Paul Auerbach, MDWilderness Medicine
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ZeroWet

Paul Auerbach, M.D.

One of the hazards of cleaning wounds in the wilderness (or in the urban setting) is splashing the irrigation (cleaning) water, because the spray can transfer body fluids (containing infectious viruses, bacteria, etc.) onto the rescuer. In this day of hepatitis, human immunodeficiency virus infection, and other worrisome diseases, it is always prudent to shield oneself properly. This includes wearing eyeglasses or goggles, latex (or non-latex) surgical gloves ("rubber" or "vinyl" gloves), and otherwise preventing your victim's body fluids from contacting your moist mucous membranes (e.g., lining of the mouth, the eyes, etc.) or entering into any significant opening in your skin (e.g., scrape, puncture wound, open cut).

An excellent device that we use in the E.R. for this purpose, and which is equally useful in the wilderness, is the ZEROWET SPLASHIELD, available through ZEROWET, Inc. of Palos Verdes Peninsula, California. A fellow emergency physician and friend, Dr. Keith Stamler, had the brilliant idea to invent this product.

When you attach the SPLASHSHIELD to a syringe, it allows you to squirt water or saline (salt) solution into a wound at a pressure of 8 to 12 pounds per square inch, which is optimal for removing dirt and debris without pushing them deeper into the delicate and vulnerable human tissues. The SPLASHIELD, which is shaped like a cup, captures the splash, and therefore prevents the rescuer from becoming contaminated with errantly directed splashed fluid, blood, and other body fluids. The new SUPERSHIELD product can be attached to a 20 milliliter or larger syringe for the same purpose, and used to directly draw up irrigant into the syringe (without detaching the shield), as well as function as a shield. So, it effectively replaces the SPLASHIELD, because it has more functionality (you have to detach the SPLASHIELD from the irrigating syringe in order to refill the syringe).

Remember, "the solution to pollution is dilution." When I travel in the backcountry, I carry a couple of plastic syringes (size 20 to 35 milliliters) and a few SPLASHIELDS or SUPERSHIELDS, so that I can be prepared to adequately rinse a couple of wounds. I use the cleanest water available, which is usually filtered and/or disinfected drinking water. This is far better than the technique of using a plastic drinking bottle with a narrow tip or with a hole pierced through the top, because the drinking bottle method does not generate sufficient pressure when compared to the syringe technique.

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