First Aid (Check Your Gear!!!)

Max R wrote: However, compressions will maintain perfusion and buy you time. Miles and miles out in the alpine? Likely futile. 

Except maybe not futile for lightning strikes

Owen River wrote: I really like the look of the NuMask. Although I wonder how effective it is as it doesn't fully cover the mouth or nose. Do you have experience using one of these? it could be a great lightweight addition for certain activities.

...

I've been hesitant to add any sorts of a hemostatic agent (like quick clot) to my kits because it has such a short timeframe before it expires, but in the right circumstances could be even better than the gauze. Does anyone else keep a quick clot in their kits?

The NuMask completely seals the mouth.  You need to manually seal the nose (either by pinching or with nose clips).  But, if you're in the normally taught CPR position, your hands are there anyways.  It's only a bit of a pain if you're trying to open the airway with a jaw thrust.

I have never kept quick clot in my kit.  I wouldn't consider it unless I was worried I'd see a lot of center body mass trauma - any external bleeding on the limbs should be controllable with WADP.  But at that point for center body mass trauma/bleeds, you'd also need packing material, so you've definitely used up whatever gauze you might have had, and you're probably considering using clean shirts too to stop the bleed...  I think the jury is still out on whether clotting agents are actually effective.

wonderwoman wrote:

We covered this in my WFR class, but they said that the only exception was in the case of lightning strike victims.  If someone is struck by lightning, CPR can make a difference in reviving them.  Not so much in other circumstances.

Regardless, I hope that I am never in an situation where I need to do CPR!

I thought drowning was the other case that CPR/rescue breathing was effective.  At least for drowning victims that aren't also hypothermic and weren't in for too long.

Tradiban wrote: Mouth to mouth is out btw, just chest compressions now.

I just re-cert'ed my CPR today, and rescue breaths are absolutely still part of Amer. Red Cross protocol.

Having spent 20 years on backcountry adventures I consider Benadryl to be the most important piece of a first aid kit.  It can't be improvised as many other things can.

Tradiban wrote: Mouth to mouth is out btw, just chest compressions now.

You have been mislead or are confused. 

Dan Daugherty wrote:

Health care provider or community CPR? We stopped having EMT's do ventilations without an advanced airway almost a decade ago but I've since retired so the AHA may have added it back.

At least at the WFR level we still do ventilation as long as there is an airway present.  Obviously, if there's no airway, no point in doing rescue breathing, and should do what you can to establish airway (including chest compressions).  Protocol is 30 compressions, 2 breaths, appr 100 compressions per minute, 10-20 breaths per minute.  I'm doing my recert this weekend, but IIRC the preference in compressions first, then breaths, but breaths first on a kid/infant not breathing unless you saw the kid stop breathing.

Dakota from North Dakota wrote:

You have been mislead or are confused. 

Change from the AHA was in 2008 and was controversial, many providers refused to change despite the evidence, and still do (see Gunkie Mike's post). 

Mouth to mouth is ineffective and deter regular people from doing cpr because they are afraid of disease.

also depends on the hotness factor.
If she's hot enough, yes, I'll go ahead and sacrifice myself for some mouth to mouth.

Tradiban wrote:

Chest compressions are uneffective and deter regular people from doing cpr because they are afraid of disease.

Wtf are you talking about. 

Tradiban wrote:

Google it, Einstein.

You’re arguing against doing chest compressions... 

Max R wrote:

You’re arguing against doing chest compressions... 

Lol, sorry, meant to say mouth to mouth, updated post. My bad   

Tradiban wrote:

Change from the AHA was in 2008 and was controversial, many providers refused to change despite the evidence, and still do (see Gunkie Mike's post). 

Mouth to mouth is ineffective and deter regular people from doing cpr because they are afraid of disease.

AHA changes every two years. But I see that you googled it and found a headline from 2008 so thanks for trying to double check yourself. I teach the AHA course and yes, literal mouth to mouth is out for obvious reasons (I thought you said ventilations but maybe you went back and changed that as well, if not my bad) Either way, it’s not JUST compressions as pocket mask and other ventilation options are still an important part of the curriculum. I apologize if I came off as rude but your statement was inaccurate and folks online are just too ready to believe anything they read (looking at you Alex Lee). 

Not that any of it really matters all that much though honestly. Being intimately familiar with save rates of ALS CPR in an urban environment (see hospitals nearby) I ask my partners not to bother working me. It’d be bad enough already without our last interaction being them cracking my ribs until I bleed out from a traumatic climbing injury. If my pupils are different sizes just tell’m I died on impact! 

Rescue breathing is still absolutely a part of AHA Provider BLS. I would throw an epinephrine autoinjector in there before I added opiates. 

Dan Daugherty wrote:

Health care provider or community CPR? We stopped having EMT's do ventilations without an advanced airway almost a decade ago but I've since retired so the AHA may have added it back.

You’re talking about prehospital healthcare, which means unless you learned it yesterday it’s outdated!  Lol

Jokes aside, Idk who “we” is but every system has different protocols. In the Front Range, for example, most EMTs very much do ventilations in CPR and can even establish superglotic airways and interosseous access (bone drill). 

Buff Johnson wrote: also depends on the hotness factor.
If she's hot enough, yes, I'll go ahead and sacrifice myself for some mouth to mouth.

Nothing hotter than locking lips with a dead chick whose actively puking and bleeding in your mouth...

 Get real. 

MD here.

CPR is going to be futile in the backcountry (exception for lightning strike, drowning, or avalanche asphyxiation).  If someone goes into cardiac arrest from blunt trauma, it doesn't really matter what you have in your first aid kit, they're not gonna make it.

Painkillers are going to be way more useful than anything silly like CPR masks, epinephrine (unless you're allergic to bees or something), tourniquets (sling + carabiner as windlass = great tourniquet), IV fluids (seen it in a first aid kit), etc.

A self-rescue walk out with a sprained ankle is much more tolerable with some tylenol and ibuprofen (or something stronger if you got it) to take the edge off.

Pain pills, super glue and tape. 

Sam Skovgaard wrote: Painkillers are going to be way more useful than anything silly like CPR masks, epinephrine (unless you're allergic to bees or something)

Could say this the other way around too. Painkillers are silly (unless you sprain your ankle or something). 

I was trying to think of items that could potentially save a life. Certainly painkillers will be more frequently useful. But having walked quite a few miles on several different sprained ankles, torn MCL, etc, painkillers are more of a luxury than a necessity.

What about a broad spectrum antibiotic like doxycycline? I have also walked a 20 mile day through the Sawtooths with what turned out to be pneumonia. If it had been 40 miles instead, and I had been alone, I could imagine the situation becoming lethal.

Owen River wrote:

The heatsheets look sweet, my one concern with mylar is its durability, so that could be a really amazing upgrade for not much extra weight. What are the cotton tringle bandages that you're talking about? are they the same size as a cravat? 

Just regular size triangular bandage, but made from cotton (not that non woven crap) and sterilized. It can be hard to find, currently I only know one manufacture, which doesn't sell to individuals.