TREKKER'S FIRST AID: DEEP WOUNDS
CEASE THE BLEEDING
Be sure to lift the wound above the heart, and apply steady pressure, to help slow the bleeding. If the gash is in a deep vein or artery, you may have to plug it with pressure directly.
Wrap the wound tightly in clean gauze.
Luckily for us, science and the military have created a great life-saving tool: Battle Dressings. Sometimes these are called “Israeli Wraps”, but you can find them on Amazon. They will wrap around a wound tightly, and self-secure, but are not adhesive. This means they will hold the bleeding, without causing pain. They typically provide multiple, sterile wrappings you can quickly open for use. They also feature a pressure bar, to help cease the bleeding.
Some battle dressings will have clotting agents on them, but you can also buy clotting powder and should carry both in your Trekkers First Aid Kit. But be wary, medical staff will have to remove the clotting agent in order to administer aid, and that may be very painful.
Once you’ve successfully stopped the bleeding, now you have to worry about what got inside of that wound while you were dressing and squeezing it. Yikes.
First things first: Clean water. If you do not have portable, clean water with you, you must make some. You need to rinse the wound with clean water as soon as possible.
Rinse it with at least a cup of clean water, downwards, and do so until you've thoroughly flushed the wound. Remember, if you cannot find a way to safely filter water, it may do more harm than good, which is why it is best to carry sterile water in your first aid kit.
CLOSE IT AND PROTECT IT
If your gash is particularly gnarly, you may need to close it, in order to protect it and to let it heal. You could grit your teeth and sew it shut yourself, and some would argue you should have a suture kit on hand for this very purpose. However... It really is better left to the pros. If you’ve taken care of it well enough so far, suturing it yourself can make it worse.
In the event you need to hold the wound closed, but do not have the ability to give yourself stitches (we don’t blame you), this is where gauze tape comes in!
You may think it's better to pour peroxide or a cream on your deep wound, but be wary: deep wounds get infected very easily, and you can trap foreign bacteria in there the more you mess with it. You may also kill healthy blood cells of your own, who are fighting whatever infection you may have. It is best to leave punctures, bites, and deep wounds partially open to the air, so that they can heal.
Pack with damp, sterile gauze, and tape the gash closed in ¼” strips. You do not want to seal the bacteria inside. Make sure the tape is long enough that it will adhere past the wound at least 1”, on both sides, so it has a smaller chance of re-tearing open. Start by pulling together the middle of the wound, and work your way out with the other strips on both sides.
After you’ve cleaned and closed the wound as best as you can, now you'll need to redress it with a sterile bandage. You must treat that wound like a newborn baby, you’re effectively handicapped now, depending on where you've been injured. You must keep this wound dry and clean through your hike or trip. Change your dressing every 12 hours, being as gentle as you can when removing the old gauze.
REMINDER: You can boil, dry, and reuse clothes and even gauze if you need to.