Blacksmithing gems and pearls

[Frosty]

Excellent point Glenn. What do you have in your 1st. aid kit to stop major bleeding? The gauze pads you find in most kits is only good so far and tourniquets are a last resort measure. What I recall from my last serious 1st. aid classes was that the decision to use a tourniquet was choosing to sacrifice the limb to save the life. 

At the time I was working remote and EMS could be hours, even days away so we had to learn about some serious stuff.

What I have in my kit, the one behind the seat in the pickup are sanitary napkins and ace bandages. I've even used them on one occasion and it worked like a charm. A 3 wheeler racer had high sided and his wheeler had rolled over him. The foot peg had gouged a wide deep piece out of his upper thigh. It was an ugly evulsion a good inch wide, probably 2" deep and maybe 3" long and still connected on one end.

He came to rest about 25' in front of us just over a bank turn. All the best action is in the curves so the best watching is on the straight just before the turn where you're less likely to get hit by an out of control ATV. This was way before 4 wheelers and 3 wheelers are really unstable. Anyway, A number of us were there in 3 fast steps. He was trying to sit up but was pretty badly roughed up by the crash. 

His obvious injury was serious bleeding through his torn jeans, he was gushing but not squirting so I was thinking he hadn't cut or torn an artery. Still, as pumped up as his leg muscles were there was a LOT of blood to leak out. I ripped his pants leg and somebody else pulled it off and I poked the evulsion back in the muscle trench in his leg and applied direct pressure.

Maybe 30 seconds had elapsed and a crowd was gathering. People crowd around accidents, usually way too close, I like to believe it's because it's human nature to help someone in trouble. Unfortunately most people don't really know what to do so they stand there, usually within a few feet. Some tend to yell, often, dumb instructions but most just stand there looking concerned.

The thing to remember if you're in this situation is you are surrounded by people who WANT to help. Give them something to do, put them to work for the cause. My first "order" was to point at 3-4 people and tell yes, TELL, them to keep the crowd back about 10'. Give them simple specific directions and they jump to work. My second was to the ladies in the crowd. "I need a sanitary napkin, NOW!" That one got an unusual response, most of the gals looked embarrassed and muttered denials. "BULL SHOOT. This is serious, dig into your purse and give me your emergency pad!" About then sanitary napkins started raining on us. I only needed a couple but 15-20 was excellence on a sunny day.

Napkins are packaged so the wrapper peals without touching the absorbent face, they are perfect for controlling major bleeding. I applied one and was leaning on it talking and joking with my patient. Keping an accident victims spirits up is as important as immobilizing a broken limb and almost as important as controlling bleeding. Good airway tops the list though. 

Anyway, I send a watcher to my pickup for my emergency kit, it was made up by me and lived in a 50cal ammo can with big red crosses on top and sides. It has lots of stuff other 1st. aid but it's a serious 1st aid kit.

What I needed was my ace bandages, the guy was bleeding through the second napkin and wasn't cooperating with pressure, not yet anyway. Another guy was helping me, we were switching off holding direct pressure, it was taking a lot and believe it or not it can be exhausting. We opened and applied another napkin, leaving the one in contact with the wound but tossing the soaked one. A guy gets back with my emergency kit and I wipe my hands off with a donated T shirt and dive in for my ace bandages.

We layered two more napkins over the wound and I wrapped while he held. The thing to remember using ace bandages is as always NOT TOO TIGHT!! Neither of us could find a pulse in his leg so I had to go by toe color. Look at your finger nails they should be pink, if they turn white you've over tightened the bandage.

Anyway, EMS was there in maybe 15 minutes and we had things as under control as we could, blood had stopped seeping through the napkins and we had the victim laughing about the sexy scar he was going to have. All was good, we could've even transported him if necessary.

When the ambulance got there the guys did a quick check for pulse, gave me a smile and a good job. They spent a few seconds checking my emergency kit nodding and smiling. There is a box of heavy flow napkins in it. Then they loaded him into the ambulance and left us there. 

Anyway, sanitary napkins and ace bandages but be darned careful to NOT wrap the wound too tightly. 

Sorry for a long story but the incident really sticks in my mind.

Frosty The Lucky.

[Irondragon Forge ClayWorks]

A very good story Frosty. My kit has about what you described with the addition of blood clotting powder (Wound Seal).

[pnut]

Tampons make for a good addition to a first aid kit also. They're good for deep puncture wounds. I agree IDF&C  styptic powder is also a must have. I have some left over from when I was fostering a parrot. I ended up having the critter for about five years. We never really became friends. He was mistreated.  Baking powder or baking soda will also work in a pinch. 

Pnut

[Irondragon Forge ClayWorks]

Granulated sugar also helps clotting. A remedy my grandmother used on me many times. Styptic powder works a treat but boy does it sting.

[Paul TIKI]

I remember the styptic pencils we used while sparring and got cut.  those hurt worse than the shot to the face for the most part.

[Frosty]

I've never carried a clotting compound, a compress and pressure has always worked. Is sugar sanitary enough to not cause problems later?

The above incident was just the first of two ambulance calls I was first responder on that corner, that afternoon. It took a good 30 minutes to get an ambulance on scene there'd already been 3 to the track that day. No blood on #2, he'd taken a hard blow to the chest, handle bar I think and was having trouble breathing. You could see broken ribs and he was bruising visibly. The patient was most comfortable sitting up with his arms crossed over his chest so I wrapped him that way with the rest of my Ace bandages and a couple more rolls other folks had on hand. We rolled his wheeler upright and behind him so he could lean. Then I just monitored his breathing and pulse while keeping him calm.

Unfortunately there was one of THOSE helpful people present who only knew one thing about 1st. aid. lay flat and elevate the feet. The fool kept shouting and making grabs at the victim, I couldn't get anyone from the crowd to bum rush the fool and I don't know why but I asked if his Mother was present. This distraught lady standing back a little way in the crowd raises her hand as says yes, the injured guy was her son. I pointed at the problem guy and told her, to paraphrase, "Your boy is as good as we can make him but THAT guy is endangering him." 

Oh LORDY! Talk about the wrath of MOM, she descended on him like an enraged demon. He left and Mom had a job she could do so she stood guard till the ambulance arrived and transported the patient.

The memory of this incident isn't as vivid, it's over shadowed by the butt gouge but these things stick in your memory. Talking about one brings more to the fore. I'm going to try and end on the above, it turned out well for everybody and I hope Mom didn't do any damage to a guy who was genuinely trying to help but . . .

Frosty The Lucky.

[JHCC]

 

8 minutes ago, Paul TIKI said:

I remember the styptic pencils we used while sparring and got cut.  those hurt worse than the shot to the face for the most part.

Those are sometimes marketed under the brand name “Nick Relief”.  A former coworker of mine gave one to a friend who was getting grief from a guy named Nick. 

[Paul TIKI]

I don't know about the brand, but I know I feared the styptic almost as much as a solid right 

[Irondragon Forge ClayWorks]

"Tell me and i forget, teach me and i remember, involve me and i learn" ~BillyBones

[Glenn]

Logic is the art of going wrong with confidence. JHCC

[BillyBones]

I always though the first aid kit they gave me in the Army was funny. It consisted of 1 field dressing. 

I was the designated combat life saver in my platoon. That meant that i had a little more than basic first aid training, things such as how to give an IV. So my kit contained much more. Saline bags, IV tubing, needles and even morphine. The life saver part is a little misleading. Your job is actually just to make the person as comfortable as possible. 

Those store bought first aid kits are absolutely useless. Filled with a little guaze and a whole plethora of useless band-aids. I keep a first aid kit in my truck. I have found that a tackle box makes a good one. I do not keep pads but that is becuase i have a supply of field dressings, if i did not i would. Among things not mentioned i also keep needle and thread and an exacto knife set. Never know when you may have to stitch someone up or preform minor surgery. I modeled my kit after the one a guy i knew that was a survival instructor had. 

[Frosty]

Thinking of a different thread Billy?

Frosty The Lucky.

[BillyBones]

No, just a tad late on the discussion. Did not realize that was almost a month ago. 

[Frosty]

ARGHH we were talking 1st. aid. I'd forgotten already. <sigh>

At least I didn't start repeating myself! (WHEW!)

Frosty The Lucky.

 

[George N. M.]

My take on 1st aid kits is that there are 2 major types:  Type 1 is a small kit for minor cuts, burns, blisters, etc. and has band-aids, antibiotic ointment, burn cream, etc.. It provides final treatment for minor injuries and may have over the counter medications like pain killers or anti-diarrhals.  Type 2 is designed to provide immediate care for serious/life threatening traumatic injuries and has things like compresses and coagulants to stop bleeding, things to immobilize limbs, IV set ups, etc..  It is designed to stabilize and treat serious things until better trained and equipped folk like EMTs or ER personnel can take over.  That is why it is called First aid.

In the shop I have a small type 1 kit and in the car I have one that approaches the type 2 (includes military field dressings and coagulants but no IV stuff).

"By hammer and hand all arts do stand."

[Frosty]

A good 1st aid kit is designed to deal with the 3Bs until EMS arrives to take over. The 3 B = Breathing, Bleeding, Bones. The first 2 are MUSTs a patient who isn't breathing has maybe minutes, Serious bleeding can take them out more quickly so they MUST be dealt with before anything else.

Not counting being on fire, about to fall a long distance, etc. 

Stabilizing bones is important for a couple reasons: You can not see what a broken bone is damaging, they've been known to tear arteries, puncture organs etc. (left lung in my case) so stabilizing them is really important to prevent further damage. Secondarily is reducing pain, a person in intense pain may not be able to lay calmly till pros arrive.  To someone in a lot of pain even a slight reduction can be a huge relief and let them calm down. 

"Bones" include dislocations it's not just breaks, some dislocations can pinch off arteries and result in the loss of a limb. Dislocations are often WAY more painful than breaks. Immobilizing a dislocation can often reduce the pain to a discomfort level. Most of the victim's movement is looking for a comfortable position, one doesn't exist so the movements can become frantic.

If the victim is holding a limb do NOT try to find a better position! The victim is already holding it in the most comfortable position. Wrap the injured limb AND the one holding it in place, not tightly but snug enough they can relax. Holding an injured limb is very tiring, any break is a good thing.

Consider anything used from a 1st aid kit as gone, just replace it. The pros are going to cut off any bandage you applied, either in the ambulance or the emergency room. If YOUR wrapping or bandages make it to Xray, give yourself a pat on the back for doing a Good job!

Frosty The Lucky.

[Glenn]

Do not tell us what you can not do - because you are right, you already decided you can not do it. 

Instead tell us what you can do to work around the problem.  Get creative, it is fun.

[JHCC]

Most of the things we think of as failures aren’t really. They’re just unsuccessful iterations on the road to the ultimate solution.

— Adam Savage

[Irondragon Forge ClayWorks]

I've been playing with clay a lot but it's the equivalent of chewing on a straw when you want a cigarette  ~pnut~

[Irondragon Forge ClayWorks]

    …I thought I was bad at forging…then I tried welding. ~Pat Masterson

[Irondragon Forge ClayWorks]

Every apparent failure is just a step toward eventual success. ~ JHCC

[Glenn]

 1000 hours working with a $100 anvil will make you a better blacksmith than 100 hours working on a $1000 anvil.  A simple set up can get you learning to hammer hot metal and progressing rather than waiting on the "perfect set up". Thomas Powers

[Glenn]

As you age, getting hurt hurts longer.  Daswulf

[Irondragon Forge ClayWorks]

Don't worry about getting older and still doing stupid stuff. You'll do the stupid stuff as always, only much slower. Hold my beer and watch this.....

[Irondragon Forge ClayWorks]

We all need to "Live dangerously as safely as possible!" ~ ThomasPowers