[pct-l] Blisters/needles

[radney@ix.netcom.com]

Rebecca made the following comment regarding blisters, on the post;
  
>someone in an earlier post mentioned some stuff having to do 
>with blisters that had already developed & had liquid inside them.
>There was some talk of draining, needle thread ... etc.

Yep, that was me! I mentioned a technique that Wolf, a fellow '97 PCT Thru 
Hiker used.  Wolf showed several of us how to do this technique while taking 
care of his own blister. As far as I know, none of us had anything but great 
releif with no infections.    

Rebecca stated that;

>A couple months ago I took a first aid course ...and they HIGHLY 
>recommended NOT opening blisters up. Here's why: When you're 
>hiking/backpacking things get dirty. Bacteria is everywhere.
>When there is a blister with liquid inside .. it might hurt but it's not
>a serious medical threat. When you penetrate the skin surface, you are
>opening up the possiblity of infection. Which can be VERY serious if you
>are in the backcountry. The first aid instructor told us that many of 
>the backcountry accidents etc. start out as very minor problems/issues.
>a tiny cut, a blister etc. Then they can get infected and you have a 
>seriousproblem.
>
>So ... yeah you can sterilize the needle etc. etc. but once the layer of
>the skin is broken you've got to be very careful about keeping it very 
>clean & disinfected. Their recomendation was ... if the skin not broken,
>leave it that way. The skin works great at being a protective barrier to 
>bacteria etc. as long as that membrane is unbroken.

Walt and I have taken Solo's Backcountry First Aid Course and highly 
recommend anyone who is going out on the trail to take a course too.  You 
never know when what you learned in class will have to be used, if not on 
yourself, on someone else.  Since this is the PCT Discussion site, here goes 
-- and YES, there is always more than one way to skin a cat and more than 
one opinion;  

I will be quoting from the book we used in our SOLO classes, "Medicine for 
the Backcountry (2nd ed -- 1994) by Buck Tilton, MS, Director of the 
Wilderness Medicine Institute and Frank Hubbell D. O. EMT Instructor for the 
Wilderness Medicine Institute. I will be quoting from Chapter 31 -- Common 
Simple Problems (p 172)  Blisters -- "Those fluid-filled bubbles are mild 
second-degree burns caused by friction.  The friction produces a separation 
of the tough outer layer of our skin from the sensitive inner layer.  Only 
where skin is callused is it thick enough for this to happen -- heels, 
soles, palms.  Other skin just wears away with friction, leaving an 
abrasion.

  "The space between the outer layer of the blister (the roof) and the inner 
layer (the base) fills with fuild drawn from our circulatory system to 
protect the damaged area while it heals.  Gravity encourages this to happen 
and causes foot blisters to swell rapidly.  Wet skin blisters much more 
quickly than dry skin, and warm skin more quickly than cool skin.  And what 
skin is more moist and hot than our feet in heavy boots after a long walk?
 
  "What should you do?  Blister heal faster when the fluid is drained, three 
to four times faster.  Besides, they feel better when the bubble is 
deflated.  Clean around the site thoroughtly with soap and water, and rinse.  
In a flame, sterilize the tip of a knife, or use a sterile scalpel.  
Carefully slice the blister open and let it drain until the fluid is gone.  
Leaving the roof intact will let if feel better and mend quicker.  If the 
roof has already been rubbed away when you discover the injury, treat the 
wound initially as you would any other -- clean it and keep it clean to 
prevent infection."  

  I know from personal experience that when a blister has formed during a  
hike, if I haven't drained it when the pressure has built up, it will burst 
on its own. Usually the "roof" gets torn and the inside new skin (base) 
becomes exposed and can become infected very quickly. In using the 
needle/thread technique I found the blister very quickly became flat 
(within a couple of hours) and also healed very quickly.  Since the cotton 
thread wicks the fluid out, the roof (dead skin) remains intact, thereby 
protecting the new skin.  Rebecca is right -- dirt harbours lots of bacteria 
and you do have to be very careful in treating all cuts and abrasions, 
whether you are at home or on the trail.           

We all did right by taking a First Aid class, we just had different 
instructors with a different approach on how we should treat blisters! 

And that is my 2 cents 

Happy Trails  -- Pat 


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