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Medical Emergencies - Part Three

WOUNDS

(Adapted from the U.S. Army Survival Manual)

An interruption of the skin’s integrity characterizes wounds. These wounds could be open wounds, skin diseases, frostbite, trench foot, and burns.

Open Wounds

Open wounds are serious in a survival situation, not only because of tissue damage and blood loss, but also because they may become infected. Bacteria on the object that made the wound, on the individual’s skin and clothing, or on other foreign material or dirt that touches the wound may cause infection.

By taking proper care of the wound you can reduce further contamination and promote healing. Clean the wound as soon as possible after it occurs by -

Removing or cutting clothing away from the wound.

Always looking for an exit wound if a sharp object, gun shot, or projectile caused a wound.

Thoroughly cleaning the skin around the wound.

Rinsing (not scrubbing) the wound with large amounts of water under pressure. You can use fresh urine if water is not available.

The “open treatment” method is the safest way to manage wounds in survival situations. Do not try to close any wound by suturing or similar procedures. Leave the wound open to allow the drainage of any pus resulting from infection. As long as the wound can drain, it generally will not become life-threatening, regardless of how unpleasant it looks or smells.

Cover the wound with a clean dressing. Place a bandage on the dressing to hold it in place. Change the dressing daily to check for infection.

If a wound is gaping, you can bring the edges together with adhesive tape cut in the form of a “butterfly” or “dumbbell” ( Figure 4-7).

Butterfly Wound Closure

In a survival situation, some degree of wound infection is almost inevitable. Pain, swelling, and redness around the wound, increased temperature, and pus in the wound or on the dressing indicate infection is present.

To treat an infected wound -

Place a warm, moist compress directly on the infected wound. Change the compress when it cools, keeping a warm compress on the wound for a total of 30 minutes. Apply the compresses three or four times daily.

Drain the wound. Open and gently probe the infected wound with a sterile instrument.

Dress and bandage the wound.

Drink a lot of water.

Continue this treatment daily until all signs of infection have disappeared.

If you do not have antibiotics and the wound has become severely infected, does not heal, and ordinary debridement is impossible, consider maggot therapy, despite its hazards:

Expose the wound to flies for one day and then cover it.

Check daily for maggots.

Once maggots develop, keep wound covered but check daily.

Remove all maggots when they have cleaned out all dead tissue and before they start on healthy tissue. Increased pain and bright red blood in the wound indicate that the maggots have reached healthy tissue.

Flush the wound repeatedly with sterile water or fresh urine to remove the maggots.

Check the wound every four hours for several days to ensure all maggots have been removed.
Bandage the wound and treat it as any other wound. It should heal normally.

 Steve's Notes: Some plants can be used to disinfect small wounds. Sap from the blisters on Balsam Fir trees is a natural antiseptic dressing, for example. Just pop the blisters and smear the sap over the cut or other wound. Another plant you can use is St. Johnswort. I once applied a few mashed up leaves to a nasty gash on my foot, replacing it occasionally, and I was amazed as it healed in a couple days with no scar. It is known to be anti-bacterial, anti-viral, and anti-fungal.

Skin Diseases and Ailments

Although boils, fungal infections, and rashes rarely develop into a serious health problem, they cause discomfort and you should treat them.

Boils

Apply warm compresses to bring the boil to a head. Then open the boil using a sterile knife, wire, needle, or similar item. Thoroughly clean out the pus using soap and water. Cover the boil site, checking it periodically to ensure no further infection develops.

Fungal Infections

Keep the skin clean and dry, and expose the infected area to as much sunlight as possible. Do not scratch the affected area. During the Southeast Asian conflict, soldiers used antifungal powders, lye soap, chlorine bleach, alcohol, vinegar, concentrated salt water, and iodine to treat fungal infections with varying degrees of success. As with any "unorthodox" method of treatment, use it with caution.

Rashes

To treat a skin rash effectively, first determine what is causing it. This determination may be difficult even in the best of situations. Observe the following rules to treat rashes:

If it is moist, keep it dry.

If it is dry, keep it moist.

Do not scratch it.

Use a compress of vinegar or tannic acid derived from tea or from boiling acorns or the bark of a hardwood tree to dry weeping rashes. Keep dry rashes moist by rubbing a small amount of rendered animal fat or grease on the affected area.

 Steve's Notes: The juice from crushed jewelweed plants can sooth a rash. I have even seen it clear up a poison ivy rash overnight.

Remember, treat rashes as open wounds and clean and dress them daily. There are many substances available to survivors in the wild or in captivity for use as antiseptics to treat wound:

Iodine tablets. Use 5 to 15 tablets in a liter of water to produce a good rinse for wounds during healing.

Garlic. Rub it on a wound or boil it to extract the oils and use the water to rinse the affected area.

Salt water. Use 2 to 3 tablespoons per liter of water to kill bacteria.

Bee honey. Use it straight or dissolved in water.

Sphagnum moss. Found in boggy areas worldwide, it is a natural source of iodine. Use as a dressing.
Again, use noncommercially prepared materials with caution.

Frostbite

See the page on Frostbite.

Trench Foot

This condition results from many hours or days of exposure to wet or damp conditions at a temperature just above freezing. The nerves and muscles sustain the main damage, but gangrene can occur. In extreme cases the flesh dies and it may become necessary to have the foot or leg amputated. The best prevention is to keep your feet dry. Carry extra socks with you in a waterproof packet. Dry wet socks against your body. Wash your feet daily and put on dry socks.

Burns

The following field treatment for burns relieves the pain somewhat, seems to help speed healing, and offers some protection against infection:

First, stop the burning process. Put out the fire by removing clothing, dousing with water or sand, or by rolling on the ground. Cool the burning skin with ice or water. For burns caused by white phosphorous, pick out the white phosphorous with tweezers; do not douse with water.
Soak dressings or clean rags for 10 minutes in a boiling tannic acid solution (obtained from tea, inner bark of hardwood trees, or acorns boiled in water).
Cool the dressings or clean rags and apply over burns.
Treat as an open wound.
Replace fluid loss.
Maintain airway.
Treat for shock.
Consider using morphine, unless the burns are near the face.

 Steve's Notes: If you are in the desert southwest, you may be able to find aloe plants. The juice from their leaves has been known to help heal burns for a long time.

ENVIRONMENTAL INJURIES

Heatstroke, hypothermia, diarrhea, and intestinal parasites are environmental injuries you could face.

Heatstroke

The breakdown of the body’s heat regulatory system (body temperature more than 40.5 degrees C [105 degrees F]) causes a heatstroke. Other heat injuries, such as cramps or dehydration, do not always precede a heatstroke. Signs and symptoms of heatstroke are -

Swollen, beet-red face.
Reddened whites of eyes.
Victim not sweating.
Unconsciousness or delirium, which can cause pallor, a bluish color to lips and nail beds (cyanosis), and cool skin.

Note: By this time the victim is in severe shock. Cool the victim as rapidly as possible. Cool him by dipping him in a cool stream. If one is not available, douse the victim with urine, water, or at the very least, apply cool wet com-presses to all the joints, especially the neck, armpits, and crotch. Be sure to wet the victim’s head. Heat loss through the scalp is great. Administer IVs and provide drinking fluids. You may fan the individual. Expect, during cooling -

Vomiting.
Diarrhea.
Struggling.
Shivering.
Shouting.
Prolonged unconsciousness.
Rebound heatstroke within 48 hours.
Cardiac arrest; be ready to perform CPR.

Note: Treat for dehydration with lightly salted water.

Hypothermia

See the page on Hypothermia.

Diarrhea

A common, debilitating ailment caused by a change of water and food, drinking contaminated water, eating spoiled food, becoming fatigued, and using dirty dishes. You can avoid most of these causes by practicing preventive medicine. If you get diarrhea, however, and do not have antidiarrheal medicine, one of the following treatments may be effective:

Limit your intake of fluids for 24 hours.

Drink one cup of a strong tea solution every 2 hours until the diarrhea slows or stops. The tannic acid in the tea helps to control the diarrhea. Boil the inner bark of a hardwood tree for 2 hours or more to release the tannic acid.

Make a solution of one handful of ground chalk, charcoal, or dried bones and treated water. If you have some apple pomace or the rinds of citrus fruit, add an equal portion to the mixture to make it more effective. Take 2 tablespoons of the solution every 2 hours until the diarrhea slows or stops.

 Steve's Notes: I have stopped diarrhea with a tea made from oak twigs.

Intestinal Parasites

You can usually avoid worm infestations and other intestinal parasites if you take preventive measures. For example, never go barefoot. The most effective way to prevent intestinal parasites is to avoid uncooked meat and raw vegetables contaminated by raw sewage or human waste used as a fertilizer. However, should you become infested and lack proper medicine, you can use home remedies. Keep in mind that these home remedies work on the principle of changing the environment of the gastrointestinal tract. The following are home remedies you could use:

Salt water. Dissolve 4 tablespoons of salt in 1 liter of water and drink. Do not repeat this treatment.

Tobacco. Eat 1 to 1.5 cigarettes. The nicotine in the cigarette will kill or stun the worms long enough for your system to pass them. If the infestation is severe, repeat the treatment in 24 to 48 hours, but no sooner.

Kerosene. Drink 2 tablespoons of kerosene but no more. If necessary, you can repeat this treatment in 24 to 48 hours. Be careful not to inhale the fumes. They may cause lung irritation. (Note: This has gone out of favor, and should be used only as a risky last resort.)

Hot peppers. Peppers are effective only if they are a steady part of your diet. You can eat them raw or put them in soups or rice and meat dishes. They create an environment that is prohibitive to parasitic attachment.

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The Ultralight Backpacking Site | Medical Emergencies - Part Three