Archive for First Aid

What to carry in the woods

Posted in Fire, First Aid, Survival, Survival Kit, Tools, Water Procurement with tags , , , , , , , , , , on February 29, 2008 by jamesshrugged
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QuikClot

Posted in First Aid, Survival, Survival Kit with tags , , , , , , on February 24, 2008 by jamesshrugged

QuikClot

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At $9.99 this product is well worth it. It is a literal life saver in the case of severe bleeding.

PLANTS FOR MEDICINE

Posted in First Aid, Survival with tags , , , on November 22, 2007 by jamesshrugged

PLANTS FOR MEDICINE

9-29. In using plants for medical treatment, positive identification of the plants involved is as critical as when using them for food. Proper use of these plants is equally important.

TERMS AND DEFINITIONS

9-30. The following terms and their definitions are associated with medicinal plant use:

  • Poultice. This is crushed leaves or other plant parts, possibly heated, that are applied to a wound or sore either directly or wrapped in cloth or paper. Poultices, when hot, increase the circulation in the affected area and help healing through the chemicals present in the plants. As the poultice dries out, it draws the toxins out of a wound. A poultice should be prepared to a “mashed potatoes-like” consistency and applied as warm as the patient can stand.
  • Infusion or tisane or tea. This blend is the preparation of medicinal herbs for internal or external application. You place a small quantity of a herb in a container, pour hot water over it, and let it steep (covered or uncovered) before use. Care must always be taken to not drink too much of a tea in the beginning of treatment as it may have adverse reactions on an empty stomach.
  • Decoction. This is the extract of a boiled-down or simmered herb leaf or root. You add herb leaf or root to water. You bring them to a sustained boil or simmer them to draw their chemicals into the water. The average ratio is about 28 to 56 grams (1 to 2 ounces) of herb to 0.5 liter of water.
  • Expressed juice. These are liquids or saps squeezed from plant material and either applied to the wound or made into another medicine.

9-31. Many natural remedies work slower than the medicines you know. Therefore, start with smaller doses and allow more time for them to take effect. Naturally, some will act more rapidly than others. Many of these treatments are addressed in more detail in Chapter 4.

SPECIFIC REMEDIES

9-32. The following remedies are for use only in a survival situation. Do not use them routinely as some can be potentially toxic and have serious long- term effects (for example, cancer).

  • Antidiarrheals for diarrhea. This can be one of the most debilitating illnesses for a survivor or prisoner of war. Drink tea made from the roots of blackberries and their relatives to stop diarrhea. White oak bark and other barks containing tannin are also effective when made into a strong tea. However, because of possible negative effects on the kidneys, use them with caution and only when nothing else is available. Clay, ashes, charcoal, powdered chalk, powdered bones, and pectin can be consumed or mixed in a tannic acid tea with good results. These powdered mixtures should be taken in a dose of two tablespoons every 2 hours. Clay and pectin can be mixed together to give a crude form of Kaopectate. Pectin is obtainable from the inner part of citrus fruit rinds or from apple pomace. Tea made from cowberry, cranberry, or hazel leaves works, too. Because of its inherent danger to an already under-nourished survivor, several of these methods may need to be tried simultaneously to stop debilitating diarrhea, which can quickly dehydrate even a healthy individual.
  • Antihemorrhagics for bleeding. Make medications to stop bleeding from plantain leaves, or, most effectively, from the leaves of the common yarrow or woundwort (Achillea millefolium). These mostly give a physical barrier to the bleeding. Prickly pear (the raw, peeled part) or witch hazel can be applied to wounds. Both are good for their astringent properties (they shrink blood vessels). For bleeding gums or mouth sores, sweet gum can be chewed or used as a toothpick. This provides some chemical and antiseptic properties as well.
  • Antiseptics to clean infections. Use antiseptics to cleanse wounds, snake bites, sores, or rashes. You can make antiseptics from the expressed juice of wild onion or garlic, the expressed juice from chickweed leaves, or the crushed leaves of dock. You can also make antiseptics from a decoction of burdock root, mallow leaves or roots, or white oak bark (tannic acid). Prickly pear, slippery elm, yarrow, and sweet gum are all good antiseptics as well. All these medications are for external use only. Two of the best antiseptics are sugar and honey. Sugar should be applied to the wound until it becomes syrupy, then washed off and reapplied. Honey should be applied three times daily (see Chapter 4). Honey is by far the best of the antiseptics for open wounds and burns, with sugar being second.
  • Antipyretics for fevers. Treat a fever with a tea made from willow bark, an infusion of elder flowers or fruit, linden flower tea, and aspen or slippery elm bark decoction. Yarrow tea is also good. Peppermint tea is reportedly good for fevers.
  • Colds and sore throats. Treat these illnesses with a decoction made from either plantain leaves or willow bark. You can also use a tea made from burdock roots, mallow or mullein flowers or roots, and yarrow or mint leaves.
  • Analgesics for aches, pains, and sprains. Treat these conditions with externally applied poultices of dock, plantain, chickweed, willow bark, garlic, or sorrel. Sweet gum has some analgesic (pain relief) properties. Chewing the willow bark or making a tea from it is the best for pain relief as it contains the raw component of aspirin. You can also use salves made by mixing the expressed juices of these plants in animal fat or vegetable oils.
  • Antihistamines and astringents for itching or contact dermatitis. Relieve the itch from insect bites, sunburn, or plant poisoning rashes by applying a poultice of jewelweed (Impatiens biflora) or witch hazel, which give a cooling relief and dry out the weeping (Hamamelis virginiana) leaves. The jewelweed juice will help when applied to poison ivy, rashes, or insect stings. Jewelweed and aloe vera help relieve sunburn. In addition, dandelion sap, crushed cloves of garlic, and sweet gum have been used. Crushed leaves of burdock have received only so-so reports of success, but crushed, green plantain leaves show relief over a few days. Jewelweed is probably the best of these plants. Tobacco will deaden the nerve endings and can also be used to treat toothaches.
  • Sedatives. Get help in falling asleep by brewing a tea made from mint leaves or passionflower leaves.
  • Hemorrhoids. Treat them with external washes from elm bark or oak bark tea, from the expressed juice of plantain leaves, or from a Solomon’s seal root decoction. Tannic acid or witch hazel will provide soothing relief because of their astringent properties.
  • Heat rash. Tannic acid or witch hazel will provide soothing relief because of their astringent properties but cornstarch or any crushed and powdered, nonpoisonous plant should help to dry out the rash after a thorough cleansing.
  • Constipation. Relieve constipation by drinking decoctions from dandelion leaves, rose hips, or walnut bark. Eating raw daylily flowers will also help. Large amounts of water in any form are critical to relieving constipation.
  • Antihelminthics for worms or intestinal parasites. Most treatment for worms or parasites are toxic—just more so for the worms or parasites than for humans. Therefore, all treatments should be used in moderation. Treatments include tea made from tansy (Tanacetum vulgare) or from wild carrot (poisonous) leaves. Very strong tannic acid can also be used with caution as it is very hard on the liver. See Chapter 4 for more deworming techniques.
  • Antiflatulents for gas and cramps. Use a tea made from carrot seeds; use tea made from mint leaves to settle the stomach.
  • Antifungal washes. Make a decoction of walnut leaves, oak bark, or acorns to treat ringworm and athlete’s foot. Apply it frequently to the site, alternating with exposure to direct sunlight. Broad-leaf plantain has also been used with success but any treatment should be used in addition to sunlight if possible. Jewelweed and vinegar make excellent washes but are sometimes difficult to find.
  • Burns. Tannic acid, sugar, and honey can be used as explained in Chapter 4.
  • Dentifrices for teeth. See Chapter 4 for other techniques in addition to using twigs of sweet gum for its anti-inflammatory, analgesic, and antiseptic properties.
  • Insect repellents. Garlic and onions can be eaten and the raw plant juice rubbed on the skin to repel some insects. Sassafras leaves can be rubbed on the skin. Cedar chips may help repel insects around your shelter.
  • Tannic acid. Because tannic acid is used for so many treatments (burns, antihemorrhagics, antihelminthics, antiseptics, antidiarrheals, antifungals, bronchitis, skin inflammation, lice), a note as to its preparation is in order. All thready plants, especially trees, contain tannic acid. Hardwood trees generally contain more than softwood trees. Of the hardwoods, oak—especially red and chestnut—contain the highest amount. The warty looking knots in oak trees can contain as much as 28 percent tannic acid. This knot, the inner bark of trees, and pine needles (cut into 2-centimeter [1-inch] strips), can all be boiled down to extract tannic acid. Boiling can be done in as little as 15 minutes (very weak), to 2 hours (moderate), through 12 hours to 3 days (very strong). The stronger concoctions will have a dark color that will vary depending on the type of tree. All will have an increasingly vile taste in relation to their concentration.

HERBAL MEDICINES, FM 21-76

Posted in First Aid, Survival with tags , on November 22, 2007 by jamesshrugged

HERBAL MEDICINES

4-117. Our modern wonder drugs, laboratories, and equipment have obscured more primitive types of medicine involving determination, common sense, and a few simple treatments. However, in many areas of the world the people still depend on local “witch doctors” or healers to cure their ailments. Many of the herbs (plants) and treatments they use are as effective as the most modern medications available. In fact, many modern medications come from refined herbs.

WARNING

Use herbal medicines with extreme care, and only when you lack or have limited medical supplies. Some herbal medicines are dangerous and may cause further damage or even death. Chapter 9 explains some basic herbal medicine treatments.

ENVIRONMENTAL INJURIES, FM 21-76

Posted in First Aid, Survival with tags , , on November 22, 2007 by jamesshrugged

ENVIRONMENTAL INJURIES

4-105. Heatstroke, hypothermia, diarrhea, and intestinal parasites are environmental injuries you could face in a survival situation. Read and follow the guidance provided below.

HEATSTROKE

4-106. The breakdown of the body’s heat regulatory system (body temperature more than 40.5 degrees C [105 degrees F]) causes a heatstroke. Other heat injuries, such as cramps or dehydration, do not always precede a heatstroke. Signs and symptoms of heatstroke are—

  • Swollen, beet-red face.
  • Reddened whites of eyes.
  • Victim not sweating.
  • Unconsciousness or delirium, which can cause pallor, a bluish color to lips and nail beds (cyanosis), and cool skin.

NOTE: By this time, the victim is in severe shock. Cool the victim as rapidly as possible. Cool him by dipping him in a cool stream. If one is not available, douse the victim with urine, water, or at the very least, apply cool wet compresses to all the joints, especially the neck, armpits, and crotch. Be sure to wet the victim’s head. Heat loss through the scalp is great. Administer IVs and provide drinking fluids. You may fan the individual.

4-107. You can expect the following symptoms during cooling:

  • Vomiting.
  • Diarrhea.
  • Struggling.
  • Shivering.
  • Shouting.
  • Prolonged unconsciousness.
  • Rebound heatstroke within 48 hours.
  • Cardiac arrest; be ready to perform CPR.

NOTE: Treat for dehydration with lightly salted water.

CHILBLAINS

4-108. Frostnip begins as firm, cold and white or gray areas on the face, ears, and extremities that can blister or peel just like sunburn as late as 2 to 3 days after the injury. Frostnip, or chilblains as it is sometimes called, is the result of tissue exposure to freezing temperatures and is the beginning of frostbite. The water in and around the cells freezes, rupturing cell walls and thus damaging the tissue. Warming the affected area with hands or a warm object treats this injury. Wind chill plays a factor in this injury; preventative measures include layers of dry clothing and protection against wetness and wind.

TRENCH FOOT

4-109. Immersion or trench foot results from many hours or days of exposure to wet or damp conditions at a temperature just above freezing. The nerves and muscles sustain the main damage, but gangrene can occur. In extreme cases the flesh dies and it may become necessary to have the foot or leg amputated. The best prevention is to keep your feet dry. Carry extra socks with you in a waterproof packet. Dry wet socks against your body. Wash your feet daily and put on dry socks.

FROSTBITE

4-110. This injury results from frozen tissues. Frostbite extends to a depth below the skin. The tissues become solid and immovable. Your feet, hands, and exposed facial areas are particularly vulnerable to frostbite.

4-111. When with others, prevent frostbite by using the buddy system. Check your buddy’s face often and make sure that he checks yours. If you are alone, periodically cover your nose and lower part of your face with your mittens.

4-112. Do not try to thaw the affected areas by placing them close to an open flame. Frostbitten tissue may be immersed in 37 to 42 degrees C (99 to 109 degrees F) water until thawed. (Water temperature can be determined with the inside wrist or baby formula method.) Dry the part and place it next to your skin to warm it at body temperature.

HYPOTHERMIA

4-113. It is defined as the body’s failure to maintain an inner core temperature of 36 degrees C (97 degrees F). Exposure to cool or cold temperature over a short or long time can cause hypothermia. Dehydration and lack of food and rest predispose the survivor to hypothermia.

4-114. Immediate treatment is the key. Move the victim to the best shelter possible away from the wind, rain, and cold. Remove all wet clothes and get the victim into dry clothing. Replace lost fluids with warm fluids, and warm him in a sleeping bag using two people (if possible) providing skin-to-skin contact. If the victim is unable to drink warm fluids, rectal rehydration may be used.

DIARRHEA

4-115. A common, debilitating ailment caused by changing water and food, drinking contaminated water, eating spoiled food, becoming fatigued, and using dirty dishes. You can avoid most of these causes by practicing preventive medicine. However, if you get diarrhea and do not have antidiarrheal medicine, one of the following treatments may be effective:

  • Limit your intake of fluids for 24 hours.
  • Drink one cup of a strong tea solution every 2 hours until the diarrhea slows or stops. The tannic acid in the tea helps to control the diarrhea. Boil the inner bark of a hardwood tree for 2 hours or more to release the tannic acid.
  • Make a solution of one handful of ground chalk, charcoal, or dried bones and treated water. If you have some apple pomace or the rinds of citrus fruit, add an equal portion to the mixture to make it more effective. Take 2 tablespoons of the solution every 2 hours until the diarrhea slows or stops.

INTESTINAL PARASITES

4-116. You can usually avoid worm infestations and other intestinal parasites if you take preventive measures. For example, never go barefoot. The most effective way to prevent intestinal parasites is to avoid uncooked meat, never eat raw vegetables contaminated by raw sewage, and try not to use human waste as a fertilizer. However, should you become infested and lack proper medicine, you can use home remedies. Keep in mind that these home remedies work on the principle of changing the environment of the gastrointestinal tract. The following are home remedies you could use:

  • Salt water. Dissolve 4 tablespoons of salt in 1 liter of water and drink. Do not repeat this treatment.
  • Tobacco. Eat 1 to 1 1/2 cigarettes or approximately 1 teaspoon (pinch) of smokeless tobacco. The nicotine in the tobacco will kill or stun the worms long enough for your system to pass them. If the infestation is severe, repeat the treatment in 24 to 48 hours, but no sooner.
  • Kerosene. Drink 2 tablespoons of kerosene, but no more. If necessary, you can repeat this treatment in 24 to 48 hours. Be careful not to inhale the fumes. They may cause lung irritation.

NOTE: Tobacco and kerosene treatment techniques are very dangerous, be careful.

  • Hot peppers. Peppers are effective only if they are a steady part of your diet. You can eat them raw or put them in soups or rice and meat dishes. They create an environment that is prohibitive to parasitic attachment.
  • Garlic. Chop or crush 4 cloves, mix with 1 glass of liquid, and drink daily for 3 weeks.

Wounds FM 21-76

Posted in First Aid, Survival with tags , on November 22, 2007 by jamesshrugged

WOUNDS

4-89. An interruption of the skin’s integrity characterizes wounds. These wounds could be open wounds, skin diseases, frostbite, trench foot, or burns.

OPEN WOUNDS

4-90. Open wounds are serious in a survival situation, not only because of tissue damage and blood loss, but also because they may become infected. Bacteria on the object that made the wound, on the individual’s skin and clothing, or on other foreign material or dirt that touches the wound may cause infection.

4-91. By taking proper care of the wound you can reduce further contamination and promote healing. Clean the wound as soon as possible after it occurs by—

  • Removing or cutting clothing away from the wound.
  • Always looking for an exit wound if a sharp object, gunshot, or projectile caused a wound.
  • Thoroughly cleaning the skin around the wound.
  • Rinsing (not scrubbing) the wound with large amounts of water under pressure. You can use fresh urine if water is not available.

4-92. The “open treatment” method is the safest way to manage wounds in survival situations. Do not try to close any wound by suturing or similar procedures. Leave the wound open to allow the drainage of any pus resulting from infection. As long as the wound can drain, it generally will not become life-threatening, regardless of how unpleasant it looks or smells.

4-93. Cover the wound with a clean dressing. Place a bandage on the dressing to hold it in place. Change the dressing daily to check for infection.

4-94. If a wound is gaping, you can bring the edges together with adhesive tape cut in the form of a “butterfly” or “dumbbell” (Figure 4-7). Use this method with extreme caution in the absence of antibiotics. You must always allow for proper drainage of the wound to avoid infection.

Figure 4-7. Butterfly Closure

Figure 4-7. Butterfly Closure

4-95. In a survival situation, some degree of wound infection is almost inevitable. Pain, swelling, and redness around the wound, increased temperature, and pus in the wound or on the dressing indicate infection is present.

4-96. If the wound becomes infected, you should treat as follows:

  • Place a warm, moist compress directly on the infected wound. Change the compress when it cools, keeping a warm compress on the wound for a total of 30 minutes. Apply the compresses three or four times daily.
  • Drain the wound. Open and gently probe the infected wound with a sterile instrument.
  • Dress and bandage the wound.
  • Drink a lot of water.
  • In the event of gunshot or other serious wounds, it may be better to rinse the wound out vigorously every day with the cleanest water available. If drinking water or methods to purify drinking water are limited, do not use your drinking water. Flush the wound forcefully daily until the wound is healed over. Your scar may be larger but your chances of infection are greatly reduced.
  • Continue this treatment daily until all signs of infection have disappeared.

4-97. If you do not have antibiotics and the wound has become severely infected, does not heal, and ordinary debridement is impossible, consider maggot therapy as stated below, despite its hazards:

  • Expose the wound to flies for one day and then cover it.
  • Check daily for maggots.
  • Once maggots develop, keep wound covered but check daily.
  • Remove all maggots when they have cleaned out all dead tissue and before they start on healthy tissue. Increased pain and bright red blood in the wound indicate that the maggots have reached healthy tissue.
  • Flush the wound repeatedly with sterile water or fresh urine to remove the maggots.
  • Check the wound every 4 hours for several days to ensure all maggots have been removed.
  • Bandage the wound and treat it as any other wound. It should heal normally.

SKIN DISEASES AND AILMENTS

4-98. Boils, fungal infections, and rashes rarely develop into a serious health problem. They cause discomfort and you should treat them as follows:

Boils

4-99. Apply warm compresses to bring the boil to a head. Another method that can be used to bring a boil to a head is the bottle suction method. Use an empty bottle that has been boiled in water. Place the opening of the bottle over the boil and seal the skin forming an airtight environment that will create a vacuum. This method will draw the pus to the skin surface when applied correctly. Then open the boil using a sterile knife, wire, needle, or similar item. Thoroughly clean out the pus using soap and water. Cover the boil site, checking it periodically to ensure no further infection develops.

Fungal Infections

4-100. Keep the skin clean and dry, and expose the infected area to as much sunlight as possible. Do not scratch the affected area. During the Southeast Asian conflict, soldiers used antifungal powders, lye soap, chlorine bleach, alcohol, vinegar, concentrated salt water, and iodine to treat fungal infections with varying degrees of success. As with any “unorthodox” method of treatment, use these with caution.

Rashes

4-101. To treat a skin rash effectively, first determine what is causing it. This determination may be difficult even in the best of situations. Observe the following rules to treat rashes:

  • If it is moist, keep it dry.
  • If it is dry, keep it moist.
  • Do not scratch it.

4-102. Use a compress of vinegar or tannic acid derived from tea or from boiling acorns or the bark of a hardwood tree to dry weeping rashes. Keep dry rashes moist by rubbing a small amount of rendered animal fat or grease on the affected area.

4-103. Remember, treat rashes as open wounds; clean and dress them daily. There are many substances available to survivors in the wild or in captivity for use as antiseptics to treat wounds. Follow the recommended guidance below:

  • Iodine tablets. Use 5 to 15 tablets in a liter of water to produce a good rinse for wounds during healing.
  • Garlic. Rub it on a wound or boil it to extract the oils and use the water to rinse the affected area.
  • Salt water. Use 2 to 3 tablespoons per liter of water to kill bacteria.
  • Bee honey. Use it straight or dissolved in water.
  • Sphagnum moss. Found in boggy areas worldwide, it is a natural source of iodine. Use as a dressing.
  • Sugar. Place directly on wound and remove thoroughly when it turns into a glazed and runny substance. Then reapply.
  • Syrup. In extreme circumstances, some of the same benefits of honey and sugar can be realized with any high-sugar-content item.

NOTE: Again, use noncommercially prepared materials with caution.

BURNS

4-104. The following field treatment for burns relieves the pain somewhat, seems to help speed healing, and offers some protection against infection:

  • First, stop the burning process. Put out the fire by removing clothing, dousing with water or sand, or by rolling on the ground. Cool the burning skin with ice or water. For burns caused by white phosphorous, pick out the white phosphorous with tweezers; do not douse with water.
  • Soak dressings or clean rags for 10 minutes in a boiling tannic acid solution (obtained from tea, inner bark of hardwood trees, or acorns boiled in water).
  • Cool the dressings or clean rags and apply over burns. Sugar and honey also work for burns with honey being especially effective at promoting new skin growth and stopping infections. Use both as you would in an open wound above.
  • Treat as an open wound.
  • Replace fluid loss. Fluid replacement can be achieved through oral (preferred) and intravenous routes (when resources are available). One alternate method through which rehydration can be achieved is through the rectal route. Fluids do not need to be sterile, only purified. A person can effectively absorb approximately 1 to 1.5 liters per hour by using a tube to deliver fluids into the rectal vault.
  • Maintain airway.
  • Treat for shock.
  • Consider using morphine, unless the burns are near the face.

Bites and Stings, FM 21-76

Posted in First Aid, Survival with tags , on November 22, 2007 by jamesshrugged

BITES AND STINGS

4-66. Insects and related pests are hazards in a survival situation. They not only cause irritations, but they are often carriers of diseases that cause severe allergic reactions in some individuals. In many parts of the world you will be exposed to serious, even fatal, diseases not encountered in the United States.

  • Ticks can carry and transmit diseases, such as Rocky Mountain spotted fever common in many parts of the United States. Ticks also transmit Lyme disease.
  • Mosquitoes may carry malaria, dengue, and many other diseases.
  • Flies can spread disease from contact with infectious sources. They are causes of sleeping sickness, typhoid, cholera, and dysentery.
  • Fleas can transmit plague.
  • Lice can transmit typhus and relapsing fever.

4-67. The best way to avoid the complications of insect bites and stings is to keep immunizations (including booster shots) up-to-date, avoid insect-infested areas, use netting and insect repellent, and wear all clothing properly.

4-68. If you are bitten or stung, do not scratch the bite or sting; it might become infected. Inspect your body at least once a day to ensure there are no insects attached to you. If you find ticks attached to your body, cover them with a substance (such as petroleum jelly, heavy oil, or tree sap) that will cut off their air supply. Without air, the tick releases its hold, and you can remove it. Take care to remove the whole tick. Use tweezers if you have them. Grasp the tick where the mouthparts are attached to the skin. Do not squeeze the tick’s body. Wash your hands after touching the tick. Clean the tick wound daily until healed.

TREATMENT

4-69. It is impossible to list the treatment of all the different types of bites and stings. However, you can generally treat bites and stings as follows:

  • If antibiotics are available for your use, become familiar with them before deployment and use them.
  • Predeployment immunizations can prevent most of the common diseases carried by mosquitoes and some carried by flies.
  • The common fly-borne diseases are usually treatable with penicillins or erythromycin.
  • Most tick-, flea-, louse-, and mite-borne diseases are treatable with tetracycline.
  • Most antibiotics come in 250 milligram (mg) or 500 mg tablets. If you cannot remember the exact dose rate to treat a disease, 2 tablets, 4 times a day, for 10 to 14 days will usually kill any bacteria.

BEE AND WASP STINGS

4-70. If stung by a bee, immediately remove the stinger and venom sac, if attached, by scraping with a fingernail or a knife blade. Do not squeeze or grasp the stinger or venom sac, as squeezing will force more venom into the wound. Wash the sting site thoroughly with soap and water to lessen the chance of a secondary infection.

4-71. If you know or suspect that you are allergic to insect stings, always carry an insect sting kit with you.

4-72. Relieve the itching and discomfort caused by insect bites by applying—

  • Cold compresses.
  • A cooling paste of mud and ashes.
  • Sap from dandelions.
  • Coconut meat.
  • Crushed cloves of garlic.
  • Onion.

SPIDER BITES AND SCORPION STINGS

4-73. The black widow spider is identified by a red hourglass on its abdomen. Only the female bites, and it has a neurotoxic venom. The initial pain is not severe, but severe local pain rapidly develops. The pain gradually spreads over the entire body and settles in the abdomen and legs. Abdominal cramps and progressive nausea, vomiting, and a rash may occur. Weakness, tremors, sweating, and salivation may occur. Anaphylactic reactions can occur. Symptoms may worsen for the next three days and then begin to subside for the next week. Treat for shock. Be ready to perform CPR. Clean and dress the bite area to reduce the risk of infection. An antivenin is available.

4-74. The funnelweb spider is a large brown or gray spider found in Australia. The symptoms and the treatment for its bite are as for the black widow spider.

4-75. The brown house spider or brown recluse spider is a small, light brown spider identified by a dark brown violin on its back. There is no pain, or so little pain, that usually a victim is not aware of the bite. Within a few hours a painful red area with a mottled cyanotic center appears. Necrosis does not occur in all bites, but usually in 3 to 4 days, a star-shaped, firm area of deep purple discoloration appears at the bite site. The area turns dark and mummified in a week or two. The margins separate and the scab falls off, leaving an open ulcer. Secondary infection and regional swollen lymph glands usually become visible at this stage. The outstanding characteristic of the brown recluse bite is an ulcer that does not heal but persists for weeks or months. In addition to the ulcer, there is often a systemic reaction that is serious and may lead to death. Reactions (fever, chills, joint pain, vomiting, and a generalized rash) occur chiefly in children or debilitated persons.

4-76. Tarantulas are large, hairy spiders found mainly in the tropics. Most do not inject venom, but some South American species do. They have large fangs. If bitten, pain and bleeding are certain, and infection is likely. Treat a tarantula bite as for any open wound, and try to prevent infection. If symptoms of poisoning appear, treat as for the bite of the black widow spider.

4-77. Scorpions are all poisonous to a greater or lesser degree. There are two different reactions, depending on the species:

  • Severe local reaction only, with pain and swelling around the area of the sting. Possible prickly sensation around the mouth and a thick-feeling tongue.
  • Severe systemic reaction, with little or no visible local reaction. Local pain may be present. Systemic reaction includes respiratory difficulties, thick-feeling tongue, body spasms, drooling, gastric distention, double vision, blindness, involuntary rapid movement of the eyeballs, involuntary urination and defecation, and heart failure. Death is rare, occurring mainly in children and adults with high blood pressure or illnesses.

4-78. Treat scorpion stings as you would a black widow bite.

SNAKEBITES

4-79. The chance of a snakebite in a survival situation is rather small, if you are familiar with the various types of snakes and their habitats. However, it could happen and you should know how to treat a snakebite. Deaths from snakebites are rare. More than one-half of the snakebite victims have little or no poisoning, and only about one-quarter develop serious systemic poisoning. However, the chance of a snakebite in a survival situation can affect morale, and failure to take preventive measures or failure to treat a snakebite properly can result in needless tragedy.

4-80. The primary concern in the treatment of snakebite is to limit the amount of eventual tissue destruction around the bite area.

4-81. A bite wound, regardless of the type of animal that inflicted it, can become infected from bacteria in the animal’s mouth. With nonpoisonous as well as poisonous snakebites, this local infection is responsible for a large part of the residual damage that results.

4-82. Snake venoms not only contain poisons that attack the victim’s central nervous system (neurotoxins) and blood circulation (hemotoxins), but also digestive enzymes (cytotoxins) to aid in digesting their prey. These poisons can cause a very large area of tissue death, leaving a large open wound. This condition could lead to the need for eventual amputation if not treated.

4-83. Shock and panic in a person bitten by a snake can also affect the person’s recovery. Excitement, hysteria, and panic can speed up the circulation, causing the body to absorb the toxin quickly. Signs of shock occur within the first 30 minutes after the bite.

4-84. Before you start treating a snakebite, determine whether the snake was poisonous or nonpoisonous. Bites from a nonpoisonous snake will show rows of teeth. Bites from a poisonous snake may have rows of teeth showing, but will have one or more distinctive puncture marks caused by fang penetration. Symptoms of a poisonous bite may be spontaneous bleeding from the nose and anus, blood in the urine, pain at the site of the bite, and swelling at the site of the bite within a few minutes or up to 2 hours later.

4-85. Breathing difficulty, paralysis, weakness, twitching, and numbness are also signs of neurotoxic venoms. These signs usually appear 1.5 to 2 hours after the bite.

4-86. If you determine that a poisonous snake bit an individual, take the following steps:

  • Reassure the victim and keep him still.
  • Set up for shock and force fluids or give by intravenous (IV) means.
  • Remove watches, rings, bracelets, or other constricting items.
  • Clean the bite area.
  • Maintain an airway (especially if bitten near the face or neck) and be prepared to administer mouth-to-mouth resuscitation or CPR.
  • Use a constricting band between the wound and the heart.
  • Immobilize the site.
  • Remove the poison as soon as possible by using a mechanical suction device. Do not squeeze the site of the bite.

4-87. You should also remember four very important guidelines during the treatment of snakebites. Do not

  • Give the victim alcoholic beverages or tobacco products. Never give atropine! Give morphine or other central nervous system (CNS) depressors.
  • Make any deep cuts at the bite site. Cutting opens capillaries that in turn open a direct route into the blood stream for venom and infection.

NOTE: If medical treatment is over 1 hour away, make an incision (no longer than 6 millimeters [1/4 inch] and no deeper than 3 millimeters [1/8 inch]) over each puncture, cutting just deep enough to enlarge the fang opening, but only through the first or second layer of skin. Place a suction cup over the bite so that you have a good vacuum seal. Suction the bite site 3 to 4 times. Suction for a MINIMUM of 30 MINUTES. Use mouth suction only as a last resort and only if you do not have open sores in your mouth. Spit the envenomed blood out and rinse your mouth with water. This method will draw out 25 to 30 percent of the venom.

  • Put your hands on your face or rub your eyes, as venom may be on your hands. Venom may cause blindness.
  • Break open the large blisters that form around the bite site.

4-88. After caring for the victim as described above, take the following actions to minimize local effects:

  • If infection appears, keep the wound open and clean.
  • Use heat after 24 to 48 hours to help prevent the spread of local infection. Heat also helps to draw out an infection.
  • Keep the wound covered with a dry, sterile dressing.
  • Have the victim drink large amounts of fluids until the infection is gone.
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