General First Aid: Dealing With Injuries Off The Grid

Living on a working homestead is a great test bed for long-term survival situations. On the homestead, you learn and put into practice the skills of self-sufficiency. You produce food. You learn to make for yourself many of the things that most folks these days run to the store to buy in a blister-packed, consumer-ready format. Unless you have very deep pockets, you learn to retask, reuse and refurbish everything from fencing to equipment and machinery. You improvise, adapt and overcome in true duct tape- and bailing-wire fashion, and keep things moving forward come what may.

In the process, you sometimes suffer injuries, so in keeping with the theme of self-sufficiency you need to develop the skills required to deal with at least the early stages of treatment. Unless you have a fully stocked clinic in your basement, dealing with injuries can involve a bit of improvisation and a whole lot of adapting and overcoming just like everything else on your spread.

Just because emergency medical services are currently available, don’t be lulled into thinking that wound and injury management aren’t skills that you need right now, because the EMS can take time to respond. Sometimes providing first aid, stabilizing an injury, and transporting a victim to professional care on your own is the most expedient course of action. In a survival setting, first aid may be the only aid available and may be a matter of life or death.

The Perfect Affordability And Carrying The Supplies You Need To Handle Most Emergencies…

The most common injuries you will encounter are cuts of varying severity, puncture wounds, and the occasional broken bone. This means that controlling bleeding, cleaning and disinfecting wounds, and stabilizing limbs are all critical skills to develop. Proper bandaging, once bleeding is under control, is also a good thing to know. The most important part of your first aid kit rides just above your shoulders, make sure it is well-stocked.

A lot of what I have learned about practical first aid I have, unfortunately, learned by experience. A lot of the hardcore improvisational first aid I have practiced or witnessed took place on commercial fishing vessels operating 100 or more miles offshore. Out there, you are on your own when someone gets hurt, and the first aid kit never seems to have what you need. Fortunately, I have paid attention every time circumstances have dictated taking a Red Cross first aid class, which has provided a solid foundation from which to work.

Items you’ll need

I have seen and treated a wide variety of knife and saw wounds offshore. When an injury occurs during fishing operations, work can’t always be halted without creating a more dangerous situation. Standard first aid practices involve stopping bleeding, cleaning the wound, and protecting it so the injured party can finish the work. It is under these conditions that I learned the value of duct tape in first aid. For some fairly severe cuts to hands, arms and legs, a sterile gauze pad can be applied over a good slathering of antibiotic ointment. This is covered with a folded paper towel secured with several wraps of duct tape. The tape has a twofold mission: first, to maintain direct pressure on the wound and stopping the bleeding, and second, to cover and protect the wound until more attention can be given to it. After work, the tape and dressing are removed for more thorough cleansing and closure. Cleansing is done with rubbing alcohol or peroxide. Following cleansing, more topical antibiotic is applied. Closure can be accomplished with Steri-Strips, which I much prefer to butterfly bandages. In extreme cases, when medical attention is days away, sutures (actual or improvised with boiled thread or fishing line), or good old super glue have been used with good results.

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At home, most of the cuts are on the hands and feet. Kids always seem to feel that taking out the trash is a quick job and quick jobs that don’t require shoes. Recently, we have had an incident with a roofing nail, and one with a broken mason jar. I have become adept at bandaging feet!

Dealing with puncture wounds

Embedded objects on fishing boats are usually hooks. It is generally best to push a penetrating object through rather than to pull it out. With fishing hooks, the procedure has been to push the barb through, and to use bolt cutters to take off either the eye or the tip behind the barb. The hook is then either pushed or pulled through, bringing the cut end of the hook out of the wound last. This leaves a puncture wound. Puncture wounds are difficult to clean and disinfect. A small syringe can be used to force alcohol or peroxide into the wound from both sides, and is therefore a good addition to your kit. I have cleaned puncture wounds from nails using this method, usually nails of the stepped on variety.

The worst injury I ever sustained was a pair of broken ribs. In rough weather, I was tossed from a galley bench and head-first down a forepeak ladder. The landing was incredibly painful, and completely knocked the breath out of me for many minutes. The biggest concern in such a case is a punctured lung, which I miraculously escaped. Circumstances dictated that I spend another 10 days offshore, and the only treatment was to spend as much time as possible lying flat and trying to be still on the deck of a pitching fishing boat, and wrapping made the pain worse and restricted breathing. I could feel the bones moving and grating the whole time.

On my return to shore, figuring I had already made it through 10 days, I sought no treatment. The next two months were the most painful of my life, and the only medication that provided any relief was 800 mg of Ibuprofin. Ibuprofin is a great addition to your first aid supplies; it is both a pain reliever and an anti-inflammatory. Ibuprofin at higher doses is a very effective treatment for breaks, sprains and dislocations.

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Back at the homestead, earlier this year, one of my 3-year-old twins had an accident while playing. We thought his arm was broken at the time, so the emergency room was in order. Before transporting him, we wanted to stabilize the injury. To create a “splint” I used a large (6-inch) elastic bandage. I unrolled the bandage about halfway, leaving a roll with about an inch and a half. I used the roll as a splint, and wrapped it to the arm with the rest of the bandage securing the whole thing with the clips supplied with the bandage. I then slung the arm using a triangle bandage and drove him to the ER. As it turns out the arm was bent, not broken. It seems that 3-year-old bones can do that; grown-up bones just shatter!

And animals, too

A few weeks ago, we had an actual broken bone in the household. This time the victim was one of our dogs. He was hit by a car and suffered a broken femur. A trip to the vet revealed that all of the procedures that could be performed were way out of budget. The healing process is supposed to take 8 to 12 weeks of quiet rest. Poppy is needing a whole lot of help to get him through this. Pets are part of the family, and worth the work, but this has also become a training exercise. A time may come when knowing how to nurse a victim through a broken limb without doctor assistance may be required. Animals and people are enough alike in anatomy and physiology that learning on a dog translates in many ways to a human patient. Pets can teach you a lot, but some lessons are more fun than others. It is also important to realize that your first aid skills may be required for your animal partners as well as for your fellow humans.

I want to state vehemently that some of the treatments outlined here are not recommended in any but under extreme circumstances where medical supplies are limited and qualified medical help is days away. I have related these things only to point out that the ability to improvise and think outside-the-box can be applied to first aid situations, particularly when the chips are down. A thoroughly stocked first aid kit and proper training are your best bets, but if you come up short you aren’t automatically out of the game.