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  1. #1
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    What to carry in first aid kit?

    What do you carry in your first aid kit?

    So far, I'm thinking rubber gloves, gauze, tape, ace bandage, povidone iodine, tweezers, irrigation syringe for cleaning abrasions. And duct tape, because duct tape.

  2. #2
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    -Steri-strips or butterfly sutures for gashes. they work much better than guaze and tape.
    -Superglue is nice for blisters and cuts. moleskin too, it's not just for heels and feet!
    -tongue depressor/popsicle stick for a finger splint
    I've actually seen 2 broken fingers/knuckles mountain biking in the last few years.
    Buddy-splinting to the next finger just doesn't work and a stick is never straight enough.

    Where do you live?
    I carry a fine toothed comb (for infants) to remove cholla cactus balls from...being stuck....to stuff.

  3. #3
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    Steristrips sound good, but I want gauze for bleeding. If a wound is bleeding and I need to apply direct pressure, I want to put some sterile gauze on the wound before I press.

    About gashes: I'm taking a wilderness first aid class, learning first aid for times when I'm an hour or more away from a doctor. And in a lot of the scenarios we're discussing, we'd be a day away from a doctor. The instructor told us in no uncertain terms NOT to try to close a deep wound, and not to superglue. She explains that if you superglue the edges of the deep wound together, all you're doing is creating a pocket for a bad infection. Rather, although it sounds awful, she says to stop the bleeding, clean the wound and pack it with damp gauze (that gauze again).

    The class notes say that a small wound on the face or scalp that doesn't have jagged edges and that is clean can be closed with a steristrip. But does that describe wounds we'd likely get when mountain biking? We can clean the wound, but is it going to be a clean slash with no jagged edges? Well, maybe. I'm guessing often it will not be.

  4. #4
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    I live in Silicon Valley, but I'm thinking what to take while bikepacking.

  5. #5
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    I can see how my post was misconstrued. I listed those things *in addition* to the usual wound control and stuff you listed.

    No, never close a wound with superglue, but it can absolutely be used on blisters and accidental knife slices.
    With regard to damp gauze, you should read up on that. As an EMT-P and former Army Medic, I personally wouldnt do it. Certainly not with camelbak water.

    In regards to the steri-strips, I would say that jagged means 'wound edges don't line up when held together, or skin/tissue flaps exist.' Youd be surprised how rare that is to have deep wounds like that.

    Quite honestly, you need to be most prepared for 'fall' wounds, not major trauma. Knee vs. rock and chainring vs. calf type stuff, possibly broken long bones. That, medical emergencies like heatstroke and heart attack and accidental knife slices and finger pinches are going to be the most common emergencies, not impaling injuries and major avulsions.

    Good for you for taking some initiative and learning some medicine!

  6. #6
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    Sorry I misconstrued.

    The situation where we were instructed to pack the wound was where the person wasn't going to be seen by a doctor or anyone with more training than us for over 24 hours. Presumably, we'd have a water filter in such cases and could refilter some water. What would you do if you were in that situation?

    I certainly hope I never see most of the things we learned about. I'd be perfectly happy not to see anything worse than a scraped knee. I hope I don't see heatstroke-- she was quoting a mortality rate of 20-70% for heatstroke (as opposed to heat exhaustion, which probably a lot of us have had and which is unpleasant but easily treated).

    Good to hear your information about steristrips. I was in a situation recently where that's just what I needed, but I didn't have a first aid kit and didn't know how to use one. It was just a minor cut, but the kid would've been better off with it closed, I think.

  7. #7
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    Quote Originally Posted by the other Anne View Post

    The situation where we were instructed to pack the wound was where the person wasn't going to be seen by a doctor or anyone with more training than us for over 24 hours. Presumably, we'd have a water filter in such cases and could refilter some water. What would you do if you were in that situation?
    You can dress a wound 3 ways:
    wet (like almost dripping),
    damp (was wet, got wrung out a lot),
    dry (straight from the package).
    Here's a quick overview of the pro/con argument of moisture and dressings:
    Pro wet:
    Doesn't stick to wounds, so removal doesn't tear off new granulation as long as it stays wet.
    Con wet:
    Water is dirty, period. Unless it's sterile from boiling, or an IV bag. You are introducing 'stuff' into the wound. and 'stuff' loves warm and wet. there's a study or three somewhere on the 'net that supports the idea that ALL wounds get infected eventually when covered with wet dressings. they disagree on how/how long/how severely.
    truly wet dressings leak under bandage compression and are messy. they ruin the outer dressing and the tape falls off, exposing the wound.
    Pro damp:
    I honestly can't think of any pros. It's too dry to be wet, and too wet to be sterile.
    Con damp:
    literally the worst of both worlds. You got it wet with water, and then presumably handled it to wring it out. With your dirty hands. Now it's too dry to not stick, but still wet enough to harbor 'stuff'
    Dry Pro:
    sterile. clean. promotes coagulation with the 'rebar effect' of the threads.
    Dry Con:
    will stick to a wound requiring re-injury of the site to remove when you tear off all that 'rebar'. This can be mitigated in the ER with a soaking in sterile water and hydrogen peroxide to break down the scab . At that point, the wound will get debrided (scrubbed out with a brush) so damage isn't a concern.

    This is all really an academic exercise. there are very few places on earth that are more than 24 hours from definitive medical care. Even the middle of the Sierras or the Rocky Mtns. are 90 minx max by Heli. You just need cell reception and GPS coords.

    Quote Originally Posted by the other Anne View Post
    I certainly hope I never see most of the things we learned about. I'd be perfectly happy not to see anything worse than a scraped knee. I hope I don't see heatstroke-- she was quoting a mortality rate of 20-70% for heatstroke (as opposed to heat exhaustion, which probably a lot of us have had and which is unpleasant but easily treated).
    You likely won't. prevention is the best medicine, and all that... re: heatstroke, once they start seizing, it's looking pretty grim for them, I won't lie.

    Steri strips are great. a travel tube of bacitracin ointment and some duct tape works pretty well too if you can get to care in under 12 hours or so.

    To circle back to a point in your second post, and a point we drifted to subsequently....first aid for a day ride, and first aid for bikepacking are two very very different things.
    My back/bikepacking kit barely fits in a quart-size ziploc. I carry some crazy stuff, like Lidocaine and sutures. Because I can.
    My 3-hour morning ride kit is maybe half a sandwich bag. It's various bandaids, a gauze, some tape, a sheet of steri-strips, sometimes some superglue, a tongue depressor, and some tylenol and benadryl.
    and that comb.
    I have tweezers in my multi-tool knife, and 2 nitrile gloves for gunky chains, or inclement weather. so I guess those too.

    Anthing else can be improvised, or best treated with a cell phone.

  8. #8
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    I have no confidence in cell service. None. I live in the San Francisco Bay Area, a populous urban area, and there are many places (including my suburban house, for ATT) that have no cell service. In my bike touring on the road, in the West, I'd say that about 1/3 of the time I'm without service. I haven't done a lot of backpacking, but the other people in my class had, and all were unanimous that cell service in the back country is usually not there. A cell phone is not a good back country rescue plan. It's easy to be a day from cell service, in remote mountain areas.

    Satellite phones are a possibility, but I'm not going to have one.

  9. #9
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    Shrug. My experience differs.
    I made calls to my house from the top of Mt. Whitney, and at several points along the Colorado Trail when I through hiked it a few years ago. Northern New Mexico is really the only place I can recall that has consistently spotty service. I can't say I've been more than an hour by foot from some kind of cell service, much less a whole day. Hell, I can cover 20 miles a day walking. You can always find service, even if it was just enough to blast off a text for someone to get help for you.
    It's a moot point. gain skills in medicine, and be cognizant of risky situations and you'll not need a cell.

    I don't think cell service is a good rescue plan either. but there's a line we all draw for ourselves as to what's fixable and what needs to be evac'd out.

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