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What first aid stuff do you bring?

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What first aid stuff do you bring?

Postby climberslacker » Tue Jan 19, 2010 1:19 am

Hey guys,

I was recently first on scene to a possible spinal injury in the mountians, but luckuly we were very close to a ranger station, so I had help within 10 minutes. But it made me wonder, what i could have done to be more prepared. Obviously I wont be bringing a C-collar, or a spine board or a stokes, but all I had was a sleeping bag (even though i was on a day hike, I always have one in winter), and a small first aid kit with one roll of gauze and a couple of 4x4s. I also had a thermarest and a pair of nitrile gloves. This was taking place in the snow, and so one of the people who was working in the nearby building rushed out a synthetic bag (helpful because I was still doing a initial assesment) and a pad that I could kneel on while holding c-spine. Ive been thinking of other things that I should have had for this, or possible a worse injury in the mountians. Im thinking maybe a cpr mask, and MAYBE a set of the most common sizes of OPAs but am not sure on the OPAs. Is there anything that you could think of that would be useful in an emergency situation that I don't have?

Thanks guys!

-CS
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Postby Alex Wood » Tue Jan 19, 2010 3:58 am

A Sam Splint is a good start. You can easily work that to immobilize the C-Spine. Also its good for any type of splinting, especially on the arms (humerus, radial, ulna). Its pretty compact too.

For airway adjuncts, I would go for the NPA (for the nose) over the OPA. NPA's are alot smaller and are a better fit for a variety of patients I think.

sterile gauze, pre-wrap, ace bandages, triangle bandages, syringe, alcohol prep pads, glucose (for diabetics)..... I would put in that CPR mask and definitely lots of gloves.
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Postby climberslacker » Tue Jan 19, 2010 5:19 am

Oh ya, i forgot, I do have a sam splint. I guess I will throw in a few crevats and maybe an ace wrap next time. Light enough, eh?

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Re: What first aid stuff do you bring?

Postby Sierra Ledge Rat » Tue Jan 19, 2010 10:31 am

Medical Kits

A lot depends on where you're going, what you're doing, how long you plan to be in the mountains, and the weather. There are a lot of variables, and the bottom line is that you really cannot make a medical kit that you can always keep handy and throw it in your pack, unless you always do one thing consistently (like day hikes or bouldering or short rock climbs.)

First, there's the minimalist approach: duct tape and a bivi gear. If duct tape won't fix the problem, then it's likely that the victim will be stuck while you go get help. You'll need something to keep the victim warm and dry and insulated from the ground while you're gone.

If I am going to carry more gear, then I start with the basics: what are the most likely problems? For climbers and hikers, it is cuts, scraps, sprains and fractures. So I start with bandages, betadine solution, peroxide, tape, butteryfly bandages, elastic wraps, splinting material. How much to take? Depends on how much room you have in the pack. If there are plenty of sticks where I'm going, then I don't take splints.

Don't forget personal protective equipment like Nitrile gloves.

Also consider area- or sport-specific needs. In New Mexico, you need tweezers to remove cactus needles. If I'm skiing deep in the backcountry, I carry webbing to convert a ski pole into a femur traction splint, and we also take at least one sled in case we need to drag someone out.

Airway devices, cervical spine splints, etc? Not really practical, except in certain situations. If you're rock-climbing along a road, then you can carry a fairly large medical kit in your car. Sure, then keep OPAs, c-collars, oxygen, etc. if you are trained to use the stuff. You'll need a cell phone, too, because if you're trained well enough to use more advanced gear to keep someone alive who would otherwise die, then you'd better get them evacuated STAT.

It's not really practical to carry CPR masks or OPAs or other airway devices deep in the backcountry. If your victim is so bad that they require such a device, forget it, they're dead. You can't do rescue breathing for 2 days straight. If all they need is quick, temporary rescue breathing support (say, following a concussion), then you can manage without the fancy devices.

But hey, if you want to carry a million-pound pack with all the toys, then knock yourself out.

I'll end this with an anecdote.

I was free-soloing Coonyard Pinnacle on Glacier Point Apron one fine summer day about 35 years ago, wearing EB rock shoes and knickers. Unfortunately, I was showered with some rockfall but I wasn't wearing a helmet. A cantelope-sized block grazed my left temple and about knocked me out. The amount of blood loss was staggering.

I tried to keep pressure on the wound with one hand, but I couldn't down climb with only one hand. Everytime I let go of the wound to down climb, I was blinded by profuse bleeding. Fearful that I was going to pass out while I was still 200 feet off the ground, I descended as fast as I could.

When I reached the ground at the bottom of the slab, a big fat tourist popped out of the woods, huffing and puffing on the verge of heart attack. He opened up his day pack and pulled out a large olive-drab Army battle dressing. He said that he had been carrying the battle dressing in his day pack for twenty years "in case of an emergency", but he never had the chance to actually use it. Gleefully, he tied the bandage around my head and sent me off down the talus to seek medical care.

Next time you see me, I'll show you my scar. Since I no longer comb a full head of hair, the scar is very obvious.

And just to reassure you, no, I do not wear knickers anymore. :roll:

climberslacker wrote:Hey guys,

I was recently first on scene to a possible spinal injury in the mountians, but luckuly we were very close to a ranger station, so I had help within 10 minutes. But it made me wonder, what i could have done to be more prepared. Obviously I wont be bringing a C-collar, or a spine board or a stokes, but all I had was a sleeping bag (even though i was on a day hike, I always have one in winter), and a small first aid kit with one roll of gauze and a couple of 4x4s. I also had a thermarest and a pair of nitrile gloves. This was taking place in the snow, and so one of the people who was working in the nearby building rushed out a synthetic bag (helpful because I was still doing a initial assesment) and a pad that I could kneel on while holding c-spine. Ive been thinking of other things that I should have had for this, or possible a worse injury in the mountians. Im thinking maybe a cpr mask, and MAYBE a set of the most common sizes of OPAs but am not sure on the OPAs. Is there anything that you could think of that would be useful in an emergency situation that I don't have?

Thanks guys!

-CS
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Postby norco17 » Tue Jan 19, 2010 4:45 pm

By the time you need an opa or npa the person is done. You should be able to hold an open airway until more advanced support arrives, if not the person is probably gone anyways. I do not carry a breathing barrier, but it wouldn't be a bad idea in more populated areas where you may be working on someone you don't know...for one of my friends I will take the risk of blowing into them without the barrier.

I normaly carry something to stop some bleeding and some pain killers and neosporin. For splinting I have tape and a thrmarest, tent poles.... or on day hikes I am normaly below tree line so I have sticks.
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Postby climberslacker » Tue Jan 19, 2010 5:10 pm

For the record, the OPA (or NPA) would onyl be carried on trips to Mt. San Jacinto, wich is EXTREAMLY populated, as there is a tram to the snow, and a victim, if close to the tram, can be down to a paramedic in 30 mins if they didn't have any C-spine or anything.

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Postby norco17 » Tue Jan 19, 2010 9:15 pm

climberslacker wrote:For the record, the OPA (or NPA) would onyl be carried on trips to Mt. San Jacinto, wich is EXTREAMLY populated, as there is a tram to the snow, and a victim, if close to the tram, can be down to a paramedic in 30 mins if they didn't have any C-spine or anything.

-CS


One large NPA and the ability to cut it shorter might be nice and save weight. I can't remember what the differences are on thickness, but the main difference is length. This would sa e quite a bit of weight and wouldn't take much longer to use.
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Postby climberslacker » Wed Jan 20, 2010 1:02 am

Ya, Ive even seen adjustable length NPA. And Like I said, my kit for long multi day hikes would be compleatly different then were I am close enough to civilization to make an actual difference.

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Postby brokesomeribs » Fri Jan 22, 2010 2:56 am

I wouldn't even dream of carrying an OPA or NPA unless I was guiding. I'd probably take a #4 or #5 and that's it. Not too many small children running around the mountains that you'll need anything smaller. But like it was said before, if a person needs an OPA in a wilderness setting - they're dead. End of story. Furthermore, if you induce vomiting in a semi-conscious patient by inserting an OPA, all you've done is exacerbated their condition by putting them at risk for aspiration. Not carrying a suction unit as well, are you?

My 1st aid kit in the mountains: Everything I have on me normally (ski/tent poles, extra clothing, etc), and then a small zippered pouch with 2 pairs of nitrile gloves, three 4x4 gauze pads, two rolls of 2" gauze, and some duct tape. I'll also carry a small selection of No-Doz, immodium, Rx strength tylenol, and maybe one or two other assorted meds.

I don't carry any "life support" devices like airway adjuncts or a CPR mask. I stick to this policy, despite orchestrating a rescue earlier this season where the fallen climber went into respiratory arrest (or had his resps drop so low as to need supplementary breathing) 3 times. Luckily, a bag-valve mask was procured by a ranger who was able to get on-scene quite quickly. This was at Peterskill, NY. There is a thread on RC.com about it.
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Postby climberslacker » Sat Jan 23, 2010 1:42 am

Like I said,

i wouldn't either as they are dead, when they are dead by triage ( no spontainious breaths )in the backcountry. But I was mostly taklign about middle country (?) with the airway adjuncts. Back country I would have a sam splint, some guaze, some gloves and tape and probably some ibuprofin.

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Postby jmeizis » Sat Jan 23, 2010 3:03 am

I generally don't carry much more than painkillers. The way I figure it if the injury is so bad (pneumothorax, internal bleeding, crushed pelvis) that it requires some kind of gear that can't be improvised out of my basic climbing and camping gear (Gamov bag, sterile surgical room, surgical knowledge) then there isn't much I can do for that person anyways and they're probably going to die no matter what I bring in my bag. If it's so minor that it doesn't require anything more than pressure or a splint then it's probably small enough that it can be handled once out of the backcountry.

Keep in mind the longest I've spent in the backcountry is two weeks, and that was in the states. I think if I went for longer, out of the country, I'd probably bring some antibiotics. Besides that I can improvise splints, litters, neck braces, and all that kind of stuff. I spent a while guiding in the backcountry and generally our kit had some big bandages and a CPR mask, there were also some pills and antiseptic type stuff. The only things I ever used were bandages and antiseptic but everyone was a WFR. I think the most important tool you can carry in the backcountry is your brain.
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Postby e-doc » Sun Jan 24, 2010 4:39 am

SometimesI take a little kit; a dressing, bandana, bandaids, duct tape, but I'm an ER/GP doc so I really only need duct tape
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Do no harm.

Postby CowHampshire » Mon Feb 08, 2010 6:26 pm

Usually my ski patrol bag: gloves, valve-mask, cravats, airways, a quick splint, gauze, tape, pen light, Tylenol, bandaids, & stuff.

Above all of this is the training and know how to safely and quickly get the person to the next level of care.
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Postby drpw » Thu Feb 25, 2010 11:21 pm

Vicodin - Probably the most useful part of the kit when it's needed.
Gauze
Scissors and Clippers
Super Glue - Works amazing.
Duct Tape
SAM Splint
Aspirin
Tylenol

I also carry a little bag of salt as well, it's amazing how much better a teaspoon of salt can make you feel when you've been working hard and have a little electrolyte deficiency.
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Postby mconnell » Fri Feb 26, 2010 12:29 am

vicodin and duct tape. If it can't be fixed with that, it ain't fixable in the back country.
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