nearlywhite said:
In addition to the peli case?
No. It either goes in a daren drum (if we are carrying one as a group, which then also holds stuff like a storm shelter, and various bits & bobs that people want kept dry), or it goes in my small SRT pod bag (as the kit itself is watertight and quite robust, notice the O-ring seal?).
On expeditions, where the caving was considerably more serious/remote, each person carried a first-aid kit like this, and kept it on them in their personal bag.
My point regarding the cannula is that establishing IV access in an emergency situations is really good if you have something to put in them - which you don't. And by the time rescue arrives it may have tissued anyway, especially if you're moving the casualty.
I'm aware of that, but it's still potentially better than nothing. And you will not be moving a casualty in that state -- certainly not once they have been moved out of danger and you've started treating them.
But regardless, I wouldn't be in a tearing rush to stick a needle in their veins. There's a pretty narrow range of circumstances where it might be appropriate. It's mostly there for the pneumothorax, and even so I consider it one of the least useful/practical items in the kit.
And that a tension pneumothorax can be tricky to decompress - you may have to resort to the knife anyway.
You really shouldn't, and if you do it's going to be
horrible beyond imagining. That is a line I'm not prepared to cross -- it's causing serious harm, with no justification for expecting it will actually help (at least, not from the training I've had, which I'm going to take more seriously than Random Caver on Forum).
Even if you
are prepared to do that (expect them to fight you!), why the hell would you
start with the knife, and not the needle?
The very low incidence of tension pneumothorax (including from broken ribs - it's more flail segment territory that causes these things) even from blunt thoracic trauma means that you're more likely to do more harm than good doing a needle thoracotomy.
I'd be very reluctant to do it, but it's better than letting them die. Obviously you would wait until it's really bloody serious -- so they've probably collapsed, they have an obviously deviated trachea, severe breathing difficulties and most likely a sense of impending doom.
And yes, you have to make sure you don't stab them in the heart, so stay outside the nipple line. And you still need consent, while they are conscious.
If push came to shove with the water issue you'd just drink the cave water - leptospirosis etc is far more preferable to haemodynamic collapse. The purification stuff is something I'd take abroad but not the UK.
Sure, just about anything is preferable to haemodynamic collapse. But why so melodramatic? Dehydration is bad; occasionally water is nasty; chlorine tabs make it better. And again, they take up bugger all space in the kit.
