Overland Medicine

Pacific Northwest yetti

Expedition Medic
We actually have a medicine sub forum here, its one of my favorite ones. Although it does not get much love.

https://forum.expeditionportal.com/forums/overland-medicine-and-health.102/



Some great solid, and clinical based proved advice here when it comes to wound closure. Like mentioned, if you can drink it. You can clean a wound with it. And however much you think is enough, double it.

Unfortunately, I have seen some front country docs do that, w/o much cleaning. And close with a lot of antibiotics. It was taught that way for a long time. Prolonged field care, remote and combat medicine have taught us. Cleaning it, has a greater level of success and < complications then the old school method. Sometimes, depending on the wound, and what made it. Or if they did a good job checking it. The choice may be made to close with minimal cleaning, (Is it already clean). However, * That has been pulled from mainstream teaching for the past 10 years or so.

TQ’s are gold. Those who say they can improvise one in the field effectively have never done so with a PT bleeding out. With possibly a few exceptions.

When I stated with medicine in 08, they were teaching PASG ( Mass pants +, TQ’s bad) Like the “ lose a limb comment above, it was taught that way. However, the loss of a limb, is still probably better than death.

During the military actions in Iraq and Afghanistan we learned a lot. Like TQ’s on for days without the loss of a limb. But it will hurt like hell, and the Surgeon and post op care will be a lot. I have personally had PT”s in the remote setting with a TQ on for long periods of time with the limb being saved. Lots of variables though.

Get trained, don’t carry stuff you don’t know how to use. You are adding weight, possibly complications. And most the time, if a stranger give me ALS equipment from their kit…I don’t trust it, and it’s my license at risk. So I’ll use my own, or build as I go.

For 90% of people they may consider an hour from the hospital as remote. Or where they go. Its really not. The US of course has some extremely remote areas and places; however, I have found most “Overlanders” are not usually more than a few hours from definitive care. With the exception of spec rescue.
 

Tac Goat

New member
All great input and an opportunity to correct old myths, and discuss current standards and products. I've been a paramedic since 93' and began my career in tactical medicine around 1999. I'm also a Critical Care Transport medic. This career has taken me to many places foreign and domestic and in all kinds of austere environments. As much as I have done, I am always learning new things. That is the intent of this thread, to share ideas and information.
In regard to tourniquets, I've used the CAT tourniquet for well over a decade and found it to be simple and effective. So when a friend asked me to try the TX2 ratchet tourniquet, I thought it was just another variation of a windlass tourniquet. The TX2 ratchets like a snowboard binding and gets really tight quickly. When I asked my friend what was the biggest benefit of the TX2 compared to the CAT he said "You ever turn a windlass with your hand crushed or fingers blown off".
Point taken. I still carry CAT's but I also carry the TX2 and TX3 tourniquets. How often do you reassess your kit and what changes have you made recently?
 

hemifoot

Observer
level 2 kit and 25 years of first aid training.every couple years we were required to retrain.first aid,confined space and packaging.
 

craig333

Expedition Leader
I was fairly briefly an EMT but I thought "well trauma hasn't changed that much". Appears I was more than a little incorrect about that.
 

Tac Goat

New member
Let’s pick up where we left off. Been traveling so I’ve been out of pocket. In summary to previous,
- Tourniquets are good, just buy from a reputable supplier
- Lots of people are taking classes and getting good training
- Antibiotics at the point of injury is becoming more common, especially in very remote areas. However it is imperative to consult your doctor before using antibiotics.
- Aid bags and kits are great again buy from a reputable source and don’t forget the over the counter (OTC) stuff as well
- Do a remote assessment of hospitals, EMS, and Search and Rescue and their capabilities for the area you are traveling to.

What else are people doing to be better prepared for a medical emergency while overlanding? Sat phones? Personal Satellite messaging devices e.g. SPOT?
 

llamalander

Well-known member
Water purification, rehydration salts and blister care go most places with me.
Benadryl, cortisone cream, good tweezers, emergency blanket and quick-clot and lots of gauze. Gloves, a few different tapes, eye drops, eyebuprofin, a knife and a lighter along with assorted band-aids & prep-pads all fit in a bag smaller than a water bottle.
More often than not, small things require attention. With a Garmin, I feel like I can attend to a lot of things before proper attention arrives. That's my walking kit. More of everything in the truck where things likely happen faster and harder.
 

TwinStick

Explorer
I have been on a few accident scenes before trained help arrived. In both instances, people had first aid kit and didn't know how to use them but others on the scene did. So, just having one is important and it did make a difference. Training is always good though.

Unfortunately in this litigious world we live in, many don't want to get involved, good samaritan act or not.
 

Steve_382

Active member
FWIW, This book is pretty good.

Can't get the Amazon link to post, but this is it.

Medicine for Mountaineering & Other Wilderness Activities​


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Tac Goat

New member
Great feedback. Definitely good idea on minor care such as moleskin and Benadryl. Also the book looks interesting and probably offers some good info.
Other points to consider is what are we doing for splinting injured limbs? and how are we moving injured people that can’t walk on their own? Lots of techniques on both of these topics.
 

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