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KlearWater as wound irrigant


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  • #1218133
    Jason Shaffer
    Member

    @pa_jay

    Locale: on the move....

    I’m having a hard time finding someone w/ 1st aid training who is familiar w/ this application at all. Any experience, comparisons, expertise? Are there any written papers on this subject?

    #1353409
    Jay McCombs
    BPL Member

    @jmccombs

    Locale: Southwest

    all you need is clean water to wash wounds. H2O2 and the like may kill bacteria but the kill living tissue to. If you give a wound a good washing with clean water you’re fine. So put the klearwater in your water, let it kill all the badies, then wash you wound with it. After that, continue to keep the wound clean and you should be fine. Don’t ever suture/glue in the backcountry…open management is always the preference.

    #1353418
    Vick Hines
    Member

    @vickrhines

    Locale: Central Texas

    Ditto Jay McCombs’ post.
    First aid is just that – First…Aid. It’s what you do until you get to professional help. Assuming the wound is bad enough to need professional help, then:

    1. Get all foreign matter out of a wound — best is a high pressure jet from a syringe or even a pinhole in a ziploc bag. Use disinfected tweezers or even a knife blade if you need to. Get everything out. No matter how uncomfortable it is. Use judgement. Like, don’t jerk that artery out, OK? Use water clean enough to drink… treated however you normally treat it, filtered enough to remove floaties followed by chemical treatment is fine. Soap is good.

    2. Leave the wound open, but covered to prevent contamination. When you get to help, they are going to wash the wound out again and inspect it for foreign matter again. Don’t feel bad; they won’t trust you to have done it right, and they will be correct to repeat it. That’s why you don’t Superglue it or butterfly it or stitch it up yourself. They will open it up again regardless. A wound can ‘heal’ on the outside but harbor infection on the inside. Then you end up with the joys of blood poisoning or an abcess. And more scarring.

    There are several decent books on wilderness medicine and you can find courses in most major cities. Or make friends with a doc.

    #1353433
    Jason Shaffer
    Member

    @pa_jay

    Locale: on the move....

    All solid advice.

    Sorry, I should have been more specific. I’m doing some prep study for WFR cert later this summer. The notes on the product page about KlearWater for emergency wound irrigation just perplexed me. I was wondering more along the lines of: when/why would this be a course of action, what dilution, etc.? Danger of tissue damage occured to me too, and was curious as to any case studies or specifics, etc. Is this indeed simply meant as treating the water prior to irrigation, no more than as would be done for drinking water? Kind of a vague write-up.

    #1353460
    Jay McCombs
    BPL Member

    @jmccombs

    Locale: Southwest

    Thats how I’d use it. I wouldn’t apply it directly to a wound at any “strength” Things that kill nasty things in water will also kill the viable tissue at the edge of the wound prolonging healing.

    I suppose if you were days from help and felt like you had a wound that was infected it might be something to try. If you are smart and take care of yourself hopefully this wont ever be a consideration. Clean your wound well the first time and then keep it clean.

    #1353464
    Rick Dreher
    BPL Member

    @halfturbo

    Locale: Northernish California

    I’m guessing it could be used as a replacement for bentadyne or hydrogen peroxide in instances when they’d normally be called for–when simple irrigation isn’t sufficient. An example might be cleaning a large scrape area with debris in it, such as you might get sliding on rock or gravel.

    Happens to me more with bicycling than hiking :-)

    Regardless, some dilution guidelines seem in order as I’d be surprised if the full-strength solution is appropriate.

    #1353470
    Jason Shaffer
    Member

    @pa_jay

    Locale: on the move....

    >I suppose if you were days from help and felt like you had a wound that was infected it might be something to try.

    I doubt it would be very effective once infection sets in — dire circumstances, few options maybe. Otherwise, yes I’d agree w/ your comments 100% Jay.

    >Regardless, some dilution guidelines seem in order

    Rick, exactly. Maybe staff will chime in. Otherwise I’ll ask an instructor or WMI staff and post back if/when I find out more. ‘Emergency use’ might be an understatement.

    #1353477
    Jay McCombs
    BPL Member

    @jmccombs

    Locale: Southwest

    The idea that you need to use some kind of antimicrobial is kinda urban legend.

    Check this from Auerbach (Wilderness Medicine)

    “Many bactericidal and bacteriostatic irrigants, including commercial soaps, ethyl alcohol, iodine solutions, and hydrogen peroxide, are available in wilderness first-aid kits. Many of these agents have been shown to result in significant microcellular destruction of tissues[14] and, when used in high concentrations, may impair wound healing. They offer no advantage over copious irrigation with sterile water or crystalloid. Although addition of antibiotics to irrigant solutions is an attractive concept, they are costly, difficult to store, and offer no advantage over irrigation with sterile water alone.”

    Just an FYI the American College of Emergency Physicians has started a Wilderness Medicine section so hopefully a lot more info on the subject will be spread and shared and ideas advanced. Should be fun.

    #1353479
    Jason Shaffer
    Member

    @pa_jay

    Locale: on the move....

    Superb info. I’m just beginning to wade thru the Auerbach. Many thanks.

    #1353481
    paul johnson
    Member

    @pj

    Locale: LazyBoy in my Den - miss the forest

    See this Thread from Nov ’05

    DrJ on AM & KW

    #1353483
    paul johnson
    Member

    @pj

    Locale: LazyBoy in my Den - miss the forest

    Sorry, my hyperlink is not appearing in the previous post, nor can I edit my post. Clicking the EDIT link in that Post takes me to the Nov ’05 BPL Thread that’s in my hyperlink. Never seen this before.

    Search the BPL Forums for:

    Fred, Paul

    enter these characters exactly as typed above, viz.

    FredcommaspacePaul

    this will find DrJ’s post

    #1353508
    Jason Shaffer
    Member

    @pa_jay

    Locale: on the move....

    Great, Paul, thanks! Here it is: KW thread

    Basically this does just clarify what was meant by the reference to use as an irrigant on the product page – that the concentration should not be higher than as per directions for drinking. Glad to see agreement here.

    The mouthwash info is useful too. Ryan says:
    >Incidentally, an activated [Aqua Mira] solution suitable for treating one liter of water (7/7 drops of A/B) can be diluted into 2-4 oz of water and make a great gargle if you suspect strep throat on a long distance hike.
    In the same post he states: >KW is not as concentrated, and is multi-use by design.

    So its safe to say that 1ml (capful) of KW in 2-4 oz of water is also easily as safe as a mouthwash? I’m prone to throat infection too so I greatly appreciate that info. Thanks all!

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