Dressings in your first-aid kit.

Thanks for posting…and your review too. Looks like a good upgrade to a standard dressing. Keeping the dressing on is half the battle.

Would Tegaderm be appropriate as a first aid dressing? Actually it looks like they have a lot of different variations on the product. I thought it just referred to breathable clear film. (Warning: this page has some gore) http://www.3m.com/3M/en_US/company-us/all-3m-products/?N=5002385+8707795+8707798+8711017+8711098+8711132+3294857497&rt=r3

Mepilex does look like a good all-in-one solution with gauze, adhesive, and a water barrier.

I used to have tegaderm sheets sent with home infusion supplies. They stick really well covering injection sights. Too good, real pain peeling them off. Pun intended. I have a couple in my FAK. I do like the all in one bandage idea.</p>

Hello. ICU Nurse and paramedic here.

We have these in the hospital. Looks just like a gauze pad with an adhesive border around it if I’m not mistaken. Nothing special, but very convenient.

Typically all you need is to clean the wound and keep it covered somehow. You can do this with any gauze but the ones you posted would be good for convenience.

I guess tegaderm would be fine for temporary covering to keep debris out. You should be changing bandages when they have drainage though.

I typically just carry a gauze roll (for bandaging or packing a deep wound), gauze pad, moleskin, a few OTC meds, tourniquet and Quick Clot In my kit. I probably would add one of these.

The mepilex is much better for wounds with exudate than tegaderm – which don’t absorb anything really.  Tegaderm do better on the breathability factor than the hydrocolloid blister bandaids.  However, the hydrocolloid blister bandaids are a bit more protective, and can absorb a small amount of exudate.

Also, with the mepilex the foam/soft part itself has adhesive – meaning it sticks to the wound much better than foam or gauze with an adhesive border around it – which is pretty handy for wounds that are likely to be exposed to mud, rain, etc…

The mepilex are hydrocolloid then?  I carry both hydrocolloid dressings and the Tegaderm films primarily for their durability: once they’re in place I can largely ignore them for days.  With traditional gauze and tape there’s the problem of replacing the dressings regularly, which can very quickly burn through supplies.

Blister?  Slap on a blister pad and keep going; no need for playing arts ‘n crafts with moleskin.

Bad laceration?  Clean it out, close it up, and cover it with film.  You’re good for the next few days, and it’s quite easy to monitor the wound as well.

Huge slash? To the bone. (Sharp edge of XC ski)

Closed up with BandAids and micropore tape, then covered in TP and more tape. BFI might have been used as well. Patient skied and walked out – carefully, before the shock wore off.
30 stitches in 3 layers in hospital later. Plus a bit of codeine.
Keep It Simple Stupid.

Cheers

“Keep It Simple Stupid.”

Roger, many of us have had to improvise to treat lacerations in the field (although yours is quite stunning), but I don’t think that’s a reason for anyone to take a dogmatic “it worked for me once therefore it works for everyone” approach here, much less imply their technique is stupid because you’re unfamiliar with it.  Having had to limp through a selection course with feet that looked like raw hamburger and 100mph tape (aka duct tape) and moleskin that kept losing its adhesion, I would’ve been really happy to have something that would actually stick to my foot.

There may be a number of solutions, but not all of them are optimal.  Yet another case where an item’s value can’t be measured in grams alone.

Hi Ian

Not arguing with you at all. The idea I am pushing is that a few good basics and some understanding (knowledge) beats the massive ER-style FAK every time. Granted, you have to get the knowledge!

With that injury we did not try to do a complete surgcal repair. We just focused on holding it all together without massive bleeding until we reached a hosptial ER. And that worked.

Cheers

‘Wisdom comes from experience. Experience comes from a lack of wisdom.’

@medicpatriot said, “You should be changing bandages when they have drainage though.”  That’s a really important point!

I learned that lesson while on a South African camping safari in Kruger — I only had a couple of replacement bandages, so I went several days before changing mine (in a dirty, dusty environment, similar to backpacking).  I ended up having to go to a doctor in the tiny town of White River for the beginnings of sepsis — lots of antibiotics, and a bunch of clean dressings later, I was fine.  But if I had been on the trail, and ignored the signs… who knows?

For most injuries a few bandaids and a bit of antibiotic ointment will do nicely.  For those relatively few more serious lacerations, an initial sterile pad and antibiotic ointment around the edges of the wound should suffice for initial treatment.  Beyond that, be prepared to cut up a LS T-shirt or similar for absorbency, and resort to a regimen of antibiotics to facilitate evacuation to competent medical help.  A 5 day round of Bactrim weighs grams, and is a component of my FAKIT that is always available and seldom used.  It goes without saying that serious tape is part of said FAKIT.

Wanted to clarify – the bandaid brand blister bandaids are hydrocolloid.

The mepilex are not (not sure 100% exactly what they are).

Roger – they absolutely would have worked in the example you mentioned – minus the use of TP and tape, although I suppose that those are items you would be carrying anyway.

I think how they really shine is that they hold up against external dirt and moisture much much better than gauze and tape.  I don’t bring gauze.  I do bring a small amount of duct tape for potential gear repair, but never dedicated medical tape (leukotape and the like).  I don’t bring moleskins – the hydrocolloid bandaids I bring are far superior for blisters.

In the hospital we use the mepilex for all manner of wounds – and while it is true that you do want to change a mepilex dressing when it is soaked to the point of no longer being intact – with a mepilex you no longer have to change the dressing when there is merely *some* drainage on the dressing.  The dressing is occlusive and effectively seals out external dirt and is water-resistant enough that you can shower with it on, which is not the case with gauze + tape.  The manufacturer/hospital/wound doctor recommendation is that they only need to be changed once a week unless the dressing becomes soaked to the point that it’s no longer intact.  Since hospitals are terrified of being sued – I suspect that in a pinch you could safely use one for much longer than a week.

Posted them here because they replace the need to carry gauze and tape and other first-aid items – therefore keeping first-aid kit simpler.

Like I said – I bring the aforementioned hydrocolloid blister bandaids, one or two mepilex, some ibuprofen and some benadryl, and that’s it.

Hi Francis

I haven’t seen mepilex in Oz, but we do have similar things. We have used lots of it on horses legs … they are good at injuries. But they (the horses) were fairly good at standing still for us.
Would the stuff have worked on that knee? Not sufficiently. I had to make lots of butterfly sutures to hold the edges together. The TP was just ‘cosmetic’.

Ibuprofen: such a harmless thing … yeah?
‘when taken regularly or in excess, it can cause various side effects. The most common side effects are nausea, vomiting, and headache. Other possible adverse effects include rash, heartburn, dermatitis, decreased white blood cells, red blood cells, and platelets, and acute renal failure. While ibuprofen does not itself affect the liver, it can have very significant effects on the kidney.’ (A web source of medical advice)
I know some refer to it as ‘Vitamin I’. This attitude could be dangerous to self.

And of course, some people have an allergic reaction to any NSAID. This reaction can take many forms: from going all red and blotchy to dying from loss of breathing. Just one or two tabs are enough to kill. Beware of just handing it out.

Cheers

Agreed Roger.  I’m an RN, so I’m well versed on the negative effects of drug overdose.  I typically travel solo, don’t have an NSAID allergy, and for me I prefer it to tylenol – which can also have negative effects on the liver when taken in excess (max 3g of acetaminophen/day before liver damage).  Alternating between acetaminophen and ibuprofen is probably gentlest on your internal organs, but if you’re just going to bring one and don’t have an NSAID allergy, heart condition, or other contraindication, I think it’s best to bring ibuprofen.

When high amounts of non-narcotic pain meds are needed (and ketorolac is not an option), the Dr’s I work with typically recommend ibuprofen over tylenol.  For everyday, intermittent use and especially for those with various heart conditions, tylenol is used.

Hi Frances

Partly I was reacting to reading a recent comment somewhere (BPL? elsewhere? dunno) that one of the poster’s friends started every day with 5 ibuprofen. Darwin territory.

Cheers

…yeah that’s a lot of ibuprofen.  Agreed.

On ibuprofen… I have taken it for years, small doses, occasionally. Until one day, after taking a regular dose and my face swelled beyond recognition, eyelids, lips, and a very shaky feeling all over (no breathing difficulty). Just all of a sudden! I didn’t use any for about seven years, then tried it again – no problems! Again, I took it on occasion, for several years, after a hard workout, before a marathon, etc. Then one day, headed out to a remote car campout, and took one. Wham! My entire body swelled up, my ankles looked like elephant legs, my face swollen again, and that odd twitchy feeling. All far from help. I recovered but will never touch that stuff again. I’ve also now developed an allergy to Aleve, same type of reaction. Scary stuff. I’m favoring a flask of bourbon now instead, for non life threatening pain situations.

Hi Karen

The allergy is to NSAIDs in general. The brand does not matter. My understanding is that the inflammation system can be triggered into a massive reaction. The nature of the reaction can vary from person to person. And apparently it can vary in severity, as your experience shows. It can be fatal.

Ventolin can SOMETIMES help, but ask your Doctor first. You can choose to carry a Ventolin inhaler in your purse (whatever) at all times. A new one should last at least 5 years.

The Ambos are quite generally familiar with the problem, and use a combined oxygen/nebuliser combo. A bit more punch than Ventolin, but the same thing really.

Cheers

As a former EMT and ski patroller I likely carry more 1st aid dressings than the average backpacker including border seal dressings and good butterfly bandages which virtually equal decent surface sutures.

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But when at my shooting range and in shooting competitions I carry a “Blowout Kit”;

1. newest version TacMed tourniquet
2. Asherman Seal for sucking chest wounds
3. QickClot type trauma dressing
4. 1.5″ wide adhesive tape – small roll
5. various sizes of gauze dressings

No accidental shootings have ever happened there but it’s a possibility and I’d like to be able to help within my training scope.

If we’re talking very large wounds for an extended time before medical treatment, I want to make it clear that you should not be closing any wounds. There is a disturbing trend about survivalist types that want to use sutures and glue. You risk causing a nasty infection that way. The best course of action is washing out the wound and packing it before covering it entirely. You will have to change these multiple times. DON’T CLOSE WOUNDS IF YOU DON’T KNOW WHAT YOU’RE DOING. You don’t *need* stitches.

I don’t carry a lot of crap anymore. Those border dressings are cool for wounds, maybe some gauze, some quick clot, and a light CAT tourniquet sometimes.

Asthmatics and those with severe allergies should always have an epi pen.