Distributing Over-The-Counter Medications To Clients

Q: The new medical advisor of our guiding company has advised us not to distribute over-the-counter medication to our clients. What is your opinion? Technically, one could argue that giving medication under these circumstances (paid guide giving to a client, non-family member) could be considered practicing medicine without a license.  Many school nurses are prohibited from dispensing… Read more »

Tractions Splints in Wilderness Medicine

Femur fractures are serious injuries that usually occur as the result of significant forces. A full assessment, focusing on critical system problems and their stabilization is the crucial first step.

Effective stabilization of femur injuries will help alleviate pain and decrease the possibility of complications. I believe that either a vacuum splint or good padding in a stable carrying device does a good job of providing both.

Although there is no literature supporting their efficacy in the prehospital setting, a commercial traction splint can be a useful tool when applied by a skilled practitioner who receives periodic training on a particular device and/or uses it during rescues or EMS calls. They should not be left on for a prolonged period of time (e.g., greater than 2 hours) unless limb neurovascular integrity and splint tension can be monitored properly and regularly.

Regardless, these are painful injuries. All require the administration of analgesics.