medical skills

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

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

Whats-Bugging-You-

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

logo

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.

 

  • 1
  • 2