daredevilkink | Discussion/Off-Topic Post #1

A lot of people write fic in which characters who would know better use hydrogen peroxide or alcohol to clean wounds. Both of these substances damage cells and shouldn't be used. Flush open wounds with clean water (preferably sterile or distilled, which you can often buy at grocery stores by the gallon - but tap will do if it's what you have) or saline solution. With non-penetrating wounds use wound scrub or mild soap.

If anyone has any questions about emergency medical care, I've worked for 20 years in veterinary medicine, mostly in specialty practice emergency and critical care, which is very similar to its human counterpart. I've treated injuries as diverse as gunshot/knife/arrow/machete wounds, venomous snake bites, other animal bites, massive multiple trauma (hit by car, long falls, etc - even a hit by train), burns of varying degree and cover, smoke inhalation, toxic ingestion, drug OD, electric shock, drowning... almost any sort of emergency you could think of.

I am also certified in human CPR, first aid, & wilderness first aid, with additional training specific to major disasters and similar large-scale emergencies.

Oh, shit. The first-aid workshop I had at camp was wrong. Eyewash would be better?

(OP) Eye wash is usually sterile water or sterile saline and would work perfectly well. But honestly, if I didn't have a gallon jug of distilled water, I would probably just use tap water unless my area was known to have contaminated tap water. Water pressure and volume are the most important factors in flushing wounds.

(OP) I will say, that if my choices were alcohol, peroxide, or nothing, the injury was clearly contaminated or significant enough that I thought it needed suturing AND I was VERY confident that the wound didn't breech the body wall, I would reach for the alcohol first, and the peroxide only if I had no other choice. They do both disinfect, but you're delaying healing time by damaging cells and causing additional inflammation. If there was any chance that the injury went into a body cavity, I would wait until I could get somewhere with water to clean it (assuming I were working on an idiot that refused hospital care).

I don't have a question, but that is one seriously metal resume

(OP) LOL! Thanks?

Ah, that explains why my infected open on my pinky took so long to heal.

(OP) Foot injuries can also take longer because they're kept in an ideal environment for bacteria (warm and potentially damp, with little exposure to air), and we don't get off of our feet and give them time to heal unless they're really severe.

ahaaaa....this would explain why the damage on my fingers used to take longer to heal during a certain period of time. you see, i have a nervous habit of picking at the skin of my fingers till they bleed, and my mom got fed up with it but sadly has no medical knowledge whatsoever. so what did she do? DIY HEALING.

this involved having me stick my hands in a tub of hydrogen peroxide for at least fifteen minutes per day. it was awful. it only stopped once she noticed it wasn't doing anything and actually harming me because a lot of the wounds on my fingers were open so it hurt, badly.

i haven't really tried to write medical care seriously yet, but thanks for the psa, because lord only knows more people would suffer like i did without it.

(OP) Yikes! D:

I'm delighted to be able to ask an expert. So I have a very kinkmeme question in the vein of medical care and certainly wound treatment.

During consensual knife-play, would it make sense to wipe down the (clean, rust-free and well-maintained) blade with ethanol before beginning?

Also, any ideas about treating shallow cuts in an aftercare sense (more for psychological reassurance)? They'd be tidy and mostly following Langer's lines. Thanks!

Wiping down blades with ethanol or another antiseptic before use is definitely a good idea.

Regarding aftercare in the BDSM-sense, I'm not really the person to give advice there.

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(Anonymous) - 2015-07-20 05:54 (UTC) - Expand

Would it be feasible for someone to have minor internal bleeding (if there is such a thing?) and still be alive the next morning if they spent the night unconscious?

Also, do you know how what kind of first aid a 911 operator would instruct someone to do if they found a person like that (non-responsive and in shock with probable internal bleeding)?

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Oh crap, I guess I need to go back and fix a story or two. Thanks for the explanation, anon!

(OP) I'm glad people are finding it useful! :D

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Re: PSA: Wound care - Also can do some medical Q&A

(Anonymous) - 2015-07-11 23:18 (UTC) - Expand

If you're still taking questions, I hope this is relevant?

Say Matt has been removing stitches and putting his fingers in wounds to keep them open.
He tells Claire that they reopened during a fight.
Could she tell it's a lie just from seeing the wound? Or would it be the repeated injuries/how long it lasts/ the eventual massive infection/ his own sketchy lying face that makes her suspicious?

I hope my English makes sense?

(OP) If he cut the sutures rather than tore them out, she should be able to tell that. As for putting his fingers in his wounds... if he did additional damage, she may be able to tell that it isn't something that would just be caused by moving wrong/over-exertion/etc., but I doubt she could specifically tell that it was self-inflicted as opposed to the result of a lucky hit.

Otherwise, it'd be his horrible lying skills. :)

Re: PSA: Wound care - Also can do some medical Q&A

(Anonymous) - 2015-07-16 20:23 (UTC) - Expand

I don't know if you'd know this but, if someone was brought into the ER by ambulance and they needed abdomal surgery, would the doctors do it right away? I'm just thinking about how you're supposed to not eat for a certain amount of time before a surgery, and whether they'd waive that in an emergency situation.

(Also, would that be something they'd just do automatically or would they need a medical proxy to ok the surgery first?)

(OP) If it were a true emergency, they would proceed with any necessary, live-saving procedure unless the medical proxy was already on hand to tell them otherwise.

The restriction on eating and drinking prior to anesthesia is primarily to limit the likelihood of vomiting and aspiration. The chance of aspiration is already quite low due to placement of an endotracheal tube to maintain the airway. I've even heard it joked that the restriction is still in place these days to save the time and hassle of cleaning up if a patient vomits, rather than a protection from complication. While that isn't completely true, I think it does serve to illustrate the reduced risk of that particular complication with today's protocols.

Note, just in case someone reads the above and decides not to heed their own doctor's advice: That isn't the case with food/drink restrictions before planned digestive-system procedures, where you want the stomach, intestines, and bowel to be as empty as possible for several reasons, including visibility and risk of contamination/infection.

Re: PSA: Wound care - Also can do some medical Q&A

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(Anonymous) - 2015-07-16 15:21 (UTC) - Expand

I am and EMT and I feel stilly because I've made this mistake and, even though we don't really flush wounds (just slap some gauze over it so someone else can deal, since everywhere you are in my county you are 10 minutes away from a hospital) I'm still fairly certain I was taught to... well not do the thing.

XD

Thanks, anyway, this is a great reminder.

(OP) :D

Silly little EMT anon again.

I don't know if you're tracking this thread, but I have some questions.
I also have a tumblr and a tumblr / Ao3 / handle email if you would prefer to talk there?

Anyway, I'm writing a fic where there is an alien invasion (again) / large scale disaster and people get wind of it before hand. Instead of evacuating like everyone else, my character (who has super strength, a decent healing factor, EMT training as well as whatever other training he would have picked up from being on the front lines) packs a bag of medical supplies and stays.

What would this character pack (he can carry one of those big EMT bags and also a back pack. He'd have only what you can get over the counter)? And, I mean, I could go find my text book but web based information is better, can you link me to a page about doing triage like this?

(OP) As an EMT, I expect that you'd have much better resources to answer this one than I would.

But my big kit includes:
disposable gloves
CPR mask
Thermometer
Sphygmomanometer
Glucometer
Bandage materials (including bandage scissors - at least two pair)
OTC meds for pain, inflammation, and allergies as well as low dose aspirin
L.A.W. (liquid antacid and water) to treat pepper spray or other mild acids
Sunscreen
Instant cold packs
Hand warmers
Cheap plastic ponchos (useful to keep from contaminating your clothes)
Lots of bandannas (useful as easy to carry face-masks)
Water (as much as you can carry - for wounds and hydration)
Granola bars
Honey
Penlight
Flashlight (mine's a solar-powered/hand-cranked flashlight/emergency radio)
Box-cutter

If I were knowingly going into a urban disaster area with only OTC gear, off the top of my head, I would also bring rope, a headlamp, bolt-cutters, cheap aluminum curtain rods (for splinting), at least two smallish tarps, and a least one extra flashlight (maybe several smaller ones). I would wear galoshes (even without natural flooding, damaged water mains can lead to sublevel flooding anywhere), and I would bring heavy work gloves, several extra pair of socks and at least one change of clothes.

All of that said, with a major disaster, a big thing to think about beyond wounds is environmental dangers. With any large urban disaster, you WILL end up with fires. What season it it? Is exposure to extreme temperatures or other weather dangers a potential threat? Downed electric lines and contaminated water are big threats. Smoke and/or airborne debris. Structural damage to buildings which is a very dynamic situation long after the initial disaster.

If any of that makes you go WTF? Please ask! I'd love to get your feedback as well.