Search found 896 matches

by Veritas
Sun Mar 30, 2014 3:59 pm
Forum: First Aid
Topic: IFAK Essentials Series: The NPA and OPA (Updated)
Replies: 16
Views: 16634

Re: IFAK Essentials Series: The NPA and OPA (Updated)

I kinda feel like if you tolerate an OPA you should probably get an ETT. I only use OPAs when we are having difficulty bagging someone just before intubation.

I like NPAs for conscious people.
by Veritas
Sun Mar 30, 2014 3:57 pm
Forum: First Aid
Topic: WWYD - Dog bite in the PAW (pun intended)
Replies: 22
Views: 3364

Re: WWYD - Dog bite in the PAW (pun intended)

I don't open up dog bites, only cat bites (if they can't be irrigated well). Irrigate with a liter or so of clean (doesn't need to be sterile) water I don't give antibiotic prophylaxis for dog wounds. The literature is not great either, a Cochrane review basically said "not enough info." For cats it...
by Veritas
Tue Oct 22, 2013 3:49 pm
Forum: First Aid
Topic: SALT Airway?
Replies: 44
Views: 6170

Re: SALT Airway?

To get entirely off topic, bc it's obvious the opinions on the SALT...I love IOs. We do not use enough of them. It makes putting in an IJ CVC a million times easier, especially when you have someone roll in who's been sick at home for four days, now in full septic shock. You can get two liters in an...
by Veritas
Sat Oct 12, 2013 2:25 am
Forum: First Aid
Topic: SALT Airway?
Replies: 44
Views: 6170

Re: SALT Airway?

Dannus: Dare I ask why you are using only Kings now? The short answer is probably 'cost'... :wink: My FD is a BLS agency only, even the paramedics on our rigs aren't allowed to intubate (unless the transport company medics are okay with them doing so). Accordingly, we are limited to basic oral and ...
by Veritas
Fri Oct 11, 2013 4:29 am
Forum: First Aid
Topic: Medication list for BOB
Replies: 18
Views: 2775

Re: Medication list for BOB

Doxy Cipro Zofran ODT Dicyclomine, perhaps loperamide would be better Epi Benadryl Motrin Albuterol Atropine If you're really paranoid I'd add 2-PAM and potassium iodide. I figure if your having an MI during a bug out you're SOL, so I'm leaving out asa and nitro. Doxy kills everything. If it doesn't...
by Veritas
Fri Oct 11, 2013 3:25 am
Forum: First Aid
Topic: SALT Airway?
Replies: 44
Views: 6170

Re: SALT Airway?

Dannus: Dare I ask why you are using only Kings now? calzone: I totally see where you'd be correct. I just wasn't sure, I've never heard of anyone actually using one. Jim, I agree. But it's always nice to have some sort of back up. What's yours? medic photog: Yea, definitely not for a true difficult...
by Veritas
Thu Oct 10, 2013 3:12 am
Forum: First Aid
Topic: SALT Airway?
Replies: 44
Views: 6170

SALT Airway?

Anybody ever used this? http://www.mdimicrotek.com/prod_salt.htm" onclick="window.open(this.href);return false; Tried it out recently in a workshop, it was interesting. Never used it on a person, wondering if anyone out there has? It's not billed as a definitive airway by any means, but that's not t...
by Veritas
Thu Oct 10, 2013 2:39 am
Forum: First Aid
Topic: Homeade Lidocane HCL?
Replies: 23
Views: 7192

Re: Homeade Lidocane HCL?

Gonna have to agree with abelru. Case reports of epi pens being injected into thumbs show no evidence of permanent damage. Like so many other theoretical risks, it has not proved up to science. Epi is nice in lido. Helps analgesia last longer, gives you less blood in the field for a better view. I d...
by Veritas
Wed Sep 18, 2013 5:07 pm
Forum: First Aid
Topic: Homeade Lidocane HCL?
Replies: 23
Views: 7192

Re: Homeade Lidocane HCL?

Lidocaine is great...home-reconsituted lidocaine is silly. Just buy the real stuff, I didn't even know lidocaine powder existed. Lidocaine is nice for regional nerve blocks, when you would normally require some sort of procedural sedation but don't have the staff or don't have the skill to manage an...
by Veritas
Thu Aug 01, 2013 10:41 am
Forum: First Aid
Topic: WWYD for the First Aid section: Rusty Nail.
Replies: 106
Views: 12069

Re: WWYD for the First Aid section: Rusty Nail.

I can tell you from first hand experience from a wound on my hand that you do pack wounds. You pull it out every morning, put it in the whirlpool, scrub it, then repack with xeroform gauze. A truly pleasant experience :gonk: for a couple of months, but it healed really well for secondary intention....
by Veritas
Wed Jul 31, 2013 12:31 pm
Forum: First Aid
Topic: WWYD for the First Aid section: Rusty Nail.
Replies: 106
Views: 12069

Re: WWYD for the First Aid section: Rusty Nail.

Veritas, I was referring to packing an infected puncture wound that was opened for cleaning / necrotic tissue removal only and did not mean to imply that someone should pack anything they can stick gauze in :oops: No worries, packing vs no packing changes all the time. Personally I think if a wound...
by Veritas
Sun Jul 28, 2013 11:26 pm
Forum: First Aid
Topic: WWYD for the First Aid section: Rusty Nail.
Replies: 106
Views: 12069

Re: WWYD for the First Aid section: Rusty Nail.

You do not have to pack a deep wound that is not infected BUT... Packing the wound with moist Gauze or the like and changing frequently will keep the wound from drying out ( inhibiting new tissue growth). It will also prevent the wound from healing unevenly or forming a pocket ( Deep ones should he...
by Veritas
Wed Jul 24, 2013 1:53 pm
Forum: First Aid
Topic: WWYD for the First Aid section: Rusty Nail.
Replies: 106
Views: 12069

Re: WWYD for the First Aid section: Rusty Nail.

Just to dispel a myth I keep seeing on here, you don't need to pack or drain a wound that is not infected. Packing/drains/any foreign body does not prevent infection. You place these things in wounds/abscesses that require draining of pus, not to prevent a fluid collection prophylactically.
by Veritas
Wed Jul 24, 2013 1:50 pm
Forum: First Aid
Topic: WWYD for the First Aid section: Rusty Nail.
Replies: 106
Views: 12069

Re: WWYD for the First Aid section: Rusty Nail.

First, you have picked a unique problem. As has been mentioned, penetrating wounds to the sole of the foot, especially through a shoe, are a special type of injury specifically. This would be totally different scenario if you cut a bare foot on broken glass, or grabbed a rusty nail with a gloved han...
by Veritas
Mon Jul 22, 2013 8:37 am
Forum: First Aid
Topic: Two questions on antibiotic use in a PAW
Replies: 6
Views: 1482

Re: Two questions on antibiotic use in a PAW

1. I would say no to the Probenecid theory, it sounds unreliable and I have literally never heard of it used in modern times for intentionally increasing plasma concentrations of antibiotics. I doubt it is a reliable or predictable method of dosing either. 2. The cross reactivity between pcn and cep...
by Veritas
Mon Jul 22, 2013 8:19 am
Forum: First Aid
Topic: you have it and carry it, do you know how to use it?
Replies: 29
Views: 3460

Re: you have it and carry it, do you know how to use it?

I'm not sure getting an MD at 17 is really a good thing...you need to grow up a little to be a doc first. I fully believe you need some street smarts before you can treat people effectively in an emergent scenario. To revisit the snakebite thing: The reason the cut and suck method doesn't work is be...
by Veritas
Wed Jul 17, 2013 1:52 am
Forum: First Aid
Topic: you have it and carry it, do you know how to use it?
Replies: 29
Views: 3460

Re: you have it and carry it, do you know how to use it?

The more I learn the less I would do to someone out of the hospital. Compressions only CPR, basic airway maneuvers, hold pressure to stop bleeding....probably little else. Those three things you describe? Arguably the three most helpful things you could do for a person pre-hospital, and also the th...
by Veritas
Tue Jul 16, 2013 3:37 pm
Forum: First Aid
Topic: you have it and carry it, do you know how to use it?
Replies: 29
Views: 3460

Re: you have it and carry it, do you know how to use it?

Even if you know how to do something, perhaps it should not be performed...prehospital intubation comes to mind.

The more I learn the less I would do to someone out of the hospital. Compressions only CPR, basic airway maneuvers, hold pressure to stop bleeding....probably little else.
by Veritas
Fri Jul 05, 2013 3:05 am
Forum: First Aid
Topic: Question Time
Replies: 25
Views: 2846

Re: Question Time

If you had to make a hasty band-aid, what would be the safest material to use. Dress with clean cotton if you need to improvise. Preferably something that doesn't have a lot of lint (gets stuck in wounds). I'd think something like a t shirt would be preferable over something like jeans or khakis. I...
by Veritas
Thu Jul 04, 2013 12:44 pm
Forum: First Aid
Topic: Question Time
Replies: 25
Views: 2846

Re: Question Time

Being truthful, if this is the PAW, it's probably a fatal wound. It's deep, extensive, and will severely limit mobility. Care will be supportive, and he may even have contractures from scars limiting his ROM if he heals. In the modern world, very treatable, just flush it out, control bleeding until ...
by Veritas
Thu Jul 04, 2013 12:14 pm
Forum: First Aid
Topic: Question Time
Replies: 25
Views: 2846

Re: Question Time

Here's a question: If you're gonna use staples, why numb it? I've been giving patients the option, most take the lidocaine, some do not. I've had some that request the shot after initially refusing, then tell me the lidocaine hurt worse than the staples and to go back to no lido. Me personally, I've...
by Veritas
Wed Jul 03, 2013 12:24 am
Forum: First Aid
Topic: Wound irrigation with drinking water?
Replies: 48
Views: 4460

Re: Wound irrigation with drinking water?

I would say no to the iodine tabs. Just regular soap and water. Or better, just lots of water. It's about the only time that quantity, not quality is better (to a point, of course, a bunch of shit water is a terrible idea).
by Veritas
Wed Jul 03, 2013 12:18 am
Forum: First Aid
Topic: Question Time
Replies: 25
Views: 2846

Re: Question Time

Of course PAW is different than real life, so I'll pretend this is PAW: Approach all traumatic wounds the same. First, stop bleeding with pressure. Once the bleeding stops, look in the wound. This will cause it to bleed more, which is okay. Wash the wound out with as much clean (not sterile) water a...
by Veritas
Tue Jun 11, 2013 3:49 pm
Forum: First Aid
Topic: Wound irrigation with drinking water?
Replies: 48
Views: 4460

Re: Wound irrigation with drinking water?

Since this has gone to a strange place, lets redirect the question into: What if you had no liquid to irrigate a wound? Might be a more constructive discussion point. I would do what IAN alluded to and do repeat dressing changes, and debride the wound often by just scrubbing with gauze. Hopefully th...

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