Guide to Basic Survival Medicine: Understanding and Treating Common Wounds

JR Montana

7 years ago

Old school survival first aid kit for miners

After basic survival health and hygiene, wounds — and treating wounds — are one of the most primary concerns of survival medicine.

A wound is simply an interruption of the skin’s integrity, including open wounds, skin diseases, frostbite, trench foot, and burns.

Whether in the backcountry/wilderness or a full-on SHTF survival situation, understanding how to treat the most common wounds in the field is a critical skill. Here’s an overview of the most typical wound types and how to treat them with proper survival medicine.

Survival Medicine: Common Types of Wounds and How to Treat Them

Open Wounds

Open wounds are a serious threat to survival, 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.

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, gun shot, 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.

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.

Proper Butterfly Closure

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.

If a wound is gaping, you can bring the edges together with adhesive tape cut in the form of a “butterfly” or “dumbbell”.

In any 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 an infection is present.

To treat an infected wound:

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.

Continue this same treatment daily until it’s clear that all signs of infection have disappeared.

If you do not have antibiotics on hand and the wound has become severely infected, does not heal, and ordinary debridement is impossible, consider maggot therapy. 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 four 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

Although boils, fungal infections, and rashes rarely develop into a serious health problem, they cause discomfort and you should treat them.

Boils

Apply warm compresses to bring the boil to a head. 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

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 it with caution.

Rashes

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.

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.

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 wound:

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.

Again, use noncommercially prepared materials with caution.

Frostbite

This injury results from frozen tissues. Light frostbite involves only the skin that takes on a dull, whitish pallor. Deep 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.

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.

Do not try to thaw the affected areas by placing them close to an open flame. Gently rub them in lukewarm water. Dry the part and place it next to your skin to warm it at body temperature.

Trench Foot

This condition 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.

Burns

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.
Treat as an open wound.
Replace fluid loss.
Maintain airway.
Treat for shock.
Consider using morphine unless the burns are near the face.

Environmental Injuries

Heatstroke, hypothermia, diarrhea, and intestinal parasites are all environmental injuries you could face in a survival situation.

Heatstroke

The breakdown of the body’s heat regulatory system (body temperature more than 40.5 degrees C [105 degrees F]) causes 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.

While the victim is cooling, expect:

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.

Hypothermia

Defined as the body’s failure to maintain a 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.

Unlike heatstroke, you must gradually warm the hypothermia victim. Get the victim into dry clothing. Replace lost fluids, and warm him.

Diarrhea

A common, debilitating ailment caused by a change of 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.

If you get diarrhea, however, 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

You can usually avoid worm infestations and other intestinal parasites by taking basic preventive measures.

For example, never go barefoot. The most effective way to prevent intestinal parasites is to avoid uncooked meat and raw vegetables contaminated by raw sewage or human waste used 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:

Saltwater. Dissolve 4 tablespoons of salt in 1 liter of water and drink. Do not repeat this treatment.
Tobacco. Eat 1 to 1.5 cigarettes. The nicotine in the cigarette 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.
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.