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Posted: 8/12/2005 5:48:58 PM EDT
While moonlighting as a network cable runner guy, I was reaching into a crawlspace with a flashlight and ran my arm directly across a hot (120V) broken old style porcelan light bulb holder (no lightbulb, didn't know it was there).
This was "Across the road", not "down the highway" on the top half of my right forearm, about 2" to the rear of my wrist. about 3/8" at deepest. Lots of blood I have a suture kit, forceps, alcohol, scissors, gauze, etc.. in backpack, however, the guy I was with nearly fainted when he saw the "issue", and being right handed, I couldn't stitch myself up, or talk the guy I was with through it. I ended up going to the E-room and ended up with 8 stitches and a tetnaus shot (because I couldn't tell them the exact date of my last one. ) Are there any tips/tricks to stitching yourself up while holding back quite a bit of bloodflow with your primary hand disabled? (Right hand couldn't reach back around to the top of my forearm...) I think this would be a handy skill to use if I get screwed up while camping alone. I think it is time I got me a staple gun. |
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The "hot" part of the story: The ensuing electrical arc across my arm from the blood somewhat cauterized it so it didn't bleed so bad, but still bled quite a bit. I wonder how much blood there would have been were it not for the arc. (soaked into shirt and pants within 30 seconds...)
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Apply direct pressure until the bleeding is greatly reduced/stopped, then sew yourself up. If direct pressure doesn't work, try a tourniquette. (for lessons, watch any gangsta movie and watch for the junkies shooting themselves up)
Seriously, never try to suture yourself. Apply dressing with appropriate pressure then seek competent medical help. |
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Bloodstopper, they work real good and come with alot of first aid kits
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Gun powder works pretty good for cauterizing wounds.
Just pack an oz or 2 and a reliable ignition source in your 1st aid kit and you're good to go next time you get a boo-boo. |
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really? all powder? or smokeless or black? SGat1r5 |
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You didnt mention whiskey in your suture kit. Id make a note of that.
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I don't know how this involves triage but just control bleeding with direct pressure. Apply a field dressing and if that's not enough go with a pressure dressing.
Since evacutaion is a short trip in you car, that's your best bet. Or if you think you're not up to it MEDEVAC in an ambulance. Do not try to suture yourself up. Let the experts do it. |
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They are selling a wound powder in some pharmacies now. I saw it in a CVS. Similar to the stuff they issue on the battle field. Pricey but in an emergency it couldmake a difference.
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Some ERs use a medical 'superglue' instead of stitches. They did this to my daughter when she split her forehead.
Do they sell it in pharmacies? |
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I use superglue on small cuts where I can get the bleeding slowed significantly, but how do you use it on something that continues to bleed? Also, how do you use it when the skin is pulled apart? I had a nasty cut on the back of my right hand from a metal fan blade, and I really should have had it stitched up or something because it left a heluva scar. I've sewed up a cut on my face (easy, 2 hands) and a cut on my left palm (harder, but at least I could use my right hand). That stapler looks mighty attractive.... And brass, you've really got to find more interesting ways to try to off yourself. |
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i always ask the nurse "so, if i just got tetnaus from this accident, will the shot do any good?". just to prove a point. |
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I have used the superglue before on small cuts. This one is a bit over 3" long. It spread apart to a bit over 1/4" and blood was coming out so fast superglue wouldn't have stuck. I know I was lucky getting to the ER after the guy I was with froze up. If it was reversed, I would have put lidocane on it, alc swab, rinse, stitch. I tried to talk him through it but he could barely get me the gauze. JarheadChiro: How does a Civie get the compact preload stapler? fizzy: Not trying to find new and inventive ways to off myself, this is just stuff "that happens" P.S. Burning Blood/Skin/Hair is the nastiest smell around..... |
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yup, that's true. i saw it on Rambo. You might want to try a roadside flare as an ignition source. |
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The glues work for small cuts that aren't bleeding too badly, but they don't work well on open wounds that need to be pulled back together or are in an area where they will be subject to stretching (i.e. an elbow or knee). The surgical glues are not as exothermic as superglue, crazyglue etc. In theory, these can get hot enough to damage the surrounding tissue; I've sen folks use them with no real problems though.
I've seen folks use duct tape too but steri-strips are a better choice. The key to good closure with steri-strips is to prep the skin first with some benzoin. You can buy these at drugstores. Staples are great for some applications, not others; in this case it probably would have worked fine. In order to get an aesthetically pleasing closure you really need two hands (and sometimes more). Flush the wound thoroughly- several hundred CCs of sterile, or at least clean, water under mild pressure. The mechanical action of flushing is very important to remove contaminants- you do not want to be closing the wound with a possible source of infection in it. You may have to scrub a bit or even clean up (trim) the edges to get a nice closure. Tetinus is a real threat- there is conflicting reports on how long they are good for, but generally figure about five years. You're rarely going to go wrong with getting a professional to take care of it. Even if you don't care about the scar right now you may in the future. Disclaimer- I'm not a doctor, I only play one over here. |
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#1 Don't do it yourself... it generally needs cleaned!
#2 Never use a tourinquet.. it can lead to amputation!! Always apply direct pressure unless there is bone jutting out. |
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Anyone can buy them. Place that sells them. The good ones are made by 3M. 3M skin staplers |
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Agreed. tourinquets are overrated and WAY overused. I wish they would teach boy scouts the concepts first... |
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Duct tape is an acceptable way to close a wound if you are more than a certain distance from help, according to wilderness first responders. I don't remember the distance.
Saran wrap has worked for me in the past. But it wasn't necessarily pleasant. |
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I second the motion that you shouldn't sew yourself up at the house. There is no point besides being able to tell people you sewed yourself up. The only time I recommend it is in an emegency situation when in the outdoors, far from help. Otherwise, take the time to go to the ER, make sure you haven't knicked any tendons or ligaments, etc. Get a tetanus shot and let someone else sew you up.
-If you ABSOLUTELY had to sew yourself up where you were spurting blood in the wilderness in the siutation you described, you would probably have to use a tourniquet (see below) for a short period of time to stop bleeding. If you have lidocaine, use it if you are forced to sew yourself back up. NEVER use lidocaine+epi on your feet,toes, hands, fingers. The epinephrine causes vasoconstriction and if you accidentally inject into an artery, you can end up killing off your finger or toe. Only use lidocaine WITHOUT epi.I DON'T recommend using a tourniquet except in a LIFE OR DEATH situation where you have no other options. If you can hold direct pressure with gauze or a bandage and get to an ER, do it. -Direct pressure is always better than a tourniquet. A tourniquet should not be used unless you are specifically trained to use one, and only then for short periods of time. In other words, unless you are a surgeon and fully understand the physiology of tourniquets, use direct pressure for everything. -Superglue kicks ass but is not sterile unless you get Dermabond which is hard for non-medical to get and expensive. The problem with using regular superglue on a contaminated wound is you can seal bacteria into the cut if you don't clean it up properly. -I love staplers also and use them all of the time. Same thing, sterility is the key. Get some povidone iodine packs. These are great for cleaning wounds. You have to let the solution dry to get the sterilizing affect, I think it involves crystallization but not sure? I do know it has to dry to work properly though. -If you are this interested in it, get some good reading on the topic and/or take a wilderness medic course in your area. Lots of good info on splinting, bleeding, etc. etc. |
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1- Stop bleeding via direct pressure, elevation, pressure points
2- clean wound 3- if deep wound, pack wet to dry 4- seek competent medical help 5- self-medicate from top shelf |
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Debridement is of the utmost importance, so I too would advise you not to close the wound by staples/sutures. Your primary concern is to stop the bleeding. If direct pressure/elevation/icepack doesn't work, then it might be nice to have this. Quickclot
It isn't cheap, but if you got the $$ it could save your life. |
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Some good info here already.
Instead of direct application of the superglue / dermabond, consider what was reccommended by a trauma doc in his SHTF / wilderness pocket guide: Use regular nylon thread, Apply a drop of SG to one side of the wound. Place the end of the thread in it. Let it dry. Then pull <slight> tension, apply a drop of SG on the other side, place the tensioned thread in the drop. Let it dry. This avoids the sterility issue re the SG. +1 for direct pressure. Lac'ed myself with a knife on the L index finger 2 Sundays ago, resulting in a 1" lac just prox. to the 2nd knuckle. Took 3 sutures, but pressure stopped the bleeding within 5 minutes. Pressure is your friend. |
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bah, it's only a Flesh Wound! |
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You'll have a good scar to scare the kids there. Best make up a pirate sword duel story now, you'll be asked about it repeatedly.
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???? Boy Scouts haven't been teaching tourniquets for 40 odd years or so. Except in cases equivalent to amputation, and when you assume everything below it will be lost. BTW after you ignite with a highway flare and that doesn't quite do it, use the drippings, that ought to take care of the little misses left over. |
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glad ur ok ... guess you'll have to hold off on ordering some ammo for a while |
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Sorry, Emergency Medical Dispatch states never use a tourniquet |
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I'd make a funny comment about the hair on your arms, but I should be nice to my team membership sponser.
Looks like the doc tried to make your arm into a baseball. |
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Tourniquet is the LAST resort and only for arterial bleeding. That is what I learned 25 years ago in the Scouts.
Now on the Superglues...if they have not been opened, they are sterile. Bacteria will catalyze these glues, even just a few cells have enough water in them to cause this. Using it for such a wound requires only the epidermis be glued. It will take longer to heal properly if the glue is any deeper. And most commercial cyanoacrylates are too brittle for this application. I am lucky to have a "doc in the box" that I trust. Something like that would have run under $400. A friend did something similar and needed me to drive him to the ER. After being told it would take 4 hours, he agreed to try the doc in the box. He was seen in 10 minutes and out with 9 sutures and tetnus in under an hour. This is a doctor-owned local chain. |
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Ground black pepper works as a good clotting agent in a pinch.
ETA: and if it does end up falling off, you just need to add salt and have an emergency food ration for those wilderness mishaps. |
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It was too deep and too much blood to get superglue to hold, maybe the method mentioned above using SG to hold down nylon string on top would have worked, I could squeeze it back together if I relaxed the muscle enough. No "doc in the box" here. I have the choice of two hospitals that hold the prices high. No insurance, and the guy drove me to the one that was closest because he didn't want blood in his car.
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