You should probably carry a first aid kit

My thinking:  1. take a WFR course so that you can adequately evaluate the injury.

                     2. contents of the first aid kit vary depending on the length and remoteness of the climb.  I always have my full kit on all climbs, easy to leave 

                        in pack for single or short multi-pitch.  

                     3. for remote climbs, one in the party should be WFR certified and one more with at least basic first aid.

                     4. consider impact of weather

                     5.  wear a helmet and carry adequate water.

                     6.  a personal locator beacon may not necessarily provide help in time depending on the severity of the injury. 

                     7.  practice self-rescue with your partners.

Idaho Bobwrote:

My thinking:  1. take a WFR course so that you can adequately evaluate the injury.

                     2. contents of the first aid kit vary depending on the length and remoteness of the climb.  I always have my full kit on all climbs, easy to leave 

                        in pack for single or short multi-pitch.  

                     3. for remote climbs, one in the party should be WFR certified and one more with at least basic first aid.

                     4. consider impact of weather

                     5.  wear a helmet and carry adequate water.

                     6.  a personal locator beacon may not necessarily provide help in time depending on the severity of the injury. 

                     7.  practice self-rescue with your partners.

                       

                             

                

                            

I would preface this with:

A. Be honest with yourself about what you can and can't do. Having actually seen a body being pounded on by a chest compression machine? Sorry guys, CPR is off the list of what I could do, at least for an adult.

B. Be straightforward with your partners re the above. As much as I would like to be there, if I'm asked to go anywhere off the well beaten track, then I should not be counted as a second, competent person, if it means full on rescuing. A third person who can haul you out, or get up an ice climb, or whatever, needs to be there.

That said, I'll do my damnedest to help, and can keep calm and functional when it matters.

If you need a screamer .... that's not me either, lol!

Best, Helen

Idaho Bobwrote:

My thinking:  1. take a WFR course so that you can adequately evaluate the injury.

                     2. contents of the first aid kit vary depending on the length and remoteness of the climb.  I always have my full kit on all climbs, easy to leave 

                        in pack for single or short multi-pitch.  

                     3. for remote climbs, one in the party should be WFR certified and one more with at least basic first aid.

                     4. consider impact of weather

                     5.  wear a helmet and carry adequate water.

                     6.  a personal locator beacon may not necessarily provide help in time depending on the severity of the injury. 

                     7.  practice self-rescue with your partners.

One WFR per party is fine, unless you're the one. Then you're better off insisting on two. 

Trauma doc here, I'm gonna rapid-fire weigh in on a few things, and give one solid piece of advice which could easily save someone's life.

My kit: 

• tylenol, ibuprofen, bendryl, caffeine, immodium
• superglue (this gets used all the time in the ED and OR)
• tape
• tegaderm dressings for foot blisters

Things that would actually be useful in an emergency: 

• a way to summon a rescue
• know-how and gear on how to keep someone warm/dry while awaiting a rescue
• ability to improvise splits/slings to facilitate self/ partner rescue (you have more than enough stuff in a typical climbing rack and your natural surroundings to accomish this)

Things that are easily substituted with on-hand gear, and as such, are superfluous to carry:

• Gauze: any wad of fabric will do, previous poster's concerns over infection are overblown, the wound will need to be washed out later regardless
• Tourniquet: sling + carabiner, twist the carabiner until the bleeding stops

Potentially life-saving tip on major (external) bleeding: save a life with two fingers.  Often, when someone has significant external bleeding, people put some sort of gauze compress on it and press (good first step!).  If the bleed is bad, the gauze soaks through, everyone's first intuition is to put another on top, then another, then another (I see trained nurses, paramedics, even doctors do it all the time).  If you come across bleeding and someone is holding a giant mass of bloody dressings on it, the first thing to do is to pull it all off, give the area a good wipe, and look to see where the blood is actually coming from (it's almost always a very discrete, single spot).  Take two fingers, a single piece of gauze or fabric, and press on that exact spot HARD.  This rarely fails.

Sam Skovgaardwrote:

Trauma doc here, I'm gonna rapid-fire weigh in on a few things, and give one solid piece of advice which could easily save someone's life.

My kit: 

• tylenol, ibuprofen, bendryl, caffeine, immodium
• superglue (this gets used all the time in the ED and OR)
• tape
• tegaderm dressings for foot blisters

Things that would actually be useful in an emergency: 

• a way to summon a rescue
• know-how and gear on how to keep someone warm/dry while awaiting a rescue
• ability to improvise splits/slings to facilitate self/ partner rescue (you have more than enough stuff in a typical climbing rack and your natural surroundings to accomish this)

Things that are easily substituted with on-hand gear, and as such, are superfluous to carry:

• Gauze: any wad of fabric will do, previous poster's concerns over infection are overblown, the wound will need to be washed out later regardless
• Tourniquet: sling + carabiner, twist the carabiner until the bleeding stops

Potentially life-saving tip on major (external) bleeding: save a life with two fingers.  Often, when someone has significant external bleeding, people put some sort of gauze compress on it and press (good first step!).  If the bleed is bad, the gauze soaks through, everyone's first intuition is to put another on top, then another, then another (I see trained nurses, paramedics, even doctors do it all the time).  If you come across bleeding and someone is holding a giant mass of bloody dressings on it, the first thing to do is to pull it all off, give the area a good wipe, and look to see where the blood is actually coming from (it's almost always a very discrete, single spot).  Take two fingers, a single piece of gauze or fabric, and press on that exact spot HARD.  This rarely fails.

^^^^This should be sticky at the top of the thread.

The doc has spoken, you don't need much, keep the fanny packs at home.

Pain relievers, TUMS, Benedryl, super glue, tape, a large bandage, a few small ones, and a knife. 

I usually have fishing line or floss, a needle, razor blade, and additional tape wrapped around/taped to my trekking poles if on a backpacking/climbing trip. 

I just bring climbing tape. By far the most likely injuries that actually matter are cuts and broken bones. You can tape a cut closed and can tape a stick or something to splint a broken bone. A PLB would be the next thing to bring but those are expensive. I guess maybe Benadryl for an allergic reaction.  All the other stuff is just a waste of time and money. Snake bite kits? Hell no.

From what I've heard in research, improvised tourniquets are far less effective at stemming bleeding and stopping distal pulse compared to commercial devices and they'd probably take a while to create and setup. One such study was regarding the Boston Bombing and they found the vast majority of them didn't work (and if you only cut off venous flow back but not arterial it's worth less than nothing) 

David Carlsonwrote:

From what I've heard in research, improvised tourniquets are far less effective at stemming bleeding and stopping distal pulse compared to commercial devices and they'd probably take a while to create and setup. One such study was regarding the Boston Bombing and they found the vast majority of them didn't work (and it you only cut off venous flow back but not arterial it's worth less than nothing) 

This, tourniquets in the hands of most people are downright dangerous, good in theory but a train wreck in practice.   Also any bleed requiring a tourniquet needs in now.  In a climbing situation, by the time you get to your partner and figure out how to get a tourniquet on it is probably too late.  

David Carlsonwrote:

From what I've heard in research, improvised tourniquets are far less effective at stemming bleeding and stopping distal pulse compared to commercial devices and they'd probably take a while to create and setup. One such study was regarding the Boston Bombing and they found the vast majority of them didn't work (and it you only cut off venous flow back but not arterial it's worth less than nothing) 

If the improvision is clothing & tree branch, sure. But slings & carabiners (or a nut tool)? I'm no doc, but I imagine that'd be faster than trying to dig out the first aid kit?

Six pages and no one mentioned whiskey and gummi bears?

rebootwrote:

If the improvision is clothing & tree branch, sure. But slings & carabiners (or a nut tool)? I'm no doc, but I imagine that'd be faster than trying to dig out the first aid kit?

Here's the study: https://pubmed.ncbi.nlm.nih.gov/26125163/

"Results: Without a windlass, improvised tourniquets failed to stop bleeding in 99% of tests (79 of 80 tests). With a windlass, improvised tourniquets failed to stop bleeding in 32% of tests (p < .0001). In tests with no windlass, attempts to stop the pulse completely failed (100%, 80 of 80 tests). With a windlass, however, attempts to stop the pulse failed 31% of the time (25 of 80 tests); the difference in proportions was significant (p < .0001)."

I'd imagine youd expect to find more useful supplies in a major city during one of the busiest days than what 2 climbers might bring up with them but I don't know what those improvised tourniquets looked like 

David Carlsonwrote:

Here's the study: https://pubmed.ncbi.nlm.nih.gov/26125163/

"Results: Without a windlass, improvised tourniquets failed to stop bleeding in 99% of tests (79 of 80 tests). With a windlass, improvised tourniquets failed to stop bleeding in 32% of tests (p < .0001). In tests with no windlass, attempts to stop the pulse completely failed (100%, 80 of 80 tests). With a windlass, however, attempts to stop the pulse failed 31% of the time (25 of 80 tests); the difference in proportions was significant (p < .0001)."

I'd imagine youd expect to find more useful supplies in a major city during one of the busiest days than what 2 climbers might bring up with them but I don't know what those improvised tourniquets looked like 

From your link: 

An experiment was designed to test the effectiveness of improvised strap-and-windlass tourniquets fashioned out of a tee shirt on a manikin thigh.

That's the problem right there. Rope/slings are far more effective. How is that plp always remember the numbers but not the (crucial) methodology?

The alternative is carrying a light tourniquet that's tested through combat and emergency situations. Btw I was referring to what was used at the Boston Bombing. They only mention that no windlass improvised tourniquets were used. I'm curious what they came up with 

Patrikwrote:

Six pages and no one mentioned whiskey and gummi bears?

That's the Second Aid kit...priceless, especially if the gummie bears are happy gummy bears

Excellent points on improvised tourniquets.  Not all improvised tourniquets are equal, and not all users of purpose-built tourniquets are either.

I've seen countless scenes in movies/TV where a dude rips off his shirt sleeve and ties it around someone's thigh and ties it with with first half of a shoelace knot (dramatic painful scream), and it stops the bleeding.  Total nonsense, Sharma probably doesn't have the strength to make that style of tourniquet effective.  I'm betting that's what a lot of Boston bombing bystanders tried because that's the only way they've ever seen it done, and movies/TV told them it would be effective (the general public also has wildly inaccurate ideas on how often CPR is successful because of movies/TV, don't get me started).

I've also seen paramedics bring in people with extremity "arterial bleeding" with real-deal,  commercial, windlass tourniquets applied improperly (not tight enough) so that they have a palpable distal pulse.

Using cord/sling to wrap an extremity and then using a carabiner as a windlass makes a highly effective tourniquet.  But just like a commercial one, you have to make it TIGHT.  Like waaay tighter than you would think.

As an aside, the sling w/carabiner windlass has been used in clever applications as a short-throw hauling  winch in self/partner rescue situations to unweight some part of the system.  In this example, a guy uses it to transfer the weight of a lifeless, hanging partner off the rope and to an anchor so he can untie and use the rope to rap to the ground: Arizona climbing accident/self rescue 

I’m a nurse in the OR. If you can’t have hemostats, cautery, a crash cart, the blood bank, maybe rib spreaders, and a trauma surgeon and anesthesiologist, you’re probably better fixing it with duct tape and a t shirt.

I do carry epi. I sometimes carry cartoon bandaids for the kids.

If you’re paranoid, get a satellite phone.

highaltitudeflatulentexpulsionwrote:

I’m a nurse in the OR. If you can’t have hemostats, cautery, a crash cart, the blood bank, maybe rib spreaders, and a trauma surgeon and anesthesiologist, you’re probably better fixing it with duct tape and a t shirt.

I do carry epi. I sometimes carry cartoon bandaids for the kids.

If you’re paranoid, get a satellite phone.

This!!!!

highaltitudeflatulentexpulsionwrote:

I’m a nurse in the OR. If you can’t have hemostats, cautery, a crash cart, the blood bank, maybe rib spreaders, and a trauma surgeon and anesthesiologist, you’re probably better fixing it with duct tape and a t shirt.

I do carry epi. I sometimes carry cartoon bandaids for the kids.

If you’re paranoid, get a satellite phone.

I'm an ER nurse and have been a professional ski patroller for many years. I'll second this and the trauma doc's info above. 

As for the flexing about arterial bleeds (or any major issue) >>> stop the threat to life/limb however you need to, worry about infection later. Dead people don't get infections so have your priorities right. Great efforts will be made once the patient gets to hospital level care to prevent or ward off infection. 

I'm not making accusations or putting anyone particular down with this statement, but discussions of how to treat emergencies tend to get highly academic with "what-ifs" and doomsday scenarios. A proper first aid kit will meet the skill level individual using it. If you aren't experienced in improvising it you may need to carry more. 

The point that a lot of people miss with all this... the end goal is to get the patient out of the woods and into a hospital asap. You aren't curing people in the field. Address the issue, make a plan on how to get out of there most efficiently, act on it, and reassess if it all is working well. 

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