Travel Medical Issues

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

Eye Injuries

Eye Injuries 300 214 Greg Ellifritz

Treating eye injuries in remote locations is a topic that doesn’t get enough attention.  These injuries are fairly common and can certainly wreck your trip or force and expensive evacuation if not managed correctly.

 

In Approach to the Red Eye, you’ll find a quality tutorial on diagnosing and treating common eye injuries in the field.  Check it out if you are at all interested in remote medical care.

 

 

Parasitic Infections

Parasitic Infections 150 150 Greg Ellifritz

I’ve traveled to more than 50 countries on all seven continents and I’ve never been afflicted with worms.  I caught giardia one time, but that was when I was hiking in the United States.

 

I think most travelers’ concerns about worms are overblown.  With that said,  here is a fairly comprehensive article about dealing with parasites.  It might be useful to stockpile a few of the recommended drugs/alternative treatments in case of an emergency.

 

What’s Bugging You? Dealing With Parasites in Humans

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Albendazole, Mebendazole, and Metronidazole are commonly available without prescription in most developing world pharmacies.  I have them all in my travel medical kit.

Wound Cleaning in Austere Environments

Wound Cleaning in Austere Environments 800 450 Greg Ellifritz

Many of you might not have a well equipped medical bag that you carry on your travels.  What if you cut yourself and don’t have accesses to definitive medical care?  What if you don’t have chemical wound disinfectants like alcohol or hydrogen peroxide?

 

The proper cleaning of wounds is of critical importance, especially in austere conditions where there are limited (or non-existent) supplies of chemical disinfectants or antibiotics.  With proper irrigation, chemical disinfectants and antibiotics aren’t likely to be necessary.  It takes about one liter of water under pressure per inch length of wound.   Here are some more tips on how to do it right.

 

Antediluvian Methods? An Evidence-Based Approach to Wound Irrigation

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You may also fine the information below valuable.

 

Wound Cleaning is One of the Most Important Skills to Know

 

This article is guide for cleaning and dressing wounds in the field.  When you don’t have the luxury of a hospital nearby, preventing infection is extremely important.

 

 

 

Wilderness Wound Closure

Wilderness Wound Closure 728 485 Greg Ellifritz

I get a lot of questions from remote travelers about wound closure in the field.  They ask about stapling and suturing.  Those skills are useful, but honestly most lay practitioners would be better off using steri-strips or glue to close wounds.

 

Check out the article linked below.  It provides one of the best tutorials I’ve seen about how to close wounds using glue.  Since the article has been released, there has been new research that has been published about using the common cyanoacrylate (Super-Glue or Crazy Glue) glues on human skin.

 

All cyanoacrylate glues are antibacterial.  The new research indicated that the over-the-counter version of these glues may sting more, but will work almost as well as the surgical Dermabond.  Your hardware store superglue will not harm tissue and will hold about one day less than the premium tissue adhesives.

 

If you are planning on adding glue to your first aid kit, I would advise buying the “gel” form of the product.  I find it easier to use than the liquid.

The Complete Guide to Using Super Glue for Cuts

 

And speaking about austere medicine, you may also want to read this article about the best way to sterilize medical instruments in the field.

 

First Aid for Sand Fly Bites

First Aid for Sand Fly Bites 960 720 Greg Ellifritz

If you travel to tropical environments (especially to beach areas in those environments) you are likely to encounter various insect bites.  The article below describes some of the likely suspects and goes over some useful treatment protocols.

 

Sand Fleas and Flies

 

I’ve had quite a bit of experience dealing with sand fly bites in the Caribbean, Egypt, and South America.  Besides the advice provided in the linked article above, I have a few more suggestions.

 

If the hydrocortisone cream recommended in the article isn’t stopping the itch, you could also try a topical corticosteroid called triamcinolone.  It is commonly sold in foreign pharmacies and is more potent than the OTC hydrocortisone you can buy here in the States.  The triamcinolone shouldn’t be used on sensitive areas of the body (genitals, face, etc.) because it may cause irritation or skin thickening.  I’m not a doctor and this isn’t medical advice, but I’ve had good luck with this product if OTC hydrocortisone fails.

 

If the rash persists for more than a couple days, visit a doctor.  You may also check out the local pharmacy.  In most countries in the developing world, pharmacies sell tubes of combination steroid/anti-fungal/antibiotic creams over the counter.  That makes a precise diagnosis unnecessary if you can’t make it to the doctor.  No matter what is causing the skin irritation, these multidrug creams take care of the problem.

 

If itching insect bites or rashes are driving you crazy and you have no medication, try hot water. Place the affected area under water (as hot as you can stand) for three to five minutes.  The hot water might neutralize the toxins that cause the rash.  The effect is only temporary, however.  You may need to repeat the process every couple hours.  Ammonia may also work to temporarily relieve the itching from some bites.

The author of the linked article wrote a book called Survival Medicine.  Check it out if you are looking for more medical information.  It is an excellent reference.

 

 

My arm after sleeping on the beach in a hammock in Colombia.  Unfortunately the hammock’s mosquito net was made for Colombian-sized people. When your limbs touch the net, the sandflies just chew right through…and yes, I was wearing DEET.

 

 

Some of the above links (from Amazon.com) are affiliate links.   As an Amazon associate I earn a small percentage of the sale price from qualifying purchases.

Travel First Aid Kits

Travel First Aid Kits 680 400 Greg Ellifritz

Check out Nomadic Matt’s article titled How To Pack A Professional Travel First Aid Kit.

This is an excellent article on what kind of first aid supplies you should carry when traveling.  For most folks, Matt’s list would be enough to treat the majority of injuries they might encounter.

I would add a few things to make it more complete:

– a CAT Tourniquet for severe bleeding

– some duct tape (because surgical tape doesn’t stick well to wet skin)

– a broad spectrum antibiotic (usually Cipro, Levaquin, or Augmentin but you may consider Azithromycin if traveling in SE Asia)

– a prescription anti-nausea medication like Zofran.

Depending upon where you travel, you may be able to buy the prescription meds I recommend over the counter in other countries.