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Looking for wilderness first aid supplies

Discussion in 'First Aid Station' started by Rescue_Ops, May 31, 2010.

  1. Rescue_Ops

    Rescue_Ops Loaded Pockets

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    Anybody know where to find dermabond or indermil cheaply? What about sutures (4/0 monofilament, large sweep cutting needle) and something to numb the area with?
     
  2. Chinaman

    Chinaman Empty Pockets

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    All dermabond is is sterile superglue.

    Also I would recomend a larger thread. Maybe 2-0 or 3-0. 4-0 isnt as forgiving due to its smaller size.

    What part of tennessee are you in BTW. If your in clarksville I could get you some of those supplies.
     
  3. Flight-ER-Doc

    Flight-ER-Doc Loaded Pockets

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    There is no such thing as cheap dermabond. It also has a very, very short shelf life, and when it's old it's dried up and unusable.

    Further, you shouldn't be suturing anything in the field since there is no way you can adequately debride and decontaminate the wound. Bring someone into my ED who you've sewed up and guess what? It's ALL coming out, and it will hurt.

    Wounds will heal just fine from the inside out.



    http://www.scribd.com/doc/26369464/If-You-Dont-Know-What-to-Do
     
  4. Flight-ER-Doc

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    It's a different formula.
     
  5. vivek16

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    Yeah, the regular superglue has some irritants inside it. I wouldn't use it for anythinig more than an annoying papercut. It's pretty nasty if you use it on anything that isn't a clean cut.
     
  6. Rescue_Ops

    Rescue_Ops Loaded Pockets

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    The sutures would be a very last resort, only to close the wound until it could be properly treated at an appropriate facility- where I would EXPECT the stitches to be removed and the wound cleaned. When you're working or playing in remote areas and help could be as long as a day away, you have to keep your options open. Not everybody is always in an area where help is 5 minutes away.

    So, dermabond wouldn't be a good solution for a wilderness FAK. What would be suitable for long term storage that would be indifferent to temperature extremes? What are the pros and cons of the indermil? What about numbing the wound with something besides lidocaine?
     
  7. Flight-ER-Doc

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    Duct tape. It also replaces sutures.

    There is NO good reason to close a wound in the field. None at all. There is no conceivable 'last resort' need, in the wilderness (todays, or post-apocalyptic) that closing a dirty wound is a good solution for
     
  8. Mcameron

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    i am really having a hard time thinking of when "field Suturing" would be the best option.....

    i personally like plain old superglue....its cheap and never goes bad

    then you also have butterfly closures, duct tape.....and then you also can wrap it up really well with a gauze...... that should really get you through most incidents that you would encounter.

    the only time i would really imagine a suture would be useful is if you were more than a few days away from help and you had someone qualified to do it.
     
  9. Flight-ER-Doc

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    Especially in that scenario, it's much better to leave the wound open to drain infection. Closing up dirty wounds is a very, very bad idea. And it's almost impossible to get a wound clean in the field - even for me, with specialized equipment.
     
  10. Roach

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    I get the impression you are firmly against people trying to pretend they know what they are doing by self-suturing. :)


    What about carrying sealed, unscented tampons for bullet wounds? Specifically in the even of a poacher making a twitch shot a moving bush and hitting someone traveling thru the wilderness. I know alot of guys (including myself) that carried them in Iraq for similar purposes. I can't think of anyone that got a wound big enough to use them however.
     
  11. Flight-ER-Doc

    Flight-ER-Doc Loaded Pockets

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    ARGHH!! Well, for a force defender....

    No. Think about tampons (difficult for most men, but work at it). Think about where they are used.

    Now, to stop blood flow, you need to COMPRESS the bleeding blood vessels. Thats why 'direct pressure' is the first step in stopping blood flow, right?

    Remember the last time you had your blood pressure checked? Someone wrapped that cuff (I went to medical school and all I learned was how to spell sphygmomanometer?) around your biceps, and pumped, and pumped...how much pressure did it take? (Rhetorical, they probably pumped it up to around 180 mm of Hg (3.5 psi more or less) and then let the pressure out). A lot more than a tampon is going to apply on it's own.

    Think a woman wants that much pressure where tampons are used? Ask your wife/girlfriend/mother if she wants a 2 liter bottle of pepsi less a glass or so, standing on the narrow end, poking her....

    In short, it's a really bad idea...and since the first place I've seen it referenced is in the fictional novels of John Ringo, I've told him I'm going to kick his gluteal muscles when I see him...this has caused me and a lot of physicians a lot of trouble......

    Aside from not applying enough pressure to stop the bleeding, it will keep blood from leaking out..to a point. People who don't understand physiology may think this is a good thing: ITS NOT. Once the blood has leaked out of the plumbing, it's not very good any more: It's dirty, it's got bacteria from the wound growing in it (it's an ideal growth medium for bacteria, and the body is keeping it at the near ideal temperature to grow bacteria), and it's actually kind of irritating to the tissues it's not supposed to be touching. It doesn't transport any oxygen or CO2. In short, being in the wrong place it's not helping much. But, it's inside the body in a cavity, sloshing around.

    Not a good thing. Letting it out is better than keeping it in. It is one of those 'dirty wounds' I was talking about. Dirty is dirty, even for a little while. Letting the blood run out (or be absorbed outside the body by a bandage) is a good thing since it helps wash the junk out of the wound.

    Your IFAK has a bunch of good stuff to plug bullet holes, use them. In particular, the combat gauze is pretty darned impressive: If you really want to plug a hole then either unwrap it and shove it in the hole, or if the hole is too small pull a few feet off the end and poke that in there....then use the rest of the roll as part of the pressure dressing.

    OBTW: Tampons are not sterile. They're not packed very well. And as I'm sure you've discovered, they're not very durable...

    HTH.
     
    Last edited by Flight-ER-Doc, Oct 20, 2012
  12. Roach

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    Note to self: Tampons are now even more evil than before.
     
  13. Chinaman

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    I think a lot of service members know about the tampon trick from the proverbial grapevine. I know Ive heard it. Its the whole "my old doc from my last unit said that he used it and he saved a guy!".

    I know from experience that a tampon alone will not work by itself, Just as Doc said above. Ive had to pack wounds with rolled gauze and the amount that I used to stop the bleed was substantial. So my assumption would be that the tampon wont do much but get in the way.
     
  14. Flight-ER-Doc

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    Thanks.

    BTW, tampons will only absorb about 15 grams of blood (less than half an ounce).
     
  15. Gnarly
    • In Omnia Paratus

    Gnarly Loaded Pockets

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    Flight-ER-Doc,
    I always enjoy reading your posts here,and have shared some of them with the ER Docs I work with!
    But:
    Do I win a prize for spotting this? { Your (likely tongue-in-cheek) deliberate addition of the extra 'm' in the middle?}
    (I went to medical school and all I learned was how to spell sphygmommanometer?)'
    Keep up the great work & fine advice here.
    ~Gnarly
     
  16. Flight-ER-Doc

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    :censored:! 4 years and I guess I didn't learn anything!
     
  17. cap6888
    • In Omnia Paratus

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    I am sure everyone agrees that Flight-ER-Doc's posts are great info. I am one of those soldiers who also had a bunch of tampons in my FAK when I was overseas. When we were in Kuwait waiting to go into Iraq, we hook up with a SF unit. The first thing the SF doc told us to do is go to the PX and get some tampons and duct tape. After seeing all the puzzled looks, he explained why. I only used them one time on a large wound on a forearm to pack the wound prior to bandaging it. It seemed to do the job well enough. I will also say, I was in Iraq in 2003 at the start of the war, and Quik Clot was still in it's infancy (the exothermic reaction was still an issue). We didn't have all of the fancy bandages that have come out by now. I am not saying what I did was the best thing, sterility is obviously an issue. But thanks to quick evacs, soldiers would be at a medical facility well within an hour. Given the choice now, there are tons of high-speed dressings that are a much better alternative than tampons.
     
  18. newtothis

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    I thought we had the tampons to hand out to the Marines?