Considerations for additional items to have in your home FAK

Discussion in 'Survival Medicine' started by DKR, Aug 2, 2018.


  1. DKR

    DKR Interesting ideas, interesting stories

    The Disclaimer for this section applies to this article.

    Reminder - First Aid 101:
    a dressing is made to go directly on an open wound, and should, therefore, be sterile. A bandage is used to hold a dressing in place.

    Adaptic 'burn' dressings.
    [​IMG]
    Description: ADAPTIC™ Non-Adhering Dressing is a primary dressing made of knitted cellulose acetate fabric and impregnated with a specially formulated petrolatum emulsion. It is designed to help protect the wound while preventing the dressing from adhering to the wound.

    Suggestion: 5 x 9 in pad. At least 6, a dozen is better. (see discussion)

    Non-adherent gauze pads.
    [​IMG]

    Description: Vendor specific, should be:
    • Sterile
    • Absorbent non-woven pad with non-stick formulation that will not stick to wound. (Typically a Nylon / Polyester Blend)
    • For use with lightly draining wounds.
    • Individually wrapped in easy-to-peel package to help maintain sterile state
    • Single Use
    Suggestion: 1 box (dozen count) in 3x3 or 4x4 and one box (dozen count) of 5 x 9 - sometimes called a sponge. (see dissuasion)

    Kerlix rolled gauze:

    [​IMG]
    Description: This rolled gauze offers quick and easy application when wrapping a limb or wound on the head. It also has excellent conformability to mold to the wound bed. An added benefit to the Kerlix™ Gauze is its unique crinkle-weave pattern. The 6-ply crinkle weave adds loft and bulk to be soft and gentle at the wound site. The cotton weave is breathable and absorbent to wick exudate from the wound. All Kerlix™ Gauze Rolls have finished edges to control the cotton from fraying. Useful to protect would site.

    Suggestion: 3 rolls of both 3 and 4 inch x 4 (or more) yards. (see discussion)

    Hydrogel silver antimicrobial self-activating wound gel (Active Ingredients: Silver Chloride)
    [​IMG]
    (several different brands are on the market. Several small containers are better than a single, large container) 0.5 oz tube is preferred. NOTE - shop around! as prices very wildly based on Vendor, location and outlet.)

    Description: This is an antimicrobial gel with silver as the active ingredient. It is formulated to offer broad spectrum protection against bacteria and provide a long ‘activity life’ that lasts up to three days Normally is a non-stinging, non-staining barrier that helps hydrate the wound area for ideal wound management.

    Suggestion: A total of 1 dot 5 oz, however you purchase. For nearly all wound management, not just burns.


    By now you are asking - why thins?

    Last weekend I managed to (stupidly) burn parts of both legs and my hand with scalding hot (green) tea. My stupidity, and laziness led to an entirely preventable injury. BTW - I now carry my morning tea in a vacuum flask..

    I was able to examine the situation, and provide treatment at home as I had the items listed above in my home FAK.. If you regularly cook over a campfire, you would be well advised to have these in your camp FAK. That and keep a 5 gallon bucket of clean, cold water at the fireside.

    Bit of a sidetrack here. Why did I treat at home and not head to the local ER/Doc in the Box?

    Rule of 9s for burns.
    [​IMG]

    (Note -



      • In children, adjust percents because they have proportionally larger heads (up to 20%) and smaller legs (13% in infants) than adults
        • Lund-Browder diagrams improve the accuracy of the % TBSA for children.
      • Palmar hand surface is approximately 1% TBS

    See https://chemm.nlm.nih.gov/burns.htm for full criteria documentation. Once you get over 9% affected area, as 1st burn and 3% for 2nd degree burn area - seek immediate professional care ALWAYS seek professional care for 3rd dghree burns, no matter the size. .

    I had minimal 2nd degree burns, of less than 1% (actually, a bit less than the surface area of one palm) The areas were cooled with cold tap water - NOT ice water - and allowed to dry. Initial pain control was via cold water soaked dressings.

    Once the blisters broke, the area was dressed with an Adaptic pad, covered in turn by a non-adherent bad - both light held in place with rolled gauze. On dry two, called the telephone accessed Registered Nurse to confirm progress, double check my treatment plan going forward and to describe what symptoms would cause me to seek professional care. Ongoing pain management is via OTC product, when required.

    Back on topic - because I had these items on hand (I'm a bachelor for the week, DW is out of town) I had more options available to me that might have otherwise been possible. This also saved a trip to the local store for supplies, and possible additional pain/exposure to contaminants. .

    Side note - I was a licensed EMT for several years and worked an ER for 8 years - thus TRAINING and Experience should drive the choice between home care vs use of Professional (expensive) health care provider.

    These items are like what many may have in their FAK, but these listed items provide a bit of specialization.

    I hope you found this informative.







     
    Last edited: Aug 2, 2018
  2. HK_User

    HK_User A Productive Monkey is a Happy Monkey Site Supporter

    About what I have in a Kit close to the front door.
     
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  3. Bandit99

    Bandit99 Monkey+++ Site Supporter+

    Just to be clear... So, if I use a Non-adherent gauze pad then I should not have to use a dressing, correct? The two are interchangeable, gauze pad vs. dressing, as long as they are Non-Adhering, right? And, I still need to put a bandage on the gauze/dressing, correct? Why can't I just tape it on?
     
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  4. DKR

    DKR Interesting ideas, interesting stories

    ???
    The non-adherent pad is the dressing.

    The use of a bandage vs tape is twp fold. The roller gauze can, with care, be reused. It needn't be sterile, but must be clean. Strips of old sheets, for example, would make very serviceable bandage material....The gauze could be boiled if you wish to have a sterile bandage. A bandage permits frequent observation of the wound site with minimal disturbance upon removal/replacement. .

    Roller gauze also provides some protection as well as cushioning. Tape, not so much. In addition, tape may not be advisable around a large wound site - the chance to reopen a wound is too great.
     
  5. duane

    duane Monkey+++

    My in laws lived with us after they were no longer able to live alone. My mother in law had a circulation problem, was in hospital for surgery and then went to nursing home for rehab. There she developed severe bed sores and we were told that there was little that could be done and little improvement and healing were noticed. We brought her home and on the advice of an older German trained Dr, got a sheep skin for her to sleep on, rinsed the wound areas 6 times a day with sterile salt water, put on a loose dressings with aloe vera as the main ingredient for the coating on the cotton dressings and changed them each time we rinsed the wounds. Since they had to heal from the outside in, it took weeks to heal them, but they did heal. None of the expensive air mattress and dressings we paid for at the nursing home were working nor were they preventing the formation of new sores. In my mind, and I am neither medically trained nor do I stay at any magic motels, in working with the elderly with medical problems, the only successful way to care for them requires a lot of attention, a lot of hand holding and spiritual comfort, and like milking the cows, you can never neglect their care for even a short time or the resulting damage can be deadly. This does not happen in most nursing homes as they for the most part have neither the staff to provide such care or the will to provide any hand holding and psychological support.
    DKR in his comments points out some valuable points about 1 st aid in SHTF situations, if you are going to prevent a minor burn, chafe, cut, abrasion, etc, from turning into a fatal infection, you are going to have to keep the area sterile, protect it from outside infection agents, allow the proper conditions, moisture, air, etc, for the body to heal itself, and all this without the aid of a Dr or the resources of a hospital. A single wound may require the replacement of a bandage several times a day for a couple weeks. Since the average 1 st aid kit may have a package of 6 or so, you had better learn how to make, wash, sterilize, and reuse the dressings, and either have pounds of gel and quarts of sterile solution-cleaning agents or know what you can use as a substitute. No problem today, but the local Wally world pharmacy no longer stocks tincture of green soap, has about 1 dozen bottles of hydrogen peroxide, 1 dozen bottles of alcohol, maybe 2 dozen packages of sterile dressings, and a couple dozen rolls of gauze. Good luck picking any up after any event. As DKR states and his training stresses, there is a big difference between 1st aid, and then either transporting the patient to a medical facility, or stopping on your way home from the emergency room and picking up enough supplies to last a few days and restocking every few days, and providing all the medical treatment for a few weeks without being able to buy any additional supplies. My grand mother was a registered nurse, trained in Switzerland about 1890's, and I can remember her boiling bandages made out of old sheets in a wash boiler on a wood stove, hanging them out to dry in the sun, then ironing them and rolling them up for reuse. This was during WW2. She used tincture of green soap, lye soap, alcohol, witch hazel, and I was to young to really know what else, to clean wound areas. My mother had a 12 year old sister die in the 1920 or so time frame from an infected boil on her neck that was treated by a Dr and she died in a hospital, so without modern antibiotics etc, no home treatment will be state of the art.
     
  6. Brokor

    Brokor Live Free or Cry Moderator Site Supporter+++ Founding Member

    Some small, simple, and very useful items to add:

    Butterfly bandages: https://www.amazon.com/dp/B00A2XIZO8/?tag=survivalmonke-20
    Splinter out: https://www.amazon.com/dp/B00A2XIZO8/?tag=survivalmonke-20
    Eye Wash adapter: https://www.amazon.com/dp/B01AT3LOD4/?tag=survivalmonke-20
    Medical Splint: https://www.amazon.com/dp/B01LYN9O22/?tag=survivalmonke-20

    And more along the lines of well being and health (especially for times when there's no more civilization) Nascent Iodine: https://www.amazon.com/dp/B00KXFXJ2I/?tag=survivalmonke-20
     
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  7. HK_User

    HK_User A Productive Monkey is a Happy Monkey Site Supporter

    Many people are allergic to tapes, even medical tapes.
     
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  8. DKR

    DKR Interesting ideas, interesting stories

    Or the adhesive on the tape. Not to mention the fun of hair removal when pulling the tape :eek:
     
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  9. arleigh

    arleigh Goophy monkey

    I find that using colloidal silver seems to be most effectively deal with every kind of issue, gash cut burn pretty much any injury to the skin internally and externally .
    I would be desperately interested to find out what it cannot do, since most irritations stem from bacteria.
     
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  10. DKR

    DKR Interesting ideas, interesting stories

    Duane makes a couple of good points.

    My FAK is focused on simple first aid - then getting to a professional facility in a hurry - and long term home care.
    It is flexible enough to handle what I know I can handle. I don't plan on doing surgery, using home made IV solutions & equipment or trying to turn into a herbalist.

    Serious injury requires serious, professional help. Even then, folks die. In a wide area disaster, where no medical care is available for long periods of time...welcome to the 3rd World. It is just that simple.

    My OP was aimed at information for folks that want to have a FAK that is flexible enough to avoid trips to the ER in the first place.
     
  11. DKR

    DKR Interesting ideas, interesting stories

    Silver chloride - not just for that Kodak moment...

    Occurrence: Silver chloride is found in nature as the mineral chlorargyrite. However, chemical synthesis is the main and inexpensive method to obtain AgCl.

    Preparation: Silver chloride is industrially produced by the simple reaction between aqueous solutions of silver nitrate (AgNO3) and sodium chloride (NaCl), resulting in a white AgCl precipitate which is easily filtered off and collected.

    AgNO3 + NaCl → AgCl + NaNO3

    Physical properties: Silver chloride exists as a white crystalline solid with a density of 5.56 g/mL, a melting point of 455 °C and a boiling point of 1,547 °C. It is insoluble in water despite being an ionic compound.

    Chemical properties: Silver chloride is insoluble in water, alcohol and dilute acids but soluble in ammonia and concentrated acids. It is a photosensitive material (it undergoes chemical reactions in the presence of light), and upon illumination, it decomposes into silver metal and elemental chlorine. This reaction is characterized by the darkening of the AgCl sample, and makes AgCl an important chemical for photographic applications.

    I looked on the web for professional comments on
    silver chloride gel.

    I found nothing. Not a single med site (Web MD, Mayo Clininc, PDR online, Kaiser Permanate, etc) would touch this.

    In looking at Silver Chloride Topical
    (A Scientific Perspective on the Use of Topical Silver Preparations | Ostomy Wound Management)

    Antimicrobial activity. Silver is effective against a broad range of aerobic, anaerobic, Gram-negative and Gram-positive bacteria, yeast, filamentous fungi, and viruses.1,6-8 In combination with its broad antimicrobial properties, silver also appears to have other prohealing or anti-inflammatory properties as suggested by the loss of rubor in chronic wounds treated with silver.
    The concentrations of silver that are needed to create a biological effect are dependent upon the local environment. In a pristine aqueous system, concentrations as low as 10 ug/L are effective in controlling bacteria, while in complex organic media, the minimum inhibitory concentration (MIC) increases 2,000-fold to the 20 to 40 ug/mL concentration reported by Ricketts et al.9 Yin et al6 determined MICs for five clinically relevant bacteria in Mueller-Hinton broth, a complex organic growth medium. The MIC values ranged from 5 to 12.5 ug Ag/mL

    This professional monograph focues on Silver nitrate, normaly only had as a prescription topical solution used in treating wounds and burns on the skin as an anti-infective agent..
     
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  12. DKR

    DKR Interesting ideas, interesting stories

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  13. Motomom34

    Motomom34 Monkey+++

    Great pdf @DKR that is packed full of info. This thread is important because bandages are a must. Question: do you store combat gauze? The military stuff is expensive vs. regular gauze. You can pack a wound with regular gauze but the military stuff has the clotting agent on it. What are your opinions on it?
     
  14. DKR

    DKR Interesting ideas, interesting stories

    I'm an 'old school' medic, so my training reflected the experiences of the (then ongoing) SEA conflict (War in Vietnam).

    While a lot of 'new' medical stuff came out of the SEA conflict, for example, MAST devices, not a lot had changed from the conflict in the RoK.

    The stuff the medics do today - and their training, is nothing short of amazing. I had applied for Goat School, but since medical was not my primary AFSC, I was turned down.

    Once a grunt has finished 68W training, they can shred out to other socialites. With study and gaining a BS, it is now possible to get licensed as a PA. Also, the drugs and devices available now are nothing short of Star Wars to my way of thinking. Watching a few episode of the Night Watch series will give an idea of just how vast the changes to "Emergency medicine" have occurred in just the last 20 years and very radically in the last 10. .Just one example is the now common use of sternal intraosseous Infusion. (see Military Trauma & Resuscitation Medical Device Products - Pyng Medical)

    Having said this, I carry only regular gauze. If you are stuffing a wound, dealing with a major evisceration (land mine/IED) or a massive penetrating wound, the clotting agent isn't really going to help that much. A tourniquet , massive IV infusion and hauling ass in the chopper/V-22 is still the ticket.

    I'm completely out of that world, other than reading to see what is in use today. I worry only about my family owing to the massive increase of BBP.... I'll stop here.

    EDIT to add - people should consider what it will take to provide long term care in/once the hospitals close. the small/individual FAK is OK for the short term, but the on-going care on an injured (or worse, burned) person is a different set (or at best tangential) set of skills and equipment.

    That might be worth a thread of it's own...
     
    Last edited: Aug 4, 2018
  15. ghrit

    ghrit Bad company Administrator Founding Member

    When it comes to stopping a bleed, I refuse to worry a whole lot about a few hairs getting pulled when the expedient use of duct tape is needed because someone raided the FAK for the good stuff. (Nah, that would NEVER happen. You do inventories, don't you?)
     
    Last edited: Aug 4, 2018
  16. arleigh

    arleigh Goophy monkey

    When the proper sources of bandage are exhausted ,I am told that the next best thing to use the victims own clothing, if they've got any ,for bandaging .Usually their own clothing has bacteria their body is already accustomed to dealing with .
    also , if the victim is loosing blood they need to consuming more water keep the fluids coming .
     
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