Joshua - March 11, 2019
Favourite part of my month is seeing a new article in my email.
Tom RaderStaff - March 11, 2019
Thanks, @Joshua! We are happy to hear you find the content valuable.
Jonnie Pekelny - March 24, 2019
Here’s a general question about first aid and self-treatment of medical problems when SHTF. My problem is that I have a pretty bad phobia of “blood and guts.” (Don’t know where it comes from, possibly the fact that I had a tonsillectomy without anesthesia! when I was a kid.) Just listening to or reading about a description of injury or wound in any kind of graphic detail makes me literally weak and nauseated. I guess most folks aren’t quite at my level but I’ve heard of other people who faint at the sight of blood, etc. For me that’s always been a block to doing any kind of serious first aid prepping, although I know it’s important. I just don’t know how to get past that block. Are there any kinds of desensitization programs or something?
Tom RaderStaff - March 26, 2019
First off, what you are describing is very common. It is called an Acute Stress Reaction (ASR), and many people experience it in relation to medical situations, especially trauma. Humans are generally not wired to deal with other humans injured. I’ve had stone-cold, pipehitting Marines literally pass out when I was giving a flu shot (needles are another medical ASR trigger).
You are correct in that desensitization is how you learn to move past it. If a description (or picture) of a wound is what triggers the response, avoid that in the initial stages.
First work on building up the mechanical skill. Practice applying the dressing and bandage on a person (or section of PVC pipe) until you can do it without thinking. Once you have the skill down pat, you have to practice while progressively increasing your stressors.
The next step is to make simulated, abstract wounds. Use a red sharpie and draw a simple line on the patient’s arm (or PVC). Practice with that until you are comfortable—you just have to work through it.
Next move up to strawberry jam (or similar). The idea is to progressively use things that look like injuries but that you know are not. From there add some Karo syrup with red food coloring.
What also helps is to understand that your training will be helping someone else through an emergency.
Another thing to consider is that the trigger could be just from reading (or listening) to descriptions—you could be fine with an actual injury (or a moulaged simulation). Personally, there are certain photos of injuries that make me sweat, but that I have absolutely treated without problems in real life.
Jonnie Pekelny - March 28, 2019
Great suggestions — thank you. But what do you do to keep building up exposure tolerance once you’re past the strawberry jam on pipe model? I mean, eventually you want to expose yourself to things that are more and more like actual wounds, I guess… (Doesn’t sound fun to me, LOL). Not sure how to arrange that in stages in real life.
Tom RaderStaff - March 29, 2019
You are right that the progression needs to continue, and unfortunately the real-world test is not something that can be simulated 100 percent.
When we teach wilderness medicine classes we use pigs feet for the wound cleaning and dressing/bandaging lab. You can also use a turkey/chicken leg, etc.
If you are near an urban EMS department, you can likely do a ride-a-along for exposure–though there is no guarantee you will see something (also no guarantee on limiting exposure either).
How do you manage simple cuts and scrapes right now? Shaving nicks? Paper cuts? Somehow I end up with some kind of minor injury at least a couple times a month. If you are able to manage those, realize that larger injuries are really the same thing–just a little bigger. The same principles apply.
Jonnie Pekelny - April 1, 2019
I do okay with small cuts and scrapes as long as they’re not super deep or bleed for really long periods of time. In fact last summer I managed to burn myself fairly significantly with hot oil on my leg while cooking. It looked pretty gross once it started peeling. That was borderline okay. Not sure if it would’ve been okay on another person. So maybe the solution is for me to inflict more and more serious wounds on myself? (Kidding).
Tom RaderStaff - April 1, 2019
Ha! Yeah, don’t do that!
It sounds like it is more the thought of the injury rather than the action. Which means you’ll probably be fine. Just practice until the skills are second nature and it won’t be a thought process–just “muscle memory”… 🙂
Nick - April 4, 2019
Thanks for the detailed presentation. If I understand correctly, there is no need to treat the wound itself with antibiotics (once its properly cleaned). Should antibiotics be taken by mouth right away, or only if and when there are signs of infection? Or does it depend on the severity of the wound?
Tom RaderStaff - April 5, 2019
Hi @Nick, that is correct–no need to put antibiotics into the wound. The most important thing is to clean the wound thoroughly and then protect it from contamination while also keeping it moist and warm (which can be done with white petroleum jelly on gauze).
There is research that shows taking a prophylactic antibiotic at the time of injury can reduce the chance of infection, but you have to dose with a solid multispectral antibiotic. In the military we had “pill packs” that (at the time) contained a dose specifically for that purpose and we instructed to take those packs for any soft tissue injury. That said it is important to have a good understanding of antibiotics before choosing one.
In general, I would take as few medications as possible, and would probably wait until there were signs of an increasing infection. If the wound was grossly contaminated, though, I would probably consider taking an appropriate antibiotic as soon as possible.
Max T - May 14, 2020
Thanks for the great article, very helpful! I have a question though after reading this and the first aid kit list (https://theprepared.com/bug-out-bags/guides/first-aid-kit-list/). It seems most of the dressings mentioned here are not on that list. Of the dressings here (non-adherent, wet, hydrogel, hydrocolloid and simple gauze) only gauze is included on the first aid list, though non-adherent dressings are recommended here for most wounds.
So I’m wondering if I should include these dressings (non-adherent, wet, hydrogel, hydrocolloid) or not. Non-adherent at least seem like a good idea to include? And hydrogels possibly worth it for burns, with hydrocolloid replacing some of the moleskin as they can also be used for blisters? Or is the extra weight/space just not worth it?