let my certification lapse, the course was now more than 81 hours. In fact, I had to take it as a 5 credit hour class at the local Junior college.

At any rate, the Basic EMT class has gone from evaluate the symptoms to a cookbook style. If they have this, and this, it is that. However, I would certainly recommend the base class for anyone that willing. You learn some great stuff, and get to spend a couple of shifts in an ER and a couple with an Ambulance/paramedic crew. Great preparation for the unanointed.

I do know that some of the public education classes thru the local vo tech offer among other things the Basic EMT class, for less than a junior college.

I would only add that if anyone is ever being in a situation where help is not immediately available the knowledge of a basic EMT could make the difference between life or death.
Posted by: chaosmagnet

Re: Equipped to Provide First Aid - 06/19/19 12:51 PM

Iíve long dreamed of taking wilderness medical classes from NOLS, but itís been hard to find the time.
Posted by: WesleyH

Re: Equipped to Provide First Aid - 06/21/19 03:25 AM

I can appreciate that. Finding time to do the things you would really love to do is difficult at best.

The BEST book regarding wilderness medicine is "Auerbach's Wilderness Medicine" currently in its 7th edition. I would caution the casual reader that is a medical text written for medical professionals. It covers about anything you could consider. . even exotic snake and insect bites from all parts of the world, and even aerospace/high altitude medicine. The 6th edition is about half the price of the 7th, and the 5th even less. However, the older editions information is generally still valid.

Sorry, I digress. . .

Yes it would be nice to attend a current NOLS class.