First Aid

Posted: December 1, 2014 in Medicine
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flag_of_the_red_crossThis is a topic dear to my heart.  I have received a lot of requests for this one.  I guess that makes sense since I do have some expertise in this field.  I am a surgeon so hopefully I have something to offer.

First off, your level of training dictates the type of stuff you need in your first aid kit.  What I need and want would be different from you.  Remember KISS.  Don’t get too fancy.  Most off the shelf first aid kits are overpriced bags of band aids.  I don’t like most of them.  That being said something is better than nothing.  I recommend building your own kit and will offer some suggestions.  BUT if you don’t have the time or will to make your own kit buy one and add to it.  You need a good kit for home and a smaller one for your car.

The most important thing you can do is get some training.  Take a course, read a book, watch videos.  Get a good first aid reference for the travel kit and at home.  Learn as much as you can but have a good reference.  I still use books all the time in my specialty.  No one knows everything.  Where There is No Doctor is a good home reference.  Living Ready Pocket Manual is decent for a travel kit.  There are multiple small reference cards and pamphlets available.  You really want to be familiar with whatever reference you have.  At least look through it a few times to familiarize yourself with its contents and layout.  Better yet would be to read it fully.  The Army First Aid Field Manual is also very good, and cheap.

If you have no medical training you will be treating a limited spectrum of injuries.  Mostly you will be treating skin issues. Cuts, abrasions, lacerations, splinters, etc.  This is where the band aids come into play.  Clean the wound thoroughly with water, tap water is fine.  Clean water is important.  Sterilize it if need be (boiling, tablets, filter, etc).  Use a lot of water, say 1 liter for good measure.  Apply antibiotic ointment (not essential) and then apply the dressing.  I prefer bacitracin to triple antibiotic ointment (neosporin).  I rarely ever use triple antibiotics (they cause a lot of skin reactions and rashes.)  Use an appropriate sized bandaid.  Keep the wound clean and change the bandages if they get soiled or soaked.  Change them at least daily if they stay fairly clean.  Avoiding infection is the key here.  Increased redness, pain, swelling and pus are signs of infection.  Seek more advanced medical attention if this happens.

Contrary to popular belief wounds heal faster if kept moist.  Not wet, but moist.  A thin layer of vaseline (or bacitracin) with a dressing over it allows the epithelial (skin) cells to regrow faster.

For moderate sized wounds you can improvise a bandage with gauze and tape.  Maxi pads work well for larger wounds and heavier bleeding.  They are much cheaper than ABD pads and other medical dressings.  Just get some and throw a few in your first aid kit.

For bigger wounds clean as described above.  Do not clean inside the wound with alcohol or peroxide.  Just lots of water.  If the wound is very large you are better off leaving it open.  It will eventually heal.  Keep it clean and covered with clean dressings.  Using suture, staples or steri strips is probably too advanced with no medical training, but these are viable options for large wounds.  Larger wounds should not be closed after 24 hours due to risk of infection.

If you run into severe bleeding apply constant, direct pressure.  This one tip could save your life.  PRESSURE is the answer to everything… well bleeding at least.  Pressure, pressure, pressure.  Get the picture?  Almost all bleeding will stop with direct pressure.  Do it as long as it takes.  You’ll be amazed by how well this works.  If I injure a major vessel in surgery guess what I do?  Apply direct pressure!  This may be the most useful tip in this whole post.

Bug bites – Best to avoid these with bug spray, bug nets, etc.  If you get them avoid scratching or traumatizing the skin which can lead to infection.  Again keep clean.  Hydrocortisone cream is helpful for itching.

Diarrhea and dehydration – this is a major killer throughout the world.  Poor sanitation and contaminated water lead to diarrhea.  Diarrhea leads to dehydration and ultimately death.  Get generic imodium tablets (loperamide) and take as directed.  Electrolyte salts are great for dehydration.  Drink lots of water, gatorade, pedialyte, etc.  This combination (loperamide and electrolytes) will save lives.  Have this in your food storage plan.

Pain killers – have tylenol and ibuprofen in all of your kits.  Stock up for your food storage.  Do not take more than 3000mg of tylenol or 2400mg of ibuprofen in a day.  They cause liver and kidney toxicity respectively.  Both are actually very good pain killers.  Ibuprofen has an anti-inflammatory property at the 600-800mg dose.

Benadryl (diphenhydramine)- you can take 25-50mg (usually one to two pills).  This drug has many uses.  Great for an allergic reaction.  It is a great sleeping aid.  It is also a very good anti-nausea medication.  Drugs like bonine and dramamine are derived from benadryl.  It will make you drowsy – see sleeping aid!

A word about expiration dates.  They are completely made up numbers based on nothing at all.  The government has tested drugs they have stored for the army over 20 years later.  Guess what?  The vast majority of them are fine.  They might lose a little potency but don’t magically turn into poison.

first aid kitThis is a decent First Aid Kit that I keep in my wife’s car.  She has even used it!  I bought it for $30 dollars 1 year ago.  This was an okay price.  It is now $40 and really too expensive in my opinion.  I would add a good penlight or headlight, scissors, and tweezers immediately. I would also add the meds above.

If you are trained in CPR get a CPR shield, the above kit has one.  If you aren’t trained in CPR consider taking a course.  Get a few sets of gloves, nitrile work well.  Consider getting involved with your local CERT.  https://www.fema.gov/community-emergency-response-teams  You will learn a lot and most of it is free or pretty cheap.

As usual, get something and make sure you have it around.  Be familiar with what is in it and how to use it.

First Aid Kit: Suggestions from today’s post

Reference book

Band Aids: assorted sizes

Gauze pads – 4×4

Maxi pads

Bacitracin

Tape

Tylenol

Ibuprofen

Loperamide

Electrolyte salts

Diphenhydramine

Gloves

Scissors

Headlight

Penlight

Tweezers

Hydrocortisone cream

Not discussed above but good to have:

Duct tape

Ace bandage

Bandana or triangle dressing

Burn gel

Safety pins

Anti-bacterial wipes

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