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OTC meds + wound disinfectant questions..

Discussion in 'First Aid Station' started by gazz98, Jun 2, 2016.

  1. gazz98

    gazz98 Loaded Pockets

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    I signed up for a Red Cross class in July to get certified in First Aid/CPR/AED.

    1. I read that some folks carry all or some combination of aspirin, acetaminophen, and ibuprofen. Many carry aspirin because it thins the blood and can help with heart issues yet you have to be careful giving to kids under 18 due to Reyes Syndrome. Acetaminophen pain and fever reducer. Ibuprofen for pain due to inflammation. Do you carry all 3? The Red Cross FAKs on their site only contain aspirin. Do you folks have any problem with generic version (Walmart, Target) of these drugs?

    2. Antiseptic, H peroxide, or alcohol wipes? Any real advantage/disadvantage to any of these? I like that they come in "sugar packets" for individual use. I'm guessing no one is rocking a bottle of H peroxide or Iodine anymore.

    3. Do you carry antibiotic cream in addition to wipes?

    My current FAK is about a 6"x7"x2" pre-made kit by J&J so space was at a premium. I just ordered a LAPolicegear small bail out bag to house the new FAK + other daily essentials (digital multimeter, some tools, etc).

    Thanks for reading this long post...
     
    Last edited by gazz98, Jun 3, 2016
  2. VinnyP
    • In Omnia Paratus

    VinnyP Loaded Pockets

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    Wow any of those three questions could start a row :)

    This is my take there will be others.

    Aspirin (In the UK) is one of the few drugs that a lay first aider can give out (Not for pain relief but for chest pain). Obviously for your own use or your family whatever works for you.

    http://hubpages.com/misc/Guide-to-First-Aid-Swabs-Towelettes-Wipes

    .. may help with question 2. But there is a lot of controversy. Bottom line Alcohol is for cleaning things and maybe your hands not for wounds. Hydrogen Peroxide is better at whitening teeth than using on wounds ...
    http://www.medscape.com/viewarticle/456300_3
    Chlorhexidine, Benzalkonium Chloride or Povidone iodine is usually OK for wound cleaning.

    Topical antibiotic is another controversial one. Carry it but the more people use it the more resistant bacteria will become. If it's a rusty nail in a farm yard then it's probably a good idea, paper cut or an ouchey knee probably not.
     
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  3. Blackheart

    Blackheart Loaded Pockets

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    I keep all of those on hand mostly for other people. Everyone has their own preference.

    You forgot one: naproxen (Aleve is one brand name). I found this to work better, for me anyway, than any of the others for pain. There's also aspirin and caffeine combo pills and powders (Excedrin is one, BC Powder is another) that a lot of people find helpful.

    There's nothing wrong with generics.
     
    Last edited by Blackheart, Jun 2, 2016
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  4. Westerdutch

    Westerdutch Loaded Pockets

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    For what its worth, i carry a little bottle of Chlorhexidine digluconate (great for cleaning abrasions with lots of crap in em but stings like a mofo) and a tube of povidone-iodine that i use to dab on band-aids or gauze when i have to pack a wound closed. I carry those two mostly because they are readily available here in very nice compact little packages and just work for me.
     
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  5. jag-engr
    • Administrator

    jag-engr Semper Bufo!
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    I would recommend generic brands, so that you don't feel bad throwing them away and getting new ones every couple of years. If you store your first aid kit in a hot vehicle (not recommended), you will need to change out the medications even more frequently.
     
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  6. graveyard

    graveyard Loaded Pockets

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    For question #2 I recommend sterile saline wound wash. Look for individual use ampules for your FAK, they may be harder to find than the large spray cans at your corner drug store. Very handy though!
     
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  7. Timlugia

    Timlugia Loaded Pockets

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    There is really no need to carry saline just for wound wash, recent studies prove that saline is no more effective than tap water.
    In fact, water pressure is a far more a deciding factor than the solution itself, hence many medical kits today has a syringe for disinfection.

    For antibiotics, I use those little dose packs.
    They are smaller and easier to use than a whole tube from the pharmacy.
     
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  8. Blackheart

    Blackheart Loaded Pockets

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    I used to be able to get saline solution in 1oz. tubes with tear-off tabs. One could squeeze the tube and get a good stream out of it, handy for flushing out an eye. Sadly, I haven't seen those 1oz. tubes in a loooong time.
     
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  9. graveyard

    graveyard Loaded Pockets

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    I get what you are saying, but most of the time when I need my FAK, I'm nowhere near tap water. Or any source of potable water. That might be different for some people.
     
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  10. Swe_Nurse

    Swe_Nurse Loaded Pockets

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    Even so you might not benefit from a smal amount of saline. Theres a risk that it will push debris further into the wound. If you carry drinking water it is far better (due to the volume).

    Sent from my D6503 using Tapatalk
     
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  11. polak187

    polak187 Loaded Pockets

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    What you should carry is 81mg chewable aspirin. Standard dose of admin is 365mg which is 4 tablets. Chew them don't swallow. Now very rarely a young person will have a cardiac condition and even rarer would be that same person with cardiac condition and rayes syndrome. So extremely rare that in my entire ems career I haven't seen both of them come up on the deck at the same time. You have a kid/teenager with chest pain most likely it's traumatic and Aspirin won't help. The most important thing about using Asa is allergy to that drug. As far as the otc pain killers go figure out what works best for you. You are the primary recipient of your kit so choose what works best for you. I don't care much for brand names. Generic versions are fine. Pay attention to expiration dates if you are not carrying them in original containers.

    Peroxide is fine but like you already observed it comes in rather inconvenient packaging. It also looses its potency when exposed to air and light so putting it in smaller container is pointless. That's where alcohol wipes and iodine wipes are better. They are handy and easier to carry.

    You can get antibiotic cream in small pockets. Handy and really helpful. Besides reducing risk of infection it also reduced scaring and speeds up healing.

    Short of aspirin which is really a life saving drug most of the small faks are comfort kits. They will treat a headache and small cuts but that's about it. Unless you planning to expand your kit to include other trauma supplies and meds you are limited to what you can treat. As much as I prefer to save and buy things in larger quantities I found out that in the long run I'm saving money if I buy items that I don't use frequently in individual packages because of the expiration or simple wear and tear meaning things shifting and banging in your kit.


    Sent from my iPhone using Tapatalk
     
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  12. graveyard

    graveyard Loaded Pockets

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  13. thekapow

    thekapow EDC Junkie!!!!!

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    antibiotic cream is only good for one thing in my opinion - boosting the worldwide crisis of antibiotic resistance. In the OR we use saline, clean water would work just as well as Swe_Nurse stated.

    You need to read up on modern wound care if you are considering H peroxide, more studies continue to accumulate indicating that hydrogen peroxide is not only ineffective when it comes to aiding overall wound healing stages, but can also slow down the entire process.
     
  14. Blackheart

    Blackheart Loaded Pockets

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  15. Timlugia

    Timlugia Loaded Pockets

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    And for those of you who are not familiar with ACCP classification
    Taken from
    Wilderness Medical Society Practice Guidelines for Basic Wound Management in the Austere Environment, 2014.
     
    Last edited by Timlugia, Jun 3, 2016
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  16. graveyard

    graveyard Loaded Pockets

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    In reference to the above post... Agreed. Sterile saline low pressure wound wash is probably about as effective as high pressure tap water, and is better than nothing in a wilderness setting if no potable water is available.

    I work in long term healthcare. Effective wound care is a huge part of what we do.

    All our recent training agrees that peroxide is probably more harmful than beneficial.

    For all daily wound care we use low pressure saline. These are not traumatic, dirty, new wounds though. In the wilderness, for new wounds, whatever clean water you have is better than nothing. So a little sterile saline in your FAK is probably a good idea. Can't hurt anything.
     
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  17. mirrorsbrightly

    mirrorsbrightly Loaded Pockets

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    That is awesome that you are getting some training! If you want to learn a little more without spending money YouTube is your friend. I will often YouTube different medical topics I want to brush up on or learn about.
    4 - 81 mg chewable aspirin is the way to go for chest pain. So 324 mg total. Another OTC med you should carry is Benadryl for allergic reactions.
     
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  18. Weko

    Weko Loaded Pockets

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    Adventure Medical is packaging hydrogen peroxide in 1 oz foil packages for use in inducing vomiting in their dog first aid kits. It's about the only thing I use it for these days. The are also making 3.4 oz bottles of saline for wound flushing, refills sold separately. I've started including large safety pins in my kits that don't have them. Aside from obvious uses, can be used to make a hole in a sealed water bottle for directed flushing
     
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  19. Swe_Nurse

    Swe_Nurse Loaded Pockets

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    How do you reach that conclusion? Sterile saline is not better than tap water and it's definitely not better (or equivalent) under low pressure.

    And no, it is not necessarily better than nothing. As I said before low pressure "cleaning" can potentially push debris and microorganisms further into a wound, which is bad news. If you're hours away from tap water it makes no sense to try to clean the wound with small amounts of saline. If you're days away you need a source of drinking water anyway.

    On top of that you have to actually carry however much saline which takes up space and weight. To get any kind of benefit you have to carry at least 100 ml which is a fairly large sized bottle. 10 ml and 20 ml will do nothing.
     
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  20. graveyard

    graveyard Loaded Pockets

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    From the above referenced material.

    "Wounds irrigated with tap water have demonstrated an equivalent, or lower, incidence of infection compared with wounds irrigated using sterile saline solution."

    "A Cochrane review including 11 randomized controlled trials showed no statistically significant differences in infection rates between wounds (including acute and chronic wounds in adults and children) that were cleansed with tap water or normal saline solution."

    "Although very high pressure irrigation decreases bacterial counts acutely, it may result in a significantly greater rebound bacterial count at 48 hours59 when compared with low- or high-pressure irrigation."

    "The optimal volume of irrigation that should be used is unknown."
     
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