Digest #4729 Thu Dec 30 18:26:45 1993 The Cavers Mailing List Digest ---------------------------------------------------------------------- Date: Wed, 29 Dec 93 14:48:47 GMT From: Wookey Subject: First aid kits I don't know that a caving first aid kit could be a successful commercial concept, but you never know. My experience of first aid kits is those we use on our Austrian expeditions. This is deep caving in high Alpine Karst with potentially very long periods of self-help required before rescuers could get there. However it seems that this is also the case for much of the wilder parts of the US, and is the general principle that makes caving first aid different from normal first aid practice (Where the books always tell you to keep doing (for example) artificial respiration 'until the ambulance arrives'!) I have also tried taking a commercial mountain first aid pack caving. This is the 'Gregson Pack' - a generally well thought-out kit which comes in mountain and kayaking options. I don't know if it just a UK thing. It is 'dayglo' green so it can quickly be found in your pack. It is a sort of unfolding PVC package with various transparent ziplock pockets on the inside with built-in plastisized pages of first aid info pointing you to the appropriate pockets according to the current disaster (burn, cut, fracture, pain). The idea is that no time is wasted fumbling about in your kit - you go straight to the spot. You can, of course change the things in the pockets according to your personal requirements, and the pack is designed to expand a little beyond its supplied size. This is a good concept, and works very well on the hill. It is somewhat waterproof - enough for on the hill, but useless for wet caving. Everything came out soaked when I tried it. The pack is about the right size and weight, but if put in a waterproof container would be too bulky to be convenient. For a caving first-aid kit to be any use it has to be small & light enough for people to take caving _every trip_. This puts severe restrictions on size and weight, especially as it also has to be water- and grit-proof. Very few UK cavers carry first aid kits normally, most just having a survival bag & mars-bar (Cos they fit in a pocket). This works quite well as by far the highest significant risk on most trips is hypothermia. Our expedition kits are assembled into the smallest size of BDH container (strong plastic cylindrical containers about 6inches long and 2.5" diameter). It is very tough to get everything in, and once unpacked you need perseverance to get it all back in - but this isn't really a problem. The idea is to include things which will allow someone to get themselves out if possible (bandages, painkillers, sutures) and a few useful bits and bobs for minor accidents. Things included are: * paracetamol/asprin: to help after minor accidents/illness. * compressed triangular bandage: useful for all strapping/minor fractures * butterfly sutures: hold a cut together. * crepe bandage: cover cuts, strap limbs, ankles. * Knife blade(wrapped): the most used item in the kit - cuts ropes, clothes, bandages, carbide pipes - included in case no-one is carrying a knife anyway * antiseptic fluid/paste: for cuts - the Austrian mud is particularly unpleasant in this respect. * anti-diaorhea (SP?) pills - grim being caught short underground (and for those who follow!) * Temgesic: strong (morphine family) painkiller for self help/evacuation after limb fractures. This is a controlled substance and so couldn't go in a commercial kit, but it is worth considering for expedition use. You need people to self-administer it (for legal reasons), and not use it when there is any head on chest injury (as it depreses breathing). It is nevertheless the easiest to administer (under the tongue), and safest of the strong painkillers. You also have to find a source - we get it through the university clinic expeditions' supply. * lint-free dressing: scrapes/burns (inclusion of this is debatable) * safety pins & zinc oxide tape: holding things together. * notepaper and pencil: very useful to write down time of accident, and observations of symptoms etc if someone has to go out for help. I think that is the lot. We haven't actually had any underground accidents in the last 4 years (since these were instigated) so I can't really report on their efficacy, but the knife blades have been very useful, and the paracetemol has been occasionally raided. For a general kit it would be worth including a survival bag, and the useabilty must be considered carefully. Plastisized intsructions/reminders are a really good idea as the user may not be a 1st aid expert (and probably did a course about 10 years ago). For serious accidents at least as important as the 1st aid available is the ability of someone to assess the casualty and make (often difficult) descisions about trying self-rescue or waiting for help. The rescuers will thank you if you can give intelligent info on the casualty's responses and symptoms. Remember this, and take some time to examine them before hurtling off to the outside world. As to doug's specific questions: * price: not more than 15 quid (25 dollars?) * container: this is the hardest bit to get right. It must be caveproof, but including instructions and the gregson pack concept of organisation would be good features. Perhaps a sort of lighweight roll containing pockets and stuffed into a caveproof container? what do those who have rescue experience from the rescuer side think about what is useful/useless? wook ------------------------------ Date: Thu, 30 Dec 93 11:02:49 EST From: Morrie Gasser Subject: Re: Caving First Aid Kit I've never found a first aid kit suitable for caving, so I'd definitely welcome one that fit the need for short (under 24 hour) trips. My goal is to take care of the minor things, not serious injures (except maybe drugs to help the pain). Packaging: 1. Physically small. This is probably my most important packaging criterion. 2. Waterproof. However the whole thing doesn't need to be in a waterproof container. It might be just as or more effective to have individual items in waterproof packets and leave unprotected naturally waterproof things, like tape or tubes of goop. The idea is to save space. If waterproofing adds considerably to the size, then I'd rather have two different kits, one for wet caves and one for dry caves. 3. Protected. It shouldn't contain anything that is damaged by mild crushing, say with the weight of a person sitting on it. The waterproofness shouldn't be compromised by crushing. 4. Flexible. A soft pouch or nylon bag is preferable to a hard case. It should deform to fit the available space in a pack. It should be of a bright flourescent color. 5. Weight. Don't care--I'd rather add a pound of weight than an extra cubic inch. How tightly is it possible to pack gauze? Contents: Not being very well trained in first aid, I can't authoritatively comment on the medical contents, but it should take care of minor scrapes, bruises, and cuts, headaches, pain, and short term infection. Tape and gauze should be hand-tearable and not require scissors. What makes a caving first aid kit special is that we can economize on space by having only enough stuff for short term aid, until we exit the cave or help arrives. Six aspirin, for example, should be plenty. A tiny 1/4-oz tube of anesthetic/antiseptic stuff might be enough. We only need one change of bandage or gauze for an injury. Price: I'll pay anything reasonable that fits my requirements. If I did a lot of longer (multi-day) expeditions, I might want to invest in a bigger, more expensive kit. One problem I've had with first aid kits is replacing things that get used. A minimalist kit as I suggested becomes worthless if each used item isn't replaced right away. If the kit contains special items, perhaps in wierd packages that aren't available in an average drugstore, then it might be nice to have a backup supply kit of items that you can take with you in your car. Another option is the ability to order separately the components. ------------------------------