Saturday, February 9, 2013

Lesson Eight: Cryotherapy

Lesson Eight: Ice works

Ever since (insert Deity of your choice) gave us the recipe for ice, its usefulness for all manner of things has been well-known. Its medical utility, contrary to what you might think about your Aunt Hilda’s Home Remedies, is pretty phenomenal—and usually overlooked.

In fact, other than snakebite and frostbite, there’s not really many common injuries you shouldn’t put it on.

Contusion? Ice it.
Laceration? Ice it.
Abrasion? Ice it.
Puncture? Ice.
Sprain? ICE.
Fracture? Ice too.
Sunburn? Ice works.
Thermal burn? Ice. Possibly in some water. Poured on a dressing if necessary.
Dental abscess/toothache? Ice, or even ice water.
(I know someone who held off a dentist visit until the office opened on Monday for a day and a half by drinking ice water. He peed a lot, but said it beat ripping his face off with a crowbar from the pain.)

And so on. Now I’m sure someone, if they tried hard, could find a couple of more things where it’d be a bad idea. Chemical burns, especially dry ones, would fit that profile. Stingray stings too - those are actually inactivated by WARM water. But seriously, how many stingrays are there in, say, Nebraska or Vermont?

So, what makes ice so spiffy?
Two things:
1) It forces small and large vessels to contract, reducing blood flow. If they’ve been lacerated/punctured/etc., this reduces bleeding. If not, it reduces swelling.
Swelling is the body’s natural response to traumatic injury. It’s also the cause of a lot of the pain subsequent to the injury. Trust me when I tell you that having your knee balloon up to the size of a football even without a separarte injury would be quite painful. Ice decreases that. Which not only saves you pain today, but also tomorrow, and the next day, because the swelling which never happened doesn’t have to dissipate. Remember that if you’re days from help and/or short on medications.

2) It numbs peripheral nerves, thus deadening your perceived pain. In other words, ice is FREE DRUGS, without any of those annoying narcotic side effects (like nausea, drug allergies, drowsiness, decreased breathing, etc.).

At home, a large bag of frozen peas (which, I confess, is the only reason you’d find peas in my house) works great.
In urban situations, ice can be had anywhere there’s a fast food restaurant. Bring your own ziplock baggie, and you’re set. In 20 years, I’ve never had anyone at any such establishment deny me a bag of ice for an injury.
Off the beaten path, you MAY have access to snow, or snowmelt running water. If not, you have to bring or find what you can. Party coolers or full cold drink cans are better than nothing.
“Break n Shake” first aid kit ice packs are okay, but it’s amazing how briefly they work on a hot day. The original product is far superior if there’s ANY way you can get some.

Caveats: Don’t put open wounds in running streams. The fish don’t want your blood, and you don’t want the bacterial paradise in your cut.
Don’t leave ice on for more than 20 minutes at a time. We don’t want to CREATE frostbite on top of your other distress. 20 minutes on, 40-90 minutes off, depending on circulation.
Don’t use chemical “blue ice” packs, or (please God, NO!) “dry” ice (CO2) [b]ever[/b] on bare skin. Wrap them thick enough to get the “coolth” through, without being cold enough to rip skin off if applied. Better yet, get frozen H20.

First aid kit ice packs can be pricey, and as I said they don’t last as long as real ice. I carry a bunch of sandwich-sized and quart-sized ziploc freezer baggies. When needed, I put ice inside one, then I put it in another one. I’ve had few leaks in 10 years with this double-bag arrangement, and when the ice melts, you can dump the water out and refill it, over and over.
On a planned outting or event, you can even pre-fill and freeze a few, and throw them in the cooler, on the theory that someone is going to do something and you’ll need it.

For a day-hike or car kit, a single break-n-shake ice bag is a justifiable luxury. For almost anywhere else, I heartily recommend multiple baggies. If you’re going somewhere with an ice chest, pre-fill and freeze a few.
At the best, you’ll have something to keep your food cold longer. At the worst, you can treat a host of minor injuries quicker, safer, and cheaper than any other way.

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