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Old 02-19-2013, 11:37 AM   #69
Gnarly Adventurer
Joined: Feb 2013
Location: Albany, NY
Oddometer: 104

Originally Posted by john e View Post
good on you for stepping up to help out a fellow rider. Just a couple of things about your suggestions that i'd change.

Get rid of the 2x2's and the 6x6's. Use 4x4's and a couple of abdominal bandages, they'll absorb more fluid and the 4x4's can always be folded or cut down. Individually wrapped, sterile 4x4's can be found at any drugstore, they're cheap and pack flat, get as many plies/thickness as possible for maximum absorption.

Antiseptic wipes are far better than alcohol wipes for cleaning any sort of broken skin, alcohol will burn and it is cytotoxic, kills the good cells as well as the bad ones. Bzk (benzalkonium chloride) wipes are bigger, work better and don't sting. They're also cheap if you buy a box of 100. I do keep a couple of alcohol wipes in my tool kit in case i ever need to apply loctite or epoxy to something, they work well for cleaning plastic and metal.

More gloves is better. Like at least 6 pairs. Nitrile is probably best as they're hypoallergenic, good for you, good for the patient.

I'd skip the vet wrap, in my experience it's not all it's cracked up to be. Once it's been stretched out it loses it's elasticity very quickly and falls off. I'd use a couple of 6" elastic bandages and tape. The elastic bandages can also be used with your splint, to hold a cold pack in place, to immobilize a dislocated or broken extremity even if you don't have a splint.

For a compression bandage, pick up an "izzy", an israeli combat bandage. They're great, they can be self applied as well as used on others. Come in a sterile package, available in 4"and 6" widths. One should suffice for the average kit.

For a splint, pick up a sam or one of the many no-name copies. Aluminum bonded with some thin foam padding they can be cut, folded, modded into just about anything. I've used them to make finger splints, just cut off a slice and make sure the edges aren't sharp. They come rolled up, very handy.

If the recommended use for the benadryl is for treatment of insect stings, get a small bottle of the children's liquid. It's much faster acting. They also make benadryl in a gel form, great for topical applications but not for internal usage. If you or anyone you're traveling with is known to be susceptible to anaphylaxis from insect stings, make sure you or they are carrying an up to date epi pen. Same thing for known diabetics and asthma sufferers, don't be like a lot of my patients and tell me that you left your epi pen, inhaler, and insulin at home. Something to remember about benadryl, it will make you drowsy, not recommended if you or the patient is going to be continuing to ride.

Saline can be found in small 20-30 ml individually sterilized squeeze bottles, very handy for flushing out wounds and debris from the eyes as well.

I'd also think about getting some sort of tourniquet, a cat or something equivalent and make sure it's not a chinese ripoff design. The protocols for treating arterial bleeding in extremities is pressure bandages followed by use of a tourniquet in many areas now. If you should come across or be involved in an incident in which a person has suffered from a traumatic injury to an extremity, you'll never stop the bleeding by trying to find a pressure point, particularly if they're wearing a riding suit. A properly applied tourniquet will save a limb as well as life in an extreme injury situation. In addition to actually stopping the bleeding, a tourniquet allows a single caregiver to deal with multiple patients once it's been applied correctly.

I'd also toss a small headlamp in with the first aid kit, it sucks to not be able to see what you're doing and you can't do much with one hand holding a flashlight.

I'd also consider separating the true "first aid" stuff from the "booboo" stuff. If you come across an accident, you need to be able to access that tourniquet or izzy right now, the pain relievers and bandaids can go into a separate bag or box to be used as needed. I keep a couple of bandaid, some advil, tums and a small bottle of eye drops in a little zippered case inside my tankbag for easy, non-emergent use. The real stuff is in a separate trauma bag. All i'm really concerned with in an emergent situation is trying to ensure the patient is breathing and trying to stop traumatic blood loss. The road rash etc. Can be fixed later when you've got everyone off to the side of the road or trail. Same thing with medications.

For reference, i am a licensed, working emt in the state of california but i'm not a doctor, in particular i'm not your doctor so take everything i've written with a grain of salt and don't rely on it to save yours or anyone else's life without further training.
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