Bruises, cuts, gashes, contusions, lacerations, slashes, trauma, boo-boos, nicks, scrapes and scratches. Whether deep in the woods, or in the parking lot of Wally world, if you geocache, there's a good chance you will have or already have experienced at least one of the above. Assessing and treating these injuries is almost second nature to most people.

According to Todd Chaffin MD, "Few wounds need to be [surgically] repaired because the body's healing potential is tremendous. Most wounds, if not contaminated or harboring a foreign body, as long as they don't get infected will eventually heal given enough time and local treatment."

A common medical axiom is "The solution to pollution is dilution." The most important thing is to irrigate the wound with copious amounts of sterile saline and, if unavailable, tap water. This dilutes any bacterial contamination and removes any particulate matter that can increase a wound's potential for infection.

All open wounds are contaminated to some extent and are potential sites for infection. The best way to prevent infection is to remove all debris from the wound and discourage further growth of bacteria.

Following this, approximating the wound edges (with tape or bandage) facilitates re-epithelialization (the body's natural tendency to contract and seal over a wound). The best cosmetic outcome and least amount of scarring will occur this way. This process takes place best in a moist (but not wet) environment. If you have antibiotic ointment, it can be provided in a thin film over the wound that will allow the wound to retain moisture. If this is unavailable, a sterile saline-moistened gauze applied over the wound is acceptable.

Sterile gauze and wrap are then applied. Leaving the wound "open to dry" allows for scab formation and crusting to develop and may make for a worse cosmetic appearance. The wound should be covered in this fashion until adequate healing has occurred, which may be anywhere from one to two weeks, depending on the location. Wounds involving the head, face and upper extremity tend to heal more rapidly then wounds further from the heart. The better the blood flow, the quicker wounds tend to heal. Wounds on the feet and legs tend to heal the slowest for this reason.

Small wounds and cuts can be treated with simple washing, application of an anti-bacterial lotion or cream and covered with a band-aid. This will probably cover 98 percent of geocaching wounds.

Treating larger wounds is a bit more involved. The person who is treating the wounds should first prepare by scrubbing their hands thoroughly with soap and disinfected water. Latex gloves help prevent the spread of infectious disease. You should always keep gloves in your first aid kit. They are usually the first thing that needs to be replenished on a regular basis since they end up getting used for CITO and many other purposes.

1. If available, boil 1.5 to 2 liters of water and prepare a disinfectant solution of 1 oz. povidone-iodine and 1 liter disinfected water. Set the disinfectant solution aside for about five minutes. If povidone-iodine solution is not available, use disinfected water to cleanse the wound. Do not use alcohol, iodine or mercurial solutions to cleanse a wound; these can damage the tissue.
2. Soak the wound in disinfectant solution for about 15 minutes to soften the skin around the opening. Use water as hot as the injured person can tolerate.
3. Sterilize a pair of tweezers by rinsing with disinfectant solution. Sterilize the tweezers just before use.
4. Pry the edges of the wound open using the sterilized tweezers. Drain the pus from the wound, wiping the pus away with cotton swabs and sterile gauze. Probe deeper pockets of the wound to see if pus is concealed there as well - this will be less painful if the wound has been thoroughly soaked. Assume there are other pockets if you find one, and drain all pockets.
5. Soak the drained wound in the fresh batch of disinfectant solution for 20 to 30 minutes. Then dry the wound with sterile gauze.
6. Spread antibiotic ointment on sterile gauze using cotton swabs. Place the gauze inside the wound to keep the wound from closing. Do not allow the edges of the wound to reseal while there are signs of infection.

Monitor the injured person for any signs that the infection is spreading: fever, chills, swollen lymph nodes or red streaks radiating from the wound. Evacuate the injured person from the backcountry immediately if there are any signs of spreading infection. Seek professional medical help immediately.

If the infection seems to be spreading and the injured person is more than 24 hours from medical care, immediately begin oral antibiotic treatment. Give high doses of antibiotics for at least five days. If you anticipate being in a remote area, consult a physician before you leave about bringing a broad-spectrum antibiotic with you for the treatment of skin infections. Make sure you bring all the instructions for usage and information about complications of the antibiotic with you into the backcountry.

Infectious diseases such as HIV and Hepatitis are transmitted via the exchange of bodily fluids. Protect yourself by wearing latex gloves. Wear goggles or glasses to protect against spurting blood or fluids. Wear a surgical mask to prevent the spread of other diseases. If you don't have gloves, a surgical mask and goggles, improvise by placing your hand in a plastic bag, wearing sunglasses and covering your mouth with a bandanna or other cloth. Gauze and bandages that have been removed from the injured person should always be handled with latex gloves or tweezers, and should be disposed of immediately. The best means of disposal is burning. Tweezers should be disinfected immediately after use.

This information is not intended as a substitute for professional medical advice or treatment.