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From: Frank Lucian <murpho_at_mediaone.net>
subject: [Paddlewise] broken paddles
Date: Thu, 20 Jul 2000 22:04:23 -0700
Speaking of broken paddles, an instructor (who works at a retail shop)
recently was telling me that he had never seen a two-piece paddle break
in the middle, and that they were actually stronger than one-piece
paddles due to the inner sleeve that holds them together. I had always
assumed that one-piece paddles were the strongest. Any thoughts or
experiences out there? 

Frank
(Who frequently uses an unfeathered two-piece Lightning paddle in the
surf without any problems.)
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From: Bob Denton <BDenton_at_aquagulf.com>
subject: RE: [Paddlewise] broken paddles
Date: Fri, 21 Jul 2000 09:18:51 -0400
That's probably true, but I have had the sleeve let go and ended up with a
270 degree feather! I use a one piece for white water and surf.

cya

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From: Matt Broze <mkayaks_at_oz.net>
subject: RE: [Paddlewise] broken paddles
Date: Fri, 21 Jul 2000 18:28:45 -0700
 Frank Lucian <murpho_at_mediaone.net>
"(Who frequently uses an unfeathered two-piece Lightning paddle in the
surf without any problems.)" wrote:

>>>Speaking of broken paddles, an instructor (who works at a retail shop)
recently was telling me that he had never seen a two-piece paddle break
in the middle, and that they were actually stronger than one-piece
paddles due to the inner sleeve that holds them together. I had always
assumed that one-piece paddles were the strongest. Any thoughts or
experiences out there? <<<

The joint isn't the most common area that paddles break but some do break
there. Some of these breaks are because a tremendous leverage can be created
if the paddle is bent when putting it together or taking it apart when only
a 1/2 inch or so of overlap exists. The inner sleeve stiffens the shaft in
one are so creates a stress riser next to the sleeve (as well as a stronger
area where the sleeve actually is). This can load up too much force into a
small area next to the joint if the paddle is severely flexed. Some two
piece joints get looser with wear and that play can also split the female
end much like the first example (which is most likely with a too hard to
take apart joint and somebody struggling to get it apart or together and
wiggling the joint side to side rather than using a twisting action. Any
tube is going to be stronger against splitting open in the middle of the
tube, where the material is continuous, rather than near an edge where it is
not as well supported by the material around it.

Given a paddle made of the same shaft material I bet the one-piece shaft
will stand up to more abuse (I'll even give odds). Some paddle makers beef
up the shafts in the middle on their two piece paddles. Lightning does this
on their ultralight graphite paddles.

I hope you are not using a graphite paddle in the surf. You will be very
unlikely to break a glass one surfing even if it is a two piece and you
paddle unfeathered. Just last week I got a Lightning back under warrantee
that split at the female end. This is extremely rare with this paddle but
not unheard of. The paddler didn't know how it had happened but I'd guess it
happened when taking it apart or putting it together. Another possibility is
it was stepped on or driven over at the edge of the female joint while it
was not together.

Matt Broze
http://www.marinerkayaks.com


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From: Mark <canoeist_at_dotzen.org>
subject: Re: [Paddlewise] broken paddles -THIS WEEKEND!!
Date: Mon, 24 Jul 2000 13:21:07 -0600 (MDT)
for those new to this discussion, paddlewise is an international boating
list, primarily aimed at and consisting mostly of sea kayakers, but there
are many others from all ends of the paddle sports spectrum. I am also
copying two of our local Canoe clubs on this. Sorry about any duplicates.  
My observations of this accident are at the end, and I don't really
descibe the injury in detail!!

On Thu, 20 Jul 2000, Frank Lucian wrote to PaddleWise:

> Speaking of broken paddles, an instructor (who works at a retail shop)
> recently was telling me that he had never seen a two-piece paddle break
> in the middle, and that they were actually stronger than one-piece
> paddles due to the inner sleeve that holds them together. I had always
> assumed that one-piece paddles were the strongest. Any thoughts or
> experiences out there? 
> 
> Frank

i broke a 2 piece this weekend, the male end broke off right at the joint.
clean break, while in the middle of a class III+ rapid. then a paddle half
hit a rock and was impaled through my leg... ok not all the way through ...

let's start at the beginning-ish [oh, please excuse typo's, still at home
on pain killers  <8-]# this is from memory 48 hrs old, although i've been
mostly unconcious since i got home saturday night.

DELETE now if you don't want the "gory" details ... 

This weekend was the Rocky Mountain Canoe Club's annual River Rendezvous.
Due to last minute changed plans, I was able to get away for a day's
paddle with them, Saturday. I drove up to the middle Colorado River, to
find the shuttles all starting to leave. I found a trip on the schedule
board, and jumped in my car after them. It was one I had never paddled.

We were to paddle from ?Catamount to Twin Bridges, a 12 miles piece of
river, dotted with a few significant rapids. Catamount [II+] was first.
Our group of 4 tandem canoes, 1 touring kayak & 3 solo canoes all made it
through fine. the sun was shining, the temperature was warm, and the water
was cold, what a beautiful day. Over all the water was low for this t ime
of the year. It made some areas very shallow and rocky, and many rocks
stuck out of the water where other paddlers didn't remember them before.
The water was running at about 825cfs while we were there.

Rodeo Rapid was the next significant rapid we would encounter. Several
people planned on portaging around this one. There was good reason, as it
can be a class IV with enough water in it... [for a review of river
ratings see http://www.dotzen.org/paddler/cpr/ratings.txt ] I think after
re-reading this, my group would agree this rapid was currently a III+/IV-
We spent a couple minutes watching a sit-on-top kayak "group" [three guys,
one boat] taking turns running the rapid... one by one, those in our group
who were running the rapid went. 

The hardest part is truely a large wave you drop over, and then slam into
the wall of a hole at the bottom. Rodeo is right!! Yee Hawwwwwwwwwwwwwww.
Up and over you went. Down into a head height wall of water, well bow+ on
the open canoes ;-) and then a couple hard pulls through the wall, and
then a turn to miss the huge rock, which was now exposed at this water
level. then a graceful eddy out to the left, and look back at wht you just
came through!! Wheeeeeeeeeeeee!!!! My line at the top was good, I felt
good about this, even iin my borrowed helmet [thanks Sammer]. Ok, bow
drops, my line is still good, now I hit the wave the sends you into the
sky, still a good line, and whooosh, there's nothing infront of me but
free fall as my nose drops into the big hole. I just have to punch through
and i'll be home free, but there's a bigger diagonal to it that i hadn't
seen from the shore, and it pushes me hard right. I'm handicapped, and
can't roll, so I've always worked hard on my bracing. Last year I was
lucky enough to paddle Maligiaq Padilla for a total of a week, over the
course of the summer, so my brace is the strongest it's ever been, or was
it? my face was hitting the water, I tried an extended sculling brace, and
that's when I realized I had a paddle half in each hand. I tried one last
sweep, and then wet exited. Right then it happened, but not so fast I
didn't know what was happening, the paddle blade hit a rock and stopped.
My body was still moving, trying to get my feet down river, and the end of
the paddle, which had been the middle 30 seconds ago, started digging into
my leg. I pulled and twisted at the same time, spinning my body away from
the rock, but I no longer had use of both legs. When swimming a rapid, the
rule is "ALWAYS feet first, but I couldn't get my legs around. Water,
lights, voices, all spinning together, but the throbbing of my leg says
"GET GOING" ... I pulled back my skirt from my leg long enough to see
blood, and was that bone? I blink, and see the kayaker [whose name I never
got] pull up along side me, as i finally get my back stroke working... I
grab on and help kick/swim myself to the shore.

I pulled my skirt back, and showed the kayaker, he whistles quickly, and
agrees I'll need help. Luckily I can see it's not spurting, I had missed
the femoral artery, thank God. By this time, Dave Allured, our trip
coordinator, gets down the shore to me. He assesses the situation, and
heads off for the 1st aid kit. Honestly, quite a few folks helped out,
which was great. After getting me bandaged up, Dave Jumped into the front
of his boat, I jumped/crawled into the stern, and we headed for the other
shore, where the road awaited. The same kayaker who pulled me out of the
river, also had his car at the riverside. We loaded my kayak ontop of his
three, and he gave me a ride to my van. While I chnaged into dry clothes,
this good samaritan moved the boat from his car to mine, and tied it down
for me.

I drove to the interstate, where my cell phone picked up a signal, and
called my wife with the bads news. We met at the hospital, as I pulled
into the Emergency room four and a half hours after the accident. I wasn't
losing blood, and I could still say my ABC's ;-) The Doctors had 6 xrays
taken of my leg, and determined there weren't any pieces of my paddle
inside my leg. Dr Mark then flushed the wound and sewed my leg closed. It
wentalmost to the bone, but my thigh muscle was strong enough to prevent
that, the paddle just [1-1.5 inches] went through the fatty tissue.

=========================
observations:
=========================

The paddle shaft broke cleanly at the joint, where the male end joins the
female end, with about 1/16" of the male end left [about 2 threads of the
fibreglass] it was a used paddle when I bought it, but used by a paddling
school, so used/mis-used quite a bit probably. I won't disclose the mfgr,
as i don't know the paddle's history, and i've used it 2+ years myself,
only on whitewater/moving water, so it's never seen a "gentle day" out of
me, as I have light-weight lake paddles.

=========================

The kayakers [to whom I will ever be grateful] were very skilled, and
quite calm, their group was a father, his son, and friend of his son, I
believe. They were playing there for about 3 hours. They also couldn't
believe the guys on the sit-on-top [no helmet, or the appropriate skills]
The Father also did recommend the Emergency Room at Frisco as being very
nice ;-) from experience he said ;-)

=========================

Trip coordinator [Dave] took charge, kept un-needed folks away, got
trained folks into scene [Jeanne(sp?), thanks!!]

=========================

Lots of stuff happened "behind the scenes" such as all my boat & gear
ending up on the opposite bank, and UP to the road. I know the Kayaker's
son towed it... but he [the son] was way too small to have carried it up
the river bank!!

=========================

I was gladd I made the decision to drive to Brighton, as my wife had to
drive to the hospital to get me, she wasn't able to find anyone to drop
her off, and drive my cra back. She had help from our daughter & friend
MUCH later that night. If she'd had have to drive to Frisco [3 hours] it
would have been much more difficult for her to have gotten my car back.

=========================

I-V's sting no matter how many times you get them.

=========================

It took a LOT of painkillers for them to stitch me up... I guess I had
tolerated the puncture for the drive, but those tiny little needles really
hurt ;-)

=========================


throw ropes were appearant to me in folks hands as I floated past, but the
noise of the river drowned out all voices, except the kayaker when he told
me to grab the rear grab loop, and I told him my leg was in banged up
shape.

=========================

Ace badages are a godsend for keeping pressure evenly distributed across a
wound.

LARGE non-stick [tefla type] pads are a must in a 1st aid kit. We used
VERY large band-aids, but it wasn't until it was time to take them off
that I remembered I'm allergic to the glue on band-aids, so I had 4 raw
patches where we crossed the 2 bandages. This was ok, as it kept the
bandages from moving around, but still painfull.

Waterproof tape stays stuck if it gets wet afterwards, but will NOT stick
to a wet leg. Dave had a towel, we dried my leg with that, and the
bandaids stuck firmly.

=========================

Cell phones or radios are generally useless in the canyons of Colorado, so
if you have one, and use one, know where you get a signal. I was able to
re-asure my group that I had less than 15 minutes to drive from our
parking spot at the take out, to where I could call home/911. I then
called my wife at predetermined intervales, so she could track my
progress. I was determined to get to our local hospital, rather than stop
on the way. I know this bothered some of the group, but I felt I knew
myself well enough, that if I were to have problems, I had the senses to
recognize it, and pull over and call 911. It was just under 4.5 hours from
the time of the accident, until I got to the hospital. I unwrapped the ace
bandage to check on blood loss every half hour, and even then, after 4+
hours, i hadn't soaked through the two bandaids to the ace bandage, so I
wasn't losing any more blood.

==================

wow, i started this 5 hours ago, and took two naps before finishing ...

so, thanks to those readers involved directly, and maybe some piece of
this helps someone else out in the future. I'll answer any questions I
can, but don't expect s speedy reply, as I'm off to bed again.

paddle wisely out there follks ;-)
mark

-- 
#-canoeist[at]dotzen[dot]org-------------------------------------------
mark zen                      o,    o__              o_/|   o_.
po box 474                   </     [\/              [__|   [__\
ft. lupton, co 80621-0474 (`-/-------/----')      (`----|-------\-')
#~~~~~~~~~~~~~~~~~~~~~~~~~~~_at_~~~~~~~_at_~~~~~~~~~~~~~~~~~~~_at_~~~~~~~~_at_~~~~~
http://www.dotzen.org/paddler     [index to club websites i administer]
---- A smooth sea never made a skillful mariner.  --  English Proverb


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From: Shawn W. Baker <baker_at_montana.com>
subject: Re: [Paddlewise] broken paddles -THIS WEEKEND!!
Date: Tue, 25 Jul 2000 08:15:12 -0600
Mark,
Thank you for relating your painful experience this weekend.  Thanks for
taking the time to relate it so quickly, and through the painkillers.  I
don't have any immediate questions, but if I do, I'll ask them in a week
or two!

Speedy recovery,
Shawn
-- 
Shawn W. Baker          0                                    46°53'N
© 2000            ____©/______                              114°06'W
~^~^~^~^~^~^~^~^~^\  ,/      /~^~^~^~^~^~^~^~^~^~^~^~^~^~^~^~^~^~^~^
baker_at_montana.com    0        http://www.geocities.com/shawnkayak/
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From: Fred Meade <chesapeake18_at_hotmail.com>
subject: Re: [Paddlewise] broken paddles -THIS WEEKEND!!
Date: Fri, 28 Jul 2000 15:16:11 PDT
Mark,
I am really glad that you are ok, barring a little soreness.  I'd hate to 
miss out on future stories.  ;-)  Follow your doc's orders, at least until 
the urge to paddle gets too great to ignore.
I had an incident on the river a few years ago in which I was injured.  I 
made some dumb mistakes, ignoring the suggestions, requests and finally 
pleading of my friends.  Fortunately, I survived without sequalae, but have 
now made it a policy that, unless absolutely necessary, I will not make any 
decisions regarding my care when I am injured.  I don't have the proper 
perspective.  Again, I am glad that you are ok.  Whenever we challenge the 
river, it is always nice to get away with it again.  ;-)
Fred

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From: Mark <canoeist_at_dotzen.org>
subject: Re: [Paddlewise] broken paddles -THIS WEEKEND!!
Date: Wed, 9 Aug 2000 21:49:51 -0600 (MDT)
i will start a seperate thread on this on paddlewise, as it will apply
directly to sea kayaking, and back country first aid. i will archive the
discussion on my website on a "hidden page" --- ie, only you folks will
know it's there, [with jackie's and contributor's permission [i will edit
out email addresses, i hate spammers] as there will be no links to it, so
folks on the smaller lists can read it and hopefully make a "better
informed" decision, if they are ever in this situation later, without
being "bombarded" with paddlewise mail ;-) of course, i would encourage
you to join the list if you haven't

follow ups:

On Mon, 24 Jul 2000, Mark wrote:

> =========================
> 
> The paddle shaft broke cleanly at the joint, where the male end joins the
> female end, with about 1/16" of the male end left [about 2 threads of the
> fibreglass] it was a used paddle when I bought it, but used by a paddling
> school, so used/mis-used quite a bit probably. I won't disclose the mfgr,
> as i don't know the paddle's history, and i've used it 2+ years myself,
> only on whitewater/moving water, so it's never seen a "gentle day" out of
> me, as I have light-weight lake paddles.

ok, i took the paddle to the mfgr/importer, walked [limped] in and calmly
asked if [steve] had ever seen a paddle break like this ;-) his reply:

not very many, do you want us to fix it?

i told him i bought the paddle 2 years ago, USED, from them... he asked
again if i wanted it fixed... prijon stands behind their products. a
little while later i was introduced to landis arnold, the owner of
wildwasser sports in boulder. he was concerned about the quality of the
product, but when he saw the model that broke, he said the ferrule was a
thin one from a limited production run... he offered me a new paddle, and
i politely turned him down... good man, great products... i have no
affiliation, blah, blah ;-)

> =========================
> 
> 
> I was gladd I made the decision to drive to Brighton, as my wife had to
> drive to the hospital to get me, she wasn't able to find anyone to drop
> her off, and drive my cra back. She had help from our daughter & friend
> MUCH later that night. If she'd had have to drive to Frisco [3 hours] it
> would have been much more difficult for her to have gotten my car back.

i will start a seperate thread on this...

> =========================
> 
> Ace badages are a godsend for keeping pressure evenly distributed across a
> wound.
> 
> LARGE non-stick [tefla type] pads are a must in a 1st aid kit. We used
> VERY large band-aids, but it wasn't until it was time to take them off
> that I remembered I'm allergic to the glue on band-aids, so I had 4 raw
> patches where we crossed the 2 bandages. This was ok, as it kept the
> bandages from moving around, but still painfull.

so, if you have pads, have a way to affix them, and remember, you are in a
wet environment, have a way to make sure stuff "stays in place"

> Waterproof tape stays stuck if it gets wet afterwards, but will NOT stick
> to a wet leg. Dave had a towel, we dried my leg with that, and the
> bandaids stuck firmly.

ok, the biggie ... from what you read, and saw [and thank you for all the
well wishes, hopefully i answered everyone personaly] what was the thing
we missed? during this whole ordeal, one basic thing was missed!! i think
this will generate a bit of discussion, after i reveal it, as it is not
appearant from my previous post, but this is clearly MISSING ... my wife
and i didn't realize it for a week, with unfortunate consequences ... i'll
let a little guessing go on, then reveal it tomorrow night, as the
questions YOU ask [like 40 questions] will also reveal other things along
the way.

i will start a seperate thread now, to generate a good discussion ;-)

mark [who really tries not to yell "FOOD FIGHT" at restaurants ;-]

-- 
#-canoeist[at]dotzen[dot]org-------------------------------------------
mark zen                      o,    o__              o_/|   o_.
po box 474                   </     [\/              [__|   [__\
ft. lupton, co 80621-0474 (`-/-------/----')      (`----|-------\-')
#~~~~~~~~~~~~~~~~~~~~~~~~~~~_at_~~~~~~~_at_~~~~~~~~~~~~~~~~~~~_at_~~~~~~~~_at_~~~~~
http://www.dotzen.org/paddler     [index to club websites i administer]
---- A smooth sea never made a skillful mariner.  --  English Proverb




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From: Dave Seng <dseng_at_gci.net>
subject: Re: [Paddlewise] broken paddles -THIS WEEKEND!!
Date: Thu, 10 Aug 2000 06:01:49 -0800
Mark wrote:

> ok, the biggie ... from what you read, and saw [and thank you for all the
> well wishes, hopefully i answered everyone personaly] what was the thing
> we missed? during this whole ordeal, one basic thing was missed!! i think
> this will generate a bit of discussion, after i reveal it, as it is not
> appearant from my previous post, but this is clearly MISSING ... my wife
> and i didn't realize it for a week, with unfortunate consequences ... i'll
> let a little guessing go on, then reveal it tomorrow night, as the
> questions YOU ask [like 40 questions] will also reveal other things along
> the way.

  I'm going to take a wild stab at this and hazard a guess that this
deep puncture wound got infected.  I'm definitely not in the medical
field, so I may be WAY off base here, but with the combination of a
puncture wound, the water that you were in, and the lack of the use of
disifectant or antibiotic cream that the risk of infection was pretty
high.  Puncture wounds by their very nature of being "closed" are
probably more susceptible to this than other cuts.  If this is true what
is the best recommendation for "irrigating" a puncture wound with some
type of antibiotic or disinfectant?

Dave Seng
Juneau, Alaska
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From: B00jum! <snark_at_tulgey.org>
subject: [Paddlewise] Puncture wounds, was Re: broken paddles
Date: Thu, 10 Aug 2000 10:46:16 -0400 (EDT)
Dave Seng writes:
 > <snip>
 > high.  Puncture wounds by their very nature of being "closed" are
 > probably more susceptible to this than other cuts.  If this is true what
 > is the best recommendation for "irrigating" a puncture wound with some
 > type of antibiotic or disinfectant?

hmm... My understanding of wound care is that antibiotics or
disinfectants kill things, including the good stuff in your blood and
so should only be used for external cleansing.  If someone can
confirm, I beleive the recommended care for puncture wounds is sterile 
water, preferably with some level of pressure (some med kits have a
plastic syringe for irrigating).


----------------------------------------------------------------------
snark_at_tulgey.org     aka Glen Acord	  http://www.tulgey.org/~snark
	if ($snark eq "boojum") {vanish("softly","suddenly")}




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From: Mark <canoeist_at_dotzen.org>
subject: Re: [Paddlewise] Puncture wounds, was Re: broken paddles
Date: Thu, 10 Aug 2000 12:42:23 -0600 (MDT)
On Thu, 10 Aug 2000, B00jum! wrote:
> Dave Seng writes:
>  > <snip>
>  > high.  Puncture wounds by their very nature of being "closed" are
>  > probably more susceptible to this than other cuts.  If this is true what
>  > is the best recommendation for "irrigating" a puncture wound with some
>  > type of antibiotic or disinfectant?
> 
> hmm... My understanding of wound care is that antibiotics or
> disinfectants kill things, including the good stuff in your blood and
> so should only be used for external cleansing.  If someone can
> confirm, I beleive the recommended care for puncture wounds is sterile 
> water, preferably with some level of pressure (some med kits have a
> plastic syringe for irrigating).

correct, they went through a LOT of water, pushed through a syringe [this
was at the ER] before they sewed me back together...

pictures [not graphic] and original post available at:
http://www.dotzen.org/paddler/cpr/accident.html

by the way, this was NOT the issue ;-)

mark

-- 
#-canoeist[at]dotzen[dot]org-------------------------------------------
mark zen                      o,    o__              o_/|   o_.
po box 474                   </     [\/              [__|   [__\
ft. lupton, co 80621-0474 (`-/-------/----')      (`----|-------\-')
#~~~~~~~~~~~~~~~~~~~~~~~~~~~_at_~~~~~~~_at_~~~~~~~~~~~~~~~~~~~_at_~~~~~~~~_at_~~~~~
http://www.dotzen.org/paddler     [index to club websites i administer]
---- A smooth sea never made a skillful mariner.  --  English Proverb

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From: Bill Hansen <bhansen2_at_twcny.rr.com>
subject: Re: [Paddlewise] Puncture wounds, was Re: broken paddles
Date: Mon, 14 Aug 2000 09:09:22 -0400
Boojum writes...<recommended care for puncture wounds is sterile
water, preferably with some level of pressure >

What's used medically is sterile saline solution. Water is hypo-osmolar, and
therefore is pretty hard on tissues, especially damaged ones. Large volumes
of sterile saline - several liters - are used to irrigate wounds, with some
moderate pressure. Most commercially made irrigation systems include a
pulsatile component, which helps to flush out debris.

Sterile water irrigant might be better than no irrigation at all, especially
if the original wound was "dirty" in some way and formal medical help is
more than a couple of hours away.

In a field situation, sterile "saline" can be made by adding a couple of
teaspoons of ordinary table salt to a liter (or a quart) of sterile water
and then boiling for at least 5 minutes. Let it cool in the container in
which it was boiled and then slosh it into the wound. Deep irrigation and
pressure irrigation wouldn't be possible in this situation, but some
cleansing would occur, which will probably be helpful.

I agree with those who have written that irrigation with antiseptic is not
good, since antiseptics will damage tissues. I have a similar aversion to
the ubiquitous "antibiotic creams". What a victory of marketing over science
those are! The antibiotics in them only reach the surface of the "cream", so
they can't penetrate into the damaged tissues. Worse yet, most of these
"creams" are actually petrolatum-based ointments, not creams at all. That
is, they're grease, and they seal a wound, which is just what you don't
want. Still, I realize that people are going to use them, just because
they're marketed so heavily. Even doctors who should know better use them.
Most of the time they (the antibiotic creams) don't do actual harm.

Bill Hansen
Ithaca NY

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From: B00jum! <snark_at_tulgey.org>
subject: Re: [Paddlewise] Puncture wounds, was Re: broken paddles
Date: Mon, 14 Aug 2000 12:59:00 -0400 (EDT)
Bill Hansen writes:
 > Boojum writes...<recommended care for puncture wounds is sterile
 > water, preferably with some level of pressure >
 > 
 > What's used medically is sterile saline solution. Water is hypo-osmolar, and

Is that to say that sterile water is *very* osmotic, meaning it is
likely to permeate the tissues and thus dilute the existing (good)
fluid? 

 > therefore is pretty hard on tissues, especially damaged ones. Large volumes

In what way is it hard on tissues?

 > of sterile saline - several liters - are used to irrigate wounds, with some
 > moderate pressure. Most commercially made irrigation systems include a
 > pulsatile component, which helps to flush out debris.

Bill, This is great info.

 > Sterile water irrigant might be better than no irrigation at all, especially
 > if the original wound was "dirty" in some way and formal medical help is
 > more than a couple of hours away.

Using sterile water is the general advice I remember from my
Wilderness Medical training [note I say 'what I remember, as opposed
to 'what they taught me' 8].  And yes, this is for a back country
scenario where your not going to get ambulance level care for more
than a few hours.

 > In a field situation, sterile "saline" can be made by adding a couple of
 > teaspoons of ordinary table salt to a liter (or a quart) of sterile water
 > and then boiling for at least 5 minutes. Let it cool in the container in
 > which it was boiled and then slosh it into the wound. Deep irrigation and
 > pressure irrigation wouldn't be possible in this situation, but some
 > cleansing would occur, which will probably be helpful.

If you had a [clean] plastic hypo, why wouldn't [moderate] pressure
irrigation be possible?

A question on saline solution - By adding salt and thus 'salinating'
the water, does it make the water less osmotic?  Is the goal to
prevent the liquid from rapidly permeating the wound?

 > I agree with those who have written that irrigation with antiseptic is not
 > good, since antiseptics will damage tissues. I have a similar aversion to
 > the ubiquitous "antibiotic creams". What a victory of marketing over science
 > those are! The antibiotics in them only reach the surface of the "cream", so
 > they can't penetrate into the damaged tissues. Worse yet, most of these
 > "creams" are actually petrolatum-based ointments, not creams at all. That
 > is, they're grease, and they seal a wound, which is just what you don't
 > want. Still, I realize that people are going to use them, just because
 > they're marketed so heavily. Even doctors who should know better use them.
 > Most of the time they (the antibiotic creams) don't do actual harm.

Thanks for the note on antiseptics/antibiotic creams.  Is there ever a 
case where antibiotic (or a specific antibiotic) cream is useful?


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From: B00jum! <snark_at_tulgey.org>
subject: Re: [Paddlewise] Puncture wounds, was Re: broken paddles
Date: Mon, 14 Aug 2000 13:27:33 -0400 (EDT)
B00jum! writes:
 > Bill Hansen writes:
 >  > Boojum writes...<recommended care for puncture wounds is sterile
 >  > water, preferably with some level of pressure >
 >  > 
 >  > What's used medically is sterile saline solution. Water is hypo-osmolar, and
 > 
 > Is that to say that sterile water is *very* osmotic, meaning it is
 > likely to permeate the tissues and thus dilute the existing (good)
 > fluid? 

oops - I read that as 'hyper-osmolar'.  Hypo, meaning 'less than'
would make steril water less osmotic.  

Bill - can you clarify?  I think I'm just confusing myself and
everyone else 8)


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From: Bill Hansen <bhansen2_at_twcny.rr.com>
subject: Re: [Paddlewise] Puncture wounds, was Re: broken paddles
Date: Mon, 14 Aug 2000 14:54:44 -0400
BOOjum asks - <If you had a [clean] plastic hypo, why wouldn't [moderate]
pressure
irrigation be possible?

A question on saline solution - By adding salt and thus 'salinating'
the water, does it make the water less osmotic?  Is the goal to
prevent the liquid from rapidly permeating the wound?>

There's a whole rat's nest of slightly different things going on which
involve terms like "osmolar...osmotic....hyper(or hypo-)tonic.." and so
forth. A simplistic way of thinking about it is that there are ions,
concentrations of minerals, on each side of a cell's membrane. There are
also what's called "ionic pumps" which maintain differing concentrations of
these minerals. But if fluid outside a cell (like sterile water) has no
minerals and the fluids inside the cell have, and need, significant
concentrations of minerals, that mis-match is going to damage the cell.
"Free" water will tend to pass into the cell, "trying to equalize the
concentration of minerals" on each side of the membrane. The result is that
the cell can be damaged, and can even rupture because of the overabundance
of water inside it. So BOOjum's first observation that pure water is "very
osmotic" in the sense that it readily tends to migrate across a cell
membrane, is quite correct.

What you're trying to do by using saline rather than water is to use a
solution which has something closer to the cell's mineral concentrations.
Saline as such isn't perfect, fo course. There are other, fancier, solutions
which can be used. But saline works well enough in most situations, and it's
just about the only thing you can make up in a field situation.

RE: Carrying a syringe - yes, that would work fine. Best would be to carry a
sterile plastic syringe of somehwere between 20 and 50 ml size in its
original plastic wrapper. I don't think you can boil these things and have
them still in usable condition, though I've never tried that. ==>I also
don't know of anyone who carries a plastic syringe for that purpose.<==

RE: The question of whether an antibiotic cream or ointment is ever useful -
Well, they're okay for minor burns. Creams, as opposed to ointments, are
good dressings for that. But they need to be removed completely, the wound
cleaned thoroughly, and the cream re-applied once or twice a day (depends on
the depth of the burn, how much pus there may be, etc etc....) for best
results. They also make a nice non-sticky coating after some minor wound
repairs; the dressing, if any is used, is easier and less painful to change
that way.

BTW - everyone has probably already realized that when I described how to
make sterile saline in a field situation I meant to start with a liter of
*clean water* rather than a liter of "sterile" water, then boiling the
resultant saline solution.    But if your water has been made potable by
adding clorine or bromine in any form, then best boil it for a while to
drive off the halogen ions, which form acids and would really smart...   :-)


Bill Hansen
Ithaca NY

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From: Mark <canoeist_at_dotzen.org>
subject: Re: [Paddlewise] broken paddles -THIS WEEKEND!!
Date: Thu, 10 Aug 2000 12:43:46 -0600 (MDT)
On Thu, 10 Aug 2000, Dave Seng wrote:
> Mark wrote:
> 
> > ok, the biggie ... from what you read, and saw [and thank you for all the
> > well wishes, hopefully i answered everyone personaly] what was the thing
> > we missed? during this whole ordeal, one basic thing was missed!! i think
> > this will generate a bit of discussion, after i reveal it, as it is not
> > appearant from my previous post, but this is clearly MISSING ... my wife
> > and i didn't realize it for a week, with unfortunate consequences ... i'll
> > let a little guessing go on, then reveal it tomorrow night, as the
> > questions YOU ask [like 40 questions] will also reveal other things along
> > the way.
> 
>   I'm going to take a wild stab at this and hazard a guess that this
> deep puncture wound got infected.  I'm definitely not in the medical
> field, so I may be WAY off base here, but with the combination of a
> puncture wound, the water that you were in, and the lack of the use of
> disifectant or antibiotic cream that the risk of infection was pretty
> high.  Puncture wounds by their very nature of being "closed" are
> probably more susceptible to this than other cuts.  If this is true what
> is the best recommendation for "irrigating" a puncture wound with some
> type of antibiotic or disinfectant?
> 
> Dave Seng

follow ups on another thread, but, BZZZZZZZTTTTTT!!!! nope, tender, no
infections...

mark

-- 
#-canoeist[at]dotzen[dot]org-------------------------------------------
mark zen                      o,    o__              o_/|   o_.
po box 474                   </     [\/              [__|   [__\
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#~~~~~~~~~~~~~~~~~~~~~~~~~~~_at_~~~~~~~_at_~~~~~~~~~~~~~~~~~~~_at_~~~~~~~~_at_~~~~~
http://www.dotzen.org/paddler     [index to club websites i administer]
---- A smooth sea never made a skillful mariner.  --  English Proverb

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