Essential First Aid (Wilderness version)

An avulsion is a wound characterized by the traumatic tearing of flesh, bone, or body part, revealing underlying tissue.

This is in contrast to other wounds:

  • Abrasion - a superficial scrape

  • Laceration - a deeper cut

  • Contusion - a bruise

  • Puncture - an object penetrates the body

Signs and Symptoms

  • If the tear is incomplete, return to normal position as best as possible. Apply direct pressure.

  • If the tear is complete, apply direct pressure to wound. Rinse with sterile saline or water.

  • Any missing piece should be bagged in a damp cloth if possible.

  • Underlying tissue is at high risk of infection. Closely monitor

  • Contact EMS if necessary

AVulsion - CARE

A laceration is the cut or tear through multiple layers of skin.

If blood is bright red and spurting, it’s a serious arterial bleed.

If blood is dark and oozing, it’s a less serious venous bleed.

Signs and Symptoms

  • Apply firm direct pressure to wound with a dressing. Remove clothing as needed.

  • Stack additional dressings as needed. Never remove the first dressing.

  • If the wound is on an extremity, apply a tourniquet 2-inches above it, especially if it’s an arterial bleed.

  • Call EMS or send for help if bleeding is not controlled within 5 minutes, about two coke cans of blood is lost, or person becomes sick (clammy, vomits, etc).

LACERATIOn - CARE

A puncture is caused by an object penetrating through the skin and into the underlying tissue. If blood is bright red and spurting, it’s a serious arterial bleed. If blood is dark and oozing, it’s a less serious venous bleed.

Signs and Symptoms

  • If removing the object won’t cause severe bleeding, remove it. If the object is large (e.g., a tree branch) DO NOT remove.

  • If severe bleeding, call EMS or send for help.

  • Apply firm direct pressure to wound with a dressing. Remove clothing as needed.

  • If the puncture is large or in a sensitive area (e.g., chest, eye), wrap bandages around the object and apply pressure without moving the object.

  • Stack additional dressings as needed. Never remove the first dressing.

  • If the wound is on an extremity, apply a tourniquet 2-inches above it.

Puncture - CARE

  • Hives

  • Itching

  • Nausea

  • Difficulty Breathing

  • Swelling, especially face

  • Vomiting

  • Cramping

  • Symptoms of anaphylaxis are

  • any combination of the above

Signs and Symptoms

  • If minor allergies, remove allergen from person.

  • Provide person with antihistamines.

  • If anaphylaxis, only epinephrine can relive the symptoms.

  • Person should have an autoinjector. Assist them with administration.

  • Make sure everyone in your group knows who has a serious allergy and where the autoinjector is located.

  • Keep autoinjector from extreme heat or cold.

Allergies - CARE

  • Chest pain (heavy pressure)

  • Fatigue

  • Nausea

  • Pain (especially on left side)

  • Shortness of breath

  • Sweating

Signs and Symptoms

  • Call for Emergency Services if possible.

  • If in Wilderness, send buddy for help if needed - you should never adventure with less than three people.

  • Offer 320 mg of aspirin.

  • Assist with prescribed medication.

  • Administer CPR if person loses consciousness and pulse and breathing are irregular. Use AED if available.

Heart Attack - CARE

  • Rib Injuries

  • Pain in Ribs or Clavicle

  • Pain when breathing

  • Bruising

  • Lung Injuries

  • Difficulty breathing - requires effort

  • High anxiety

  • Flail Chest - when several ribs are broken leaving a floating region of ribs

  • Sucking chest wound - blood bubbles and makes noise when breathing

Signs and Symptoms

Rib Injuries

  • Sling the same-side arm

  • Encourage deep breathing

  • Person may wish to hold a bulky blanket against the injury for pressure

Lung Injuries

  • Evacuate/Call EMS immediately

Flail Chest

  • Evacuate/Call EMS immediately

  • Person may want a bulky bandage to keep flail in place

Sucking chest wound

  • Dress with air-tight dressing

Chest Injury - CARE

  • Deformity

  • Swelling

  • Open Wounds

  • Pain or discomfort

  • Bruising

  • Difficulty moving

  • Unusual sounds from injury

  • Loss of circulation/sensation

  • A compound fracture is when

  • the bone penetrates the skin.

Signs and Symptoms

  • Splint

  • The splint should be made of rigid material: sticks, tent poles, pack frames, etc.

  • If nothing else is available, a soft splint may be used: towel, sleeping bag, clothing, etc.

  • Tie the splints tight with tape, roller bandages, clothing, etc.

  • Don’t try to reset a bone as you may cause interal injuries you can’t treat.

  • Adjust injured region to have the body as close to anatomically neutral as possible.

Broken bones - CARE

  • Bleeding

  • Indentation in skull

  • Pain in head or neck

  • Change in level of consciousness

  • Nausea

  • Disorientation

  • Dizziness

  • Lethargy

  • Clear fluid (CSF) or blood from ears or nose

  • memory loss

  • headache

  • seizures

  • eyes not in sync

Signs and Symptoms

  • Sit person down

  • Clean wound if needed

  • Monitor and record any changes in symptoms including time stamps

  • If person sleeps, check every two hours

  • If serious, immobilize head and neck, contact emergency services, and evacuate

Head injuries - CARE