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#276881 - 09/30/15 02:57 PM Re: Building and Modifying First Aid Kits [Re: Russ]
hikermor Offline
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 7705
Loc: southern Cal
I was fortunate that my EMT training, provided by my employer (National Park Service) emphasized wild situations and inability to reach a medical facility, which standard Red Cross (call 911) certainly does not. Most of my experience over the last forty years, both on the job and as a volunteer, has been in fairly wild, off road settings. Most of my experience came when tourniquets were out of favor, and considered only a last resort. I have been a first responder at probably about two hundred incidents involving bleeding. In all cases, a firm bandage and dressing, augmented occasionally by direct pressure, stopped the bleeding.

One of these was a virtual arm amputation (subject walked into a rear helicopter rotor) but apparently muscle spasm clamped down the blood vessels.There was surprisingly little blood involved. Good thing - where do you apply a T when the arm is off at the shoulder?

The cornerstone of my first aid treatment is an elastic bandage,used for immobilization of a dinged appendage or, properly applied, as a pressure dressing on a bleeding wound. They are not the kind of thing you apply and forget. Watch them carefully and readjust as necessary. It is best if the patient is conscious.

In any case, your equipment should reflect your training and experience. This discussion is a splendid example of this....
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Geezer in Chief

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#276883 - 09/30/15 03:30 PM Re: Building and Modifying First Aid Kits [Re: Jeanette_Isabelle]
gonewiththewind Offline
Veteran

Registered: 10/14/08
Posts: 1517
Trauma is not just caused by gun shot, think car accident, gas explosion, falls, chain saw, etc. A simple fall on a trail can produce a penetrating wound and collapsed lung or sucking chest wound.

If pressure is dispersed, then it will not work. It is actually surprising how much pressure it takes to stem arterial bleeding. Some people may need to place most of their body weight on the wound, directly on it. What is described by Tjin is more for cuts that do not produce massive bleeding.

While my experience may not be normal (at least I hope it isn't), it has taught that you can keep a person alive in spite of massive trauma. It does involve learning how to do it. I highly recommend the Wilderness First Aid course, wherever you can get it. It is not only taught by the National Outdoor Leader School (NOLS), though they may be the best. It is focused on dealing with a wide variety of injuries and illnesses where help may take some time to get to you.

In spite of all of the training I have had, experience tells me that I always need to plan for communications and trying to get help with evacuating the casualty. First aid, especially in trauma cases, is only to keep them alive until more help arrives or you can get them out. Deep in a canyon with no roads in the Summer, even a sprained ankle can be catastrophic in certain circumstances.

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#276885 - 09/30/15 03:51 PM Re: Building and Modifying First Aid Kits [Re: gonewiththewind]
hikermor Offline
Geezer in Chief
Geezer

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


In spite of all of the training I have had, experience tells me that I always need to plan for communications and trying to get help with evacuating the casualty. First aid, especially in trauma cases, is only to keep them alive until more help arrives or you can get them out. Deep in a canyon with no roads in the Summer, even a sprained ankle can be catastrophic in certain circumstances.


Amen to that.

With anything reasonably serious (the victim is not ambulatory) you need either a helicopter or a crew of eight to sixteen, plus specialized gear (typically something like a wheeled litter) plus time to get to definitive care.

My experience was before cell phones were common, but typically ambulatory victims ambled out, and SAR was notified for those who were immobilized. Thank heaven for helicopters! They save time, effort, and lives.

Today cell phones or something more sophisticated make response both quicker and more efficient. The SAR team goes in with a much better understanding of the situation.
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#276886 - 09/30/15 03:57 PM Re: Building and Modifying First Aid Kits [Re: Jeanette_Isabelle]
Tjin Offline
Pooh-Bah

Registered: 04/08/02
Posts: 1821
*did a edit on my post. The example was only about ace bandages, not when to use it.

I long learned that there are many different procedures between country's and regions. Many are opposite of the other, which at first will drive you nuts... After awhile you just reconigze different training and it doesn't matter.

I agrea with everybody here, get trained (and then you will also know what to pack).
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#276890 - 09/30/15 08:39 PM Re: Building and Modifying First Aid Kits [Re: Jeanette_Isabelle]
Jeanette_Isabelle Offline
Carpal Tunnel

Registered: 11/13/06
Posts: 2946
Loc: Nacogdoches, Texas
Yesterday, at Big Lots, I bought what looks like a store brand first aid kit distributed by Tender. It looks like one of the older Easy Care first aid kits. I don't like the plastic case, it's hard to open and close. For $5 it makes an economical refill kit.

Jeanette Isabelle
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I'm not sure whose twisted idea it was to put hundreds of adolescents in underfunded schools run by people whose dreams were crushed years ago, but I admire the sadism. -- Wednesday Adams, Wednesday

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#276891 - 09/30/15 09:34 PM Re: Building and Modifying First Aid Kits [Re: Jeanette_Isabelle]
TeacherRO Offline
Carpal Tunnel

Registered: 03/11/05
Posts: 2574
along those lines, I like my kits to be clearly labeled on the outside - red and if possible "First Aid" and open to show the contents in a clear way for a non-me user.

I like them to fold open and show gloves, booklet and large sterile pads, in that order. ( and an cpr mask when possible)

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#276892 - 10/01/15 05:15 AM Re: Building and Modifying First Aid Kits [Re: Jeanette_Isabelle]
CANOEDOGS Offline
Pooh-Bah

Registered: 02/03/07
Posts: 1853
Loc: MINNESOTA
i did not read all the posts but the the kit should be labeled for a fast find and not just by the owner but by anyone who finds and needs to use it.big easy to read labels like PAIN-BEE STINGS-APPLY TO BURNS will help in those confusing minutes when first aid is needed.a kit that opens like Teacher said with gloves and pads right on top.
with all the small computer stuff they have now someone should make a talking instruction book.a RN sort of calm voice would say when you push the bleeding button.."remove the pad from the green package and push down on the wound" or something like that.
in the Army we were told never to use our own wound bandage on someone else,they should have one on their belt.thats something to think about in a large group like Scouts.everyone has a ziplock bag with the basic fast first aid stuff in it someplace handy.
that way if six people sprain their ankle the main kit does not run out of elastic wraps because everyone has one.

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#276893 - 10/01/15 05:29 AM Re: Building and Modifying First Aid Kits [Re: Jeanette_Isabelle]
acropolis5 Offline
Enthusiast

Registered: 06/18/06
Posts: 358
Eons ago, 1971 to be exact, when you could (and I did) be certified as a National Registry EMT by written test and practical examination, I was one of the 17 founding members of an urban Volunteer Ambulance Corps. Envision high rise buildings and 5 converging highways, pre common use of seatbelts and purpose designed vehicle crash zones and collapsible steering columns. Prior to us, police just picked up victims and beat it to a hospital. To maintain a sub 4 minute response time, the 3 person duty crew was in uniform, in the Ambulance building. We didn't stay inexperienced for very long. We ran about over a thousand real emergency calls a year. The membership rapidly expanded, thank heaven.

We found our biggest challenge was a response to an unknown event in a high rise building, not all of which had elevator control overrides. Standard practice was 2 crew members to go up, one to stay with the rig to bring up extras. The problem was to have the first two carry enough equipment to deal with life threatening issues, light enough to run with, up several flights of stairs or on the 30th floor, even if an elevator was available, because extras would take precious time to arrive. Standard kits in ambulances at that time were built around heavy tool boxes. Purpose built backpacks & shoulder bags were unknown. I designed a multi purpose kit , from an air traveler's type shoulder bag , to carry trauma supplies ,bandages/ tape, triangulars,sterile saline, zephyrin chloride ,choke forceps(pre-Heimlich), wire ladder splints,"turkey baster" bulb syringe+ small barrel body with makeshift shortly tube cathprovided basic suction, plastic oral airways ,burn sheet, cord clamps & bulb syringe, activated charcoal, BP cuff, stethoscope, run sheet-vitals pad and penlights to hold in your mouth if there was no power. That kit weighed about 12-15 lb.s. Add to that a portable two-way radio and a positive pressure resuscitator connected to a D size O2 bottle in a hard case and we were ready for most life threatening issues. Anything else we needed could be called up later, including the gurney.

The gurney issue, in small elevators was a major problem. We later solved it by working directly with the Ferno Washington company to design and build the first or one of the first ambulance gurneys that could raise the back and drop the foot, to become a chair. It also had early auto dropping and locking wheel legs. Now this is all industry standard and commonplace.


As the region became more urban I assisted other neighboring corps to assemble similar kits. I loved doing this and over the years I developed additional modular kits for our and other corps. I was fortunate to later be able to trade ideas with a very few like minded volunteer designers.

In my 5 years of service, I responded to hundreds of serious car accidents, shootings, stabbings, poisonings, heart attacks/ strokes, jumpers, floaters, CPR calls (3 sucessful resuscitations, dozens of failed attempts) , a forceps choke save on an unconscious woman & other traumas . I even delivered a baby on the narrow floor of an apartment hallway! Thankfully all went well with that. I "retired " as a Life Member when I graduated Law School. Many of my colleagues became ER doctors, nurses, oral surgeons, medial techs, engineers & other professionals.

I return to my corps ever so often to ride as an observer and of course I peruse the kits. They haven't changed that much, except they've added Narcan, anaphylaxis auto injectors & pulse Ox meters.

I still design and build first aid kits, compact survival kits & GHBs for family and friends, especially for their kids going to college abroad or on long hiking trips. I have even received some compliments from pros in the field, who examined my kits.

I've had a pretty sucessful career as an attorney. But of all the things I have ever accomplished, the two things I am most proud of are my kids and my volunteer ambulance service.


Edited by acropolis5 (10/02/15 05:34 AM)

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#276894 - 10/01/15 01:10 PM Re: Building and Modifying First Aid Kits [Re: acropolis5]
chaosmagnet Offline
Sheriff
Carpal Tunnel

Registered: 12/03/09
Posts: 3819
Loc: USA
Originally Posted By: acropolis5
I've had a pretty sucessful career as an attorney. But of all the things I have ever accomplished, the two things I am most proud of are my kids and my volunteer ambulance service.


Made of awesome.

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#276897 - 10/01/15 10:46 PM Re: Building and Modifying First Aid Kits [Re: acropolis5]
JeffMc Offline
Member

Registered: 05/10/15
Posts: 129
Loc: Northwest Florida
Originally Posted By: acropolis5
... I've had a pretty sucessful career as an attorney. But of all the things I have ever accomplished, the two things I am most proud of are my kids and my volunteer ambulance service.


That was an interesting story; thanks for sharing it. I have a similar background as an attorney/paramedic/firefighter. Now I work in disaster management & response, and I still enjoy reviewing, designing and assembling FAKs and similar kits.

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