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Hunting Injuries — Myths and Misconceptions

Tuesday, September 21st, 2010

By Buck Tilton

With the season of the orange-clad huntsman comes an opportunity for a wound — more than 35,000 of these incidents occur in the U.S. each year — usually relegated to the wilds of major metropolitan areas. What you don’t know or what you think you know, but are mistaken, can make someone with a gunshot wound worse. So, let’s take aim at some of the enduring myths and misconceptions surrounding this potentially life-threatening injury:

MYTH: Modern, high-powered bullets always leave exit wounds larger than entrance wounds.
THE REALITY: It ain’t necessarily so. A tumbling, twisting, mushrooming bullet may surely create a wound much larger when it leaves a body, but often the bullet breaks apart or shatters a bone, and small fragments blow out of the body through a hole or holes smaller than the entrance wound. Remember, don’t focus solely on the entrance wound and forget to look for the exit wound.

MYTH: Big bullets leave big holes and vice versa for little bullets.
THE REALITY: Think again. Sharp edges (such as arrowheads) slice the skin, but bullets stretch skin, crushing it momentarily before blasting through, and the elasticity of skin causes it to bounce back, leaving a hole typically smaller than the bullet’s size.

MYTH: You can judge the path of a bullet through a body by the orientation of the entrance and exit wounds.
THE REALITY: BZZZ! Wrong answer. The hunk of lead can make mysterious turns and ricochets once inside a body, entering, for instance, the shoulder and ending up passing through the abdomen or entering the thigh and ripping up into the chest.

THE CORRECT RESPONSE

Check for both entrance and exit wounds, yes, and apply direct pressure with bulky material such as the trauma pad from your first aid kit or shirts and bandannas. When external bleeding has stopped, cover the wounds with sterile dressings. The petrolatum dressing with AMK’s Hunter kit works very well at protecting the wound and speeding up the healing process. In arm and leg wounds, bones may have been broken. Check for broken bones and splint the extremity if necessary. Treat for shock and go for help ASAP.

Make sure your kit includes trauma pads and QuikClot for stopping serious bleeding

SOME POINTS ABOUT ARROW WOUNDS…

If you base your management of impaled arrows on John Wayne movies (think of the “Duke” in one his many popular Westerns, heroically ripping out Indian arrow after Indian arrow as if they were bothersome splinters), number yourself among the first-aid impaired. Today’s broadheads are not only razor sharp but also designed to tear apart large chunks of an animal’s anatomy. Pushing one through or, even worse, trying to pull one out usually enlarges the problem substantially.

THE CORRECT RESPONSE

You can cut off, if you’re able, the visible shaft down to, say, three or four inches. Pad around the shaft well with gauze or clean clothing and tape or tie the object securely to prevent movement. If the object is stuck in an arm or leg, be sure the tape or ties does not cut off blood flow past the tape or ties. Treat for shock. Go for help.

RECOMMENDED GEAR LIST

AMK’s Hunter Kit Includes 5″ x 9″ and 8″ x 10″ trauma pads for stopping bleeding, among other hospital quality wound care materials; Nitrile Gloves for safely handling blood-soaked bandages; and MD-penned Easy Care™ Card with instructions on how to stop bleeding.

Trauma Pak With QuikClot®Comes with essential wound care materials, including a 25 g pack of QuikClot Sport, the US Military’s Hemostatic bandage of choice; stops serious – even arterial bleeding – in as little as five minutes.

Buck Tilton has authored 36 books on outdoor safety, including Wilderness First Responder, which won an award for excellence in medical writing from the American Medical Writers Association. For the last 20 years, Buck has contributed hundreds of articles on wilderness safety to Backpacker. In addition to his writing and journalism, Tilton also co-founded the Wilderness Medicine Institute (now WMI of NOLS), which remains the largest school of wilderness medicine in the world.

Essentials for Family Camping First Aid

Thursday, July 15th, 2010

It’s summertime! That means it is time to get outside and explore your state and national parks, recreation areas, and favorite campgrounds.  Before you pack up the kids into the SUV,  be sure to review this list of outdoor first aid tips from wilderness safety expert Buck Tilton, who this month joins AMK as a regular blogger. Welcome aboard Buck!

Buck Tilton is AMK's Newest Expert Blogger

AMK's Newest Expert Blogger Buck Tilton

When you pack for a camping trip, a first-aid kit is a mandatory item. Heck, it has been on the list of Ten Essentials ever since the invention of lists. If your gear includes the Adventure Medical Kits’ Day Tripper with the Easy Care First Aid System, you can handle the most common problems—even without advanced first aid training.

Day Tripper features the Easy Care First Aid System

Day Tripper features the Easy Care First Aid System

Cuts and scrapes send you looking for the kit most often. Three goals are worthy of consideration:

1. Stop Serious Bleeding
Almost all bleeding can be stopped with direct pressure: pressure from your hand directly on the wound (preferably with gloves on). Adding a product such as QuikClot to your medical kit will put you in control of more nasty bleeds. You can allow small wounds to bleed to a stop, a process that may help clean them a bit.

QuikClot Sport stops serious bleeding in as little as five minutes

2. Prevent Infection

Cleaning Wounds
Proper wound cleaning and dressing will prevent infection in most wounds. Cleaning also speeds healing and reduces scarring. The best method for cleaning is mechanical irrigation delivered from a high-pressure, irrigation syringe with 18 gauge plastic tip. The best cleaning solution is disinfected water—water that’s safe to drink. Draw the solution into the syringe, hold it about two inches above the wound and perpendicular to the wound, and push down forcefully on the plunger. Use at least half a liter, more if the wound still looks unclean. Without an irrigation syringe, you can improvise by using a biking water bottle, forcing water from a hydration bladder, or punching a pinhole in a clean plastic bag full of water. Embedded pieces of gravel and dirt will need to be scrubbed clean from the skin to further reduce the chance of infection.

3. Promote Healing

Dressing Wounds
Wounds heal faster with less scarring if they are kept slightly moist with an antibiotic ointment. Then use a dressing to completely cover the wound and ideally extend a half-inch or so beyond the wound’s edge. The bandage will fix, protect, and further assist the dressing. It can be conforming gauze, tape, elastic wraps, clean cotton strips, or improvised out of anything available. For very small wounds, the dressing and the bandage are available as a unit, often called a Band-Aid, found in all first-aid kits.

Treating Sprains
First aid for a sprain, another common injury, is RICE: Rest, Ice, Compression, and Elevation. Do not use the injury (Rest) for about 30 minutes while you reduce its temperature (Ice) as much as possible without freezing. Without ice, soak the joint in cold water, or carry chemical cold packs, or wrap the joint in wet cotton and let evaporation cool the damaged area. Compression requires an elastic wrap. Wrap it toward the heart and snug but not tight enough to cut off healthy circulation. Elevation refers to keeping the injury a few inches higher than the heart of the injured person. Taking an anti-inflammatory medication  such as ibuprofen (200mg –  follow directions on package)  will help to reduce both pain and inflammation. After 20 to 30 minutes of RICE, remove the treatment and let the joint warm naturally for 10 to 15 minutes before use. If it hurts a lot, don’t use it—and find a doctor.

Treating & Preventing Stomach Ailments
Diarrhea is the most common illness disturbing a family camping trip. You can greatly reduce your chances of contracting diarrhea, if you always wash your hands before eating and make sure the cook crew prepares food with freshly cleaned hands. If soap and water aren’t available, keep alcohol-free Adventure® Hand Sanitizer nearby; it kills 99.9% of bacteria, but won’t dry out the skin like alcohol-based sanitizers do. There are many causes, but with all causes, dehydration is the immediate problem. Mild diarrhea can be treated with water or diluted fruit juices or sports drinks. Persistent diarrhea requires more aggressive replacement of electrolytes lost in the stool, and Oral Rehydration Salts provide the best treatment. Rice, grains, bananas, potatoes are okay to eat. Fats, dairy products, caffeine, and alcohol should be avoided. Anti-diarrheal drugs should be considered. If the diarrhea is not under control in about 24 hours, head for your physician.

Wash your hands before cooking and eating

Wash your hands before cooking and eating

Preventing & Treating Insect Bites & Stings
The little biters–mosquitoes, black flies, gnats, even ticks—tend to be the most bother but are the least serious camping problem. Pack to prevent the bites with a DEET-based product such as Ben’s® or go DEET free with Natrapel® 8 hour, containing a 20% Picaridin formula. After a bite, there’s, well, AfterBite, America’s favorite.

Buck Tilton is a wilderness medicine and survival expert and author, who has written 36 books on outdoor safety. Over the past 20 years, he has contributed hundreds of articles and a regular column to Backpacker. Tilton also co-founded the Wilderness Medicine Institute, now WMI of NOLS, which is the largest school of wilderness medicine in the world. This month he joins AMK as a regular blogger.