When you want, or need, to know more than the superficial, such as when you are
where there is no access to a physician.
Prototypically: Medicine at Sea
This medical information is provided for education purposes only. I am making no attempt to practice medicine over the internet. This is being written to give some basic knowledge for those that are physically isolated from access to professional medical care, such as sailors at sea. This is to help in deciding whether an emergent medical condition exists, how to initially deal with it, and whether evacuation is needed. It is by no means exhaustive or meant to replace personal medical attention. Please do not contact me regarding your personal condition. Over the years I have received many emails from people asking for help with their personal chest pain, or whatever. Sometimes they write during acute pain. This is ridiculous. You can't practice medicine over the internet. If I find their email, after it has been filtered by my spam filter, it may be days or weeks later. My response, if any, will be to contact their regular provider. Even a bad doctor in person is better than an email. Please use this information in the spirit in which it is intended.
Sincerely, Mark R. Anderson, M.D.
my other interests
(Yes, I know this is sketchy, and needs expansion, with pictures. Please be patient.)
Practically any wound will heal eventually if left open if you:
1) Prevent exsanguination
2) Prevent life threatening infection
Wash it out
Pressure stream of water, (preferably with a bit of salt, e.g. 1/2 tsp./cup)
Use lots: Clean sea water OK if you finish with known clean water.
Unprovoked bite from potentially rabid animal (almost never in the US, but common in the 3rd world).
Get prompt medical attention. If it's rabid, you need the vaccine early. Once rabies symptoms develop, you will certainly die.
Wash all bite out VERY THOROUGHLY, especially human bites. Treat prophylactically with antibiotics if on the hand or feet. Augmentin is usually a good choice.
Not “Serious” unless over a quart is lost
Apply direct PRESSURE for 15 min. Ice bag.
Cauterize point bleeders if REALLY necessary. E.g. soldering iron, red hot paper clip
Tourniquet: Essentially never. Conceivably if multiple limbs w/ major wounds.
Question if it needs it.
Closure traps in infection.
Puncture wounds left open. Severely crushed wounds also.
Tape strips, tie hair together, superglue
Sutures (within 6 hrs. of injury, 24 hrs. for face)
Lidocaine into edges.
Needle enters perpendicular. Blanket stitch.
Clean and dry 1-2 days. Stitches/tape remain 5 days (face) 7-10 days elsewhere.
Infection: Hot, red, pain, tender, swelling. Open if pus. Antibiotics, (cephalexin or TMP/SMX)