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#107109 - 09/26/07 09:42 PM Field surgery
dchinell Offline
Enthusiast

Registered: 02/08/02
Posts: 312
Loc: FL
At the end of August my sister and I went on a canoe trip in Algonquin park. We were on our second day when I got us lost. We spent about two hours fighting our way up a constantly narrowing river before I figured out where I'd gone wrong.

On the way back I slipped on a slimy rock. While trying to catch myself, I jammed my left-hand thumb against a waterlogged (also slimy) branch, bent back the upper-left quarter of the nail, and pushed some slivers into the flesh under the nail.

It wasn't very painful. I squeezed it to try to bleed out as much junk as I could, then turned my attention back to navigation.

Later that day I tried to clean the dirt from under the nail using my SAK Classic, but didn't have much luck.

That night it started to throb. I looked at it around 2:00 a.m. and noticed that it was swollen. The swelling sealed the nail against the flesh, preventing drainage. I squeezed some pus out, and went back to sleep.

Next day it was a little worse, but I put some triple-antibiotic as far under the nail as I could stand, put on a bandaid, and soldiered on.

That night I started to get concerned. At very least, if things kept getting slowly worse, I was looking at a painful two or three days. I worried that it might get worse faster.

The next morning I tried soaking some dental floss in alcohol (diluted methanol) and drawing it under the nail to sterilize the area and pull out the slivers and dirt.

This didn't prove very effective, but it did gradually inure me to the pain. Eventually, I decided I had to cut the nail away to get the underlying flesh cleaned out. (Not the whole nail, just the part that had been bent back.)

I was able to to do a pretty neat job of this using my SAK Classic. It's a Wenger, and while the scissors wouldn't work well, the blade was very sharp and slender, and did a great job.

After that, I started a routine of soaking my thumb in hot water morning and night, applying antibiotic cream, and covering it well. After two days it was back to normal -- or at least to the point where I was no longer worried.

Lessons learned:

1. Check all liquids and jells in my first aid kits on a regular basis. Almost all of the alcohol wipes were dry. I had to go through three kits to get enough that were still wet.

2. I'd sneered at the roll of white adhesive tape that came in one AMK kit I was carrying, but it was invaluable for protecting the end of my thumb. Humble stuff, but very versatile.

3. Carry salt. I'd stopped carrying a little plastic bag of table salt, but I would have loved to have had it to soak my thumb in. It's great for a sore throat as well.

4. I can't substitute or improvise an irrigation syringe. I'm going to start carrying one on long trips.

Bear

PS: I'm aware of the danger of topical application of methanol, but it was all I had. I'm considering using ethanol for my stoves in future.
_________________________
No fire, no steel.

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#107114 - 09/26/07 10:44 PM Re: Field surgery [Re: dchinell]
Blast Offline
INTERCEPTOR
Carpal Tunnel

Registered: 07/15/02
Posts: 3760
Loc: TX
Yowza! I was lucky enough to be near my doctor and his wonderful bag of tricks.

Note to self: give doctor's nurse a big "thank you" kiss.
Note #2 to self: keep DW from reading this board for a few days.

Self surgery is not something I'd want to try. That being said, would have burning/melting a hole through your thumbnail to relieve pressure help any? You needed to get the slivers out. I guess cutting away the nail was the only option, probably what a doctor would have done.

Would an irrigation syringe real have helped much?

-Blast
_________________________
Foraging Texas
Medicine Man Plant Co.
DrMerriwether on YouTube
Radio Call Sign: KI5BOG
*As an Amazon Influencer, I may earn a sales commission on Amazon links in my posts.

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#107118 - 09/26/07 11:18 PM Re: Field surgery [Re: Blast]
frostbite Offline
Member

Registered: 07/22/07
Posts: 148
Loc: TN
I read about a woman who accidentally slammed her finger in a door and the nail turned all black and blue. The doctor burned a hole in the fingernail to drain the blood out just like you suggested.

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#107119 - 09/26/07 11:57 PM Re: Field surgery [Re: frostbite]
MDinana Offline
Pooh-Bah

Registered: 03/08/07
Posts: 2208
Loc: Beer&Cheese country
Burning nail holes is usually just for blood blisters. Heat up a paperclip til it's hot, and it 'melts' through. You can also drill through with a needle.

Alcohol pads dry up quick, like 6 months or so. Plan accordingly.

Field expedient syringe: poke a very small hole in the corner of a plastic bag, fill with water, squeeze. I suppose you could just spray it out of your mouth too, despite how dirty that water would become.

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#107127 - 09/27/07 02:03 AM Re: Field surgery [Re: dchinell]
eric_2003 Offline
Journeyman

Registered: 09/14/07
Posts: 56
Originally Posted By: dchinell

3. Carry salt. I'd stopped carrying a little plastic bag of table salt, but I would have loved to have had it to soak my thumb in. It's great for a sore throat as well.



Salt is great, as it can also be used if you need to make a rehydration solution in case of severe diarrhea or vomiting on longer trips. You'd have to carry 4 times the amount of sugar too though.

I love my vial of poviodine - diluted it can be used as a gargle as well, and is a better diluted soak than the salt.

Eric

PS - good work on the injury

Also, does DW stand for Da Wife?

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#107130 - 09/27/07 02:29 AM Re: Field surgery [Re: dchinell]
CANOEDOGS Offline
Pooh-Bah

Registered: 02/03/07
Posts: 1853
Loc: MINNESOTA

i would say the main message here is that you did not give up
in treating the injury but kept trying different methods to
clean and protect it..major injuries are rare,its the minor
ones that we all get that in a camping/survival sitution
become nasty..any thought on a antibiotic to put in a kit..
i have about 30 penicillin tabs in mine for treating dental
abcesses mainly..

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#107155 - 09/27/07 01:07 PM Re: Field surgery [Re: Blast]
williamlatham Offline
Enthusiast

Registered: 01/12/04
Posts: 265
Loc: Stafford, VA, USA
I crushed the tip of my finger on day in an old fashined scissors gate elevator (ow!) The nail instantly turned black. I tried drilling through the nail with a needle, but was a little discourages at the progress so I simply inserted the needle under the nail from the front. Boy did it releave the pressure as blood squirted all over the place, but it felt soooo much better. The nail at this point was not attached to the nail bed and there was no pain from the needle. A couple of days later the nail proceeded to curl up away from the nail bed as it dried out. I borrowed a nail file from a female co-worker and remove it.

I have also used the ziplock with a pin hole in the corner as an improvised irrigation syringe. I was also talking to an army medic and he said that in Iraq the used to simply punch a hole in the bottle (peroxide, water, provodone???) and simply squeeze the bottle to irrigate.

Bill

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#107158 - 09/27/07 01:16 PM Re: Field surgery [Re: williamlatham]
bsmith Offline
day hiker
Addict

Registered: 02/15/07
Posts: 589
Loc: ventura county, ca

heat a paper clip - it's blunt - and burn a hole. it's like a hot knife through butter.

if a needle touches the nail bed, OWWWW.

_________________________
“Everyone should have a horse. It is a great way to store meat without refrigeration. Just don’t ever get on one.”
- ponder's dad

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#107164 - 09/27/07 02:10 PM Re: Field surgery [Re: dchinell]
jamesraykenney Offline
Enthusiast

Registered: 03/12/04
Posts: 316
Loc: Beaumont, TX USA
Originally Posted By: dchinell
At the end of August my sister and I went on a canoe trip in Algonquin park. We were on our second day when I got us lost. We spent about two hours fighting our way up a constantly narrowing river before I figured out where I'd gone wrong.

On the way back I slipped on a slimy rock. While trying to catch myself, I jammed my left-hand thumb against a waterlogged (also slimy) branch, bent back the upper-left quarter of the nail, and pushed some slivers into the flesh under the nail.

It wasn't very painful. I squeezed it to try to bleed out as much junk as I could, then turned my attention back to navigation.

Later that day I tried to clean the dirt from under the nail using my SAK Classic, but didn't have much luck.

That night it started to throb. I looked at it around 2:00 a.m. and noticed that it was swollen. The swelling sealed the nail against the flesh, preventing drainage. I squeezed some pus out, and went back to sleep.

Next day it was a little worse, but I put some triple-antibiotic as far under the nail as I could stand, put on a bandaid, and soldiered on.

That night I started to get concerned. At very least, if things kept getting slowly worse, I was looking at a painful two or three days. I worried that it might get worse faster.

The next morning I tried soaking some dental floss in alcohol (diluted methanol) and drawing it under the nail to sterilize the area and pull out the slivers and dirt.

This didn't prove very effective, but it did gradually inure me to the pain. Eventually, I decided I had to cut the nail away to get the underlying flesh cleaned out. (Not the whole nail, just the part that had been bent back.)

I was able to to do a pretty neat job of this using my SAK Classic. It's a Wenger, and while the scissors wouldn't work well, the blade was very sharp and slender, and did a great job.

After that, I started a routine of soaking my thumb in hot water morning and night, applying antibiotic cream, and covering it well. After two days it was back to normal -- or at least to the point where I was no longer worried.

Lessons learned:

1. Check all liquids and jells in my first aid kits on a regular basis. Almost all of the alcohol wipes were dry. I had to go through three kits to get enough that were still wet.

2. I'd sneered at the roll of white adhesive tape that came in one AMK kit I was carrying, but it was invaluable for protecting the end of my thumb. Humble stuff, but very versatile.

3. Carry salt. I'd stopped carrying a little plastic bag of table salt, but I would have loved to have had it to soak my thumb in. It's great for a sore throat as well.

4. I can't substitute or improvise an irrigation syringe. I'm going to start carrying one on long trips.

Bear

PS: I'm aware of the danger of topical application of methanol, but it was all I had. I'm considering using ethanol for my stoves in future.


I have been using Everclear in my stoves and it works great.
I was beginning to think it was not that great an idea to cook using a fuel that had poison mixed in it.
It is hard to find anything purer than Everclear.
I use the stuff to de-grease my face, clean my glasses, disinfect wounds, and fuel my stove.

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#107262 - 09/28/07 06:00 PM Re: Field surgery [Re: dchinell]
asfried1 Offline
Newbie

Registered: 02/07/07
Posts: 31
If you ever need to irrigate a wound, the consensus of the wilderness medical community is that it is completely OK to use any water source that is safely drinkable (filtered, treated, etc.). So I don't carry an irrigation syringe in my medical kit. I simply plan to irrigate wounds by using my drinking hose and drinking water pressurized by squeezing the bladder under my arm.

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