Gloves

 

The first thing in your First Aid kit should be your gloves.

When we think about gloves in First Aid we think about blood.  We wear gloves to protect ourselves from ALL body fluids which are ALL capable of transfering disease and infection.  

That's the obvious stuff but it is useful to have a few spare pairs in your kit because you never know when you are going to need to improvise.

 

Improvised Chest Seal

The classic improvised treatment for an open chest wound is to tape a plastic sheet along three edges to cover the wound but leaving the fourth side open to allow the wound to 'vent'.  Based on the Asherman Chest Seal's flutter-valve design, we can improve that by simply cutting off the thumb from a medical glove:

You are not going to cut the thumb straight off the glove, imagine cutting the thumb off around the thumb joint.  About an inch all around the base of the thumb.

Cut the very tip off the thumb and open up the base.   This can be stuck to the chest, covering the open wound. 

Important:

This is not the kind of improvisation anyone would attempt when the happen across an open chest wound.  Your priority is to cover the wound with anything airtight IMMEDIATELY.  This is a technique which may replace your initial seal once the rest of your treatment has been administered and the casualty has been stabilised.

You've now got the remained of a glove left.   What can you do with that?

 

Needle Decompression

Using the same theory as before, before attempting Needle Decompression, cut the 3rd and 4th fingers from the glove (just in case you are having a really bad day and need to do this twice).

Insert the needle into the glove finger before penetrating the chest.  With the canulla in place and need removed, when secured the finger becomes a one-way flutter valve allowing for decompression without allowing air in.

 

Now you've got a really weird looking bit of glove left over.  What can you do with that.

 

Tourniquet

You had a nice velcro tourniquet but your partner stole it so you are going to use this scrap as a quick TQ for cannulation.

Or for tying the IV tube or Sp02 lead the the casualty's wrist to stop them dislodging it when they move.

 

Wound Irrigation

All wounds need to be cleaned but in an austere environment with limited supplies, using sterile syringes for wound irrigation might not be the most appropriate use, or you just might not have a syringe (but you will, of course, always have a syringe).

 

Which Gloves?

Latex gloves are the most comfortable gloves to wear with the least loss of tactile function but there is a minor risk or allergy to the wearer or the casualty.

 The Health & Safety At Work Act (1974) places a general duty upon employers to keep employees and others (such as clients) healthy and safe at work.  The Control of Substances Hazardous to Health (COSHH) Regulations 2002 asks employers to undertake an assessment of any substances used at work that are hazardous to health.

Natural rubber latex is a potential allergen and therefore falls into these categories, as such many first aid and medical organisations have withdrawn the use of latex gloves (as well as 'powdered' gloves) to eliminate the risk of causing harm to the user and the potential of a subsequent court case for compensation.

The two popular options are non-powdered vinyl or nitrile.

Vinyl gloves are the cheapest and most durable but least stretchy and with the greatest loss of sensitivity.  Nitrile gloves are more durable than latex and more elastic than vinyl gloves which is why they have become the most popular choice.

 

If you are carrying gloves as part of your kit, you can keep pairs together and protected from dirt and water in the yellow container found inside a Kinder egg.  It's not sterile, but that doesn't matter1, it's clean.  And a good excuse to eat chocolate.

 

 

1.  Perelman VS, et al/  (2004)  "Sterile versus nonsterile gloves for repair of uncomplicated lacerations in the emergency department: a randomized controlled trial."  Annals of Emergency Medicine. Mar;43(3):362-70.

 

Back to more articles on Equipment