thanks guys
 

Thanks for your input MotoEdde

All your posts always seem to be spot on the money. I guess the bottom line is take a sensible first aid kit AND dress to crash, and you should be OK

Adventure motorcycling handbook, page 108
And the list does include 2 x syringes with two needles per person

I do like the look of the QuikClot pads as posted by MetusUK for if the S**T hits the fan

Shaun

advice from a doctor (who should know..)
 

Hi UKiceman,

An interesting an worthwhile thread, and finally one I may be able to contribute to, being a doctor, specialising in anaesthesia, and with qualifications in wilderness, expedition and first aid medicine.

Firstly the advice about not suturing yourself is good - I wouldn't do it to myself unless I really, really had to! And local anaetshetic isn't necessarily required - I got my head stitched up by a fellow student after a Australian Football match when I was at uni - on the kitchen table, instruments steralized in boiling water and no anaesthetic until afterwards when we made it to the pub for post-match drinks! That is not my professional advice... Seriously, the anaesthetic can hurt as much as the stitching but it is great for larger lacerations.

Also I agree with much of the advice about dirty wounds - closing one can provide a perfect breeding ground for bugs. Copious washing is more important than closing it - get it clean and bandage it to keep it as closed as possible and protected from further soiling.

The supplies in your first aid kit (one is essential) are to buy time and have quality supplies for when a local medically trained person arrives, as well as to treat minor cuts and abrasions yourself.

Doing a first aid course is excellent, as you mention not only for this trip but for everyday life. They stress the ABC's (Airway, Breathing, Circulation) that will buy time so that someone might be saved from dying - far more important than stitching your leg.

Wilderness First Aid courses also teach things like strapping/bandaging ankles/wrists (minor trauma is by far the most common type of injury), splinting broken llimbs and treating snake bites (much less common you'll be glad to know).

By the way adrenaline is not the teatment for snakebite - antivenom is (for the venomous ones) so medical help is a must when bitten. You need to bandage the limb tightly, splint it, move as little as possible and get help.

Adrenaline is the treatment for "shock", which in medicine means the collapse of vital body systems - where ABC's come in. If someone on your trip has a history of an anaphylactic reaction, an allergic reaction resulting in shock, they should be carrying adrenline anyway, often in the form of an "epipen" which delivers one metered dose.

Check out some frist aid books. The one I use is found at:
Treksafe: Pocket First Aid and Wilderness Medicine manual

Finally travel medical clinics which do vaccinations are good places to get decent first aid kits.

Sorry if some of this info has already been mentioned by I am in a hurry in an internet cafe! Hope it helps.

BTW my connection to this excellent site is that with 2 mates I am heading around europe from July to November this year. Will be posting a want ad for 2 bikes very soon!

Cheers,
Damien P Daniel

Nice advice Doc.

Thank you for contributing.

Are you sure that adrenaline has no place in the treatment of snakebite? I'm thinking anaphylaxis...

And what do you recommend for hangovers - I need this advice within 6 hours, please!

Thankyou.

Please ignore my post above.
 

Please ignore my post above. The cold light of day has made me realise that further discussion of the medical treatment of snakebite here is futile, if not dangerous. Sorry.

Don't feel too bad today, actually :)

a proper doc
 

WOW, a proper doctor, thanks for contributing Doc. Am going to get that book for sure! I can probably miss the first aid course because; I’ve got to do a full week course every two years with a refresher every year at work.

But, I’d like to do a Wilderness course for the hell of it, sounds fun :) even if you don’t use it proper training in anything is always good.
Thanks for posting

Shaun

beers and bites...
 

To Shaun, I'd definitely recommend a wilderness first aid course - they are heaps of fun and very useful and practical. In Australia wilderness guides do them as part of their accreditation, and that is where I sometimes teach. Great classrooms!

To Stretcher Monkey, you are right - if the snakebite causes anaphylaxis then adrenaline is the treatment. Most venomous snakes don't cause anaphylaxis though, and most snakes aren't venomous anyway. So it's not an issue in most parts of the world (but definitely is here in Australia!).

As you say, this may not be the right place for an in-depth discussion on snakebite, so I'll leave it there for now, but I'd be happy to answer any questions if people have them.

Or if I can be of help in another way, let me know, as I'm new to the site but am keen to contribute as my mates and I are getting lots of useful advice in other forums and greatly appreciate it.

Also I've finally had a good read of all the previous posts, so I'd like to add:

Cheers to mattcbf600 for the wound management post too - nurses are the experts in that area, not doctors, that was great info.!

And I back up the advice about getting some training and confidence if you are going to administer drugs (esp. drugs like adrenaline) - no one does it more than us in anaesthetics, and no one makes more mistakes than we do. It can go pear-shaped very quickly...Prevention is the key, but experience is the answer if it happens anyway...

Lots of common sense advice in the rest of the posts which is the most important type!

Cheers Guys,
Damien

PS Whoever finds a cure for hangovers should win the Nobel Prize...

Question for doc
 

Thanks for all the useful info from yourself and other. Would you happen to know who in Sydney region provides a wilderness first aid course. We've booked ourselves in for the St Johns remote first aid course, but that is it.

On another note, I was reading info on altiture sickness on the link you supplied to the handy first aid book. We will hopefully be crossing the pamir highway which is at least 4000 meters above sea level (this will be in a 4x4). My question is that it states that the max daily height gain should not exceed 300m. does this apply to regardless of whether you are trekking or sitting in a warm (hopefully) car driving... A bit confused at the moment re safe limits in ascending if you not actually doing any activity.:confused1::confused1: or am I trying to kid myself here...

Thanks

Cheers Damien - I still miss A&E!

m

You are having a laugh...
 

or you have a short memory.

Altitude Sickness
 

RE: Wilderness First Aid Courses

Not certain about Sydney. The one here in Tassie (actually they do 3 a year) are run through TAFE. Might be worth checking out.


RE: Altitude sickness - good question

Unfortunately you can still be susceptible even if you drive up to altitude, once you get out and start exerting yourself. You can even get it in the car if fitness is an issue. Everyone is different too. It's all about exertion (ie your body requiring more oxygen) at an altitude where it is delivered at a lower partial pressure, and therefore more difficult for your body to get and use. Best bet is to take it slow - go up, get out and test the altitude for you, and maybe even go what the climbers do - go up a certain altitude each day, and then descend a bit for the night's sleep. This acclimatises them to each level. Also, acclimatise as much as possible when you first get to the higher region and be on the look out for the symptoms in each other. It's quite easily treated by descending again.

See: Non-Physician Altitude Tutorial
"The trick is to limit your daily upward travel to stay within that tolerance zone."

And: Base Camp MD - Guide to High Altitude Medicine

Cheers,
Damien

Thanks for the info doc. Will have a look at the links.

Regarding fitness, we would consider ourselves in fairly good shape, running 3-4 times a week (between 45min and 60 min each run). We are hoping to squeeze some running gear into the 4x4 to stay fit on the road. this will probably be ideal to keep doing a few runs when you start getting to the Mongolian high country and so further on, doing short runs to get use to altitude and shortness of breath/oxygen in the air.

Will be interesting to see how much it will take out of us doing a normal run at say 1000 meters above sea level...

stitch or staple?
 

I've been watching for a while so I guess i'll jump in today...

I carry a skin stapler. You can purchase them on the net (got mine on EBAY) for a few $. They come loaded with stainless staples, are sterile and are good for lacerations in areas absent of cartlidge or bone. (hands, elbows, shins). I also carry wound glue (also on EBAY) that is not toxic like super glue and holds well to superficial partial thickness lacerations. It also forms a protective layer on the wound that keeps it from snagging on clothes. These are VET supplies, so if you have a problem with that...don't buy them but they are safe if used correctly. For cleaning and pre-wound care, I have a small squirt bottle mixed with hydrogen peroxide and betadine....kills the nasty stuff and you can irrigate with the squirt bottle...fairly painless. I'm not sure you want to carry suture kits with hypo neddles, syringes and lido-epi for wound numbing...though, if you got your hands on it...a couple sqirts into the wound and waiting 5 minutes does wonders before injecting for numbing the wound. Just remember not to inject anything with epinephrine near ears, eyes, nose and toes. (venous constriction could cause distal tissue death) Just my .02.

I always carry a self-circumcision kit in case I find myself in a Muslim country and need to, you know, "blend in".

Just wanted to throw something in regarding wound cleaning - though I'm no medic. Heard that even bottled water can't always be trusted in some places, so perhaps a decent water filter might be of use. Just got one - see below - which seems to tick all the boxes. Good filters apparently - used by UN in disaster areas and all that and recommended for wound cleaning - though I suppose many filters will do a similar job.

DrinkSafe-Systems, UK.

Aquagear Water Filter

Vials are a problem too
 

At a now closed medical center in Nevada, US, reused syringes caused hepatitis C contamination in medication vials. Later, even if a sterile syringe was used, it was put into a medication vial that was comtaminated due to the prior unsafe practices.