Wecome To RVs and OHVs

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Sunday, August 14, 2011

First Aid Kits and Training

Accidents can happen anytime, anywhere.   This is no more apparent than when camping.  The very nature and location of camping activities presents situations outside our normal day-to-day lives where we may very well incur injuries that need more than some first aid spray and a Bandaid -- and professional medical help may be many miles and/or hours away.  Many outdoor activities carry a risk of serious injury.  Even if we are careful, wear proper safety equipment, keep our equipment in good condition, and are experienced and take proper precautions, "stuff" happens.  Because many if not most camping activities occur in remote locations, having good first aid skills is essential to deal effectively with injuries since emergency medical services will probably some distance away.   Proper first aid can prevent additional trauma and sometimes can, literally, be life saving.  You can never have too much first aid training and practice.   Keep your skills and certifications up to date by participating in regular training exercises and classes.  Recommended procedures are updated quite regularly.  Sometimes knowing what NOT to do is as important as knowing what TO do.  First aid supplies and training will also come in handy in any kind of disaster situation -- at home, at work, or on the road.  Being adequately prepared for camping and exercising your training will help you be ready for emergencies at home.

Proper preparation involves two main ingredients:  good first aid skills and proper resources, such as a good first aid kit and appropriate supplies.  You will need both of these in order to deal with medical emergencies on the trail or in camp or during an emergency at home.  But even with both of these, the most important thing of all is to keep a cool head.   If you panic, your ability to help yourself and others will be substantially diminished.  Maintaining your cool when a loved one is severely injured is not easy.  Even the sight of a stranger's wounds may cause you to cringe or even become physically ill.   Proper training and preparation will make it easier for you to get past the gore and screaming and focus on what to do.   It isn't going to help your victim if you scream 'Oh My God!' and turn away or throw up.  No matter how bad it looks to you, do your best to stay calm and do whatever is within your power and training to assist.

You can buy a good first aid kit at just about any camping, sporting goods, pharmacy, or department store.  There are many brands, styles, and sizes to choose from.  The kit you need depends on the kinds of activities you and your associates will be involved in, the number of people involved, and the kind of injuries you might expect.   Small, simple first aid kits that fit in your pocket and basic skills are adequate for minor personal injuries -- small cuts and scrapes, minor burns, blisters.  These are usually adequate for simple outings like picnicking, camping, and hiking. You can sometimes even pick these up at "dollar stores" so everyone should have one in his pocket or pack. instantly available for their own needs or those of their companions.  If you're involved in more vigorous activities (horse back riding, OHVs, rock climbing, water skiing, jet skis, snowmobiles, etc.) that might lead to more serious injuries such as broken bones or arterial bleeding, you need a more sophisticated first aid kit and more advanced training.   If you want advanced first aid kits, look for kits designed for hunters.  Even then you will need to supplement commercial first aid kits to meet your particular needs.  None of them will come with your prescription medications and only the largest and most elaborate and expensive will include the splints, large dressings, and large bandages you may need for "extreme" activities.   Government surplus stores are a good place to pick up some of these items.  Surplus military supplies are usually heavy duty and can be had at bargain prices if you shop around.  You can also improvise.  You can make your own bandages from bed sheets or other cotton cloth.  Bandannas make good slings and bandages.  Sanitary napkins and even tampons can be used for dressings.  They are readily available, inexpensive, and are often more absorbent than ordinary gauze dressings.   Splints can be made from sticks or scraps of wood or rolled newspapers or magazines. A convenient type of commercial splint is a wire splint.  These are made from expanded metal.  They come in a roll and can be easily cut to size.  They can be formed to fit most limbs comfortably and once unrolled and formed, create a rigid splint.  They are comfortable and light weight. The initial roll form makes them easy to carry in fanny packs and first aid kits.  The only downside is they are a bit pricey and you may have to special order them.  In a pinch, you can use rolled up newspapers or magazines to immobilize fractures.  I have actually done that several times and gotten praise from the triage nurses when my patient arrived at the ER.   I supplement my commercial first aid kits with extra OTC pain relievers. I can usually find a variety of generic pain relievers at the local dollar store, making it inexpensive to have just about every type of OTC pain reliever on hand to accommodate the preferences and needs of everyone in your group.  Whether your patient is allergic to certain products or simply has a preference for what works best for him/her, having the right one on hand is always helpful.   Even if it is only the "placeo effect", having the pain reliever you're used to using seems to work better for most people.   I've found that anti-diarrheal medications are handy for outdoor activities too and you won't find them in most commercial first aid kits.  Camping frequently means eating unfamiliar foods and all too often involves other sources of digestive problems.  Antacids are also good to have on hand.   I have also found it useful to have several different types of antiseptic since some people may be allergic to certain formulas. The latest guidelines proscribe using alcohol or hydrogen peroxide to cleanse open wounds. In addition to being painful, these powerful antiseptics can kill healthy tissue along with the germs. Flush wounds with clean, preferably sterile, water. Don't have any water handy?  Surprisingly, urine is sterile, unless the donor has a urinary infection.  A student in a first aid class once asked a nurse about using soda pop to cleanse wounds and she quickly advised him that urine would be a better alternative.  The sugar in soda pop is an ideal medium for bacterial growth and would promote infection.  Apply a modest amount of antiseptic to prevent further infection or use an antiseptic bandage. For small wounds I like Bandaids treated with silver. Silver has natural antibiotic properties and few people have adverse reactions to it.  Speaking of silver, liquid colloidal silver was once a very popular antiseptic and is very effective.  You may have to search online to find a source for it.  It seems to me it also speeds healing.

First aid kits are often sized by the number of people and number of days they are designed to support.  Match your first aid kit to your situation, based on how many people you will be responsible for and for how long you think you will need coverage.  The math is pretty easy if you have, say, a family of 4 and you want to cover your weekend (2 or 3 day) outings.   Estimates can be more difficult if you are planning for a local emergency where you may not know how many victims you might be treating or for how long before normal emergency medical services are restored.  For camping and on the trail, you will necessarily need to limit how much stuff you carry, but for long term emergencies at home it is good to build up as large a stock of supplies as you have budget for and room to store.

You can obtain first aid training through local Red Cross approved courses.  These are often offered by scouting organizations, schools, adult education programs, fire departments, civic groups, churches, hospitals, and local government agencies. Once you have mastered basic first aid skills, you may want to seek advanced training.  Many advanced first aid courses are available.   I had a unique opportunity to go beyond ordinary advanced first aid.  My wife was working for a medical school and I was able to attend a course in Advanced Wilderness Life Support to enhance my preparations for handling off-road emergencies.  We both also obtained the training to become certified as Red Cross Professional Rescuers.  I frequently tout the benefits of getting C.E.R.T. (Community Emergency Response Team) training and strongly recommend it to everyone.  The medical triage and first aid modules provide excellent training for all kinds of emergency medical operations and coupled with CPR and first aid certification should prepare you for most of the situations you will encounter during outdoor recreational activities.

You will probably need to customize your first aid kit to fit the specific needs and preferences for you and your family.  Most comprehensive kits come with at least one generic pain reliever like aspirin or acetaminophen.  Check to see what you have in yours and supplement per your own preferences.  I try to keep a supply of several generics in my RV medicine cabinet, including aspirin, acetaminophen, and ibuprofen.  Antiseptics are another item that is often subject to strong personal preferences.  Some people are terribly allergic to some antiseptics, so make sure you have products in your first aid kit compatible with all members of your group.  If anyone is allergic to bee stings, have your doctor give you a prescription for an epi-pen and teach you how to use it.  If anyone in your group takes prescription medications, keep an up to date stock in your first aid kit.  Make sure all medications are clearly labeled with the type of medication and the expiration date.  If you don't have an expiration date, record the purchase date so you at least have some idea how old things are so you can replace them before they become ineffective or even dangerous.  Some medications, such as aspirin will give off a recognizable odor when they start to go bad. If you detect a vinegar smell when you open your aspirin bottle, it is time to toss it out and replace it.  Still, if you open your aspirin in an emergency and the only bottle you have smells like vinegar, I would consider them better than nothing and use them anyway.  In fact, an Army study concluded most medications are good for at least 15 years after their expiration date, so don't be too quick to toss out things you might need in a future emergency unless there are obvious signs of deterioration or contamination.

Many people confuse bandages and dressings.   What is often called a bandage is really a combination of a dressing and a bandage.  A dressing is used to "dress" or cover the wound. A bandage is used to hold the dressing in place.   A Bandaid is essentially a combination dressing and bandage.  Thus, the pad on a Bandaid is a dressing; the plastic or fabric adhesive strip it is attached to is the bandage.  For large wounds, gauze pads are frequently used as dressings and held in place by cloth or tape bandages.  A dressing protects the wound from dirt and infection and also absorbs blood.   Sanitary napkins make excellent emergency dressings.

Responding quickly, confidently, calmly, and appropriately to a medical emergency saves lives and helps set the stage for the victim's comfort and recovery.  Stay calm and methodically apply your training and skills as required by the situation. If YOU scream, turn away, or throw up, it isn't going to help anyone.  On the other hand, if you remain calm and move with confidence, your patient(s) will respond better and you'll be able to accomplish a lot more.  One of the most useful techniques I learned in C.E.R.T. training is a "60 second assessment".  This is particularly useful when the number of victims exceeds the number of rescuers, which is often the case in an emergency situation.  You methodically examine each victim from head to toe, especially looking for signs of serious (life threatening) injuries, but taking inventory of all injuries for subsequent triage and treatment.  You use touch, sight, and hearing to locate injuries.  You may feel unusual bumps or depressions in body parts. You may detect soft spots that shouldn't be soft (like the skull) or places that are hard that shouldn't be hard (like the abdomen).  Inappropriate soft spots are likely signs of crushed bones or tissue.  Rigidity in the abdomen may indicate internal bleeding.  If your victim is conscious, ask them questions:  where are they injured?  where does it hurt?  how bad is the pain?  how were they injured? In addition to the facts they give you, you can discern something about their mental state from their answers.  Though it isn't a pleasant idea, pain is actually your friend when doing an assessment, though your patient may not agree.  We don't want to intentionally inflict pain on an injured person, but if they cry out when you gently touch them, you have found an injury and that is important information.  Wear latex gloves if possible to prevent both infecting your victim and contaminating your own hands.  Begin by running your hands lightly over their head.  Start with the scalp and work your way down.  Check your hands frequently for blood, especially after checking the back of the head or other places you can't easily see.  Gently check cheek, nose, and jaw bones and eye sockets for signs of bruising or broken bones.  Look for bleeding or other fluid in the eyes and ears. Bleeding from eyes and ears is not good, but clear liquid is even worse since it is probably cerebral fluid from the brain indicating a serious head injury.  Check the back of the neck.  If you find any protruding bones whether they have broken the skin or not, there is likely a cervical spine injury. Do not move the victim unless they are in immediate danger of further injury.  Try to immobilize the neck to reduce the risk of further injury.  Next run your hands down their arms and hands.  Once again you are looking for distortions, pain, or blood.  If you find no injuries, try gently lifting their arms to check for shoulder injuries.  You should not attempt to relocate a dislocated shoulder if you have reasonable access to emergency medical services (within an hour or two).   If the victim complains of numbness or tingling in the affected limb, or if a check for capillary refill indicates restricted circulation, it may be advisable to attempt to relocate the shoulder right away -- if you have been trained in the technique!   Next, check the back and ribs.   Any unusual protrusions may indicate broken or dislocated bones or the presence of a foreign object. If there are no indications of protruding bones, press firmly on the rib cage with your palms to check for broken ribs.  If the ribs are cracked, broken or bruised, your victim will cry out.  If they are broken, you might feel or hear the ends grinding together.   About all you can do for injured ribs is wrap the victim's chest tightly to restrict unnecessary movement and prevent additional injuries.  Some practitioners now advise against tightly wrapping ribs because it can inhibit breathing so use discretion.   Some containment can improve comfort but don't make it so tight it restricts breathing.  Press on the abdomen to check for rigidity or pain.  Rigidity may indicate fluid build up from internal injuries.  Run your hands down both sides of both legs, ankles, and feet. You will need to begin your examination uncomfortably close to the victim's crotch.  A damaged femoral artery can be life threatening (the person can bleed to death in about 3 minutes) and the artery runs the full length of the inside of the thigh.  You don't want to have them die because you -- or they -- were too shy for a thorough assessment.

Treating serious injuries.  In an emergency situation you will have to do some triage.  That means you need to identify and treat the most serious injuries first.  That doesn't mean taking care of the first victim you come to, the person who screams the loudest or who is the bloodiest first.  Check the ABCs -- airway, breathing, and circulation.  A person whose airway is blocked won't live long -- about 3 minutes before brain damage beings to occur.  Nor will they survive long if their heart has stopped or they have severed or blocked arteries.  Arterial bleeding can be differentiated from other bleeding by the way it spurts with each heartbeat.   "Ordinary" bleeding will just ooze or flow. Some "ordinary" injuries, like scalp injuries, will bleed profusely but such bleeding is not life normally threatening unless left untreated for long periods of time and can usually be controlled by direct pressure.   Place a dressing (preferably sterile if possible) over the wound and apply direct pressure to slow the bleeding.  You may be able to have the victim hold the dressing in place if they are conscious or you may be able to assign other "walking wounded" victims to assist you so you can examine other victims.  If you encounter spurting blood, you MUST control the bleeding quickly or the victim WILL bleed to death.   Typical locations for severed arteries include the neck, thigh, chest, and arms.   You may be able to control even arterial bleeding with direct pressure, depending on the location and extent of the injury.   In some cases a tourniquet many be required.  The general advice is to avoid using a tourniquet unless there is no alternative.  Tourniquets can cause loss of limbs below the tourniquet, but it is better to lose a limb than a life.   At one time there were recommendations to release the tourniquet periodically to allow blood to flow into the closed off limb in an attempt to preserve it.  Today the recommendation is that once you have applied a tourniquet, leave it in place until it can be removed by medical professionals.   Loosening it can allow contaminated blood from below the tourniquet to return to the heart causing further complications, even death.  Better to lose a limb than a life.  Another serious injury that needs special attention is a compound fracture.  First of all, what is a compound fracture?  Simply put, it is a broken bone that protrudes through the skin.  A broken bone that does not poke through the skin is a simple fracture.   If you will have access to professional medical services in a reasonable amount of time (a few hours at most) simply rinse any dirt and debris off the exposed bone using clean water, cover it with a dressing and try to keep it moist and immobilize the break to prevent further injury.  Do NOT try to put it back in place.  In an extreme, long term emergency where medical attention may not be available for days or more, you may need to attempt to retract the bone for the patient's comfort and to minimize further injury and infection.  Here is where some extra training is a necessity.  DO NOT try to set any broken bone or reduce a dislocation if you haven't been trained to do so!  For both compound and non-compound fractures, splint the break by attaching something rigid parallel to the bone and secure it above and below the fracture.  Secure the splint in at least two locations on each side of the break and immobilize the joints above and below the break to prevent movement that could produce more injuries.  In normal circumstances, do not try to re-align the broken bone, just secure the damaged limb in place with as little movement as possible.   In a long term disaster situation where trained medical help will not be available in a reasonable amount of time, you may need to be able to set broken bones.  So get trained if you can.   Wood splints are commonly used on broken limbs, but lacking wood you can use a rolled up newspaper or magazine, cardboard, even a rolled up towel -- anything that will help immobilize the break.  A broken leg can usually be securely fastened to a healthy leg if no other splints are available.  Secure the splint both above and below the break, making sure you don't tie it so tightly as to shut off circulation.   Keeping it from moving will greatly reduce pain, improve the patient's comfort, and prevent further injuries.  Broken fingers and toes can be taped or tied to adjacent digits to stabilize them.  About all you can do for broken ribs is wrap the torso to limit movement.   Broken hands, feet, wrists, and ankles should be immobilized using a splint.

Shock is another serious condition that occurs with many injuries and it can be life threatening if not treated.  Shock occurs with any trauma and can occur without physical injury.  Shock usually does accompany serious physical injuries.  And remember, your victim might not have any external wounds and yet have serious, even life threatening internal injuries.   I know of a dirt bike rider who crashed really hard, got up and dusted himself off, and insisted he was OK.  He refused any assistance and rode back to camp.  A few hours later he was dead from a ruptured spleen.  Careful monitoring of his condition may have detected his internal injuries in time to get treatment.  Abdominal pain and swelling, headache, dizziness, and large areas of purple skin are all signs of internal injuries.  If you or your victim experience any of these, especially if they get worse was time goes on, seek immediate medical help.  Signs of shock include low blood pressure, fast weak pulse, profuse sweating, nausea, dizziness, fainting, clammy skin, shallow rapid breathing, and blue fingernails or skin.   If a victim has any of these signs, especially more than one, they are going into shock.   If possible, lay the victim down, elevate their feet, and cover them with a blanket or coat to keep them warm.   I once passed out in a dental chair and the first thing the idiot dentist did was to set me up!   The boys in my scout troop know enough to lower the head to treat shock!  The first thing the paramedics did when they arrived was lower my head.   Reassure your victim and immediately begin treatment for any life-threatening injures.  One way to assess blood pressure any where is what is called "capillary refill". Squeeze a fingertip or press on a fingernail for a second or two, then release and see how quickly the color under then nail returns to normal.   If it takes longer for your victim to return to normal than it does for you, they are probably in or going into shock or have some injury that is affecting circulation, such as a severed or pinched blood vessel.

There are legal considerations you need to be aware of to avoid expensive liability, especially when treating strangers.   In most states there are "Good Samaritan laws" that provide some measure of legal protection but they do not protect you against gross negligence or inappropriate actions.  You will not be protected if you attempt treatment that is beyond your skills and training.  Before beginning treatment on any victim, ask their permission.  If they are unconscious or otherwise mentally impaired you may be covered by the concept of "implied consent".   A good way to approach a stranger at an accident scene it to say something like "I am medically trained.   Is it OK if I treat your injuries?"   Stating you are "medically trained" helps give them confidence in allowing you to treat them.   What does it mean to be "medically trained"?   Obviously if you are a doctor or nurse you are medically trained.   For purposes of assisting victims in a disaster or other emergency situation, having first aid certification could be considered being "medically trained".   If you are first aid certified, chances are you are better prepared to give assistance than most of the other by standers.   As long as you provide treatment within the scope of your training you should be safe from prosecution.  The answer to the question "Should I try to help?" should usually be an unequivocal "YES!".   You can always turn treatment over to more qualified medical personnel as they arrive, but doing nothing in those first few critical minutes could have serious negative affects.

There are important psychological aspects to giving first aid.  Whenever you treat a victim, you need to present a confident appearance.  Your attitude is going to have a significant affect on how your victim responds to your treatment.   Strive to control your reactions to their injuries.   It isn't going to do them any good if you scream or turn away or cover your face or cry or throw up!   If your victim is conscious, tell them you are "medically trained" and ask permission to treat them.  Telling them you are medically trained does not imply that you are a doctor, but gives them confidence in your ability to assist them.   Keep them informed about what you are doing.  Some parts of a good 60 second assessment may require rather intimate contact with your victim.   Make sure they know your actions are purely to assess and treat their injuries and avoid any prolonged contact that could be misinterpreted.  However, do make sure your assessment is thorough.  Better you and your victim experience a little embarrassment than you miss a severe chest injury or a severed femoral artery (a life threatening injury).  Make sure any bystanders are also aware of your training, your intentions, and your actions.  A paramedic at an automobile accident got sucker-punched by a female victim's boyfriend when he attempted (appropriately) to remove the victim's bra to administer CPR -- largely because the paramedic failed to explain what he was doing.  By the way, bras should always be removed to perform CPR.  They interfere with proper pressure and movement, and, in the case of under-wire styles, can cause further injuries.   I've heard of bra wires puncturing the victim's lung during attempted CPR with the bra in place.   CPR is a vigorous and demanding activity.   Even properly done it can break ribs.  Once you start CPR, you don't stop until you are relieved by another competent rescuer, told do so by emergency medical services personnel, or you become too tired to continue. And that's not just "I'm tired of doing this" kind of tired, it's "I really am too completely worn out to give even one more push"!  At that point it isn't likely to be a deliberate decision, but rather involuntary collapse.  And, by the way, don't perform CPR on a victim wearing a "DNR" (Do Not Resuscitate) medical ID.

First aid training may come in very handy in any kind of local disaster as well as out in the woods.  Local emergency services will be stretched beyond limits in a wide-scale event such as an earthquake, hurricane, or tornado.  Remember:  YOU are the only first responder you can really count on!  You may be on your own for days or even weeks and have to rely on the skills and equipment you have on hand.  Get the training and equipment now, before you need it!  Run through potential scenarios in your head and plan your response today.   Practice with your local C.E.R.T. or other emergency response team.  Coordinate with and educate your family and your neighbors and co-workers.

Advanced and specialized supplies and equipment.  A fairly inexpensive item that can come in useful for many extreme sports injuries is a back board.  It may be needed to transport your victim if there are any spinal injuries. Spinal injuries can occur in many sporting event accidents.  Crashing on OHV, falling off a horse, skiing accidents, and diving accidents are among the most obvious ways spinal injuries can occur.  If you even suspect spinal injuries, as a precaution you should stabilize the victims neck (medics all this "C-spine" for cervical (neck) spine). This is usually done with a cervical collar.  In an emergency  you might  use towels or sheets to limit movement.  A backboard can be made from a piece of plywood.  It should be about 2 feet wide and 6-7 feet long.  Cut hand-holds about every 18" or so along both sides so several people can get hold of it to securely move victims. Rounding the corners will make it easier to maneuver in tight spaces and through doorways.  If you need a backboard and don't have one you may be able to improvise using a door or table.  Other useful items, though usually somewhat expensive, are hemostatic dressings.  These dressings are treated with chemicals that stop blood flow.  Be aware that some people who are allergic to shell fish may have an severe allergic reaction to the chemicals in hemostatic dressings.  In an emergency or for minor wounds, you can use cayenne pepper to stop bleeding.   You might hang on to leg, neck, and back braces if anyone in your family has used them or look to pick some up at garage sales or thrift stores.   A cervical collar is a good addition to any first aid kit for extreme sports and for disaster preparedness.  Same with crutches.  You probably won't want to pack them along on camping trips, but they might be a useful addition to your home first aid supplies for extended emergencies.   It wouldn't hurt to tuck a pair away in an RV closet if you have the room.  These days portable defibralization devices (AEDs) are becoming fairly common in airports, schools, and even restaurants and some other businesses.  They are still too expensive for most home first aid kits, but if you have the budget, they would be definitely be good to have.  They are simple to use and may save a life. Make sure get trained how to use them.  It isn't difficult and most of it is automatic, but you still need the training.   Until you can acquire your own, keep an eye out for where you might find one.  These days you might find them in airports, restaurants, theaters, malls, schools, and other public places.  I recently saw an advanced first aid kit designed for emergency preparedness that includes lidocaine, hemostatic powder (stops bleeding), sutures, and a tourniquet.   I am not certain of the legal requirements for using lidocaine or suturing wounds, but in an extended emergency situation where normal medical services may be interrupted or weeks or months, having advanced supplies like these might be advantageous.  You probably wouldn't need them for incidents arising during normal recreational activities.  Along those lines, antibiotics may be something to have on hand.  Since stockpiling prescription medications is severely limited by current laws, you might look into veterinary or aquatic versions.   Some aquatic antibiotics are identical to the human prescriptions, right down to the color and numbering on the capsules.  And you don't have to have a prescription to buy them.  In dire emergency, even feeding a victim of infection moldy bread may be beneficial.  Bread mold is the source of penicillin.

Wilderness medicine.  In the unlikely event you get lost or stranded without any medical supplies, it can be useful to know what natural resources may be helpful.  Since natural resources will vary from location to location, be sure to research what lives and grows in the areas you will be visiting.  As an example of natural remedies, consider that willow bark was used by Native Americans and other primitive peoples going back as far as 400 BC much like we use aspirin, to treat pain and inflammation.  It actually contains an ingredient (salicin) similar to the active ingredient in aspirin (acetyl salicylic acid).  In fact, acetyl salicylic acid, is actually a synthesized version of salicin. You can chew the inner bark or seep it in hot water and drink the tea. Aspen and poplar also have similar properties.  I found that chewing about 6-8" of bark stripped from a green branch about 3/16" gave me about the same relief as a couple of aspirins.   Another way to use willow bark it so make it into a mild tea.   Do not use or administer anything containing salicin to anyone who is allergic to aspirin. Diarrhea and some other stomach problems can be treated using charcoal (readily availble in the wood ash from most campfires).  Just grind up a tablespoonful, mix it in a cup of water, and drink it.   It tastes TERRIBLE, but it can relieve a lot of the stomach distress. Another use for charcoal is to apply it around your eyes to help prevent snow blindness.   If you lack dressings and bandages, you may be able to make your own from local plant materials.  Covering an open wound with a large clean leaf and securing it with vines or long grass, for example.   Check out the resources in the areas you frequent so you can take advantage of them if you find yourself in a survival situation.  Not all resources are available in all areas.   Having extensive knowledge of  the marvelous pharmacological benefits of tropical jungle plants won't do you much good in a pine or hardwood forest or in the desert.

Good Samaritan laws protect providers of first aid in most states.  That means that if you are acting in the best interests of your victim(s) within the scope of your knowledge and training you are generally protected from criminal charges and civil suits.  However, if you go beyond your training and certifications and something goes wrong, you could be liable.   Good Samaritan laws are designed to protect first responders and encourage ordinary people to help -- within the scope of their skill, knowledge, and training.

Look out for yourself!  When it comes to helping people, you need to consider yourself your number one priority.  This isn't a totally selfish concept. Y ou can't help others if you become a victim.  Assess the situation before you jump in to help someone.  Can you help them without endangering your own health and safety?   Every year many would-be rescuers become additional victims when they generously attempt to help someone when it isn't safe to do so.  If you are dealing with injuries where there are bodily fluids like blood present, wear rubber gloves. A concept taught to emergency services personnel is: If its wet and it isn't yours, don't touch it!

As the Boy Scouts say, "Be prepared!"

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