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#287795 - 01/12/18 06:08 PM Improvisation, especially First Aid
hikermor Online   content
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 6082
Loc: southern Cal
No matter how large or well supplied your FAK may be, if the emergency is great enough (just consider the current Montecito mess just up the road here in SoCal!). At some point you will need to depart from protocols to some degree, make something up on the spot, and take measures to deal with the situation.

An example from my experience: We were on a pleasure climb, a long time SAR colleague, myself, and a friend of his. We ran into a guy who had been hit in the head by rockfall, with obvious cranial trauma. At that our companion was an MD, with three years experience in the local ER. Treating our victim, we realized that we needed a cervical collar, given the high probability of occult neck trauma. We shortened my 3/8" blue foam sleeping pad by 5 or 6 inches,folded it over, tastefully allied duct tape, and voila! a C-collar.

At least it worked well enough in the subsequent evacuation.

Splints, especially, are often improvised. What would you recommend for improvised, reasonably adequate, measures to deal with situations?
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#287797 - 01/12/18 07:32 PM Re: Improvisation, especially First Aid [Re: hikermor]
Russ Online   content
Carpal Tunnel

Registered: 06/02/06
Posts: 4621
Loc: SOCAL
In the Wilderness First Aid course, improvising a C-collar with a sweater, or an arm splint from a magazine would demonstrated and then practiced. The WFA instructors were big on improvisation, a necessary skill when you are a great distance in time and miles from a medical facility.

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#287798 - 01/12/18 08:12 PM Re: Improvisation, especially First Aid [Re: hikermor]
chaosmagnet Online   content
Sheriff
Carpal Tunnel

Registered: 12/03/09
Posts: 2832
Loc: USA
Good stuff. I have taking Wilderness First Responder on my bucket list.

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#287804 - 01/12/18 09:46 PM Re: Improvisation, especially First Aid [Re: hikermor]
TeacherRO Offline
Pooh-Bah

Registered: 03/11/05
Posts: 2211
to me, all first aid is improvised.

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#287808 - 01/12/18 10:41 PM Re: Improvisation, especially First Aid [Re: hikermor]
clearwater Offline
Old Hand

Registered: 03/19/05
Posts: 988
Loc: Channeled Scablands
Large blanket pin to keep the airway open in transport. Thru the tongue and lower lip.

Ice Axe traction splint.

Webbing for outside the boot ankle support.

Hard hat wash basin.

Warm wet black teabags for eye infection.

Campfire charcoal for upset stomach.

Salt, water sugar for oral rehydration solution.

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#287828 - 01/13/18 06:45 PM Re: Improvisation, especially First Aid [Re: hikermor]
Pete Online   content
Veteran

Registered: 02/20/09
Posts: 1331
"Large blanket pin to keep the airway open in transport. Thru the tongue and lower lip"

Most of your recommendations sound good. But I suggest that you avoid the first. Find another way to accomplish the task, without solutions that involve cruelty. I understand that EMT's are often so "training oriented" that it becomes a strange type of fixation, and they forget to be human beings. I can think of ambulance crews I knew, when I did my own EMT training. And they would sit around and laugh at doing intubation on conscious patients, who were tried down, immobilized with restraints, and then had plastic shoved down the their throats by the EMT's.

Personally, I'd rather be dead. Than to put up with "EMT waterboarding". But it's a reality out there.

My constructive suggestion - find a better solution.

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#287848 - 01/14/18 10:05 PM Re: Improvisation, especially First Aid [Re: hikermor]
Pete Online   content
Veteran

Registered: 02/20/09
Posts: 1331
BTW, it terms of improvisation.
always seemed to me that pieces of thick cardboard were really helpful. but you need them to be long. maybe 3 feet long. you can bend cardboard (down the axis, lengthways), and use duct tape to wrap it. and it's excellent for building splints very quickly. The nice thing about cardboard - very easy to cut with scissors. So you can shape it - to your own purposes. also, if you don't use it for EMT purposes, you can always burn it as fire material.

the main disadvantage. it's useless if it gets soaked with water. if there was such a thing as "water-resistant" cardboard strips, it would be nearly ideal.

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#287851 - 01/15/18 01:16 AM Re: Improvisation, especially First Aid [Re: Pete]
clearwater Offline
Old Hand

Registered: 03/19/05
Posts: 988
Loc: Channeled Scablands
It was part of an Wilderness EMT training. Most groups I worked had airways in the first aid kit tho.

How would you improvise an airway?


Edited by clearwater (01/15/18 01:17 AM)

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#287862 - 01/15/18 02:19 PM Re: Improvisation, especially First Aid [Re: clearwater]
hikermor Online   content
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 6082
Loc: southern Cal
Improvised airway - Simply reach in and pull the lower jaw forward. Turning the victim on his side (provided there are no cervical issues!) is also recommended.

Quote from Wilkerson's Medicine for Mountaineering, 3d ed., p.49

"insert a large safety pin through the meaty part of the tongue and hold the tongue forward by taping the pin to the chin or anchoring it in a similar manner. Although this technique sounds and appears brutal, it is simple, highly effective, and produces no permanent damage."

Emergency medicine is often not rated PG....
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#287871 - 01/15/18 10:33 PM Re: Improvisation, especially First Aid [Re: hikermor]
Teslinhiker Offline
Veteran

Registered: 12/14/09
Posts: 1325
Originally Posted By: hikermor


Quote from Wilkerson's Medicine for Mountaineering, 3d ed., p.49

"insert a large safety pin through the meaty part of the tongue and hold the tongue forward by taping the pin to the chin or anchoring it in a similar manner. Although this technique sounds and appears brutal, it is simple, highly effective, and produces no permanent damage."

Emergency medicine is often not rated PG....


And just to think, people actually pay to get their tongues pierced, when they can be having a 1st Aid attendant do it for free.
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Earth and sky, woods and fields, lakes and rivers, the mountain and the sea, are excellent schoolmasters, and teach some of us more than we can ever learn from books.

John Lubbock

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