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#297308 - 10/18/20 09:24 PM Re: First aid kit upgrades [Re: Jeanette_Isabelle]
RayW Offline
Addict

Registered: 12/06/01
Posts: 601
Loc: Orlando, FL
Originally Posted By: Jeanette_Isabelle
I have those needles in the event I'm on a scene in which a person has the training but not the tools with them.
Jeanette Isabelle


I have been in this situation. Years ago we were at the local gun range and someone had their face to close to the scope when they pulled the trigger, the scope hit him right between the eyes. The wound was deep enough to need stitching. There were about a dozen people there including a medical doctor and I was the only one with a first aid kit. Which wasn't much more than a boo boo kit. After stopping the bleeding and a cursory exam the Dr sent him to the ER to get cleaned up and stitched up. With close and readily available medical care on a non life threatening issue it wasn't a problem. But it is eye opening that no one else had anything with them. So even if you don't have have the training it isn't a bad idea to have the tools available just in case.

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#297335 - 10/21/20 03:27 AM Re: First aid kit upgrades [Re: TeacherRO]
gulliamo Offline
Member

Registered: 09/11/02
Posts: 181
Loc: Denver, CO, USA
What about the Nasopharyngeal tube? Is this another "special training" item or is this something which is practical for me to carry with the intent to use given YouTube level of training?

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#297336 - 10/21/20 01:00 PM Re: First aid kit upgrades [Re: gulliamo]
Jeanette_Isabelle Offline
Carpal Tunnel

Registered: 11/13/06
Posts: 2946
Loc: Nacogdoches, Texas
I'm not sure about that. If you do learn at home, you will need the dummy to practice. That or you will need a volunteer. The following video will explain why it would be difficult to get a volunteer.

https://www.youtube.com/watch?v=yrXD1ryCD1o

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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#297344 - 10/22/20 12:02 PM Re: First aid kit upgrades [Re: TeacherRO]
chaosmagnet Offline
Sheriff
Carpal Tunnel

Registered: 12/03/09
Posts: 3819
Loc: USA
Ideally, you would find a TCCC instructor and take a class to learn how to use an nasopharyngeal airway (NPA). There should be a training dummy involved. In one class I took, there was an adjunct instructor who let us practice NPA deployment on him (and no, it was not enjoyable for him).

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#298204 - 01/28/21 12:04 AM Re: First aid kit upgrades [Re: TeacherRO]
TeacherRO Offline
Carpal Tunnel

Registered: 03/11/05
Posts: 2574
I often re-pac a kit in to a waterproof/dustproof case

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#298213 - 01/30/21 12:07 PM Re: First aid kit upgrades [Re: TeacherRO]
Macgyver Offline
Journeyman

Registered: 05/24/06
Posts: 88
Loc: Victoria Australia
1) I always add a small surgical kit including needle holders, a range of sutures, scalpel blades etc. I used to work in a Vet clinic and have had to use the sutures for cuts and minor stab wounds a few times. A quick suture if you know what you are doing, while the tissue is still largely numb from shock, is much less traumatic than a visit to the emergency room and the 4 or 5 hour wait... more needles and then a quick sewing job that could be done at home. (if you have the skills)

2) I add SILVERLON compression bandage material in sealed packs which is used on burns and to help regeneration of wounds. This is self sterilizing and can be reused many many times. When kept damp it keeps the wound free from bacteria and fungal growth allowing largely scar free regeneration to the tissue. (DO NOT USE SALINE WITH IT THOUGH)

3) I like to have cayenne pepper in a large vial which is useful in case of internal bleeding and it also helps with blood clots in veins and increases restricted blood flow.

4) I always carry either a V-Zap unit or similar spark generator unit to treat venomous bites and stings. I have lost count of the number of times that I have needed them for everything from allergic reaction to mosquito bites to spider and snake bite. Living in Australia this is my absolute must have for my emergency kit.

5) I have a stethoscope, several digital thermometers, a blood pressure meter and at least one pair of bandage scissors.

I have been considering adding some Israeli bandages and an air splint as well...

I keep the entire lot in a backpack that I can grab when I need it. The hardest thing is keeping my youngsters out of it, to them it is a wonderful collection of things. I need to restock my sutures after finding them scattered around the house in an opened state... Grrrr. I guess I will have to get a practice surgical kit and start teaching them emergency suturing wink

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#298217 - 01/30/21 08:06 PM Re: First aid kit upgrades [Re: Macgyver]
KR20 Offline
CEP
Member

Registered: 07/19/05
Posts: 105
Loc: Arizona
Originally Posted By: Macgyver
1) I always add a small surgical kit including needle holders, a range of sutures, scalpel blades etc. I used to work in a Vet clinic and have had to use the sutures for cuts and minor stab wounds a few times. A quick suture if you know what you are doing, while the tissue is still largely numb from shock, is much less traumatic than a visit to the emergency room and the 4 or 5 hour wait... more needles and then a quick sewing job that could be done at home. (if you have the skills)

2) I add SILVERLON compression bandage material in sealed packs which is used on burns and to help regeneration of wounds. This is self sterilizing and can be reused many many times. When kept damp it keeps the wound free from bacteria and fungal growth allowing largely scar free regeneration to the tissue. (DO NOT USE SALINE WITH IT THOUGH)

3) I like to have cayenne pepper in a large vial which is useful in case of internal bleeding and it also helps with blood clots in veins and increases restricted blood flow.

4) I always carry either a V-Zap unit or similar spark generator unit to treat venomous bites and stings. I have lost count of the number of times that I have needed them for everything from allergic reaction to mosquito bites to spider and snake bite. Living in Australia this is my absolute must have for my emergency kit.

5) I have a stethoscope, several digital thermometers, a blood pressure meter and at least one pair of bandage scissors.

I have been considering adding some Israeli bandages and an air splint as well...

I keep the entire lot in a backpack that I can grab when I need it. The hardest thing is keeping my youngsters out of it, to them it is a wonderful collection of things. I need to restock my sutures after finding them scattered around the house in an opened state... Grrrr. I guess I will have to get a practice surgical kit and start teaching them emergency suturing wink


WOW, I'm at a loss here! A lot of this will get you in trouble here in the States! Israeli Bandages are great, Air splints cause compartment syndrome and have been removed from care for over a decade! Look at SAM splints or Vacuum splints. Suturing in the field is risky and you better know your wound care or you just made things worse. V-Zap, not touching that one. Changed my mind, Get them to a hospital with anti-venom, don't play doctor!

20
Paramedic
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#298220 - 01/30/21 09:41 PM Re: First aid kit upgrades [Re: TeacherRO]
hikermor Offline
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 7705
Loc: southern Cal
It's "update the geezer time"....

I have often applied air splints successfully 9bck in the 1980's), typically in the mountains with rapid transport, usually helo, to a lower elevation ER. Naturally pressure required adjustment during transport and all were well award of this. Typically we did not achieve a definitive diagnosis in the field and splint application was a cautionary measure. Compound, grossly distorted fx's were a different story.

A quick peek on the internet evidently shows air splints stil eing marketed. Whose call has made them obsolete?

this is a straightforward request for current information. i am well aware that protocols change with time.

Agree that many of the practices advocated in the post you responded to do seem a bit far out. Guess they play by different rules down under....
_________________________
Geezer in Chief

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#298221 - 01/30/21 10:03 PM Re: First aid kit upgrades [Re: hikermor]
KR20 Offline
CEP
Member

Registered: 07/19/05
Posts: 105
Loc: Arizona
Originally Posted By: hikermor
It's "update the geezer time"....

I have often applied air splints successfully 9bck in the 1980's), typically in the mountains with rapid transport, usually helo, to a lower elevation ER. Naturally pressure required adjustment during transport and all were well award of this. Typically we did not achieve a definitive diagnosis in the field and splint application was a cautionary measure. Compound, grossly distorted fx's were a different story.

A quick peek on the internet evidently shows air splints stil eing marketed. Whose call has made them obsolete?

this is a straightforward request for current information. i am well aware that protocols change with time.

Agree that many of the practices advocated in the post you responded to do seem a bit far out. Guess they play by different rules down under....


Due to the fact that air splints completely encircle the extremity and use pressure for rigidity you have basically placed a pressure device. It doesn't take a whole lot of pressure to stop venus blood return. When that is stoped you started the cycle of compartment syndrome. I'm not sure of the events that started the removal of air splints from use, but it has been covered in our Continuing Ed training for over 10 years and we have had them removed from our protocols for use.

20
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#298222 - 01/30/21 10:31 PM Re: First aid kit upgrades [Re: hikermor]
Alan_Romania Offline

Addict

Registered: 06/29/05
Posts: 648
Loc: Arizona
In reference to Air Splints.
You can still buy them and there are people still using them however they considered antiquated and most EMS agencies have removed them from their equipment or they have been proscribed in protocols.

There are a few reasons that Air Splint have go by the wayside:
  • They are limited in their utility compared to other options like SAM Splints or Vacum Splints.
  • They have contraindications that other types of splints don't have due to the splints fully encapsulating the extremities. Compartment syndrome is a real concern with long times to definitive care.
  • While you can visualize the extremity better with an air splint, other reassessments can be more difficult than with other properly applied splints.
  • MOST providers do not properly reassess the pressure of the splint but simply assess for distal pulses. Venous flow is restricted before arterial flow is; compartment syndrome can be developing with a distal pulse present. This issue is compounded in air medical evacuations.

People do still use them, but there are a lot of treatments that are still being performed that aren't considered best practices.

Personally, I have never been a fan of air splints. They are easy to apply and that's it. They were an ok option for a long time, but newer technologies have improved the options.

If room and weight aren't an issue, vacuum splints are significantly better; they aren't affected by temperature or elevation and most can be manipulated to fit the patient's needs.

If room and weight is an issue, I am going with SAM splints. While more difficult to apply than a vacuum splint, they can be manipulated to fit the patient's need and are lighter and more compact.

If you search the internet you can find some cool pictures of a hydration bladder being used as an improvised splint... in wilderness and survival medicine. Improvised splinting is the standard I don't carry too much in the way of splinting supplies when I am in the backcountry in a non-professional role like backpacking.


Edited by Alan_Romania (01/30/21 10:35 PM)
_________________________
"Trust in God --and press-check. You cannot ignore danger and call it faith." -Duke

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