Talkback: Monday Tip - First Aid Kits

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18/06/2012 at 12:22
Steristrips are better than butterfly sutures, 'cause they work on scalp better (so I'm told, not been in a position to compare). So better to go for them than the butterflies.

Pete.
18/06/2012 at 18:16

> Steristrips are better than butterfly sutures

I'd go with Leukostrips; they're not paper, and thus more durable in an outdoor setting.  And I can get them...

My thoughts on outdoor FAK (and those of other UKC readers, especially vark's).  I assumed help available within a few hours.

The topic also came up recently on backpackinglight, and has had a recent post that's very similar in theme to vark's on UKC.

18/06/2012 at 19:03

As the article points out, basic first aid knowledge - including CPR - is more importantant than the FAK itself.

The suggested list includes ibuprofen or aspirin tablets (presumably as a general analgesic?) but given its anti-inflammatory properties I prefer to pack a tube of ibuprofen gel because I find it more swift and effective in relieving localised pain (in knees or ankles, for example). I also carry a small plastic bottle of antiseptic hand gel instead of the impregnated wipes.

A few Compeeds in a pocket are a must, FAK or no FAK.

18/06/2012 at 19:44

The point about training being more important than specific FAK items is undoubtedly true, but also bloody difficult to maintain if you're not involved regularly in some kind of medical or rescue career or service.

I'm a recreational outdoors type. Twice in the last 25 years I've had cause to attend a 2 or 3 day outdoors first aid course and come away with a certificate valid for 3 years (the last time about 6 years ago). Both times, within a matter of months certainly, weeks probably, all that crammed knowledge has ebbed away and I'd have dreaded being called upon to try to put it into practice. Training is only really going to be effective if the skills are part of your day job or if you undertake regular refresher training  - which tends to be far more practical for outdoor professionals or MR personnel than for casual hill-goers.

18/06/2012 at 19:53

I'm not a UKC member, so can't read their recommendations

Strappal tape is hugely sticky and good for holding blister pads and dressings in place. I've not had to test it on holding a temporary splint so far.

18/06/2012 at 20:12
Are the compeeds for you or others? Eliminating the cause is very easy to make them redundant. Would't that then make compeeds SAK (second aid kit)
18/06/2012 at 20:56
Mainly for others, Parky. Just an occasional bit tape is usually enough for me.
18/06/2012 at 21:31

You carry plasters for someone else just in case. Blimey, does this largesse extend to useful and heavy items?

18/06/2012 at 22:09
Yes Don't you?
18/06/2012 at 22:11
ed h wrote (see)

... does this largesse extend to useful and heavy items?

Like a fridge full of beers?

18/06/2012 at 22:26

Right on....non-alcoholic one's of course

19/06/2012 at 09:36
A couple of ibuprofen and some plasters (so blood from shallow cuts doesn't get all over my clothes). I've come to the conclusion that it's either minor enough to not be a problem - or severe enough that a FAK just isn't going to cut it. Blisters? Walk through the pain, it goes away.

I could probably make a case for a small roll of gaffer tape. That's what I initially used to hold my hand together when I broke it a year ago in Knoydart, but it was less comfortable than simply pressing the broken bone into place with my other hand, so I took it off. You could use it to hold a t-shirt around a bigger wound in lieu of a bandage, I suppose. But then, I only had the gaffer tape because I was on my bike...
19/06/2012 at 09:45
Montgomery Wick wrote (see)
 Blisters? Walk through the pain, it goes away. I could probably make a case for a small roll of gaffer tape. That's what I initially used to hold my hand together when I broke it a year ago in Knoydart, but it was less comfortable than simply pressing the broken bone into place with my other hand, so I took it off.

I really grazed my knee once in Surrey
19/06/2012 at 19:35

For blisters, which fourtunatly I very rarely get, I use zinc oxide tape, the 'white' stuff.

 I have yet to find a way to get the likes of compeed to stay on.

19/06/2012 at 20:06
Friars balsam was good for making tape stick to sore points when I went for a spell of foot bother.   I had a split head sorted with superglue at a&e years ago.  Much easier than a plaster unless bald.
19/06/2012 at 23:35
huskyman wrote (see)

For blisters, which fourtunatly I very rarely get, I use zinc oxide tape, the 'white' stuff.

 I have yet to find a way to get the likes of compeed to stay on.

Since finding that using compeed made my socks all gacky, I've always covered over compeeds with quality zinc oxide tape...  lasts for days n days even when got wet feet...


Personal FAK,Backpacking,  I take Compeed, ZO tape, a couple of medium non stick dressings, a sanitary towel - various painkillers (some prescription - strong), immodium, a few plasters, steristrips Lavender oil (antiseptic, good for burns stings and bites, headaches, sleeping) and a small tick twister. - in an Aloksak-3"x4"

Daywalking I take compeeds and ZO tape  and painkillers
20/06/2012 at 12:59

> I'm not a UKC member, so can't read their recommendations

My comments on the UKC thread:

<captain>

I think, fundamentally, we have to ask what the purpose of a FAK is. To be perfectly frank, most FAK items are for providing comfort, or for the prevention of infection (to the 'casualty' from the environment or from the 'casualty' to other people). They really have little function for anything life-threatening, since they generally assume an urban location within 8 minutes of an emergency ambulance.

Quite clearly, this is not the case for rural and mountain environments. However, in these environments, we can probably dispense with the 'there, there, Mummy make it better' comfort. And, assuming we're only hours from civilisation, we can probably ignore the issue of casualty infection, since such infections are unlikely to be life-threatening in that timescale, and can be treated with antibiotics once we're back in civilisation.

So, most simple cuts and grazes can be dealt with by a simple water wash, and maybe covering with a bit of Micropore tape.

Blisters are best dealt with using specialist hydrocolloid patches.

More interesting in terms of choices of action are ankle sprains; minor sprains may be dealt with by simply tightening a boot, or using a support bandage, allowing the casualty to self-extract, but more severe sprains may need rescue.

Now for the more interesting injuries, such as severe cuts and fractures. It's likely that in such an event, we would call in emergency rescue, so we need to stabilise the situation for the time it takes for rescue to arrive, which, depending on location, may be a few hours.

For a severe cut where blood loss might prove life-threatening, we need to stem the blood flow, with pressure, tourniquet, or more recent blood-stemming products. Again, whilst infection would be an issue if the wound were left untreated thereafter, in the short term, infection isn't our primary concern; blood loss is. Once we've stemmed the blood loss, then we might clean up in and around the wound, and cover it simply; some spare clothing would do the job pretty well, but you might take a simple bandage.

For fractures, we need to stabilise to prevent pain and reduce blood loss from the fracture (trying to manage shock). So, some means of splinting, along with relevant training and experience. Splinting might simply be gaffer tape and whatever stiff things come to hand; karrimat, sit mat, tent poles, etc.

Then we need to have means to shelter the party with the casualty, to prevent hypothermia.

Beyond that, we're into medical conditions, which start to fall outside the remit of first aid, but aspirin may be useful for minor heart issues; brufen for aches, pains & inflammation; some antihistamine for stings, bites and allergic reactions; something to deal with ticks, and something to prevent the squits should they strike.

20/06/2012 at 12:59

<contd>

So, my FAK for 'day event' use contains:

Micropore tape
various sizes of leukostrip sutures
a 2" bandage
a crepe bandage
pack of Compeed patches
aspirin
brufen
piriton
immodium
a large scalpel blade
O'Tom tick twister
antiseptic wipes

I'd like to add a sachet of coagulant powder such as Celox, if I could get one.

I carry gaffer tape, a 3mm JiffyFoam sit/casmat, a survival bag and spare warm clothing for me as part of my normal kit.

Whilst I acknowledge Caralyn's comments about the revised CPR instructions (I spend quite a lot of time in the CD section of BHF's second-hand shops, so I'm very familiar with Vinny...), again, I'd suggest that these are intended for an 'urban audience', on the assumption that an ambulance isn't far away. For remote CPR, I think breathing may still usefully be employed, even though I do note her observations on survival rates. If dealing with a mate, I'd like to think that I'd really tried my best.

</captain>

Edited: 20/06/2012 at 13:01
20/06/2012 at 12:59
Vark's comments (I think he's an A&E consultant)

<vark>

Most of the time a first aid kit will be used to deal with minor inconveniences. What it should contain therefore depends on the extent to which you want to avoid such inconveniences.
For climbing in the peak I would take a roll off zinc oxide tape. Anything that can't be fixed with tape means going home or calling MR.
Further afield I might take analgesia, antihistamines and an inhaler.

All the talk of resuscitation masks and SAM splints is fairly pointless. If someone needs CPR they will not survive. THere may be the rare opportunity to decompress a tension pneumothorax to treat someones cardiac arrest. This could be done with a big cannula as mentioned above or using a knife to make a thoracostomy. How many people would have the balls to do this? Probably none other than those who do it for a living.
SAM splints work well but there are plenty of other things you could use to improvise. A splint may keeps someones fracture immobilised but it is unlikely to make the difference between walking out and not walking out.

You don't need to carry saline to irrigate wounds. There good evidence that there is no benefit of saline compared to running a wound under a tap so use running water/ your drink etc.

Dressings are not necessary in the early stages. Anything bleeding needs pressure not a particular kind of dressing (unless everyone starts carrying Celox bandages).

Group work will be different because there will be an obligation upon the leader to provide a particular standard of care. The standard of care will not be specific to the outdoors but will be defined in more general terms and hence you will end up lugging around a load of pointless kit

[captain's editorial: this list was quoted earlier in the thread, and vark is commenting on it; it's the BS-8599-1 small FAK list]
1 x First Aid Guidance Leaflet- Not a bad idea but perhaps a bit late at the point you need to use it
4 x Medium Sterile Dressings, 1 x Large Sterile Dressing- bit OTT
2 x Triangular Bandages- can be improvised
6 x Safety Pins- you wouldn't find them used in an ED, everything is fixed with tape
2 x Eye Pad Sterile Dressings- use the above dressings
40 x Sterile Adhesive Dressings (Plasters)- bit OTT
20 x Sterile Cleansing Wipes- use water
1 x Micropore Adhesive Tape- use you finger tape
6 x Nitrile Disposable Gloves (Pairs)- personal choice
2 x Finger Sterile Dressings- pointless, use the dressings above
1 x Resuscitation Face Shield- no use in the wild
1 x Foil Blanket- you will probably have more effective kit with you
1 x Burn Dressing- use the above dressings
1 x Shears - carry a knife
1 x Conforming Bandage- could be improvised.

If you want to make a difference you need proper training rather than kit.

</vark>
20/06/2012 at 13:32

many thanks capt.

it would appear, at least initially, that a further section of "you will die horribly" received wisdom has been consigned to the pointless bin.

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