Adventure Medical Kits - Adventure Discussions
24h-payday
     Posts Tagged ‘Dr. Weiss Advice – Improvisational Techniques’

How to Prevent & Treat Blisters

Tuesday, September 20th, 2016

Did you know blisters are one of the most common injuries in the outdoors and the most common injury for hikers? Within hours, a small rub in your boots can turn into a painful blister. However, with a few basic preventions tricks and early treatment, you can protect your feet and keep a blister from interrupting your adventure.

 

blister on foot

Blisters are the hiker’s #1 injury

Blister Prevention

To keep blisters from developing in the first place, eliminate as many contributing factors as possible. Simple actions taken before you hit the trail and once you’re on the trail can make a huge difference.

Before You Hit the Trail

The first step in preventing blisters it to make sure the gear you’re putting on your feet isn’t causing the problem. Here’s five steps you can take before you hit the trail to stop blisters in their tracks:

  1. Make sure your shoes fit properly. If your shoes are too tight you’ll have pressure sores, while shoes that are too loose lead to friction and irritation. Outdoor retailers like REI often will be able to measure your foot and help you find the right size using a calibrated fit device. A good check you can do yourself though is to pull the insoles out of your shoes and stand on them. You should have a thumb’s width of clearance between the end of your toes and the insole. You want that extra space in the front of the boot so you don’t end up jamming your toes against the toe box on the way down.
  2. Choose your socks with care. As a rule, avoid cotton socks and opt for water-wicking materials like merino wool or synthetics. Everyone has unique feet, making it important to find what works for you and your boots. Sock height, cushioning, and fit all contribute to giving your feet the best in-shoe experience. REI gives some great advice on choosing the sock that’s right for you.
  3. Break new boots in. Even the right footwear can still cause blisters if you don’t break it in. Before heading out on a trip, make sure to spend some time in your new boots, ideally while wearing the socks you’ll use on the trip. You might look funny walking around your home or the office in hiking boots, but your feet will thank you later. Once you’re ready to hit the trail, best practice says start with a short hike – you don’t want to find out you didn’t break them in enough when you planned a 15 mile day.
  4. Avoid prolonged wetness. Moisture breaks down your skin and predisposes it to blistering (that’s why choosing the right sock is so important). Keep your feet dry, and pack an extra pair of socks so if you’re first pair get wet (those mountain streams are everywhere), you can swap out for a dry pair right away.
  5. Protect problem areas. No one knows your feet like you do – if you are prone to blisters in a certain area, be proactive about protecting that area from harm. Before hiking, apply moleskin to sensitive areas where blisters are likely to occur. The moleskin will reduce the friction against your skin, effectively stopping blisters and hot spots before they can even start.

Even if you put moleskin on your feet before setting out, it’s always important to pack more in case the unexpected occurs. If you are prone to nasty blisters, consider adding GlacierGel to your first aid kit as well, as the hydrogel dressing is ideal for stopping the pain from and protecting fully-formed blisters. The Blister Medic contains both moleskin and GlacierGel, making it a lightweight addition to your pack that keeps you prepared. Make sure to go through your first aid kit before setting out to make sure you don’t need to re-stock blister items

On the Trail

Once you hit the trail, there are still things you can do to prevent blisters. Hot spots are sore, red areas of irritation that develop into blisters if allowed to progress. Identifying hot spots early to stop them from becoming blisters will save you miles of pain.

The key message? Pay attention to your feet. It’s easy to ignore slight irritations or brush them off in order to avoid having to stop on the trail, but take our word on it: you don’t want to ignore hot spots. If you think you feel a hot spot, take the time to stop and address it sooner than later.

Treating Hot Spots

If you catch a hot spot early on, you can easily stop it from becoming a blister by covering it with a small piece of moleskin.

covering a hot spot with moleskin

Treat small hot spots by covering them with moleskin, which is included in the Hiker kit

For more irritated hot spots, you can cover them with GlacierGel or use moleskin. Whichever you use, make sure to prep the surrounding skin using an alcohol wipe for maximum adhesion. If you use moleskin, make sure to grab a donut-shaped piece (you can get them pre-shaped here or simply cut a small hole in the center of a rectangular piece).

Position the moleskin so the hole is over the hot spot, making sure the adhesive surface isn’t touching the irritated skin. This raises the area around the hot spot, preventing further rubbing. If necessary, you can secure the moleskin in place with medical tape from your medical kit.

Blister Treatment

Sometimes blisters occur despite our best efforts. Properly treating the blister can help minimize pain and further damage to the area.

For Small Blisters

If the blister is still intact, do not puncture or drain it. Instead, follow the same steps outlined above on treating serious hot spots by protecting it with GlacierGel or moleskin. If you’re using moleskin, you may need to use several layers, as the moleskin doughnut needs to be higher than the blister to be effective.

moleskin doughnut on blister

You may need to use several layers of moleskin to get above the blister

For Large or Ruptured Blisters

If the blister is large but intact, puncture it with a clean needle or safety pin at its base and massage out the fluid. The fluid contains inflammatory juices that can delay healing.

Once you’ve punctured the blister (or if you’re dealing with one that’s already ruptured), trim away any loose skin from the bubble and clean the area with an antiseptic towel or soap and water. You should then apply antibiotic ointment and cover the area with a non-adherent dressing or GlacierGel to prevent contaminants from entering the wound and to promote healing.

applying glaciergel

GlacierGel dressings help protect and heal ruptured blisters

You can then use moleskin (or molefoam) to protect the wound from further rubbing. Use a doughnut-shaped moleskin to raise up the area around the blister – remember to use enough layers to raise the moleskin above the height of the blisters with its dressing. Secure the moleskin in place with medical tape.

You’ll want to change the dressing every day and keep a close eye on it for infection. Signs of infection include redness, swelling, increased pain, or a cloudy fluid under the dressing. If infection occurs, remove the dressing and allow the area to drain. Consult a doctor as soon as you are able.

  • Trim away any loose skin from the bubble and clean the area with an antiseptic towel or soap and water.
  • Apply antibiotic ointment and cover with a non-adherent dressing or other dressings like Glacier Gel.
  • Utilize Moleskin to protect the area. Take a small piece of moleskin and cut a circle in the center approximately the same size as the area.
  • Center the oval over the hot spot and secure into place with tape. This will act as a buffer against further rubbing. Change the dressing every day.
  • Inspect the wound daily for infection-this includes redness, swelling, increased pain, or cloudy fluid under the dressing. If infection occurs, remove the dressing and allow the area to drain. Consult a doctor as soon as you are able.

Gluing a Blister

If you are far from help and must continue walking for an extended period of time, an alternative treatment is to glue the blister in place. This method is initially painful but can be effective in backcountry scenarios, especially if you’re low on typical blister first aid supplies.

Begin by draining the blister of fluid. Then, place a small amount of tincture of benzoin (or glue if that’s all you have) in the drained blister. Press the loose skin overlying the blister back into place and cover the site with a suitable dressing (if you have nothing else, duct tape can work). The extreme pain produced by the benzoin on your skin will only last a few minutes.

glueing blisters

Tincture of benzoin is included in the Ultralight/Watertight .7 kit

Basic First Aid Skills- How to Treat a Sprained Ankle

Tuesday, June 14th, 2016

ankle injury

Adventure Medical Kits Empowers You Series

Heading out into the wilderness can be an amazing experience that allows you to explore remote areas and challenge yourself. As a smart adventurer, you’ve probably already taken the steps to prepare for your journey by bringing along the basics for survival (Food, Water, Shelter, First Aid Kit, extra Clothing ) and knowing the terrain. But anytime you’re a few hours from advanced medical care, you are assuming risk and should be prepared for injuries and illnesses. That’s why it’s good to know some first aid basics. In our Adventure Medical Kits Empowers You Series, we’ve compiled a list of skills and treatments we consider essential for anyone who goes out in the backcountry. Our articles are not a substitute for professional medical training or treatment. We recommend taking a full Wilderness First Aid course for more comprehensive knowledge and seeking professional care as soon possible.

Basic First Aid Skills- How to Treat a Sprained Ankle

Taken from Adventure Medical Kits’ Wilderness & Travel Medicine Guide, By Dr. Eric A. Weiss

There you are, just hiking along the trail when suddenly the footing changes and you roll your ankle to one side. You feel it stretch and maybe even feel it tear. It stops you cold and it hurts.

SPRAINS

A sprain is stretching or tearing of ligaments that attach one bone to another. Ligaments are sprained when a joint is twisted or stretched beyond its normal range of motion. Most sprains occur in the ankle and knee.

Signs and Symptoms

Symptoms include tenderness to the site, swelling, bruising, and pain with movement. Because these symptoms are also present with a fracture, it may be difficult to differentiate between the two. Use caution and treat the injury until x-rays or further medical evaluation is available.

Treatment

  1. First aid begins with R-I-C-E (see below). If the victim cannot bear weight at all, use a splint to stabilize the foot and ankle and get assistance out of the backcountry.
  2. If the victim can still walk, use a C-Splint,  compression wrap or tape the ankle for support.
  3. Continue R-I-C-E-S for at least 72 hours following an injury and administer a non-steroidal anti-inflammatory drug (NSAID) such as Ibuprofen, 3x per day with food to reduce pain and inflammation.
  4. As soon as possible, seek medical evaluation to determine the need for X-rays to check for fracture.

A leg tensor bandage being applied outdoors

R-I-C-E-S- Immediate steps for treating sprains and strains

Rest: Resting takes the stress off the injured joint and prevents further damage.

Ice: Ice as quickly as possible as it will reduce the swelling and pain. Apply an ice pack or cold compress to the area for up to 20 minutes, 3-4 times per day. Follow with a compression bandage. Wrapping is key, as the joint will swell as soon as the ice is removed.

Compression: Compression wraps prevent swelling and provide support. Pad the injury with socks or soft items, and then wrap with an elastic bandage. Begin the wrap at the toes and move up the foot up and over the ankle with the wrap. The wrap should be comfortable but not too tight. If the victim experiences numbness, tingling or increased pain, loosen the wrap.

Elevation: Elevate the injury above the level of the heart as much as possible to reduce swelling.

Stabilization: Tape or splint the injured area to prevent further damage.

Next Steps:

Continue R-I-C-E-S for at least 72 hours following an injury and administer a non-steroidal anti-inflammatory drug (NSAID) such as Ibuprofen, three times per day with food to reduce pain and inflammation.

 

Ask the Doc Mailbag Round-Up

Friday, July 2nd, 2010

Here are some questions that people reading our blog have submitted recently…

Q: How do I verify the expiration date on your oral rehydration salts?

A: The manufacturer of the oral rehydration salts we use does not include and expiration date on the package, as rehydration salts aren’t classified as a drug by the FDA.  Because this product is fairly inert (unlike a pharmaceutical), I wouldn’t have a problem stocking a packet that was a few years old in one of my own kits.  However, if you are concerned that your product is too old to be used safely, you can contact our customer service department and arrange a replacement.

Q: What are the differences between the SOL Thermal Bivvy and the Heatsheets Emergency Bivvy?

A: The Heatsheets bivvy is made of a single layer of metalized polyethylene, making it very lightweight.  It is a true emergency product in that, while being easy to repair and resistant to tearing, it won’t stand up to repeated heavy use.  Also, because the material doesn’t breathe, you will have condensation when you’re inside it, making your clothing wet.

The SOL Thermal Bivvy is made from a much more durable 2-ply non-woven fabric material with a metalized coating.  It will work as a primary sleep system in temperatures down to 50 degrees or provide about 15 degrees of extra insulation when used over a standard sleeping bag.  In emergency situations, this bivvy is much more comfortable to occupy, since you can use the Velcro side opening to regulate heat and moisture inside the bivvy.  Of course, the trade off with the Heatsheets bivvy is that the SOL Thermal Bivvy is bigger and weighs about 4.5 more ounces.

Q: Does your space blanket hold cold in and protect from the heat outside. I want to cover dry ice and boxes of bottles. If it can cool a little that would be better than nothing at all.

A: The Heatsheets blanket will help keep cold from escaping, although it is hard to quantify by how much.  The studies done on this material focus on heat reflectivity, although the same principle is used to make metalized heat shades like reflective cooler interiors or automobile sun shades.  If you do try it, I’d be interested to know how well it works.

Q: I have just ordered and received the Trauma Pak with QuickClot from LA Police Gear (excellent company).

I consider myself a fairly well prepared individual (various Red Cross First Aid, WMS Wilderness First Aid Course, CPR, AED, etc.) and intend to keep this small trauma pak kit in my shooting/range bag, along with other general first aid supplies (my heavily modified AMK Day Tripper – actually, it’s mostly just the bag any more with so many various add-on kits and items).  Fortunately, I live in Dallas and have excellent access to high quality emergency medical aid – but certainly would not want to just stand there for 5 to 7 minutes until EMTs arrive for a problem.  I intend to keep the kit sealed in the original package and watch the expiration date.  What I am writing about is the instruction sheet – was hoping that more information was on the exterior of the package or available on your web-site (if there I couldn’t find it).  Just don’t want the first time reading any specific, particularly new information to be during an actual emergency.

Is it possible to get a copy of the instruction sheet by e-mail or on-line?

A: You make a good point about not waiting until an emergency to read key medical information.  I will post a copy of the instructions on our company blog, located at www.adventuremedicalkits.com/blog.

Q: Going to Botswana in June 2010.  Should I use DEET repellant or not?  I don’t know the pros and cons.

A: There has been quite a lot of research done concerning the safety of DEET – much more than can fit in this email.  To break down the basic issues: DEET is an extremely effective insect repellent, and it has been on the market for half a century with very little (if any) known toxic effects.  That being said, some have argued that DEET may have adverse health or neurotoxic effects.  The EPA, which regulates insect repellents and insecticides, has evaluated the merits of these controversial studies and concluded that DEET is still safe for human use, with 30% concentrations such as Ben’s 30 Wilderness formula being safe for use on children above two months of age.  One other potential downside of DEET is that it can melt synthetic fibers and plastic, such as Gore-tex jackets, fishing line, or nylon clothing.

If you are concerned about DEET, I highly recommend using Natrapel 8-hour, which is made using a 20% concentration of the ingredient Picaridin.  Picaridin has been widely used in Europe for around 20 years and has made its way into the US market over the last few years.  It is just as effective as DEET and will not affect plastics, so many people prefer it to DEET for that reason alone.

Personally, if I am on a backpacking trip in high infestation areas, I use Ben’s Max 100% DEET because it has always worked for me, and that’s what I trust, although some of my coworkers swear by Natrapel 8-hour.  As long as you’re using a CDC-recommended ingredient (such as DEET or Picaridin) and following the label instructions so that you’re applying it often enough, you should be able to keep insects at bay.

Q: We purchased the Suture/Syringe Kit from Adventure Medical Kits but were disappointed not to have instructions for use. Can you recommend a book(s) for those who might need to deal with the contents in an emergency?

A: Because this kit is designed to be purchased and used by professionals only, we don’t include instructions in it. Suturing wounds, administering injections and IV’s, and performing field surgery are not practices that are advisable for a novice to perform – these types of procedures require professional instruction with hands-on demonstrations and significant field experience. In a case where surgery or suturing is indicated, it is best to stabilize the patient as much as possible and either evacuate the patient so medical care can be obtained or await wilderness rescue. If you are traveling in an area where sterile supplies may not be available at a local hospital, this kit (or the smaller Suture/Syringe Medic) can be given directly to the medical practitioner to ensure the use of safe equipment.

Q: I have a Thermo-Lite 2.0 Bivvy and it is a bit stinky.  Can I put it through the laundry?  How do you recommend it be cleaned?

A: I wouldn’t recommend machine-washing a Thermo-lite 2.0 Bivvy (now renamed the SOL Thermal Bivvy).  To clean it, wash it by hand using warm water and mild soap, and hang it to dry.  Open the velco side-vents as far as they go to aid in drying.

Q:  Could you tell me yourself or direct me to a site that would explain the usual procedure to treat a deep open wound, especially using the products of AMK.  Recently I had an episode where I cut my finger with a chain saw and luckily I had some quickclot at home which stopped the bleeding quickly until I could get to the hospital. I was by myself and had to drive myself to an emerg. clinic nearby. They simply deadened the finger with a shot(wow!), soaked it in a Betadine solution and stitched it with 6 stiches. Then wrapped it in a splint and gauze.

But what would I do if something like this happened out on a hike or wilderness trip? Could this be handled with substitute or similar medical products and medicine?

A: As you found out, stopping the bleeding is the most important step to take when confronted with a laceration, so it’s good to have a pack of QuikClot on hand at home and in your pack if you’re in the wilderness.  Once bleeding is under control, the best way to clean and close a wound is to irrigate it (preferably using an irrigation syringe) to clear out debris and then to hold the edges closed with wound closure strips (or butterfly bandages).  This technique is explained in detail in Dr. Weiss’s Comprehensive Guide to Wilderness Medicine, and you can see an improvisational technique, should you find yourself without the requisite supplies here: http://www.adventuremedicalkits.com/blog/2008/07/dr-weiss-advice-wound-irrigation-technique/

Most of our most popular kits contain an irrigation syringe and wound closure strips, including the Ultralight / Watertight .9, Weekender, and Hunter.  If you already have a medical kit and just need wound closure supplies, we also offer the Wound Closure Medic, which you can find here: http://www.adventuremedicalkits.com/product.php?product=95&catname=Wound%20Care%20%20/%20Burn&prodname=Wound%20Closure%20Medic.

Dental Emergencies – Tips from Dr. Weiss

Friday, June 25th, 2010

Everyone has had a toothache at some point in their lives, but what do you do when you are in a remote area, traveling in a developing country, or on a back-country expedition?  Below are some tips from AMK’s Founder, Dr. Eric A. Weiss about what to do when you find yourself with a dental emergency far from the nearest dentist…..

Excerpt from A Comprehensive Guide to Wilderness & Travel Medicine, by Dr. Eric A. Weiss.

 

A Comprehensive Guide to Wilderness and Travel Medicine

 

DENTAL EMERGENCIES

TOOTHACHE

The common toothache is caused by inflammation of the dental pulp and is often associated with a cavity. The pain may be severe and intermittent and is made worse by hot or cold foods or liquids.

Treatment

1) If the offending cavity can be localized, a piece of cotton soaked with a topical anti-inflammatory agent such as eugenol (oil of cloves) can first be applied.

2) Place a temporary filling material, such as Cavit® or zinc-oxide and eugenol cement, into the cavity or lost filling site to protect the nerve.

ʻWEISS ADVICEʼ [IMPROVISED TECHNIQUE]

Quick relief of dental pain and bleeding.  Bleeding and pain from the mouth can often be relieved by placing a moistened tea bag onto the bleeding site or into the socket that is bleeding.

(more…)

Dr. Weiss Advice – Wound Irrigation Technique

Thursday, July 31st, 2008

Dr. Weiss Advice – Improvisational Technique – Wound Irrigation Using a Plastic Bag and Safety Pin

Fill a clean plastic sandwich or garbage bag with disinfected water and puncture the bottom of the bag with a safety pin or pointy knife. Hold the bag just above the wound and squeeze the top firmly to being irrigating.

Carry a first aid kit with wound irrigation supplies!

Learn more wilderness medicine, improvised techniques and first aid tips – click here for Dr. Weiss’s Comprehensive Guide to Wilderness and Travel Medicine.

Dr. Weiss Advice – Relief For Dental Pain

Thursday, July 31st, 2008

Dr. Weiss Advice – Improvisational Technique – Quick Relief of Dental Pain

Bleeding and pain from the mouth can often be relieved by placing a moistened tea bag onto the bleeding site or into the socket that is bleeding.

Carry a Dental Medic with you!

Learn more improvisational techniques and first aid tips – click here for Dr. Weiss’s Comprehensive Guide to Wilderness and Travel Medicine.

Dr. Weiss Advice – Making a Sling with Safety Pins

Thursday, July 31st, 2008

Dr. Weiss Advice – Improvisational Technique – Making a Sling with Safety Pins

If the victim is wearing a long-sleeved shirt or jacket, pin the sleeved arm to the chest portion of the garment with two safety pins. If the victim is wearing a short-sleeved shirt, fold the bottom of the shirt up and over the arm to create a pouch. Pin this to the sleeve and chest section of the shirt to immobilize the arm.

Learn more improvisational techniques and first aid tips – click here for Dr. Weiss’s Comprehensive Guide to Wilderness and Travel Medicine.

Dr. Weiss Advice – Creating Ankle Support Using a SAM Splint

Thursday, July 31st, 2008

Dr. Weiss Advice – Improvisational Technique – Creating Ankle Support Using a SAM Splint

Wrap a SAM Splint around the foot and ankle, with the shoe in place and secure it with tape. This will help stabilize the joint while walking. You may need to stop periodically to tighten or re-wrap the splint.

You can buy a SAM splint here.

Learn more improvisational techniques and first aid tips – click here for Dr. Weiss’s Comprehensive Guide to Wilderness and Travel Medicine.

Dr. Weiss Advice – Replacing a lost filling

Thursday, July 31st, 2008

Dr. Weiss Advice – Improvisational Technique – Replacing a Lost Filling

Melt some candle wax and allow it to cool until it is just soft and pliable. Place the wax into the cavity or lost filling site and smooth it out with your finger. Have the victim bite down to seal the wax in place and remove any excess wax.

Check out our Dental Medic kit here.

Learn more improvised techniques and first aid tips – click here for Dr. Weiss’s Comprehensive Guide to Wilderness and Travel Medicine.