The backcountry is beautiful. It is majestic and untouched by the moderness of society. It can bring us closer to God. Sometimes, closer than we need to be to coming face to face with him. It is because of all these things that we can enjoy it and appreciate it, but, we must also remember to respect it. At the end of it all, we must remember that it is wild and therefore unpredictable. It is often easy to become absorbed in its seemingly innocent appearance, ignoring threats or dangers that are all around. An ounce of preparation can save a pound of suffering.
As we pack our bags and gear, we always remember the necessities. Arrows, broad heads, releases, knives, skinners, rangefinders, binos, extra socks, scent sprays, and more. We rarely think of bandages, tourniquets, slings, and other medical supplies. These often come as an afterthought but I’d like to change that. If for nothing else, just to bring all my fellow outdoorsmen awareness of some reasonable dangers and some of the steps you can take to treat them. After all, just because we are all at the mercy of nature when we are in her domain, this does not mean that we are resigned to be her victim should the worst case scenario become our reality. So let’s get started shall we?
“As we pack our bags and gear, we always remember the necessities. Arrows, broad heads, releases, knives, skinners, rangefinders, binos, extra socks, scent sprays, and more. We rarely think of bandages, tourniquets, slings, and other medical supplies.“
Joshua Hicks
Some of the most common injuries sustained outdoors are lacerations. We’ve all been somewhat desensitized to them. We have all had a paper cut or even a mishap with a knife and a finger. Maybe a few of us have needed sutures or even heavy bandaging. Even fewer of us have needed more, however the risk is there for us more than the average person. In a quick thought manner, can you think of something you’d take hunting and the scenario in which you could be seriously cut? I can. Knives, skinners, broad heads, and more are regularly packed for the sole and intent purpose of cutting flesh. This is not to mention hand saws, machetes, and brush cutters packed to clear branches and a plethora of other sight and shot hindrances. The ecstatic high of adrenaline we experience when we have a successful harvest is unlike anything to which most of modern society can relate. It’s primal and encoded into our DNA by God. That high sometimes cast a feeling of completion over the rest of the hunt, however, the fact of the matter is that the harvest, that is to say, the actual kill, is only a third of the process. We must still field dress, pack, drag, or carry it out, and process the meat. All of these require knives and cutting implements. For the sake of this article, we will focus on the field dressing of the animal.
As we have all experienced, field dressing an animal isn’t easy, pleasant, or clean. When mixed with the cavity fluids and high adrenaline of the harvest, using a knife can become dangerous. Now at this point I understand if I am beginning to lose you or you are saying, “yeah, yeah, don’t run with scissors” or “never hand an open knife blade first to your pal”. I assure you I am not your Grandpa and that’s not where this is going, so bear with me. When reaching into the cavity or pulling the hide, our vision can become obstructed to the point that we are essentially cutting blind. A minor slip of the hand and we have acquired a shiny new laceration. This may have now become a life threatening situation. Do you know the next step? Can you identify an emergency from an inconvenience? Have you prepared for just such a scenario or have you felt too safe for too long doing what is normal and comfortable?
Any laceration or break in the skin should be viewed as a potential threat when in the wilderness. Arterial bleeding is far more pressing of a matter than venous but both can be life threatening. In emergency medicine, we have a saying that reminds us of the urgency to control bleeding. What is that saying you ask? “All bleeding stops, eventually.” With that in mind, let us focus on stopping it before the lack of blood supply does. I’ll take this time to give a brief description of the difference between arterial and venous bleeding. Arterial blood is carrying fresh oxygen and other nutrients to the entire body. It has not been used and is a vibrant red. The other major identifier is that it is under tremendous pressure inside the vessel. Once released, it will spray a good distance outside of the body and will do so with the beat of the pulse. This is very noticeable and easily observed. Venous blood is returning to the heart and lungs to be resupplied and pushed back out through the arteries. Due to the fact that it has low oxygen and nutrients as well as being on the return end of our vascular system, it is very dark in color and under much lower pressure making its loss much slower in nature(Of course this all depends heavily on the size of the laceration). It is the most common color of red we associate with bleeding. We’ve seen it in every scrap, scratch and papercut we’ve ever received. It will most likely steadily ooze out rather than spray. These are the essential visual differences between the two. Knowing them can save a life.
Assuming this laceration has produced a dark red blood in high volume or a bright red blood that is spraying with the beat of a pulse, direct pressure should be immediate. Israeli gauze would be the best by far but anything, including your bare hand will suffice. If it is producing high pressure, bright red blood spray, direct pressure will not be enough but it will buy time to get another option or device in place. This would be the time for a tourniquet. Do you have one in your pack? Have you set up an individual first aid kit, or IFAK? If so, kudos to you! We rarely rise to the occasion but always fall to our greatest level of preparation. If you do have a tourniquet, do you know how to use it? For all answers to that question, here is a crash course.
“This would be the time for a tourniquet. Do you have one in your pack?“
Joshua Hicks
Tourniquets are an implementation designed to occlude blood flow below their placement. That is to say, they should completely stop it. If there is no blood flow, there is no bleeding. This is good in the short term but harbors its own complications in the long term. The tourniquet should be placed above the joint closest to the laceration. An example would be a laceration of the arteries in the forearm necessitates a tourniquet placement at or above the elbow or a laceration of the brachial artery in the bicep region would necessitate a tourniquet placement above the injury and as high into the armpit as possible. This is where it becomes unpleasant, as if an arterial laceration wasn’t unpleasant enough. It must be tightened to block all blood flow to the site of the hemorrhage and this is very painful. After placement, tightening the device should be done until the bleeding stops and then a half turn past that. A pulse below the wound should not be present. If it is, then it needs to be tightened again. At this point, time is of the essence and the placement time of the device should be noted to the minute, either on the device or on the person. This will help emergency teams in the hospital. Now it’s time to get moving. Didn’t pack a tourniquet? Improvise and make one. Wrap a strip of cut cloth, from a t-shirt or anything with you, 2-4 times around the limb above the site of injury. With a knot tied where the ends meet, slide a sturdy, thin object like a metal ink pen, allen wrench from your bow maintenance kit (which I know you remembered to pack), or even an arrow without the broad head(after all, you don’t need 2 lacerations), through the cloth and begin to turn it like a knob. Every turn will increase the pressure exerted on the vessels under the skin to eventually occlude the blood flow. This method isn’t as effective as a commercial tourniquet but it can buy much needed time to seek help at a higher level.
Bleeding can kill. Slowing it can buy time for rescue. Stopping it can immediately save a life. Take the time to address this as a preparation for hunting season. Prepare for every scenario and make sure your hunting party has at least a working knowledge of what cautions to take. It seems like a trivial pursuit until catastrophe strikes. Then and only then does the value of preparation become apparent. We train for the pursuit but let’s also train to manage the unseen killers. We all deserve to spread the gift of hunting to the next generation and enjoy a steak over the campfire while we discuss our victories not consoling our friends over a loss of life.
I will cover sprains, fractures, and other bone injuries in my next article. I want all outdoorsmen to become the best hunters they can be and that includes elevating our ability to survive an emergency by saving ourselves. Remember, we rarely rise to the occasion but always fall to our greatest level of preparation.