medical skills

Stingray Injuries

Stingray Injuries 768 610 Greg Ellifritz

I’ve seen a couple of stingray injuries in my travels over the years. They can be pretty nasty.   I once did a sea kayaking trip of the coast of Belize and the support boat driver got stung in the ankle while checking the moorings of the boat one night.  He was out of commission for about three days, unable to walk and having really bad flu-like symptoms.

Read about how to treat these stings in the field if you travel in areas near the ocean.

 

Stingray Injuries

Advanced Bleeding Control

Advanced Bleeding Control 800 451 Greg Ellifritz

Many of my readers regularly carry tourniquets and other more advanced medical devices on their person or in their car when in the USA.  But a lot of those folks leave their kits at home when they travel.  Folks are worried about having bags too heavy or are concerned about the potential legality of some medical equipment in other countries.

 
Can you control a femoral artery bleed when traveling without your medical kit?   Here are some great tips

 

“SUMMARY: Putting your knee in a casualty’s groin can eliminate common femoral artery blood flow. The key is to place your knee gently in the groin crease, putting too much body weight into your knee will be painful to the casualty, and they will not remain underneath it.”

 

Can’t I just kneel on his groin?

Skin Problems While Traveling

Skin Problems While Traveling 2016 1512 Greg Ellifritz

Have you considered what happens when you get a strange skin rash while traveling far away from medical care?  I didn’t until I took a trip to Belize in 2005.  My back was itching, so I took off my shirt to find this.

I didn’t know much about wilderness medicine at the time and had no idea it was just a simple heat rash.

 

Many of you might be in a similar position, having a strange rash, but not knowing what caused it.  That’s a common condition in the developing world.

 

A handy solution I carry in my medical kit now is a cream like this one, available over the counter at almost all developing world pharmacies.  I got this one in Mexico and it was about $1.50 US.

 

 

This cream contains a corticosteroid, an antifungal medicine, and an antibiotic.  One of those three drugs should fix almost any dermatological condition you might have

 

I am not a doctor and this is not medical advice.  I’m just sharing something I’ve found handy that is an everyday medical solution in developing countries, but would require a prescription to get in the USA.  It resides in all of my travel medical kits.

 

If you are looking for more information on similar topics, I have an entire section about remote and travel medicine in my book, Choose Adventure.

 

Back Injuries in Remote Environments

Back Injuries in Remote Environments 150 150 Greg Ellifritz

Your companion slipped and fell while hiking.  He may have a back injury.  How do you decide whether it is safe for him to walk out or if you need to medically evacuate?  This article gives some good suggestions for field level spinal clearances if help is far away.

 

Anyone who participates in athletic pursuits in third world countries without a quality EMS system should understand this information.

 

Backcountry Emergencies: Why You Should Learn How To Identify Spinal Injuries

 

 

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Medical Management of Frostbite

Medical Management of Frostbite 300 42 Greg Ellifritz

If your adventure travels take you to cold places, you’ll want to review this complete guide for treating frostbite in the field.

A New Proposal for Management of Severe Frostbite in the Austere Environment

How Not To Get Killed at the Airport

How Not To Get Killed at the Airport 569 1024 Greg Ellifritz

Written by Greg Ellifritz

 

LAX Shooting 2013 5

Since the shooting at LAX airport on November 1st, I’ve received lots of questions about how to stay safe in an airport when traveling.  Most of my readers carry weapons that can’t be carried past airport security.  Thus, their commonly relied upon means of defense isn’t available and they need an alternate defense plan.  It’s actually hard to give solid self protection advice for surviving airports.  Few good options exist.

 

America is one of the few countries in the world that allows relatively free access into the ticketing area of an airport.  In other countries, you will see lots of rifle-toting soldiers, checkpoints, and bomb sniffing dogs even before passengers get to the ticket counter or security lines.  It was only a matter of time before a terrorist or criminal chose to exploit this weakness.

 

Think about it…a terrorist could cause exactly the same result (mass casualties and a crippling strike to our economy) as bringing down a plane without ever having to board.  If terrorist groups bombed or shot up the unsecured ticketing areas of several airports sequentially, they would kill thousands and force Americans to stop flying.  And the terrorists could do it without having to remove their shoes at the security check or try to smuggle a bomb past the body scanner.  It would be easy.  That’s why the shooter at LAX chose that location to fire his weapon.

 

In reality, this has been done before.  Have you heard of the Moscow airport bombing?  It happened in January 2011.  Up to three Islamist suicide bombers set off bombs in the ticketing area of the Moscow airport, killing 37 people and injuring more than 180 more.

 

Here’s a brief video of the immediate aftermath…

I predict that we will see more attacks like this in coming years.  So what can we do to avoid getting killed?  Here are a few suggestions….

 

1) Don’t rush.  Get to the airport with plenty of extra time to spare.  When you are hurried and worrying about catching your flight, you aren’t paying good attention to what’s going on around you.  Not rushing to catch your plane will give you more time to keep an eye on your surroundings and avoid anything that makes you uncomfortable.  Download the My TSA App for your phone to get real time updates on delays and specific security wait times at the airport of your choosing.  Check the data and plan ahead so that you don’t have to hurry.

 

2) Do as much as possible to avoid standing at the ticketing counter.  Check your luggage at the curb (not allowed if you are checking firearms) or travel with a carry on only to avoid standing in the ticketing line.  Print your boarding pass at home.  The less time spent where people gather (especially lots of clueless people) the better.

 

3) Get through security as quickly as you can.  Even though our airport security is a farce, you are still safer inside the checkpoint than outside.  Don’t eat or have coffee in restaurants outside the security checkpoint.  Clear security quickly and then find a place to eat.  The best advice for clearing security quickly is in this Wired Magazine article.

 

Airsecurity2

4) Once you clear security, find your gate, any emergency exits, and any place where you might be able to acquire weapons for a more serious hostage situation or terrorist bombing.  Food preparation areas will generally have knives.  Maintenance areas will generally have tools.  Look for cleaning carts to find irritant chemicals.  You might need any of those items if things go bad.

 

5) Get away from as many people as possible.  Terrorists target large groups of people.  I’m a big fan of avoiding such groups and thus, I’m also a huge proponent of using airport lounges.  You will most likely have access to a lounge if you are traveling in Business or First Class or have preferred status with a certain airline.   Lounge Buddy is an App you can put on your phone that will tell you all of the available lounges and what the requirements are for entry.   You can also become a member of Priority Pass.  For an annual fee, you can get a set number of free lounge visits every year, even if you are flying coach.

 

Lounge Buddy Screen Shot

Lounge Buddy Screen Shot

 

6) Weapons and Equipment.  To be honest, for most terrorist attacks, any weapons that you are able to legally carry through security are likely to be inconsequential to the overall outcome.  I really don’t think you will take out multiple suicide bombers with your “tactical” pen.

 

But most of you carry weapons on a daily basis, so I’ll go over a few options for airport carry.  My first recommendation is to NEVER SMUGGLE ANYTHING ILLEGAL THROUGH SECURITY.  Yes, some things may make it through, but I don’t think the risk of spending years in prison is worth the advantage of having a small knife or something of the sort.  There are better defense options available that won’t get you thrown in prison.

 

– Canes: Canes are legal on an airplane.  You don’t even have to feign a limp.  As long as the cane doesn’t have a sword inside, it’s pretty much allowed to go through….even nasty fighting canes like the TDI/KaBar model.  While I don’t think canes are the best weapon to use ON a plane, they work well in the airport and in the terminal.

 

– Flashlights:  You should definitely have a flashlight in your carry-on.  I always carry at least two.  One of them is a headlamp that allows me to see and operate without tying up my hands.  It also works great when you are trying to read and you happen to be in the seat with the malfunctioning overhead reading light.

 

In addition to the headlamp, I also carry a flashlight that I can hit someone with.  I usually end up carrying a Surefire or Fenix brand light that uses two CR123 batteries.  They are bright, durable, fairly light, and perfect to use to defend yourself from a serious criminal

 

– Tactical pens:  Some pens are made stoutly enough to serve as impact weapons.  I would avoid the ones that are spiky or look like a weapon.  Those may be confiscated by TSA.  I prefer the lower profile tactical pens.  I carry one made by my friend Rick Hinderer all over the world and have never had an issue.

 

It’s probably a good idea to pack a pre-stamped, self addressed envelope in your carry-on bag.  If for some reason the TSA doesn’t like your pen or flashlight, you can mail it home to yourself.

 

-Improvised impact weapons.  Think along the idea of “a rock in a sock.”  A couple of D-cell batteries inside a long tube sock (put together after you clear security) makes a very nasty impact weapon.  I generally use an old biker weapon instead…a bandanna threaded through the hasp of a padlock.  You are limited only by your imagination.

 

Neither bandannas nor padlocks are prohibited by the TSA....

Neither bandannas nor padlocks are prohibited by the TSA….

 

7) Medical Supplies.  Don’t forget medical supplies.  The first aid kits on airplanes are laughably sparse.  And if something really bad happens in the airport, you shouldn’t expect to get help quickly.  Check out this article if you don’t believe me…

 

LAX security officer bled for 33 minutes as help stood by

 

In addition to the large medical kit I have in my checked bag, I also carry a smaller kit on my person or in my carry-on.  All the items inside must be TSA-legal and small enough that they don’t take up much room.   Mine is carried in a small Blackhawk nylon pouch.  Inside, I carry the following:

 

– A “snivel kit” with bandaids, OTC meds, antibiotic ointment and the like

– A CAT Tourniquet

– A Triangular bandage, carabiner, and key ring.  The bandage can be used for many conditions.  When I put the three together, I can make another tourniquet ala Paul Gomez (see video below)

– Duct tape

– Chest seals

– Pressure Dressing

Celox Hemostatic Gauze

– Prescription pain meds, anti-nausea meds, and broad spectrum antibiotics

– Safety pins

– Gauze pads

-Water purification tablets

Blister treatment

Here’s my “plane kit”…

 

Open

My airplane first aid kit (since photo was taken, I’ve replaced the TK-4 tourniquet with a CAT)

 

Having traveled to more than 50 countries in the last 15 years, this stuff is important to me.  I hope I gave you a few ideas to help keep yourself safer.

 

 

 

 

Mammalian Bite Wounds

Mammalian Bite Wounds 184 37 Greg Ellifritz

When you travel in the developing world, your risk of getting bitten by stray cats, dogs, and feral rats increases significantly.  One of the most important skills you should have is to know how to handle animal bite wounds.

 

The article linked below covers the basics for treating a bite wound.  You’ll note that the most commonly prescribed antibiotic for animal bite wounds is Augmentin.  I always carry some of it in my travel medical kit.  If your personal doc won’t prescribe a dose for you to take on your trip, you can generally buy it without a prescription in most developing world pharmacies.

 

Mammalian Bites: ED presentations, evaluation, and management

Tonsillitis In Austere Settings

Tonsillitis In Austere Settings 300 168 Greg Ellifritz

 

The basics of diagnosing and treating tonsillitis when definitive medical care is unavailable.  If you travel with children, this is critical information.

 

Wound Closure with Super Glue

Wound Closure with Super Glue 225 225 Greg Ellifritz

In very remote areas without available medical attention, it might be necessary to close a wound.  Doing so with steri-strips is the easiest method, but steri-strips don’t always work in extremely wet conditions.

 

The next best option is to use a tissue glue.  Super Glue or Crazy Glue is of a very similar chemical composition and may be easier to find.  I always carry a tube of the gel superglue in my third world first aid kit.

 

The article below goes into great detail about how to effectively use the glue to close a laceration.  Highly recommended.

 

Skin Glue in Survival

Marine Animal Bites and Stings

Marine Animal Bites and Stings 768 506 Greg Ellifritz

Adventure travelers often play in the ocean.  Ocean snorkeling, diving, swimming, surfing, and kayaking all expose on to the chance of being bitten or stung by some aquatic critters.

 

Over the years, I’ve experienced many of these envenomations.  Lots of jellyfish stings.  My sea kayaking tour guide got stung by a stingray in Belize.  It laid him up for a couple days.  This can be very serious stuff if you aren’t careful.

 

Even those of you who visit “tame” locations should still be cautious.  Last month I wanted to test my new snorkel mask before taking an ocean excursion.  I waded into the ocean off the beach of our five-star resort in Cancun.  I was in water about three feet deep and dove in.  I was instantly face to face with a pissed off stingray.  I’m amazed I didn’t get stung.

 

This is a compilation of simple first aid tips for handling marine animal bites and stings in the field.

 

Marine Animal Bites and Stings