Friday, February 26, 2010

Blood, Guts, and No Worries: Woundcare in the Wild

In the event of a zombie attack... wait, oh, that's right, there are no zombies attacking these days. Just the Taliban. ;) Seriously though, have you noticed that there are a good number of zombie attack preparedness sites out there in blogger space?

I mean come on ...they're slow and falling apart like my uncle's Chevy. That thing can't even get out of the driveway without losing it's oil pan. I'd be more afraid if there was an attack of rabid old people: they have canes. And they can spit their dentures out at you from a mile away. Think about it, their walkers scraping the ground as they stalk towards you, mole hairs waving in the wind. Some carrying rolling pins, shouting, "In my day we didn't have internet!" Now that's scary.

But whatever slow moving decrepit thing, whether it be zombies or rabid fossils, is attacking in the apocalypse, you need to prepared. Dude, but if you can't out run either of them, you deserve getting bit.

Now I can't train you to fight off a zombie, but I can teach you how to handle wound care in the wilderness. I can't tell you how happy I am to finally get to the wound care series of these posts.

I couldn't wait to post this so much that I have already posted some of this on a wonderful site, called American preppers. So to all my Preppers buddies: Sorry for the repeat.

First Aid on the Frontline

In all medical situations, even those within the hospital setting, any medical professional must act according to a certain order of important principles because of their lifesaving nature.... the ABCs.

A - Airway
B - Breathing

C - Circulation

D - Disability

Airway: Basically, you make sure that they have an open trachea (windpipe) or an open way to breathe. No open airway: No way they can breathe. (Image taken from: California White Water Rafting and First Aid. This is a site specializing in training wilderness medicine hands-on.)

Breathing: You look, listen, and feel for their breathing. This is also where rescue breathing comes in. Give two breaths. Refer to Rescue Breathing Video.

Circulation: The bleeding. Here is where you treat the wounds. You wait until you know that they have an open airway and are breathing before even attempting to take care of their bleeding.

Handling their airway and breathing can be quite simple in many circumstances. If they are screaming, talking, complaining, or swearing at you like they're a drunken sailor than they have an open airway and they are breathing. See. Simple.

Disability: This step is where you check to see if they can move all four extremities and splint broken bones. If they are waving a bird at you, then they can move that extremity.

Now for the good stuff...

Blood, Guts, and Gore...

Okay, so only a little blood, no guts, and well, the gore is up to your perspective.

When faced with wounds, there are a few goals that you need to focus on, especially out in the boonies.

1. Control the Bleeding: The whole point of the Circulation portion of the ABCs.
2. Clean the wound and prevent infection

3. Reduce discomfort and promote healing

4. Minimize the loss of function
(we're dipping into the disability stage here, but still we need to mention it.)
5. Perform correct care and transport of patient

Before I get into the nuances of wound care, I would like to stress here that you need to attempt some form of body-substance-isolation (BSI) first. BSI is a full body cover-up kit. And I seriously doubt that any of you are carrying a surgeon's gown mask, and surgeon's gloves in your backpack. So let's make one with stuff you might be already wearing.

Eye cover: Ski goggles or sunglasses or even regular glasses (not as great as those ski goggles, but hey, it's coverage).

Gloves: Any water barrier gloves or barrier material, such as those Ziploc sandwich bags your PBJ is sitting in, or the plastic grocery bag that you are carrying to put your trash in.

Body cover: Because some of these wounds can make Old Faithful look like a weak geyser. Parka. Ski Jacket. Big garbage bag with holes for arms. Or that "Kiss the Cook" apron works too.

Alright, you're covered up and you throw a tarp down for your poor bleeding patient to lay on.

Now you're ready to deal with the Slasher flick before you.


How do we control bleeding?
Pressure. Pressure. Pressure.

Literally, you apply pressure to the wound. Get your gloves in there, if you don't have gauze, and apply some direct pressure to the wound. (Be one with the oozing wound... Ohmmmm).

Direct pressure, elevation of the body part, and packing with a moist sterile dressing or clean cloth (if sterile is unavailable) will stop most hemorrhaging.

I, personally, like to add to my wilderness kit a little hemostatic qauze or agents like Celox, Gelfoam, Surgicel, or Jello (non-sterile)... there's always room for Jello. These speed up the clotting process considerably.

Stop the bleeding and pad with sterile gauze or clean cloth... or you could even use one of your Ziploc sandwich bags minus the PBJ to dress the wound... than affix it with roller gauze, surgical tape, or that duct tape that you know you tie around your ski poles or walking sticks. Duct tape is your friend.


Irrigation is more than just a farming tool.
Basically, you take sterile water and spritz down the wound, washing debris, soil, foreign bodies, etc from the wound. Well, you forgot to shove that liter of sterile fluid in your backpack, but you do have your sports water bottle or canteen.

Remember your goggles... they come in handy right at this point. You spritz them, they spritz back.

In situations where you don't have irrigation available, use a ziploc bag filled with clean water, put a pin-sized hole in it, and spray the wound clean.

Visible debris can be removed with sterile forceps or if you don't have them, tweezers dipped in alcohol.

You know, also contact eye solution can be used to irrigate a wound. Not only is it a clean isotonic solution, but it also has some minor elements of bacteriocides within it.

You can use honey or sugar as a natural antiseptic. Except with the honey, avoid putting the honey on the good intact skin, just put it in the wound then cover it with a sterile or clean dressing. With the sugar, just pour it in. Your patients will say that you're sweet for treating them so wonderfully. I will discuss the benefits of honey later in a different post.


There's more to do than just knock them out with a tree log.

Stabilize the extremity with the wound. Strips of duct tape can be used to close a wound in place of steri-strips if you don't have them on hand. Dermabound and its non-sterile cousin, tissue glue can work as well. Be careful with super glue... it can cause chemical burns. (I will discuss superglue in a different post.)


Lastly, if it's wounded, get rid of it.
No, you don't shoot them... although there are some whiners out there that might tempt you to do so.

Seriously, if a person has been wounded, evacuate them. They need to get proper medical care.

The following is a list of "wound" situations where evacuation of the patient should be as rapid as possible:

-Infected wounds, deep penetrating wounds, impaled objects, wounds with ligaments, joints, tendons, or bones exposed

-Animal or human bites. (Yes, human bites can happen. Some people get awful hungry in the wilderness.)

-Severe blood loss

Next time, we will talk about using natural antiseptics.


If you have any further questions, feel free to email me or post a comment and I will get back to you as soon as I can.

(UPDATE: I do want to thank a reader that has enlightened me on my typos. Remind me never to speed through a blog without grammar checking it first. ;).

Also, I have been informed that there are an epidemic of "fast zombies"... I would have thought those were medical students rushing of campus after a week of exams, but apparently, there are other types of fast zombies.

I would like to express my appreciation for the reader that helped me realize all this. Thank you :). )