Re: Srupp's First Aid Thread
Principle Number Three:
- All our goals in wilderness pre-hospital emergency survival as it pertains to blood loss and bleeding is directed at limiting the loss of blood.
Principle Number Four:
- Direct Pressure: This is always the first, and best action when there is blood loss. We are talking moderate to severe bleeding. The nature and severity of the bleed will dictate the action. Massive bleeding will require instant direct pressure via the palm of your hand directly over the bleed. If it is not a fracture, significant pressure is needed. Rubber gloves, gauze pads, and other bleeding suppression supplies can be dug out and be ready for use…but apply that direct pressure as soon as you can. Infection, and non- sterile techniques take a distant second, backseat priority to blood loss. Always.
- Spraying arterial bleeds are pretty noticeable; and while direct pressure is applied, the thought process is that this is beyond my control or abilities and we must be making attempts at a higher level of medical intervention. This is the time, and sooner is better.
Principle Number Five:
- Dressings: Apply a sterile gauze dressing over the wound. Once that dressing is in place it does not get removed. Ever. If it bleeds through the first dressing, add more over it. Keep adding if the dressing becomes saturated and soaked through. If it appears that the bleeding has stopped, DO NOT remove any bandages to check. If you run out of bandages, use clothes, towels, space blankets. Improvise…Adapt…Overcome.
- I personally carry a pressure dressing: what some call an Ace bandage, or an Israeli dressing: tie with enough pressure to stop the bleeding, but not cut off circulation distally.
- Gauze rolls, while effective for keeping a gauze dressing in place, DO NOT provide enough constant pressure to keep the bleeding stopped; a tensor bandage can.
Principle Number Six:
- Elevate the affected area above the level of the heart: a laceration to the hand: pressure on the hand, lifted up to the head level. This allows gravity to assist you to reduce the blood pressure to the limb, helping stop the bleed. An axe to the foot: lay the patient down and elevate that leg.
- Severe lacerations : We lay the patient down. So that if a drop in blood pressure occurs, they do not pass out, fall down, and create more injuries. This also assists by allowing the heart to contract less forcefully, lowers the blood pressure, and creates less bleeding.
Principle Number Seven:
- For severe bleeding there are pressure points:
- For the hands and lower arms: on the inside of the arm between the bicep and humerous, press along the humerous and roll towards the bicep.
- For the lower legs: follow the pant line as if it had been ironed with a crease running up the centre of the pant front…where it meets the crease of the leg at the hip…press down with hard pressure, with a karate style edge of open hand, while using your other hand to add more pressure.
So...Preparation:
- Pressure direct
- Position of the injured part
- Position of patient
- Pressure points
- There are different types of injuries that cause bleeding, no matter how caused, external lacerations are basically cuts.
- The best treatment by far is to avoid these…cut towards your chum, and not your thumb.
- Usually direct pressure is sufficient for most normal cuts.
- The most dangerous cuts are arteries in your hands or your wrists: medical emergencies demanding medical intervention.
- However, sometimes the knife penetrates or punctures: it goes in embedded tip first. These penetrating injuries often hide the depth and severity of the injury, blood loss.
- If something penetrates the human body…leave it there. The absolute best item to control bleeding is the item that penetrated, punctured, and made the wound. It fits the wound channel 100%, so again, leave it there in place.
- Place a slit in the gauze, slide it over the penetrating object, make a ring pad, circle and stabilize the penetrating object in place. If the object is a branch or something long, cut if off gently so not to disturb the wound. A knife, a stick, anything that penetrates the human body is a medical emergency.
- A severe finger cut can be bandaged up, and it is splinted to the adjacent finger…less movements help keep the wound stay closed.
- A severe laceration to the leg is splinted to the adjacent leg using a blanket in between.
- Sometimes bleeding is caused by fractures. A severe fall can cause a fracture; which is an injury to hard tissue, ie. an arm, leg, ribs. The sharp broken off bones can be as sharp and as bad as a knife cut: you treat the bleeding the same, with the addition of splinting. If the bone is broken but the skin is not, this is called a simple fracture, or a closed fracture. Where the bone pokes through the skin, this is called a compound fracture. A serious bleeding issue could be due to a significant fall, where the liver splits apart due to the pressure of landing, or a rib breaks off and lacerates the liver.
- If there is a history of a significant fall, about fifteen feet or more, and the signs and symptoms of shock are present, this is a medical emergency.
- Any bleeding or injury to a patient who is taking ASA therapy as a preventative cardiac protocol, or those at increased risk of CVA (stroke) who are currently taking Coumadin or Warfarin in a therapeutic dose are all at risk of a ******ed clotting process and this makes stopping bleeding much more difficult. They often exhibit a sensitivity to bruising.
- It must be noted that most patients with significant bleeding will often become thirsty. It is imperative that you give them nothing to drink or eat. They are NPO (nothing per oral). That is a rule.
For truly significant bleeding, there are a couple of last stop measures…
- There is QUICK CLOT III…or CELOX bandage or powder. Both are chemical agents that cause extreme clotting and a life or death chance at stopping deadly bleeding.
- Beyond this, there is a last resort…one to be used in life over limb and not to be taken lightly…this is a TOURNIQUET.
- If you decide to purchase the Quick Clot or the Celox, and you need to apply it, ensure that you keep the packaging and hand it to the paramedic or life flight crew, as well as with the time you applied it.
- Same goes for the tourniquet…ensure you mark on the forehead of the patient the time you applied the tourniquet. And follow directions for when to temporarily release pressure in order to try to save the limb.
This is a List of Potential Products to Pack With You Always for Treatment of Wilderness Bleeding:
- A one-page guide to emergency first aid…we all have brain farts…emergencies can be very upsetting; disrupting the memory. Have a one-page guide in your pack.
- Crazy Glue…for small, minor cuts.
- One compress bandage…Ace or Israeli
- One gauze roll
- Five sterile gauze pads
- One tensor bandage
- Twelve Steri-Strips or butterfly closers
- One small Friars Balsam
- One aluminum Mylar blanket
- Four pairs of Nitrile gloves
- Twelve small alcohol wipes
- Neosporin for infection (at camp)
- Two feminine hygiene pads (make excellent base layers for serious cuts)
- One roll of Transpore tape
- One roll of white electrician tape
- Generation Three Quick Clot…or Celox gauze or powder
- Makings of a tourniquet…or store-bought one
Re: Srupp's First Aid Thread
Quite the read, thanks for posting Steven...
Re: Srupp's First Aid Thread
Thanks Srupp threw my Quickclot Trama pak back into my pack.Also have the Israeli kit just need to watch the video on that one again.
Re: Srupp's First Aid Thread
Re: Srupp's First Aid Thread
Re: Srupp's First Aid Thread
Great info there, thanks for sharing Srupp
Re: Srupp's First Aid Thread
This is some great info thanks.
Re: Srupp's First Aid Thread
Thanks for sharing! Those pressure points to stop bleeding really are interesting. I am planning on taking a level 3 first aid or do you think it's overkill?
Re: Srupp's First Aid Thread
Hmmm IMO..level 3 is for workplace..lots of concentrating on WCB standards, totaly different than remote wilderness emergency with limited first aid suplies" I would be looking for a emergency outdoor wilderness survival first aid course.or even advanced course..not level 3 ofa"..imo.
Cheers
Steven
Experienced instructor...field experience not book learning....big difference. .
My hardest decisions in this presentation. .what to include. What not to.keep it simple but informnative. .
The addition of urine output is designed for ICU "not wilderness first aid..too may variables..it realy was challenging to keep it at the length I did.
Happy to answer pm questions on bleeding..and feedback on worthwhile? For couple more.fractures..care of unconscious victim.hypotermia. .heat exhaustion. Heat stroke.cardiac.chest pains..etc
If there is interest.if the bleeding presentation was at the correct level, audience..
Cheers
Steven