How to Apply a Tourniquet in the Wilderness Setting:

January , 2011/in Control bleeding, Medical Response, Rescue Training, Trauma, Treatment/by WMN Editors

January/February 2011 ISSN-1059-6518 Volume 24 Number 1

How to Apply a Tourniquet in the Wilderness Setting:

Brad L. Bennett, PhD, NREMT-P, WEMT, FAWM

Captain, US Navy (Ret.)

Member, Committee on Tactical Combat Casualty Care

SOLO Wilderness Medicine Instructor

Tidewater Search & Rescue, Virginia

Member, Committee on Tactical Combat Casualty Care

“The new concept of Tactical Combat Casualty Care (TCCC)

has revolutionized the management of combat

Casualties in the prehospital tactical setting.”

R. Mabry, MD and J. McManus, MD

Critical Care Medicine, 2008

Is there a place for a tourniquet in your backcountry jump kit? Well, possibly, but does everyone in the backcountry need to carry them? Does wilderness epidemiology provide evidence for the frequency of severe bleeding? Does shock result in the same outcome no matter the mechanism of injury? Are all tourniquets effective? Should we use them? It is not that simple! The answer is not yes or no, but, when, where, why, how and which ones? The following discussion is the most up-to-date information from the Department of Defense tourniquet use on thousands of casualties over the past 10 years. The answers to these questions should become clear as you read this article.

ADVANCED WOUND MANAGEMENT

November , 2010/in Bandaging, First Aid Kits, Skin, Soft Tissue, Trauma/by WMN Editors

The fact is that soft tissue injuries, such as abrasions, lacerations, and puncture wounds are very common. We have all had these sorts of injuries at one time or another, and most of the time they are simply a nuisance, easily remedied with a little tender loving care, soap and water, and a Band-aid. But, it’s not always quite that easy. Even a simple wound, if not managed properly, can turn into a potentially life-threatening infection.

When working in disaster response, medical mission relief, wilderness medicine, or remote medicine, the skills of wound management are of critical importance. The wound may be a small abrasion on the knee that simply needs a good scrubbing to clean it out or a large, jagged laceration caused by the slip of a chainsaw, resulting in a deep gash, that is bleeding profusely, and full of bark, dirt, and oil. Regardless, any and all soft tissue injuries need proper attention to facilitate healing and, more importantly, to minimize the risk of a serious infection.

ISSN-1059-6518

STREAMS, SLIPS, AND STICKS

November , 2010/in Blisters, Environemtal Injuries, Feet, Lower leg, prevention/by WMN Editors

November/December 2010 ISSN-1059-6518 Volume 23 Number 6

By Frank Hubbell, DO

Illustrations by T.BB.R. Walsh

STREAMS, SLIPS, AND STICKS

It may sound trite, but one of the riskier activities for hikers is crossing streams. Not major white water rivers with Class 3 or 4 rapids, but small, shallow, slow-moving streams and rivulets that are 1 – 2 feet deep and 6-10 feet wide with a stream bottom that is lined with smooth river stones and many larger rocks sticking up several inches above the water. The stones are just close enough together to make hopping from one wet, slippery rock to another impossible to resist.

Bedbugs

November , 2010/in Bites and Stings, Rash, Skin itching/by WMN Editors

November/December 2010 ISSN-1059-6518 Volume 23 Number 6

By Frank Hubbell, DO

Illustrations by T.B.R. Walsh

Bedbugs:

For the past 5 issues of the WMNL, we have discussed human ectoparasites. In this issue we will complete the topic with a discussion about bedbugs.