Bunker Med – Suturing Under Austere Conditions – PART IV
PART IV OF IV Download “Suturing Under Austere Conditions Guideline” by clicking on link below: www.box.net DISCLAIMER: TECHNIQUES AND INFORMATION EXPRESSED IN THIS VIDEO SERIES ARE INTENDED FOR INSTRUCTIONAL PURPOSES ONLY. APPLICATION CARRIES POTENTIAL FOR INJURY AND HARM. USE COMMON SENSE. SEEK APPROPRIATE TRAINING. THE VIDEO PRODUCER ASSUMES NO LIABILITY. No “hallway monitor” comments please. It is recognized that this will be used rarely in difficult situations and as such not optimal for sterility or technique. Sterility in an austere wilderness environment will be difficult, if not impossible, to achive. This information is meant to help those that may be required to provide this level of care in a difficult situation. This 4-part video series, Suturing Under Austere Conditions”, covers the basic tenants of suturing as aa wound management option under austere conditions such as a remote wilderness setting. There are a number of risks that need to be considered, so this should not be the first closure choice for wound closure. Exposure from cold, wet, windy, dark conditions will add significant difficulty. Appropriate training and practice are paramount before adding this to your wilderness medicine treatment arsenal. ALOKSAK® ELEMENT-PROOF BAGS www.loksak.com www.rei.com bepreparedtosurvive.com www.thewaterproofstore.com
@bigjohn20081983 – suture material is readily available to the general public via many sources, including REI which markets the Adventure Medical Suture Kit. That said, there are a always expedient alternatives to anything, including wound management. Suture is essentially a monofilament nylon material with a swaged needle. Fishing leader would be a reasonable alternative w/ a small curved carpet needle. Not my first choice of course, but then a gain, suturing in the field is not a first choice.
@Vandy1212 – remember in the field at best this is a clean procedure. It is always good to clean any instrument in the field before using it. Plain water is perfect for irrigation of wounds. You don’t need to use normal saline (NS) for irrigating a wound. Besides, I doubt saline is going to be readily available in the field. Thanks for watching!
@Vandy1212 – I try to answer as many posts as possible. It is sometimes very difficult as I gat a lot of email every day from multiple sources, including YouTube. If I were to use a needle driver in my kit it would be a standard needle driver. I did include a standard needle driver in my Level II kit. Many thanks for the kind words and support!
One poster asked you about which needle driver you would use if you indeed did carry one in your kit and you didn’t answer. I am interested in this answer too.
Finally, I absolutely loved your video. You are very skilled and taught me some things I have never thought of during the suturing process. Love your channel and will watch all the videos.
Sir:
This is just me. I think I would have POURED some of the full strength
Betadine on the Leatherman before grabbing the suture needle, or, at least have wiped it down with alcohol or somehow decontaminated it.
Also, I could be totally wrong about this, but wouldn’t an isotonic solution be better for irrigation? Water to me would macerate the wound. Wouldn’t NS be better? If you don’t think so, I’m open to an education..I love this stuff.
get some .5 percent plain xylocaine and some 25 guage needles or diabetic needles and you can numb it up.
Thank you so much for sharing your knowledge with us. I hope I never have to use this knowledge, but if I do, I’ll have you to thank.
Outstanding series Doc….thankyou.
Outstandig quality of Information. This is really helpfull. Thanks a lot.
i know this is probaly a very stupid question but can someone who can not get the suturing kits for whatever reason or dose not have them when they need them use mono fishing line or something similar and if so what type of neddle would the use or say like the mono leaders for a fly fishing pole thank in advanced john
i cant watch past 1:35 either.
Am I the only person that can’t watch past 1:35 before the video hangs?
Not that I am aware of . . . and you bring up a good point in that this procedure for most will be done without anesthetic. It can be done but will be painful. This is another reason that this needs to be considered for a last resort procedure under austere conditions, i.e. not able to evac to or no medical resources available.
great stuff. I’m truly motivated to save some pig’s feet! Semper Gumbi!
@ USNERDOC – I was thinking about this and since I dont do this everyday and being in a not ideal condition is there something I can put in my LVL 1 kit that will allow me to numb the area where I would be doing this so the person is not moving everywhere?
Hi! Thanks alot for this video, super! 1 question, how deep do you put your stiches? In the skin or just below? Thanks /Niklas
great series and this was one area of my Level 1 kit I needed some over view on. Thanks for taking the time to make this series and I think I will be doing some practice on some pigs feet my self. Thanks again.
Good point. They all have expiration dates, so I think you just have to use good judgement. My recommendation is to use the monofilament products such as nylon or prolene. Given good common sense, I don’t see how an expiration date would effect the use of these materials in an emergency.
You are more than welcome!
Thanks! I appreciate the comments and support.
I agree . . . I see this as a life skill . . . basic understanding of first aid is vital. I’m posting these for those that want to push the envelope for difficult situations.
Thanks for watching!
You are more than welcome! Thanks for the support.
Thanks for the great comments and for watching!
I get a lot of questions on where to get suture material, so keep an eye peeled for a source list soon to posted.
You certainly could carry a needle driver which would be a good option. They don’t weigh very much but would add a bit of bulk to you kit as well as some stiffness. Needle drivers would not make a very effective splinter removal tool. Since aneedle driver and multi-tool would be need to be wiped down with an alcohol pad before use, I doubt you would gain any increased cleanliness.
this is just me, but I think expiry dates are more for absorbable sutures like catgut, since it’s made from a natural material, possible to rot and lose it’s necessary strength to hold a wound closed, could also cause infection by attracting bacteria to the rotting suture.