How to handle common injuries when you’re far away from medical care

Because accidents can happen at unexpected times and in remote places, it’s important to know what to do in. Here are tips to follow if someone sustains an injury when you’re far away from medical care.

1) Burns

The two goals of burn treatment are to remove heat from the skin as quickly as possible and prevent the burn from getting infected.

If someone is burned, pour cool, clean water over the burn for at least 20 minutes. Do not use ice to cool a burn because it will trap heat against the skin and, in some cases, cause frostbite or other soft tissue damage.

Next, apply antibiotic ointment to the burn. If you don’t have antibiotic ointment, you can use petroleum jelly, aloe, or honey instead, since they form a barrier against infection. Then wrap the burn in a clean bandage.

If it’s been more than 10 years since the injured person’s last tetanus shot, they should get a tetanus booster within the next 48 hours.

2) Sprains & fractures

The most important thing to do if someone sustains a sprain or fracture is to stabilize the injured extremity by immobilizing the joints above and below the injury. Immobilization alleviates pain and stabilizes a fracture, so it doesn’t become displaced (out of alignment).

Many First Aid kits contain disposable splints and large linen triangle bandages that can be used to fashion a splint. If those supplies are not available, you can use large sticks and strips of fabric to fashion a splint as well.

Ice can be applied to the injury for 15-20 minutes every hour. And over-the-counter pain medications like acetaminophen or ibuprofen are also often useful for pain control.

A fracture that breaks through the skin (called an open or compound fracture) or a fracture that causes a loss of pulses or sensation in the limb should be considered an emergency.

3) Bee & wasp stings

If someone is stung by a bee or wasp, it’s important to remove the stinger as quickly as possible, since stingers release venom into the skin. You can remove the stinger with tweezers if you have them or, if you don’t have tweezers, you can scrape the stinger off with the edge of a credit card.

Ice can be applied to the sting for 15-20 minutes every hour to alleviate pain, swelling, and itching. Oral or topical antihistamines are also often useful to alleviate redness, swelling, and itching. And ibuprofen or acetaminophen can be helpful if the sting is painful.

The biggest risk of a bee sting is a serious allergic reaction called anaphylaxis. If someone experiences a widespread rash, throat swelling, wheezing, dizziness or difficulty breathing after being stung, they need emergency medical care as soon as possible, since this reaction can be fatal if not treated with an injection of epinephrine and other emergency measures.

4) Cuts & wounds

If someone sustains a cut, abrasion, or other skin wound, it’s important to flush the wound with clean water as soon as possible to remove any contaminants and lower the risk of infection.

Next, apply antibiotic ointment and a clean bandage. As in the case of burns, if antibiotic ointment isn’t available, petroleum jelly, aloe, or honey can be used to create a barrier against infection.

If a cut is actively bleeding, it’s also important to apply firm pressure until the bleeding is controlled. If pressure alone isn’t enough to stop the bleeding, have the person elevate the bleeding extremity above their heart. Because of gravity, blood flows down faster than it flows up, so elevating a wound is an effective technique to slow bleeding. If there is excessive bleeding that doesn’t stop after 10 minutes of pressure, then the cut will need stitches. If a person sustains a minor skin wound, they should get a tetanus shot if it’s been more than 10 years since their last booster. If a person sustains a major wound, they should get a tetanus shot if it’s been more than 5 years since their last booster.

5) Neck & spine Injuries

Neck and spine injuries are dangerous because they pose a risk to the spinal cord. If the spinal cord is damaged or severed, it can lead to permanent paralysis or, in some cases, death.

Neck and spine injuries are commonly sustained by diving head-first into shallow water, falling from a significant height, or sustaining trauma in a motorcycle or car accident.

If someone has a neck or spine injury, assume they have fractured the vertebrae at the site of the injury and hold them as still as possible, because the sharp edge of a fractured bone can sever the spinal cord if it isn’t firmly stabilized.

If a person is in immediate danger -- i.e., in a burning car -- remove them from the immediate danger as gently as possible. Lay them on a flat surface and instruct them to lie as still as possible. Make sure someone “holds C-spine” by putting their hands along the sides of the injured person’s head and neck to hold their cervical spine still until help arrives.

Sources:

https://www.emedicinehealth.com/wilderness_splinting/article_em.htm

https://www.mayoclinic.org/first-aid/first-aid-burns/basics/art-20056649

https://www.webmd.com/first-aid/bee-and-wasp-stings-treatment

https://www.verywellhealth.com/first-aid-for-cervical-spine-injury-1298718

https://www.verywellhealth.com/how-to-control-bleeding-1298304

Written by Sarah Thebarge, Physician Assistant