Emergency! Graphic image

[jamesneuen]

Just a test.......



You are part of a communal group. While you are going about your day someone who was chopping wood for the cook fires is brought to you.

http://www.boernebushmasters.org/wp-content/uploads/2015/01/Wounds.Foot_.Axe_.jpg


Begin!!!!

[robsdak]

is this a SHTF thing or a week long camping trip?

SHTF do the best with what i have on hand, medical wise. clean, access the damage, stitch as necessary, dress and try to make as comfortable as possible. then ***SMACK him in the back of the head for being stupid!*** wait and see what happens. might lose the foot...

trip. tend to it best as possible. seek medical attention ASAP! ***SMACK him in the back of the head for being stupid!*** while waiting for proper transportation to arrive.

UPDATE

now looking at it. thinking the big toe is a goner. clean,cut, stitch and wait. look for a Post-SHTF Rehab Center. he's going to have to learn to walk, again. another ***SMACK him in the back of the head for being stupid!***

[ak474u]

ewwwww

[bacpacker]

That'll make everyone pay attention with chainsaw as and axs

[Brownwater Riverrat 13]

Happy Valentines Day! That's the purdiest heart I ever did see! Well my initial assesment is it's been cleaned and prepped, but I'll go real life. UH, communal group so we're on our own I guess and I know what WE have so I get to use that.

Serious toe jam, uh jamb, uh ok, you're going to be OK bud we can work with this. Flush irrigate see what I can see, I see the above. No arterial, no major venus bleeder, just capillary. Any visible tendons detached? Hmmm? I really looks like he missed the one on top of the big toe so maybe we're good here. I see the toe bones are intact just one's STBD the other is PORT I cannot screw or splice bones. so setting these two bones back in place is going to suck. This person will have to be given a few pain killers a shot of booze for intensity. A peice of leather between the teeth while I remove any fragments. Fuck It we'll do it the SAR way "Incapacitae the victum" a quick punch to the face he'll need to be out for this. IZZY! OK once done with that (setting the little piggies) I would remove any debris, clean again, flush and suture. Imobilize the toe and foot, keep said lumberjack sedated and give antibiotics. As for IV...........I have the starter kits but I'm short on the bags right now, I'll have to come up with a solution for that. HEY! anybody in the colony got and IV bag?

Comments, arguments, dissertations?

- - - Updated - - -

Elevate!

- - - Updated - - -

Keep Royal Canadian Kilted Yaksman warm...............warm with kitty blanket. Made from cats I personally sniped in Canada near Sniper's porch. I was a migrant worker on a visa, they had a ferral feline problem in Canada and needed to Hire mercenaries. Long story.

Damn see what you made me do!

[robsdak]

Happy Valentines Day! HEY! anybody in the colony got and IV bag?


yeppers... 3

[Brownwater Riverrat 13]

Well get over here! Like I said, I'm taking this scenario as we are on our own. So this Yaksman is going to need to remain bedridden, long term he'll most likely have nerve damage, he might regain full usage, he might not. Depends on infection and the individual, uh I mean Yaksman, them Canadians are supposed to be tough.

[jamesneuen]

Firstly, assess the damage and administer whatever sedative we have on hand. Morphine-Everclear.

Secondly, Determine how bones are separated and if there are any fragments. Looks to me like the big toe is a loss and fragmented but just shaved the metatarsal of his large toe on the inboard side.

Thirdly, clean the wound and remove the big toe bone fragments as it looks like it was broken. I would remove both sides of big toe and enough muscle to perform a combat amputation without the complication of sawing any protruding bone.

Fourth, CLEAN AGAIN AND AGAIN

Fifth, Suture and fold over skin from big toe to cover metatarsal. Ensure use of disposable sutures with no rolling of skin to allow the wound to drain as it has to heal from deeper inside.

Sixth, Immobilize leg with no walking

Seventh, Monitor 2x daily for heat, excess drainage, discoloring or any other sign of infection. If infected, any of the -illins would be my go to from the fish department. Otherwise simply some colloidal silver and whatever pain management we can do.

Eight, Only reopen to reclean if absolutely essential.

[Brownwater Riverrat 13]

Sounds like you've done this before..........I've been schooled maybe?

[jamesneuen]

Emergency Combat Medic from military. They don't cover much fixing though. Just stabilizing. They would say clean, staunch, wrap and transport.

Everything I just listed was from my own reading. I've actually practiced deep tissue stitches on some turkey breasts though. LOL. The hard part for me would be getting the supplies to do a procedure like I listed properly on the civilian side. I have my ECM bag issued to me but that's about it and they have next to none of the things I have listed above.

Dissolving suture material, saline wash, painkillers, anesthetic, and antibiotics are all VERY hard to accumulate on civilian side, especially in large quantities.

[Domeguy]

Wow...that's some ingrown toenail. This is way beyond my pay grade. If it happened to me, assuming we are in total SHTF senerio, I might use the last 9mm bullet in my Glock, and apply it to my temple. So I asked Mrs. Domeguy, a nurse. First off would be 911, but if we are way beyond that, she suggests,
1. Irrigate the wound with clean water. 2. Check for arterial bleeding, and if so, apply tourniquet, and may apply one anyway if excess bleeding. 3. Clean out any foreign objects, and any bone chips and other bad stuff. 4. Wrap tightly in clean gauze, and apply a splint. She suggests not suturing at this time due to two factors. A) Healing starts from the inside and works it's way to the outside. The wound might need to be packed with antibiotic soaked gauze and re-wrapped every day or so. B) you don't want it sutured if there is an infection, as the entire wound could become a puss filled bomb waiting to explode. 5. Keep it elevated, with complete bed rest for a month or so. All of this is assuming there is no other medical help around.

[jamesneuen]

Domeguy,
did your wife mention the type of sutures? As I understand it, there are 2 separate kinds, deep tissue and surface. I was referring to deep tissue sutures which is why I specified the dissolving sutures. I was just of the thought that doing the sutures would cut down on the healing time dramatically, preserve some of the muscle and bone, and encourage it to heal in the proper manner.

ie, I chose to sacrifice the big toe due to the fact that a large chunk of the bone appeared to be on the inboard side while the metatarsal was still outboard and what looked like a small sliver was at the base of the injury. To me that would mean the ligatures and tendons allowing movement and use of the toe are already gone and the bone is dramatically compromised. That puts me in the thought that the toe is already a lost cause and no natural healing will happen without some encouragement to put things back in the right place.


Not trying to argue just facilitating discussion.

On the other hand I didn't even think about checking for compromised arteries due to the lack of blood in the picture. I would assume this is after they have cleaned the wound already so unless I saw a rhythmic push of blood I wouldn't have thought about arteries and applying a tourniquet or pressure points to staunch bleeding.

Also, in a SHTF, no help ever scenario, what would she suggest using as antibiotic gauze to apply daily? That would seem to consume a lot of supplies unless you could reproduce your own. Silver impregnated gauze is what I have been told to use lately for large wound closure and daily dressing. (home health care for personal injury) Would using a gauze soaked in that colloidal silver I mentioned be much the same?

I would love to hear a rebuttal to anything from anyone. My personal experience is very limited as far as drastic measures go. I can only respond with what I have read and tried to understand.

[robsdak]

Dissolving suture material, saline wash, painkillers, anesthetic, and antibiotics are all VERY hard to accumulate on civilian side, especially in large quantities.

what area are you in? military? i am a civilian and have access to all of it. maybe your not looking in the right places? not calling you out, just saying...

[jamesneuen]

By all means, if you have a source of supply for the things I mentioned please let me know.

Coast Guard, and also in Key West where there is a ton of nothing but bars.

Online is my only option for obtaining things down here usually. Most of the things I mention require you to have a medical license to acquire or if looking on the vet side, a prescription.

I'm not saying that when I have an infection I can't get meds. I am saying that advanced things such as anesthetics and non-OTC painkillers are almost impossible to find legally.

[robsdak]

MODs not in anyway am i doing nor condoning any illegal activities...

sources are my military buddies, nurses and for scripted meds, my doctor. i can ask and 'if' i have a need, i can obtain a 90 day supply. anybody should be able to do that? you can't?

other sources would be Ebay, medical supply sites? i have ordered from both with no issues or hassles.

being the not so legal part is, giving them to someone else. but in the above stated scenario, i highly doubt it's going to matter much where the meds come from.

[jamesneuen]

I am not trying to argue points or even argue in general. I am trying to see the exact sources you would site for obtaining each of the things I mentioned.

So where would I go finding a general anesthetic available to everyone?

Where would I find local anesthetic even beyond creams and gels? Such a inject-able lidocaine? The picture I posted has the gentleman's foot cut in half almost. I don't think a couple 500mg Motrin is going to "cut it".

Saline wash is simple, just large quantities of plain eye drops. I get that.

I could go to a medical site and buy a box of dissolving sutures, standard box with no frills of dissolvable sutures 12pk at 36in is almost $250 for nearly any given type. I will give you that one but that one is not simply cost prohibitive, half the sites that sell them require a medical license. Non-dissolving could be something as simple as monofilament fishing line soaked in alcohol though.

Antibiotics are simple enough as any pet store or amazon has them.

But amassing any drug at all beyond the antibiotics is legally dangerous seeing as possessing anything over 300 pills could label you with intent to distribute drug charge if it is a controlled.

I am asking for completely legal and ethical means of obtaining them now to be prepared without getting a felony.

Yes I could go Medieval on it and just give him a belt to bite until he blacks out from the pain of my cutting on his foot.

Or we could just treat him like the dumb horse he is for injuring himself like this and do like DOMEGUY said and tell him to eat a bullet. I'm a stubborn individual though and I refuse to take those as answers unless I have to.

DOMEGUY said he would consider himself dead. I refuse to call someone dead till they're cold and dead, and even after that I don't have to like it.

[Domeguy]

She said antibiotic soaked would be best, but in out scenario, we don't have the best. She said to use dry clean gauze, soaked in saline solution, and change daily. As the wound would slowly heal, it would pull out the dead tissue as it was changed. It also might need irrigating with saline,and maybe, SLIGHT cleansing to remove dead tissue. Keep warped, rinse and repeat. This is what she did when I had a slight mishap with a pressure washer last summer. Of course nothing near this accident. This is after surgery, after the packing was removed. So I'm thinking something, but on a larger scale.http://i48.photobucket.com/albums/f226/gantsum/5da678697b29834e6167811b00ad9aba_zps324ddb90.jpg
And after looking again at the picture, she would suggest amputation to about where you can see the bone, as she thinks it would most likely die off and cause more complications. And change your name to Gimpy.

[robsdak]

I am not trying to argue points or even argue in general. I am trying to see the exact sources you would site for obtaining each of the things I mentioned.

i thought i answered the question you asked? see below...

"sources are my military buddies, nurses and for scripted meds, my doctor. i can ask and 'if' i have a need, i can obtain a 90 day supply. anybody should be able to do that? you can't? "

not to sound rude, as for my exact sources. your not. as far as what i have listed here, is what you got.

i think the problem here is your wanting to preform surgery on this gentleman's foot. in a SHTF scenario, your not, plain and simple.

[jamesneuen]

Domeguy- Ick, that looks nasty. Lets keep you away from power tools. The saline sounds like more of a doable solution to me without sucking up all the resources and yeah then I think we agreed on where to amputate the big toe.

Rob-I think we are having a breakdown in communication and that's where the issue lies. To save any major function in his foot would require surgery in my opinion and without some of the things I have listed it wouldn't happen.

SHTF I want to be prepared for everything I might encounter. Do I plan on doing an appendectomy on someone? Hell no but trying to fix this guy's fucked up foot, sure. If surgery is what is required then I would do my best. You said about as much of the same in your post but without the specifics.

You simply stated that you had easy access to get everything listed there and I think you mean you would acquire them through those people being in your group after SHTF? If so then that was my misunderstanding.

I took it to mean that you had access to get them now easily through some retailer or friendly doctor. Yes there are people I would call on that I might be able to get these things after SHTF but as of right now I make do with what I can get and hope that I have what I need if something like this happens.

My definition of SHTF isn't that things turn off for a year or two then everything goes back to normal. Mine is that I don't plan on it ever coming back if it goes. EMP, Depression, Korean invasion, what have you.

[Domeguy]

Originally Posted by jamesneuen
I am not trying to argue points or even argue in general. I am trying to see the exact sources you would site for obtaining each of the things I mentioned.
i thought i answered the question you asked? see below...

"sources are my military buddies, nurses and for scripted meds, my doctor. i can ask and 'if' i have a need, i can obtain a 90 day supply. anybody should be able to do that? you can't? "

not to sound rude, as for my exact sources. your not. as far as what i have listed here, is what you got.

i think the problem here is your wanting to preform surgery on this gentleman's foot. in a SHTF scenario, your not, plain and simple.

I'm a bit confused. Are you talking theoretically in a SHTF scenario, or in real life? I go to a pain clinic every month, and can only get a 1 month supply of heavy duty pain killers. Any thing more that a 30 day supply would end me up in jail as a dealer. If you can get any extra through buddy's and such, that that is greats or you, but the rest of us can't do it

[robsdak]

misunderstanding, OK. as for the photo you showed, IF it happened now while camping, on the farm. as said, off too the ER AFTER, whatever needed to be do done to him and the ***SMACK***

post SHTF situation. it would be dealt with in the proper manner. cleaned, debridement, stitches (deep tissue) and wound closure.

as for the proper meds to knock him out??? just will be dealt with.

as for access to it right now? i do. without going into specifics and not getting anyone in trouble. i have boys i went to school with that are in units that do this kind of thing and have access to all of the things listed, short of the meds. those are accounted for, STRICTLY!

i don't think you know where i am. i have Air Force, Army Special Forces and Army Rangers real close and have friends in all.

i have friends that are nurses that can/will/have provided other things that i have asked for. bandages, tapes, gauze, topicals, suture kits, IV supplies, ect.

pain killers, again, not a problem. if i have a prescription for it, i can have/get it. let it be at that.

DG 30 day supply might be all you can have where your at? or that might be the Pain Management Clinic's policy? i am sure it's to keep 'drug seekers' from abusing them or folks from selling them. i am neither.

[Brownwater Riverrat 13]

Emergency Combat Medic from military. They don't cover much fixing though. Just stabilizing. They would say clean, staunch, wrap and transport.

Everything I just listed was from my own reading. I've actually practiced deep tissue stitches on some turkey breasts though. LOL. The hard part for me would be getting the supplies to do a procedure like I listed properly on the civilian side. I have my ECM bag issued to me but that's about it and they have next to none of the things I have listed above.

Dissolving suture material, saline wash, painkillers, anesthetic, and antibiotics are all VERY hard to accumulate on civilian side, especially in large quantities.

Mine was from Navy SAR/EMT, blah, blah, but I this I pulled out of my head from what I could remember and did this as soon as I saw it and I utilized what I have on hand.

I dig the scenario thing I have partaken in a few in the past. These things can be real fun and brain teasers, pickers and farts. But it's a way to exchange information and help each other out. So your commune has a damn hospital and that don't play fair with me!

I think everyone is covering your shopping list........yes?

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misunderstanding, OK. as for the photo you showed, IF it happened now while camping, on the farm. as said, off too the ER AFTER, whatever needed to be do done to him and the ***SMACK***

post SHTF situation. it would be dealt with in the proper manner. cleaned, debridement, stitches (deep tissue) and wound closure.

as for the proper meds to knock him out??? just will be dealt with.

as for access to it right now? i do. without going into specifics and not getting anyone in trouble. i have boys i went to school with that are in units that do this kind of thing and have access to all of the things listed, short of the meds. those are accounted for, STRICTLY!

i don't think you know where i am. i have Air Force, Army Special Forces and Army Rangers real close and have friends in all.

i have friends that are nurses that can/will/have provided other things that i have asked for. bandages, tapes, gauze, topicals, suture kits, IV supplies, ect.

pain killers, again, not a problem. if i have a prescription for it, i can have/get it. let it be at that.

DG 30 day supply might be all you can have where your at? or that might be the Pain Management Clinic's policy? i am sure it's to keep 'drug seekers' from abusing them or folks from selling them. i am neither.


I have but one comment here boys..........OPSEC!

[robsdak]

LOL i didn't give away any more info than was needed. i am good with what i said. people should just realize that not all folks on forums or the interweb are 'computer jockey's' and can do what they say. i thought the reason for being here was prepping? well that and making fun of ST? LOL

[jamesneuen]

BWRR- Like I said, all those things would be nice to have but could be done without.

Rob- I realize that everyone has their sources and connections if something were to happen so that was my misunderstanding.

[robsdak]

no harm, no foul.

[eagle326]

Hell Sniper would just take it off and make Toe Foo.

[Brownwater Riverrat 13]

BWRR- Like I said, all those things would be nice to have but could be done without.



OK well next time you throw a damn foot up there you better come packin with your real toys. :cool:

Now if you want to throw one up there and say "here's the only supplies you have on hand", well there's another story. "Man's got to know his limitations" but ya gotta put the book down and use your head. We don't have books here, we do it on the fly! You threw it on my table, what the hell did you expect me to do, go to the library? Damn Yaksman coulda fuckin died!


sometimes I just drip with sarcasm.
.
.
.

[jamesneuen]

lol. field surgery manual says it should be read to you by someone as you do the procedure.

[Vodin]

Hmm, elevate the leg, clean and stop the bleeding. Wrap and transport to robsdak for the proper corrective method. :) I can deal with the sights and most smells of injuries. A good assistant I would be unfortunately only know the basics.

[jamesneuen]

Alright, wanna try another one?

[Brownwater Riverrat 13]

Wait.............................................. .................................................. .............let me go get my manual.

[jamesneuen]

lol, somebody else got one they wanna put up?

[robsdak]

Hmm, elevate the leg, clean and stop the bleeding. Wrap and transport to robsdak for the proper corrective method. :) I can deal with the sights and most smells of injuries. A good assistant I would be unfortunately only know the basics.

we aren't preforming brain surgery... LOL good gawd, it's only a mangled foot. :) hell he might die before you can get him too me.


anybody up for a Sucking Chest Wound? :p

[jamesneuen]

ooooo good one. wanna post it up and try to find a picture?

[Sniper-T]

Meh... 'tis only a flesh wound. Walk it off

[Domeguy]

OK, I'll post one, as I already know the outcome. I appear at your door, (we are good neighbors) and tell you I might need some help. I tell you about an hour ago, I got my left ring finger hit with the tip of a pressure washer as it quit working. It was only about 1/2 second contact, and I was wearing latex gloves with leather gloves on top. The pressure washer only was spraying water, no chemicals, and was at 3000 psi with the needle valve on it. I take off my glove and show you this. You only have what ever medical supplies you have on hand. I didn't believe in prepping because all I have to do us call 911 and someone will show up. But when I tried to call, the phones were all dead, including my cell phone, and for some reason, the power is out, and none of my cars will start.http://i48.photobucket.com/albums/f226/gantsum/2f33d05d9ea1b0aca29cf0a561455daa_zpscad90bb7.jpg

[realist]

I would want to drain it. I would have them soak it in hot water to soften it up. Many times this will open it up to drain just from the pressure inside. Scrub it out well. If it were a family member and didn't drain I would lance it and put a triple antibiotic ointment on it, bandage and send them on their way. Change daily.

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Hey real quick on the first one. DG is right you do not want to suture too soon, it needs to heal from the inside out. On the inside you want to use sutures which will dissolve. In this situation a doc would probably put in a drain. Also regarding the question about colloidal silver I don’t have any experience with however I do have personal experience with an antibiotic material called Silversorb. This is used to protect against infection and to prevent the wound from drying out or scabbing over. I had a couple of leg wounds and the stuff worked great.

[Socalman]

Without ready any other posts yet, first stop any bleeding. Treat for shock. Apply sterile bandage. Keep the patient off feet. Perhaps administer any pain killer that may be on hand, though aspirin might not be good as it is a blood thinner,

The next steps depend on the situation. Assuming we are not in an area with emergency treatment centers or it is a SHTF situation, clean the wound as best as possible in the given situation. Treat with whatever antiseptic may be available. Cover again with sterile bandage. Find someone who may be skilled enough to suture. Monitor for infection several times a day and continue to apply antiseptic.

[realist]

or you could just cut it off and let him grow a new one.....

[Domeguy]

I would want to drain it. I would have them soak it in hot water to soften it up. Many times this will open it up to drain just from the pressure inside. Scrub it out well. If it were a family member and didn't drain I would lance it and put a triple antibiotic ointment on it, bandage and send them on their way. Change daily.

- - - Updated - - -

Hey real quick on the first one. DG is right you do not want to suture too soon, it needs to heal from the inside out. On the inside you want to use sutures which will dissolve. In this situation a doc would probably put in a drain. Also regarding the question about colloidal silver I don’t have any experience with however I do have personal experience with an antibiotic material called Silversorb. This is used to protect against infection and to prevent the wound from drying out or scabbing over. I had a couple of leg wounds and the stuff worked great.

If this was a real SHTF event, I probably would not have survived. I posted this to show how the little things can be big things in a bad situation. I had to have surgery latter in the week. The pressure washer had done a lot of damage damage inside that couldn't be seen, so it was a trick question. The finger tip was dying, and by the end of the week, it was really stinking from the finger rotting. If left alone, the infection would have most likely killed me. This is what it looked like a week after the surgery.http://i48.photobucket.com/albums/f226/gantsum/54b2e97fdb20e68b607e1b805e31ee3c_zpsub5zcnww.jpg

[Sniper-T]

I like the hole. Great place to stash small things. Handier than in a backpack. and best of all, untreated, it could've just kept increasing in size. lol

Pretty nasty, I am guessing that was one of those ultra high pressure stripping tips?

What's the finger look like now?

[Domeguy]

I was hoping for a second storage place for belly lint, for starting fires, but unfortunately it healed up. And yes, it was the zero degree needle gauge, at 3000 PSI. I really thought everyone would soon be able to call me "stubby", but I got lucky.

http://i48.photobucket.com/albums/f226/gantsum/57ac1f8c486a53aee90d791f5a336edf_zpsjyv7o8r5.jpg

[Stormfeather]

Well... I would have said amputation all the way around... but Im pretty medieval when it comes to treating other peoples wounds. My own... egads... I dont want to think about it!

As for a GREAT place to get IV's, rigs, suture kits, ect ect, I usually shop thru www.dealmed.com. These guys a great, and pretty nicely priced compared to alot of others.

[Sniper-T]

Time to resurrect this thread...

I came across this pic, and I'm really not sure what the guy did, but it's pretty nasty.

So, two questions
1. your thought on what caused the accident?
2. Your treatment. (Let us say SHTF, no resources other than what you have)

http://i605.photobucket.com/albums/tt140/Sniper-T/ImageUploadedByCanadianGunNutz1419865480_911969_zp szwcpmgei.jpg (http://s605.photobucket.com/user/Sniper-T/media/ImageUploadedByCanadianGunNutz1419865480_911969_zp szwcpmgei.jpg.html)

[realist]

That is what you call a meat slicer....

[jamesneuen]

Got his fingers caught in a spool of razor wire?

Tons of peroxide then bandage loosely. Change bandages every day or two. Ensure that the wound stays damp but sterile. If needed use a saline solution to moisten the bandages.

[Domeguy]

I saw that picture on the web in the past, and if memory servers me correct, it was indeed a meat slicing tenderizer type of blade, like for making cube steak. Ouch.

[Sniper-T]

^ I would agree. they do look mighty tender.

I'd be curious as to what kind of tendon damage there is. bandages and sterility can heal the wounds... but will those fingers ever move again?

I can suture the skin/meat easily enough, but sewing tendons back together? I'm pretty sure that is above my ability (by a lot)

That said, I think it would be easier to do as James suggested, and have the person with useless fingers, than to amputate... unless infection made that necessary.

[Domeguy]

It's a sure bet he will need someone else to pick his nose for him for a while.!

But seariously, it looks like all of the cuts are not seariously deep, and the bleeding seems to be under control, so careful irrigation with sterile water, and bandage, with cleaning of dead tissue in the near future. Its gonna hurt like a mother in the mean time. It's amazing how fast the fingers can heal, if they have good blood flow.

[realist]

So that is how they spiral cut ham. Well I suggest he just let someone else do the ham.