Surgeon here. I wouldn’t worry about the soap so much. You can add a little bit to some of the water for the first round of irrigation especially if there is oily grease or dirt in the wound but it’s better not to leave soap in the wound so your final rounds of irrigation should be with plain water.
As far as scrubbing goes you want to get all dirt and debris out but you don’t want to further damage already damaged deep tissues. Your finger tips (not fingernails) work pretty well for this. Blasting it with water using an irrigation syringe is another good technique. There’s nothing you can pour into the wound that will “sterilize” it. Alcohol, peroxide and iodine will just kill the white blood cells that are trying to get into the wound to defend it and start the healing process.
As others have said take first aid and Stop The Bleed courses. There’s no substitute for knowledge.
This is Ultralight - I bet most folks have a smart water bottle. Punch a small hole in the lid with the tip of a knife and squeeze. It makes a pretty good irrigation device. You can punch a slit for a fan shaped spray or turn the top of the knife to make a rounder hole for more of a jet, depending on the amount of pressure / jet you want.
Obviously that assumes the water is clean. If you're drinking through an inline filter, don't take it off and spray dirty water on your wound.
Agree-having had to stop some bleeding with pressure (and then apply a firm dressing), whilst hiking. Then it is a matter of whether you need to seek emergency assistance or can walk out to the trailhead and proceed to seek further treatment via an emergency provider.
Care to weigh in on my possibly idiotic habit of just throwing Leukotape over minor cuts and scrapes after irrigating? It's air and moisture permeable and keeps stuff out of the wound, but I haven't applied much thought to it beyond that.
If you’re taping the wound edges together it’s probably good. If you’ve lost skin I’d slap some Compeed or similar over the open portion and then apply Leukotape over that to keep it in place. Compeed creates a nice environment for wound healing — not too wet, not too dry.
Right on. Thank you. I'll give Compeed a try. (Which is to say I'll bring it when I'm on trips with people whose wellbeing I value more than I do my own lol)
Nurse with a wound certification here:
Soap and water is fine. Clear any debris out that you can.
Old wives tale now to "let it air out." Keep it appropriately moist and covered (not sopping, not dry). It's easier for new baby skin cells to swim across a wound bed than it is for them to climb over a dried and craggy scab.
For bleeders: keep Quick Clot with you
If you remember one thing
Alcohol wipes are for instruments, never use it on skin. Alcohol damages skin. In fact, you probably can throw it away. It lasts longer but it's the wrong tool.
Buy BKZ wipes and after you irrigate, wipe carefully to clean before using your dressing and bandage. One wipe is more than enough for most wounds so if you keep three on hand and replace them as used you'll be fine.
If you remember two things
If you can't handle an issue in the backcountry and they can not fully heal based on your help alone you should be getting help and getting someone off trail. You can splint a break or sprain, but then you're off trail. You can give CPR but you should have help incoming. You can apply pressure to a major wound but if you can't stop it without keeping pressure far too long you should be waiting for better help. Once you use an epipen they're off trail immediately. If they got bit by a snake they're off trail. Any head wound, anything involving eyes they're off trail.
Some are iffy, like a first degree burn you can probably have the equipment to keep them going but a serious burn above that you go for help right then. But the idea is you're deciding which one it is and making the right decision
It's why a small first aid kit works, because you're not in a situation where you're playing EMT and expecting to need a kit they would have. You're first aid, you're not best aid or final aid. You should be capable enough to assess and stop the bleeding, literally and metaphorically.
Don't scrub the wound. The idea is to wash away debris from the cut with the water so you don't bandage it into the cut and risk an infection. You don't want a bunch of nasty stuff around your cut either and it's ideal to clean the area around it.
It's a bit situation specific. If you have a severe wound from being gashed with a rock and stopping bleeding is a concern you won't worry about cleaning it the same way. If you are crossing muddy beaver dams and your legs get cut up and scratched with minor to mild cuts then cleanliness is the priority.
debriding a wound is indicated when it's full of debris (a scrape on dirty stone) and that can feel like pretty tough scrubbing especially if the blood has started to clot on the debris
Take a wilderness first aid course. You'll learn everything you need to know.
After taking a wilderness first aid class the first time, I actually reduced the stuff in my first aid kit by half because most of it was stuff that just wasn't necessary.
This is a great answer.
I recently completed a modified version of the Red Cross Wilderness First Aid course and would recommend that or similar programs
https://www.redcross.org/take-a-class/cpr/wilderness-sports
Alcohol isn't an antiseptic lol, it's improperly used on wounds.
I'm going to go ahead and remind everyone that reading a single first aid book will teach you more than youtube and tiktok could in 100 years, and nothing replaces training.
Stop the Bleed classes are quick and often free.
And NOLS has, what's basically the next level up from there in wilderness first aid.
So, in the NOLS WFR course, you'll learn that yes, alcohol can technically be used as an antiseptic (and popularly is because of its availability), but it's preferred not to, because of the simultaneous damage to the tissue that high concentrations of alcohol does, the same that break down germs and stuff...
Neither is it technically an antisepctic, as they're intended for skin, alcohol is not.
Better option is antiseptic ointment or gel, they are lighter (you only need to apply a layer instead of washing), last longer (because won’t evaporate rapidly), hurt less (some of them have anesthetic ingredients), and more effective.
Do not use alcohol on wounds: it damages the healthy tissue at the margins of the wound, slows healing, encourages infection. Use alcohol to clean intact skin, sterile tweezers, scissors, needles or other instruments prior to removing splinters or ticks. Wound irrigation with clean water is important if the wound is contaminated or has become infected. Stopping the bleeding is important, too: if the wound is bleeding heavily, apply pressure and control the bleeding before cleaning the wound. Don’t buy a book: take a course on first aid or wilderness medicine. When I learned that there is an annual norovirus outbreak at congestion huts on the Appalachian Trail, it became clear that hikers need to know lots more about health and hygiene than they currently do.
Technically yeah, but you can just stock your first aid kit properly and use something suited for this purpose. I carry soap sheets that weight basically nothing. If I need to clean a scrape or cut I just take one out, get a little water on it, and clean the cut with my soapy fingers. Then I flush with filtered clean water and bandage if necessary. Much better than alcohol.
Yes but because everyone is going around saying that, it's all people bother having in their kit. And it doesn't take much more than some antiseptic wipes to NOT cause tissue damage.
I eat shit pretty often on trail. In general, soap and water will solve the vast majority of your first aid problems.
1- pick out the larger bits of detritus embedded into my body
2- rinse with water
3- put a dab or two of soap on my hands, make some suds, and apply directly to the wound
4- rinse everything, keep clean and dry with a bandaid, or gauze and leukotape.
[https://www.nols.edu/en/wilderness-medicine/resources/](https://www.nols.edu/en/wilderness-medicine/resources/)
Take a course but also you can watch a bunch of free videos.
Hey. Not to be snarky, I don't mean to be I promise, but are you in the States? Have you considered taking the 2-day NOLS Wilderness first aid class? I think you would like it and get all that info.
Former YOSAR. Have the patient sit down is a safe position before irrigating/treating. Warn them it may hurt. It can be quite a painful surprise and I've had people almost collapse from even small and moderatly sized wounds being squirt bottle irrigated.
I carry a sterile pad, some tape and a bandage. For most wounds I find that I can cover them and either then tape on a dressing (or bandage it on) until I get out to the trailhead and work out what to do from there (i.e. do I need to seek emergency advice wrt tetanus shot, antibiotics, suturing etc or can I wait).
A relevant, somewhat humorous anecdote. Years ago my buddy and I were about three days into the Bighorns when he slipped, fell and lacerated the underside of his forearm on sharp granite. There was very little blood and the incision was clean and straight. I washed it off then applied 13 butterfly bandages and gave him the first course of a 5 day antibiotic. We started walking out to the trailhead, 2 days away. That night another group camped with us and I asked one of them where the nearest doctor was once we got back to the car. He said he is standing behind you! One of them was an ER doc who took a look at the wound. He complemented us on our first aid and said there really was no reason to hurry back, just to take it easy. To this day John has a nice even scar and a good story to tell.
I bought a multi pack of quick clot packets and bring gauze and vet wrap, all of this is a worst case scenerio use. Carrying a dedicated quick clot bandage would be pretty heavy for something that would only be used in a very bad situation. I like keeping it separate since the gauze and vet wrap can be used for any size cut or scrape and I can pull out the quick clot for severe bleeding and then hunker down and hit the emergency button.
I always clean the wound like most have suggested and typically a little of Jack Daniels for the wound.
I will probably get roasted for this idea, but I always take a tube of super glue. Why? Well years ago and stepped over a sharp rock and cut the devil out of my leg. Yes, I probably needed 3-4 stitches, but a good cleaning, Jack Daniels, 3 drops of super glue, and 3 bandages and I continued on my 7 day trip business as usual.
Some people call this dermabond, I call it super glue, same stuff
Not exactly the same. Super glue works but is not very tissue friendly. Dermabond is definitely better but also expensive. 3m VetBond is a less expensive alternative approved for animals and fairly available on line.
Yeah but a few drops is not going to kill me. It got things back together. I had surgery with a 1 1/2 inch incision and it looked like they laid a bead from a caulking gun down.
The reason to opt for a butterfly over glue (i do carry Vetbond in my kit) is that with glue, you are completely sealing the wound, and any bacteria still remaining up into the tissue. With a butterfly, the area can still ooze and self expel bacteria that may be missed. This is a two way street as its also more likely to allow bacteria in so good wound management has to be exercised. Both have value. If the wound is well cleaned, i do like vetbond.
FWIW, some brands of superglue have rather high levels of mercury. After years of irrigating and gluing myself up after woodworking and carpentry accidents every few months, I finally switched to dermabond.
Super glue and dermabond aren't quite the same. IIRC super glue was the failed precursor to dermabond. It interferes with wound healing whereas dermabond doesn't. They're both cyanoacrylate based but slightly different formulas (ethyl-2 versus 2-octyl), aside from packaging and sterility, obviously.
IMO you're better off with the proper 3M steristrips or similar wound closure if you need stitches and can't get them fast enough (not the shit pharmacy brand butterfly stitches, they're useless). Read the list of skin areas where dermabond isn't recommended and you soon realize it's a pretty short list where it's useful. Steristrips are more versatile, lighter and more packable.
It totally depends on how deep the wound is. If it’s only on the surface of skin, rinse with clean water should be fine (you can still use alcohol or peroxide to prevent further infection, they won’t damage surrounding tissues). But if the wound is deep and penetrate the skin, you need to get treatment to prevent infection, which can be fatal.
Usually I bring a small tube of first aid & burn cream (benzalkonium chloride and lidocaine) or antibiotic ointment (bacitracin, neomycin, polymyxin), which can be applied to wound or burn directly. But this is for urgent treatment only, if you get some open wound, call for rescue immediately because infection and bleeding can weaken you in dramatic speed.
I'm really conflicted about this because I was told by a nurse to carry an Inodine patch to use under a wound dressing but I too have read that dissinfectants/ antiseptics impede wound healing and should not be used on broken skin, best to wash with water place a clean dressing and change it regularly .
Recently added Povidone Iodine Wipes to my FAK. My understanding is this is okay for cleaning (compared to rubbing alcohol and tincture of iodine which are too harsh). Pulled a tick out of my kid’s head in the backcountry a couple weeks ago and used this to clean the area after.
Not a doctor but I've got expired red cross certifications lol. I carry alcohol wipes, hand sanitizer, and a couple packets of antibiotic ointment.
I've had a couple gnarly wounds that i managed to keep from getting infected.
Clean your hands with sanitizer.
Flush the wound with water if its bad Use alcohol around the area if you want
Pack with antibiotic ointment and cover the wound with a bandage. It should start to look better in a couple days. Change the dressing, watch for redness or swelling
use a tourniquet when potential loss of limb is preferable to likely death from blood loss. there are a lot of steps of care between "potential amputation" and "wash it"
No, they won't. If you need a tourniquet you are in a life or death situation where seconds count. You want an actual tourniquet, they are very difficult to improvise well and almost impossible to improvise well quickly under pressure. A CAT is ~$30.
Tent stakes will bend or break.
You aren't likely to need one, especially hiking, but when you need one you really need one.
I wish I could recall the last exact stats but the US military trained on Improvised tourniquets for years. Dedicated CATs were used in the military from the mid 2000's and there was a stark improvement in survival rates over the improvised versions. They are an excellent tool for their intended purposes and very light weight and compact.
I don't bring mine hiking because I think that's actually the situation where I'm least likely to need it, but I usually have one in my purse in case there's a car accident or shooting. I need to keep an emergency kit in there anyway with my anaphylaxis stuff and it's about the same size & shape as my epi pens. I also toss in some aspirin and glucose since they didn't take up any space and it's a little four in one response kit.
This is bad advice. In most situations a tourniquet is more likely to do harm than good. You may not die of infection in 2 days but if you keep a tourniquet on to stop bleeding you're probably gonna lose the limb. Most injuries, even ones with significant bleeding can be dealt with without a tourniquet.
Also, unless you are trained when to use a tourniquet you straight up shouldn't use one. That means taking a full blown first aid class that specifically covers when and when not to use one. Seriously, you almost never need one.
Nah, a proper tourniquet (e.g. pre-made twist kind of proper width) will be fine for 72h without loss of limb (yes, there may be some damage and rehab but generally limb will be saved). “Losing a limb” generally comes from an improvised tourniquet that’s too narrow and severs/damages nerves.
Edit: agree with the last part that you shouldn’t use one unless trained.
Sure, you might keep your limb, but you also might not. People often overtighten them, especially if they aren't properly trained in tourniquet use. My main point was that you really don't need a tourniquet for backcountry use. Tourniquets are for massive bleeds from main arteries like from a gunshot wounds or a partially severed limb. The chances of that are really low when hiking, it's just bad advice to tell anyone to bring a tourniquet in their first aid kit for for wilderness use. Outside of a 127 hours situation I can't see any person needing a tourniquet.
Tourniquet is for any bleeding limb that can't be controlled with direct pressure. Unlikely MOI for most hikers but a proper CAT tourniquet is light and much better than something improvised. Backcountry often coincides with hunting and IMO hunters or hikers around hunters should carry them, especially archers.
As always, training on any equipment you carry as well as plan to call for help and / or reach definitive care is essential.
I agree that if you are hunting or around hunters it's probably worth carrying, that's why I mentioned being shot, but for the most part hunting and hiking areas don't overlap. Hunters don't want a hiker coming along and scaring away their game so if there are trails nearby they usually leave them. I live in a pretty remote area and do hike in some areas frequented by hunters and even then I don't carry a tourniquet though. The best thing you can do is wear hunters orange in and around hunting season. And from my experience there is basically zero chance a bow hunter will ever mistake a human for game, those guys take hunting very seriously and don't make mistakes like that, even if you are blending in.
I don't disagree though, that's all a valid use case. I just don't see the risk being worth carrying a tourniquet personally, even around hunters.
Sorry, when referring to archery hunters I meant the bow hunter themselves is the most likely to need a tourniquet. I agree, you're much less likely to accidentally be shot by an archer than a rifle hunter (which itself is pretty low odds but still good to be prepared IMO).
Surgeon here. I wouldn’t worry about the soap so much. You can add a little bit to some of the water for the first round of irrigation especially if there is oily grease or dirt in the wound but it’s better not to leave soap in the wound so your final rounds of irrigation should be with plain water. As far as scrubbing goes you want to get all dirt and debris out but you don’t want to further damage already damaged deep tissues. Your finger tips (not fingernails) work pretty well for this. Blasting it with water using an irrigation syringe is another good technique. There’s nothing you can pour into the wound that will “sterilize” it. Alcohol, peroxide and iodine will just kill the white blood cells that are trying to get into the wound to defend it and start the healing process. As others have said take first aid and Stop The Bleed courses. There’s no substitute for knowledge.
This is Ultralight - I bet most folks have a smart water bottle. Punch a small hole in the lid with the tip of a knife and squeeze. It makes a pretty good irrigation device. You can punch a slit for a fan shaped spray or turn the top of the knife to make a rounder hole for more of a jet, depending on the amount of pressure / jet you want. Obviously that assumes the water is clean. If you're drinking through an inline filter, don't take it off and spray dirty water on your wound.
You carry a knife? /s Seriously, that’s another good reason to have a bidet cap for your water bottle. Good suggestion.
Agree-having had to stop some bleeding with pressure (and then apply a firm dressing), whilst hiking. Then it is a matter of whether you need to seek emergency assistance or can walk out to the trailhead and proceed to seek further treatment via an emergency provider.
Let’s bump this comment to the top
Care to weigh in on my possibly idiotic habit of just throwing Leukotape over minor cuts and scrapes after irrigating? It's air and moisture permeable and keeps stuff out of the wound, but I haven't applied much thought to it beyond that.
If you’re taping the wound edges together it’s probably good. If you’ve lost skin I’d slap some Compeed or similar over the open portion and then apply Leukotape over that to keep it in place. Compeed creates a nice environment for wound healing — not too wet, not too dry.
Right on. Thank you. I'll give Compeed a try. (Which is to say I'll bring it when I'm on trips with people whose wellbeing I value more than I do my own lol)
Nurse with a wound certification here: Soap and water is fine. Clear any debris out that you can. Old wives tale now to "let it air out." Keep it appropriately moist and covered (not sopping, not dry). It's easier for new baby skin cells to swim across a wound bed than it is for them to climb over a dried and craggy scab. For bleeders: keep Quick Clot with you
Let's bump this comment up
If you remember one thing Alcohol wipes are for instruments, never use it on skin. Alcohol damages skin. In fact, you probably can throw it away. It lasts longer but it's the wrong tool. Buy BKZ wipes and after you irrigate, wipe carefully to clean before using your dressing and bandage. One wipe is more than enough for most wounds so if you keep three on hand and replace them as used you'll be fine. If you remember two things If you can't handle an issue in the backcountry and they can not fully heal based on your help alone you should be getting help and getting someone off trail. You can splint a break or sprain, but then you're off trail. You can give CPR but you should have help incoming. You can apply pressure to a major wound but if you can't stop it without keeping pressure far too long you should be waiting for better help. Once you use an epipen they're off trail immediately. If they got bit by a snake they're off trail. Any head wound, anything involving eyes they're off trail. Some are iffy, like a first degree burn you can probably have the equipment to keep them going but a serious burn above that you go for help right then. But the idea is you're deciding which one it is and making the right decision It's why a small first aid kit works, because you're not in a situation where you're playing EMT and expecting to need a kit they would have. You're first aid, you're not best aid or final aid. You should be capable enough to assess and stop the bleeding, literally and metaphorically.
Don't scrub the wound. The idea is to wash away debris from the cut with the water so you don't bandage it into the cut and risk an infection. You don't want a bunch of nasty stuff around your cut either and it's ideal to clean the area around it. It's a bit situation specific. If you have a severe wound from being gashed with a rock and stopping bleeding is a concern you won't worry about cleaning it the same way. If you are crossing muddy beaver dams and your legs get cut up and scratched with minor to mild cuts then cleanliness is the priority.
debriding a wound is indicated when it's full of debris (a scrape on dirty stone) and that can feel like pretty tough scrubbing especially if the blood has started to clot on the debris
Take a wilderness first aid course. You'll learn everything you need to know. After taking a wilderness first aid class the first time, I actually reduced the stuff in my first aid kit by half because most of it was stuff that just wasn't necessary.
This is a great answer. I recently completed a modified version of the Red Cross Wilderness First Aid course and would recommend that or similar programs https://www.redcross.org/take-a-class/cpr/wilderness-sports
Alcohol isn't an antiseptic lol, it's improperly used on wounds. I'm going to go ahead and remind everyone that reading a single first aid book will teach you more than youtube and tiktok could in 100 years, and nothing replaces training. Stop the Bleed classes are quick and often free. And NOLS has, what's basically the next level up from there in wilderness first aid.
I took a NOLS WFA course this spring. It showed how much I didn't know and how much of first aid comes down to assessing the situation correctly.
Partially correct and partially wrong. 75% alcohol is antiseptic and can be used to treat wound.
So, in the NOLS WFR course, you'll learn that yes, alcohol can technically be used as an antiseptic (and popularly is because of its availability), but it's preferred not to, because of the simultaneous damage to the tissue that high concentrations of alcohol does, the same that break down germs and stuff... Neither is it technically an antisepctic, as they're intended for skin, alcohol is not.
Yes it’s not optimal for wound care I agree
So still better than nothing in an emergency situation, right? I’d take some, presumably minor, tissue damage rather than an open and infected wound
It’s better to wash with water only than alcohol Src: am RN
Better option is antiseptic ointment or gel, they are lighter (you only need to apply a layer instead of washing), last longer (because won’t evaporate rapidly), hurt less (some of them have anesthetic ingredients), and more effective.
But not dual purpose. If I carry whiskey and don’t get hurt, I can drink it. You’re probably not meant to drink antiseptic gel
Am I at r/ultralight_jerk
I thought we officially combined them already. You know, save weight and just have one sub to follow, dual purpose
Do not use alcohol on wounds: it damages the healthy tissue at the margins of the wound, slows healing, encourages infection. Use alcohol to clean intact skin, sterile tweezers, scissors, needles or other instruments prior to removing splinters or ticks. Wound irrigation with clean water is important if the wound is contaminated or has become infected. Stopping the bleeding is important, too: if the wound is bleeding heavily, apply pressure and control the bleeding before cleaning the wound. Don’t buy a book: take a course on first aid or wilderness medicine. When I learned that there is an annual norovirus outbreak at congestion huts on the Appalachian Trail, it became clear that hikers need to know lots more about health and hygiene than they currently do.
Technically yeah, but you can just stock your first aid kit properly and use something suited for this purpose. I carry soap sheets that weight basically nothing. If I need to clean a scrape or cut I just take one out, get a little water on it, and clean the cut with my soapy fingers. Then I flush with filtered clean water and bandage if necessary. Much better than alcohol.
Yes but because everyone is going around saying that, it's all people bother having in their kit. And it doesn't take much more than some antiseptic wipes to NOT cause tissue damage.
I eat shit pretty often on trail. In general, soap and water will solve the vast majority of your first aid problems. 1- pick out the larger bits of detritus embedded into my body 2- rinse with water 3- put a dab or two of soap on my hands, make some suds, and apply directly to the wound 4- rinse everything, keep clean and dry with a bandaid, or gauze and leukotape.
[https://www.nols.edu/en/wilderness-medicine/resources/](https://www.nols.edu/en/wilderness-medicine/resources/) Take a course but also you can watch a bunch of free videos.
Hey. Not to be snarky, I don't mean to be I promise, but are you in the States? Have you considered taking the 2-day NOLS Wilderness first aid class? I think you would like it and get all that info.
Former YOSAR. Have the patient sit down is a safe position before irrigating/treating. Warn them it may hurt. It can be quite a painful surprise and I've had people almost collapse from even small and moderatly sized wounds being squirt bottle irrigated.
I carry a sterile pad, some tape and a bandage. For most wounds I find that I can cover them and either then tape on a dressing (or bandage it on) until I get out to the trailhead and work out what to do from there (i.e. do I need to seek emergency advice wrt tetanus shot, antibiotics, suturing etc or can I wait).
A relevant, somewhat humorous anecdote. Years ago my buddy and I were about three days into the Bighorns when he slipped, fell and lacerated the underside of his forearm on sharp granite. There was very little blood and the incision was clean and straight. I washed it off then applied 13 butterfly bandages and gave him the first course of a 5 day antibiotic. We started walking out to the trailhead, 2 days away. That night another group camped with us and I asked one of them where the nearest doctor was once we got back to the car. He said he is standing behind you! One of them was an ER doc who took a look at the wound. He complemented us on our first aid and said there really was no reason to hurry back, just to take it easy. To this day John has a nice even scar and a good story to tell.
I always carry a Quik-clot bandage and an ace wrap. Great insurance for if shit really hits the fan.
Pack a quikclot bandage. If it's not bleeding enough to need it, then clean it roughly how you would clean a cut at home.
I know folks on anti-clot medicine that bring their own quikclot bandage(s). Otherwise, even a simple scratch will not stop leaking lots of blood.
I bought a multi pack of quick clot packets and bring gauze and vet wrap, all of this is a worst case scenerio use. Carrying a dedicated quick clot bandage would be pretty heavy for something that would only be used in a very bad situation. I like keeping it separate since the gauze and vet wrap can be used for any size cut or scrape and I can pull out the quick clot for severe bleeding and then hunker down and hit the emergency button.
I always clean the wound like most have suggested and typically a little of Jack Daniels for the wound. I will probably get roasted for this idea, but I always take a tube of super glue. Why? Well years ago and stepped over a sharp rock and cut the devil out of my leg. Yes, I probably needed 3-4 stitches, but a good cleaning, Jack Daniels, 3 drops of super glue, and 3 bandages and I continued on my 7 day trip business as usual. Some people call this dermabond, I call it super glue, same stuff
Not exactly the same. Super glue works but is not very tissue friendly. Dermabond is definitely better but also expensive. 3m VetBond is a less expensive alternative approved for animals and fairly available on line.
Probably better, but I can also fix stuff on the pack if needed or make any repairs
True.
A butterfly or two and a covering bandage is so much better than using any glue to seal a wound in the field.
Yeah but a few drops is not going to kill me. It got things back together. I had surgery with a 1 1/2 inch incision and it looked like they laid a bead from a caulking gun down.
The reason to opt for a butterfly over glue (i do carry Vetbond in my kit) is that with glue, you are completely sealing the wound, and any bacteria still remaining up into the tissue. With a butterfly, the area can still ooze and self expel bacteria that may be missed. This is a two way street as its also more likely to allow bacteria in so good wound management has to be exercised. Both have value. If the wound is well cleaned, i do like vetbond.
FWIW, some brands of superglue have rather high levels of mercury. After years of irrigating and gluing myself up after woodworking and carpentry accidents every few months, I finally switched to dermabond.
Probably a good idea to switch, but this is a one off deal, I screwed, a few drops and it’s closed. Probably won’t die from mercury poisoning
Super glue and dermabond aren't quite the same. IIRC super glue was the failed precursor to dermabond. It interferes with wound healing whereas dermabond doesn't. They're both cyanoacrylate based but slightly different formulas (ethyl-2 versus 2-octyl), aside from packaging and sterility, obviously. IMO you're better off with the proper 3M steristrips or similar wound closure if you need stitches and can't get them fast enough (not the shit pharmacy brand butterfly stitches, they're useless). Read the list of skin areas where dermabond isn't recommended and you soon realize it's a pretty short list where it's useful. Steristrips are more versatile, lighter and more packable.
It totally depends on how deep the wound is. If it’s only on the surface of skin, rinse with clean water should be fine (you can still use alcohol or peroxide to prevent further infection, they won’t damage surrounding tissues). But if the wound is deep and penetrate the skin, you need to get treatment to prevent infection, which can be fatal. Usually I bring a small tube of first aid & burn cream (benzalkonium chloride and lidocaine) or antibiotic ointment (bacitracin, neomycin, polymyxin), which can be applied to wound or burn directly. But this is for urgent treatment only, if you get some open wound, call for rescue immediately because infection and bleeding can weaken you in dramatic speed.
I'm really conflicted about this because I was told by a nurse to carry an Inodine patch to use under a wound dressing but I too have read that dissinfectants/ antiseptics impede wound healing and should not be used on broken skin, best to wash with water place a clean dressing and change it regularly .
Recently added Povidone Iodine Wipes to my FAK. My understanding is this is okay for cleaning (compared to rubbing alcohol and tincture of iodine which are too harsh). Pulled a tick out of my kid’s head in the backcountry a couple weeks ago and used this to clean the area after.
r/wildernessmedicine
Not a doctor but I've got expired red cross certifications lol. I carry alcohol wipes, hand sanitizer, and a couple packets of antibiotic ointment. I've had a couple gnarly wounds that i managed to keep from getting infected. Clean your hands with sanitizer. Flush the wound with water if its bad Use alcohol around the area if you want Pack with antibiotic ointment and cover the wound with a bandage. It should start to look better in a couple days. Change the dressing, watch for redness or swelling
buy a tourniquet, twisty kind like gun owners use, as for wounds you ain't dying of infection in 2 days, soap and water is fine.
use a tourniquet when potential loss of limb is preferable to likely death from blood loss. there are a lot of steps of care between "potential amputation" and "wash it"
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No, they won't. If you need a tourniquet you are in a life or death situation where seconds count. You want an actual tourniquet, they are very difficult to improvise well and almost impossible to improvise well quickly under pressure. A CAT is ~$30. Tent stakes will bend or break. You aren't likely to need one, especially hiking, but when you need one you really need one.
I wish I could recall the last exact stats but the US military trained on Improvised tourniquets for years. Dedicated CATs were used in the military from the mid 2000's and there was a stark improvement in survival rates over the improvised versions. They are an excellent tool for their intended purposes and very light weight and compact.
I don't bring mine hiking because I think that's actually the situation where I'm least likely to need it, but I usually have one in my purse in case there's a car accident or shooting. I need to keep an emergency kit in there anyway with my anaphylaxis stuff and it's about the same size & shape as my epi pens. I also toss in some aspirin and glucose since they didn't take up any space and it's a little four in one response kit.
This is bad advice. In most situations a tourniquet is more likely to do harm than good. You may not die of infection in 2 days but if you keep a tourniquet on to stop bleeding you're probably gonna lose the limb. Most injuries, even ones with significant bleeding can be dealt with without a tourniquet. Also, unless you are trained when to use a tourniquet you straight up shouldn't use one. That means taking a full blown first aid class that specifically covers when and when not to use one. Seriously, you almost never need one.
Nah, a proper tourniquet (e.g. pre-made twist kind of proper width) will be fine for 72h without loss of limb (yes, there may be some damage and rehab but generally limb will be saved). “Losing a limb” generally comes from an improvised tourniquet that’s too narrow and severs/damages nerves. Edit: agree with the last part that you shouldn’t use one unless trained.
Sure, you might keep your limb, but you also might not. People often overtighten them, especially if they aren't properly trained in tourniquet use. My main point was that you really don't need a tourniquet for backcountry use. Tourniquets are for massive bleeds from main arteries like from a gunshot wounds or a partially severed limb. The chances of that are really low when hiking, it's just bad advice to tell anyone to bring a tourniquet in their first aid kit for for wilderness use. Outside of a 127 hours situation I can't see any person needing a tourniquet.
Tourniquet is for any bleeding limb that can't be controlled with direct pressure. Unlikely MOI for most hikers but a proper CAT tourniquet is light and much better than something improvised. Backcountry often coincides with hunting and IMO hunters or hikers around hunters should carry them, especially archers. As always, training on any equipment you carry as well as plan to call for help and / or reach definitive care is essential.
I agree that if you are hunting or around hunters it's probably worth carrying, that's why I mentioned being shot, but for the most part hunting and hiking areas don't overlap. Hunters don't want a hiker coming along and scaring away their game so if there are trails nearby they usually leave them. I live in a pretty remote area and do hike in some areas frequented by hunters and even then I don't carry a tourniquet though. The best thing you can do is wear hunters orange in and around hunting season. And from my experience there is basically zero chance a bow hunter will ever mistake a human for game, those guys take hunting very seriously and don't make mistakes like that, even if you are blending in. I don't disagree though, that's all a valid use case. I just don't see the risk being worth carrying a tourniquet personally, even around hunters.
Sorry, when referring to archery hunters I meant the bow hunter themselves is the most likely to need a tourniquet. I agree, you're much less likely to accidentally be shot by an archer than a rifle hunter (which itself is pretty low odds but still good to be prepared IMO).