Bored EMT here, and an outdoorsman. Post your first kit/contents and I rate/give suggestions for it.
Don't have a first aid kit? Name me a price, the kind of camping you do, around how much weight you can carry around and I'll find you something good for it!
1. Don't buy shit you don't know how to use. (scalpels, IV sets, airways in most cases)
2. Have something for both major and minor trauma.
3. Have a tourniquet.
4. Have shears
5. Have a shitload of gauze.
Interesting question, and I might not be the expert to tell you, since I haven't really ever worked in a desert-like environment. In terms of injuries, they'd still be roughly the same, and if anything I'd recommend making sure to ALWAYS stay hydrated. Dehydration is a bitch, and a number of 911 calls we get attribute to it. I'd pack some water that you'd use in an emergency-only type of situation. Only other thing I can think of would be to try to prevent obvious heat-stroke, have some sort of a shelter from the sun, etc.
A little bit out of my scope, but the best answer is to have a balanced meal, with fiber, so your shits are not terrible. >>670406 pretty much has it figured out
Pretty good. What kind of gauze? I'd suggest a cheap sam splint as a decent addition, and some gloves just in case. Also, you allergic to something that you carry an epipen? Just curious
Whatever cheap stuff they have at CVS for the gauze. Thanks for the recommendations though, I'll grab those next time I'm there.
>Are you allergic
I am allergic to some foods, but carry an epipen going /out/ because you never know if once you go out you'll find out you happen to be/happened to develop an allergy to something that you don't normally encounter, like insect stings/bites or some plants. Also useful for cardiac arrest whatever that's worth.
Small kit I actually carry on day trips:
Meds (Ibuprofen, Robax (Ibu+methocarbamol), benadryl, ceterizine, imodium)
Small tube of super glue because I have one
I know I should throw in some folding scissors.
Bigger kit for longer trips: Adventure Medical .7
If you're out somewhere and a guy goes into cardiac arrest, he's just dead man. Unless you're right by a roadway, and can get help immediately there. Even then he still has a less than 5% chance of survival, even if everything went perfect. If you're /out/, it won't go perfect. He's just dead.
You shouldn't carry an epipen if you're not prescribed it. You should only use it to avoid death. Benadryl is better for 99% of allergies, especially if you don't have a specific allergy that you're trying to avoid. Generally your first allergic reaction to something isn't severe anyways. Go ahead and take it some day when you're stung by a bee and are mildly itchy, you'll regret it. I know people who do have severe allergies, and they avoid taking their epipen until they absolutely have to because it sucks so much.
Speaking of cardiac arrest, an epipen can cause it, so don't use it unless you're having severe anaphylaxis.
Also, the dose of epinephrine for cardiac arrest is more than 3 times the amount what's in an epipen, and it's given via IV, and it's given every 3-5 minutes. An epipen would do nothing in a cardiac arrest. The little amount that would be injected into the muscle would absorb slower too, since they're not adequately perfusing their muscle tissue.
Confirming what this guy said. DO NOT give epi during someone's arrest unless they are in anaphylaxis (allergic reaction to something causing the swelling of the airway)
Besides the scissors, this seems like a good kit. Throw in some gloves, and you're good to go, especially on small trips. Also might need some medical tape, to secure gauze etc. I guess you could throw in a TQ, but that's really up to you. What kind of antispectics btw?
Don't worry mate, I'm not a total idiot, I know not to use medication I don't need. It's more of a just in case thing since I generally carry one with me anyways as my allergy is to something relatively common in today's foodstuffs and you never know if you happen to get unlucky and have a piece fall into your food at the factory that processes every thing imaginable.
Also I was joking about that cardiac arrest thing for the most part. I go out solo and it's really questionable what I could do if I myself were in cardiac arrest.
That kit's primarily intended for using on myself but you're right about the gloves, I'll see if there's room in the pouch.
I figure either the vet wrap or athletic tape would do to secure the pads at least temporarily if I ever need to use one, besides being good for other things (I'd want to clean up properly at home anyway, or if it's bad enough, get it checked out).
>What kind of antispectics btw?
Can't remember exactly and the kit's downstairs. That little cotton swap has antiseptic in the tube, just break off one end, also stole a couple of the wipes out of the Adventure Medical kit.
Saline or sterile water is what we use for flushing wounds, along with alcohol wipes. Saline and sterile water dont exactly disinfect though, unlike alcohol, and alcohol wipes which I personally recommend for cheap disinfectant.
Yeah this is what I've got so far
>Non latex (vinyl?) disposable gloves
I've got a smallish bottle of contact solution about 1/3 full, I guess I can throw that in too
Another few recommendations (former army combat lifesaver). Have something on you with your bloodtype on it, label any pills clearly, and also have some sort of guide on how to use the contents or emergency first aid in your kit like
You may not be the one using your kit, someone may be using on you with no clue whatsoever.
Since my hiking pack has MOLLE webbing my kit is in a small MOLLE pouch with the typical red cross patch and my blood type patch on it with that guide packed in with the materials as well.
Also pic from an older first aid thread.
Having your blood type is generally irrelevant, because any time you receive blood, they will do a type and cross anyways, or give a universal donor type blood.
Many people think their blood type is one thing, and it's actually another, so a hospital does not rely on that, unless it's in an actual medical document at their facility.
Well you're in a remote location and they can't drag along all the equip for a test etc best to have something on you with your blood type and any allergies if you're incapacitated.
Better to be safe than sorry, especially if it's something as simple as a patch or a card in your wallet/first aid kid.
Keep in mind that your body gets the shits for a reason, if you stop it is possible to get sick. For a day or two to get home, it's ok, for a week to avoid dehydration you probably fucked either way.
MREs are best stool herdeners.
i have a standard motorbike first aid kit in my bag should do the trick in most cases.
> sterile bandage strips (10 cm x 5 m): 2 pc
> sterile compressa (6 x 6 cm/100 sheet): 1 pc
> hand sanitizer tissues: 4 pc
> gloves: 1 pair
> adhesive tape (1,25 cm x 5 m): 1 roll
> scissors (stainless steel, 110-150 mm): 1 pc
> iodine (or something like that) (30 ml): 1 pc
> bandaids (6 x 10 cm): 2 pc
> hygenic facemask (for cpr): 1 pc
> surgical mask: 1 pc
> first aid in pictures: 1 pc
> inventory: 1 pc
Small rolls of gauze x3
That elastic cling bandages thingy. X1
Bunch of iodine
Alcohol swabs, iodine swabs
Hemostasis powder pouch x1
Cold packs x1
Anti diarrhea pills x12
Small bottle of tea tree oil x1
Saline in those disposable squirt tubes. X3
Couple of bandannas
Couple of condoms
Splinter removal tweezers
7 days worth of antibiotics
I really want to get some strong painkillers but I wish I could do it legally...
If you're that remote, getting blood to you would probably not be viable. In most situations, they would just give IV fluid to stabilize your blood pressure and evac you. If they somehow DID get blood to you, it would be universal donor blood (O negative).
Any type of help you'd be getting would not carry all the different types of blood. They'd carry O negative. It would not be viable to carry every type. Emergency services carry O negative.
Also, you can do a bedside test with blood on a simple card, that can test reaction of your blood type. It's not as reliable as a lab test, but will work in an emergency.
Listen, I get it, in a combat situation like you were tained, it can save your life. The rest of the world though can not, and would not rely on a blood type you had written down, engraved on a tag, or embroidered on your pack. It's too unreliable. You would get O negative blood, or be typed and crossed and receive your blood type.
You really will not have any advantage by listing your blood type on yourself.
Listing your allergies however can help you. Along with any significant medical history and medications you take.
You use a tourniquet when your only other option is bleeding to death.
You can stop nearly all bleeding with firm, direct pressure over the wound.
If you have a significant arterial bleed in an extremity, a tourniquet is effective. The commercial ones reduce risk of tissue damage. It has been found they work well without risk of losing that limb as long as proper care is provided quickly.
However when you're /out/ in a remote location, and you apply a tourniquet, you need to be prepared to lose that limb, as it is a possibility.
so basically not worth packing because you gonna lose the limb anyways or die.
can't you just alternately open the tourniquet while putting pressure on the wound to extend the limb viability to hours?
I don't carry one and I'm a paramedic. I've been one for 12 years and never needed to use a tourniquet for serious bleeding. We also have very very little gun violence in my area though, and tourniquets are often used on extremities that have serious bleeding from gun shots. The only gun shots we get are suicides, and people who have really good aim.
If you have lost serious, serious blood, and are in what we call shock, do not ever release the tourniquet. Thats medical shock, not the feeling of being surprised like TV shows.... "omg he's in shock!". That's just a way that uneducated people describe someone who is bewildered.
ACTUAL medical shock, is when the body is losing the ability to compensate for the loss of fluid. Low blood pressure, pale skin, weakness, rapid heart rate. All signs that your body is not able to cope with the amount of blood you've lost. The body can effectively manage losing about 2 liters of blood. We get people all the time that have been bleeding, and they're like "I thought I was going to bleed to death!", when they've only lost maybe a cup full of blood at most (meanwhile waving the injury around putting pressure on it once every few minutes then stopping). It's amazing how many times we go somewhere for someone bleeding, and they are like "OMG IT WON'T STOP!". We put direct pressure on it for a minute or 2 and it's stopped.
Picture a 2 liter bottle of soda full of blood. That's about how much you have to lose to really start to have shock. You can survive losing more, but it's not a good thing regardless.
If you have not lost much blood, your skin color is good, and are not dizzy, releasing the tourniquet and rechecking for bleeding may be ok after about 1 hour.
I'd say definitely not. When you're hurt, and need to get out of a situation, it's going to hurt regardless of a pill of ultram. The only thing that will do is make you more weak, tired, and lower your blood pressure. Anti-inflammatory drugs like ibuprofen are better, as they can reduce pain and swelling while not effecting your blood pressure or mental status. Opiates take away pain at a neurological level. They do nothing to treat an injury, they only block pain reception. Anti-inflammatory drugs reduce pain by actually treating the injury. Narcotics can actually increase bleeding by a significant amount, as they dilate blood vessels. They are absolutely contraindicated (not advised) in situations where internal bleeding, or significant external bleeding is a possibility.
>Fabric bandages in varying sizes
>non-stick gauze pads
>~4oz hand sanitizer
>~4oz 70% isopropyl
>leatherman squirt PS4
>waterproof container marked with red cross
Thanks medic bro. Don't really have much to add to your answers, and thanks for helping out with the thread.
For a kayak this seems pretty perfect. I'd maybe get a pocket mask for resuscitation, given that you're going to be near water, but otherwise I don't see much else you'd need.
I'd get more gauze and less bandaids, since gauze is generally better and more practical imo. Get either kling (roll gauze) or some tape to secure your 4x4s with, duct tape ain't the best for that. You don't need a suture stapler.
You an army medic, or just have it bought from someone? There are a loooot of things in here that you probably should not even consider using.
For anyone interested, I'm thinking of setting up a shopping list for medical supplies that include pretty much anything you'd need or use. Miight end up being quite pricy, but it will be in pretty decent bulk packs that you can re-order. Hope to at one point get something along the line of logical increments in terms of price.
Elevating the wound helps, but laying down with your feet up (trendellenburg position) has been found to be ineffective, and even counter productive.
The main priority is to stop the bleeding. Firm direct pressure is the key.
My kit is the same for walking/kayaking/work/bike etc as it's all the same backpack
>oral and nasal airways
>various banadages/ plasters
>several triangular bandages
>tuff cuts, tweezers
>aspirin, Ibuprofen, paracetamol, glucogel, loratadine
>several saline solution vials (the ones for eye washing but good for washing cuts etc)
>alcohol wipes, nitral gloves
I'm amazed people can get antibiotics so easy, I suppose this is one of the reasons the world is fucked in that regard
Pretty good kit there, however I'd recommend packing some more things for bleeding control. Gauze, 4x4s along with some kling (Roll of gauze pretty much) or tape to keep it on a wound. For more serious situations, I'd recommend bringing a larger trauma dressing, or something like an Israeli bandage. A tourniquet wouldn't hurt either.
This is the 21st century dude. Emergency medical help is always less than ten minutes away.
gauze, pads and roll
waterproof adhesive tape
tweezers and sheers
water purification tablets
Any recommendations on what I should add?
SAM splint, and some triangular bandages for broken limbs. Maybe an Israeli bandage. You got the basics well covered.
What kind of pain relievers? You don't know how to set an IV, and even if you do, you won't get much use of it. Get rid of that. Make sure all your meds are not expired. Otherwise you're pretty good.
>12oz 100% grain alcohol
Better off with lesser proof. The 100% stuff shouldn't be used on wounds or consumed due to how it is processed to get to 100%. It is really isn't 100% pure grain alcohol, there's still some benzene in it.
The IV needle isnt for setting an IV. i just figured a large sharp needle would be handy innawoods. painkillers are ibuprofen 800s and aspirin with codiene. i have a perscription for it. Also, i recently read that WHO and the military did an actual shelf life test on medications, and as long as their stored properly, they last a while.
For long-term trips:
1 quickclot sponge
benadyrl, immodium, ibuprofen, asprin
a wad of gauze
a compression bandage
a few butterfly bandages
I want to add more, like an israeli bandage or a sam splint, but I'm concerned with weight and bulk in my pack and not sure. What do you think I should add?
I'd suggest to have something different from a wad. Get a few sheets of 4x4s and some roll gauze (kling, stretch, gauze etc) in addition. Quick clot is honestly kinda meh, but bring some more gauze. Can replace bandaids with it, but not really too big of an issue. I'd definately go for a sam splint, at least over an israeli. If you get some sterile gauze, and you have a tourniquet, you're pretty well covered for bleedings. I am not sure how heavy the quickclot sponges are, but if you want to trade them out for a SAM, I'd go for it. Lastly, get some medical tape. Duct tape is good, but not for medical stuff.
Typically 2 epi pens are carried, or at least from what I've seen. The biggest mistake people make is to delay administiring it, or not following the directions to administer it properly. There will be some safeties, but please just follow the directions.
1. Remove safeties from the injector. Keep your fingers clear of the buisness end. Don't put your thumb over the tip, to make sure that in a panic, you don't accidently stab your finger.
2. Administer it on the thigh. Yes, it can be administered through clothing, so don't worry about it. Inject, and HOLD THE NEEDLE there for at least 10 seconds.
3. Get some help if you haven't already.
Here's my FAK. Now /out/ can tell me how it's wrong and I'm a fag.
Gonna be a realist and say that the FAK that you need is generally very minimal. The best piece of equipment you can have is the ability to call for help. You don't need torniquets or tough cut scissors.
You just need basic provisions for foot care, a few things for wound care, maybe a few paracetamols.
Literally anything else is pure fantasy.
Literally why? When you come to hospital with butchered sutures that you did yourself outside, the first thing we would do is cut it all back open, wash it properly and suture/dress it appropriately.
Stop being retarded. Use some steristrips and a bandage.
Delayed primary closure is actually preferred when wounds are at high risk of infection. Early closure by your retarded self at some dirty campsite will increase the risk of abscess formation. And you probably can't suture for shit btw.
by "wad" I meant a roll, it's in a little plastic package, but yeah, good point, more gauze is probably a good idea.
the quickclot weighs practically nothing, so I thought it was worth it if there's serious bleeding. I have a SAM splint at home, I just don't have it in my kit, I probably will add it. Thanks!
Just had 10 hour post blizzard shitshow shift. Answering what was asked
Get more gauze, get rid of the silly syringe, get some more fukken gauze, and get something for more serious bleeding control. Either a tq, or an Israeli bandage. Otherwise looks ok. asked
Do not buy a suture kit unless you know how to use it. Chances are, you don't, so don't. I don't suggest you do it either.
The only reason I'm kinda skeptical of quickclot is that it does have some complications that may arise at the hospital, and that the wounds that can be treated with just gauze, and stopped with gauze, should be stopped with gauze. Israeli if that doesn't work, tq if that doesn't work. It just, doesn't really fit anywhere in that progression if that makes sense. It has more complications then an Israeli bandage would, but I doubt it would have as much effect on a serious bleeding as an Israeli bandage. You might find people who disagree, but I personally don't see it as useful.
Taking more questions.
Not entirely true, because during that time you can take benadryl and allow it time to work, and often the anaphylaxis starts to subside once you're removed from the allergen. It may only offer 25 minutes of relief if used alone under worst case situations, but can give time for other treatment to be provided.
As another anon said, closing the wound can increase the risk of infection if it's not properly cleaned. Since you were outside, it was not properly cleaned. Even if you think you cleaned it well enough, trust me, you didnt.
You absolutely do not want to suture something closed while outdoors. You're just asking for infection.
Clean it, dress it, and take it closed if the skin is hanging open badly. Otherwise you're just making it worse.
I wouldn't trust OP's advice for anything but life or death, evacuation stuff. Not sure he's qualified for actual medical advice. I would rather hear it from a doctor or nurse who usually ends up cleaning up after the EMT disasters.
I sympathize with your bordom buddy. Just post your kit and leave it at that.
Yeah, exactly. You shouldn't be using quickclot unless you're going straight to the hospital. Not good for minor /out/ wounds, but it's probably worth carrying and could save your shit if you have serious arterial hemorrhaging on an extremity.
I'll say this, I'd rather have a paramedic with me while /out/ than a nurse.
A nurse works in a facility as a general rule, where everything is clean, and there are unlimited supplies. This isn't always the case, but 99% of nurses work this way. They never have to adapt, or improvise. A nurse also never has to make critical judgements. They only are able to follow orders given by a doctor. A paramedic, while having a set of protocols, constantly has to make quick decisions about treatment, while improvising and adpating.
It's real easy for a nurse to start and IV and give some med in a clean, well lit hospital room, with a doctor right around the corner. It's another thing to be laying in a puddle of mud, in the pouring rain, with no contact with any doctor, with a guy who's just been ejected out of a car during an accident, trying to start his IV.
A nurse never has to figure out a way to get a guy out of a wilderness after he's fallen down a ravine, a nurse never has to carry a 300lbs guy down 4 flights of steps while he vomiting and struggling to breathe, a nurse never has to deal with people out in the environment.
Nurses are awesome, but they are awesome in their environment. Paramedics environment is more closely related to /out/.
When you tie a tourniquet, it would kill you to remove it, even if you put pressure on the artery. Not because of blood loss, but because when a limb is constricted/crushed by something, the potassium contained in the cells pass through the cell membrane and end up in the blood, resulting in hyperkaliemia (excess of potassium in the blood) which stop the heart. It's a matter of minutes.
I'm a nurse but english isn't my first language, so idk if what I'm saying makes sense.
It's not so much medical advice, as it is gear advice. A paramedic is more qualified then a nurse is for pre-hospital operations. Of course it's just advice, and you may take it as skeptically as you want, but if you see any actual bad advice here, let me know, and I'll be sure to correct myself, or defend myself.
A CAT is not difficult to learn how to use properly, though it would probably be a good idea to post a couple of videos on how tos. It really is not that difficult though.
Just from a clinical perspective, a paramedic is more qualified then a nurse in emergency medicine. Of course, this is just typically, as there are EM, ER nurses. Honestly the only advice I'd take over a paramedic would be that of a physician.
To further clarify, I am not going to answer something like "I have severe allergic reactions to peanut butter, as well as two replaced knees. What should I bring when going camping?". I am answering questions that pertain mostly to trauma equipment (along with disinfectants), and on what to do during specific trauma situation.
well make sure you don't actually crush the muscle tissue with your tourniquet that's the entire point. then you don't have to worry about potassium.
that is in part why wide band shaped tourniquets are developed.
During a crushing injury, yes this can be a concern.
If a tourniquet is on correctly, you won't have this build up. It's not only potassium with tourniquets, it's myoglobin protiens. They come from muscle tissue being damaged, and travel to the kidneys, causing kidney failure, it's called rhabdomylosis.
If a tourniquet is apply correctly, you can avoid this. But yes, it is a concern.
Stitches, if not done right are worse than no stitches. You need to scrub that shit super clean and you arent gonna do that in the woods. Suturing in the woods is asking for an infection and further complications. Id laugh at you for wanting to be some rambo shit if you came into the ER when Im working.
soft tip squeezy syringe
some sorta topical anti itch
soft tip syringe for flushing/ anal delivery of water when dehydrated/vomiting
1. What kind of gauze and how much?
2. Not sure if you meant to list the triangular bandage as singular, but you probably should have more then one. Makes it more versatile for the various types of fractures one might sustain. Also I'm not exactly sure if you are serious about the anal delivery of water, but I'd not suggest that.
I'd recommend adding
1. Something for emergency bleeding control. An Israeli bandage, and a tq would do wonders.
2. SAM splint would be pretty good addition.
EMTbro, it has been said a couple of times in this thread that it's very hard or impossible to clean a wound properly while /out/
Can you point us to a resource where we can learn how to do that? I don't want to lose a toe or a finger (or godforbid a larger member) because I didn't clean it properly.
I wouldn't freak out to that extent about infection, and it's pretty easy to avoid. There aren't really super intense methods of avoiding infection but here are some tips.
1. Wear gloves. Gloves can help to make sure that no matter how much filthy shit your hand has touched, that it won't get on the wound. Just make sure to keep your gloves (along with other medical equipment safe. Here is a video on how to take gloves on and off safely.
Secondly, I'd try to disinfect the wounds if possible. If it's a small cut, disinfect the area with wipes, or if you have clean (drinking) water, use water as well to irrigate.
Lastly, bandage that shit up. The reason I talk about getting a lot of gauze is that it makes it easier. If it's a smaller wound, replacing the gauze is fine, however try to simply add on more gauze, to stop the bleeding if what you have is not enough. The main concern is to try to keep the wound safe from the elements, and it's not all that difficult to accomplish in field conditions.
It is as much of medical advice as answering the question of "what should I bring with me camping so I can sleep away from rain?" with "tent". Is it advice? Sure. Does it take 2 years of camping experience to answer it? Nope. Besides, I am giving the same protocol that we are given under by a medical doctor.
Fellow EMT here.
5x PAIRS of xl Nitrile gloves.
2x SOF-T TQ's, NIW
2x 3"x3y Coban, NIW
1x QK Gauze, Z fold
2x Primed Gauze
2x H&H H bandage, flat fold.
(Yes I know my IFAK is heavier than shit.)
3x packs of moleskin
1x Bug Bite stick
1x Chap lip
1 pack of bandaids
5x antiseptic wipes
20 Antihistamines (I have occasional allergies, and they are tiny)
What do you think of my FAK ? I use it when I go /out/, usually 3 - 4 nights in the wild.
Any sugestion to improve it ?
It contains :
On the outside pouch :
_Notebook with my name, adress, alergies, blood type and other important informations.
On the inside :
_Water Purification Tablets
_Bandaids (many sizes)
_Gauze Compress x4
_Alcoholic Compress x3
_ "Sos Burn" Compress x3
_Small scissors (I have a bigger one with my leatherman)
>Confirming what this guy said. DO NOT give epi during someone's arrest unless they are in anaphylaxis (allergic reaction to something causing the swelling of the airway)
>If you're out somewhere and a guy goes into cardiac arrest, he's just dead man. Unless you're right by a roadway, and can get help immediately there. Even then he still has a less than 5% chance of survival, even if everything went perfect. If you're /out/, it won't go perfect. He's just dead.
>You shouldn't carry an epipen if you're not prescribed it. You should only use it to avoid death. Benadryl is better for 99% of allergies, especially if you don't have a specific allergy that you're trying to avoid. Generally your first allergic reaction to something isn't severe anyways. Go ahead and take it some day when you're stung by a bee and are mildly itchy, you'll regret it. I know people who do have severe allergies, and they avoid taking their epipen until they absolutely have to because it sucks so much.
>Speaking of cardiac arrest, an epipen can cause it, so don't use it unless you're having severe anaphylaxis.
ABSOLUTE SHIT ADVICE
Please stick to topics for which you have knowledge, and when it comes to resuscitation, you clearly have none. It is dangerous to atempt to wheeze your way through the initial measures for cardiac arrest.
>Also, the dose of epinephrine for cardiac arrest is more than 3 times the amount what's in an epipen, and it's given via IV, and it's given every 3-5 minutes. An epipen would do nothing in a cardiac arrest. The little amount that would be injected into the muscle would absorb slower too, since they're not adequately perfusing their muscle tissue.
Another idiot. Epi pen is 1:1,000, epi IVP is 1:10,000. It's high dose via IM. If miles from any trails and decent LZ, and you have it and no other recorse, it could be considered via deltoid after getting help, opening airway and high quality compressions for 2 minutes have begun.
oh great we tubed the goose... um ok so like does anyone here have a BVM? can't i just puff onto the big straw? wait i have to inflate the cuff?
this isn't like the TV shows.
this is hard. i think he's dead
>I'll say this, I'd rather have a paramedic with me while /out/ than a nurse.
>A nurse ... never has to adapt, or improvise. A nurse also never has to make critical judgements. They only are able to follow orders given by a doctor.
>A paramedic, while having a set of protocols, constantly has to make quick decisions about treatment, while improvising and adpating.
Unlicensed prehospital providers follow strict orders either standing or direct via medical control. They exert zero independent practice.
>A nurse never has to figure out a way to get a guy out of a wilderness after he's fallen down a ravine, a nurse never has to carry a 300lbs guy down 4 flights of steps while he vomiting and struggling to breathe, a nurse never has to deal with people out in the environment.
Gosh, it's like you only know about RNs from what fictional accounts you've sat on your ass and been spoon-fed to see. For the most part there are lazy floor nurses that aren't more than robots, but then again, use this not as a justification for your lack of knowledge.
You should remember there are nurses working in Africa and rural south America suturing and treating war refugees.
In the air as you read this right now there are flight nurses that make EMT basics look like overdressed volunteers - that is to say that most paramedics and EMTs that aren't in a busy 911 municipal system are utterly useless interfacility drone posers.
>a paramedic is more qualified then a nurse in emergency medicine. Of course, this is just typically, as there are EM, ER nurses. Honestly the only advice I'd take over a paramedic would be that of a physician.
Until you arrive in the ED and you're basically pushed out of the way and your garbage report is ignored and your shit interventions are reversed.
Jesus, dude. This is /out/ and we don't need a packing list for SFAS. We're talking boo-boos, sunburns, blisters, and the occasional sprain.
The dose for cardiac arrest is 1mg of epi IV.
An epi pen has 0.3mg, given IM
That means the cardiac arrest dose is more than 3 times what's in an epi pen.
You are not giving good advice.
You clearly have never been out of whatever shit ER you volunteer at.
A paramedic does have to make independent decisions.
A nurse does anot exam then relays to a doctor, who orders treatment, that is carried out my a nurse.
A paramedic does an exam, decides appropriate treatment, then administers it.
Yes the paramedic is following a protocol, but the treatment for something like shortness of breath varies greatly based on the exam. A nurse never has to decide if the etiology is something like CHF vs COPD because a doctor is always there to decide that for them.
You seem awful mad for having such little knowledge. You didn't even know what a dose of epi pen was.
>You seem awful mad for having such little knowledge. You didn't even know what a dose of epi pen was.
Holy shit asshole. you are clueless. You sound like a transfer service EMT-Basic that has delusions of medical school one day.
A one time shot of an EpiPen is 0.3mg IM in 0.3ml -- that is the 1:1000 concentration known as high dose -- or one-third the intravenous dosage of 1.0 mg (1:10,000 concentration) recommended q 3-5 min during a cardiac arrest.
Please stop pretending you know what you're talking about. You don't.
That said, anyone from the transporter in the hospital pushing the stretcher to the dispatcher taking 911 calls from drunks has to make independent decisions.
However where you fail in understanding is what authorized decisions anyone working in EMS is permitted to make, is per direct physician order. Nurses use clinical judgment to work with physicians, propose orders, carry out with safety appropriate ones, refuse inappropriate ones, and create plans of care to get a pt admitted or discharged.
A technician who is with a pt for maybe at most 45 minutes does none of this.
Just stick to driving the nursing home patients home from dialysis and ideally directly home without stopping at Burger King. This is about all they pay you $9/hour to understand.
Explaining ß agonist effect, the Frank-Starling law, high v. low dose concentration epinephrine, and dose absorption curvers and rates of IM vs. IV are a complete waste of time to some random millenial generation prick on an anime imageboard.
By the way folks, if you're camping, someone croaks in front of you, and you have an EpiPen, after following BLS guidelines, you might consider in your desperation slamming it into the closest largest muscle near the heart and hoping it's not an LCA occlusion and that there is some residual LV function that might generate a pulse. It's subtherapeutic, but unlike what the asshole in >>670471 said, an EpiPen migh do something in a cardiac arrest after you get a round of compressions moving about 18% of blood volume around.
is the best advice in this thread.
>On the inside :
>_Water Purification Tablets
>_Bandaids (many sizes)
>_Gauze Compress x4
>_Alcoholic Compress x3
>_ "Sos Burn" Compress x3
>_Small scissors (I have a bigger one with my leatherman)
Aloe, some NSAIDs in one of those plastic tube, a few transparent dressings, and room for cushiony warm clean socks.
Maybe a reflective mirror and IR glowsticks for Medivac looking for your lost ass.... or for that impromptu peyote-induced 3am rave at base camp.
I made my FAK and IFAK two separate items because of this. If/When I go hunting I add my IFAK to my kit in case I get hit. The FAK stays in my bag, the IFAK is a separate baggie all its own.
You still didn't rate it though.
This is not true. An epipen would provide little to no benefit in a cardiac arrest situation.
The limited perfusion provided by compressions is not adequate to allow the epinephrine via IM to properly absorb.
Couple this with the fact that the dose of an epipen is 1/3 the recommended dose for cardiac arrest, and the benefit would be insignificant.
It generally would not be harmful, however the time spent administering the epipen is better served doing adequate chest compressions.
Despite current guidelines for epinephrine during cardiac arrest, there is little evidence to support it actually making a difference in patient outcomes.
>one 6" izzy bandage
>3x H&H gauze
>three pairs of Nitrile gloves
>three packs of 325mg ibuprofen
>one pack of 400mg aspirin
>3 alcohol swabs
I should have multivitamins and antiseptics.
Would you say she got....
I've never seen such samefagging except for on /pol/ and /k/ with adolescent angst meeting internet junkies turning on and off their trips while posting for hours hoping for some semblance of human interaction.
You don't have to assert your pretend second-class medical education title here. No one cares, and it's pretense. I could tell you I am a late-20s veteran ER RN with great tits and a perfect ass, or a salty mid-30s combat medic in some dusty FOB on his 8th tour, or a PGY-5 chief surg resident. It wouldn't matter one bit.
Giving a shot of an epi pen to a corpse for whom you are flogging has little to no benefit with such a low concentration, into a poorly perfused cyanotic extremity without adequate systemic circulation even in the face of high quality compressions. Besides, for all of you EMTs and volunteers, it is clearly outside of your scope of practice.
Do I recommend sticking an EpiPen in a dead patient with CPR in progress? No. If a patient went into respiratory arrest and then the first 20 seconds of cardiac arrest would 0.3 mg of epinephrine work? Not even the internationally published cardiologist titans know. There is no research to date.
Technically, using an autoinjector epinephrine 0.3 mg is a Class III intervention per per ACLS guidelines.
Arrich J, Sterz F, Herkner H, Testori C, Behringer W.Total epinephrine dose during asystole and pulseless electrical activity cardiac arrests is associated with unfavourable functional outcome and increased in-hospital mortality.Resuscitation. 2011 Nov 11. [Epub ahead of print]
Jacobs IG, Finn JC, Jelinek GA, Oxer HF, Thompson PL.Effect of adrenaline on survival in out-of-hospital cardiac arrest: A randomised double-blind placebo-controlled trial. Resuscitation. 2011 Sep;82(9):1138-43. Epub 2011 Jul 2.
In sum, fuck all of you.
The post that started all of this was to irritate tripfags, teenaged explorer scouts, volunteers, and wannabe inner city medics.
OP get something simple that avoids aches, pains, sunburn, and torn skin. That's all you need.
Addenda for you:
Vasopressin rationale for exclusion and update on the VSE protocol.
Interesting reads below if you actually work in medicine and skim the journals.
Hagihara A et al. Prehospital Epinephrine Use and Survival Among Patients with OHCA. JAMA. 2012; 307(11):1161-68.
Nakahara S et al. Evaluation of pre-hospital administration of adrenaline (epinephrine) by emergency medical services for patients with out of hospital cardiac arrest in Japan: controlled propensity matched retrospective cohort study. BMJ. December 2013.
Jacobs IG, Finn JC, Jelinek GA, et al. Effect of adrenaline on survival in out-of hospital cardiac arrest: a randomised double-blind placebo-controlled trial. Resuscitation. 2011; 82:1138–1143.
Mentzelopoulos S, Zakynthinos S, Tzoufi M, et al. Vasopressin, epinephrine, and corticosteroids for in-hospital cardiac arrest. Arch Intern Med. 2009;169:15-24. PMID: 19139319.
Mentzelopoulos S, Malachias S, Chamos C, et al. Vasopressin, steroids, and epinephrine and neurologically favorable survival after in-hospital cardiac arrest: a randomized clinical trial. JAMA. 2013;310(3):270-9. PMID: 19139319.
Varvarousi G, Stefaniotou A, Varavaroussis D, et al. Glucocorticoids as an emergency pharmacologic agent for cardiopulmonary resuscitation. Cardiovasc Drugs Ther. 2014;28:477-88. PMCID: PMC4163188.
Ong ME, et al. A randomised, double-blind, multi-centre trial comparing vasopressin and adrenaline in patients with cardiac arrest presenting to or in the Emergency Department. Resuscitation. 2012;83:953-960.
Ducros L, et al. Effect of the addition of vasopressin or vasopressin plus nitroglycerin to epinephrine on arterial blood pressure during cardiopulmonary resuscitation in humans. J Emerg Med. 2011;41:453-459.
Agreed. Let's additionally concur that 99.9994% of the vistors to this website shouldn't be anywhere near field administration of vasoactive drugs.
Also, that none of the foregoing is medical advice whatsoever, rather merely entertainment, commentary, and general information.
Again, good night. Hoping for a silent night.
Camera's busted so no pics, but it contains:
3 square slings
4 pairs sterile gloves (2 latex, 2 nitrile)
sticking plaster tape
aluminium foil (in case of cavity breach/collapsing lung)
water purifying tabs
Epi-Pen (if I'm with a group)
pathology-grade hand sanitizer
I keep it in a milsurp .308 box to prevent crushing
all you EMRs. How would you treat a venomous spider or snake bite? do you tourniquet the limb? do you cut the bite and bleed it out? do i need vasoconstrictor? what treatment can i do that will get me to a cure.
I'm a metro emt, so I have 0 experience with venom. But basics would be proper TQ placement, and then keep the wound lower than the heart at all times.
I would suggest you keep the bitten person stationary, and go find help if you can. Keep the heart rate as low as possible, prevent the blood from moving around.
Do not use a tourniquet, and don't cut the wound.
You won't be able to bleed out enough venom to matter by cutting it. The whole cut, suck, and spit is just for movies.
If you're bit by something like a rattlesnake, it's rarely deadly. You actually want the venom to go through your whole body, not stay occluded in one limb. You can lose the limb by the venom staying in that limb with a tourniquet.
desu I just run with an AMK water tight and ultralight .05 I've stuffed a strip of anti histamines, some 30/500 DCH, and space blanket. Of all stuff in the UK /out/ wise it's hypothermia that is the biggest risk
Realistically if I need more than this kit I'm in need of a trip to a hospital.
okay so mine isnt entirely camping, but i ride a motorcycle litterally everywhere (i dont even own a car) and for the longest time ive said "i need to get a first aid kit together"
weight isnt an issue but size is.
as of right now i have two rolls of gause and a roll of duct tape in my back pack, and a little tube of knock-off neosporin, and i always have at least two knifes on me that i call good enough for cutting gause or tape or clothing, because theyre both shaving sharp
i have 30 dollars to add to it, what do i put in?
i plan on taking it fishing a lot, and as for camping i go out with the bare minimum for a weekend.
I've been trained on how to use it all, as well as had an NPA inserted.
That's why I don't have a pneumothorax(?) decompression kit. I haven't been trained on how to use it and I don't want to do more harm than good.
Oh, and I believe I have an older one. There isn't any red on it, two hole buckle, no white atrip to write the time on. Looks similar to pic related.
That's a first Gen 1. I would suggest putting the $20 down to get the Gen 7. There's a reason why there have been 6 more generations, and although the Gen1 is still a very good option.
Groovy on training, just asking. Have fun!
Not to be a faggot contrarian, but I don't really see any improvements worth buying a new one over.
However; it wouldn't be a bad idea to buy a new one. I tried "the stranger" a few times with it, and I really shouldn't be fucking around and possibly causing wear on something as serious as this.
>Adds too much extra weight.
Stopped reading here.
>various bandaids both pre-cut and non pre-cut
>sharpie for marking tick bites
>500mg acetylsalicylsyre/50 mg caffeine tabs
>orange bandana tied to the outside for visibility
in a Marz IFAK with a first aid patch
eh, could be more organized, could be more varied