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bojibob
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01/03/2011 10:43AM   (Thread Older Than 3 Years)
This is 1 of 10 Wilderness Challenges I will be posting. The purpose of these is to get feedback on what you would do under these circumstances. I'm not looking for a "Right Answer" I'm looking to see how the many very knowledgeable people here on BWCA.com would react in a time of decision in Canoe Country

Wilderness Challenge #1 “Axe yourself, what now”

Situation: You're traveling by Canoe on a Solo in Quetico Provincial Park. You have chosen to take some of the seldom used portages between Woodside and Hulburt. While crossing the portage a deadfall is completely blocking the portage. (See Maps)













You decide to use your razor sharp Granfors Small Forest Axe to chop through the deadfall. You manage to clear away the branches and go to work on the thickness of the tree. As you hammer through the last ½ inch of the log, your axe blows through the wood and hits you directly on your shin bone opening a 5” inch gash. Blood is now pouring out and you can see the white of the bone

Important Equipment Available:

Spot Device
First Aid Kit that includes QTY-1, 1/8” Steri Strip, Suture Kit, Antibiotic Cream, 1 small Quick Clot and assorted small bandages.

Axe yourself, what now?

Challenge Mentors: Beemer01 (Bryan) and Bojibob (Rob)
 
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520eek
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01/03/2011 11:21AM  
I hope the spot works!! Go back to my gear get out the first aid kit and spot. The only question at the moment is should I stay or go back a little bit where there might be a better chance of seeing some one? Irrigate and irrigate and clean that wound before I try any thing. Not sure if I could suture myself but I will try bandage/compress of some sort and see how that goes. If it looks okay after that and bleeding is dang near stopped I would opt for getting out on my own. If I cant get bleeding to stop, It's time to re-evaluate and see how much I have slowed it down. Now it's time to turn back and find place where i can use the spot and hit the "button". Hope it works, cuz if it dont I now have a situation I didn't anticipate. Major bummer...I would think I can get the bleeding slowed down or even stopped, so its time to turn around and get out.
 
Savage Voyageur
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01/03/2011 11:53AM  
Wow five inch gash in the shin bone. You need medical attention as soon as possible. First things are to stop the blood loss. This could be accomplished by removing your tee shirt and wrapping it around the wound. Then hobble over to get the spot device and activate the send help button. Next is to continue to address the wound. As much as I would "like" to use my new Suture kit, haha I would try to wrap my leg tightly with a compress of some type. I would not be worrying about getting an infection and hope doctor can and clean it out properly later. This is because my main concern is to stop the bleeding not an infection. You would not want to bleed out on the trail. With a cut five inches long and bleeding a lot and have blood everywhere, I would think that 1/8 Seri strips and Band-Aid would be worthless, they would not stick or hold.

As far as the Quick-clot, I have read good and very bad things about this stuff. Not sure if it is true, read it on the Internet so it must be true. I have read the stuff does work and clot blood, but it should be used after a tourniquet. Wow that says a lot about the stuff. I have also read that the stuff is used for major trauma wounds. Police and army medics use it in life threatening situations. This is truly that time one would try it out but only after compression and maybe a tourniquet. I have read that it causes burns and doctors can feel the burn through their gloves. It also leaves major scars and can be hard to heal after using the quick-clot. I would think that this stuff would be hard to clean out later by a doctor. Again not sure about this stuff only what I have read. I would like to hear from someone who has used this on a wound this big and also the results later.

Ok now you have stopped the bleeding with the compression bandage, alerted the spot device to call for help. Now comes the hard part, waiting for help. It is now a mind game so you will need to stay calm and alert. I don't care how hot it is out get your sleeping bag ready or climb into it or cover up. You do not know if you will go into shock so be ready. You now need to elevate your leg above your head and stay hydrated. Write a note to those who need to be contacted about your health with anything the doctors need to know.

This thread makes me rethink taking an axe.

 
brerud
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01/03/2011 02:07PM  
Axes are evil!

I have never looked at a SPOT device before but if there is a send help button that is the first thing I would do after I attempted to stop the bleeding.

First thing is to stop the bleeding - a cut that big may be bleeding enough to kill me. If it is a gusher, I stay put, hit the send help button and start a big fire right there out of the deadfall. I put on green leaves and other smoke making materials to hopefully get noticed by someone on a nearby lake or those responding to the SPOT. Good comment about the sleeping bag, anything to stay warm and buy time is worth a try.

If it isn't bleeding that bad..... (there are spots on the chin where there isn't a lot of flesh between the bone and skin)I would still hit the send help button but head back out towards a more popular lake. I hope that the responders would be able to follow the beacon as it is moving. I have to be careful not to open up the wound and start bleeding while I am moving. At some point I need to stop and wait for help unless the bleeding has completely stopped.

 
Beemer01
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01/03/2011 02:08PM  
Geez this sounds familiar.....
 
bojibob
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01/03/2011 02:11PM  
quote Beemer01: "Geez this sounds familiar....."


Anyone you know Bryan? :-)
 
01/03/2011 02:23PM  
i would never bring a tool as dangerous as an ax on a solo trip. no saws either. even a knife is asking for trouble.
 
Beemer01
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01/03/2011 02:32PM  
Well - from my perspective, sharp tools are all part of wilderness travel, so I pack a hatchet (however, not an axe though some do, and it could be argued that had the unfortunate solo traveller used an axe and not a hatchet this injury would not have happened in this fashion)as well as a folding saw and multiple knives. All are very sharp and I carry a whet stone to keep them that way - few things are more dangerous than a dull tool.

I think this is as much a question of how tools are to be used as it is a wilderness first aid question....
 
brerud
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01/03/2011 02:42PM  
Here is an article from the Ely Echo about an incident very similar to this that happened this fall.
hatchet accident

I heard that the guy is lucky his friends left him to get help when they did - he might not be alive today if they had tried to get out on their own.
 
01/03/2011 02:50PM  
I have a question about how the Spot works. When you hit the button are they going to look for you where the button was pushed or can the rescuers track you if you move?
 
Mad_Angler
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01/03/2011 02:53PM  
First, I'd cut some strips from a clean shirt. I'd use the strips and the QuickClot to stop the bleeding.

Now assuming the quickclot seemed to be working, I'd relax for 30 minutes to calm down, start to think straight, and make sure the wound was not bleeding any more.

Then, I'd slowly make my way back to Woodside. I'd set up camp at the portage. I want to have a good shleter, food, and water.

I'd sleep for the night. I'd have the SPOT nearby if things took a turn for the worse.

If the wound was good in the morning, I'd start to make my way out.
If the would was bad in the morning, I'd use the spot and get help help.
 
01/03/2011 03:13PM  
I am basing my response on how I would portage when soloing. That is, I would take my gear on the first trip, and leave the canoe, paddles and fishing gear at the portage landing as the 2nd load.

Ok, so now I have a 5" gash in my shin. After the initial pain subsides, I carefully inspect the wound. Hopefully I find the shin bone has absorbed most of the blow and the axe has not cut deeply into muscle or veins/arteries. I use a clean t-shirt to apply pressure. If the bleeding doesn't stop to my satisfaction, I'd use the Quik Clot. Once the bleeding is stopped, I realize the gashed/exposed bone is highly susceptible to infection, so I add salt (from my food supply) to my water bottle and irrigate the wound. Then apply the antibiotic cream and use the steri-strip and assortment of small bandages in an attempt to close/cover the wound. I'd then put more cream over the bandages and wrap the wound with a clean t-shirt. I would not use the sutures fearing I'd infect the wound.

Knowing even with the SPOT I'd be difficult to locate or heard in my present position, I decide to head to an open area. I am worried about the structural damage to the shin bone and fear it may break if I try to walk on it. I use my axe and knife to fashion a splint from the cut deadfall branches. Tie the splint to my leg using rope or torn clothing strips. I also fashion 2 crude but sturdy crutches. Using the crutches to pull myself upright, I make sure I can travel without putting much, if any weight on the injured leg. I then go though my gear and decide what I need to survive for at least two days. Rain tarp, sleeping bag, rope, sturdy knife, food, a pot, stove, fire starting material, 1st aid, map, SPOT, headlamp, etc. I stuff this light load into my small personal pack.

I am closer to Hulbert but don't know what lies ahead. I decide its best to take the "known" trail back to the Woodside landing, plus there is a source of water along the way. Plus, my canoe is there which will be easy to spot from the air. Hopefully I arrive there with my "ditch" pack and then activate the emergency signal on the SPOT. I then pray whomever is monitoring sees the signal quickly and calls the authorities with my location. Biveyed on the ground, I get into the bag to keep warm and keep the tarp handy. In case of rain I'll cover myself as best I can. I try to move as little as possible awaiting the rescue, and hoping some other trippers pass by and hear my shouts for help. I likely would not try to get into the canoe and paddle anywhere for fear of reopening the wound or increasing the chance of infection.
 
Savage Voyageur
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01/03/2011 03:18PM  
quote Chilly: "I have a question about how the Spot works. When you hit the button are they going to look for you where the button was pushed or can the rescuers track you if you move?"



I remember watching Bojibob's trip and we could track him on a map. I would think that the spot would still track you. Read the post below about last falls accident. He tried to walk the 1 1/2 mile portage and could not.
 
01/03/2011 04:42PM  
Pressure bandage immediately (none in first aide kit,make out of clothing). Hit SPOT button. Assess wound and location. Consider moving closer towards water; closer towards help and drinking water, knowing that shock will probably be coming at some point.

If wound is too severe, stay put, fire, water, shelter, food and stay awake. If still bleeding use quik clot. Tourniquet is last resort.

Sit tight, drink water and wait for help.
 
Mad_Angler
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01/03/2011 05:00PM  
Why are so few people using the Quick Clot?

This seems like a perfect application: urgent need to stop bleeding, fairly open wound (Quick clot doesn't seem suited for internal bleeding or gun shots), minimal concern about scarring, , etc
 
01/03/2011 05:17PM  
rob? what time of year is did this occur? (im resisting looking at the posts)
 
01/03/2011 05:21PM  
I've read a lot of these but this is the first one I've participated in.

I never carry an axe, but that kind of injury could happen in other ways. I DO carry a Spot.

First I'd wash it out with clean (filtered) water, then fashion a compression bandage of what ever I could, shirt, gauze pad etc. Knowing my tendency to over react I'd check my watch to make sure I gave compression a chance to work. Five inches is a long gash. It's only 3 1/2 across my hand from outer edge of index to outer edge of pinkey, so I'd need a bandage to hold pressure on the wound. If pressure alone didn't do it I'd apply the Quick Clot.

If the bleeding stops the next step is to slowly make my way back to the beginning of the portage if I could. I'd get the sleeping bag and make sure I had ample water. I'd pitch my tent and lie down, leg elevated with my Spot beside me. If bleeding stopped I'd wait until morning and reassess. If bleeding continues or inflammation occurs I'd press the button for SAR. If things seem to be stable I would make my way slowly out, choosing whichever way was shortest and/or easiest. I'd keep the spot handy at all times. If I felt that I was unable to continue I'd hit the emergency button for SAR.
 
ozarkpaddler
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01/03/2011 05:40PM  
Never used a SPOT before, but would be a good time!

Would get my dish soap out along with lots of clean water (boiling if I had to) and irrigate the wound as much as I could stand. Unless I damaged an artery, I wouldn't worry about the stifling the bleeding for several minutes. Antibiotic ointment applied, I would dress it with whatever clean bandaging I had. Get comfortable, await help. Keep leg elevated slightly and keep wound clean and dry. Hey, if I HAVE the spot, I'm going to use it. It may save my leg. A bad infection would be difficult to stifle keeping that wound damp & dirty making my way out. TW
 
01/03/2011 05:42PM  
Guess I'd activate spot, and use all medical treatment available. Try to stay calm to lower my heart rate( yeah right) shock I believe does this. Slowly make my way to a busier area. Hope for the best. Hope to God the Grim Reaper isn't packing an axe! Guess you could light an island on fire??
 
01/03/2011 06:23PM  
Stop the bleeding. There is no hope for me and my infatuation with sharp tools. I have had some very bad cuts and always been able to stop the bleeding without visiting a doctor. Trying to move retrograde can do more to a serious gash than not going to the doctor at all.

Stop the bleeding. If it needs to be cleaned, use a temporary tourniquet and clean it quickly with clean water and antiseptic around the edges, but don't get too much antiseptic into the wound.

Wrap it tight enough so the bandage stops soaking and stay put for a couple days. Replace the bandage a couple times a day. Soon you will be able to get it to where you can get back on the water.

That being said, you should always have a well equipped first aid kit. Lots of sterile gauze pads and rolls. Bleeding is the most likely serious mishap to be prepared for.
 
bojibob
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01/03/2011 06:27PM  
quote kanoes: "rob? what time of year is did this occur? (im resisting looking at the posts)"


Not Stated: Assume JULY??
 
PortageKeeper
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01/03/2011 06:28PM  
quote Mad_Angler: "Why are so few people using the Quick Clot?


This seems like a perfect application: urgent need to stop bleeding, fairly open wound (Quick clot doesn't seem suited for internal bleeding or gun shots), minimal concern about scarring, , etc"


I was wondering the same thing since... that's what it's for. I have carried QuickClot on portage clearing trips since before it was on the open market. I had to wait for mine, while they made sure the military had as much as they wanted.

The SPOT is a given, and comes immediately after bleeding is controlled.

I'd assume that "one small QuickClot" means it's one of the new pads that they now sell (mine is the larger packet of powder). On a five inch gash that is now "pouring blood", I'd likely tear the pad open and pour it into the long gash. Otherwise, the pad may not cover a large enough area to stop the blood flow.

Moving around, let alone trying to hike a portage with one leg, is likely to start the bleeding all over again. I'd stay put for long enough to let things settle down. If things went south then, they most certainly would have if I had tried to get out that day, with my leg hanging lower than my heart.

Shhh, I hear a plane!

 
01/03/2011 07:01PM  
knowing my quick clot is the small size id cut it in half, preserving as much integrity as possible and apply it to the wound, wrapping it firmly with shreaded tshirt material and try to stay calm.

now that i have stopped the bleeding (an assumption) i would focus on closing the wound the best i can. id skip the steri strip and suture kit and go right for the duct tape (i always have that along). then cover the closure with a tighly rolled up tshirt and tie off with more shreaded tshirts.

id then carefully work my way back to agnes. paddling south on agnes would be alot less stressful on the wound than tryng to get to kahs and push out from there.

its july, you ARE going to see people on agnes. flag down the first person/group you see to get more assistance. you may need assistance getting out and the good thing is, youll get it....they are canoers. :)

 
01/03/2011 08:11PM  
Before I read any other replies, and without thinking too much to try to simulate being in the situation:
Well, I am glad that I keep my blades sharp. At least I have a clean cut, instead of a raggedy, blunt tear of the flesh and maybe a broken bone.
First concern is whether I have severed and artery. From the description, I will say that there is no spurting. OK. Now I must stop the bleeding. I am conscious, and nothing in the problem indicates that I am in imminent danger of shock. So let’s disinfect and get to work on the cut. Compression first to see if I can stop the bleeding in that way. If not, then the clotting agent. Once I get the bleeding stopped, I must close the wound or bind it up. I don’t think one steristrip is going to close a 5” wound. I don’t think I am going to be able to suture this wound, either. I am going to use whatever bandage I have to cover the wound, then take my bandana ortear a strip of cloth from my pants or shirt and bind it up as tightly as I can. I want to try use compression and binding enough to get me the short distance to the lakeshore.
I am not in a position yet where the SPOT is really going to do me much good. I need to get to Hurlburt, where a float plane can land. I am going to take water, all the first aid gear I have, my day pack, my ditch kit, and something to keep me warm(usually I have a light jacket of some sort in the daypack).
With this stripped down load, I am going to get to Hurlburt and use the SPOT to summon SAR.
Once I summon help, I am going to sit tight. Even if I pass out, SAR will be able to find me on the shore of Hurlburt.
 
01/03/2011 09:58PM  
quote kanoes: "id skip the steri strip and suture kit and go right for the duct tape (i always have that along)."

hahaha. I read the OP earlier today and mulled it over during the day - conclusion here was duct tape too...
 
01/04/2011 08:20AM  
OWIE!

After reading everyone elses responces I find myself agreeing with Kanoes. I would steralize it as much as possible using the first aid kit, try to buttervly the cut closed as good as I could then duct tape the hell out of my leg. Then, it is time to make a bee line for the most direct way out of the BWCA and seek medical help. I think I would stash all non esensials in the bush if I could and return later (or ask the nearest outfitter) to get them.
 
01/04/2011 08:28AM  
Leaves me wondering - where are your first aid kits (or duct tape as the case may be)? Are you already a significant distance from them such that even accessing them is an additional danger? Mine is usually in the day pack and I/we single portage so gear should all be nearby, but I haven't soloed up there and not sure what configuration would be typical during a portage like that. If you double portage when soloing, is the first aid kit always with you somehow?
 
PineKnot
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01/04/2011 09:14AM  
quote BWPaddler: "Leaves me wondering - where are your first aid kits (or duct tape as the case may be)? Are you already a significant distance from them such that even accessing them is an additional danger? Mine is usually in the day pack and I/we single portage so gear should all be nearby, but I haven't soloed up there and not sure what configuration would be typical during a portage like that. If you double portage when soloing, is the first aid kit always with you somehow?"


I have a ditch kit that usually stays with me, could be used for triage, but not much more than that. As a double portager, I usually have my main pack with me on the first portage, which would include extra gauze, medicines, duct tape, etc..and of course, the gol dang AXE!

As for the scenario, after many many choice words, I'd end the tirade with "I'm such a dumb-AXE!!"

This area of Quetico is fairly remote. The portages are quite rugged. May not see anyone for days. For me, continuing on to Woodside or Agnes is less an option than getting back to Hurlburt and thinking about getting to Kahshahpiwi, where you'd find more people, maybe even someone with medical experience.

I'd do things in the following order.

1. Stop the bleeding. Use my belt as loose tourniquet above the knee. With main pack with me, I'd irrigate, compress, and dress the wound as best I can. I'd use duct tape right away and hobble back to the canoe.

2. If my pack is not with me, things just got a lot worse. Probably use my belt and shirt or pants to try stopping the bleeding. Get eaten alive by mosquitos hobbling back to the canoe. Remove the dressing, reirrigate, load in the bacitracin, compress and redress. I'd only use the Quik-Clot if I couldn't stop the bleeding with compression.

3. DON'T PANIC YET!

4. I don't think I'd try to get to Kahs via Trant right away. Traveling right away on this fresh wound through rugged/wet portages will likely do more harm than good.

5. If unable to travel at all, I'd opt for the SPOT 911 right away.

6. If I am able to travel, I'd head to a nearby campsite on Hurlburt, which I'd have marked on my map prior to my trip. Once there, I'd set up the tent, reassess the wound, elevate the leg, eat something, take mortin. Try to sleep, and reassess things come morning.

7. Morning is decision time--do I stay or do I go? Years ago on Poohbah, I had a 3/4-inch fillet knife gash to the bone on my thumb--took 3+ days to completely stop the bleeding and several months to heal. Good thing my son was with me on Poohbah. I don't know about this axe gash. Getting back to PP will be really tough--at least 2 days of travel, lots of rugged portages, mud, etc. If I felt okay, I'd opt to stay on Hurlburt another day and then try to travel to Kahs where I could expect some help and new bandages from other paddlers. If the bleeding burst open and I couldn't control it prior to getting to Kahs, I'd SPOT 911 and hunker down till rescue.

Now, after going through this thought process and not being a medical expert, something in my gut tells me this is a really serious wound. The correct action is probably get back to Hurlburt and SPOT 911 right away.
 
inthewoods
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01/04/2011 09:30AM  
not ever using a spot, how do you know it is working do you get a signal back?

first thing is to stop the bleeding, a cut on the shin, will bleed alot but no artery damage so stopping the bleeding will not be dificult. once stopped and wrapped to prevent infection, there is no choice but to pack up and head out.

i would decide how long it would take me to get out and if i had to lighten the load to get out faster i would cache some stuff and return later to get it.

although not a great situation to be in, not really a come and get me situation either.
 
01/04/2011 09:49AM  
Irrigate, irrigate, irrigate! then stop the bleeding by closing it up as best I can, whether that is from cutting up a clean t-shirt (assuming I have my pack) or using the gauze in my FA kit (i always have one on my lifejacket --and I NOW will never be without it unless I am at camp, haha). use either duct tape or the tape provided in the kit. Then, once the bleeding has stopped, it's time to rest and take some pain meds (once more, in the FA kit --i'm thinkin' the Tylenol variety. nothing to put me to sleep!)

Once the bleeding has stopped, bring whatever I have back to whichever end I have the rest of my gear at... carefully! and then make camp there and wait a day or two to see how I am healing. Irrigation and swapping bandages every 3 hrs or so. Also using the antibiotic cream --only on the closed wound. Infections SUCK! and they tend to get worse if you get anything into an exposed area. If it looks like it is healing, once I can portage I head out the best way I can. This may not be the shortest way, but it would be the direction with the easiest portages. Since I had to CLEAR this portage, and cut myself in the process, I'm thinking that 'back the way I came' may be the best option.

Use the spot ONLY if necessary to call for help (if I can't stop the bleeding, or if an infection sets in!).
 
Beemer01
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01/04/2011 10:09AM  
This is proving to be a very valuable posting with lots of good ideas in terms of what to carry in (I'd never heard of Quick Clot until Rob introduced it) and how to deal with this situation (emergency?).

I'm certainly learning a lot, and hopefully everyone else is as well!

Keep it coming!
 
PineKnot
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01/04/2011 11:22AM  
Any medical folks (docs, nurses, EMTs) out there ready to comment...I'm really curious to hear what you think an injured, non-medical paddler should probably do...
 
01/04/2011 12:34PM  
How much money does it cost to hit the button? Do the rescuers come out in a canoe, float-plane, helicopter, 1969 Dodge Charger ext?

At first thought I would be worried about passing out from blood loss before I hit "the Button".

First I'd apply average to firm pressure with some of the cloth like stuff in the first aid kit. I'd be laying on the ground with leg elevated. Once the cloth is full of blood, keep it there and add another on top. Id keep this up for 10-15 minutes and if the bleeding hasn't stopped I'd hit the button.

I guess the exact placement of the cut and what internals got cut would help. Did you get lucky and just cut the skin and then hit the bone or are is there muscle, tendon ext damage as well?
 
Beemer01
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01/04/2011 02:31PM  
Well - it sounds to me like a very deep penetration gash that either hit or at least exposed the shin bone.

This is not good.
 
Mad_Angler
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01/04/2011 02:45PM  
quote Beemer01: "Well - it sounds to me like a very deep penetration gash that either hit or at least exposed the shin bone.

This is not good."


What is significant about exposing the bone? Would it make a bone infection likely? I hear those can be really bad. How much time would it take for an infection to develop?

I wouldn't expect a fatal amount of blood since there doesn't seem to be much meat on the front of the shin
 
PineKnot
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01/04/2011 04:42PM  
quote Mad_Angler: "
quote Beemer01: "Well - it sounds to me like a very deep penetration gash that either hit or at least exposed the shin bone.

This is not good."


What is significant about exposing the bone? Would it make a bone infection likely? I hear those can be really bad. How much time would it take for an infection to develop?

I wouldn't expect a fatal amount of blood since there doesn't seem to be much meat on the front of the shin"


I don't know if the 5 inch gash could lead to loss of blood and shock. But last August, I had a shallow 1/2 inch cut on the shin that kept opening up and bleeding for a couple days...dopey me should have kept it under a bandage longer than I did. Now a 5-inch gash from an axe? Could be very significant bleeding me thinks. I do know I don't clot as fast as I used to...
 
01/04/2011 05:21PM  
after some more thought....

If this was me I wouldn't have SPOT and I would deal with the bleeding and then get going to closest way out/towards people.

I came across this exact same problem during my solo last summer (tree blocking trail). I went under with the bags and over with the canoe. Of course, around the tree could be another option. I am not opposed to using an axe, use them a lot, but would be very last option.
 
The Lorax
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01/04/2011 06:34PM  
First of all, I'm a big fan of the small bow saw over the axe any day for safety reasons. You'd never find an axe in my gear list.

A five inch gash down to the bone is pretty severe. Too big, I would imagine for the clotting spray to work.

In this case, I would stay calm, stop or at least slow the bleeding, elevate the leg and hit the SPOT.

Sorry....I'm calling it a day where I would usually work through most problems.
 
bojibob
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01/04/2011 06:48PM  
I would like to post a little information on a SPOT for those of you that may or may not be familiar with them.

First there are now 3 models of the SPOT.

1st Generation SPOT, has 3 modes.

"OK" - sends a text or pre-determined email message to those that you designate.

Actual sample message:

Rob Doane
Latitude:48.11734
Longitude:-91.38251
GPS location Date/Time:08/21/2010 15:52:11 EDT

Message:We are OK. The Quetico Journey continues

"HELP" - sends a text or email to those that you designate.

We did not use this on our trip. But I had given emergency contact information to select people advising them that if they got the HELP message to start dialing in case our 911 was not received by SAR.

"911" - sends an emergency message through the GEOS tracking service to local SAR locations. This includes the GPS Location information like the two previous messages.

The second generation SPOT adds a second pre-determined message that is not changeable from the Device. Example: "We have arrived at the pick up point - come get us"

The ultimate SPOT if used with a specific DeLorme GPS has more features than I care to type but you can read about it here:

SPOT


Other Points:

SAR services are not FREE with the purchase of a SPOT, you can buy insurance that will reimburse SAR costs for a nominal fee.

SPOT needs a clear line of sight to the sky to be effective.

The location where you engage a spot is the GPS location that will be sent. I don't recommend you move from that location.

I purposely put the incident in the center of the portage to make you determine where and when you would engage the SPOT if you chose to do so. Also, why did you pick that location?

I do not work for SPOT - I only offer this information to expand your understanding of the device for the purposes of the scenario.

In this scenario you have a 1st Generation SPOT.

 
01/04/2011 08:21PM  
To hear you all tell it:

We must have had pioneers, trappers and loggers bleeding to death all over the north woods a hundred years ago. Accidents happen for sure but come on, axes are a tool that is to be used and respected but not feared. My 2 cents would be take a full size axe, as they tend to be safer. In this case probably poor limbing technique and a dull edge. Ok back to the challenge.
 
01/04/2011 10:03PM  
Some of you have asked about quick clot. As I understand it, it generates a large amount of heat and can destroy a lot of tissue. Knowing that there aren't any major arteries in front of the shin...I would not put on the quick clot. Pressure is all that you likely need. The biggest danger here is infection. You've cut all the way to the bone, infection can be real bad.
 
01/05/2011 08:26AM  
Thanks for that info DrNatus, I know I don't usually give infection the respect it deserves.
 
01/05/2011 09:58AM  
quote drnatus: "Some of you have asked about quick clot. As I understand it, it generates a large amount of heat and can destroy a lot of tissue. Knowing that there aren't any major arteries in front of the shin...I would not put on the quick clot. Pressure is all that you likely need. The biggest danger here is infection. You've cut all the way to the bone, infection can be real bad.
"


Quik Clot New Formula

Like my PLB, I carry this stuff (several packs) hoping I never need to use it. But will not hesitate to if needed.

butthead

PS; "SAR services are not FREE with the purchase of a SPOT, you can buy insurance that will reimburse SAR costs for a nominal fee." bojibob.
charging for SAR
Cost of a rescue is something I would not (want to) consider in any emergency situation. I am in favor of charging in the case of a false alarm.

bh
 
01/05/2011 11:39AM  
This message has had HTML content edited out of it.


Quik Clot New Formula

Like my PLB, I carry this stuff (several packs) hoping I never need to use it. But will not hesitate to if needed.

butthead

bh"

According to the comments under the video, the new formulation of quick clot is not available to the general public, only the old heat producing formulation is. I have no way of verifying this. The video also only used water, which may be an adequate test, but may not...depending on how the quick clot works.

In general, people tend to overestimate amount of blood loss. People panic at the sight of blood. Try this, get some red kool-aid or V8 or something red. Get a teaspoon, fill it and then dump it on the counter. Imagine that it is blood- looks like a heck of a lot of blood doesn't it? Then ask someone else how much fluid is there. This is not a very accurate scenario, but it may provide insight into how the average person perceives fluid amount.

Back to this situation. The cut is on the pretibial region- no large blood vessels in that area. Pressure, pressure, pressure. The biggest problem with applying pressure is we tend to lift the dressing and look to see if it is still bleeding- don't do that. Hold it without looking for 20-30 minutes, then do it again. If you are holding significant pressure and blood is still coming through and quickly soaking the bandage...it MAY be time to reach for the quick clot.

Bottom line for the average bwca paddler- do not jump to use quick clot, use it appropriately.
 
01/05/2011 03:40PM  
I am one of those people who don't care for blood --especially my own! I was told a long time ago that it always looks worse than it is, so your scenario with the kool-aid/V8 strikes home with me. Heck, just think about what happens when you drop a small glass of water on the kitchen floor. It's EVERYWHERE! and there's what, maybe 1/2 a cup of fluid? but it seems to cover quite a bit of space..

just my 2 cents on this subject.

anyways, i'm one of those people who always has to remember that, or else I'd have serious problems when I HAD a bleeding problem. (dizziness etc... I'm BAD if I actually think about it.)
 
01/05/2011 04:00PM  
My biggest worry is that a cowboy comes by and is packing a six shooter.
 
troutbreath
distinguished member (182)distinguished memberdistinguished memberdistinguished member
  
01/05/2011 05:11PM  
This is a fine predicament!

My first course of action would be to stop the bleeding. I would apply the Quick Clot to the wound. I expect that the Quick Clot would not be enough to completely stop the bleeding but that it, along with firm pressure and the remainder of the kit, would stop the bleeding. I would secure the Quick Clot and bandages with my bandana.

Knowing that Kahshahpiwi is an entry point lake (and assuming that was the direction from which I traveled) I would begin to head back there via Trout. Taking my time and not pushing my pace, I would work my way back resting more frequently than I might feel necessary.

If at any point I felt that I could not continue, I would then use the SPOT device to signal for assistance.
 
kbalser
member (30)member
  
01/06/2011 08:39AM  
I'm going to reply to this before looking at the other answers. Of course the first thing is to treat the wound. Use the antibiotic, sew up the gash, then wrap it up to try to keep it as clean as possible. You must control the bleeding, then do whatever you can to minimize the risk of infection. I can only hope that I would be able to sew my own leg when faced with this situation.
Next on the list, travel to wherever you think you have the best chance of finding another person or persons must be attempted. Still, you must not bleed too much. You might be more able to paddle than walk (portage). Finding some help before infection sets in may make all the difference. The thought of something like this is part of why I never take an axe on my trips.
 
520eek
distinguished member(1384)distinguished memberdistinguished memberdistinguished memberdistinguished member
  
01/06/2011 10:19PM  
quote suko: "Stop the bleeding. There is no hope for me and my infatuation with sharp tools. I have had some very bad cuts and always been able to stop the bleeding without visiting a doctor. Trying to move retrograde can do more to a serious gash than not going to the doctor at all.


Stop the bleeding. If it needs to be cleaned, use a temporary tourniquet and clean it quickly with clean water and antiseptic around the edges, but don't get too much antiseptic into the wound.


Wrap it tight enough so the bandage stops soaking and stay put for a couple days. Replace the bandage a couple times a day. Soon you will be able to get it to where you can get back on the water.


That being said, you should always have a well equipped first aid kit. Lots of sterile gauze pads and rolls. Bleeding is the most likely serious mishap to be prepared for. "
nice cut on finger...from that implement you are holding???
 
01/07/2011 11:29AM  
In this situation, the cost of SAR would not even cross my mind. Really, how much is your leg worth to you?
I know there are lots of folks who are not doing so well in the money dept these days, but money is only money. Sooner or later, you'll be able to make more of that. I cannot make more legs.

These excercises are superb for getting us thinking about these issues now, while we are home and happy. The situation challenge says I have a SPOT. This is excatly why I bring that equipment. To summon the right help in case of an emergency. When I am in trouble I really need to be honest with myself and understand my limitations. I am a city dweller out in the woods for fun. I am not a woodsman or a fur trapper from the 1700's.

Now I have read the posts of others and I missed the possibility that my bone may break easier after being chopped. But I still think I try to get Hurlburt. I would reconsider what items I bring with me. The sleeping bag is a great idea. And some form of shelter, tarp or tent. Getting a fire going is a great idea, but I would do so once I got to the shore of a larger body of water, again to allow a float plane and SAR to find me.

drnatus, thanks for your expert contributions. I have never used Quik Clot and don't know anything about it. I think I need to take another first aid course. Splints, compression, tourniquets, and sutures I have some practice with, but I sure wouldn't want to try to canoe my out with a cut this large.
 
01/07/2011 01:30PM  
quote BWPaddler: "Leaves me wondering - where are your first aid kits (or duct tape as the case may be)? Are you already a significant distance from them such that even accessing them is an additional danger? Mine is usually in the day pack and I/we single portage so gear should all be nearby, but I haven't soloed up there and not sure what configuration would be typical during a portage like that. If you double portage when soloing, is the first aid kit always with you somehow?"


Duct tape - I keep several feet of duct tape wrapped around each and every water bottle. It is always there and we never forget all our water bottles. Also, the water bottles are always distributed evenly among all my trippers, so everyone always has duct tape.

FA Kit - We have one big FA kit with the main pack and a small FA kit per person. I wear a fanny pack while portaging that has the FA kit, a pocket knife, a bandana, and sometimes a granola bar or candy.

Compass and whistle on a lanyard around my neck.

(My teenagers have no end of fun calling me OLD MAN and URKEL and whatnot because I wear the fanny pack. :) )
 
airmorse
distinguished member(3420)distinguished memberdistinguished memberdistinguished memberdistinguished member
  
01/07/2011 01:47PM  
I would agree with what most have said about this particular situation.

Stop the bleeding.

Attempt this first with compression and elevation and then if that doesn't work then use quick clot. After the blood has stopped dress the wound. After that take a break and access the situation. Be prepared to spend the night (depends on what time of the day this took place). Keep hydrated and properly nourished.

If you can't stop the bleeding and IF you are going to hit the 911 feature on the Spot Locator I will say this.

After having first had experience with a group that ran into problems and hit the 911 button I would say this.

MAKE SURE YOU UNDERSTAND HOW IT WORKS. MAKE SURE YOU PROGRAM THE PHONE NUMBERS THAT ARE GOING TO GET YOU THE FASTEST HELP POSSIBLE...IT'S AN EMERGENCY FOR GOSH SAKE. DON'T PROGRAM IT TO CALL FAMILY OR FRIENDS BACK HOME...THEY MAY OR MAY NOT BE HOME OR NOT ABLE TO ANSWER THE PHONE AT THE TIME OF THE CALL.

After hitting the 911 button I would sit back and wait and start a fire to stay warm. Don't expect John Wayne and the Calvary to rescue you by the end of the day.
 
solotrek
distinguished member(992)distinguished memberdistinguished memberdistinguished memberdistinguished member
  
01/07/2011 02:06PM  
quote butthead: "
quote drnatus: "Some of you have asked about quick clot. As I understand it, it generates a large amount of heat and can destroy a lot of tissue. Knowing that there aren't any major arteries in front of the shin...I would not put on the quick clot. Pressure is all that you likely need. The biggest danger here is infection. You've cut all the way to the bone, infection can be real bad.
"



Quik Clot New Formula


Like my PLB, I carry this stuff (several packs) hoping I never need to use it. But will not hesitate to if needed.


butthead

PS; "SAR services are not FREE with the purchase of a SPOT, you can buy insurance that will reimburse SAR costs for a nominal fee." bojibob.
charging for SAR
Cost of a rescue is something I would not (want to) consider in any emergency situation. I am in favor of charging in the case of a false alarm.

bh"

Did anyone who saw the QuikClot video pick up on the name of the top of the line treatment? I couldn't quit understand what he said. Thanks!
 
01/07/2011 02:30PM  
You have a 5" gash in your leg and the bone is visible...don't be a he-man and try to get out yourself...try to stop/slow the blood flow, hit the rescue button on the SPOT, and stay put until you're rescued. Walking on that is going to be very painful and will only keep the wound open and the blood flowing out. The only moving that should be done is possibly moving to an area where the SPOT will work or getting water or something like that.
 
01/07/2011 03:23PM  
drop everything right then and there take your shirt an apply pressure. Wait 20-30 minutes before looking. If blood loss has stopped wrap up leg and hobble back to gear. If blood loss has not stopped assume you nicked an artery- use spot.

If blood loss has stopped and you are back at your gear stop to access the wound. See if it is clean.. if it is not wash it out with purified water, if it is apply lots of first aid ointment then wrap wound.. use skin tape if needer get in canoe and see if you can make it out. If it starts bleeding again or the pain is unmanageable use spot.

just wanted to add, if I didn't have a spot I always carry my whistle. I would blow that 3 times in a row every 10 minutes. That sound can go really far.
 
01/07/2011 03:26PM  
quote nojobro: "You have a 5" gash in your leg and the bone is visible...don't be a he-man and try to get out yourself...try to stop/slow the blood flow, hit the rescue button on the SPOT, and stay put until you're rescued. Walking on that is going to be very painful and will only keep the wound open and the blood flowing out. The only moving that should be done is possibly moving to an area where the SPOT will work or getting water or something like that."

I'm with her!!!

I would try to be as visable as possible after I did the compression and hit the SPOT. Elevate the leg and try to maintain hydration and warmth while waiting for rescue.

If no rescue came over a 4-6 hour period of time I would start to get worried about infection. If the and bleeding had stopped -I think I would attempt to get as far out as I could. Prepping the leg with a good compression- maybe with duct tape

I'm new to this game, but I am assuming I can't just say:
I would NEVER carry a "razor sharp ax" and if per chance I did- I would NEVER randomly swing it on a portage- most especially if I was soloing!!! But that's what I really want to say....
 
01/07/2011 04:46PM  
"QuikClot® Home™ is based on the same formula that helps the military, EMS, police and fire departments save lives."

From their website.
 
Beemer01
Moderator
  
01/07/2011 05:06PM  
Ripple - always carry razor sharp tools and implements.... just know how to use them safely.
 
01/07/2011 05:07PM  
WWKCD?
 
01/07/2011 05:08PM  
quote Beemer01: "Ripple - always carry razor sharp tools and implements.... just know how to use them safely."


I very high quality, razor sharp - 6" knife is always with me.
Kept in its leather pouch on my belt- unless carefully brought out. Not wielded randomly. Have yet to find a need for something bigger.

I think guys tend to make the mistake with tools that bigger is better.
 
ozarkpaddler
distinguished member(5163)distinguished memberdistinguished memberdistinguished memberdistinguished memberpower member
  
01/07/2011 05:14PM  
quote PineKnot: "Any medical folks (docs, nurses, EMTs) out there ready to comment...I'm really curious to hear what you think an injured, non-medical paddler should probably do...
"

Well, I've been a R.N. almost 24 years now, a few in E.R. IMHO, without seeing the wound, cleaning and keeping it clean and dry is the most important aspect. I keep some absorbable suture stuff in my 1st aid kit if I have bleeding that just won't stop, but this is not a wound you want to "Close" and seal in the bacteria, dirt, et al that was introduced when the axe penetrated. TW

 
PineKnot
distinguished member(2021)distinguished memberdistinguished memberdistinguished memberdistinguished member
  
01/07/2011 05:25PM  
quote ozarkpaddler: "
quote PineKnot: "Any medical folks (docs, nurses, EMTs) out there ready to comment...I'm really curious to hear what you think an injured, non-medical paddler should probably do...
"

Well, I've been a R.N. almost 24 years now, a few in E.R. IMHO, without seeing the wound, cleaning and keeping it clean and dry is the most important aspect. I keep some absorbable suture stuff in my 1st aid kit if I have bleeding that just won't stop, but this is not a wound you want to "Close" and seal in the bacteria, dirt, et al that was introduced when the axe penetrated. TW"


Thx, op. Does that mean you shouldn't bandage it up after stopping the bleeding? And if so, wouldn't that make traveling out through the mud and water the wrong thing to do?
 
ozarkpaddler
distinguished member(5163)distinguished memberdistinguished memberdistinguished memberdistinguished memberpower member
  
01/07/2011 08:05PM  
quote ozarkpaddler: "Never used a SPOT before, but would be a good time!
Would get my dish soap out along with lots of clean water (boiling if I had to) and irrigate the wound as much as I could stand. Unless I damaged an artery, I wouldn't worry about the stifling the bleeding for several minutes. Antibiotic ointment applied, I would dress it with whatever clean bandaging I had. Get comfortable, await help. Keep leg elevated slightly and keep wound clean and dry. Hey, if I HAVE the spot, I'm going to use it. It may save my leg. A bad infection would be difficult to stifle keeping that wound damp & dirty making my way out. TW"


PineKnot, this was my original post. Again, it's my OPINION, and what I would do based on my experience. I would personally put emphasis on cleansing and sterile 4x4's and wrap it with Kling (both are in my kit). IF I had to make my way out, I would try my best to keep it dry and clean. If dressings got wet, dirty, saturated, I would change and use clean clothing if I had to to keep wound clean and dry. I'd not be "Wet footing" it at the portage landings!

As for the "Quick Clot," IMHO, it would depend on how much and how long. Unless you're on anticoagulent therapy or have liver or bleeding disorders, I doubt you're going to lose that much blood if it's not arterial. I think cleaning thoroughly, dressing, then elevating a bit while you rest should stem the flow adequately. I would be very careful about using anything that could seal bacteria and/or foreign bodies into the wound! TW
 
01/07/2011 08:17PM  
ok, a general question now. how soon can an infection begin? (on an injury like this one)
 
PineKnot
distinguished member(2021)distinguished memberdistinguished memberdistinguished memberdistinguished member
  
01/07/2011 08:20PM  
Thx, op. Along with kanoes general question re how much time before infection, would you also recommend a dressing of dry clean bandages applied looser than say a dry clean dressing tightly wrapped, for example, with duct tape?
 
01/07/2011 08:59PM  
quote kanoes: "ok, a general question now. how soon can an infection begin? (on an injury like this one)"


A lot depends on who the cut is on. For your average bwca paddler, I doubt you'd have signs of infection any earlier than 12-24 hours, and likely later than that. If you are an end stage renal failure diabetic on chemotherapy, with AIDS....then not so long.

So, first I'd hold pressure on it. Push SPOT. If the bleeding has essentially stopped- not soaking through bandages, I'd look at it after the 20-30 minutes. I would then try to irrigate the crap out of it, using whatever water I had....ASSUMING....that I had relatively easy access to more water to be filtered or boiled. If I couldn't get to water, I'd save the water I had to drink. Then I would place a tight, not strangulating, bandage. Any signs of bleeding, then more pressure is needed.

To be honest, if it was me...alone...I doubt that by hitting the shin area I'd have caused structural damage to the bone (unless I had to pull the stuck ax out of the bone). I'd try to walk on it or make a splint from nearby sticks and duct tape. I'd probably even do that before hitting the SPOT, but I am pig headed and think I'd be able to make it out and I don't recommend this for you, the reader.

I think that the bleeding will be more easily stopped than most people think, even with a wound of 5 inches....and this mainly has to do with location.

Now, if we are talking femoral artery...hit the SPOT, grab the quick clot, say your act of contrition.....simultaneously!
 
01/07/2011 09:23PM  
good stuff dave. thanks.
 
01/08/2011 12:42AM  
quote solotrek: "
quote butthead: "
quote drnatus: "Some of you have asked about quick clot. As I understand it, it generates a large amount of heat and can destroy a lot of tissue. Knowing that there aren't any major arteries in front of the shin...I would not put on the quick clot. Pressure is all that you likely need. The biggest danger here is infection. You've cut all the way to the bone, infection can be real bad.
"




Quik Clot New Formula



Like my PLB, I carry this stuff (several packs) hoping I never need to use it. But will not hesitate to if needed.



butthead


PS; "SAR services are not FREE with the purchase of a SPOT, you can buy insurance that will reimburse SAR costs for a nominal fee." bojibob.
charging for SAR
Cost of a rescue is something I would not (want to) consider in any emergency situation. I am in favor of charging in the case of a false alarm.


bh"

Did anyone who saw the QuikClot video pick up on the name of the top of the line treatment? I couldn't quit understand what he said. Thanks!"
HemCon

I also think it is wise to diferentiate the retail first aid products from pro first responder products.
"Quik Clot" has a variety of hemostatic products ranging from EMT use to home use (such as nose bleed ). Other brands are also available, BleedArrest .

butthead
 
01/09/2011 11:12PM  
Can someone talk about shock and/or panic? I'm pretty level headed and I don't think I would panic... usually a logical thinker, etc. But what about the various kinds of shock one might experience in this case?
 
solotrek
distinguished member(992)distinguished memberdistinguished memberdistinguished memberdistinguished member
  
01/10/2011 08:05AM  
quote butthead: "
quote solotrek: "
quote butthead: "
quote drnatus: "Some of you have asked about quick clot. As I understand it, it generates a large amount of heat and can destroy a lot of tissue. Knowing that there aren't any major arteries in front of the shin...I would not put on the quick clot. Pressure is all that you likely need. The biggest danger here is infection. You've cut all the way to the bone, infection can be real bad.
"




Quik Clot New Formula



Like my PLB, I carry this stuff (several packs) hoping I never need to use it. But will not hesitate to if needed.




butthead



PS; "SAR services are not FREE with the purchase of a SPOT, you can buy insurance that will reimburse SAR costs for a nominal fee." bojibob.
charging for SAR
Cost of a rescue is something I would not (want to) consider in any emergency situation. I am in favor of charging in the case of a false alarm.



bh"

Did anyone who saw the QuikClot video pick up on the name of the top of the line treatment? I couldn't quit understand what he said. Thanks!"
HemCon


I also think it is wise to diferentiate the retail first aid products from pro first responder products.
"Quik Clot" has a variety of hemostatic products ranging from EMT use to home use (such as nose bleed ). Other brands are also available, BleedArrest .


butthead"

Thanks, BH!!
 
01/10/2011 09:43AM  
quote BWPaddler: "Can someone talk about shock and/or panic? I'm pretty level headed and I don't think I would panic... usually a logical thinker, etc. But what about the various kinds of shock one might experience in this case?"


I second that, because I AM one of "those people" who would like more info about shock. I'm not a big blood guy --especially his own! I'm OK around other people bleeding, but not me, so it would be helpful. Call me squeemish!
 
deadeye
member (9)member
  
01/10/2011 03:06PM  
I always pack quick clot and a staple kit. I would use the quick clot then staple it shut. Make a splint to add support to the injured leg. Hit the spot and start moving with just enough supplies to get out. Id rather take my chances trying to get out than sitting around and dieing in the bush.
 
01/10/2011 05:22PM  
quote Amok: "
quote BWPaddler: "Can someone talk about shock and/or panic? I'm pretty level headed and I don't think I would panic... usually a logical thinker, etc. But what about the various kinds of shock one might experience in this case?"



I second that, because I AM one of "those people" who would like more info about shock. I'm not a big blood guy --especially his own! I'm OK around other people bleeding, but not me, so it would be helpful. Call me squeemish!"

AMOK - This ones for you...
:)

My Own Blood
 
Beaverjack
distinguished member(1655)distinguished memberdistinguished memberdistinguished memberdistinguished member
  
01/13/2011 11:14AM  
This scenario actually happened to me, on a less-wild scale 20 years ago. I bandaged myself and walked back to my truck. Bottom line is that you do what you can. In the hypothetical case, if I was able to stop the bleeding and walk, I'd probably stash most of my gear and head out. If the bleeding wouldn't stop or I couldn't cowboy-up and walk, I'd hit ths SPOT (which I don't have). Infection would not be a primary concern because I will get to help in plenty of time either way. Just stop the bleeding and keep the wound reasonably clean and elevated. Hydrate profusely. I happen to own that very axe, and it will skin a fish, but I've learned a thing or two in the last 20 years. Not surprising that the real incident of this nature happened to a young fellow.
 
01/15/2011 11:33AM  
Interesting beaverjack - thanks for sharing your real life experience.
 
Goober
  
03/13/2011 10:59AM  
OK, I have been lurking on this forum for quite some time quietly. Now I will throw my 2 cents in, from the perspective of a 7 year Firefighter/Paramedic with both urban and rural experience, as well as lots of personal wilderness experience. I will even post 2 ways, first how I would personally respond, and 2nd how I would recommend the average paddler respond.

1. I would cleanse the would with hopefully filtered water, then compression bandage with available materials(gauze and tape or t-shirt, doesn't matter much at this point). Meanwhile start some water to boiling. If bleeding is controlled with first bandage, great. Leave bandage there for now. Once water boils, let cool enough to apply, clean the wound out, and re-dress with cleanest stuff available.

If bleeding isn't controlled with first bandage, apply a 2nd one over the top, DO NOT remove the 1st bandage. Apply firm direct pressure, lay down, elevate leg on canoe or whatever available. If after 15 minutes still bleeding profusely, I would then quick clot. Again, elevate the leg and let the quick clot work for 30 minutes or so before picking up and moving on. I would also dress over the wound after quick clot to attempt to keep clean. Proceed home. If I was unable to stop bleeding with quick clot, then I would summon help and start sewing.

I have to go now, I will follow up more later!
 
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