Essential First Aid Tips For Your Gap Year.

Knowing just a few first aid essentials is an important skill when you are travelling the world, and will go a long way to helping you deal with the inevitable simple cuts, scrapes and situations that you will come across. Here is an emergency nurses advice on what to do when you need to administer first aid to yourself or anyone else on your gap year.

Let’s face it, when you are throwing yourself headlong into all the adventure that going on a gap year gives you, even the most careful of people will have the occasional accident. Whether that’s a twisted ankle from an arduous trek  or one too many beers on that hostel pub crawl, , the occasional cut or bruise or even having an arse covered in leeches when trekking through a damp jungle in rainy season (I mention no names)! It will happen, and that is why travel insurance is so important, but on top of that it is also important to know a few first aid basics of what to do in those situations

Now as a professional nurse I can give you qualified information and advice but please make no mistake this is in absolutely no way a substitute for actual training. A little bit of knowledge can go a long way but if at any point you aren’t sure of what to do, you need advice, or your injury is a little bit more than your basic first aid kit can handle, then get yourself to the nearest clinic, hospital or any medical professional as quickly as you can.

So what are the first aid fundamentals that you should know?

Make Sure Your First Aid Kit Is Well Stocked.

This is an absolute basic requirement and I always carry my first aid kit with me wherever I am. Knowing how to pack a good travel first aid kit is important, and that doesn’t always mean getting the biggest fanciest one filled with the latest gear like rebreathers and tourniquets. The average traveller is not in any way medically trained, and no one is expecting them to be, so why carry a lot of extra stuff you won’t know how to use? Stick to the absolute basics and you will use them.

Cuts And Grazes.

Most cuts and grazes are minor and can be easily treated with over the counter dressings from your first aid kit.

Stop the bleeding. This is always the first step. Just apply firm (but not too firm) pressure on the wound with a piece of sterile gauze if possible or any clean and dry absorbent material if not. If you have a cut to your extremities, arms or legs, then try and keep them raised if you can.

*Pro Tip: Ladies, if it is a heavy wound and you need to stop the bleeding quickly while you get help, and there is nothing else available, then you can press feminine hygiene pads on the wound and use a bandage to keep them in place if necessary.

Clean the wound. Any wound should be cleaned thoroughly before you apply the dressing. Use clean drinking water and pour thoroughly over the wound itself. The aim is to clean the wound of any dirt or debris. If you can see any debris in the wound then try and get it out if you can with flowing water, if you can’t then it may need to be cleaned by a professional. You can use an antiseptic wipe on the skin around the wound to clean up any blood, but do not go near the actual wound itself with it. Dry the wound with a clean gauze pad or by resting a towel  on it and then apply the dressing.

When you should get medical help.

• If the wound is large (longer than 5 cm) and you cannot stop the bleeding.
• You are bleeding from an artery.
• There is loss of sensation near the wound or you cannot move the effected limb.
• If the wound is large, spread out, jagged or otherwise has caused a lot of soft tissue damage.
• If there is a possibility there is a foreign body still inside the wound, ie a piece of glass.
• If the wound is to your head or face.

Watching For Infection.

It is not enough that you have to clean and dress any given wound, but you also have to watch for infection too. In many ways this can be more problematic that the wound itself.

You will need to check on and change the plaster or dressing frequently, the frequency depends on the type of wound and the dressing itself but you will know when the dressing needs changing. When you do this it is important that you see if it is becoming infected.

Signs of infection.

• Persistent or increasing pain in the wound itself.
• Swelling and redness that gets increasingly worse (a little swelling and redness can be normal in any wound as part of the healing process).
• Discoloured pus forming in or around the wound.
• Feeling generally unwell.
• A high temperature of 38 degrees (100F) or above.
• Swollen glands in the neck, armpit or groin.

If you see or notice any of these symptoms then you have gone beyond simple first aid and need to seek advice and possibly get some antibiotics. (Do not just start taking antibiotics ‘just in case’).

Minor Burns And Scalds.

Burns aren’t really a backpacker specific or common injury, but it doesn’t really do any harm to know the basics.

• Cool any burn with lukewarm running water for a minimum of 20 minutes, tap water is ideal because you need to keep the water flowing if possible.
• Do not use ice or iced water, these can be as bad on a burn as hot or scalding water.
• Contrary to popular belief do not slap a load of greasy butter on a burn.
• If you can, remove any clothing or jewellery from near the burnt area. If you can’t, or material is stuck to the skin, you may need professional help.
• Do not place any cotton wool style dressing on a burn wound.
• Keep the wound clean (keep running lukewarm water over it).
• Do not burst any blisters (as this can lead to infection).
• Mild burns or scalds that don’t need any treatment (what we technically call superficial epidermal burns because they only affect the top layer of skin) usually heal in a week or so without any treatment or scarring.
• Painkillers such as Paracetamol or Ibuprofen are ideal to treat any pain.

When you should get medical help.

Although most minor burns can be treated on your own with the tips above, if however the burns are more serious you should not hesitate in seeking help. A bit of basic common sense can judge this really.

• If the burn covers a large area (bigger than your hand), then get help.
• Any burns caused by chemicals or electricity should be professionally treated.
• Burns that immediately cause sever blisters or exposes any deep layers of skin or bone should be checked by a professional.
• If the burn is circumferential, as in it goes completely around a limb or your torso, or if it is to the face, you should seek help.
• If you can, cover the burn with cling film or a clean plastic bag until you can get medical help.

Sunburn.

Sunburn is a much more common traveller injury, and should not be dismissed lightly. Most of the time sunburn is pretty mild and does not need a visit to a clinic, nurse or doctor, and whilst it may feel uncomfortable should heal up in a week. During this time there are things you can do to relieve the symptoms.

• Cool the skin by sponging it with cool (not cold) water or having a cool shower.
• A cold compress with a towel dipped in cool water and placed over the affected area will help.
• Aloe vera is your best friend when you have sun burn and can be applied directly or with a cold compress on top.
• Stay well hydrated and drink plenty of fluids (water is good but this also includes juice as well). This will keep you cool and prevent dehydration.
• Ibuprofen or paracetamol can be taken for any pain.
• If the skin is very inflamed, then speak to a pharmacist who may give you some hydrocortisone cream.

When you should get medical help.

If the sunburn covers a very large area and you start to exhibit other symptoms, then you should seek medical help. Look out for symptoms including:

• Sever blistering or swelling that does not subside after a day or two.
• Chills.
• A high temperature (38C or 100F) or above.
• Dizziness, headaches or nausea.

Insect Bites And Stings.

Insect bites and stings are a common problem for travellers all over the world. The absolute majority of the time they are nothing more than an annoyance and will get better in a few hours or a day or two at most.

Occasionally though they do pose a bigger risk and can become infected, can spread disease such as malaria and even cause a severe allergic reaction or anaphylaxis. If you do get bitten or stung:

• Remove any insect, stinger or tick that may be attached to your skin.
• Make sure the wound area is clean with soap and water to prevent infection.
• Apply a cold compress or ice pack to reduce swelling, this can be repeated as much as is needed.
• Don’t scratch the bite, as this may lead to infection.
• If the wound is painful or uncomfortable then basic painkillers such as paracetamol or ibuprofen should be enough.
• If the wound is itchy then see a pharmacist about over the counter hydrocortisone or antihistamine.

When you should get medical help.

• If symptoms do not improve or get worse after a few days.
• If the bite or sting is on or near your mouth, throat or eyes.
• If the bite or sting swells to a large area, this may be an allergic reaction.
• If the bite starts exuding pus or gets increasingly painful or swollen after over the counter medication.
• If you start wheezing, have difficulty breathing, develop swelling in the face, mouth or throat, have difficulty swallowing or feel dizzy or faint, then this should be considered a medical emergency and you should get medical help immediately.
• If you start developing flu like symptoms, swollen glands or a high temperature (38C or 100F) or above. This may be a sign that you have contracted an insect borne disease.

Heat Exhaustion Or Heatstroke.

These conditions can be quite common in travellers on extended treks in tropical or desert regions, and if heat exhaustion is untreated it can lead to heatstroke or sunstroke which are considered medical emergencies. I have personally seen the symptoms start developing in other travellers several times on many treks over the years, and they can be so easy to dismiss until they become a problem.

Heat Exhaustion.

This is essentially severe dehydration, where your  body is not getting enough fluids and starts to react. Symptoms include:

• A headache (one of the first signs of dehydration).
• Dark or offensive smelling urine.
• Lethargy, tiredness or general weakness.
• Feeling faint or dizzy.
• A decrease in blood pressure (although you won’t know this without medical treatment) and an increase in pulse rate (anything above the average normal rate of 60 – 100 beats per minute) .
• Muscle cramps.
• Heavy sweating.
• Intense thirst.

Heatstroke.

If the above symptoms aren’t treated, it can lead to heatstroke or sunstroke. This is where the bodies temperature becomes dangerously high and the body is no longer able to cool itself and starts to overheat. This should be considered as a medical emergency and help should be sought as quickly as possible. More severe symptoms may start to present themselves such as:

• Confusion and disorientation.
• Seizures.
• Loss of consciousness.

What to do.

If you or someone else you are travelling with has signs of heat exhaustion, then you should:

• Get them to lie down in a cool place such as a room with a fan, air con or in the shade.
• Remove any unnecessary clothing and loosen everything else. The aim is to expose as much skin as possible.
• Cool their skin with whatever you can, cold compresses, a cold wet flannel, anything you can use to keep them cool and wet.
• Fan them to cool them down if you don’t have a fan available.
• Keep them hydrated and get them to drink as much as possible. Water is best but fruit juice and rehydration sports drinks are just as good.

When you should get medical help.

Most people should respond really well to this within 30 minutes. If they don’t, or they are already developing the more severe symptoms of heatstroke, then you should get medical help immediately.

Strains And Sprains.

With the amount of adventure activities and partying on gap years and around the world adventures, strains and sprains are actually pretty common. These common injuries affect the muscles or the ligaments, especially around the knees, ankles, wrists and fingers and thumbs, and the majority don’t actually require medical treatment but can be looked after on your own with a bit of know how.

• Use PRICE therapy which stands for protection, rest, ice, compression and elevation.
• For the first 2 -3 days rest up and avoid using the affected joint or muscle as much as possible.
• Cold compresses and ice will help to keep the swelling down. Don’t apply ice directly but wrap it in a towel or something similar.
• Avoid the heat for a few days if you can, don’t sit out in the sun.
• Compression bandages are good for keeping swelling down but don’t wrap them so tightly that it restricts blood flow and remove them before sleeping.
• It is a good idea to book yourself or upgrade to a private room in a hostel or a guesthouse for a few days if possible, especially if your mobility is limited with a knee or ankle injury, so you can rest, keep your injured limb elevated and minimise activity. Just catch up on a few Netflix shows or finish that book.
• Basic painkillers such as paracetamol should be sufficient for any minor sprain or strain. Non steroidal anti inflammatory medications such as Ibuprofen aren’t recommended in the first couple of days.
• After a few days of rest then try and move about as normal (this is all relative and you shouldn’t push yourself too far either) or do some basic movement and rotation exercises to get the joint or muscle back to normal. Muscles can take a day or two longer than joints.
• There is no hard and fast rule on how long it takes a sprain or strain to heal. For minor injuries you should be able to use the injured limb again – even if it is still a little tender – after a week or so of rest. You should be pretty much back to normal after a month or two, but it can take a lot longer too if the injury is more severe.

When you should get medical help.

Most sprains and strains can be treated without medical help and just take a bit of rest and rehab, but there are obviously exceptions to that. If you have any of the following symptoms or there is no improvement at all after a few days of self treatment then you should seek further medical help and advice.

• If the pain is severe, lasts longer than a couple of days and is not helped with paracetamol.
• If the joint or muscle cannot be moved at all.
• If you can’t put any weight or pressure at all on the joint or muscle or it gives way when you try to use it.
• It looks disjointed or is an unusual shape.
• If there is numbness, discolouration of the skin or coldness in any part of the joint or muscle.

Now remember that as important as it is to have a good working knowledge of how to look after yourself and how to use a good, basic first aid kit to patch yourself up when needed, it is just as important to know when to get help too. 

If something does happen and you need advice, don’t hesitate to go and get it. If you can’t get to a nearby clinic or hospital, then there is also my online travel clinic if you need it. I may not be able to physically patch you up myself but I can advise you on what to do and where to go next when you need it.

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Related Articles.

Ask A Nurse. 10 Of Your Most Common Health Questions Answered.

Common Backpacker Illnesses And Diseases.

First Aid Kit Checklist.

How To Stay Fit And Healthy On Your Gap Year.

Travel Health Considerations Before You Go.