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#181199 - 09/02/09 11:32 PM Re: Mental exercise: add to my FAK [Re: Lono]
UTAlumnus Offline
Old Hand

Registered: 03/08/03
Posts: 1019
Loc: East Tennessee near Bristol
Safety pins? They're good for emergency fly repair.
For wound closure, I'll stick to the butterfly/steri-strips.

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#181200 - 09/02/09 11:45 PM Re: Mental exercise: add to my FAK [Re: UTAlumnus]
yelp Offline
Member

Registered: 06/04/08
Posts: 172
Loc: Colorado
Safety pins - excellent multipurpose item.

Wound closure? From my very limited understanding, that's not something you want to do in the field; seals the wound up and lets it fester. Better to let it drain after you've stopped bleeding (overlap that avulsion with the host limb; don't just lay it back in place).

But if closing a wound is something you want to do, tape (and a lot of it with 4x4s) will do nearly as well as a suture kit.
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(posting this as someone that has unintentionally done a bunch of stupid stuff in the past and will again...)

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#181201 - 09/02/09 11:51 PM Re: Mental exercise: add to my FAK [Re: yelp]
comms Offline
Veteran

Registered: 07/23/08
Posts: 1502
Loc: Mesa, AZ
Well that's an interesting point and maybe I am hijacking my own thread with this question (if so I will put on track later) but...

wouldn't Quick Clot be a viable means of closing off a wound that in the past would require safety pin?
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Don't just survive. Thrive.

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#181202 - 09/02/09 11:56 PM Re: Mental exercise: add to my FAK [Re: UTAlumnus]
aloha Offline
Old Hand

Registered: 11/16/05
Posts: 1059
Loc: Hawaii, USA
The most serious wound I have had to administer first aid for when camping was an almost severed finger. Gauze and adhesive bandages kept everything intact until he was able to get to the emergency room.

I think having something for shock would have been good as I think he was about to go into shock. After getting him seated I gave him water while I wrapped everything up and talked to distract him. If I had coffee ready, I would have given him some.

What do you guys suggest to have in a FAK for treating shock? I know at that point, he wasn't thinking straight. I am thinking if I was by myself, what could I take to help keep my head together. Caffeine tablets?
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http://hanzosoutdoors.blogspot.com/

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#181211 - 09/03/09 02:02 AM Re: Mental exercise: add to my FAK [Re: aloha]
scafool Offline
Pooh-Bah

Registered: 12/18/08
Posts: 1534
Loc: Muskoka
Aloha, this answer might be on a tangent from Comms' thread starter question but I really wanted to respond to your question with something.

Other than having blankets there is not much you would specifically have in a FAK to treat shock.

Shock is usually a result of circulation problems.
Either heart failure or a serious bleed.
Shock can also be caused by allergic reactions or low blood sugar (diabetic shock)
Shock is actually your body dying from lack of blood sugar and O2

If you had O2 and a way to administer it that might help.
Reduced blood flow means reduced O2 to the brain and body.
If I had the training to administer oxygen I might do that, but I am not trained for giving O2.
Gas cylinders are big and heavy so the chances that I would have one with me are very slim too.

Fainting is a bit like shock but is not really shock because it is self limited and it usually just temporarily affects the brain.

If they are going into shock from blood loss the first thing is to stop the bleed.
If they have already lost a lot of blood you could give them more blood through an IV, if you were trained for that.
I am not trained for anything like that.
I am not about to drag IV supplies around with me all the time either,
even if I had the training.


Fear produces adrenalin.
If the shock is from adrenalin (the fight or flight response) you certainly don't need to be giving them more stimulants like coffee or tobacco.
Brandy is not an answer either because alcohol interferes with the circulatory system too.



I stole this from a random internet page. It seems to be an article published by a vitamin seller.
http://www.vitaminsuk.com/index.php?main_page=articles&topic=firstaidforshock
Quote:
First Aid for Shock



Causes of Shock

Recognition of Shock

Treatment of Shock



The circulatory system distributes blood to all parts of the body, carrying oxygen and nutrients to the tissues. If the circulatory system fails, and insufficient oxygen reaches the tissues, the medical condition known as shock occurs. If the condition is not treated quickly, the vital organs can fail, ultimately causing death. Shock is made worse by fear and pain.


Causes of Shock



Shock can develop when the heart pump fails to work properly, causing a reduction in the pressure of the circulating blood. The most common cause of this type of shock is a heart attack.



Shock can develop as a result of a reduction in the volume of fluid circulating around the body. The most common examples of this are external or internal bleeding, or loss of other bodily fluids through severe diarrhoea, vomiting, or burns. The blood supply is diverted from the surface to the core of the body. The main symptoms and signs of shock relate to such redistribution of the circulation.


Recognition of Shock



Initially, a flow of adrenaline causes:



* A rapid pulse.
* Pale, grey skin, especially inside the lips. If pressure is applied to a fingernail or earlobe, it will not regain its colour immediately.
* Sweating, and cold, clammy skin (sweat does not evaporate).



As shock develops, there may be:



* Weakness and giddiness.
* Nausea, and sometimes vomiting.
* Thirst.
* Rapid, shallow breathing.
* A weak, ‘thready’ pulse. When the pulse at the wrist disappears, fluid loss may equal half the blood volume.



As the oxygen supply to the brain weakens:



* The casualty may become restless, anxious and aggressive.
* The casualty may yawn and gasp for air (‘air hunger’).
* The casualty will eventually become unconscious.
* Finally, the heart will stop.


Treatment of Shock



DO NOT let the casualty move unnecessarily, eat, drink, or smoke.



DO NOT leave the casualty unattended. Reassure the casualty constantly.



* Treat any cause of shock which can be remedied (such as external bleeding).
* Lay the casualty down, keeping the head low.
* Raise and support the casualty’s legs (be careful if suspecting a fracture).
* Loosen tight clothing, braces, straps or belts, in order to reduce constriction at the neck, chest and waist.
* Insulate the casualty from cold, both above and below. Contact the emergency service.
* Check and record breathing, pulse and level of response. Be prepared to resuscitate the casualty if necessary.



This other article from
http://www.emedicinehealth.com/shock/article_em.htm
talks about shock and how to treat it in much more depth.
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May set off to explore without any sense of direction or how to return.

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#181222 - 09/03/09 04:20 AM Re: Mental exercise: add to my FAK [Re: scafool]
comms Offline
Veteran

Registered: 07/23/08
Posts: 1502
Loc: Mesa, AZ
Thanks scafool, yes lets get back on track.

PLEASE REVIEW THE FIRST MESSAGE OF THIS THREAD. IT IS A LIST OF ITEMS IN MY AMK ULTRALIGHT .7 MED KIT. I BOUGHT THIS WITH THE INTENTION OF ADDING OR REPLACING PIECES OF THIS KIT WITH OTHER FAK ITEMS I MAY ALREADY HAVE.

LOOKING AT THE CONTENTS, AND KEEPING THE ORIGINAL PACKAGING, WHAT WOULD YOU ADD?

Its a mental exercise. Imagine you're looking at several kits in a store, comparing all the benefits of one over the other and knowing what you know from experience.
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Don't just survive. Thrive.

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#181229 - 09/03/09 09:04 AM Re: Mental exercise: add to my FAK [Re: NightHiker]
JIM Offline
Old Hand

Registered: 03/18/06
Posts: 1032
Loc: The Netherlands
Originally Posted By: NightHiker
Originally Posted By: comms
I have seriously considered a small irrigation syringe. Any third motions on that?

Not a bad thing if you've got the room for it("small" is problematic though, anything less than 20ml is a PIA to try to flush a wound with - just my opinion, YMMV). You can also use a water bladder - a good steady squeeze on the bladder generates adequate pressure for flushing



You'll definately want a quart- or gallon ziplock bag instead of an irrigation syringe.

Ziplock can also be used for:

- occlusive dressing
- storing severed finger, tooth, etc.
- irrigation of wounds, eye.
- cooling burns
- storing unused, but opened dressings
- cooling sprains
- general waterproofing of items
- gear repair

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#181254 - 09/03/09 03:08 PM Re: Mental exercise: add to my FAK [Re: NightHiker]
paramedicpete Offline
Pooh-Bah

Registered: 04/09/02
Posts: 1920
Loc: Frederick, Maryland
You can always use a safety pin to secure the toungue in establishing an airway:

Quote:
A temporary airway can be established by attaching the anterior aspect of the victim’s
tongue to the lower lip with two safety pins. An alternative to puncturing the lower lip is to
pass a string through the safety pins and hold traction on the tongue by securing the other end
to the victim’s shirt button or jacket zipper.


from:

Backcountry 911: 1,001 Uses for Duct Tape and Safety Pins

Pete

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#181263 - 09/03/09 03:56 PM Re: Mental exercise: add to my FAK [Re: NightHiker]
comms Offline
Veteran

Registered: 07/23/08
Posts: 1502
Loc: Mesa, AZ
No actually this is good. The kit comes with 3 small safety pins which I think I will switch out for the larger diaper safety pins.

I read that first piece about the use of them for open airways and thought, "No way", then read you actually saw it. Crazy.

NOW BACK TO THE MODIFICATION OF MY AMK ULTRALIGHT MED KIT.
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Don't just survive. Thrive.

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#181308 - 09/03/09 07:49 PM Re: Mental exercise: add to my FAK [Re: NightHiker]
Lono Offline
Old Hand

Registered: 10/19/06
Posts: 1013
Loc: Pacific NW, USA
Originally Posted By: NightHiker
Originally Posted By: Lono
Originally Posted By: NightHiker
You're obviously not in touch with today's pierced and inked society wink

I'm thinking more along the lines of self-care and if Ive got a wound that's bad enough that I'm considering using safety pins to help keep it closed a couple of small puncture wounds are far from the top of my concern list. Personally I keep a couple of packets of 4-0 etilon sutures in my FAK but that's me. Safety pins are excellent multi-taskers anyway.


Whatever floats your boat I guess. If a wound is too big for steri-strips (and duct tape) then I hope to be transported to a hospital before I pull a Rambo to sew it up (which always seemed like a really cool movie scene to me). I would pack the wound with gauze before I attempt to close a wound that big.


Back to the gaping wound situation - if you're within 24 (maybe 36) hours of getting to medical attention packing is the way to go but if your severely injured and have to wait a day or two before SAR is going to start looking for you.... Personally, when I'm in the backcountry I don't carry enough medical supplies for extended wound care and daily dressing changes.

Good, thought provoking thread


That's a good explanation. I still disagree, I generally hike with enough dressings to change (a single major wound) for a few days, and if I'm with Scouts between us we have enough for Armageddon. Ultralight FAK is not in my DNA, in terms of essentials its the last place I will economize for weight, as it will remove treatable scenarios. If we hike in N days from help, I need to be able to treat a wound for at least N+2 days.

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