First Aid: Treat Major Wounds
How to identify trouble signs and prevent potentially fatal complications.
If you’re close to a trailhead, treating deeply sliced or scratched skin is straightforward: Get to a hospital, fast. In the wilderness, you have to judge
the wound’s severity, clean it aggressively, and watch for infection as you evacuate. Here are tools to help:
1. Diagnose: Evaluate the wound and evacuate if... >> You see underlying structures like bone, tendons, or ligaments beneath the skin. >> Anything (splinters, sand, etc.) is embedded in the flesh and you can’t remove it. >> A resulting scar would be a cosmetic concern (on the face) or impede joint function. >> The victim or wound shows signs of infection or rapid worsening (increased redness, swelling, pain), or at any point after the first 24 hours.
2. Treat: Clean a wound >> Scrub or irrigate. Rub abrasions with gauze and water to remove visible debris. Flush deep cuts with at least one liter of high-pressure water
using an irrigation syringe (improvise with a hydration bladder and hose). Expect pain; additional bleeding and oozing will help flush the wound. >> Use soap. Suds kill invisible bacteria. >> Close the skin. If the wound edges don’t touch, tape the skin gently. Don’t overlap skin or close a cut that gapes more than half an inch;
leave those open. >> Cover it. Apply antibacterial ointment and the cleanest bandage you’ve got.
3. Monitor: Detect and slow infection >> Note changes. Pain, redness, and swelling should peak within 24 hours. >> Manage it. See signs of worsening? Reclean the cut, replace bandages, and soak the cut several times a day in hot water. Rush evac plans.
4. Evacuate: Determine your method >> Walk out: Almost always the best choice. If the victim is capable, get going. Splint to stabilize surrounding tissue. >> Ask for rescue: If the victim can’t hike, get help. No cell or emergency beacon? Ideally, one person stays with the victim while two people hike out.