If I could only carry one first aid specific item in the wilderness, it would be an irrigation syringe.
There’s a lot that can be done with bandannas, duct tape, and paracord. A multitool, spare clothing, sleeping pad, tarp, poles – pretty much everything in a pack, including the pack itself, can be fashioned into some kind of medical implement with a little ingenuity. But cleaning a wound will always remain difficult. It also remains extremely important. Infection is both very common and very inconvenient in the wilderness, where you’re well away from definitive care.
Clean water should always available and irrigation is a simple and effective method of cleaning a wound. But water just poured over a wound won’t do much good. Pressure is needed. Occasionally you might hear people claim that you can fill up a ziploc bag with water, cut or poke a hole in one corner, and squeeze the bag to force out a stream of water. That’s certainly better than nothing, but in my experience the pressure from that is not comparable to the pressure from a syringe. With an irrigation syringe, you can take the cleanest water available (usually your drinking water) and shoot it into the wound. Pressure washing the wound like this allows you to easily clean out all the grit and dirt. There’s no need to go poking around in there with unsanitary tools, probably causing more harm than good. A 12cc syringe like the one I carry costs $1, weighs 8 grams (0.28 oz), and takes up very little room. I can’t think of a reason not to have one in your pack!
Remember: a clean wound is a happy wound. You can put all the effort you want into the perfect bandage, but if the wound isn’t clean, you’re going to have some problems down the line.
A stye is a sort of pimple on the eyelid, caused by a bacterial infection at the root of the eyelash. The common treatment for the infection is applying a hot compress to the area, which encourages the stye to drain. I had a small stye on the inside of my lower left eyelid last week and decided to see if I could speed the healing process along with herbal experimentation. It ended up healing in 2 days.
The first day I applied a thyme compress to the area twice, for 15 minutes each. The compress I made by simply making a cup of thyme tea (steeped for 20 minutes for medicinal strength) and soaking a sterile gauze pad in it (with occasional re-soaking throughout the 15 minutes process as the compress lost its warmth). Thyme contains Thymol, an antiseptic which acts as a sort of antibiotic.
Of course, with any infection, the most obvious thing to reach for is Echinacea. I was out of tincture at the time, but I made a cup of tea with some dried Echinacea purpurea root before bed the first night.
The second day I repeated the twice daily 15 minute compress, but this time with Chamomile (Matricaria recutita). Chamomile has a reputation as general-purpose healer, and is also a relaxant.
The morning of the third day, there was no evidence of the stye.
The week before last, I had a fungal infection on my left foot, marking the first time athlete’s foot has paid me a visit– I’m usually rather good about wearing shoes in public places, sandals in public showers, et cetera. But the combination of barefoot martial arts and wearing socks most all the time (it’s cold! remember, I don’t use heating) – particularly soon after I get out of the shower – gave the fungi a hospitable environment in which to grow.
I noticed it early as an itch on the foot, which was unusual and so warranted research. Google told me that this could be the sign of an infection, so my first thought was to rub Tea Tree Oil over the base of the foot and between the toes. I did this after a shower every day, but after 3 days the foot had begun to look worse. So, I performed further research: what athlete’s foot was, how it grew, and possible remedies. This led to me devising the following schedule (note that I shower in the evenings):
Morning:
Upon waking, rub the foot with rubbing alcohol (70% isopropyl), which is both cleansing and drying.
Before leaving for the day, rub the foot with Tea Tree Oil, an anti-septic.
Afternoon:
Soak in a garlic bath for 30 minutes, then towel dry.
Evening:
After shower, powder the foot with Baking Soda.
Before bed, rub the foot with Tea Tree Oil.
Observing this schedule, the infection cleared up in 5 days.
Luckily, the temperatures have been rising lately, so I was also able to stop wearing socks whenever home. This gives my feet ample time to dry after the shower, and all night to breathe.
The garlic bath is made by crushing 4 garlic cloves and placing them in a large pot of warm water, with a splash of rubbing alcohol added. It’s quite pleasant, though not recommended for members of the undead.
The Wednesday before last I managed to fracture a rib at Fight Club. It failed to make itself known during class – only later did I inventory a small, sharp pain upon taking deep breathes. My journal that night accounts:
1-2-08 10:12 PM
It hurts when I breath.
Is that bad?
Thinking nothing of it, I returned to class on Thursday, which proved to be a mistake, the pain after that night being far greater. At this point, I decided that something was not quite right. My next journal entry reads:
1-4-08 8:10 PM
My self-diagnosis is that I have a fractured rib. It is either the 2nd or 3rd rib (or both) down from the top on my right side. I don't think it anything serious: my breathing is even, at a normal cycle and depth, and (as near as I can tell) there are no abnormal sounds. This leads me to believe that it is a minor fracture, not a break, and that the lung has not been punctured by a stray splinter.
Deep breaths are painful, but not so much as to discourage them. Certain obtuse movements of the right arm, as well as twisting of the torso, causes pain. The most painful act is bending over to tie my boots -- methinks it is gravity dropping all my guts and exerting pressure onto the rib. I now kneel instead. I have yet to cough.
Consulting the medical books I have lying about (and the global interwebs), the only treatment for such an ailment proved to be observing a minimum of one deep breath an hour and a strict rest cure, to last till the rib was healed, which on average takes 2-3 weeks. Clearly, this would not do. A month absent from Fight Club would be regrettable, but a month without running or riding my bike or any other activity that involves frequent deep breaths would not be possible (though the pain was not enough to discourage my normal cycle and depth of breathing, what was previously aerobic had become anaerobic and what was anaerobic was right out). As such, I decided to alter my diet in an attempt to assist the healing process.
Calcium & Silica
Of course, it is common knowledge that bones need Calcium to grow. I dislike milk, but instead increased my intake of almonds, broccoli, carrots and salmon; all of which are rich sources of the mineral. For teas, I purchased Horsetail and Nettle, to supplement the Alfalfa and Chamomile which I already had. Horsetail and Nettle, it just so happens, are also a source of Silica, which, I’ve read, aids in the proper assimilation of Calcium.
Magnesium & Vitamin D
But, surely, Calcium is not all that is required? Further research indicated that both Magnesium and Vitamin D intake should be increased when consuming more Calcium. And what herbs provide an ample source of both Magnesium and Vitamin D? Why, Alfalfa, Horsetail, and Nettle, of course! It’s almost as if Mother Nature knows what she’s doing. Food sources of Vitamin D include egg yolk, salmon, and sweet potatoes. Food sources of Magnesium may be seafood, apples, bananas, brown rice, and salmon.
Phosphorous & Copper
Care should be taken to increase the amount present of two other minerals, as well: Phosphorous and Copper. Eggs and salmon, it turns out, are excellent sources of Phosphorous. Copper may be acquired through almonds. (Side note: I’ve discerned that it is not possible to kill oneself by eating too many sprouted almonds. If it were, I surely would be dead by now.)
Results
So my diet changed to consist of much salmon, brown rice, carrots, apples, bananas, broccoli, with the odd sweet potato and a hard boiled egg once a day. Whenever I felt the need to munch on something, I’d toss down a handful of sprouted almonds (as I’m doing right now). Each morning I would have a cup of Nettle tea, each night a cup of Horsetail tea. If I felt the desire for tea in the middle of the day, I would mix together a bit of Chamomile with a bit of Alfalfa.
All said and done, the rib healed in a week and a half.
Did my diet influence that? Well, diet couldn’t not influenced the body, but as this is the first time I’ve fractured a rib, I’ve no bench-line against which I can measure; save only that the Medical Establishment deemed 2-3 weeks an appropriate number to publish here and there. It certainly didn’t hurt.
(Food and herbal sources of vitamins and minerals were all gathered from the CedarLily Vitamin & Mineral chart that John Gallagher used to sell.)
After taking the WFR course last month, I was given a 20% off coupon at the NOLS store. So, I decided to treat myself to a few goodies.
MDI CPR Micromask. Being triple certified in CPR, it may look a little foolish if I didn’t carry a mask with me – at least on trips. This one is pocket sized, so it now lives in my right cargo pocket. It’s considered one time use because the little tube is inserted into the patient’s mouth. Masks are a better choice than those flimsy plastic sheets they sometime give you in classes for a couple reasons, the first being BSI – Body Substance Isolation. Patients have a tendency to vomit. Rescuers have a tendency not to want to eat their patients vomit. These masks do a better job of protecting you. Full masks, even better. The second reason is that the air you inhale is about 21% oxygen, but you exhale only 16%. Thus, breathing for a patient is less effective than the patient breathing for themselves. Masks help to concentrate your breath, making each of your attempts more effective. Full masks also allow your breath to enter through the nostrils.
First Aid Restock Pack. This thing includes all sorts of little goodies. Odd-and-ends that are most frequently used from your kit, and you probably neglect to replace. Plus some 2nd Skin, which is probably the single coolest first aid item available.
Patient Assessment Bandanna. Bandannas have a multitude of uses; whether to keep hair under control, wipe your hands, use as a pot holder, or even filter water. For the wilderness rescuer, the bandanna doubles as a cravat: use it tie a splint or boil it for a sterile bandage. This one has the patient assessment system on it, so when your adrenaline is pumping and you forget what the hell you’re supposed to be doing, just farce wiping your brow with this and cheat a glance at the list – without losing face with your patient or bystanders. Included on the bandanna is a fill-in-the-blank SOAP note. That little piece of crucial documentation that everybody always forgets, but will save your heiney in court.
Tomorrow is day one of my Wilderness First Responder course, the next step up from the Wilderness First Aid course I took last year.
Essential for anyone who spends significant time in remote places or who has a professional career in the outdoors, the Wilderness First Responder (WFR) course will prepare you to make difficult medical decisions. This course is fast-paced and engaging. You’ll spend half your time outside of the classroom doing hands-on skills and realistic scenarios. In addition to scenarios, you’ll participate in a full-scale night mock rescue. WMI’s curriculum encompasses a wide range of topics including long-term patient care, wound management, straightening angulated fractures, reducing dislocations, litter packaging and administering medications. You’ll complete this course with the tools and confidence to manage patients in the backcountry for multiple days. The intensive 80-hour curriculum is nationally recognized and supported by the Wilderness Medicine Institute’s Medical Advisory Panel. You’ll be taught by dynamic educators who have practiced both wilderness and urban medicine. This 10-day course is ideal for all professionals operating in remote environments. Adult CPR certification is included. The WFR course is pre-approved for 70 hours of EMT CEU’s by CECBEMS.
8am-5pm for 10 consecutive days. Oughta be fun, as long as they provide nap time.
Brigitte Mars’ Natural First Aid is a nice little book for dealing with home, and some wilderness, ailments. The book begins with a short introduction to basic first aid – CPR, splints, and the like – and follows that with “An A-Z Guide to Ailments and Injuries,” including everything from nosebleeds to jellyfish stings. Each ailment includes possible herbal and homeopathic techniques for prevention and remedy. The books also includes a chapter on “Surviving Nature’s Challenges,” which discusses basics of topics such as surviving bear attacks, making fire, and giving birth.
The book, sadly out of print, is very basic, and is no replacement for real first aid training, but certainly warrants a spot on your bookshelf for herbal reference.
Today was my Red Cross CPR and First Aid class. The 2 hours spent on first aid were a joke. Compared to that, Wilderness First Aid might as well be an EMT course. We just watched a video for the different illnesses and wounds covered, and the solution for all of them was “dial 911”.
The CPR portion of the 9AM-4PM class, on the other hand, was great. I learned a lot – not surprising, as I didn’t know anything about it going in – and might even remember a thing or two.
I recommend signing up for the CPR class. The instruction was good, the classmates fun. (Speaking of which, I was the only one taking the course for fun. All else were required by work or school.)
So now I am certified by the Wilderness Medicine Institute in Wilderness First Aid, the American Red Cross in Standard First Aid, and the American Red Cross in Adult CPR. This winter I plan to take the week long Wilderness First Responder course. Look out medics.
