4X4REVIEW.COM: Basic 1st Aid


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Basic First Aid

Please read the disclaimer.

By: Daivd Haines

Introduction.

I am not a professionally trained medical technician. What is gathered here is based on research easily found throughout the internet and experience gathered from doing basic combat first aid training in the United States Army, as well as experience gained from my own personal injuries. This article is to get you thinking about situations that could happen as much as it is to tell you how to handle them. It is important to realize that the worst can happen to you and it does not always happen to the "other guy". The worst usually happens when you are least prepared to handle it. Further, you should contact your local Red Cross chapter or some other medical training affiliation to recieve formal training. Teh classes are inexpensive, if not free, and are definately worth it. The infomration learned from these classes are invaluable and may not only save someone else's life, but maybe your own!
Get yourself a good first aid manual and put it inside your first aid kit!

Prevention and Preparation: The first step in first aid.

The Army uses a process it calls risk assessment. What this is in normal terms that we can all understand is a method for insuring you are using common sense. To put it simply ask yourself these questions before you go driving off into the wild.

Identify the difficulty of the activity and make an honest assessment of your capabilities and experience. If you don't do this you are taking the first step in asking for trouble.

Is it a tough trail? What can go wrong? Are you prepared to deal with possible situations that may be presented? What will you do in the event of vehicle breakage, injury, land mis-navigation? Do I have a means of communication to get medical help? Do I have a means of marking my location so help can quickly find me? Have I told anyone of where I am going before I left and what time I should be back?

Identify specific risks before you leave (snakebite, spider bite, heat, cold, rough terrain, etc.) What steps have I taken to reduce the risk? Obviously one is step is to have a good first aid kit with components to address specific threats (snake bite?) in the area you will be travelling. I would say that when it comes to first aid it is better to be over prepared. I will always opt to "have" rather than "wish" in a bad situation. Be familiar with the components of your fist aid kit. There is nothing more disconcerting than being in the middle of a medical emergency and your trying to figure out how to use your kit. If you have them familiarize yourself with the use of bee sting and snakebite kits.

Some common steps that can be applied for all the first aid. The first and foremost is to remain calm. This is often easier said than done. Panicking does absolutely nothing to improve a bad situation; as a matter of fact it often makes it worse. Remaining calm allows you to think clearly as well as not overly panicking the injured person. Your calm helps reassure the injured person that everything will be all right. Further, continually reassure the injured person that he or she will be all right. Keep the injured person protected from the elements (sun, rain, wind, cold, and keep him warm (unless your dealing with heat stress/stroke)). If the injury is serious enough for the person to be evacuated by medical personnel take steps to treat for shock just to be on the safe side. Keep the person warm and comfortable, continually reassuring him that he will be O.K. Seek medical attention as required based on the seriousness of the injury.

Cuts and Bleeding

A scrape is not a serious wound, but it does pose a threat because dirt and germs are usually ground into it. This makes infection possible.

The scrape should be washed thoroughly with soap and water. An antibiotic cream or ointment can then be applied. It is important to keep the wound clean and dry by choosing a band-aid or dressing that completely covers it.

Cuts can be more serious than scrapes depending on the depth, amount of bleeding, and possible nerve and tissue damage. Cuts will usually bleed more than a scrape. This is good and bad. While the cut bleeds, it is cleaning itself, removing dirt and other matter. For cuts that are bleeding profusely, some measures need to be taken to control the flow of blood.

The most effective means of controlling bleeding are covering the wound with a dressing and applying direct pressure. Next elevate the wound above the level of the person's heart. Once the dressing is on the wound, secure it with tape or other bandage. If the person is conscious he or she can continue to apply direct pressure to the wound. It is also important not to tie the dressing too tight. As a guideline you should be able to put two fingers under the dressing. Also pay close attention to the coloration of skin below the wound. We want to apply direct pressure; we don't want to cut off circulation.

If the wound continues to bleed you must apply another dressing on top of the original dressing. For this dressing, a guideline is that you should be able to put one finger under the dressing to check for tightness. Continue to apply pressure to the wound with your hands or the hands of the injured person.

If the bleeding continues even after these steps apply direct pressure to a pressure point above the wound. This works by pressing the artery against the bone, which constricts the flow of blood. For example, if the wound were on the leg, you would place the heel of your hand and press where the leg bends at the hip. Generally, if you can feel a pulse at the spot it is a pressure point. However, this is a last resort, a tourniquet can be applied. A tourniquet is rarely used because of the potential to cause more damage than it prevents.

Impaled Objects

This is when a foreign object is stuck in the body. Do not remove an impaled object. It is very important to immobilize it with dressings and seek professional medical attention. Removing an impaled object is another example that more harm than good can come from it if not done by professional medical personnel. A prime example is a small stick that has impaled the eye. No attempt should be made to remove the stick or twig. To immobilize it you should cover both eyes to prevent the person from looking around and causing further damage to the injured eye. Immediately seek medical attention.

Sprains and Strains

A sprain or strain is an injury to tissue, tendons, cartilage, and/or nerves in a specific area. Ankles are some of the most common sprain injuries. Indications of a strain include immediate swelling, black and blue discoloration of the skin and sharp pain.

The best treatment for sprains is known as RICE. That is Rest, Ice, Compression, and Elevation. First get off the injured body part. Apply ice for 5-15 minutes every hour to reduce and prevent swelling and also to reduce pain. Heat should not be applied for the first 24 hours. Compression is also used to minimize swelling. Use an ACE or elastic bandage and wrap the area. Elevation prevents fluid build up in the injured area. All these steps lessen pain and swelling of the affected area.

Dislocations

Dislocations can be painful (No kidding). Signs of a dislocation are swelling, deformity, tenderness, and discoloration. Untrained people should not reset a dislocation (with all respects to Mel Gibson a.k.a. Martin Riggs). The best that can be done is to immobilize it with a splint, elevate it above the heart if possible, and seek medical attention.

Fractures

There are two basic types of fractures or broken bones: a fracture that pierces the skin and one that does not. A fracture that pierces the skin is known as a compound fracture, one that does not is a simple fracture.

Signs of a fracture include swelling, discoloration, tenderness, loss of feeling in the extremity and pain. Sometimes the bone snapping can be heard. Medical attention should be sought immediately.

A simple fracture should be splinted and medical attention sought. It is important to splint the fracture in the position it is broken do not try to correct any strange angles. Like dislocations, leave the repositioning to trained medical personnel. Serious bleeding may occur with a compound fracture. Do not apply pressure to a compound fracture to stop the bleeding, nor should you EVER try to push the bone back into the wound. Cover the injured part with a sterile pad. Apply a splint to keep the bone from causing further injury to the surrounding tissues. Keep the person warm and reassured and treat for shock.

Critters

When bitten by an animal, it is necessary to determine if the animal in question is a carrier of the Rabies virus. Rabid animals act strangely. For example, animals that are usually active at night may be active in the daytime. A wild animal that is normally afraid of humans may not run from you. Animal may include drooling, apparent paralysis, irritability, meanness, or unusual calmness. If the animal is a pet, have someone find the owner. If the animal is wild or unknown, call your local animal control or Humane Society; they are equipped to capture the animal, you should not attempt it yourself. Do not allow the animal's saliva to come in contact with any open sores or cuts on your hands while you are caring for the person. All of the saliva must be washed out of the wound to prevent further contamination.

To care for an animal bite scrub the wound and surrounding area for 10 minutes with an antibacterial/antiseptic or just plain old soap and water, dry the wound and cover with a sterile dressing. Transport the person to a medical facility immediately for further evaluation and treatment.

If the wound is deep, you should be sure that the person's tetanus booster shot is up to date. If you are not sure, or it has been 10 years or more, go get the shot.

Snakes

The best advice when it comes to snakes is to stay away from them! If you encounter a snake move away slowly, he is as scared as you are. Snakebites are rarely fatal in the U.S. and most deaths can be attributed to allergic reactions, poor health, and allowing too much time to pass before medical treatment is received.

To care for a snakebite wash the wound, immobilize the area, and keep it lower than the level of the heart. Keep the bit person calm and minimize his activity (you wnat to keep their heart rate down as much as possible to slow the spread of the venom). Continue to observe for allergic reactions. Seek medical treatment immediately. If you have a snake bite kit you may attempt to suction the wound with a snake bite kit (Don't try and suck it with your mouth). You should also, if you have a pen or marker, write down the time the person was bit by the snake well above the wound on their body. Every 15 to 20 minutes, draw a circle (gently) around the inflamed area and mark the time. Keep doing this so that the medical professionals can see the total elapsed time and how fast the venom is spreading and affecting the surrounding tissue. If you don't have a marker or a pen, don't worry, just make a mental note on the time the person was bitten and approximately how fast the area swelled at 15 minute increments.

Insects

The most important thing to remember with any insect bite is to watch the person stung or bitten for allergic reactions. If you know that you or anyone in your party is allergic to bee stings it is a good idea to carry a bee sting kit.

Scrape the stinger away from the skin using a fingernail or credit card. Wash the site with soap and water, then cover it to keep it clean. Ice or a cold pack can be applied to ease swelling.

Spiders & Scorpions

Spiders: There are only two types of spiders whose bite can be fatal in the United States. The first is the black widow, which is black with an hourglass shape on its belly. The other is the brown recluse, which is light brown with a dark brown violin-shaped marking on its back. Both spiders inhabit dark, quiet places such as brush piles, garages, and attics. In other words, they won't come looking for you. Bites are usually the result of unwary humans reaching into an area they are in. Common locations for a spider bite are arms and hands. The person may not even realize that they have been bitten until they begin to feel sick or notice the swelling bite mark.

Scorpions: Scorpions live in the southwestern United States and Mexico. Their hangouts are under rocks, logs, and on the bark of certain trees. They are most active at night and are drawn to warm objects. Campfires, cozy sleeping bags and boots are common places to find these critters hanging around you. Be sure to shake out your sleeping bag, clothes and boots before climbing in or putting them on. Although a scorpion sting is quite painful, there are only a few species whose sting can cause death. The symptoms for both spider bites and scorpion stings are similar to other sudden illnesses. Their person may experience nausea and vomiting, difficulty breathing or swallowing, sweating, and increased salivating, severe pain in the affected area, swelling, and redness or some indication of a bite/sting. Wash the area and apply a cold pack or ice. Scorpion sting or spider bite antivenin is needed for both Black Widow bites and scorpion stings so seek medical attention.

Shock

Shock usually develops from another injury. It is when an injured person's circulatory system does not deliver blood to the entire body. Shock is a life threatening condition and medical attention will be required.

Signs of shock include confused behavior, irritability, pale or clammy skin, irregular breathing, irregular pulse, nausea, vomiting, and thirst. If a person is injured seriously enough i.e. fracture, large cut or bleeding, steps should be taken to treat and thereby prevent shock regardless of whether you believe he or she is actually in shock.

First have the person lie down in a shaded area, get control of external bleeding and keep the person warm. You can warm the person with blankets, clothes, or lacking anything else, your own body heat. Elevate the person's legs unless there is a neck or back injury. If the persons leg or legs are fractured you will not want to raise them. Do not allow them to drink. Continue to reassure them and get medical help as soon as possible.

Heat Injury

Heat cramps are painful muscle spasms often occurring in the legs or abdomen. They are the least serious form of heat injury. This is the first warning that the body is having trouble handling the heat. While the exact cause of these cramps is not understood, it is generally agreed that sweating caused by strenuous exercise in a hot environment causes a change in the body's electrolyte (salt, potassium, and other needed nutrients) balance. Dehydration may also contribute to the cramping. To treat cramps get the person out of the heat or to shaded spot. Give them cool water or a Gatorade� type sports drink. Stretch or massage the affected muscle. Once the cramps subside the person may go back to normal activities, just insure they are drinking plenty of fluids.

Heat Exhaustion is the most common heat injury. It usually occurs when sweat cannot sufficiently cool the person's body. Signs of heat exhaustion include cool or clammy skin, headache, nausea, dizziness, or weakness. To treat heat exhaustion get the person out of the heat, loosen tight clothing and remove sweat-soaked clothing, apply cool, wet towels or cloths to the skin (use ice packs if necessary) and fan the person. If the person is conscious, give them cool water to sip, but don't let them gulp it, which could result in vomiting. If necessary, regulate how much water they are given. (Once 4 oz. glass every 15 minutes.) The person should continue resting and should not resume normal activities the same day. If the person refuses water, vomits, or shows signs of changes in consciousness, the condition is getting worse. Call for medical attention.

Heat Stroke is not as common as heat exhaustion, but it is very serious. When the body is subjected to more heat that it can handle, the core temperature will rise rapidly, causing the body systems to shut down. This is a serious medical emergency that will result in death if not treated. Signs of heat stroke include red, hot, dry skin, confusion, irregular pulse, and irregular breathing. Call for medical assistance immediately. If the person vomits, position them on their side. STOP GIVING FLUIDS. Keep the person lying down. Continue cooling the body using any means necessary. Place ice packs or cold packs under armpits, on the groin, on the neck, on wrists, and on ankles. (Cold cans of soda or beer work well for this if you don't have ice packs.)

Here are some items you should consider having in your first aid kit: