No Roads Expeditions - Kokoda Trekking Portal

Basic first aid includes knowing how to deal with minor cuts and abrasions. In the hot, humid and jungle environment it is very important to deal with wounds before they get worse and become infected. 

The key is keeping the wound clean. If bleeding is controlled, the wound should be thoroughly washed. Although sterile saline is best for irrigating wounds (rinsing them out), the next best solution is to clean the wound from a fresh water source (preferably running clean water). The more water you use, the better. Remove as much of the visible dirt as possible. 

When you have cleaned the wound, dressing the wound will keep further contamination from entering the wound. Sterile gauze is best. Change the dressing at least once a day and every time the area is heavily contaminated. 

Use an antibiotic ointment and apply directly to the wound. Use of antibiotic pills should be reserved for treatment of actual wound infections – not for the prevention of infection. 

Chafing is a potentially serious problem in the moist jungle environment of Papua New Guinea, leading to bleeding, skin infections and extreme discomfort. 

Salt when you sweat can gather in your clothing, often around the edges of your shorts, and dries the clothing hard. This can cause chafing between the legs and  once it starts it gets painful. Change the clothing and rinse at camp under water.   Women sometimes suffer chafing under their arms and breasts.  

Careful, early attention should be given to any areas that appear to be chafing with liberal use of barrier ointments like Bepanthen or Paw Paw cream. Infected chafing areas may require antibiotic therapy. 

You may need to apply the cream more than once per day, especially when it has been raining heavily all day.

Consider wearing a pair of short tights, such as Skins or bike pants to help prevent rubbing against your skin. There are many brands & sizes available now.

A common sight around camp each day is trekkers with their first aid kits out, dealing with foot or ankle injuries. Hopefully, you will not get any if you prepare well and train in your shoes and socks.

Nevertheless, you should know how to deal with minor injuries to your feet, ankles and other basic first aid treatments. Even people who do not normally get blisters may suffer foot problems due to the damp and steep conditions. The No Roads expedition guide is trained in wilderness first aid and can provide some advice, but the best thing is to know what works best for you and fix it.

You should know how to do the following basic first aid techniques which are documented in most First Aid handbooks:

• strapping your ankle or knee
• blister management (both as one is forming and after one has formed)
• cuts and scratches
• applying antiseptic cream or powders
• applying basic wound dressings (band-aids etc.)

A friction blister is usually caused by irritation from continuous rubbing or pressure, typically on your feet where your footwear rubs such as on the back of your ankle, toes and sides of your foot.

One warning sign that a blister is about to develop is redness and warmth on the skin called a "hot spot." Next, fluid fills the space between the top two layers of skin to provide protection from continued rubbing. When this happens you will see a blister that looks like a little bubble on the skin.

If you have any "hot spots" during trekking, it's important to treat them right away to prevent the blister from developing. Try to keep your feet dry or change socks if possible and allowing your feet to dry whenever possible. Another treatment option is to apply a 2nd skin dressing or moleskin and tape the sensitive area.

How to Treat a Blister
If you do get a blister, the goal is to keep the blister from getting bigger and avoiding infection. Signs of infection include pus draining from the blister, very red or warm skin around the blister, and red streaks leading away from the blister).

Small unbroken blisters that don't cause discomfort can be left alone to heal, because the best protection against infection is a blister's own skin. However, large, painful blisters can be drained as long as you keep the top layer of skin intact and covering the blister.

Wash your hands using the anti-septic hand-wash, and put on your protective latex type gloves from your first aid kit.

To safely drain a blister, first clean the blister and the surrounding area with rubbing alcohol or antibiotic soap and water. Next, sterilise a needle and puncture a very small hole at the edge of the blister and drain the fluid by applying gentle pressure. Once drained, place antibiotic ointment on the blister and cover with a bandage and let it heal naturally.

Prevention of blisters can be achieved applying hydrocolloid pad dressings (eg Dr Scholl, Spenco) to pressure areas. These often come off in extreme moisture and require an elastoplast dressing over the top to remain in place. The common pressure areas are the side of the big toe and the ball of the foot, but obviously this varies and individuals should become familiar with their particular pressure areas during training.

If a blister has excessive amounts of pus draining from it, starts to smell, or becomes red, the blister is probably infected and will need further attention. Antibiotics may be required if the blisters become infected with bacteria. Ask your expedition guide for advice.

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