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#287810 - 01/12/18 11:08 PM Re: Bug Out First Aid Kit [Re: hikermor]
Russ Offline
Geezer

Registered: 06/02/06
Posts: 5357
Loc: SOCAL
Yep, I keep a pair of nitrile gloves readily available so they’re the first thing you find when either of my larger FAK’s is opened. My small kit, not so much; a pair of nitrile gloves would significantly increase the size of the kit and since it’s an owwie kit... Remember, the gloves are mostly to protect the responder from contaminants/bodily fluids. For owwies, I pull a band-aid, hand it to the vic’ in the wrapper and let him/her self treat.

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#287811 - 01/13/18 12:27 AM Re: Bug Out First Aid Kit [Re: hikermor]
Jeanette_Isabelle Online   content
Carpal Tunnel

Registered: 11/13/06
Posts: 2946
Loc: Nacogdoches, Texas
Originally Posted By: hikermor
The thing that works is to have one or two pairs right on top, ava ilable as soon as your bag is opened. Saves a bit of time and helps the aider to avoid a potentially serious error.

I have the personal protection items in the side pocket for that reason.

Jeanette Isabelle
_________________________
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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#287812 - 01/13/18 12:39 AM Re: Bug Out First Aid Kit [Re: Jeanette_Isabelle]
Jeanette_Isabelle Online   content
Carpal Tunnel

Registered: 11/13/06
Posts: 2946
Loc: Nacogdoches, Texas
Originally Posted By: Jeanette_Isabelle
Originally Posted By: chaosmagnet
I'd recommend that you delete the decompression needles unless you have been trained to use them, and add more chest seals instead. If you are not a medical professional a decompression needle is way outside the scope of your practice, and a lot of harm can be done if they are used improperly.

I have not been trained with the decompression needle. I acknowledge learning the procedure from the book, which is what I did, is not the same. One thing the author drives home more than anything else is:

If the situation is desperate and the victim is literally dying, there is only one thing that you can do to possibly save his life.

Pleural should not be undertaken lightly and should be attempted only is the victim appears to be dying.


With that established, should I delete the decompression needles from the list?

Chaos Magnet, should I include the decompression needles for the reason I stated or is the victim's chance of dying the same regardless of what I do or don't do?

Jeanette Isabelle
_________________________
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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#287813 - 01/13/18 12:48 AM Re: Bug Out First Aid Kit [Re: Jeanette_Isabelle]
Jeanette_Isabelle Online   content
Carpal Tunnel

Registered: 11/13/06
Posts: 2946
Loc: Nacogdoches, Texas
Originally Posted By: Jeanette_Isabelle
As for practical experience, I helped my grandmother with her oxygen therapy (though I don't anticipate that experience coming in handy in the future). I treated three burns, wrapped a sprained ankle, treated a hand caught in a door and I applied and changed bandaging (not including band-aids) more often than I can count.

Hikermor, I acknowledge my limitations and I have been on the lookout for a first aid class in the area. If there is one, I haven't found it yet. I hope my hands-on experience counts for something.

Jeanette Isabelle
_________________________
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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#287815 - 01/13/18 01:00 AM Re: Bug Out First Aid Kit [Re: Jeanette_Isabelle]
chaosmagnet Online   content
Sheriff
Carpal Tunnel

Registered: 12/03/09
Posts: 3819
Loc: USA
Originally Posted By: Jeanette_Isabelle
Chaos Magnet, should I include the decompression needles for the reason I stated or is the victim's chance of dying the same regardless of what I do or don't do?


If you do everything within your scope of practice and someone dies anyway...you did everything you can do. If you as a non-professional stick a needle in someone’s chest and they die, you could end up with massive civil liability or even go to prison, depending on the law where you live and the circumstances. But I’m not a lawyer.

A chest seal is likely to keep someone alive to get them to definitive care, if applied correctly in time and the patient has tension pneumothorax. More, vented chest seals is better. I have been formally trained on decompression needle usage, and I would start with a chest seal every time.

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#287816 - 01/13/18 01:32 AM Re: Bug Out First Aid Kit [Re: chaosmagnet]
hikermor Offline
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 7705
Loc: southern Cal
A lot is going to depend on circumstances. I might try desperate measures on a close relative, for instance, that I would never attempt on a stranger.

In my first EMT class (many moons ago) which was given by my employer to those of us who would be operating out deep in the woods (this was years before the Wilderness oriented courses were developed), our instructor, a Navy corpsman with lots of experience, introduced us to the "crico," a procedure where you cut into, or puncture the esophagus, hopefully below the larynx, in order to open the airway when other measures were ineffective. I understand this procedure has been successfully performed using no other instrument than a ball point pen.

I have yet to be faced with the need to attempt this maneuver, and I just mention it as an example of a "Hail Mary" procedure that is theoretically available in desperate circumstances.

Remember that rapid transport to definitive care (a decent ER) is critical to a good outcome - the Golden Hour. When faced with a situation requiring care, you simply do the best you can and cross your fingers. I believe most of those I have treated have survived...
Do the best you can, according to your capabilities and training, and sleep soundly at night.
_________________________
Geezer in Chief

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#287817 - 01/13/18 02:27 AM Re: Bug Out First Aid Kit [Re: Jeanette_Isabelle]
Famdoc Offline
Member

Registered: 04/29/09
Posts: 155
Loc: PA
A couple of points, clarifications:
A needle thoracentesis to decompress a tension pneumothorax is relatively easy to do, but requires some assessment skills to know when and where to do it. The stethoscope is very useful for that. The IV catheter JI mentions may be useful for others to use who have such skills, but don't have the needed equipment at the time of need.

The rare person who has a spontaneous pneumothorax (without a penetrating wound, mostly tall skinny adolescents), will not be helped by a chest seal: There is nothing to seal on the skin. For relief, the needle thoracentesis provides the quickest relief and can sometimes avoid need for a chest tube.

A one-way flap valve can be fashioned from a nitrile or latex glove finger cut off from the glove to fit over the hub of the thoracentesis needle/catheter and secured in place to prevent air -reentry.

Emergency cricothyroidotomies are really rare; done mainly for acute upper airway obstruction from a suddenly swollen epiglottis, or massively swollen tongue, or a hangman's injury, etc. The trachea is what is intentionally punctured, not the esophagus: One more reason to carry a small very sharp blade, and a pen, which can be disassembled and the longer part of it thrust thru the new opening in the trachea to allow air-exchange. Again, someone else at the scene may have the skills, but not the equipment needed.

YouTube of course has the videos.

The American College of Surgeons Advanced Trauma Life Support course and Tactical Combat Casualty Courses cover these techniques, but these courses may be very difficult to access if you are not in medicine/nursing/EMT/Paramedic/firefighting/law enforcement already.

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#287818 - 01/13/18 03:37 AM Re: Bug Out First Aid Kit [Re: Famdoc]
chaosmagnet Online   content
Sheriff
Carpal Tunnel

Registered: 12/03/09
Posts: 3819
Loc: USA
Originally Posted By: Famdoc
The rare person who has a spontaneous pneumothorax (without a penetrating wound, mostly tall skinny adolescents), will not be helped by a chest seal: There is nothing to seal on the skin. For relief, the needle thoracentesis provides the quickest relief and can sometimes avoid need for a chest tube.


Good to know -- the only tension pneumothorax that I've been trained to expect is immediately following a gunshot wound, stabbing, or similar traumatic injury.

Quote:
The American College of Surgeons Advanced Trauma Life Support course and Tactical Combat Casualty Courses cover these techniques, but these courses may be very difficult to access if you are not in medicine/nursing/EMT/Paramedic/firefighting/law enforcement already.


TCCC-type training is much easier to get than it was a few years ago for firearms instructors; some classes are advertised for the (much larger) concealed carry market.

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#287819 - 01/13/18 04:04 AM Re: Bug Out First Aid Kit [Re: Famdoc]
hikermor Offline
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 7705
Loc: southern Cal
FamDoc - Thank you for weighing in with good info!
_________________________
Geezer in Chief

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#287823 - 01/13/18 12:04 PM Re: Bug Out First Aid Kit [Re: Jeanette_Isabelle]
LesSnyder Offline
Pooh-Bah

Registered: 07/11/10
Posts: 1680
Loc: New Port Richey, Fla
Famdoc/Chaos... I had a young man in my Chem I class (around 17yr)tall, thin, with small chest/rib development suffer from spontaneous lung collapse in class.... he had very ashen complexion, difficult breathing... luckily we had EMT within 5 minutes, and a RN on staff that supported him with oxygen...I had been in a motorcycle accident several years previous, was checked out at the ER and released, and suffered one the next afternoon...

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