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First Aid

Old 09-16-08, 08:49 PM
  #26  
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Originally Posted by Cave
What do people take? Here's more-or-less what's in mine (changes a bit depending on whether I'm a nominated medico on an organised tour, or just travelling by myself).
My thoughts (why yes, I am a doctor....) :

1) Where will you be riding? If always a stone's throw from a decent size town (tour down the Natchez Trace Parkway, etc) there's not much one needs to bring - just basic "first aid kit" supplies to clean up the mess until one reaches a store to get the real thing - and even gas station convenience stores in the States are good suppliers. In the Outback, or sub-Saharan Africa, obviously things change....

2) What do you know how to use? Like your tool kit, there's not much point in carrying stuff you're not familiar with, or wouldn't be comfortable using.

3) Who are you responsible for? As "chief medic" on a group tour, I'd be real hesitant to list certain items as "group" items - antibiotics, for instance. Giving your colleague cephalexin when her road rash starts to turn funky may be fine, unless she forgot she's allergic to it - not that she's gonna sue you, but she'll be irritated (literally) if she gets a rash all over! Better to have each member provide their own consumables recommended by their own doc for items which may cause allergic reactions, GI upset, etc.

4) As someone mentioned, I'd work on items which multi-task. You don't need adhesive tape if you carry a bit of duct tape in your tool kit, for instance.

5) RE: specific items others have listed: Alavert (loratadine) orally dissolving lozenges are absorbed faster than benadryl (beesting treatment, etc) & aren't as sedating. A couple of aspirin tabs in the kind of single-dose pouch you buy at a gas station to have that fat old guy who's having a heart attack chew until the EMTs arrive. If you're gonna bring an antibiotic besides cephalexin (for traveler's diarrhea, etc), azithromycin is nearly as effective as ciprofloxacin w/o the potential of sudden tendon rupture. And if I were traveling where venomous snakebite were a significant possibility, I'd carry this.
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Old 09-17-08, 12:39 AM
  #27  
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Thanks for the comments, some very good points above.

And if I were traveling where venomous snakebite were a significant possibility, I'd carry this.
Not sure if American snakes' venom works differently than Australians', but suction extraction went out of favour here at least 20 years ago. Both in first aid and in medical school we're taught to immobilize the limb and apply a compression bandage (the joke being what do you do if you get bitten on the neck; I guess your version would be, what do you do if your colleague is bitten on the bum!). The idea is that the venom travels predominantly in the lymphatics, and that NOT cleaning or shaving the site lets you swab the bite site so you can test for which antivenom to give.
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Old 09-17-08, 02:24 AM
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As to being bitten on the bum by a venemous snake, there is supposed to be a case famous in bushwalking circles in which a woman on an organised hike through Cradle Mountain-Lake St Clair in Tasmania went to have a toilet break and was bitten on the buttock by a snake. She was too embarrassed to tell anyone until it was too late. She died.

Machka and I were talking the other day about women's sanitary pads as being a good option for a wound dressing. Machka said her first aid course trainers actually had suggested taking some along in a first aid kit anyway.

I can't recall having to use anything from a bike tour first aid kit since I started to carry one (and even before) except for Elastoplast patches (they are much better sticky-wise than Bandaids) and painkillers.

My most serious injury on a bike was a posterior dislocation of my right shoulder, and no first aid kid was going to help the three kilometre ride back to a doctor's surgery for that one!

And Cave, I think you said somewhere else that you stick knives into people for a living. I assume that means you are a fully fledged surgeon.
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Old 09-17-08, 05:01 AM
  #29  
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Originally Posted by Rowan
Machka and I were talking the other day about women's sanitary pads as being a good option for a wound dressing. Machka said her first aid course trainers actually had suggested taking some along in a first aid kit anyway.
Yes they work great. I have not used them when touring, but have often carried (them and occasionally used them) in the larger first aid kit I carry on my sailboat and in other outdoor settings.
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Old 09-17-08, 05:03 AM
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Originally Posted by tpelle
Anything more serious than that and I'm dialing 911 (as long as I don't land on and break my cell phone).
I don't think it wise counting on a cell phone signal in all of the places folks tour even in the US. On the TA there were lots of places where there was no signal for fairly long distances. I am sure other rural areas of the US are the same.
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Old 09-17-08, 02:55 PM
  #31  
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I keep a pdf copy of the excellent book "Where There Is No Doctor" saved on my computer for travel to outback places. It's free and has saved us several times.



When traveling in the van we took a copy along with us, but that was not practical on the bike.

We carry a sharps kit for international travel where the needless or cutting instruments may be questionable.



And a malaria test kit for travel in malarial zones.

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Old 09-17-08, 10:41 PM
  #32  
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Originally Posted by staehpj1
I don't think it wise counting on a cell phone signal in all of the places folks tour even in the US. On the TA there were lots of places where there was no signal for fairly long distances. I am sure other rural areas of the US are the same.
There are large dead patches on the Great Allegheny Passage and C & O Canal Towpath. On the GAP it's cell silence from just beyond Connellsville to Meyersdale, a distance of nearly 50 miles. From south of Cumberland, MD, to Hancock it's pretty dead as well.
 
Old 05-06-09, 12:52 PM
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First Aid

https://www.bikeforums.net/showthread.php?t=537975
^^^
That thread was just made a sticky in General Cycling.
Touring should have one too, that's a gimme.

First Aid
How do you deal with injuries while on tour?
What do you have in your first aid kit?
Insurance?
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Old 05-06-09, 02:06 PM
  #34  
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If I'm touring in the US, I don't think I'm ever more than a couple hours from a town. There aren't too many injuries that are less than an ambulance ride and more than what can wait a couple of hours to treat. Normally I don't even clean a wound for at least 45 minutes (until the ibuprofen kicks in). So my first-aid supplies are fairly minimal. Is this too much wishful thinking? What kind of injuries can you still ride on but can't wait a while to treat?
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Old 05-06-09, 02:40 PM
  #35  
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Originally Posted by The Historian
There are large dead patches on the Great Allegheny Passage and C & O Canal Towpath. On the GAP it's cell silence from just beyond Connellsville to Meyersdale, a distance of nearly 50 miles. From south of Cumberland, MD, to Hancock it's pretty dead as well.
I would want one of these SPOT GPS locators if I were riding anywhere remotely remote. I know my wife would appreciate my being able to let her know where I am, and the 911 button could be useful if something extreme happened.

https://www.findmespot.com/en/
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Old 05-06-09, 03:02 PM
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Originally Posted by John Nelson
If I'm touring in the US, I don't think I'm ever more than a couple hours from a town. There aren't too many injuries that are less than an ambulance ride and more than what can wait a couple of hours to treat. Normally I don't even clean a wound for at least 45 minutes (until the ibuprofen kicks in). So my first-aid supplies are fairly minimal. Is this too much wishful thinking? What kind of injuries can you still ride on but can't wait a while to treat?
Blisters, road rash, crap in your eye, and splinters, small burns, minor cuts. Not all injuries occur while on the bike.
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Old 05-06-09, 03:37 PM
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One thing I now keep in my first aid kit are Adaptic non-stick pads made by Johnson & Johnson. They are expensive ($1/each) but work. They are a gauzy material that goes between the oozing cut/abrasion and the absorptive pad and guarantee no sticking. They were a god-send in France where my left arm required stitches and had major road rash after a fall.

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Old 05-09-09, 11:11 PM
  #38  
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I also carry one of those small plastic mask things (don't know the proper name) for protecting youself when giving mouth-to-mouth rescuscitation.
I don't know if you can contract HIV or other contagious diseases from someone's bleeding mouth, but I'd rather be on the safe side (especially if there were lots of broken teeth)
Making a hole in a plastic bag can help somewhat, but the masks have a mouthpiece which keeps the airways free aswell...
To be honest I'm not sure if I would give mouth-to-mouth rescuscitation to a bleeding, vomiting, broken toothed stranger without a mask, but knowing me I probably would, then regret it... Do any of you doctors have advice as to the risks involved in this?
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Old 05-10-09, 01:15 AM
  #39  
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imi,

I'm an EMT (and firefighter) and wouldn't give mouth to mouth without good protection either, one casualty is bad enough. To be honest, compressions are much more effective than breaths. In fact, probably within the next five years, the American Heart Association will probably do away with layperson mouth to mouth (breaths) in favour of just compressions. If you think about the heart as being a pump, starting it and stopping it is ineffectual for priming it. Just as you start to get the needed pressure that it takes for the heart to pump the blood, you stop to fill up the lungs - with most of the air going into the stomach which will make them vomit. It's better just to continue to keep the pressure going.

And yes, doing mouth to mouth unprotected with someone bleeding from the mouth, vomiting or even drooling (it's hard to get HIV from saliva), you can contract HIV, hepatitis (more common than HIV), or other communicable disease from them if they have it... which you won't know for several agonizing days, weeks, or even months (meanwhile you and your family go through hell). And just for the record poking holes in a plastic bag isn't going to protect you... a pocket mask or other barrier needs to have a one way valve so that you don't get their fluid on you or into your mouth.

Hope this helps.
Cheers!
tdp

Last edited by twodeadpoets; 05-10-09 at 01:22 AM.
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Old 05-10-09, 02:55 AM
  #40  
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Thanks twodeadpoets, good information.
The heart/breathing rescuscitation I have learned here in sweden is the 30 compressions/2 breath model, which is putting the emphasis on compressions for getting air into the lungs and pumping it round.
I've never had to do rescuscitation, but I believe everyone should learn and be prepared...

Once on a road in the french countryside a SUV swerved and panic-braked right in front of me... A woman leaped out of the car, opened the passenger door and grapled her coughing, heaving and not breathing child out. Being on the spot I hugged the kid from behind and did a "heimlich manouver" freeing a coin the kid had stuck in his throat. The mother bundled her kid back in the car and drove off without a word of thanks or acknowledgement!.. I put this down to shock... I rode off, happy the kid was ok, and glad that I had the knowledge of how to help
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Old 05-10-09, 05:15 AM
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That's a great story and I agree that she was probably in shock and maybe a little embarrassment (though you would still think a little different reaction). I also think you are right that the best payment to someone is knowing that they just saved a life.

Cheers!
tdp
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Old 05-10-09, 10:20 AM
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Originally Posted by twodeadpoets
imi,

I'm an EMT (and firefighter) and wouldn't give mouth to mouth without good protection either, one casualty is bad enough. To be honest, compressions are much more effective than breaths. In fact, probably within the next five years, the American Heart Association will probably do away with layperson mouth to mouth (breaths) in favour of just compressions. If you think about the heart as being a pump, starting it and stopping it is ineffectual for priming it. Just as you start to get the needed pressure that it takes for the heart to pump the blood, you stop to fill up the lungs - with most of the air going into the stomach which will make them vomit. It's better just to continue to keep the pressure going.

And yes, doing mouth to mouth unprotected with someone bleeding from the mouth, vomiting or even drooling (it's hard to get HIV from saliva), you can contract HIV, hepatitis (more common than HIV), or other communicable disease from them if they have it... which you won't know for several agonizing days, weeks, or even months (meanwhile you and your family go through hell). And just for the record poking holes in a plastic bag isn't going to protect you... a pocket mask or other barrier needs to have a one way valve so that you don't get their fluid on you or into your mouth.

Hope this helps.
Cheers!
tdp
I thought the US had already gone to compression only CPR.
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Old 05-10-09, 12:06 PM
  #43  
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We are just beginning to inform layrescuers about hands only CPR for adult rescue and the trend is headed that way for all CPR however at the moment we still certify people to do compressions and breaths (30 to 2 on adults and children). It will be another 3 to 5 years before we drop the mouth to mouth portion of the training. That said, we do strongly urge people who do not feel comfortable or who do not have barriers to just do compressions. For the bystander (without formal training), AHA recommends calling 911 and then doing hard and fast compression only CPR (handsonlycpr.eisenberginc.com).
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Old 05-26-09, 08:17 PM
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As mentioned earlier, Coban is one of the best simple first aid inventions ever.

My first Aid kit that i have on standby to throw in my bag for camping, backpacking or anything consists of:
painkillers, antihistamines, dressings (small band-aids and 4x4's), steri-strips, cravats/triangular bandage, moleskin, wire splint and a roll of tape. And depending on the trip, a CPR mask.

I have first aid training for ski patrol in the winter time (Outdoor emergency care) and CPR stuff.

I'm not exactly sure of what you mean by "in anger" though.
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Old 06-03-09, 02:33 PM
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I keep a small, cheap First Aid kit I found here. https://www.utahmountainbiking.com/sh..._firstaid.html
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Old 06-04-09, 02:06 AM
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yes! i'd been trained some basic first aid. like cpr and how to take care for some broken bones.
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Old 06-14-09, 09:52 PM
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WOW, this is utterly awesome and essential information. Thank you all.

I am planning a self-contained solo tour from Las Vegas, NV, USA to east coast, fly to UK, wander Europe then on to southeast Asia & probably Australia before I find a new home. I hope to meet and travel with people that know more than I do, more is better.

Red Rock Canyon is about 10 miles away from downtown Las Vegas, cell phones do not work there and someone else might not cross paths with you for an hour or more. It takes a lot more effort to get to medical attention when you need it, even more when it is an emergency. That effort when you are hurt means you are using more energy faster and you have less of it, your blood is pumping faster, maybe spreading poisons or bleeding out, easier to go into shock, pass out, what is next? In an emergency calm down. Running around screaming does not extinguish a fire.

Having something tiny but irritating in my eye is worse than being blind - both my eyes are reflexively squeezing shut and my whole body focuses on getting that little bit OUT even if I have bigger and more immediate problems. Falling off a bike can break big bones; a leg, arm or skull. Some of my layman reactions are wrong - ice, heat, elevation or compression? I listened to experts all my life but that just makes me an educated layman.

Feeling confident that nothing serious will happen sounds like evolutionary suicide. Preparing as best you can for what might happen and putting serious effort into consistently improving your preparations and abilities is not about relying on dumb luck.

The military doctors and nurses that took care of me and everybody else right out of surgery had maxipads - the largest size female sanitary pads available. That 'recommendation' speaks volumes to me.

Stopping major bleeding, cleaning the wound, closing the wound, keeping it clean and preventing or treating infection seem like the order of business for simple cuts. Am I right? Putting broken bones back into place then immobilizing them is something I have only been on the receiving end of. I feel nauseous just thinking about broken bones. Anything more serious than those basics is beyond me unless I think they are going to die right here, right now.

In addition to all that has been said: Baking soda, apple cider vinegar and salt are also going to be in my pack. They are all good, safe, mild cleaners and might help with minor medical problems. Baking soda is good for brushing teeth, salt is good for cleaning wounds, vinegar discourages a few things from feeding on you. They even make food taste better.

I wish I could take my Nortech Therma-Kool hot/cold compresses with me. Nothing beats an ice pack wrapped in a towel for pain and anti-inflammatory, a hot, moist compress also works wonders for aches and pains like arthritis. Go ahead, tell me about those things you break and shake, they are not the same.
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Old 06-15-09, 01:05 PM
  #48  
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Check out the multiple survival uses of potassium permanganate: https://en.wikipedia.org/wiki/Potassium_permanganate
I always carry a small plastic phial of the stuff ('though it's possibly not allowed on aeroplanes; anyone know?)
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Old 06-16-09, 01:01 PM
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tourniquet from old tube

Hi,
I wanted to have a tourniquet just in case.
I made it from old bike tube:


Cut the tube to half, and remove the valve.
If there is an emergency you can use a spare tube that you carry.

Make sure that when applying the tourniquet, you need to write the time (hh:mm) on the forehead of the person. This lets the medics know how long there is no blood flow to the area.

Here is a movie in hebrew (sorry) that shows how to put it: movie in hebrew.
Fast forward to the middle of the movie, to see the procedure.

regards,
Kfir
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Old 07-16-09, 06:10 PM
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cave stupit question ,but what do you use superglue for.am i missing out here.
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