Wilderness medicine Wednesday - Sutures and Staples and Glue, oh my

Let's talk about why you SHOULD NOT carry a suture kit.
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[@anninwhack1998]

Really useful information. Thanks!!!

[@AdventureOtaku]

Thanks for watching!

[@davidpoots8362]

Im medically qualified and completely agree, emergency first aid must be kept simple, clean and dress the wound until it can be treated properly in an ED.

[@AdventureOtaku]

Thanks!

[@pudellvr]

Brett, great info. One thing I think would make a great addition to a wilderness kit is Skin Prep Pads. It helps the dressing adhere to surrounding skin. As a nurse, I use them all the time with dressing changes. Makes steristrips last longer.

[@AdventureOtaku]

Yeah, I didn't get into details about actually closing wounds - I need to be careful not to delve into NOLS curriculum! - We use tincture of benzoin to prep the area, which does the same sort of thing. Great point though.

[@roastawk]

Thanks, Brett! Just a few items: 8:39 I think I know where you will be in Brooklyn down to the foot, if not the inch. (Don't worry, I will not be showing up. I've got an ambulance shift that day 🙂) I ran into one of your WFA students on a hike. She had nothing but great things to say about you! She's quite the fan. I gave her some advice on how to become an EMT with minimal expense. (For anyone else reading this, the advice is: find a volunteer ambulance corps near you. Some teach EMT courses, and some will even pay for the course if you pass and volunteer.) 9:19 The link to your Epipen video is missing.

[@AdventureOtaku]

Thanks brother! I think I heard about you running into her! I totally agree on the volunteer thing, it is how I started and it is great for building actual patient contact time. BUT a lot places don't have volunteering options. Even where I live in Eastern PA, there is volunteer fire, but no EMS.... Thanks on the link, I'll fix it now!

[@NunzioBruno]

Always great videos! I'd love to hear you talk more about how things like Neosporin slow the healing process when it comes to punctures and cuts.

[@AdventureOtaku]

I misspoke when I added neosporin to that list, which is why added the tag later about neosporin. Other things like Alcohol and hydrogen peroxide Kill damaged skin cells surrounding the wound. So the wound edges have dead skin cells, then its surrounded by damaged cells, followed by healthy cells. Things like Alcohol or hydrogen peroxide kill those damaged cells. You can put things like Neosporin, aquefor, Bacitracin on a gauze over the wound, or in some cases on the wound to keep it moist, but that is all it is doing. You can also just use Vaseline. Doing the same thing - but neosporin has the added allergic reaction issue… use Vaseline.

[@NunzioBruno]

@AdventureOtaku Awesome, thanks for the clarification!

[@Simon_W74]

Very interesting video. I did buy some transparent dressing to go into my First Aid kits. Even bought extra Steri Strips as not all of my kits came with them. I wouldn't add a suture kit or Staples as I don't know how to use either and would definitely do more harm, and we don't want to add to the problem. Glue isn't something I would have looked into either as I know it is very different to the CA glues that i use for joinery and carpentry. Even though CA glue is brilliant at sticking skin together accidentally, if your not quick enough to break your fingers apart before it flashes off. I wouldn't use it on a cut no matter what.

[@AdventureOtaku]

Those transparent dressings are my go to bandage in a wet environment.

[@DrPV]

Good job on video.

[@AdventureOtaku]

Thanks Doc!

[@Toomuchgearguy]

I need to take that course someday!

[@AdventureOtaku]

Yes, you do.

[@Usonian7]

7:30 got it, don't waste the whiskey.

[@AdventureOtaku]

Totally don’t waste the whiskey

[@gadgetman_nz4092]

I must admit to having my finger operated on long after the anaesthetic had worn off. Was a little uncomfortable but not too bad. When I was wheeled down to the ward and the matron came to check the circulation I remarked, "Yeah, I can feel that OK." She quickly retorted, "You've had an arm block. You can't feel that! If you could feel that you'd be able to wriggle your fingers." To which I simply replied, "What, like this?", as I wriggled the fingers for her. She huffed, "But you would have felt them operating on it!" I responded, "Yes it wasn't too comfortable, but it wasn't too bad, the worst part was the sharp corner of the table on my elbow." She pulled an awful face as I continued, "I got the arm block about 5:30pm and it was 11:30pm when they finally took me into theatre. The day has been long enough, I just wanted them to get on with it." A lot of pig hunters carry the staplers for their dogs when they get ripped up. They'll frequently use the stapler on themselves when they too get ripped up. I carry steristrips. I just used bandaids the couple of times I tore wounds open after having the stitches removed.

[@AdventureOtaku]

I can’t speak to staples on dogs. And you can find things better than band aids that will stay on in more difficult conditions.

[@gadgetman_nz4092]

@@AdventureOtaku It was the early hours of the morning, about 3am, so I just used what was easily at hand. They both still look a bit ugly, but that suits me.

[@AdventureOtaku]

I can’t speak to staples on dogs. And you could find things instead of band aids that will work way better, in terms of staying on in rough environments.

[@mosulmedic7048]

I typically deter people from packing sutures, staples and glue. Wrap the wound and let that treatment be done outside of austere environments. Honestly, most people go overboard when prepping medical kits. The amount of useless items people put in their kits " just in case" is crazy

[@AdventureOtaku]

Agreed. Thanks for watching

[@richardyap7873]

Hi Doc, How about using potassium permanganate diluted to clean the wound?

[@AdventureOtaku]

I have to be honest and say I wasn’t familiar with it, but after reading about it, Im going to say no for the same reasons we don’t use hydrogen peroxide or alcohol.

[@we317]

What do you think about Honey Wound Gel for keeping a wound moist? I’ve seen it advocated for by the University of Utah backcountry medicine program and I now carry a tiny tube of Medihoney rather than Neosporin. I really appreciate your backcountry medicine content and have studied the NOLS Wilderness Medicine Book and am signed up to take the WFA class this winter (in the southwest). Thanks for getting me interested in learning more 😁

[@AdventureOtaku]

University of Utah has a great Outdoor ed system and includes a lot of Wilderness Med Stuff. Im fine with Honey, if you are using it to keep the wound moist where appropriate. But it HAS to be local honey. It can absolutely NOT come from a supermarket shelf. Like, you need to know someone with bees.

[@DwightFitzmorris]

Hi Brett, Would using alcohol to sterilize the wound flushing device work prior to filling with the sterile saline? Nova Scotia Dwight.

[@AdventureOtaku]

Maybe…. I know that isn’t the answer you want. Too many variables in the equation to know for sure. A) I am not sure you can actually sterilize plastic B) you would need a fair amount of liquid isopropyl alcohol. Which you probably wouldn’t be carrying. Issues like that.

[@arcanum3000]

@@AdventureOtaku That gives me an idea for a probably impractical and/or excessively niche product: A titanium irrigation syringe that can be safely boiled in a camp pot for sterilization in the backcountry.

[@AdventureOtaku]

@arcanum3000 very niche

[@DwightFitzmorris]

@@AdventureOtaku I understand... thank you.

[@tehbieber]

How do you feel about those strips that have a little staple embedded in each side to pull the skin together? Micromend are the ones I've seen

[@AdventureOtaku]

Haven’t seen micromend but check out tincture of benzoine which we use to hold steri strips in place. Glue like, but naturally occurring and I don’t have to put homes in you