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 *************************************************************************** PaddleWise Paddling Mailing List - All postings copyright the author and not to be reproduced/forwarded outside PaddleWise without author's permission Submissions: PaddleWise_at_PaddleWise.net Subscriptions: PaddleWise-request_at_PaddleWise.net Website: http://www.paddlewise.net/ ***************************************************************************
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 *************************************************************************** PaddleWise Paddling Mailing List - All postings copyright the author and not to be reproduced/forwarded outside PaddleWise without author's permission Submissions: PaddleWise_at_PaddleWise.net Subscriptions: PaddleWise-request_at_PaddleWise.net Website: http://www.paddlewise.net/ ***************************************************************************
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")} *************************************************************************** PaddleWise Paddling Mailing List - All postings copyright the author and not to be reproduced/forwarded outside PaddleWise without author's permission Submissions: PaddleWise_at_PaddleWise.net Subscriptions: PaddleWise-request_at_PaddleWise.net Website: http://www.paddlewise.net/ ***************************************************************************
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 *************************************************************************** PaddleWise Paddling Mailing List - All postings copyright the author and not to be reproduced/forwarded outside PaddleWise without author's permission Submissions: PaddleWise_at_PaddleWise.net Subscriptions: PaddleWise-request_at_PaddleWise.net Website: http://www.paddlewise.net/ ***************************************************************************
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 *************************************************************************** PaddleWise Paddling Mailing List - All postings copyright the author and not to be reproduced/forwarded outside PaddleWise without author's permission Submissions: PaddleWise_at_PaddleWise.net Subscriptions: PaddleWise-request_at_PaddleWise.net Website: http://www.paddlewise.net/ ***************************************************************************
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? ---------------------------------------------------------------------- snark_at_tulgey.org aka Glen Acord http://www.tulgey.org/~snark if ($snark eq "boojum") {vanish("softly","suddenly")} *************************************************************************** PaddleWise Paddling Mailing List - All postings copyright the author and not to be reproduced/forwarded outside PaddleWise without author's permission Submissions: PaddleWise_at_PaddleWise.net Subscriptions: PaddleWise-request_at_PaddleWise.net Website: http://www.paddlewise.net/ ***************************************************************************
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) ---------------------------------------------------------------------- snark_at_tulgey.org aka Glen Acord http://www.tulgey.org/~snark if ($snark eq "boojum") {vanish("softly","suddenly")} *************************************************************************** PaddleWise Paddling Mailing List - All postings copyright the author and not to be reproduced/forwarded outside PaddleWise without author's permission Submissions: PaddleWise_at_PaddleWise.net Subscriptions: PaddleWise-request_at_PaddleWise.net Website: http://www.paddlewise.net/ ***************************************************************************
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 *************************************************************************** PaddleWise Paddling Mailing List - All postings copyright the author and not to be reproduced/forwarded outside PaddleWise without author's permission Submissions: PaddleWise_at_PaddleWise.net Subscriptions: PaddleWise-request_at_PaddleWise.net Website: http://www.paddlewise.net/ ***************************************************************************
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 </ [\/ [__| [__\ 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 *************************************************************************** PaddleWise Paddling Mailing List - All postings copyright the author and not to be reproduced/forwarded outside PaddleWise without author's permission Submissions: PaddleWise_at_PaddleWise.net Subscriptions: PaddleWise-request_at_PaddleWise.net Website: http://www.paddlewise.net/ ***************************************************************************
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