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  1. #101
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    Default Re: First Aid Kit Contents

    Tampons and other female sanitary products should deal with the bleeding they're designed for.

    Do not be stupid and put them in active bleeding wounds, it is an old wives tale that has no place in modern medical advancement.

    There is proper gear readily available to deal with all types of traumatic bleeding now days.

    If you're unsure ask and I'll answer. For once I've found something thats "in my lane"
    Si Vis Pacem Parabellum


    2012 Hilux 2x4 D/L
    A few basic mods.

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  3. #102
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    Default Re: First Aid Kit Contents

    Quote Originally Posted by hunter26 View Post
    Tampons are excellent for bullet wounds,stabbing holes,ladies emergency,fire starter.. I have borrowed a few ladies pads for my first aid kit to be used on minor wounds,as it is sterile and does not stick to wounds like cotton wool
    Jelonet gauze will provide a much better barrier between wound and dressing than a sanitary pad.

    It is cheap and can be bought at most pharmacies.
    Si Vis Pacem Parabellum


    2012 Hilux 2x4 D/L
    A few basic mods.

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  5. #103
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    Default Re: First Aid Kit Contents

    I saw this thread searching for other topics.
    I read it out of interest, but after reading the posts I felt I needed to make a comment.

    By way of reference I was medically trained in RSA but now live and work in Australia.
    My area is Intensive Care.
    I have also done pre-hospital emergency care and expedition medicine.
    I have a great interest in remote-area travel (Australia is prime real estate for this!)

    I understand that the original list posted was several years ago, and that it has been updated by a medical practitioner (I think I understood that correctly).
    Nonetheless, there were several points that stood out for me.
    The first was that the contents listed, and the philosophy behind several choices, reminds me of the situation in the mid-nineties when I was still in South Africa.

    With that let me list some of my concerns:
    1. Lignocaine with adrenaline - ditch it, dump it, throw it away! There is no real advantage to using it over plain adrenaline and massive disadvantages. Anywhere where there is an end-arterial supply - ears, digits, flaps, etc - one cannot use adrenaline containing local anaesthetics. The original author may have understood this but others taking his advice may not! Even in Australia tertiary care hospitals lignocaine with adrenaline is not readily available in emergency departments because its misuse by ignorant junior doctors resulted in many digits falling off (not to mention the legal mayhem afterwards)!
    So, everyone should just do themselves a favour and carry the plain flavour!

    2. Intravenous fluids! In the emergency situations likely to be encountered by 4X4 and remote travel enthusiasts there is absolutely no requirement for multiple types of fluids - Normal Saline will do the trick! There is no physiological advantage to carrying several different crystalloids for essentially the same purpose - fluid replacement. Also, if the administration of certain drugs requires a 5% dextrose solution then carry a couple of bags for that purpose.
    Here is a question for those carrying kits with multiple drugs - are you absolutely certain what drugs are compatible with which IV fluids?
    Nearly all are compatible with Normal Saline but a few might require 5% dextrose in water.
    If all the drugs one is carrying are compatible with NS then don't waste your time carrying any other crystalloid apart from NS.
    NS will tick all the boxes!
    Colloids! Really an expensive waste of space, weight, and money! Some of the biggest trials in the history of Intensive Care medicine have conclusively proven that colloid hold no inherent advantage over crystalloids!
    So, just use that space and weight allocation for Normal Saline since it is the Swiss army knife of IV fluids...

    3. Parenteral NSAID's (Voltaren etc). Throw them out! Both lists mention Morphine and the revised list also mentions (without listing specific agents) intubation drugs for a rapid sequence induction. IMO, strongly held, is that anytime a parenteral analgesic is required in the context of severe illness or injury an NSAID is NOT to be given. I have seen far too many instances of severe renal failure in this context where the illness or injury, by itself, should not have caused renal failure. If one is really carrying morphine or Fentanyl use that instead.
    Given the variety of uses that morphine can be put to in various emergency situations it makes sense to carry morphine in place of something like parenteral Voltaren whose indication is uni-dimensional...
    Also, apart from renal failure I have seen parenteral NSAID's cause catastrophic asthmatic attacks in susceptible individuals requiring intubation and mechanical ventilation. And, even taking a good history to try to evaluate the risk will not always identify all those who would be susceptible...
    My advice, stick with narcotics for parenteral analgesia!
    The odd dose of an oral NSAID for pain or headache is fine.

    4. Endotracheal intubation. I have several points for consideration here...
    If one is close to definitive help and the clinical indication for intubation is there then it may be worthwhile to intubate. If one is in the middle of Central Kalahari National Park, then I am not so sure...

    With respect to drugs required for a rapid sequence intubation I have some reservations here. Some of these drugs - particularly muscle relaxants are hard to keep. Furthermore, look at the indications for emergency intubation in the pre-hospital scenario - most of these patients are unconscious already! There is no point in doing an RSI! (A severe head injury might be an exception...)
    Also, a classic RSI in a haemodynamically unstable patient will hasten their death.
    And, think about this too: what happens if one give a sick and hypoxic patient a muscle relaxant and then one cannot intubate the patient? And what if one battles with a bag-valve-mask to ventilate that paralysed patient?
    I promise you that patient will die long before even suxamethonium will wear off...
    Leave RSI's for anaesthetists doing elective anaesthetics!

    Well, if one is to intubate then what are the alternatives?
    For most emergency indications the patient will already be deeply unconscious or even in an arrested state - these patients don't need an RSI anyway!
    For those who are still conscious, or, in that annoying netherland where they cannot protect their airway but resist attempts to instrument their airway then a technique known as an "awake intubation" is the way to go.
    I will explain the fundamentals but this technique needs to be formally learnt from an anaesthetist, intensivist or emergency physician who actually knows the technique and is confident in employing it.
    Firstly, this is not a technique for a head-injured patient with likely cervical spinal trauma...
    Otherwise it can be a very useful tool to add to the armamentarium!
    One will need to communicate well with the patient what one plans to do and as the process proceeds each step of the way. Talking to, and communicating well with the patient is worth lots and lots of doses of sedative drugs in this context!
    The process involves using a sprayable local anaesthetic (we use 10% lignocaine spray) that is used to progressively anaesthetise the mouth and pharynx, and eventually, all the way to the vocal cords. A simple tongue depressor (or something that function like one) is used initially to help access the mouth and oropharynx. As one goes further and further a laryngoscope with a size 3 or 4 blade becomes necessary.
    This process of anaesthetising the airway will take many minutes - perhaps as many as ten or even more!
    Leave the patient in their most comfortable position to breathe - often this will be sitting upright because most patients, in this situation, will be intubated because for respiratory distress and these individual will want to sit up as much as possible.
    Do not rush the process - let the anaesthetic work!
    Continue talking to and reassuring the patient.
    Every time one gives some local anaesthetic one is instrumenting the airway - learn from the process!
    If you have oxygen then use it between dosing the local anaesthetic spray.
    By the time I am viewing the cords and spraying them with local anaesthetic I know exactly how easy or difficult the airway is (in truth nearly all airways are not really anatomically challenging).
    Sometimes, 1-2mg of midazolam are handy but I will frequently actually intubate without using ANY CNS depressant.
    Occasionally a bougie can be handy if the airway is more than a grade II.
    Remember to keep talking to the patient - I will be reassuring the patient even as I am slipping the tube between the cords.

    What are the very real advantages of this kind of intubation technique:
    a. One does not need to rely on hard to store drugs.
    b. More importantly, the patient actually continues to contribute to keeping himself or herself alive by continuing to breathe and maintain their blood pressure (the opposite happens with a general anaesthetic and a muscle relaxant).
    c. If the airway is going to be impossible then one will know that before trying to actually intubate, and, when one pulls the laryngoscope out the patient will be breathing and perfusing, and conscious, rather than mostly dead! Nothing is lost!

    Just to reiterate - don't try this until you have some formal training - an RSI intubation it is not...

    That said, I first learnt this technique in South Africa, and when I came to Australia had several colleagues try to beat it out of me!
    Imagine my surprise when a few years ago some of my ICU colleagues offered to teach me "awake intubation"!
    When I pointed out that I already knew the technique I was told just what a cocky bastard I was!
    So I let them "teach" me, and gratefully adopted the technique, now with the blessing of my colleagues!

    This is my first post on the forum and I have taken a bit of a chance here....
    I hope that the points raised will get the attention of those who can actually understand the merits of the points raised - doctors, CCA's and the like.
    I don't mind constructive discussion so feel free to contribute...

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  7. #104
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    Default Re: First Aid Kit Contents

    Quote Originally Posted by Tony Jay View Post
    I saw this thread searching for other topics.
    I read it out of interest, but after reading the posts I felt I needed to make a comment.

    By way of reference I was medically trained in RSA but now live and work in Australia.
    My area is Intensive Care.
    I have also done pre-hospital emergency care and expedition medicine.
    I have a great interest in remote-area travel (Australia is prime real estate for this!)

    I understand that the original list posted was several years ago, and that it has been updated by a medical practitioner (I think I understood that correctly).
    Nonetheless, there were several points that stood out for me.
    The first was that the contents listed, and the philosophy behind several choices, reminds me of the situation in the mid-nineties when I was still in South Africa.

    With that let me list some of my concerns:
    1. Lignocaine with adrenaline - ditch it, dump it, throw it away! There is no real advantage to using it over plain adrenaline and massive disadvantages. Anywhere where there is an end-arterial supply - ears, digits, flaps, etc - one cannot use adrenaline containing local anaesthetics. The original author may have understood this but others taking his advice may not! Even in Australia tertiary care hospitals lignocaine with adrenaline is not readily available in emergency departments because its misuse by ignorant junior doctors resulted in many digits falling off (not to mention the legal mayhem afterwards)!
    So, everyone should just do themselves a favour and carry the plain flavour!

    2. Intravenous fluids! In the emergency situations likely to be encountered by 4X4 and remote travel enthusiasts there is absolutely no requirement for multiple types of fluids - Normal Saline will do the trick! There is no physiological advantage to carrying several different crystalloids for essentially the same purpose - fluid replacement. Also, if the administration of certain drugs requires a 5% dextrose solution then carry a couple of bags for that purpose.
    Here is a question for those carrying kits with multiple drugs - are you absolutely certain what drugs are compatible with which IV fluids?
    Nearly all are compatible with Normal Saline but a few might require 5% dextrose in water.
    If all the drugs one is carrying are compatible with NS then don't waste your time carrying any other crystalloid apart from NS.
    NS will tick all the boxes!
    Colloids! Really an expensive waste of space, weight, and money! Some of the biggest trials in the history of Intensive Care medicine have conclusively proven that colloid hold no inherent advantage over crystalloids!
    So, just use that space and weight allocation for Normal Saline since it is the Swiss army knife of IV fluids...

    3. Parenteral NSAID's (Voltaren etc). Throw them out! Both lists mention Morphine and the revised list also mentions (without listing specific agents) intubation drugs for a rapid sequence induction. IMO, strongly held, is that anytime a parenteral analgesic is required in the context of severe illness or injury an NSAID is NOT to be given. I have seen far too many instances of severe renal failure in this context where the illness or injury, by itself, should not have caused renal failure. If one is really carrying morphine or Fentanyl use that instead.
    Given the variety of uses that morphine can be put to in various emergency situations it makes sense to carry morphine in place of something like parenteral Voltaren whose indication is uni-dimensional...
    Also, apart from renal failure I have seen parenteral NSAID's cause catastrophic asthmatic attacks in susceptible individuals requiring intubation and mechanical ventilation. And, even taking a good history to try to evaluate the risk will not always identify all those who would be susceptible...
    My advice, stick with narcotics for parenteral analgesia!
    The odd dose of an oral NSAID for pain or headache is fine.

    4. Endotracheal intubation. I have several points for consideration here...
    If one is close to definitive help and the clinical indication for intubation is there then it may be worthwhile to intubate. If one is in the middle of Central Kalahari National Park, then I am not so sure...

    With respect to drugs required for a rapid sequence intubation I have some reservations here. Some of these drugs - particularly muscle relaxants are hard to keep. Furthermore, look at the indications for emergency intubation in the pre-hospital scenario - most of these patients are unconscious already! There is no point in doing an RSI! (A severe head injury might be an exception...)
    Also, a classic RSI in a haemodynamically unstable patient will hasten their death.
    And, think about this too: what happens if one give a sick and hypoxic patient a muscle relaxant and then one cannot intubate the patient? And what if one battles with a bag-valve-mask to ventilate that paralysed patient?
    I promise you that patient will die long before even suxamethonium will wear off...
    Leave RSI's for anaesthetists doing elective anaesthetics!

    Well, if one is to intubate then what are the alternatives?
    For most emergency indications the patient will already be deeply unconscious or even in an arrested state - these patients don't need an RSI anyway!
    For those who are still conscious, or, in that annoying netherland where they cannot protect their airway but resist attempts to instrument their airway then a technique known as an "awake intubation" is the way to go.
    I will explain the fundamentals but this technique needs to be formally learnt from an anaesthetist, intensivist or emergency physician who actually knows the technique and is confident in employing it.
    Firstly, this is not a technique for a head-injured patient with likely cervical spinal trauma...
    Otherwise it can be a very useful tool to add to the armamentarium!
    One will need to communicate well with the patient what one plans to do and as the process proceeds each step of the way. Talking to, and communicating well with the patient is worth lots and lots of doses of sedative drugs in this context!
    The process involves using a sprayable local anaesthetic (we use 10% lignocaine spray) that is used to progressively anaesthetise the mouth and pharynx, and eventually, all the way to the vocal cords. A simple tongue depressor (or something that function like one) is used initially to help access the mouth and oropharynx. As one goes further and further a laryngoscope with a size 3 or 4 blade becomes necessary.
    This process of anaesthetising the airway will take many minutes - perhaps as many as ten or even more!
    Leave the patient in their most comfortable position to breathe - often this will be sitting upright because most patients, in this situation, will be intubated because for respiratory distress and these individual will want to sit up as much as possible.
    Do not rush the process - let the anaesthetic work!
    Continue talking to and reassuring the patient.
    Every time one gives some local anaesthetic one is instrumenting the airway - learn from the process!
    If you have oxygen then use it between dosing the local anaesthetic spray.
    By the time I am viewing the cords and spraying them with local anaesthetic I know exactly how easy or difficult the airway is (in truth nearly all airways are not really anatomically challenging).
    Sometimes, 1-2mg of midazolam are handy but I will frequently actually intubate without using ANY CNS depressant.
    Occasionally a bougie can be handy if the airway is more than a grade II.
    Remember to keep talking to the patient - I will be reassuring the patient even as I am slipping the tube between the cords.

    What are the very real advantages of this kind of intubation technique:
    a. One does not need to rely on hard to store drugs.
    b. More importantly, the patient actually continues to contribute to keeping himself or herself alive by continuing to breathe and maintain their blood pressure (the opposite happens with a general anaesthetic and a muscle relaxant).
    c. If the airway is going to be impossible then one will know that before trying to actually intubate, and, when one pulls the laryngoscope out the patient will be breathing and perfusing, and conscious, rather than mostly dead! Nothing is lost!

    Just to reiterate - don't try this until you have some formal training - an RSI intubation it is not...

    That said, I first learnt this technique in South Africa, and when I came to Australia had several colleagues try to beat it out of me!
    Imagine my surprise when a few years ago some of my ICU colleagues offered to teach me "awake intubation"!
    When I pointed out that I already knew the technique I was told just what a cocky bastard I was!
    So I let them "teach" me, and gratefully adopted the technique, now with the blessing of my colleagues!

    This is my first post on the forum and I have taken a bit of a chance here....
    I hope that the points raised will get the attention of those who can actually understand the merits of the points raised - doctors, CCA's and the like.
    I don't mind constructive discussion so feel free to contribute...
    Print this excellent info and put in all first aid box lids !!
    Thanks.
    There is no task too simple for some people to complicate !



    Ford Figo 2016

  8. #105
    Join Date
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    Default Re: First Aid Kit Contents

    Our traveling first aid kit dates back as far as this thread ....

    Recently the kit has been used a couple of times to deal with scrapes of kids learning to cycle ...

    And then I realised just how impractical our kit was packed.


    For a basic swab and Savlon I needed to take most of the contents out the zip-bag .... then open another bag and spill the contents to get to the plasters.

    Obviously not a bag that saw a lot of action in the last decade .... which is probably a good thing.


    In fact, I remember only three things ever being used from the first aid bag:
    - needle to dig splinters our of my feet (all too often)
    - Aloe gel for burn wounds (couple of times, though mostly for other campers)
    - In 2011 Outdoorwharehouse sold a product that you sprayed onto an insect bite. This stuff WORKED !! Once the container was empty we were never able to get this again ....



    Back to the present -
    Last week I stocked up on plasters and swabs ... for the cycling kids (scary how parents takes their kids to a MTB park to cycle and have absolutely nothing with them for when the kid bleeds..)

    I used this opportunity to through away the horrible zip-bag. We bought a single level plastic container with 7 compartments.


    Before packing it, we took time to actually check the dates on the medicine ... I DID say the bag is as old as this thread !! Which means a lot of the medicine was thrown out (gave it to a nurse, not sure how they dispose of it).


    We now have an up to date first aid box, with meds good for a few years. The Savlon, swabs, and plasters are in a small bag inside the First aid box - thus I can get just this bag from the car and take care of the typical "scrapes and bruises".


    I went a step further - inside the lid is a full list of the items in the box, sorted as per compartment.



    Here's hoping the first aid kit can go another decade without needing more than Savlon and a plaster.

  9. #106
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    Default Re: First Aid Kit Contents

    Few pics of my med gear.

    1 bag mounted behind drivers headrest.
    Other bags all go into my primary aid bag. Lastly there is a medicine bag for prolonged wound care.

    Works well for me.
    Si Vis Pacem Parabellum


    2012 Hilux 2x4 D/L
    A few basic mods.

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  11. #107
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    Default Re: First Aid Kit Contents

    Not sure if it is mentioned on the prev pages (just too lazy to read all of them)
    I carry a couple of condoms in my bike emergency kit. Should you have a gash or nasty cut on your arm/leg and don't have / ran out of emergency kit. you simply cut off the tip and pull it over like a sock until you can get further help.

    Pierre van Pletzen

    "A day without laughter is a day wasted"

    Isuzu V-CROSS
    KTM 1290 Super Adventure

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  13. #108
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    Default Re: First Aid Kit Contents

    Quote Originally Posted by Wandering_Soul View Post
    Few pics of my med gear.

    1 bag mounted behind drivers headrest.
    Other bags all go into my primary aid bag. Lastly there is a medicine bag for prolonged wound care.

    Works well for me.
    Im not familiar with the stores in SA. Where is the best place to get these types of supplies? Also, not sure if the above kit includes them already but I would also like to include disposable skin staplers and vetbond tissue glue to my eventual kit. Are these items easily available in SA?

  14. #109
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    Default Re: First Aid Kit Contents

    Are you allowed to travel across borders with Morphine?
    _______________________________________
    Andrew van Staden
    Old Wheeler

  15. #110
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    Default Re: First Aid Kit Contents

    Quote Originally Posted by Mulva View Post
    Im not familiar with the stores in SA. Where is the best place to get these types of supplies? Also, not sure if the above kit includes them already but I would also like to include disposable skin staplers and vetbond tissue glue to my eventual kit. Are these items easily available in SA?
    They are, speak to Meddev, Cerberus Tactical and Be Safe Paramedical suppliers.
    Quote Originally Posted by Hedgehog View Post
    Are you allowed to travel across borders with Morphine?
    Long process. But possible.
    Si Vis Pacem Parabellum


    2012 Hilux 2x4 D/L
    A few basic mods.

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  17. #111
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    Default Re: First Aid Kit Contents

    Quote Originally Posted by Tony Jay View Post
    I saw this thread searching for other topics.
    I read it out of interest, but after reading the posts I felt I needed to make a comment.

    By way of reference I was medically trained in RSA but now live and work in Australia.
    My area is Intensive Care.
    I have also done pre-hospital emergency care and expedition medicine.
    I have a great interest in remote-area travel (Australia is prime real estate for this!)

    I understand that the original list posted was several years ago, and that it has been updated by a medical practitioner (I think I understood that correctly).
    Nonetheless, there were several points that stood out for me.
    The first was that the contents listed, and the philosophy behind several choices, reminds me of the situation in the mid-nineties when I was still in South Africa.

    With that let me list some of my concerns:
    1. Lignocaine with adrenaline - ditch it, dump it, throw it away! There is no real advantage to using it over plain adrenaline and massive disadvantages. Anywhere where there is an end-arterial supply - ears, digits, flaps, etc - one cannot use adrenaline containing local anaesthetics. The original author may have understood this but others taking his advice may not! Even in Australia tertiary care hospitals lignocaine with adrenaline is not readily available in emergency departments because its misuse by ignorant junior doctors resulted in many digits falling off (not to mention the legal mayhem afterwards)!
    So, everyone should just do themselves a favour and carry the plain flavour!

    2. Intravenous fluids! In the emergency situations likely to be encountered by 4X4 and remote travel enthusiasts there is absolutely no requirement for multiple types of fluids - Normal Saline will do the trick! There is no physiological advantage to carrying several different crystalloids for essentially the same purpose - fluid replacement. Also, if the administration of certain drugs requires a 5% dextrose solution then carry a couple of bags for that purpose.
    Here is a question for those carrying kits with multiple drugs - are you absolutely certain what drugs are compatible with which IV fluids?
    Nearly all are compatible with Normal Saline but a few might require 5% dextrose in water.
    If all the drugs one is carrying are compatible with NS then don't waste your time carrying any other crystalloid apart from NS.
    NS will tick all the boxes!
    Colloids! Really an expensive waste of space, weight, and money! Some of the biggest trials in the history of Intensive Care medicine have conclusively proven that colloid hold no inherent advantage over crystalloids!
    So, just use that space and weight allocation for Normal Saline since it is the Swiss army knife of IV fluids...

    3. Parenteral NSAID's (Voltaren etc). Throw them out! Both lists mention Morphine and the revised list also mentions (without listing specific agents) intubation drugs for a rapid sequence induction. IMO, strongly held, is that anytime a parenteral analgesic is required in the context of severe illness or injury an NSAID is NOT to be given. I have seen far too many instances of severe renal failure in this context where the illness or injury, by itself, should not have caused renal failure. If one is really carrying morphine or Fentanyl use that instead.
    Given the variety of uses that morphine can be put to in various emergency situations it makes sense to carry morphine in place of something like parenteral Voltaren whose indication is uni-dimensional...
    Also, apart from renal failure I have seen parenteral NSAID's cause catastrophic asthmatic attacks in susceptible individuals requiring intubation and mechanical ventilation. And, even taking a good history to try to evaluate the risk will not always identify all those who would be susceptible...
    My advice, stick with narcotics for parenteral analgesia!
    The odd dose of an oral NSAID for pain or headache is fine.

    4. Endotracheal intubation. I have several points for consideration here...
    If one is close to definitive help and the clinical indication for intubation is there then it may be worthwhile to intubate. If one is in the middle of Central Kalahari National Park, then I am not so sure...

    With respect to drugs required for a rapid sequence intubation I have some reservations here. Some of these drugs - particularly muscle relaxants are hard to keep. Furthermore, look at the indications for emergency intubation in the pre-hospital scenario - most of these patients are unconscious already! There is no point in doing an RSI! (A severe head injury might be an exception...)
    Also, a classic RSI in a haemodynamically unstable patient will hasten their death.
    And, think about this too: what happens if one give a sick and hypoxic patient a muscle relaxant and then one cannot intubate the patient? And what if one battles with a bag-valve-mask to ventilate that paralysed patient?
    I promise you that patient will die long before even suxamethonium will wear off...
    Leave RSI's for anaesthetists doing elective anaesthetics!

    Well, if one is to intubate then what are the alternatives?
    For most emergency indications the patient will already be deeply unconscious or even in an arrested state - these patients don't need an RSI anyway!
    For those who are still conscious, or, in that annoying netherland where they cannot protect their airway but resist attempts to instrument their airway then a technique known as an "awake intubation" is the way to go.
    I will explain the fundamentals but this technique needs to be formally learnt from an anaesthetist, intensivist or emergency physician who actually knows the technique and is confident in employing it.
    Firstly, this is not a technique for a head-injured patient with likely cervical spinal trauma...
    Otherwise it can be a very useful tool to add to the armamentarium!
    One will need to communicate well with the patient what one plans to do and as the process proceeds each step of the way. Talking to, and communicating well with the patient is worth lots and lots of doses of sedative drugs in this context!
    The process involves using a sprayable local anaesthetic (we use 10% lignocaine spray) that is used to progressively anaesthetise the mouth and pharynx, and eventually, all the way to the vocal cords. A simple tongue depressor (or something that function like one) is used initially to help access the mouth and oropharynx. As one goes further and further a laryngoscope with a size 3 or 4 blade becomes necessary.
    This process of anaesthetising the airway will take many minutes - perhaps as many as ten or even more!
    Leave the patient in their most comfortable position to breathe - often this will be sitting upright because most patients, in this situation, will be intubated because for respiratory distress and these individual will want to sit up as much as possible.
    Do not rush the process - let the anaesthetic work!
    Continue talking to and reassuring the patient.
    Every time one gives some local anaesthetic one is instrumenting the airway - learn from the process!
    If you have oxygen then use it between dosing the local anaesthetic spray.
    By the time I am viewing the cords and spraying them with local anaesthetic I know exactly how easy or difficult the airway is (in truth nearly all airways are not really anatomically challenging).
    Sometimes, 1-2mg of midazolam are handy but I will frequently actually intubate without using ANY CNS depressant.
    Occasionally a bougie can be handy if the airway is more than a grade II.
    Remember to keep talking to the patient - I will be reassuring the patient even as I am slipping the tube between the cords.

    What are the very real advantages of this kind of intubation technique:
    a. One does not need to rely on hard to store drugs.
    b. More importantly, the patient actually continues to contribute to keeping himself or herself alive by continuing to breathe and maintain their blood pressure (the opposite happens with a general anaesthetic and a muscle relaxant).
    c. If the airway is going to be impossible then one will know that before trying to actually intubate, and, when one pulls the laryngoscope out the patient will be breathing and perfusing, and conscious, rather than mostly dead! Nothing is lost!

    Just to reiterate - don't try this until you have some formal training - an RSI intubation it is not...

    That said, I first learnt this technique in South Africa, and when I came to Australia had several colleagues try to beat it out of me!
    Imagine my surprise when a few years ago some of my ICU colleagues offered to teach me "awake intubation"!
    When I pointed out that I already knew the technique I was told just what a cocky bastard I was!
    So I let them "teach" me, and gratefully adopted the technique, now with the blessing of my colleagues!

    This is my first post on the forum and I have taken a bit of a chance here....
    I hope that the points raised will get the attention of those who can actually understand the merits of the points raised - doctors, CCA's and the like.
    I don't mind constructive discussion so feel free to contribute...
    Hitting many nails and many heads.... Thank you! I am of opinion that you are one of those "losses to SA"
    Jan
    Suzuki Grand Vitara Summit (2017)
    (Previously owned (Only the Zooks really matter): Jimny 2010, Jimny 2013, SX4 2014, Vitara 2016)
    Current Motor cycle: BMW 800GS

  18. The Following User Says Thank You to Epinephrine For This Useful Post:


  19. #112
    Join Date
    Mar 2019
    Location
    Randfontein
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    Default Re: First Aid Kit Contents

    Hi All.

    Just a quick question, do you not need a doctors subscription for most of these items mentioned.

    How does a normal camping guy like me get this, and what training is needed to administer what I believe to be the high end of the medical kit.

    For me a normal large plastic box type from Dischem pharmacy is enough.

    Also please note, I did not read through all the posts, just picked a few up here and there.

    Thanks

  20. #113
    Join Date
    Aug 2009
    Location
    Cape Town/Where ever oil is found
    Age
    66
    Posts
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    Thanked: 23

    Default Re: First Aid Kit Contents

    Quote Originally Posted by Gary110 View Post
    Hi Alan,

    I am a registered American Heart Association first aid instructor, and could offer the course at a big discount to forum members. However the course is not that good for wilderness type medicine, although it does cover CPR and the use of an Automed External Defibrilator (AED). What I will be doing is setting up a "manual" of first aid basics for everyone, and then what I could do in the future is offer a first aid course based on that to forum members at a cost that will only cover my expenses. But this course will not be recognised by any official institution or association, and will therefore be completely "off the record". I will first have to discuss the merits etc. thereof with Dirk, as I dont want to advertise on the forum without being a Commercial Member, and as this would not be my normal business, and I would not be making any profit per se, I really wouldnt want to sign up as a commercial member.

    Once I have the "course notes" set up, I will discuss all this with Dirk and see how we can move it forward for the benefit of all forum members. Watch this space...
    there are ocal courses one that comes to mind is St Johns They do from beginers to level much higher up Do the one that suits you Remember it can save a life
    Land Rover 300 Tdi Sadly sold
    Bush lapa Vlooi B263 This is the best investment I ever made,next to SWAMBO asking to marry me
    76 Series LAND CRUISER 4.2 Donkey It' now history
    The black TOUAREG V6 is history Will get one again one that works
    Now TYDSAAM is a PAJERO DiD GLS The Bush Lapa is NO HURRY
    And SWAMBO a TOYOTA YARIS
    The CORSA bakkie for the little tasks

  21. #114
    Join Date
    Jul 2022
    Location
    Miami, QLD, Australia
    Age
    35
    Posts
    3
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    Default Re: First Aid Kit Contents

    Hi Gray,

    Thank you for sharing the most valuable information. It's really great and appreciate it.

  22. #115
    Join Date
    Dec 2021
    Location
    Lausanne
    Posts
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    Default Re: First Aid Kit Contents

    Quote Originally Posted by Gary110 View Post
    Ok guys, I have finally put finger to keyboard and made up a list of things that I believe should be in a Vehicle First Aid kit. There are 3 sections to the kit; firstly the items that I think everyone must have in a kit, secondly the items that you should have, and thirdly the items that would be nice to have in your kit.

    Of course this is also dependant on how far you may be travelling from the nearest medical facility, or for how long. I think that the "must haves" are what would really work well for a day at a local track or the dunes, the should haves would be good for a trip into the bush, but still within a couple of hours of a good hospital, and then the "nice to haves" for the serious overlanders up into Africa.

    Please, this is not the Alpha and Omega of first aid kits. Many guys have some very good ideas for items in a first aid kit! Lets hear them! And if its really good I will amend the list to include it! I have put the list as an attachment so you can download it and print it a lot more easily, feel free to do so, its a list to help everyone get a kit together as effectively and cheaply as possible. If you feel that there is something on the list that you personally dont need, then leave it out! And if there is something that you personally want to add to it, then thats also ok! This list is just what I have found, in my personal experience as a paramedic in both SA and many African countries, to be what works for me.

    What I also must stress though is that everyone does a first aid course. Not because the job says that you have to, or because I say so, but because the life you save could just be that of a loved one. Do the most advanced course that you can afford, the money will never be wasted!

    I will also be setting up a document that will help the guys out there with what to do in some of the more common emergencies, and illnesses away from home. Sort of a "Bush medicine for the Layman" type document. I will also post it as an attachment so that it can be downloaded and printed and kept in a folder in the car until needed for reference. However as there is so much that can go wrong and there is so much that I would like to write about that this will take me some time. So just be patient guys, I'll do my best. 8)

    Also many thanks to Stan Weakley for all his help and input into this! Much appreciated Stan

    Attachment 107701
    Thank you very much !!!

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