sterile syringes and anesthetic ?
 

Hello people

I’ve looked at a lot of peoples first aid trip preparation lists online and in books, A LOT have 2 x sterile syringes. Now, I’m not completely stupid so I’m assuming they are to hold anesthetic to inject if you need to stitch your leg or some other part.

I’m sure if I went to my doctor and asked for 2 x sterile syringes with anesthetic he’d say "bugger off son, don’t be silly". So I guess you take some kind of advance first aid course and get a certificate which says your trained and then your doctor says the magic words “yes, I can help with that”

Can anybody help with input on this question ?

Regards
Shaun

Pick up a couple mini-bottles of vodka...and stuff in your bag...good way to say thank you for road side assistance/advice and can also be used as anti-septic/anesthetic or hand/face cleaner.

The airplane size...

good reply dude
 

lol :) I was thinking more like whiskey

There is no "first-aid" course that is going to qualify you to administer anaesthetics by injection.

Although not a controlled drug as such, I'm not aware that you are able to purchase injectable Lidocaine Hydrochloride, (local anaesthetic) over the counter, anywhere. Your GP is not going to give you any either. Now syringe & needle is another matter. You want these if you are unfortunate enough to be in a region where re-use is likely, and you need an intra-muscular/venous or subcutaneous injection.

Surgical adhesive dressing
 

After some searching, looks like Medical/Surgical adhesive bandages/dressing is the way to go, or super glue with micropor tape. Also, clean the wound very well first! Don't try this at home kids :) ask a grown-up to help

I don't think you should be getting into wound closure at all. Even if a wound is slightly dirty, it's preferable to leave it open. If a closed wound develops infection, you really are in trouble.

Best thing to do on this front is go see the chaps at Nomad Travel & Outdoor - they have quite a few clinics and they can help out out with this kind of thing - they're real experts.... in fact we spoke to them about this very point at the Travel and Adventure Show.

They can help with prescription drugs and other restricted items for your trip - they'll advise based on your experience and knowledge and prescribe what they feel is appropriate after a detailed conversation with you about your journey.

Go here - Journey To Russia on blip.tv (you'll need to let it download in the flash player - watch the grey strip at the bottom).

and then move the video to 02:11 where you'll see me talking to one of their nurses and Jason Gibbs - their pharmacist.

You can email them direct on medical@nomadtravel.co.uk

true
 

TRUE

So, your miles from anywhere, have a bad off and gash your leg open ! then what.... i've taken lots of courses at work on advance first-aid so i could deal with the first aid...but, leave it open its going to get an infection, don't do the proper prep and close it, its going to get an infection.. you are your own medic on the road ? how would you deal with an open wound miles from a 1st world doctor ?

this might be an interesting thread :)

thanks for replying so fast dude

shaun

thanks
 

Thank You - Very Good Tip...... i will get intouch

didn't watch the vid, so this may have been answered. But I think people take syringes to give to qualified medics so they can be sure they have something sterile being inserted into them. I don't think it's for Rambo style self-surgery.

the Nomad guys are very good (and quick), but expensive. You can get (are entitled to) a lot of things on the UK NHS, but you have to wait.

Hola Dougeramos
 

Yup. Nomad gave me a couple of syringes from their shop in London N15 - you're supposed to give them to doctors etc who are about to inject you in hygienically dubious regions. England for example. I forgot 'em when I had 3 operations in Mauritania but it all turned out alright in the end. *turns purple and expires*

Hello Shaun,

I do get your point, although many 3rd world doctors are better than 1st world doctors...and some barefoot doctors are better than that!

Where are you planning on going? If you did have a bad off, and you did injure yourself so badly that you had a gaping hole in ya, and providing that didn't inhibit your mobility enough to get back on your bike/start walking, then...

1. Wound might be clean enough - stick some antibiotic/anaesthetic cream in it, wrap it up, seek medical attention.

2. Clean detritus from wound with water, preferably salty or with some drops of iodine in it. Stick some antibiotic/anaesthetic cream in it, wrap it up, seek medical attention.

Jobs a goodun!

I don't know about darkest Africa, far-flung Asia, but in Latin America, the locals will be all over you in minutes if you give the road a proper scraping.

Chao

fix myself kit
 

Hi Chao

I’m starting to plan a six month ride, leaving in 2 years time when I’ve saved the cash.

8-week run from the UK down to Dakar then back up to spain. I’m never likely to do the Dakar rally I’m not that crazy but i would like to ride to dakar. After spain 4 months will be spent going to Mongolia via Caspian Sea through Turkey, Georgia & Azerbaijan into Kazak then my target Mongolia. After that, back to the UK.

total bout 24 weeks ish.... so, need a good fix myself kit :)

thanks for replys m8
shaun

Advice on temporary measures for an open wound from an ex-nurse (if you take this advice and expire it's not my fault - use due diligence!)

Wound, open to the air and bleeding.

If you're not immediately able to get to a doctor/nurse then you need to get the wound in such a state that you can - you're route isn't that arduous or far from civilization so you shouldn't have too much of a problem.

So for a temp' (1/2 day at most) fix.

Clean the would with sterile water - take a few of these - Eyewash Sterile Sodium Chloride 10ml x 100 - Eyewash - Eye Care from First Aid Warehouse UK - and 'flush' the wound of any visible dirt. Do not under any circumstances use any antiseptic cream on an open wound.

Wipe the surrounding area with a wipe - Trigene Wipes Pack 10 Individual Sachets - Biohazard Products - Biohazard Disposal from First Aid Warehouse UK - alternatively you can take some antiseptic liquid - Savlon liquid 250ml - Antiseptic - First Aid / First Aid Essentials from First Aid Warehouse UK - but this is more difficult to administer yourself. In an emergency you can use the Savlon to clean the wound directly - be aware this will hurt - alot - dilute.

If the wound is bleeding heavily you'll need to apply direct pressure - and may not be able to clean as above - make sure you have something can use with a bandage to apply that pressure - Cederroth Large Bloodstopper Bandage - Ambulance Dressings - First Aid / First Aid Essentials from First Aid Warehouse UK

But if the wound is not that big, then just use a normal bandage and wound dressing - do NOT attempt to close the wound yourself on the road - get to a doctor ASAP - these are temporary measures to stop the bleeding and get you to help.

To cover your wound directly use - Melolin Non Adherent Dressing 5 x 5cm - Advanced Wound Care - First Aid / First Aid Essentials from First Aid Warehouse UK - then cover with a suitable bandage - ensure there is pressure on the wound to stop the bleeding. Ambulance Dressings - First Aid / First Aid Essentials from First Aid Warehouse UK

Some people prefer these - Field Dressing 20x19cm - Ambulance Dressings - First Aid / First Aid Essentials from First Aid Warehouse UK - which will stop the bleeding and get you near enough to help - easier than the above as it's all combined.

Hope that helps.

m

The NOMAD TRAVEL info is spot on you can't beet those guys for both advise and supplies. 2 years ago i went on a 4 day course in Hereford got the lowdown on what drugs to take on a remote trip, how to sew "myself" up (be aware of liabity issues on others) and tretment of infections etc. The following week i walked in to Nomad store and purchaced a full kit including local anestheic, a range of antibiotics and adreniline. Luckily not had to use any of it other than antibiotics.Will attend another course this year and recomend such a course to anyone traveling on ther own to remote places.
Steve..

Sounds like a good course. Did Nomad supply you with injectable Lidocaine? I presume the adrenaline was issued in case allergic reaction, snakebite etc?

If you want the top notch stuff!
 

QuikClot® adsorbent hemostatic agent speeds coagulation & rapidly stops blood loss .: Z-Medica Corporation

I've used them (not on me) and will testify how great they are for severe wound injuries

Yep Lidocane was injectable for sewing up wounds and the adreniline was for snake bites etc.This day and age it's easy to get most things but anyone thinking of making such additions to ther kits will need to take training in the use of such drugs incase of adverce reactions ie heart atack with adreniline.

Adrenaline administered in those amounts would be unlikely to induce "heart attack", but certainly possibility of arrythmia. It's also good for reducing bleeding when you are trying to get those sutures in. You can even use it in life-threatening asthma attacks.

I stand corrected about my this stuff not being available over the counter! Times have changed.

Please be careful with this kind of stuff guys - for a start Nomad wont sell it to you if they feel you're not sufficiently trained, and you can very easily end up doing yourself much more harm than good.

Get on a good expedition medical course (not just first aid), Nomad can advice which ones.

m

Yeah agreed, and frankly, I'm not sure any short course, expedition or otherwise, would provide the skills to practise this kind of stuff. Hence my surprise that these kind of drugs are available in the format that they are.

cutting myself open
 

I’ve got a couple years to keep falling off my bike cutting myself open, stitching myself up for the hell of it! - lol - it’s a needle and thread - I put a zipper in my jacket once, what more do you want…. :rolleyes2:

Think we've done this one then guys. Good we're all in agreeance that proper medical training is the first step once you've done that do it again because when you have to step up to the mark all you've learnt goes straght out of your head (remembering my first heart atack situation).
Steve.

hypo,s
 

Syringes can be got from any druggie hand out clinic free of charge, as to how many you want thats up to you, but askin for too many might get you admitted and the RTW trip abandoned. LOL.

just the job
 

this looks like just the ticket, will look into this a bit more. a 4 day course will cost a few bucks i recon. still, once its learned! handy for other situations in life, not just crashing :)

good tip
 

thats a good tip! - However, I’d like the training and the drugs as well..

this stuff looks good as well....

1st Aid at HU meeting
 

Will there be a good basic 1st aid course or talk at the H.U meeting in July, is there any one thats willing to give there advice free there, would be nice to have that on the schedule this year. :D

It makes some sense to take a basic form of a sterile kit if heading to developing countries. Syringes with hyperdermic needles. Something thats not been mentioned is intravenous catheter needles ("IV line" or "drip") this is a very common item. If you are going to get treated for heat stoke, dehydration, and many drugs are administered intravenously. It's only a needle and a short tube. (small) If you're serious about 1st aid etc and wish to take syringes (sound logic) it would make sense to take IV catherter or 2 as well.

If you do take them, and even if you don't; if the hospital staff are going to use their needles etc or yours, make sure they only take them out of the sterile wrappers in front of you or your travel partner. it's not un heard (though not common) of for clincs to re-use this gear. -This is simple safe logic even if you don't take a sterile kit with you.

You will often see a syringe in a kit without needles. This is for irrigation of a open wound etc ( put the saline solution(purified salty water) in the syringe and use it to squirt it into the wound etc to clear out any foreign bodies (bits of Mongolian road).

Something to think about is entering a country with hyperdermic needles; it can lead to some hard questions if found in the lugguage. This would also include any medicene in tablet form not sealed in foil trays. Just make sure you can answer in certain terms exactly why you have this stuff with you. If you don't have DR or paramedic in front of your name leave the morphine, adrenaline etc at home.

If you are intrested in such gear have a look at the impressive range of first aid kits from the UK's lifesystems. they do a reasonable priced sterile kit ( 18 gbp for their middle one) have a look here; LIFESYSTEMS® Travel Healthcare - Travel First Aid Kits - Sterile Kit

First aid stuff should have the same logic as all your other gear.....think do i really need it??? what do i have already that will make do. If you're going to do a course don't bother with the local red cross or St John. their course are designed with the idea you're at home or work, not half a days ride from a clinic. Find a course for wilderness or remote places. it will be based closer to something usefull for you.

i personally wouldn't bother...
I carry only exam gloves, assorted cloth plasters, 2-3 x sterile wound dressings. glad wrap (to cover burns keeps it clean and won't tear your skin off after....bike fuel...cooker fuel...) a roll of athletic straping tape - much more usefull than several bandages. use it to cover dressings, strap a pulled wrist fix your tent..... and some saline solution to clean bits out, flush eyes etc same as anything.... keep it simple.... keep it functional.

Ok...this is getting a bit nutty and some myths are being perpetuated...

If I were a traveller passing through, I would focus on the following:

1. Understanding the language, including medical terms, of the areas you're passing through; as the local medical worker's diagnosis and treatment of your ailment will depend on your ability to communicate its symptoms, etc.

2. Understand the type of care and materials medical implements you need for that care...the book Where There is No Doctor is an excellent read....whether it being through a course or book. These medical materials ARE available locally...you'd be surprised if you ask in the local language...including clean needles etc.

3. Realize what your limitations are versus a professional medical care provider, irrelevant of where you're injured. Ask them questions if you need to...to better understand your ailment.

West Africa, Mongolia, some backwoods clinics are NOT rife with clinics sharing needles, and impropriety etc. as some of these myths perpetuate...while travelling, stop by a local clinic and see for yourself...you'd be surprised.

Hell think about it this way, if they were able to acquire a clean needle at some point, I'm sure they'd be able to acquire one in case you need it...just ask, if unsure you're provided one...they'll open it out of the packaging for you!

Lastly, crossing borders with needles and drugs labelled in foreign languages for local customs agents, CAN create misunderstandings like having them believe you may be importing illegal drugs, etc. And THAT will spoil your holiday more likely than the potential incident you're preparing for.

Bottom line, mitigate your risk...

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.