Sometimes a major hunt can be ruined or at least frustrated by a seemingly minor problem. For instance, a blistered heel makes it challenging and painful to walk. Or a speck of something lodged in your eye, and the irritation increases until the “speck” begins to feel approximately the size of a ponderosa pine.
What should you do? And, sometimes as importantly, what shouldn’t you do? Many well-known, generally accepted “treatments and cures” are ineffective at best, and some will worsen the problem.
The Little Thing
Nosebleeds are a good example. Most think the correct procedure is to pack tissues up the nostrils while sitting with the head leaned back; perhaps applying an ice pack to the bridge of the nose to help control bleeding. In fact, every one of these steps is a mistake. For common nosebleeds it’s rarely necessary, or helpful, to use packing. (Usually, the wound is torn open again when the waste is removed.) Leaning back is a mistake because it sends blood down the throat instead of out the nostrils. Swallowed blood leads to nausea and vomiting, which increases internal pressures that exacerbate bleeding. As for the traditional ice pack, medical studies have shown that externally applied ice “is an innocuous but completely ineffective maneuver.”
The simple but correct procedure? First, distinguish if the nosebleed is the standard, frontal (“anterior”) type, wherein the blood flows out of the nostrils when the person is sitting straight up or standing; versus the less common “posterior” type, which is a wound further back in the nose. With posterior bleeding the blood drains mostly down the person’s throat, perhaps causing choking, blood spitting, and vomiting. A posterior nosebleed can be a serious condition, especially if connected to some head or facial trauma. Unless the bleeding can be stopped quickly, the victim should be evacuated to hospital care.
To stop a common anterior nosebleed, first, lean forward slightly in the sitting position. Gently blow the nose to remove any clots. Next, still leaning forward, pinch the nostrils firmly to close them against the middle cartilage of the nose. Maintain this position for fifteen minutes, without releasing the pressure. (Some doctors suggest using the nostril pinch for five minutes–especially for light bleeding, and if that doesn’t work, then tweak for another ten, and so on, up to a twenty-minute interval.) After the allotted time, let go and see if the bleeding has stopped.
With a typical nosebleed, where significant trauma isn’t involved, this usually does the trick. If the bleeding continues, use a shot or two of an Afrin or Neo-Synephrine-type nasal spray if available, to help constrict the blood vessels, then try the nasal pinch again for a full twenty minutes. After the bleeding has stopped, avoid bending your head lower than your heart or lifting heavy objects for the next several hours. To reduce the onset of nosebleeds, particularly when they are most likely to occur (in dry air, in cold weather, at high altitudes, and in smoky or dusty atmospheres) keep the inside of your nostrils lubricated with a daily swab of Vaseline, nasal ointment, or periodic sprays of a saline mist, such as Ocean.
For external bleeding from a cut or laceration, the best response is constant pressure directly on the wound. A compress of sterile dressing is preferred, but in emergencies, you can use any clean cloth or even a bare hand. The key is to keep the pressure constant–no dabbing or lifting of the dressing to see how the wound is doing. The clotting process stops blood flow within fifteen minutes of direct pressure. Elevating the injury above heart level will reduce blood pressure to the site. In some cases splinting will help stop bleeding by keeping the clot site from shifting and opening. If ice is available, you can apply it in moderation to help constrict blood vessels at and near the wound.
With light to moderate burns and severe sunburn, you should not use ice to relieve the pain, no matter how tempting that might be. Putting ice directly on a burn can increase tissue damage. With a first-degree burn, the skin is reddened and painful, but there is no blistering. (A second-degree burn reaches into deeper layers of the skin, is even more painful, and causes blistering.)
With any burn, the first step is to stop the heat and the burning process as quickly as possible. The best treatment is immersion in freezing water. Next best is the application of cold, wet compresses. Do not use butter, lanolin, vitamin E cream, or any of the commercial steroid creams (such as hydrocortisone) on a burn. Benzocaine sprays can help the pain for intervals but can also trigger an allergic reaction. With a first-degree burn (again, no blisters present), an application of a moisturizer such as Vaseline Intensive Care, Aloe vera gel or lotion, or Bernard gel can help soothe the skin. If the burn continues to be painful, such as with a severe sunburn, a healthy dose of an anti-inflammatory such as aspirin or ibuprofen can provide significant relief.
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Blisters–the kind that often form on a heel or hand–are another kind of burn, caused by friction. The best way to deal with a friction blister is to catch it early when it’s still in the “hot spot” stage. At this point, you feel discomfort inside your boot or on your finger, but you don’t want to stop and deal with it. (We’ve all been there.) The smart approach is to take a break and do what’s necessary to prevent the development of a full blister. Tighten or readjust your boot laces, change socks, cover the hotspot with a piece of tape, moleskin, or gel-dressing; or dab on Vaseline or antibiotic ointment to lubricate against friction. This small attention can save you much discomfort, misery, and even disability down the trail.
Despite that good advice, which I do follow myself sometimes, blisters happen. Small, minor blisters can form and break open without causing much trouble, depending on their location. These should be treated like abrasion wounds–cleaned gently with soap and water, smeared over with antibiotic ointment, and covered with a sterile dressing or Band-aid. Larger, fluid-filled blisters, especially those in a critical place such as the foot, need more careful treatment. First, they should be drained, using a needle or knife point that’s been sterilized with alcohol or flame. Cleanse the area of the blister with soap and water, then insert the sterilized point in the lower margin of the blister. If you poke in and up from the side (never down into the blister), this will be painless. Press out the fluid, but leave the covering skin intact, since this will help guard against infection. Spread on an antibiotic ointment and cover with one of the “hot spot” type dressings that will both protect the wound and reduce ongoing friction.
What about the all-too-common problem of an eye irritation? Most often this is a “foreign body” lodged against the eyeball, causing discomfort, tearing, and redness. The simplest way to handle this problem, when possible, is to immerse your entire face in clean water–in a lake, stream, sink, or basin–and blink your eyes repeatedly. The next best solution is to irrigate from a cup or water bottle. Tilt your head sideways with the affected eye up. Gently pour water over the eye, from the outside edge toward the nose. You don’t need to hold your eye wide open during this process; it’s okay to blink as the water runs through. Usually, this procedure takes care of the problem.
If the irritation continues, you need to search for the source, either with a mirror or, preferably, with someone else’s help. Pull the lid nearest to the irritation away and roll the eye in various directions. Use a flashlight if possible to look both on the surface of the eye and on the inside of the lids. If you locate the foreign object, use a wet cotton swab or the moistened corner of a gauze pad to gently lift the object off the membrane. However, if it doesn’t want to budge, leave it alone. The object might be embedded in the eyeball, and attempts at removal could cause more severe damage. Patch the eye for comfort if necessary and get medical help as soon as possible.