Cuts and scrapes are common when traveling in the wilderness. Although most are minor, knowing how to properly treat wounds in the backcountry is an essential skill. Deep wounds can cause serious bleeding, and even small cuts can lead to infection.
Steps to treat backcountry wounds and cuts:
1. Stop the bleed
2. Clean the wound
3. Prevent infection
Step 1: Stop the bleed
The most effective way to stop bleeding is by applying direct pressure to the artery. Use your fingers (wear gloves) to provide localized pressure with your fingers. This can be very painful, especially if you have to dig your fingers into a cut to reach the artery. For deeper wounds, pack the laceration with gauze, then apply direct pressure.
If bleeding slows, it is possible to apply a temporary pressure dressing, which will continue to provide pressure to the wound, hands free.
If you fail to stop bleeding using direct pressure, the last resort is to apply a tourniquet ~1-2 inches above the wound. Tourniquets must be removed by a medical professional and will require a rapid evacuation. Tourniquets should be wide and padded. Tighten until bleeding stops.
Step 2: Clean the wound
Once you have managed to stop the bleed, the next step is to clean and irrigate the wound. Because of the risk of infection and growing prevalence of antibiotic resistant bacteria, cleaning all wounds in the backcountry is essential.
Start with clean hands. Remove any debris or foreign bodies. Irrigate the wound using clean water. If you have a irrigating syringe, pressurized water can help to clean. If not, plan to use a copious amount of water. It may help to carry iodine to quickly treat water for disinfection.
Step 3: Prevent infection
The next step is to properly bandage the wound to prevent infection. If wounds appear to “want to close,” it is best to aid them by using Steri-Strips, a butterfly bandage or other supplies to hold the wound shut. Steri-Strips are adhesive strips which allow you to “stitch” the wound closed. For wounds that “don’t want to close,” pack with moist gauze. (You can use any clean ointment to moisten the gauze, e.g. Neosporin, Aquaphor). Cover the wound with a dressing such as a Bandaid or semi-permeable dressing, such as Tegederm. If using a traditional gauze dressing, make sure to clean and replace the dressing once per day.
After treating the wound, monitor for signs of infection. These include redness, swelling and fever. Depending on the severity of the cut, you may need to evacuate.
Note: This article is meant to serve as a skills refresher. Learning how to treat common injuries is every backcountry user’s responsibility. Some of the techniques described above may require additional training.