Breaks, burns, and cold injury
Splint it as it lies. Cool a burn with water, not grease. Frozen fingers get thawed once.
Broken bones
- 1.Look at the whole person first — air and bleeding beat a crooked arm.
- 2.Do not straighten a bone that has come through the skin unless the fingers or toes below are blue-black and you have no hope of a clinic. Then one gentle pull in line to restore color, and stop.
- 3.Splint as it lies. Pad the bone. Immobilize the joint above and the joint below. A rolled newspaper, a board, a SAM splint, or the other leg (for a broken leg) with padding between.
- 4.Check fingers or toes after you tie: pink, warm, they can wiggle. If you tied too tight, loosen.
- 5.An open break: wash what you can see, cover clean and moist, splint, treat for shock. This is the infection risk of their life.
Note. A femur (thigh) break can hide a pint of blood inside the thigh. Treat them like they are bleeding even if the skin is closed. Keep them down and warm.
Sprains, shoulders, fingers
Cannot tell sprain from break in the field? Treat as break for a few days. Rest, wrap, elevate, cool if you have ice. A walking sprain still wants a boot or wrap.
A shoulder that is clearly out, and you know the person, and no clinic is coming: one standard method is to lie them face-down on a table with the arm hanging, a few pounds in the hand, and wait 15–20 minutes for the muscle to quit. Do not yank like a movie. If it will not go, sling it and live with it. A second try that wrecks the nerves is worse than a bad shoulder.
A finger out: a firm pull in line, then buddy-tape to the next finger with a scrap of cloth between. Not the thumb — that one waits if you can.
Burns
- 1.Get the heat off. Cool running water 10–20 minutes. Not ice directly on skin.
- 2.Cut clothing away unless it is melted into them — then leave it and cut around.
- 3.No butter, grease, toothpaste, or ‘burn salve’ from a rumor. A clean dry sheet or a clean wet cloth if it is still burning-hot.
- 4.Blisters: leave them closed. If one rips, trim the dead skin with a clean scissor and cover.
- 5.Drink. Burned people leak fluid. Oral rehydration if they can swallow (see Illness).
| How bad | Field plan |
|---|---|
| Red only, like a sunburn | Water, aloe or nothing, shade. They will be sore. |
| Blisters, smaller than their own palm | Clean cover, change daily. Ibuprofen. |
| Blisters bigger than a palm, or any burn on face, hands, feet, groin, or around a joint | This is a hospital burn. In the field: fluid, clean cover, watch breathing if the face or smoke is involved. |
| White, leathery, or charred; no pain in the center | Deep. Same as above. They will need skin they do not have. Keep it clean. Do not expect a miracle. |
| Smoke, closed room, singing of nose hairs, soot in spit | The airway can swell hours later. Sit them up. Steam. Get them out of the smoke. Watch all night. |
Frostbite and trench foot
A wood stove will burn numb frostbitten skin before they feel it. Use water you can hold your own hand in.
White, waxy, numb fingers, toes, ears, nose after a January stand or a wet boot all day. Do not rub with snow. Do not thaw at the fire and then walk home on it — freeze–thaw–freeze kills the tissue.
If you can keep it from freezing again: warm water about 100–104°F (hot tub, not cooking) until pink and painful. Then dry, pad, and do not use that hand or foot as a tool. Blisters later are normal. Leave them.
Wet cold for days without freeze (creek boots in March): trench foot. Dry, warm, elevate, air the feet every night. Change wool socks. This is how woodsmen lost feet without a frost.