First Aid: Wounds
This post is the start of a new series on first aid. Better to learn it and not need it.
Obligatory disclaimer: I have compiled info here as a reference, but I am not giving medical advice. Please seek care from a licensed medical professional.
NOTE: if you’re squeamish or meh about this topic and inclined to skip this post (which I totally understand), do one thing: watch this video. It could save someone’s life.
A list of supplies with links to purchase is at the bottom of this post. (I do not make any commision off of purchases.)
How to clean a small or moderate wound
Text version:
wash and dry your hands thoroughly
wear [non-latex] disposable gloves if available [some people are allergic to latex]
don't try to remove anything embedded in the wound [e.g. a large splinter, knife, etc. – seek medical care in these cases]
rinse the wound under running tap water for 5 to 10 minutes
soak a gauze pad or cloth in saline solution or tap water, or use an alcohol-free wipe, and gently dab or wipe the skin with it – don't use antiseptic as this may damage the skin
gently pat the area dry using a clean towel or pad of tissues, but nothing fluffy such as a cotton wool ball – strands of material can get stuck to the wound
apply a sterile dressing, such as a non-adhesive pad with a bandage, or a plaster – use a waterproof dressing if available.
if blood soaks through the dressing, leave it in place and add another dressing, and continue to apply pressure on the wound
if an arm or leg is affected, you should raise it above heart level if possible
change cover dressing at least once daily
More on rinsing
Source: https://wildsafe.org/resources/wilderness-protocols/wound-cleaning
High risk wounds (imbedded debris, devitalized tissue, bites, open fractures, deep structure involvement) should be irrigated with large amounts of water under pressure (e.g.: using a 30 or 60cc syringe with an 18-gauge catheter).
If the wound cannot be completely cleansed of foreign material or the quantity of irrigation water is insufficient, rinse the wound with 1% povidone-iodine solution.
DO NOT use pressure irrigation on puncture wounds where irrigation fluid cannot easily drain away.
Covered or uncovered?
Answer: Cover it, probably.
Cleveland Clinic Recommendation
“Most wound treatments or coverings promote a moist — but not overly wet — wound surface. For example, [after cleaning the wound,] healthcare professionals usually apply a topical antibiotic ointment to a scrape or small cut, and then cover it with gauze or a bandage.
This keeps new skin and other cells alive. It also helps protect the area from dirt, germs and further injury and may feel more comfortable than leaving a wound open.”
Source: https://health.clevelandclinic.org/cover-wound-air
Are stitches needed?
Source: https://www.goodrx.com/conditions/wound-care/do-i-need-stitches
Size
Bigger, deeper cuts are generally more serious. Here’s when to consider stitches:
Wide, gaping wounds that leave deeper layers of skin and fat exposed
Wounds that are more than ½ inch long may need stitches
Bleeding
If your wound is more than a superficial scrape, apply direct pressure to help stop the bleeding. Get medical attention if your cut won’t stop bleeding after applying firm, direct pressure for 10 minutes.
Risk
High-risk wounds that likely need medical attention include:
Very deep wounds that might affect tendons or ligaments
Wounds with foreign bodies (dirt, glass, etc.) stuck inside
Alternative to stitches: DermaQuik
Here’s an alternative to stitches for smaller wounds that aren’t bleeding severely.
DermaQuik: https://www.dermaclip.com/dermaquik/
DermaQuik comes in both a regular and a Sport Extreme version. The latter has a stronger adhesive.
What about Super Glue?
You actually can use Super Glue for slice-type cuts that do not have debris and are low risk for infection.
An alternative: Dermabond is a medical-grade skin glue.
More info: https://www.jnjmedtech.com/en-US/product/dermabond-advanced-mini-topical-skin-adhesives
Bites - animal and human
Key takeaway: Bites are highly prone to infection. Seek medical care.
Courtesy of the ProCPR youtube channel.
Larger wounds - how to stop bleeding
Seriously, watch this video. Don’t skip it. It could help you save a limb or life someday (courtesy of the PrepMedic youtube channel).
Key takeaways re first steps:
For larger wounds, apply tourniquet first, then clean and dress wound.
Tourniquets can be on for up to four hours (during transport to emergency medical care) without resulting in limb loss.
Longer versions of above video (also from PrepMedic youtube channel).
Stop the Bleed overview
Tourniquets: two important points
40 second video. Basically: yes, they’re very painful, and the person having one put on should know this ahead of time. It might actually be good to have an extra person or two nearby to assist if needed.
Also, another important point that I’ll let the video cover... (Courtesy of the Real Response youtube channel.)
Gauze alternative for wounds that aren’t bleeding profusely: Celox Granules
Celox™ Granules mold to the shape of the wound to get firm pressure on to the source of the bleeding even in complex shaped injuries.
Source: https://www.celoxmedical.com/cx-product/celox-granules/
Apply pressure
For large wounds, pack wound (except chest wounds — see bullet wound video below), then maintain pressure.
Where applicable, direct pressure (e.g. finger over spot of largest bleeding) is more effective than general pressure (e.g. flat of hand).
If stationary, maintain finger pressure, add wound packing material as needed as blood seeps through.
If unable to remain stationary, use an emergency bandage (aka pressure bandage, sometimes also “Israeli” bandage).
The original “Israeli bandage” is made by the company PerSys Medical. Here’s their video on how to apply the bandage to different parts of the body.
Gunshot wounds
Courtesy of PrepMedic once again. Has some overlap with the Stop Bleeding video above, but also covers info specific to gunshot wounds.
Key takeaway re chest wounds: DON’T pack chest wounds because you might interfere with breathing. Use an adhesive chest bandage instead.
Jump to chest wound section of video.
Don’t assume you can learn from a book in the moment
I had a very interesting online exchange with a former EMT who a) said the above info is pretty solid, happily, and b) 100% encouraged getting training, so that you (we) have first aid knowledge before it’s ever needed.
First aid is NOT something that one should attempt to learn on the fly, since in a life or death situation, “you can end up doing more harm than good” (as one redditor put it). Also, those precious seconds might matter.
Learn more
PrepMedic Youtube Channel - hands down the best channel I’ve found so far. Please like, subscribe, etc. and do all the things to support this guy!
The American Red Cross offers a First Aid for Severe Trauma (FAST) course that includes training on using tourniquets and applying pressure to wounds. There are likely similar courses in other countries.
Find wilderness medicine training courses. In the US, recognized training providers include
Also check classes offered by your local college/university outdoor or extension program.
Many firearm safety organizations also provide firearm first aid/first responder courses.
Online option: check out the Austere First Aid course offered by the website The Prepared. I’m becoming a big fan of their content - very solid.
Supplies for your med kit
Most of the links below go to medicalgearoutfitters.com, which is the supply site the PrepMedic youtube channel recommends. If you want to be extra kind and give the good dude at PrepMedic a small commission, use his affiliate link for all purchases.
DermaQuik (alternative to stitches #1)
Dermabond skin glue (alternative to stitches #2)
Povidone Iodine Prep 16 oz bottle or box of 100 packets
First Honey also makes a sterile and antibacterial manuka honey ointment to use in place of bacitracin (note: manuka is correctly pronounced MAH-noo-ka - which I learned from this video)
Wound packing material / different option / different option with hemostatic agent (more expensive)
Celox granules - OR - Celox granules with applicator for bullet or knife wounds
Chest seal for bullet or puncture wounds to the chest
PerSys emergency bandage (available in different sizes)
Skinny Medic Stop the Bleed Kit - includes a tourniquet, 4" pressure bandage, gauze (Combat Gauze, Celox Rapid, or Compressed Gauze), 5x9 trauma dressing, pair of large gloves
Non-latex gloves (people with latex allergies can have an anaphylactic reaction to latex)
Bandaid or gauze and tape to surface dress small wounds
Or, honey bandages - also available on Amazon
AND last but not least: medical info! This includes your info (i.e. info that first responders will need to know if you ever need emergency care), as well as
Lingo to know
You may encounter the acronym IFAK — it stands for “Individual First Aid Kit.”
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That’s it for now. I’ll continue to update as I learn more.
May you never need this info.
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Previously on The Thoughtful Prepper...