Medical Considerations in the Backcountry
When discussing trauma, we should not fail to mention ballistic trauma due to the nature of our long range hunting pastime. With wartime medicine having such an impact on civilian pre-hospital medicine, the use of tourniquets has come back into favor. This piece of equipment is another part of vital gear carried by today’s warfighters. The most common tourniquet found is the Combat Application Tourniquet. It is readily available, and could make the difference between life and death in the remote areas we all hunt. The average person can hemorrhage his entire blood volume in 2-3 minutes if a tourniquet is not applied. This is a valuable part of a first aid kit that, given the right environment, can save you or your buddy’s life when applied quickly and correctly. I would like to mention here that belts are commonly mentioned as impromptu tourniquets. As a general rule, they are too wide and do not make a good device. But anything would work if you have the ability to tighten it enough. Once applied, the tourniquet should be left on and be tightened enough to stop all external hemorrhage.
The Combat Application Tourniquet, the most widely used field tourniquet in the world.
Another hemorrhage control tool is a hemostatic agent. Most of you have heard of QuikClot. There are several hemostatic agents on the market, and we have coined the term QuikClot for all of them (like Xerox for copiers). These are usually an impregnated sponge or gauze pad with clotting agent. This can be placed in a severe wound and stop the bleeding with a chemical reaction. These are effective if used properly, but require some skill and training.
The easy to use hemostatic agent QuikClot helps control bleeding until help arrives or you can get to an appropriate medical facility.
Hemostatic agents are available for the civilian consumer and are usually a good addition to your kit. These materials are applied deep in the wound, so it is not for the faint of heart. The material makes an artificial clot and it has a reaction to blood. If the product cannot be placed directly on the bleeding vessel, it will not place the clot in the correct location and the bleeding will continue. Direct pressure and dressings must be added to the application of hemostatics. The first generations of hemostatics had a pretty aggressive heat reaction to the wound. The newer models of the hemostatics are not nearly as caustic.
Think about gunshot wounds like a trashcan. If the bleeding is at the bottom of the trashcan and all you do is put a lid on it, the bleeding will continue. If you pack the trashcan, then force the lid on it, you will stop the bleeding. Putting pressure down in the wound at the site of bleeding is imperative.
This may seem like an unlikely article in which to quote Plato’s book, The Republic, but his words, “Necessity is the mother of invention,” can be applied to medical incidents, since they are not often planned. While teaching several Special Operations groups from Iraq and Afghanistan, I have seen photos of tourniquets made out of bandanas and sticks, ratchet straps, and all sorts of impromptu materials to achieve hemostasis. If by chance you forget your first aid kit, do not hesitate to utilize a t-shirt or bandanna or rifle strap, or whatever you may find. Sterility is not an issue in dire circumstances. Antibiotics are readily available at the hospital; it is your job to stop the bleeding and to get the victim to a facility.
A few other odds and ends you may include are a pair of EMT scissors, safety pins, chem light, SAM splint, and a foil blanket. All of this kit can be thrown in your one gallon Ziploc and stowed for use. Most all of these can be purchased at your local drug store.
Assurance that someone always knows where you are when out on a trip is very important. With the common usage of satellite phones and SPOT transmitters, keeping aware of your location with handheld GPS, and the ability to forward that information to rescuers can be imperative to your survival in the wild. With the recent story of the family in Colorado surviving after their Jeep accident in subzero temperatures, always think about “what if” you had to stay in the backcountry longer than expected.
Putting together a small first aid kit could mean the difference between an enjoyable hunt with relief from a slight headache, to saving a friend’s or your own life during a catastrophic accident. It’s the best piece of gear you hope you will never use, so dedicate a pocket on that pack to a small insurance policy.
And be that Boy Scout: Be prepared.
• One gallon Ziploc bag
• EMT Shears
• Chem light
• Safety Pins
• 4x4 gauze pads
• 4 Inch roll gauze or Olaes bandage
• Travel size medications (Benadryl, Advil, Tylenol, Imodium)
• Travel size sunscreen (even in winter)
• SAM Splint
• Foil emergency blanket
• Extra personal medications
• Medical or Duct tape (wrap several feet around itself)
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