The First Aid Kit Thread
- Thread starter Dave
- Start date
100% this. Sutures are not to be done in the field.
Dealt with a nasty flap avulsion once. Knew it was going to need stitches but we knew we couldn't/shouldn't do them in the field. Put a non-stick pad under the flap, wrapped with a metric ton of gauze and a compression bandage. ER Doc thanked us profusely saying it would have been 10x more painful to rip out hastily done stitches and separate the skin (not to mention infection risk) and also applauded our decision to insert the non-stick pad. It made (re)cleaning the wound easier and allowed them to remove some potentially necrotic tissue before they stitched it up. By leaving the flap on there it also prevented them from needing to do a skin graph. They ended up applying three rows of sutures. Two internal that would eventually dissolve and one really nice row on the outside that was super tight. The scar wasn't as bad as one would expect from such a wound.
So yeah, long story short: clean, stabilize, transport, let the ER deal with closing it up.
Dealt with a nasty flap avulsion once. Knew it was going to need stitches but we knew we couldn't/shouldn't do them in the field. Put a non-stick pad under the flap, wrapped with a metric ton of gauze and a compression bandage. ER Doc thanked us profusely saying it would have been 10x more painful to rip out hastily done stitches and separate the skin (not to mention infection risk) and also applauded our decision to insert the non-stick pad. It made (re)cleaning the wound easier and allowed them to remove some potentially necrotic tissue before they stitched it up. By leaving the flap on there it also prevented them from needing to do a skin graph. They ended up applying three rows of sutures. Two internal that would eventually dissolve and one really nice row on the outside that was super tight. The scar wasn't as bad as one would expect from such a wound.
So yeah, long story short: clean, stabilize, transport, let the ER deal with closing it up.
Stabilization is key, and provides much needed RELIEF to the patient. Like a child with a "band aid", there is a very real psychological component here. If you can see the boo boo, or the blood, you are more stressed.
Stabilizing not only provides much needed pain relief, but it also provides a respite from the visuals associated with the injury.
Makes transport so much easier for everyone if you package them well. Also remember to keep them warm - that mylar survival blanket and some duct tape will do wonders to prevent shock
Stabilizing not only provides much needed pain relief, but it also provides a respite from the visuals associated with the injury.
Makes transport so much easier for everyone if you package them well. Also remember to keep them warm - that mylar survival blanket and some duct tape will do wonders to prevent shock
The body needs water to fight infection. And drinking water promotes circulation as it keeps tissue supple. A little glucose doesn't hurt either.
Good timing on the bump to this thread. I finally pulled the trigger and ordered the BROG "Medium" FAK bag. It's arriving today and I'm excited to start transferring stuff into it tonight.
My wife gave me some (good natured) ribbing this week: "I'm not sure what exactly it says about you that you're so excited to spend $100 on an empty bag, but it says something."
I'll own that!
My wife gave me some (good natured) ribbing this week: "I'm not sure what exactly it says about you that you're so excited to spend $100 on an empty bag, but it says something."
I'll own that!
Good timing on the bump to this thread. I finally pulled the trigger and ordered the BROG "Medium" FAK bag. It's arriving today and I'm excited to start transferring stuff into it tonight.
My wife gave me some (good natured) ribbing this week: "I'm not sure what exactly it says about you that you're so excited to spend $100 on an empty bag, but it says something."
I'll own that!
My wife gave me some (good natured) ribbing this week: "I'm not sure what exactly it says about you that you're so excited to spend $100 on an empty bag, but it says something."
I'll own that!
The best reason to buy a new First Aid Kit bag is because your old one is starting to fall apart. The second best reason is because it forces you to take inventory and re-stock. I've replaced all of the meds and adhesive bandages from the old kit. The meds because it's easier to ensure I've got full-stock on everything that might have been whittled away by use, and the adhesive stuff because I DO find that such bandages stop sticking as well after 10 years...
Also supplementing with more gauze items - more and bigger pads and many additional rolls.
This isn't even everything - I realized I should grab a photo after I'd already started loading stuff over to the BROG kit bag.
Overall, I'm pretty happy with the organization the BROG bag affords. I'm probably going to re-pack these a little - I'm waiting on a small tear-away pouch that I'll use on the front panel as a "boo boo" kit (and to relocate the gloves and EMT shears to).
I'm also upgrading a few more items - better tweezers and supplementing the disposable thermometer strips with a reusable one.
There's still some room left, but packing in everything from the original (differently shaped) bag would break the organization a little bit. I've dropped from three instant-ice packs to two (bulky items) and eliminated one of the huge 2" rolls of self-adherent wrap as it's redundant to the other wraps and tapes I have since added to the kit.
Also supplementing with more gauze items - more and bigger pads and many additional rolls.
This isn't even everything - I realized I should grab a photo after I'd already started loading stuff over to the BROG kit bag.
Overall, I'm pretty happy with the organization the BROG bag affords. I'm probably going to re-pack these a little - I'm waiting on a small tear-away pouch that I'll use on the front panel as a "boo boo" kit (and to relocate the gloves and EMT shears to).
I'm also upgrading a few more items - better tweezers and supplementing the disposable thermometer strips with a reusable one.
There's still some room left, but packing in everything from the original (differently shaped) bag would break the organization a little bit. I've dropped from three instant-ice packs to two (bulky items) and eliminated one of the huge 2" rolls of self-adherent wrap as it's redundant to the other wraps and tapes I have since added to the kit.
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I keep a "boo-boo kit" few commonly used items in my truck cab even though I don't have kids. There are a couple of Band-aids brand plasters* with a rubber band around them in my center console since I'm far more likely to need them than anything else, simply to keep blood stains off anything. A small bottle of Ibuprofen, a small bottle of Zyrtec and a roll of Tums. There's always a spare bandana in there too. I keep a small "blow out kit" in the door pocket. The boo-boo kit is actually one of those cheap Toyota branded "1st Aid kits" that came in a FJ Cruiser that I was given; I hesitate to call it a 1st aid kit and I certainly wouldn't spend money for it. It's Velcroed to the cabinet in the back, easily accessible when you open the camper shell/tailgate and contains small commonly used stuff including a magnifying glass and a tick remover; most of the stuff that came in it is/was junk and got tossed. There is a more extensive kit in the cabinet but still not what I see a lot of folks carrying. I've been a paramedic for twenty five years now, much of it working remote duty/austere, and I'm always amazed at how much stuff many folks carry- and even more so when you realize most of them have minimal 1st aid training and they're often the first to want to jump in. Just my experience.
*I have yet to find any off-name brands that are worth even buying.
Edited since the actual "boo-boo kit" is in the back of the truck and there's only a few comfort items and a blow out kit in the cab itself.
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100% this. Sutures are not to be done in the field.
Dealt with a nasty flap avulsion once. Knew it was going to need stitches but we knew we couldn't/shouldn't do them in the field. Put a non-stick pad under the flap, wrapped with a metric ton of gauze and a compression bandage. ER Doc thanked us profusely saying it would have been 10x more painful to rip out hastily done stitches and separate the skin (not to mention infection risk) and also applauded our decision to insert the non-stick pad. It made (re)cleaning the wound easier and allowed them to remove some potentially necrotic tissue before they stitched it up. By leaving the flap on there it also prevented them from needing to do a skin graph. They ended up applying three rows of sutures. Two internal that would eventually dissolve and one really nice row on the outside that was super tight. The scar wasn't as bad as one would expect from such a wound.
So yeah, long story short: clean, stabilize, transport, let the ER deal with closing it up.
Dealt with a nasty flap avulsion once. Knew it was going to need stitches but we knew we couldn't/shouldn't do them in the field. Put a non-stick pad under the flap, wrapped with a metric ton of gauze and a compression bandage. ER Doc thanked us profusely saying it would have been 10x more painful to rip out hastily done stitches and separate the skin (not to mention infection risk) and also applauded our decision to insert the non-stick pad. It made (re)cleaning the wound easier and allowed them to remove some potentially necrotic tissue before they stitched it up. By leaving the flap on there it also prevented them from needing to do a skin graph. They ended up applying three rows of sutures. Two internal that would eventually dissolve and one really nice row on the outside that was super tight. The scar wasn't as bad as one would expect from such a wound.
So yeah, long story short: clean, stabilize, transport, let the ER deal with closing it up.
The doc in Kanab thanked me for not pulling the melted crocs off - the damage would have been much more severe and infection risk would have greatly increased. The moral of the story - know your limitations and don’t make matters worse.
