- Time of past OR future Camino
- First one in 2005 from Moissac, France.
Hi - many of you will know that I am a Unitarian Franciscan and go to Camino a couple of times a year to offer first aid and pastoral care? Mainly because of that pesky Good Samaritan story that ends with the command "then go, Ye, and do likewise" (Luke 10:25-37).
Well, the beginning of the main pilgrim season is already upon us and around the world tens of thousands are planning and packing - right now! Visualise how many rucksack loads are currently spread out on a floor or bed with the virgin pilgrim standing there, scratching their head!
Now, I know that as part of this there is the issue of what to carry to look after oneself but I thought I would extend that thought into the possibility of helping others - so here is a rather rambling account of a small first aid kit, and some tips, for helping other pilgrims.
A first aid kit for helping others is a bit of a problem because it is a compromise, weight and bulk being the most important considerations. Really it is down to the individual.
As the first step is cleanliness, to make the wound/blister really clean, antiseptic wipes are a must, as are clean tissues to dry the area. If possible it is a good idea to get them (or you) to wash the feet first as, apart from cleanliness it removes the skin oils so that plasters stick properly.
Although when properly used by someone who knows how to look after themselves they work really well I no longer use compeed as I have seen too many problems with them as it is hard to make them stick properly unless the foot is clean, dry, and oil free, and also very difficult to remove where one has been stuck over an unclean wound that has become infected - a not uncommon sight. Another reason for good hygiene – stick a compeed over a few microbes and you set up a perfect petrie dish!
So I use fabric plasters, the type that have adhesive all the way round the centre pad. Then I may place a length of strip plaster, cut to size, to add extra cushioning, over the first plaster.
The blister formed because there was some form of rubbing or continuous pressure, as well as by dirty sweat – clean feet well creamed with clean socks is a good preventative way to go!
The plaster protects the wound, allowing it to heal, and the fabric strip on top adds a barrier between the skin and whatever it rubbed against. An alternative is to use a large fabric plaster, edged all round, as a top dressing, a final cushion.
Then, before you plaster, you have to flatten the blister – there are two schools of thought on this – leave the blister alone and cover it, and drain the blister and cover it. The thing is, most blisters in ‘normal’ life come from walking for one day, or a run, or new shoes. When the person gets home they shower, cover the blister, and then wear different shoes – simple. But the pilgrim is pounding their feet for hours every day, carrying a load, in the same footwear. If the blister is left full each footstep will pound it and the inner edges of the blister will widen through the pressure, making a larger and larger blister, so, for pilgrims, I believe that the blister should be drained. Never ever thread cotton through them! This allows an open sweating wound covered in sweaty socks that is just perfect for an infection!
I use disposable scalpel blades (No. 11 blade) as the blades allow me to cut a good but small ‘V’ shape at each end of the blister, which means I can gently press it flat with ease – needles don’t always make big enough holes – and you do have to get all the liquid out as by leaving some in a new blister may reappear after some more pounding. (by the way, although the British army do this, don’t remove the blister skin, leave it in place as a healing covering).
The good thing about using plasters is that one can give spare plasters to the pilgrim so that they can still shower and then replace. I give enough to get them to the next supermarket/pharmacy where they can buy their own.
In an ideal world you would wear latex gloves – but these are one-use and you would use lots of them! So clean your hands really well with a medical hand cleaner. Cleanliness at all times is key.
Again – people who thread cotton to keep blisters open are in error, it is a perfect way of introducing dirt into the wound.
So – my basic list: all easily replaceable in supermarkets and pharmacies in Spain .
A good hand cleaner for your own hands – medical one, a small bottle will do, or gel, as it goes a long way..
Antiseptic wipes – lots.
Tissues - and cotton wool if wanted. One can also carry moleskin and/or sheep’s wool, to give cushioning to a hot spot that has not yet formed a blister.
Some disposable scalpel blades or a couple of large needles – these can be re-used by boiling them or by washing in alcohol.
A tube of antiseptic cream – Germolene is good as it has a local anaesthetic too - or antiseptic iodine spray.
A variety of fabric plasters of all shapes and sizes (fabric as waterproof ones don’t adhere strongly enough) - the type that have adhesive all round the edges with a medicated island pad in the middle. Also butterfly shaped plasters as they work very well in between and on toes.
A variety of large plasters with adhesive all round to cover the first plaster and/or strip plaster. This is uncut plaster that comes boxed, usually in one metre lengths.
You could carry corn plasters - they are ring shaped cushion pads, adhesive on one side, which are rather good for separating toes that are being squashed together.
Not necessary really but you could carry spray plaster. It works well after cleaning a graze on the body as it seals it, stays for days, and allows people to shower.
You could carry cohesive bandage rolls. Very good for supporting knee ligaments, painful ankles, and so on. One must be careful not to put them on too tight (or too loose). Pilgrims can remove them for showering and then replace as they do not stick to the skin.
A pair of small scissors, tweezers, safety pins. Tick removal tool. (Scissors to cut the edges of large plasters so they can be pressed flat, without wrinkling on curved parts of the foot). An eye bath - one can get cooled boiled water from a kettle or carry specific sterilised water tubes.
You could take bandages; elastic compression rolls for twisted ankles, elbows, wrists, etc – these things do come up but the bandages are bulky – you could carry one or two and replace if used?
Also possibly a triangular bandage - for hurt arms, not really needed as you can tuck the hand into a shirt, or use their belt but good to have as when worn it warns other people of the situation and properly relaxes and comforts the pilgrim - also great for making a head bandage.
An emergency foil blanket - for those in shock, or out on Camino waiting for an ambulance.
You will also need some ziplock bags – great for sorting your items and keeping them clean and dry, but you will also need one to put the discarded wrappings and so on into, otherwise there will be bits everywhere! A small plastic lidded container for putting old blades into or to keep the needles in if using those, perhaps with a small amount of medical alcohol so they are cleaned as you walk.
Only carry over-the-counter medicines as one is not a doctor and they cannot be “prescribed”, only offered, and one must always check that the pilgrim is not allergic. If in doubt, perhaps due to language problems, don’t.
Some Paracetomol.
Ibuprofen (check they are not allergic) – you can get stronger ones in Spain than the uk 200’s.
Ibuprofen gel (for strains) – you can buy Voltaren Emulgel in Spain, a different active ingredient that works really well.
(I also carry tiny grip-seal bags so that I can squeeze a small amount into them so that the pilgrim can self medicate until they reach a pharmacy).
A small pack of Aspirin – if someone is having heart attack symptoms one to be chewed to powder, or if they are unable, one to be crumbled into the mouth.
A few max strength Lemsips (named Lemsip in the UK), they are Flu control Paracetomol + decongestant powders – gives symptomatic relief for those with chills, etc.
Non-Drowsy Hay-fever pills – (antihistamines) - also good, at double dose, for bedbug reaction.
Dioralyte sachets – fast replacement of body salts and liquid for those with diarrhoea or exhaustion or dehydration. A dehydration that one commonly sees in hot weather is where the pilgrim has been drinking vast amounts of water but getting weaker and weaker as they have been leaching out their electrolytes - these sachets are the “magic” answer to that.
I carry a small bottle of Olbas oil. Few drops on a tissue and then inhaled clears bronchial tubes and that ‘stuffed up’ feeling.
Get a good first aid manual and read it intensively before you go. The thing to remember is that first rule of first aid is “do no harm” – so if you are concerned about someone, or/and your own level of skill, take them to the doctor instead of trying to treat them. Of prime importance is to learn how to do CPR as you never know when someone will have a heart attack. Also the Heimlich manoeuvre for when someone is choking on lodged food.
There are Youtube videos and you can practise on a friend or your partner - it is really good to know how to do both of these - you may save a life.
Some tips – check the inside of the boots to see if there is a problem there that has caused the blister.
Also, blisters on/between toes are usually because the boot is too tight there. Get them to remove the laces and put them back but not using the first two or three sets of holes, this allows the boots to open at the front and flex at the toes. Alternatively make the laces really loose until the third or fourth eyelets and tie a half hitch knot at each one so that when the boot is tightened up the front section cannot tighten but remains loose.
Tell pilgrims not to tie their boots over-tight, and to take them off at least three times a day, socks too. Allows the feet to breathe, then put socks back on opposite feet, so that any rubbing points are removed. Then not to tie them too tight again. Foot size increases throughout the day, especially so for all-day walking pilgrims. Folk who do their boots up tight in the morning and leave them like that all day are giving themselves grief.
If someone has right size boots, ok socks, is doing them up properly, and still getting blisters then suggest that they pop into a supermarket and buy a few pairs of ultra thin socks to wear under their normal socks – this double socking allows the foot to move without rubbing – or, they buy a good cream and cover their feet every morning and evening to make them slick and slippy. – oh, and tell them never to shower in the morning, removes all the oils in the feet – not good.
If someone has small round translucent ‘blisters’ on their shoulders, back, neck, face that appear to be quite clear inside these will be bedbug bites. They need an antihistamine – double doses, repeated, of hay-fever tablets (non-drowsy) will help. If allergic reaction is severe get them to a doctor where they will be given a horse-syringe sized injection of antihistamine!
That is about it I think – if you think of anything I have missed do let me know!
and ....... Buen Camino!!
Well, the beginning of the main pilgrim season is already upon us and around the world tens of thousands are planning and packing - right now! Visualise how many rucksack loads are currently spread out on a floor or bed with the virgin pilgrim standing there, scratching their head!
Now, I know that as part of this there is the issue of what to carry to look after oneself but I thought I would extend that thought into the possibility of helping others - so here is a rather rambling account of a small first aid kit, and some tips, for helping other pilgrims.
A first aid kit for helping others is a bit of a problem because it is a compromise, weight and bulk being the most important considerations. Really it is down to the individual.
As the first step is cleanliness, to make the wound/blister really clean, antiseptic wipes are a must, as are clean tissues to dry the area. If possible it is a good idea to get them (or you) to wash the feet first as, apart from cleanliness it removes the skin oils so that plasters stick properly.
Although when properly used by someone who knows how to look after themselves they work really well I no longer use compeed as I have seen too many problems with them as it is hard to make them stick properly unless the foot is clean, dry, and oil free, and also very difficult to remove where one has been stuck over an unclean wound that has become infected - a not uncommon sight. Another reason for good hygiene – stick a compeed over a few microbes and you set up a perfect petrie dish!
So I use fabric plasters, the type that have adhesive all the way round the centre pad. Then I may place a length of strip plaster, cut to size, to add extra cushioning, over the first plaster.
The blister formed because there was some form of rubbing or continuous pressure, as well as by dirty sweat – clean feet well creamed with clean socks is a good preventative way to go!
The plaster protects the wound, allowing it to heal, and the fabric strip on top adds a barrier between the skin and whatever it rubbed against. An alternative is to use a large fabric plaster, edged all round, as a top dressing, a final cushion.
Then, before you plaster, you have to flatten the blister – there are two schools of thought on this – leave the blister alone and cover it, and drain the blister and cover it. The thing is, most blisters in ‘normal’ life come from walking for one day, or a run, or new shoes. When the person gets home they shower, cover the blister, and then wear different shoes – simple. But the pilgrim is pounding their feet for hours every day, carrying a load, in the same footwear. If the blister is left full each footstep will pound it and the inner edges of the blister will widen through the pressure, making a larger and larger blister, so, for pilgrims, I believe that the blister should be drained. Never ever thread cotton through them! This allows an open sweating wound covered in sweaty socks that is just perfect for an infection!
I use disposable scalpel blades (No. 11 blade) as the blades allow me to cut a good but small ‘V’ shape at each end of the blister, which means I can gently press it flat with ease – needles don’t always make big enough holes – and you do have to get all the liquid out as by leaving some in a new blister may reappear after some more pounding. (by the way, although the British army do this, don’t remove the blister skin, leave it in place as a healing covering).
The good thing about using plasters is that one can give spare plasters to the pilgrim so that they can still shower and then replace. I give enough to get them to the next supermarket/pharmacy where they can buy their own.
In an ideal world you would wear latex gloves – but these are one-use and you would use lots of them! So clean your hands really well with a medical hand cleaner. Cleanliness at all times is key.
Again – people who thread cotton to keep blisters open are in error, it is a perfect way of introducing dirt into the wound.
So – my basic list: all easily replaceable in supermarkets and pharmacies in Spain .
A good hand cleaner for your own hands – medical one, a small bottle will do, or gel, as it goes a long way..
Antiseptic wipes – lots.
Tissues - and cotton wool if wanted. One can also carry moleskin and/or sheep’s wool, to give cushioning to a hot spot that has not yet formed a blister.
Some disposable scalpel blades or a couple of large needles – these can be re-used by boiling them or by washing in alcohol.
A tube of antiseptic cream – Germolene is good as it has a local anaesthetic too - or antiseptic iodine spray.
A variety of fabric plasters of all shapes and sizes (fabric as waterproof ones don’t adhere strongly enough) - the type that have adhesive all round the edges with a medicated island pad in the middle. Also butterfly shaped plasters as they work very well in between and on toes.
A variety of large plasters with adhesive all round to cover the first plaster and/or strip plaster. This is uncut plaster that comes boxed, usually in one metre lengths.
You could carry corn plasters - they are ring shaped cushion pads, adhesive on one side, which are rather good for separating toes that are being squashed together.
Not necessary really but you could carry spray plaster. It works well after cleaning a graze on the body as it seals it, stays for days, and allows people to shower.
You could carry cohesive bandage rolls. Very good for supporting knee ligaments, painful ankles, and so on. One must be careful not to put them on too tight (or too loose). Pilgrims can remove them for showering and then replace as they do not stick to the skin.
A pair of small scissors, tweezers, safety pins. Tick removal tool. (Scissors to cut the edges of large plasters so they can be pressed flat, without wrinkling on curved parts of the foot). An eye bath - one can get cooled boiled water from a kettle or carry specific sterilised water tubes.
You could take bandages; elastic compression rolls for twisted ankles, elbows, wrists, etc – these things do come up but the bandages are bulky – you could carry one or two and replace if used?
Also possibly a triangular bandage - for hurt arms, not really needed as you can tuck the hand into a shirt, or use their belt but good to have as when worn it warns other people of the situation and properly relaxes and comforts the pilgrim - also great for making a head bandage.
An emergency foil blanket - for those in shock, or out on Camino waiting for an ambulance.
You will also need some ziplock bags – great for sorting your items and keeping them clean and dry, but you will also need one to put the discarded wrappings and so on into, otherwise there will be bits everywhere! A small plastic lidded container for putting old blades into or to keep the needles in if using those, perhaps with a small amount of medical alcohol so they are cleaned as you walk.
Only carry over-the-counter medicines as one is not a doctor and they cannot be “prescribed”, only offered, and one must always check that the pilgrim is not allergic. If in doubt, perhaps due to language problems, don’t.
Some Paracetomol.
Ibuprofen (check they are not allergic) – you can get stronger ones in Spain than the uk 200’s.
Ibuprofen gel (for strains) – you can buy Voltaren Emulgel in Spain, a different active ingredient that works really well.
(I also carry tiny grip-seal bags so that I can squeeze a small amount into them so that the pilgrim can self medicate until they reach a pharmacy).
A small pack of Aspirin – if someone is having heart attack symptoms one to be chewed to powder, or if they are unable, one to be crumbled into the mouth.
A few max strength Lemsips (named Lemsip in the UK), they are Flu control Paracetomol + decongestant powders – gives symptomatic relief for those with chills, etc.
Non-Drowsy Hay-fever pills – (antihistamines) - also good, at double dose, for bedbug reaction.
Dioralyte sachets – fast replacement of body salts and liquid for those with diarrhoea or exhaustion or dehydration. A dehydration that one commonly sees in hot weather is where the pilgrim has been drinking vast amounts of water but getting weaker and weaker as they have been leaching out their electrolytes - these sachets are the “magic” answer to that.
I carry a small bottle of Olbas oil. Few drops on a tissue and then inhaled clears bronchial tubes and that ‘stuffed up’ feeling.
Get a good first aid manual and read it intensively before you go. The thing to remember is that first rule of first aid is “do no harm” – so if you are concerned about someone, or/and your own level of skill, take them to the doctor instead of trying to treat them. Of prime importance is to learn how to do CPR as you never know when someone will have a heart attack. Also the Heimlich manoeuvre for when someone is choking on lodged food.
There are Youtube videos and you can practise on a friend or your partner - it is really good to know how to do both of these - you may save a life.
Some tips – check the inside of the boots to see if there is a problem there that has caused the blister.
Also, blisters on/between toes are usually because the boot is too tight there. Get them to remove the laces and put them back but not using the first two or three sets of holes, this allows the boots to open at the front and flex at the toes. Alternatively make the laces really loose until the third or fourth eyelets and tie a half hitch knot at each one so that when the boot is tightened up the front section cannot tighten but remains loose.
Tell pilgrims not to tie their boots over-tight, and to take them off at least three times a day, socks too. Allows the feet to breathe, then put socks back on opposite feet, so that any rubbing points are removed. Then not to tie them too tight again. Foot size increases throughout the day, especially so for all-day walking pilgrims. Folk who do their boots up tight in the morning and leave them like that all day are giving themselves grief.
If someone has right size boots, ok socks, is doing them up properly, and still getting blisters then suggest that they pop into a supermarket and buy a few pairs of ultra thin socks to wear under their normal socks – this double socking allows the foot to move without rubbing – or, they buy a good cream and cover their feet every morning and evening to make them slick and slippy. – oh, and tell them never to shower in the morning, removes all the oils in the feet – not good.
If someone has small round translucent ‘blisters’ on their shoulders, back, neck, face that appear to be quite clear inside these will be bedbug bites. They need an antihistamine – double doses, repeated, of hay-fever tablets (non-drowsy) will help. If allergic reaction is severe get them to a doctor where they will be given a horse-syringe sized injection of antihistamine!
That is about it I think – if you think of anything I have missed do let me know!
and ....... Buen Camino!!