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First Aid kit for helping other pilgrims

David

Veteran Member
Camino(s) past & future
Moissac to Santiago Spring 2005 was the first foray.
Hello all. As some of you know I go to Camino once or twice a year to offer first aid (and pastoral care) to pilgrims. Being one of those pesky Christians - a Unitarian Franciscan - the mission is based on the specific command from Jesus at the end of the parable of the Good Samaritan "then go, Ye, and do likewise". (Luke 10:37).

An Australian pilgrim recently wrote to me as he and his wife were soon off to their second Camino to ask what I would suggest for a first aid kit to carry with the intention to help others. He had seen many pilgrims who needed help on his first pilgrimage but had no kit to help them with. How marvellous, to not only return but to return with the intention of helping others ... I think the Americans would exclaim "Way To Go!!"

So - below is some info and a first aid kit list and some tips .... if you would like to help others then please do think about taking something similar.
This is my first attempt at this cut down kit - my first aid kit is ridiculously large and extensive! - so would also appreciate thoughts on it. I don't think that it would weigh too much.

Although I do mention this further down I would like to mention two things. Read and learn a good first aid book before you go, and, the first thing to remember in first aid is the first rule "do no harm" - so if one meets a problem that one feels is either serious or that one does not have the skills to help, then get them to a doctor.

So ... here it is ...
Small first aid kit for helping others

A first aid kit for helping others is a bit of a problem because it is a compromise between what you would like to carry and weight, weight being the most important consideration. Really it is down to the individual. The first step is cleanliness, to make the wound/blister really clean, so 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.

I do use compeed but only on very simple blisters, not the type that are in between toes and so on, as it is hard to make them stick properly (another reason for good hygiene – stick a compeed over a few microbes and you set up a perfect petri dish!).

Mainly I use fabric plasters, wherever possible the type that have adhesive all the way round the centre pad. Then I may place gaffer tape (duck tape) over the 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 way to go!

The plaster protects the wound, allowing it to heal, and the gaffer tape adds a barrier between the skin and whatever it rubbed against –and it is ‘slidey’ too, allowing the foot to move without friction.

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 cover the blister and then wear different shoes – simple. But the pilgrim is pounding their feet for hours every day, carrying a load. If the blister is left 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.

I use disposable scalpels as the blades allow me to cut a good ‘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, never 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/chemist where they can buy their own.

In an ideal world you would wear latex gloves – but these are one-use and you would use loads of them! So clean your hands really well with a medical hand cleaner.

Thought – people who use 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 chemists 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. If really stuck use whiskey!

Antiseptic wipes –lots

Tissues

Some disposable scalpels, (or just possibly a couple of large needles) – these can be re-used by boiling them, though take care not to put the plastic handles into the water as they will bend.

A tube of antiseptic cream – Germolene is good as it has a local anaesthetic too - or antiseptic spray

A variety of fabric plasters of all shapes and sizes (waterproof ones don’t adhere strongly enough)

A variety of large plasters with adhesive all round to cover the first plaster (saves on taking heavy gaffer tape –this cannot be done on toes of course).

Some cotton wool - great for padding, especially between toes.

Some Paracetomol

Ibuprofen (check they are not allergic) – you can get stronger ones in Spain than one can get elsewhere.

Ibuprofen gel (for strains) – you can buy Voltaren Emulgel in Spain, possibly superior to Ibupofen gel

A small pack of Aspirin – if someone is having heart attack symptoms one to be chewed to powder and then swallowed, or if they are unable to do it themselves, one to be crumbled into the mouth.

A few max strength Lemsips (named Lemsip in the UK), they are Flu control Paracetomol + decongestent powders – gives symptomatic relief for those with chills, etc

Hay-fever pills –(antihistamines) - also good, at double dose, for bedbug allergic reaction.

Some Dioralyte sachets – fast replacement of body salts and liquid for those with diarrhoea or exhaustion or dehydration.

A pair of small scissors, tweezers, safety pins. (Scissors to cut the edges of large plasters so they can be pressed flat, without wrinkling).

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 take bandages; elastic compression rolls for twisted ankles – these things do come up but the bandages are not light – 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 great for making a head bandage.

You will also need some ziplock bags – 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!

Get a good first aid manual and read it intensively before you go. Or if you have the time go on a first aid course. The thing to remember is that the 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.

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 one, two, or even three sets of holes, this allows the boots to open at the front and flex at the toes.

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. As you may already know, 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 thin socks to wear under their boot 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 ‘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 tabs will help.

That is about it I think – if you think of anything I have missed do let me know!

Buen Camino!
 
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dougfitz

Veteran Member
Camino(s) past & future
Spain: Mar 2010, Apr 2014, May/Jun 2016. Norway/Sweden: 2012, 2018. Other: 2011, 2019. CP (tbc)
@David, thank you very much for sharing this information about your mission, and the advice about what one might include in one's first aid kit to assist others. I am sure that pilgrims appreciate and will benefit from the support that you offer, but it appears to go well beyond first aid as I know it.

As a qualified first-aider in Australia, there are some issues about your recommendations, and my view is that in that context, what you are doing would appears to enter into the realm of initial medical treatment. - something I would strictly avoid as a first aider.

The first of these is the provision of pharmaceuticals, which is clearly beyond first aid protocols, and even your own injunction to do no harm. It is a personal choice to use over-the-counter or other medications, and unless an individual is appropriately qualified, it is inappropriate to provide them or advice on the use of such medications in a first aid context, irrespective that it might be done if good faith. Boring, I know, but I consider the provision of gratuitous advice on the use alternative medicines and folk remedies in the same way.

The second area is the treatment of blisters. A blister that is intact and has not ruptured is a challenge, but it is not a wound, and does not need to be treated as such. A blister that has ruptured, or been ruptured deliberately, is a minor wound, and needs to be treated with much more care. Why would you inflict that harm and risk on someone as a first-aider? If flies completely in the face of your injunction to do no harm. And to do it in completely un-sterile environments adds to the risks and potential harm if infection occurs.

A few years ago, I was thrust into the role of the 'blister fixer' for a group pilgrimage walk here in Australia, and following that worked up a protocol on minor wound treatment with one of the medical practitioners on the walk. Here is an extract from that protocol for blister treatment

There are a number of considerations when considering what assistance to offer an individual with hot-spots or intact blisters.
  • Any treatment on the walk or at the evening accommodation is in non-sterile conditions, and any techniques that involve cutting or piercing the skin should be avoided. In any case, incision of a blister should only be considered by an appropriately qualified person.
  • Many blister treatments are based on not continuing the activity that caused the blister, and are unsuitable for pilgrims who wish to continue to walk. As an example, any treatment that involves padding across the blister area will increase the pressure on the blister when the pilgrim is walking, increasing the chance that the blister will burst, and then needs to be treated as a wound.
  • Any treatment needs to consider how to reduce aggravation causing the hot-spot or blister, or development of similar blisters. This should include examination of socks and shoes for pressure points and the like. In the extreme, pilgrims might consider easing pressure by cutting some small vertical slits in their shoes at a pressure point, eg to relieve pressure on a bunion.
  • Hot spots and blisters between toes and at the sides of the feet are generally caused by friction, and can best be treated by creating a barrier to reduce the skin rubbing against the sock and shoe. In the case of toes, treatment might include taping the individual toes or taping adjacent toes together. Consider a single layer of a product such as 3M’s Micropor or Medipor, Smith & Nephew’s Leukopor or Fixomull stretch or standard moleskin.
    • For toes, cut a 25mm wide by 80 mm long strip and lay it over the affected toe along the length from 15 mm past the nail. Elsewhere, use a single layer to extend the coverage 10-15mm past the obvious hot spot.
    • While moleskin will normally be more effective and last longer, it is thicker than the other products mentioned and might not be as good an option for someone whose shoes are already tight.
    • Advise the pilgrim to leave the tape on when showering.
  • Blisters on the ends of the toes and under the toe nails are often the result of wearing boots or shoes that are too small, when the tip of the toe comes into contact with the front of the shoe box.
    • Treatment should avoid creating any greater pressure on the front of the toes, ie should use the thinnest dressing material available. In this case, pilgrims should also consider walking in the thinnest socks that they have available with them or can get, eg from another pilgrim.
    • They should also be advised to make sure their footwear is tightly laced to keep the toes as far back from the front of the shoe as possible and to stop the foot sliding around in the shoe and rubbing.
  • Where an experienced walker is able and willing to provide this, it would be beneficial to provide specific instruction on boot lacing techniques as an adjunct to the evening administrative briefing on the first or second evening of the walk.
I also realised that I could not stop people from inflicting minor injuries on themselves by piercing or incising blisters, but I never, never offered that as a first aid treatment, even though if I was put in the position of assisting them treat these wounds, I would do that to the best of my ability.

I also know that there are many people willing to have their blisters treated by draining the blister, ie by piercing or incising them. My message is that this goes well beyond basic first aid treatment. Every practicable step needs to be taken to ensure that infection does not occur, and the minor wounds that are created are properly treated at the time, and are given appropriate care until they heal.

Regards.​
 
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Camino(s) past & future
CF SJPdP to SdC
(May 2015)
CF Sarria to SdC
(May 2016)
CF SJPDP-SdC
(May 2018)
VdlP (2022?)
Doug, I quite understand your reply and the reasoning behind it. Unless I was a medical professional, I would be very reluctant to assist with anything beyond basic 1st Aid.

So can I ask your opinion from another view?

If I am treating myself for blisters, David's treatment regime does seem to make sense. Taking account of the infection risks, it would seem to be to a reasonable way to 'get mobile' again and minimise the ongoing blister pain.

Would you adopt his style of treatment on yourself?
 
W

whariwharangi

Guest
A blister that is intact is a wound. Its a burn caused by friction.

The aim in blister treatment is to reduce friction. That means draining the blister.

I use a needle that has been sterilized over a lit match (the lit part is important). The needle is used (after it is cooled off) to created a pinhole at the edge of the blister through which blister fluid is carefully pressed out. The skin is left intact until it dries out and falls off. The best time to do this is just before retiring for the night as it gives the blister a chance to dry out overnight.

Infection is a risk, however a blister left untreated will only get larger until it bursts ... and then you still have exposure risks.
 
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Camino(s) past & future
CF SJPdP to SdC
(May 2015)
CF Sarria to SdC
(May 2016)
CF SJPDP-SdC
(May 2018)
VdlP (2022?)
A blister that is intact is a wound. Its a burn caused by friction.

The aim in blister treatment is to reduce friction. That means draining the blister.

I use a needle that has been sterilized over a lit match (the lit part is important). The needle is used (after it is cooled off) to created a pinhole at the edge of the blister through which blister fluid is carefully pressed out. The skin is left intact until it dries out and falls off. The best time to do this is just before retiring for the night as it gives the blister a chance to dry out overnight.

Infection is a risk, however a blister left untreated will only get larger until it bursts ... and then you still have exposure risks.

That seems to make sense. So to dry the blister overnight, I presume you leave it open to the air? Then dress it in the morning.
 

jeffnd

Active Member
Camino(s) past & future
March/April 2014
It amazes me that people will forgo a basic first aid kit to save weight. It amazes me even more that I've seen this weight-saving "tip" passed along here and on other Camino forums!

"Oh, you don't need a first aid kit. You can get everything at the pharmacy!"

That is great advice, so long as you can manage to only need medical attention in a decent sized town from 9am to noon, and 4 pm to 7 pm, Monday through Saturday.

My personal favorite reason for not bringing a first aid kit is, "You can just borrow whatever you need from your fellow pilgrims!". Really?? Don't be that person who is always bumming Compeed and pain killers.

I appauld the folks who are willing to help out when needed, but seriously, bring your own stuff!
 

David

Veteran Member
Camino(s) past & future
Moissac to Santiago Spring 2005 was the first foray.
Thank you for your replies, and yes, I too think that one should carry a first aid kit on Camino, it is the sensible thing to do. This particular 'kit' is to do with helping others in mind so may be larger than a personal kit.

- in response to the criticisms above -

- the over-the-counter items such as Ibuprofen I recommend to carry aren't carried to be "prescribed" - this is a first aid kit, a Camino first aid kit - and are carried to be given to pilgrims who ask for them - they are their own prescribers. This is a kit to be carried where one can be miles away from any chemists - miles away. If one meets a pilgrim with a cold or an inflamed knee and they have nothing to help them then to mention that one carries such things as painkillers or Ibuprofen or antihistamines or Lemsips allows them to ask for them and they are helped. Is this a bad thing? Or should one leave such things at home and let the person suffer by themselves? You choose.

The aspirin is a different case. Early administering of chewed or crumbled aspirin to heart attack sufferers saves thousands of lives each year - as well as knowing how to do cpr we should all carry some aspirin at all times.
Dioralyte sachets are also a different case. They are given not only to adults but to children and babies throughout the third world to save their lives and are invaluable - and safe - when given to those who are severely dehydrated for any reason.

The blister situation - I mention quite clearly that there are two theories and that it is my belief that the draining of blisters is the correct one. It can be extremely painful to continue to walk on full blisters and the constant pounding will either make them larger and larger or they will burst, which really introduces dirt and infection into the wound.

Cleanliness as a first - I think that I covered that quite clearly.

I have not started this post to enter into arguments with anyone - the kit and tips merely as a suggestion for those who think further than their own health and welfare, who wish to help others.

Thank you.
 
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Stellere

Active Member
Camino(s) past & future
March 2014 - con mi padre
I started with a very small first aid kit, just enough for my own needs. In Larrasoana - where there are no pharmacies and the hospitalera (who by the way only showed up at 6PM, stayed about 15 minutes to assign beds without giving a smile to anyone and then disappeared) very impatiently and unkindly barked "no" when I asked in Spanish if they had any supplies at the municipal albergue - we met a girl with oozing weeping wounds covering the backs of both feet. They were like blisters on steroids. Horrible. The reasonable thing would have been to stop walking, but she wasn't open to even considering that possible. Too big for compeed, too big for plasters, too big for anything that any of us had. I did my best, gave her some antiseptic wipes, my one square of gauze and my duct tape, but even the square of gauze was too small to cover one blister, let alone both. And yes, she kept walking the next day.

After that, I started carrying very basic extras: compeed, large gauze, extra tape, antiseptic wipes. I'm not a blister expert, so I didn't tell anyone what to do. But I shared what I had often enough that I had to replenish several times - even though neither my walking partner nor I had any problems with blisters.

The next time I walk a camino, I will leave with a very well-stocked first aid kit! It's a very terrible feeling to watch someone suffer and not be able to offer any help at all.
 

wayfarer

Moderator
Staff member
Camino(s) past & future
SJPP-Santiago-Finistera-Muxia. April/May 2012
Sarria-Santiago Sept. 2013
SJPP - Almost Orrison April 2014
I always carry a first aid kit and one big enough to see to the needs of others as well. In 2012 all of the items used were by other pilgrims. One of the most used items were rehydrating powders that I gave many of the younger pilgrims who had got in trouble from walking to far too fast and not drinking enough, some were quite ill. I would also agree with David, non prescription meds are ok to carry and give to people in trouble so long as you check that there are no allergies involved. I carry all these items in my car as well just in case.
 

dougfitz

Veteran Member
Camino(s) past & future
Spain: Mar 2010, Apr 2014, May/Jun 2016. Norway/Sweden: 2012, 2018. Other: 2011, 2019. CP (tbc)
A blister that is intact is a wound. Its a burn caused by friction..
An injury maybe, but not a wound. Common English usage distinguishes between wounds and other forms of injury. The simple definition is that a wound is 'an injury to living tissue caused by a cut, blow, or other impact, typically one in which the skin is cut or broken.' Neither are blisters classed as contusions or closed wounds.

The aim in blister treatment is to reduce friction. That means draining the blister.
There are many more ways of reducing friction available than just draining the blister. I listed several in the protocol I shared.

... however a blister left untreated will only get larger until it bursts ... and then you still have exposure risks.
I'm not suggesting that a blister goes untreated, but is treated in ways other than puncturing it, both to prevent it spreading, and for pilgrims to allow them to continue to walk. Even if an intact blister eventually bursts, it will have delayed increasing the risk of infection that puncturing it unnecessarily will introduce.

If someone wants to treat themselves, and puncture the blister, that is a very personal decision. I don't advocate it, and won't help someone do it as a first-aid technique when there are good alternatives available.

Regards
 

Kanga

Moderator
Staff member
Camino(s) past & future
Francés x 5, Le Puy x 2, Arles, Tours, Norte, Madrid, Via de la Plata, Portuguese, Primitivo
David thank you for a valuable service. Sounds to me like you are doing a great job.
Sorry Doug but Camino knowledge about blister treatment is far superior to anything a first aider or doctor would know. Experience counts.
If you don't pop the blister with a needle it only grows (as David says, because Camino walkers keep rubbing the same place) and gets worse and tears - a disaster. If you do use a needle as soon as a blister appears there is instant relief from pain, the skin stays intact to protect the area and the blister gradually heals into a tough patch of skin.
If you don't agree you haven't tried it.
It goes without saying that you wipe the blister and needle first with antiseptic.
The critical factor is to keep the skin intact, which is why I would not use a scalpel. And do not on any account squeeze. Just let the blister drain by itself and pop each night as necessary.
I think it is a treatment best self administered as sometimes four or five "pockets" develop within the blister that need popping and only the sufferer knows when they have all been found.
I say this without wanting to get into an argument (no correspondence will be entered into LOL) but as information from my experience for those who want to know.
 

dougfitz

Veteran Member
Camino(s) past & future
Spain: Mar 2010, Apr 2014, May/Jun 2016. Norway/Sweden: 2012, 2018. Other: 2011, 2019. CP (tbc)
So can I ask your opinion from another view?

If I am treating myself for blisters, David's treatment regime does seem to make sense. Taking account of the infection risks, it would seem to be to a reasonable way to 'get mobile' again and minimise the ongoing blister pain.

Would you adopt his style of treatment on yourself?
Definitely not. There are generally treatment approaches that will get you mobile without having to puncture the blister. These are reasonable, not puncturing the blister as a first response. Even if I know that the treatment will only be able to prevent the blister bursting for a day or two, I think it is worth gaining that time.

I worry that someone has let a blister get so large that the only treatment that will keep them going is to drain the blister. This indicates that they have completely failed to pay any heed to the warning signs such as hot spots, completely failed to implement reasonable checking measures such as removing their boots and inspecting their feet when having a break at a bar or on the roadside, and walked through the pain of a large blister developing oblivious to that fact and not sought to treat the blister early, nor to minimise its spread. Its not a good sign that any sensible treatment regime will be followed.

Regards,
 

David

Veteran Member
Camino(s) past & future
Moissac to Santiago Spring 2005 was the first foray.
Kanga - I don't cut huge holes with a scalpel, just a tiny knick with the tip of a No. 11 blade which is very pointed, not that much bigger than a needle hole but it makes a V shaped hole rather than round. I have found that a round hole blocks quickly whereas the V shape doesn't so is easier to drain. They are very very small holes - nothing horrid!! ;)
I also use one-use scalpel blades that come in individually sealed packs to enhance cleanliness.

wound1
wuːnd/
noun
  1. 1.
    an injury to living tissue caused by a cut, blow, or other impact, typically one in which the skin is cut or broken.
Typically when the skin is cut or broken but not always - a wound is an injury to living tissue, which includes blisters and bruises. A wound that has a cut or is broken is known as an open wound.

A blister is a wound. It is a wound within the layers of the skin, not visible on the surface. Essentially it is a burn wound. The body tries to heal itself by producing a liquid that is both healing and provides padding.
Draining the blister provides immediate relief from the pain.
Draining the blister allows the surface skin to be gently pushed flat, protecting the area and removing the probability of the blister widening through continued trauma.
Covering the drained blister protects from infection and allows healing.
Covering the dressing makes a cushion between the blister and whatever caused it.
Checking the inside of the footwear at the point of trauma allows one to possibly remove the problem, the cause of the blister.

This is a video from a specialist. He points out that there is a difference between blister treatment at home - leave it - and when one has to carry on - treat it. In fact, not only does he drain the blister, he actually removes all the external blister skin before covering the area - he is speaking about being 'out in the field' such as when in the army - I think that pilgrims are in a similar situation.

 
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dougfitz

Veteran Member
Camino(s) past & future
Spain: Mar 2010, Apr 2014, May/Jun 2016. Norway/Sweden: 2012, 2018. Other: 2011, 2019. CP (tbc)
David thank you for a valuable service. Sounds to me like you are doing a great job.
Sorry Doug but Camino knowledge about blister treatment is far superior to anything a first aider or doctor would know. Experience counts.
If you don't pop the blister with a needle it only grows (as David says, because Camino walkers keep rubbing the same place) and gets worse and tears - a disaster. If you do use a needle as soon as a blister appears there is instant relief from pain, the skin stays intact to protect the area and the blister gradually heals into a tough patch of skin.
If you don't agree you haven't tried it.
It goes without saying that you wipe the blister and needle first with antiseptic.
The critical factor is to keep the skin intact, which is why I would not use a scalpel. And do not on any account squeeze. Just let the blister drain by itself and pop each night as necessary.
I think it is a treatment best self administered as sometimes four or five "pockets" develop within the blister that need popping and only the sufferer knows when they have all been found.
I say this without wanting to get into an argument (no correspondence will be entered into LOL) but as information from my experience for those who want to know.
@Kanga, I think I have sufficient long distance walking experience, and experience treating walkers who have blistered, to know what I am talking about. When I was asked to be the blister fixer for a group of 24 older walkers on Camino Salvado in 2011, the only walker whose blister ruptured and caused problems was someone who had declined to let me treat her feet. Every one of the pilgrims on that walk that accepted the first aid treatments that I offered, none of which involved draining their blisters, successfully walked on to our destination at New Norcia. At that stage, some had walked with their treated blisters for over five days.

When I first started longer distance walking, I did drain a particularly large blister that I had foolishly not attended to when it started forming. I didn't find that any more effective than leaving the blister intact, using a low friction covering and possibly building a small ring around the blister so that it is better protected inside a boot or shoe if it is on the side of the foot rather than on the sole. I have tried it, and I definitely don't agree with you on this.

Let me suggest that until you have tried both approaches, as I have, your experience in the success of one approach is not a sound basis for commenting on the alternative.

Regards,
 
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koilife

Veteran Member
Camino(s) past & future
CF w/ son #1 (2013); Logrono-Leon/Salvador/Primitivo w/ son #2 (2016); Portugues w/ son #3 (2020)
I worry that someone has let a blister get so large that the only treatment that will keep them going is to drain the blister. This indicates that they have completely failed to pay any heed to the warning signs such as hot spots, completely failed to implement reasonable checking measures such as removing their boots and inspecting their feet when having a break at a bar or on the roadside, and walked through the pain of a large blister developing oblivious to that fact and not sought to treat the blister early, nor to minimise its spread. Its not a good sign that any sensible treatment regime will be followed.
I suspect this stems from ignorance of just how bad a blister can get, or from a belief that they can simply tough it out until they get to the albergue for the evening. Experience will correct this.

The more problematic case arises from a belief that blisters are part of the suffering of the pilgrim, and therefore are to be endured (which is true) but not to be avoided (which is masochistic) because there is something noble, heroic, or holy in that suffering. Unfortunately, in this case experience reinforces the wrong behavior. I worry that the girl above referred to by @Stellere fell into this later case.
 

David

Veteran Member
Camino(s) past & future
Moissac to Santiago Spring 2005 was the first foray.
oh, I agree with you, Kanga; yes, definitely works, definitely preferable, and the walker is instantly pain free.
 

bokormen91

Active Member
Camino(s) past & future
CF, Via Podensis, Baztan, Coastal Portugese, sections on others...
Seems a bit like a discussion for the sake of it...

I do appreciate what David does and sort of expect that many of the people that David helps are of the "You can just borrow whatever you need from your fellow pilgrims!" that jeffnd mentioned.

I'm also a qualified First aider and understand that I have have both things to offer and limitations as to what I can offer. I have seen so many people offer time, advice and resources to fellow pilgrims, and consider this one of the beauties of the Camino. I can also understand issues mentioned by dougfitz.

However, Europe has not reached the silly stages of litigation, yet, so people are still willing to help their fellow man. I hope this continues.

If people lack common sense, are too worried about the weight to carry some basic 1st aid equipment, more fool them. I think we can all count ourselves lucky that people like David are willing to compensate for others stupidity. People have a responsibility for their own health - that responsibility does not stop just because they have decided to join the Camino. If anything - that responsibility is increased so that they do not cause unnecessary suffering/inconvenience to their fellow pilgrims.

Ofc accidents can happen, and there can be major unforeseen events - however, if you look at David's list, most of it comes under the 7 Ps: Proper Prior Planning Prevents P*ss Poor Performance. - Blisters also comes under this in 90% of cases - boots not walked in (having boots in the 1st place, if you've never used them before, don't start - it's not the Mount Blanc Circuit), deciding to walk another 5-40km when you already feel the niggle: stop, have a rest day, you'll be fine, pressing on you won't.

I sincerely hope that Europe does not succumb to the litigious circus, and that there will always be room for those that have the surplus energy for others and will continue to help their fellow man. For the rest - if you're too dumb to realize what you're doing is dumb, I'll put my faith in higher powers and Darwinism.

If I get a blister on my next Camino - I hope David is nearby:)
 

wayfarer

Moderator
Staff member
Camino(s) past & future
SJPP-Santiago-Finistera-Muxia. April/May 2012
Sarria-Santiago Sept. 2013
SJPP - Almost Orrison April 2014
Im not sure about the rest of Europe but Ireland recently passed "good samaritan" laws which means that if you help anyone who has had an accident or medical event they cannot sue you if anything goes wrong. I would love to see this happen worldwide and maybe it would stop the "sue culture" which seems to be spreading. Long live people like David.
 

David

Veteran Member
Camino(s) past & future
Moissac to Santiago Spring 2005 was the first foray.
I'm not sure about the rest of Europe but Ireland recently passed "good Samaritan" laws which means that if you help anyone who has had an accident or medical event they cannot sue you if anything goes wrong. I would love to see this happen worldwide and maybe it would stop the "sue culture" which seems to be spreading.

How civilized! France has a law that makes it illegal for a citizen not to go to the aid of another citizen in need. I am all for both laws!!
 

David

Veteran Member
Camino(s) past & future
Moissac to Santiago Spring 2005 was the first foray.
Re heart attacks. The thing is, we just never know when our help may be needed, especially when isolated out on Camino. I have had a heart attack casualty and used both CPR and rescues breaths. It was made rather messy as the man had fallen and cut his face so both our faces became bloody, which was unpleasant to say the least. It is not always successful. My casualty came back twice but sadly eventually died. . -

Both methods are not just for heart attacks, a drowned person needs this too, as soon as possible, even before they are fully pulled out of the water.

So, for those not wishing to do CPR plus breathing into the mouth one can do CPR by itself -

like this .. (and funny too) - if you feel that you would want to do rescue breaths - breathing into the mouth - then please read the text below the video


If you feel up to it you should give chest compressions with rescue breaths. If you are not completely confident, attempt hands-only CPR instead. The thing is, in this case we are all amateurs and a person is losing their life - one has to act.

Adults: Place the heel of your hand on the centre of the person's chest, then place the other hand on top and press down by 5–6cm at a steady rate, at approximately 100 compressions per minute. After every 30 chest compressions, give two breaths. Tilt the casualty's head gently and lift the chin up with two fingers. Pinch the person’s nose. Seal your mouth over their mouth and blow steadily and firmly into their mouth. Check that their chest rises. Give two rescue breaths. Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.

Children over one year old: Open the child's airway by placing one hand on the child’s forehead and gently tilting their head back and lifting the chin. Remove any visible obstructions from the mouth and nose. Pinch their nose. Seal your mouth over their mouth and blow steadily and firmly into their mouth, checking that their chest rises. Give five initial rescue breaths. Place the heel of your hand on the centre of their chest and press down by at least one-third of the depth of the chest. Use two hands if you can't press down hard enough with one. After every 30 chest compressions at a rate of 100 per minute, give two breaths. Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.


Babies under one year old: Open the baby's airway by placing one hand on their forehead and gently tilting the head back and lifting the chin. Remove any visible obstructions from the mouth and nose. Place your mouth over the mouth and nose of the infant and blow steadily and firmly into their mouth, checking that their chest rises. Give five initial rescue breaths. Place two fingers in the middle of the chest and press down by one-third of the depth of the chest. Use the heel of one hand if you cannot press deep enough with two fingers. After 30 chest compressions at a rate of 100 per minute, give two breaths. Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.

I hope that you never have to do this, but if you know how to do it you can save a life :)
 
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W

whariwharangi

Guest
I've gotten away with carrying minimal stuff for first aid on hikes for years.

I carry an e-reader. I have on it a US Military First Aid Manual (cuz it was free to download). I am looking for a more readable and searchable e-title first aid manual. Thats the beauty of electronic books ... you can carry a library.

There is a large desire to avoid weight. So a first aid kit should carry stuff for injuries that are likely to occur. Otherwise you can carry the 2 kg 1st aid pack complete with bells and whistles.

So what kind of injuries are likely to occur?

The life threatening stuff I've encountered hiking involved allergy to bee stings ... on three separate occasions. Another occasion was allergy to food. So I like to carry at least aspirin though a stronger antihistimine would be preferable. However, I don't like carrying non persciption drugs. They are relatively expensive and have expiry dates and the incidents don't happen that often.

I would guess the most common injury on the camino is blisters. I try to carry stuff that has more than one use such as needles for sewing buttons can be used for punture of blisters. I suppose the real men in the crowd could even sew stitches if needed.

The serious injury I had experience with on the camino was someone trimming a pole with his knife and sliced his hand open. The large fabric bandages just slid off due to the blood. Fortunately someone else had a roll of gauze.

I'll close here saying tendonitis and other overuse injuries are not first aid situations. The response to these injuries is to get them to a doctor no matter how loud they howl in protest.
 
Camino(s) past & future
Some, and with luck, some more.
I'm confused.

David wrote a post which as far as I can see is wholly within the spirit of a Camino and as far I can discern with the interests of fellow pilgrims at heart.

Forgive me, all, is it not a laudable thing David has promoted and practices?

Would it not be enough and in keeping within the ethos of our forum to simply PM him if we have others views?

I fear it is unworthy of this forum to have any poster put in the position of having to 'defend' (if that's the correct word in this instance) their post.

Buen Camino to all.
 

hecate105

Veteran Member
Camino(s) past & future
'09 Portuguese Estellas '14 Aurelia '16 St Davids '17 Via Augusta/V dl P. '18/'19 Michael Mary Way
I always carry a first aid kit - and damn the weight! On the top of everything else is a good wad of sheep's wool (lovingly collected by hand off of barbed wire fences on Dartmoor and washed in a net bag...) At ANY sign of a hotspot or blister I stop and stuff a good piece of the sheep's wool into my sock at the offending place. Hence no blisters.... But linament for aching muscles, an eye bath for suicidal mini-flies, lavender oil for burns and rose oil for hangovers or other nausea all come in handy for me, himself and for any pilgrim, walker or stray we come across.... and of course a hipflask of a decent single malt is an absolute imperative!!
 

hecate105

Veteran Member
Camino(s) past & future
'09 Portuguese Estellas '14 Aurelia '16 St Davids '17 Via Augusta/V dl P. '18/'19 Michael Mary Way
Ahh JohnMcM, it is our pesky human nature that leads us to argue, disagree and grumble, as long as we can do it with good grace, tis interesting to read the differing opinions. I know what you mean tho'.
 

annakappa

Veteran Member
Camino(s) past & future
Part frances jun 07/rest frances may- jun 2008/Frances sept-oct 2009/ Sanabres Oct 2010/Frances sept-oct 2011/Aragones Sept-Oct 2012. Hospitalero Sept 2010, Amiga in Pilgrim's Office Oct 2013. Part Primitivo Oct 2013. Portugues from Porto June 2015.
On my first Camino, I had multiple blisters around the heels after a few days walk. Since then, I never had another, apart from one mini blister on another Camino, which the hospitalera drained with a sterilized needle, covered it with some fresh sabila (aloa) gel cut from a plant in her garden and then covered with a square of sterilized gauze and a super product called Omnifix, which is a sort of elastic tape, cut to size, which accommodates itself to any shape ( my heel in that case). You can buy a roll in any pharmacy in Spain. The dressing should be taken off at night to give the ex- blister time to dry out and the repeat the dressing, together with the aloe gel in the morning. By the next evening the blister had disappeared! Anne
 

annakappa

Veteran Member
Camino(s) past & future
Part frances jun 07/rest frances may- jun 2008/Frances sept-oct 2009/ Sanabres Oct 2010/Frances sept-oct 2011/Aragones Sept-Oct 2012. Hospitalero Sept 2010, Amiga in Pilgrim's Office Oct 2013. Part Primitivo Oct 2013. Portugues from Porto June 2015.
To follow up from my previous post, my mini first aid kit contains :
2 Ibuprofen pills, 2 acetominafen pills, a cut off piece of the Omnifix tape, a few sterilized gauzes, a mini bottle of iodine and a mini bottle of aloe gel ( which I decanter from a larger one at home), one elastic bandage, some sachets of electrolytes which can be added to your bottle of water if you feel dehydrated when walking. That's it. I consider that this covers the immediate first aid and the rest can be bought in the next pharmacy.
HOWEVER, I consider that prevention is better than cure, especially as regards to blisters and so I bought in Spain a tube made of solid gel, covered with a kind of netting, which can be cut to the length of your prone-to- blister toes. From day one, I protect several toes covered this way and would never consider walking without this precaution. I also have removable gel heel protectors. Anne
 

tploomis

Active Member
Camino(s) past & future
Camino Frances Sept. to Nov., 2013
The heart and soul of my first aid kit is duct tape, which I wrap around my water bottle to keep it handy and in an easy-to-dispense form. If I feel a hot spot on my foot, duct tape is the first thing I put on, and that usually keeps it from developing into a blister. I am somewhat prone to sprained ankles, and although I have never needed to use duct tape on a sprain to get me to a place where I can rest, elevate, compress, and ice the sprain, the duct tape is there in case it is needed to provide a support wrap. Most nicks and scratches don't seem like a big deal to me. I wash them off with my drinking water and continue on. If I had a serious gouge that needed pressure to stop the bleeding, the duct tape would serve that function as well -- so far it's never come to that. About ten years ago I crawled off a mountain with a broken leg. I did not have my duct tape with me for that one. It probably would have given some feeling of security to my leg, but would not have allowed me to walk on it. I tried Compeed on the Camino for a blister starting on my baby toe. It worked well but got gooey residue on my socks, and that wouldn't come out.
 

koilife

Veteran Member
Camino(s) past & future
CF w/ son #1 (2013); Logrono-Leon/Salvador/Primitivo w/ son #2 (2016); Portugues w/ son #3 (2020)
I haven't seen much mention of using compound of tincture of benzoin (CTB) to help as an adhesive to keep bandages in place longer or to toughen the skin where the blister is located. I've included a Wikipedia article on it. There is also mention of US military using plain tincture of benzoin as a "hot shot" to replace drained blister fluid (OUCH).

When I feel a hot spot forming, I cover the area with a drop of CTB and then apply a "slick" bandage protection, such as Dr. Scholl's blister prevention pads. The slick will last for several days, even with showering, etc. The same goes for ensuring any bandaging (regardless of whether I pierce the blister or not) stays put until I'm ready to remove it. I prefer this to duct tape which I find tends to roll at the edges and then gum up areas in my socks, which causes them to stick to my feet and then bunch in adjacent areas.

As to how much I bring, a 5 ml or 10 ml bottle is more than sufficient unless dealing with a large amount of blisters.
 
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JennyH94

Pilgrim in progress
Camino(s) past & future
CF - sections and whole (2012-2019) and part VF (2017)
Hi everyone -

David - Such an interesting thread. Any pilgrim who receives your excellent treatment and care is truly blessed - thank you for the wonderful work you do on the Camino helping those in need.

I have a slightly over-the-top account of the 5 Stages of a Camino Blister, which is taken from "The Year We Seized The Day", a Camino memoir by Colin Bowles and Eli Best, two authors who met at a writer's festival and decided to walk the Frances with no training. Colin's account really spells out why blisters need to be treated either at the hot spot stage or promptly if a blister forms.

Colin - Day 10, Najera to Santo Domingo ...

Stage 1)
A hot spot appears, an angry mark somewhere on your feet. It is slightly sore and throbs when you take your boot off.
Stage 2)
A small blister appears. It hurts a bit when you walk. When you take your boot off everyone tells you to burst it with a sterilized needle. It will feel better … you ignore them. What do they know?
Stage 3)
The next day as you walk, you know what it is like to be the subject of the ‘Spanish Boot’, an instrument of torture used in the Spanish Inquisition, where the foot was placed in a steel boot and the boot was tightened by iron screws until it was the size of a toddler’s welly (wellington!).
Stage 4)
The blister bursts inside your boot and turns into a patch of raw flesh the size of a 50 cent piece. When you take off your boot, the skin, flesh and raw nerve endings stick to the woolly parts of your sock and are all removed together. You take off your sock and ring out the pus and the blood like a squeegee mop. Everyone asks you why you didn’t burst the blister with a pin.
Stage 5)
The next day you find on your foot a suppurating wound the size of a bath mat. You cannot stand on your foot, even walking is agony. You still have another month to walk!

This account has stayed with me ever since reading it prior to my Camino in 2012 - I did develop ONE blister and I did treat it promptly by the lancing method, with good results - i.e. no further problems.

Cheers everyone - Jenny
 

wayfarer

Moderator
Staff member
Camino(s) past & future
SJPP-Santiago-Finistera-Muxia. April/May 2012
Sarria-Santiago Sept. 2013
SJPP - Almost Orrison April 2014
Re heart attacks. The thing is, we just never know when our help may be needed, especially when isolated out on Camino. I have had a heart attack casualty and used both CPR and rescues breaths. It was made rather messy as the man had fallen and cut his face so both our faces became bloody, which was unpleasant to say the least. It is not always successful. My casualty came back twice but sadly eventually died. . -

Both methods are not just for heart attacks, a drowned person needs this too, as soon as possible, even before they are fully pulled out of the water.

So, for those not wishing to do CPR plus breathing into the mouth one can do CPR by itself -

like this .. (and funny too) - if you feel that you would want to do rescue breaths - breathing into the mouth - then please read the text below the video


If you feel up to it you should give chest compressions with rescue breaths. If you are not completely confident, attempt hands-only CPR instead. The thing is, in this case we are all amateurs and a person is losing their life - one has to act.

Adults: Place the heel of your hand on the centre of the person's chest, then place the other hand on top and press down by 5–6cm at a steady rate, at approximately 100 compressions per minute. After every 30 chest compressions, give two breaths. Tilt the casualty's head gently and lift the chin up with two fingers. Pinch the person’s nose. Seal your mouth over their mouth and blow steadily and firmly into their mouth. Check that their chest rises. Give two rescue breaths. Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.

Children over one year old: Open the child's airway by placing one hand on the child’s forehead and gently tilting their head back and lifting the chin. Remove any visible obstructions from the mouth and nose. Pinch their nose. Seal your mouth over their mouth and blow steadily and firmly into their mouth, checking that their chest rises. Give five initial rescue breaths. Place the heel of your hand on the centre of their chest and press down by at least one-third of the depth of the chest. Use two hands if you can't press down hard enough with one. After every 30 chest compressions at a rate of 100 per minute, give two breaths. Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.


Babies under one year old: Open the baby's airway by placing one hand on their forehead and gently tilting the head back and lifting the chin. Remove any visible obstructions from the mouth and nose. Place your mouth over the mouth and nose of the infant and blow steadily and firmly into their mouth, checking that their chest rises. Give five initial rescue breaths. Place two fingers in the middle of the chest and press down by one-third of the depth of the chest. Use the heel of one hand if you cannot press deep enough with two fingers. After 30 chest compressions at a rate of 100 per minute, give two breaths. Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.

I hope that you never have to do this, but if you know how to do it you can save a life :)
I am a volunteer First Responder in my local community and this advice is excellent David. Every month I have the AED bag and the responder phone for a 24 hour period, thankfuly I have only been called out once and that was a false alarm.I would encourage everyone to do a basic CPR cource as you never know the day a friend, family member or complete stranger may collapse in front of you and it would be good to know what to do to give them a fighting chance to live until the paramedics arrive.
On the issue of blisters I thankfuly did not get any on the last Caminos so I hope I never meet you in a professional basis David but over a glass of vino tinto. :)
 

dougfitz

Veteran Member
Camino(s) past & future
Spain: Mar 2010, Apr 2014, May/Jun 2016. Norway/Sweden: 2012, 2018. Other: 2011, 2019. CP (tbc)
Im not sure about the rest of Europe but Ireland recently passed "good samaritan" laws which means that if you help anyone who has had an accident or medical event they cannot sue you if anything goes wrong. I would love to see this happen worldwide and maybe it would stop the "sue culture" which seems to be spreading. Long live people like David.
The Civil Law (Miscellaneous Provisions) Act 2011 enacted by the Oireachhtas amended a number of acts, including the Civil Liability Act 1961. Similar legislation has existed in Australia for decades, and I suspect pervades legal systems based on English Common Law. In Europe, the broadly equivalent moral principle is incorporated into systems based on the Napoleonic Code as the Duty to Rescue.

Unfortunately, @wayfarer, the provisions of the Irish act speak generally about the provision of assistance, advice or care but then narrows this to include only the provision of first-aid, treatment with an AED and transporting the person from the scene of an emergency to a hospital or other place where they can get medical treatment.

I have already ventured the view that some of what @David describes goes beyond first-aid, and certainly in the Australian context, there is the prospect that as a result the support that he provides would not be covered under our Good Samaritan legislation. I don't know how Spanish law on this matter would interpret the support he is providing to pilgrims.

Regards,
 

newfydog

Veteran Member
Camino(s) past & future
Pamplona-Santiago, Le Puy- Santiago, Prague- LePuy, Menton- Toulouse, Menton- Rome, Canterbury- Lausanne, Chemin Stevenson, Voie de Vezelay
Interesting discussion here. I will add that not all of the USA is litigious to the point that you can't help your fellow man.

In Oregon we have a good samaritan law protecting people who give aid to the best of their ability. I work as a volunteer ski patrol, and no one has successfully sued a ski patrol in Oregon if that patroller had clear intent to help and did not represent their credentials to be more than their training. If you say your medical training is none, basic first aid, Emt, or physician and stick within your ability and consent of the person you are treating, the law is on your side.
 

pbucilla

Member
Camino(s) past & future
Frances May -June 2014
First-aid must be defined within the context of the situation. First-aid in a large urban center is different than in a more remote rural setting. Everyone is entitled to their opinion and to choose their own method of dealing with blisters. If the blister sufferer gives their consent and no one has misrepresented their knowledge and ability, help where and how you are able. I think we need to laud those who are donating their time, their supplies, and their caring compassion rather than trying to diminish their contributions.
 

David

Veteran Member
Camino(s) past & future
Moissac to Santiago Spring 2005 was the first foray.
Well, not long now before I go back on the Camino - a couple of weeks or so. Just about all of the people I meet out there are friendly, kind and pleasant, positive, open, and genuine, even when they are in some pain; that internet thing that happens when the Trolls eventually appear, with their negative anti-life, anti-joy, anti-pleasure, dogmatic, pedantic attitude, just doesn't seem to happen out there - I am so glad.

I have my St John Ambulance diplomas of course, which I keep up to date, renewing every three years, but all the first aid I offer is quite simple, safe, and straightforward, the sort of thing that the pilgrim would do for themselves were they able. I have taken some pilgrims to the local surgery when their condition has appeared serious - of course, who wouldn't? Local police talk with me and are pleased with what I am doing, and hospiteleros always invite me in, giving me a warm welcome - for that I am also glad.
Not once out there have I had the negative anti-life anti-joy responses that I sometimes seem to attract on the internet in certain forums. I think that it is because there is a difference between posting something negative from a distance and actually being in front of a person and saying the same thing.

All is well. I hope that none of you have any physical problems when on your next Camino, and that if you do there is someone there willing to help you, as you would help them.

Buen Camino!! :):):):):):):)
 

CaminoKris2013

Active Member
Camino(s) past & future
(2014)
David, when are you starting? I am leaving in a couple of weeks...hope we run into each other.


Sent from my iPhone using Camino de Santiago Forum
 

David

Veteran Member
Camino(s) past & future
Moissac to Santiago Spring 2005 was the first foray.
Cool, CaminoKris! Florida to the Camino, it will be fine for you, marvellous dry weather (except no alligators, sorry :)).
I hope to be out there from late May, about the 26th. I will be basing myself at Puenta La Reina for a week (Brierley end of Day 4) - the newbuild refugio with campsite just over the bridge - and then at Castrojeriz (Brierley end of Day 14) - the refugio and campsite "Camping Camino de Santiago" which, by the way, is a truly Fab stop. Good little refugio and campsite, on the left as you go in, 200 metres past the first bar. Stunningly clean, games room, top showers and bathrooms - gender separated!, launderette, and a snug bar with food, and the food is local produce cooked by the mother of the family who owns the site - top place and cheap too!! - and if you need a break there is no problem staying for more than one night, none at all.

But I will be open, as usual, to alterations in plans.

If you see an old fat man with a head like a potato, dressed in brown, probably smiling, and carrying a large green first aid kit - walking or with a bicycle - please do say hello - we can share a mug of tea or a good glass or two of good Spanish wine!

Before I go I will post a message on the forum, same as the last years - I check in as often as I can in case anyone messages me who needs help of any sort, from first aid to an urgent lift to an airport because of a crisis at home, and as I have a car at my base point I can zoom to rescue, should a pilgrim need me.

Buen Camino!! ;)
 
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ksam

Veteran Member
Camino(s) past & future
Portuguese '08, Frances '11, del Norte '14, Invierno '16, Ingles '17, Primitivo October 2018
[/QUOTE]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. .....
...

Buen Camino![/QUOTE]

Just this little piece of information here may save having to carry all the rest of the stuff!! Take care of ya feet and they will take care of you!! Excellent ideas for things to bring or get and use while on the way. Please God...may you need none of it!! :)
 

Dzyduck87

Northwest Canada
Camino(s) past & future
May 2014
I am an EMR - Emergency Medical Responder, and I love the high horse people can get on when they don't actual have much field/trauma experience. I was on a flight from Africa and was paged for a nauseous woman. I told her she could have some of my Gravol (anti-nauseant medication in Canada). Is that in my scope of practice? No. Would I be fired in a second if I gave a nauseous woman on an ambulance Gravol? Yep. Would I do exactly what David said if I were in his position? Yes. Yes, my protocols would never have me pop athletic blisters. But I have my little bag of tricks and list of spanish first aid phrases and if I come across them I will pop them with a sterlized needle and antiseptic wipe the bananas out of that sucker.

The more experience you have, the less you care about legalities. There are paramedics where I'm from who won't even stop at accidents if they are off duty and can see the victims are awake and walking because there "is too much paperwork". We had a gentlement in my province who was fired because he rescued an unconscious coworker from a suffocating environment without having his "confined spaces" ticket. Malarkey. This fear of liability is in place because of the 0.05% times that something has gone wrong. Popping a blister opens the area to infection, which is why it needs to be kept covered and clean. It also relieves pressure allows the area to dry out and heal if covered correctly. Medical professionals are advised not to pop them because virtually that means you're actively doing something that could increase the risk of infection for the patient if they're careless with the cleaning of the area.

Well I care more about your hide than mine so I'll take that risk and trust you to be responsible with your body. I'd also teach a bystander how to hold c-spine if the case called for it. We are lucky for those who are compassionate enough to take the rule book with a grain of salt.

When I am on my camino I will use my judgement and hope I don't get sued. We had a girl in Navasha with second degree burns on her ears and we cleaned the wound with table salt and bottled water. Use what you have, keep it clean and prevent further damage. If any of you see me on the camino between May 25th and July 10th and need first aid help, let me know. I'll have a mustache head scarf and a black backpack. Virtually the only nono I would air publicly at a civilian level is that if you have prescribed Nitro, don't give it to anyone else with chest pain. Don't take chances if you're not confident in yourself. If you'd like to be more confident then approach your local EMS station and volunteer for a ride along on a Friday night.

Thank you so much for your post David. The Camino is lucky to have you. I will likely come back and reference the list when I get there to supplement my own. There's always going to be someone who knows better.
 
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David

Veteran Member
Camino(s) past & future
Moissac to Santiago Spring 2005 was the first foray.
Dzyduck87. Corrected. Thks. Predictive text can be unproductive.

ooppsss -sorry, I wrote that as if we were talking, said with a quizzical grin ... when I saw it is this morning it seemed like being picky ... oh dear, textonly ....
 
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sriyantra

Active Member
Camino(s) past & future
Frances September "2014"
David thank you for a valuable service. Sounds to me like you are doing a great job.
Sorry Doug but Camino knowledge about blister treatment is far superior to anything a first aider or doctor would know. Experience counts.
If you don't pop the blister with a needle it only grows (as David says, because Camino walkers keep rubbing the same place) and gets worse and tears - a disaster. If you do use a needle as soon as a blister appears there is instant relief from pain, the skin stays intact to protect the area and the blister gradually heals into a tough patch of skin.
If you don't agree you haven't tried it.
It goes without saying that you wipe the blister and needle first with antiseptic.
The critical factor is to keep the skin intact, which is why I would not use a scalpel. And do not on any account squeeze. Just let the blister drain by itself and pop each night as necessary.
I think it is a treatment best self administered as sometimes four or five "pockets" develop within the blister that need popping and only the sufferer knows when they have all been found.
I say this without wanting to get into an argument (no correspondence will be entered into LOL) but as information from my experience for those who want to know.
Kanga I just wrote down "matches" to go with the blister needle, but if I am taking antiseptic anyway I take it from your advice that I can now cross "matches" off my list! Having a practice packing day today..... Is it necessary to take latex (or in my case latex free) gloves? I know I was told to always carry them in the car in case of an accident because people might not want to help if they don't have access to gloves and there is blood present. Just wondered about the Camino. Thanks.
 

Kanga

Moderator
Staff member
Camino(s) past & future
Francés x 5, Le Puy x 2, Arles, Tours, Norte, Madrid, Via de la Plata, Portuguese, Primitivo
Kanga I just wrote down "matches" to go with the blister needle, but if I am taking antiseptic anyway I take it from your advice that I can now cross "matches" off my list! Having a practice packing day today..... Is it necessary to take latex (or in my case latex free) gloves? I know I was told to always carry them in the car in case of an accident because people might not want to help if they don't have access to gloves and there is blood present. Just wondered about the Camino. Thanks.

You don't need matches - last time I had a tiny bottle of antiseptic hand gel and I used that - put a dob on the needle and gave it a thorough rub with a tissue. I didn't take any other antiseptic.
I wouldn't bother with latex gloves unless you need them to prevent your hands drying out and cracking from all the hand washing.
I try to only take things that have at least two uses - so soap doubles as shampoo and laundry detergent, a moisturiser with a high sunscreen factor also works as a hair conditioner (!), anti-chaff cream is also a highly effective antiperspirant and deodorant (same active ingredient).
 

sriyantra

Active Member
Camino(s) past & future
Frances September "2014"
The main thing about first aid; it isn't what you bring with you. Its about using your brain and the materials at hand. A good first aid course is more valuable than any first aid kit.
Yes I agree. I retired as a teacher last year so I have done lots of first aid courses over the years. I am trying to do the double up idea like Kanga suggested. Thank you.
 

Lisa Cook

New Member
Camino(s) past & future
(fall 2014)
DearDavid,
I think that this is a wonderful, wonderful thing you are doing. I can imagine the relief of the poor soul who finds themself in need of help, in pain, in a foreign country, doesn't speak the language, alone, exhausted, questioning why you are doing this and having no clue how to help themselves. Many people will not have been in such a position ever before in their adult lives.

You might could make a small instruction sheet on foot care, blister care, etc. so the person can begin doing the things necessary to help themselves for the rest of the walk and go into more detail than you could "on the spot". Also, you could include a list of supplies the person should get when they get to a town. Even if you tell them, having it written down, with the Spanish translation would be great. Jon Vanhoff, the author of the wonderful book "Fixing Your Feet" has an active blog and provides first aid to athletes of extreme sports. He may be willing to help you decide what are the most important things for a pilgrim to know and do in this, somewhat unique, situation.
This would help solve the problem of treating the ignorance to proper foot care as well as the actual issue.

You may also want to make a sign for your pack. Just a piece of fabric with bold writing saying "BLISTER MINISTRY". You could put little velcro pieces in the corners and on your pack, so it can easily be taken out of the way. At the bottom you could put a tally mark for each person, along the lines of "Summer 2014 over ________ served.

Thank you for the idea and inspiration I am making Blessing Bags for pilgrims and have another thread about it. I will make little blister kits also, but with instructions of some sort as I have no experience, yet, of my own of treating feet,
Lisa
 

susanawee

susanawee
Camino(s) past & future
Camino Frances-(2013/14/18
Camino Salvado Perth -(2015)
West Highland Way (2016)
Lyon France 2017
Thank you for your replies, and yes, I too think that one should carry a first aid kit on Camino, it is the sensible thing to do. This particular 'kit' is to do with helping others in mind so may be larger than a personal kit.

- in response to the criticisms above -

- the over-the-counter items such as Ibuprofen I recommend to carry aren't carried to be "prescribed" - this is a first aid kit, a Camino first aid kit - and are carried to be given to pilgrims who ask for them - they are their own prescribers. This is a kit to be carried where one can be miles away from any chemists - miles away. If one meets a pilgrim with a cold or an inflamed knee and they have nothing to help them then to mention that one carries such things as painkillers or Ibuprofen or antihistamines or Lemsips allows them to ask for them and they are helped. Is this a bad thing? Or should one leave such things at home and let the person suffer by themselves? You choose.

The aspirin is a different case. Early administering of chewed or crumbled aspirin to heart attack sufferers saves thousands of lives each year - as well as knowing how to do cpr we should all carry some aspirin at all times.
Dioralyte sachets are also a different case. They are given not only to adults but to children and babies throughout the third world to save their lives and are invaluable - and safe - when given to those who are severely dehydrated for any reason.

The blister situation - I mention quite clearly that there are two theories and that it is my belief that the draining of blisters is the correct one. It can be extremely painful to continue to walk on full blisters and the constant pounding will either make them larger and larger or they will burst, which really introduces dirt and infection into the wound.

Cleanliness as a first - I think that I covered that quite clearly.

I have not started this post to enter into arguments with anyone - the kit and tips merely as a suggestion for those who think further than their own health and welfare, who wish to help others.

Thank you.
I reckon that the above is a very good, clear and helpful post and response to any negativity.
 

susanawee

susanawee
Camino(s) past & future
Camino Frances-(2013/14/18
Camino Salvado Perth -(2015)
West Highland Way (2016)
Lyon France 2017
Hi everyone -

David - Such an interesting thread. Any pilgrim who receives your excellent treatment and care is truly blessed - thank you for the wonderful work you do on the Camino helping those in need.

I have a slightly over-the-top account of the 5 Stages of a Camino Blister, which is taken from "The Year We Seized The Day", a Camino memoir by Colin Bowles and Eli Best, two authors who met at a writer's festival and decided to walk the Frances with no training. Colin's account really spells out why blisters need to be treated either at the hot spot stage or promptly if a blister forms.

Colin - Day 10, Najera to Santo Domingo ...

Stage 1)
A hot spot appears, an angry mark somewhere on your feet. It is slightly sore and throbs when you take your boot off.
Stage 2)
A small blister appears. It hurts a bit when you walk. When you take your boot off everyone tells you to burst it with a sterilized needle. It will feel better … you ignore them. What do they know?
Stage 3)
The next day as you walk, you know what it is like to be the subject of the ‘Spanish Boot’, an instrument of torture used in the Spanish Inquisition, where the foot was placed in a steel boot and the boot was tightened by iron screws until it was the size of a toddler’s welly (wellington!).
Stage 4)
The blister bursts inside your boot and turns into a patch of raw flesh the size of a 50 cent piece. When you take off your boot, the skin, flesh and raw nerve endings stick to the woolly parts of your sock and are all removed together. You take off your sock and ring out the pus and the blood like a squeegee mop. Everyone asks you why you didn’t burst the blister with a pin.
Stage 5)
The next day you find on your foot a suppurating wound the size of a bath mat. You cannot stand on your foot, even walking is agony. You still have another month to walk!

This account has stayed with me ever since reading it prior to my Camino in 2012 - I did develop ONE blister and I did treat it promptly by the lancing method, with good results - i.e. no further problems.

Cheers everyone - Jenny
A story which SHOULD be read and re-read by ALL prospective walkers and the lessons described, learned, heeded and committed to memory, then brought back to the forefront of one's brain and acted upon should one of these dreadful blisters raise its', at first, little head. I saw many people who had dreadful infections because they failed to act at the very beginning......just saying....Camino Smiles.
 

David

Veteran Member
Camino(s) past & future
Moissac to Santiago Spring 2005 was the first foray.
I'm back from Camino now .. funny thing - I met Michael Caine and his wife in Puenta La Reina at a cafe, they were there as a support team for some pilgrim friends of theirs ... I was chatting about blister prevention with a pilgrim and he came up and offered the advice (in his unique voice) - "as soon as you get a hot spot get the boot and sock off and slap a plaster on it, job done." I was waiting for him to say "not many people know that" but he didn't.

As they were incognito I left them to themselves - but it is top advice - stop straight away, get the boot and sock off and slap a plaster over the hot spot - indeed, job done!

Buen Camino!
 

susanawee

susanawee
Camino(s) past & future
Camino Frances-(2013/14/18
Camino Salvado Perth -(2015)
West Highland Way (2016)
Lyon France 2017
I'm back from Camino now .. funny thing - I met Michael Caine and his wife in Puenta La Reina at a cafe, they were there as a support team for some pilgrim friends of theirs ... I was chatting about blister prevention with a pilgrim and he came up and offered the advice (in his unique voice) - "as soon as you get a hot spot get the boot and sock off and slap a plaster on it, job done." I was waiting for him to say "not many people know that" but he didn't.
As he was incognito I left them to themselves - but it is top advice - stop straight away, get the boots and socks off and slap a plaster over the hot spot - indeed, job done!

Buen Camino!
How wonderful that was David....Camino smiles.
 

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