If you have a good relationship with your primary care physician- they may be able to prescribe you a prophylactic antibiotic to have on hand for your back country trip- that way if you do injure yourself, you can begin treatment before symptoms of the infection begin.

Great article, thank you. I have had great success with just puncturing a small hole in the top of a disposable water bottle, like the one shown, and squeeze the bottle to spray the wound. Makes a great pressure wash and no need for a syringe. You don't get the clever irrigation shield though.

That works as well! And you don't destroy your bottle in the process.
The problem I've found, after teaching this stuff for years, is that punching holes in the lid is a problem that vexes a significant number of students. I've seen people stab themselves, crack the lid, etc. So unless someone has a good awl, or metal spike they can heat, etc. I tend to leave that as an in person demonstration skill.
But still, great for pointing it out!

We have similar backgrounds:  I rolled with 1/8 in my Iraq days, became a paramedic while in nursing school and worked CVICU for freaking ever...ugh!  

I love the idea of cutting the top of the water bottle off for use as a splash shield.  Good trick!  I will be stealing that!  I am sure to carry iodine _swabs_ to clean wounds the best I can.  I carried wipes and they seem to dry out much faster than the swabs.  Still though, change out the swabs twice a year to prevent their drying out.

Hooyah!

S/F DevilDoc

Doc,  glad to have you back here.  I really appreciate your fundamental approach to first aid and trauma treatment. I'm always looking forward to your next article.

I'm glad that you mention about cleanliness vs. sterility.  I've seen a lot of really well known folks who should know better advocate that since you can't have sterile in the field then you shouldn't bother with cleanliness either and be fine with duct tape and a "used" bandanna.  That approach is simply WRONG and dangerous.  There's no reason a person can't go into the field with some 4X4's or compressed gauze, an irrigating syringe, gloves, ace-style wrap, suture strips, and a roll of proper med tape.  You can put the whole kit together for about $10 (if you buy generic elastic wraps) and vacuum seal and you're good to go with a kit that's about 4 ounces.

I cringe when folks mention duct tape and first aid together.  It will work if that's all you have, but good luck trying to remove it to check a wound on your 2 day hike back to civilization without destroying the bandage and most folks experience severe irritation from the adhesive when applied directly to the skin.

One thing that I carry is some iodine wipes/prep pads.  I'll put a couple of these in my water to make an irrigation solution about the same color as light tea and statistically is better than plain water for wound irrigation but that's up for debate.  I assume that I could also use these to chemically treat drinking water in an emergency, but I sure wouldn't want to live with the taste.

vettepilot427  That is a good tip about the iodine wipes--I may steal that.  Just have to inspect every so often to make sure they haven't dried out.

Be my guest, I got the tip from a WFR instructor. I find about 3 pads per liter is about the right dilution, that's using the cheap ones. Don't mix in your good water bottle because it stains and you'll never get the taste out. Disposable bottles or a collapsible bottle just for the purpose is your best bet. Also make sure that you don't get it on any clothing that you don't want stained.
I use this at work because I'm the onsite first responder and I have to treat cuts regularly (we work with sheet metal). I bought a box of zip top packaging bags and I make up "cut kits". Each kit has 4X4's, non-stick pads, suture strips, benzoin swabs, alcohol pads, iodine prep pads, and a pair of gloves. Basically, everything that I need to treat a minor cut or prep for a trip to the urgent care for stitches. I keep the irrigation syringes and first aid tape (I like the Durapore brand) in my main bag.
For about $20, I can buy enough supplies to make up a dozen or more kits.

For small cuts, I've always considered it good to let it bleed to wash out and dirt that might have gotten into the wound? After all, my blood is more sterile than anything I'm likely to have with me.

I've also been told that in combat situations where clean water is not available, urine will serve as substitute. Never tried that though.

Good ideas or not?

InklingBooks

For the love of all that is holy, please do not pee in wounds.  Urine is not really "sterile".  There are trace amounts of bacteria in it, and it can pick up bacteria when leaving the urethra.  Not to mention the pH of urine, especially in someone in an austere environment, is going to be really, really poor for tissue healing.  Waste materials, when left in contact with the skin, break tissue down pretty rapidly.

Blood with sufficient pressure to wash out grunge is probably something that needs controlled and controlled pretty rapidly... That said letting a little bit run out is a million times better than urine.  :)

Awesome post. I always enjoy reading the medical articles posted here on ITS.

Fantastic article! Thanks for the imaginative skills practice tips.