First Aid Kit Contents - Page 6





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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 !



    Chev Aveo and Atos and Polo.

  8. #105
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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.

    "A day without laughter is a day wasted"
    M.Benz GL350CDi Be AMG AKA "worshond"
    KTM 1190R 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?
    _______________________________________

    Dum vivimus, vivamus!

    With a mild case of "Camping Personality Disorder" or CPD

    a five cylinder bakkie

  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)
    Beta 400rr Enduro
    Wife: Suzuki Vitara GL+
    (Previously:Suzuki Swift GLS, Suzuki SX4 GLX)
    KTM 150 xc

  18. #112
    Join Date
    Mar 2019
    Location
    Randfontein
    Posts
    2
    Thanked: 0

    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

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