First Aid Kit's - Home made vs Pre-Made

5:38 p.m. on March 25, 2010 (EDT)
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I was just kind of curious as to whether most of us here relied on first aid kits made/compiled by a company or made our own kits ... and if home made what was included in the kits.

7:37 p.m. on March 25, 2010 (EDT)
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We just add things but maybe take the big scissors and tweezers out, as they are on a multi-tool or penknife.

Add strong pain killers, real blister kit, anti-emetic, anti-diarrhoea, tick twisters, champagne and so on. All in one of those waterproof roll bags (ortliebs are nice but expensive).

8:12 p.m. on March 25, 2010 (EDT)
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All the home-made kits I've come up with over the years have always fit my need better than any pre-made's I've used. Granted, I'm comfortable with a couple tampons, a tube of super glue, and a sharp knife, so I admit that I'm not prepared for any situation that might come along; but for me, a spartan first aid kit thrown together inside of a zip-lock works every time. +1 for added painkillers and those J&J Advanced Healing Blister pads. Extra Alcohol pads too.

I do like the cool little nylon case you get with the Adventure Medical UL .9 kit though...

9:17 p.m. on March 25, 2010 (EDT)
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Watch the review Arson did on the Adventure Medical Kits Ultralight .3, he gives a lot of good insight into what makes up a good kit.

9:52 p.m. on March 25, 2010 (EDT)
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Just redid my home-made one. Have been building them since Boy Scouts and won't quit anytime soon. I know exactly what goes in them, exactly how much I have, and where it all is. Just upgraded its bag to a "Medkit" by Badlands Packs. Very nice... a little heavy, but FAK's are one thing I don't believe in "going light" on.

3:57 a.m. on March 26, 2010 (EDT)
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i bought a kit to start but have addid to it since. mostly stuff for blisters it seems to be most common in people on da trail thats if i see any people.

7:54 a.m. on March 26, 2010 (EDT)
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My wife is a nurse and we chose a kit together, which she then augmented. I keep meaning to catalog its contents for posterity, so perhaps this thread makes for a good excuse to finally do that.

7:56 a.m. on March 26, 2010 (EDT)
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I will buy a pre-made kit from wal-mart(Johnson & Johnson/fairly reasonable)then disect it and add and take out whats needed and what isn't. To me it gives the basic foundation of a decent bc kit and you can always grab the items that are a bit more specific for what type of situations you are possibly gonna encounter. It typically comes in a bulky plastic case and I get rid of it pretty quick in exchange for a few zip-loc bags and mark the bags w/a sharpie. Then stuff them into a freezer bag. I still use the case by my "man-cave" work bench for other things like spare parts, etc.

11:50 a.m. on March 26, 2010 (EDT)
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I Frankenstein it, adding and subtracting what the purpose and situation calls for. I have yet to see one "off the shelf" that had just what I would want/ need and without extra unnecessary crap.

2:03 p.m. on April 8, 2010 (EDT)
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The stuff I use every trip and carry extra of is painkillers/anti-inflammatories, as I am 58 and need more help recovering than you youngsters. WFR training and some research brought to my attention the diffs.

Aspirin can be important for thinning the blood if someone is having chest pain that might be Angina Pectoris, but that thinning is exactly what we don't want in the backcountry due to potential internal bleeding in the event of a bad fall. So I think asprin is out except for Angina.

Ibuprofen is the thing in most cases as it is both painkiller and anti-inflammatory, though it may limit clotting, same as asprin.

Acetaminophen, a painkiller only, can be taken in addition to Ibuprofen as it works on the brain instead of an injury site. But there is a risk of liver damage from Acetaminophen overdose especially in combination with alcohol. I take a Naproxen, a non-steriodal anti-imflammatory, daily with food to help with a degenerated thumb joint.

Painkillers are out in the case of head injuries with suspected brain damage due to the potential of hemmorage and increasing intercranial pressure.

6:56 p.m. on May 18, 2010 (EDT)
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Funny, just did a blog post on this after falling off my bicycle.

We go superminimal and take our own stuff (in a zip loc) Last big fall was a few years ago and we had anough stuff to cope (ok) It DID hurt a bit while we were on the trail and the knee took 3 weeks to heal properly

10:04 p.m. on May 18, 2010 (EDT)
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I prefer to just build my own nowadays. If you do it long enough you kinda already know just what you need, and since everyone is different an off the shelf kit is not likely to have all the things you need.

The kits meant for wilderness travel will get you a lot closer to what you need than a kit from Wally World. But I just make a list and go get what I need and pack it the way I like.

I also think that duct tape and a big wad of gauze along with an anti-biotic cream ( I like Neosporin) makes a darn good bandaid, and can be cut to the size needed.

For scrapes and stuff I love Bactine in the little squirt bottle.

Plus of course I take my own mix of medications that treat the problems I tend to have.

12:06 a.m. on May 20, 2010 (EDT)
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Arson's video is a must see.

3:14 a.m. on May 20, 2010 (EDT)
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My wife is a nurse and we chose a kit together, which she then augmented.

11:29 a.m. on May 20, 2010 (EDT)
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I have built my own FAKs for 40+ years, but, will also buy and augment the Adeventure little yellow ones, with spare clinggauze, triangular bandages, those eva splints and I am going to get bloodclotting powder.

I carry some serious meds, OxyContin, Morphine Sulphate, Lomotil and an E-pen plus sleepaids, such as Trazodone and I forget the one I currently have.

I carry a pretty serious FAK and a pretty extensive Emergency Kit as I go alone into some very wild and remote places. I have the training, experience and self-discipline to due this correctly and it has helped me and partners several times.

I am "old school" to the core and believe in being capable of "self-rescue" and "survival" alone without electronic gadgets that often go "fubar" in the bush or trusting the "county mounties" to come haul my elderly carcass back to "civilization" and this has/does work for me for many years.

9:12 a.m. on July 15, 2010 (EDT)
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my question is what are the essentials to put in a BC FAK. Noone seemed to answer that question

5:03 p.m. on July 15, 2010 (EDT)
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I built my own kit, also Being a SAR Paramedic for almost 10 years now I an ego to feed, I find the store brought kits add to much “fluff crap” to fill the box up. I carry 3 kits on me when I’m out on the trails. The first one is my personal kit this is carried on my shoulder strap it is the standard USMC individual combat kit (IFAK), Next a more extensive emergency aid kit that goes into my pack this kit is my SAR kit, I will bring it with me when I am on active SAR runs or if I am out on heavily populated trails that are used by week-end warriors I have it in a roll pack that measures 5 inches round by 36 inches wide by 18 inches high for organization and if I pack the saline in one of the outside bags, if not the roll will be about 10 inches in diameter and I will carry it on the outside of my bag in a MOLLE Butt pack. The last kit is my K-9 kit and Katie (my beloved German Sheppard) carries this in her pack. These are my kits, for you "Dwoods8581" I would go with the USMC combat Individual kit (IFAK), I looked up some up for you here is the link if you look around you might finda kit that cost less, but for your money this is an awesome readymade kit...they run from $85.00 up $130.00

If you’re wondering why I have such detailed list of my kits I just had to submit and had my kits re-certified in July with the Virginia Disaster Medical Assistance Team (DMAT) and EMS task force preparedness

Personal Kit:
(1ea) 3.5 oz. Quikclot Packet 2ea) TK4 Tourni-Kwik Self-Application Tourniquet 40"
(2ea) "H" Compression Bandage w/8" x 10" Ab Pad
(2ea) Primed Compressed Gauze 4.5" x 4.1 yards
(5ea) Adhesive Bandage 2" x 4 1/2"
(10ea) Adhesive Bandages, 3/4" x 3"
(2ea) Triangular Bandages, 40"x40"x56" Non-sterile
(1ea) Combat Reinforcement Tap 2" x 100"
(1ea) Burn Dressing 4" x 16", Water-Jel
(8ea) Bacitracin Antibiotic Oinment 0.9 gram
(1ea) Povidone-Iodine Topical Solution USP 10% 1/2 floz.
(1ea) Water Purification Tablets 10 Pack, Katadyn Micropur, Sodium Chlorite

(10) Insect sting relief pads

(1) First aid/burn cream_tube

(20) 1-1/4"x2-5/8" Alcohol cleansing pad

(20) 1-1/4"x2-1/2" Povidone-iodine infection control wipe

(1) Tube Hydrocortisone cream

(1) Hollister Restore Wound Cleanser, Pump Spray, 8 oz

(1) Eye wash, 4 oz

(10) Smelling Salts (1) Antiseptic Bio Hand Cleansing Gel, 4 oz.

(2) Quick Relief Blood Clot Powder
(1) Spray on bandage, 3 oz

(2) 2"x4.1 yd. Conforming gauze roll bandage, sterile

(1) 4"x4.1 yd. Conforming gauze roll bandage, sterile

(2) 2"x3" Heavy woven patch bandage

(30) 3/8"x1-3/4" Butterfly wound closure

(12) 2"x2" & 3"x3" Gauze dressing pads

(8) 3"x4" Non-stick pad with adhesive edges

(4) 8"x10" Trauma pad "x9" Trauma pad

(4) HemCon Hemostatic Bandage - 4 in. X 4 in

(1) 36"x36"x51" Triangular sling/bandage with 2 safety pins

(15) 3"x3" Gauze dressing pad

(1) 3"x5 yd. cohesive elastic bandage, latex-free, wrap

(25) Heavy woven 1"x3" Flex-Fabric™ bandage

(25) Heavy woven Knuckle & Fingertip fabric bandages

(2) 3"x5 yd. Latex free elastic bandage with two fasteners

(1) 1"x5 yd. Waterproof tape

(1) 1/2x5 yd Waterproof tape

(1) Ambu® Res-Cue CPR Mask Kit includes Adult Mask & Infant Mask

(1) Glucose Test kit and strips

(6) Glutose 15 Oral Glucose Gel

(30) Ez-Lance_Normal Model (40ul)

(1) Fingertip Pulse Oximeter

(1) MooreBrand® Airway Management Kit
· 6 airway (sizes 1-6)

·1 pediatric laryngoscope handle

· 1 medium laryngoscope handle

· 5 Miller laryngoscope blades (sizes 0-4)

· 4 MacIntosh laryngoscope blades (sizes 1-4)

· 2 large laryngoscope lamps

· 2 small laryngoscope lamps

· 1 adult Magill forceps

· 1 pediatric Magill forceps

· 2 C batteries

· 2 AA batteries

· 10 Surgilube packets

· 3 10mL syringes

· 5 tube holders

· 2 each ET tubes (sizes 2.5 mm - 10.0 mm)

· 2 adult stylets

· 2 child stylets

· 1 Dermicel 1" tape

(1)Needle holder hemostat (used for suturing)
(1) 5" curved hemostat
(1) Scalpel handle
(1) Sterile scalpel blade
(1) Surgical probe
(1) Operating scissors
(1) Suture lip scissors
(1) 5" Pointed forceps
(1) 10 Non-Suture wound closure strips
(10) Tincture of benzoin swab (10) 2 Antiseptic towelettes
(10) 2 Alcohol pads
(1) Unit of { 5-0 Black nylon STERILE suture (used for fine external skin and mouth cuts) with attached needle}
(1) Unit of 3-0 Black nylon STERILE suture (used for external muscle skin
areas) with attached needle

(2) 40mg/ml, 5 Ml single dose 4% Lidocaine Hydrochloride Injection, USP(2) 30 gauge 10CC syringes
(2) Emergency blanket

(1) Center Foam Splint 18 inch

(1) Center Foam Splint 24 inch

(4) Emergency Glow/Light Stick white

(4) Emergency Glow/Light Stick red

(1) Plastic Razor
(1) Bio-Bag
(1) LED Light head lamp

(4) Spare AAA batteries

(1) Tweezers, Metal

(6 sets) Exam quality vinyl gloves

(10) Cotton tipped applicators

(4) Instant cold compress

(2) Instant heat compress

(2) Face Mask

(1) Instant-Read Ear Thermometer

(2) Units Baxter Saline 0.9% Sodium Chloride Injection 1000ml IV

(1) Unit Lactated Ringers 1000ml


(1) Tube Sharps Container

(2) Irrigation piston syringe

(1) Stethoscope

(1) Digital Aneroid Sphygmomanometer – Adult

(1) Digital Aneroid Sphygmomanometer - child

(1) Bottle-Benadryl 50 mg 50 tablets

(4) Bottle Advil 50 tablets

(20) Pepto Bismol tablets

(30) Electrolyte tablets

(1) Bottle Excedrin Extra-strength 50 tablets


(1) bottle Water Purification Tablets (50 tablets per bottle)

(26-Tabs) Vicodin ES contains 750 pain medication

(30) Nabumetone tablets 750 mg used to treat pain or inflammation

(10) Cephalexin Cap 250mg

K-9 Kit
Medical Drugs and Equipment:

(1) PRN Wound Powder
(1) Bacitracin-neomycin-polymyxin Eye Ointment
(1) tube Triple Antibiotic Ointment
(1) bottle of Chlorhexidine Solution
(10) Alcohol Pads
(10) Q-tips and Cotton Balls
(1) Gauze Roll 2x5 yards
(1) Thermometer Kit
(4) Surgilube Packets
(4) Tongue Depressor
(2) pairs Sterile Surgical Gloves
(1) Support Bandage
(10) Antimicrobial Handwipes
(1) ½ inch Tape roll
Temperature Control Section
(2) Cold Packs
(2) Triple Distilled Water with Preservative
Emergency Equipment - Sterile Pack
(1) Gauze Roll
(2) rolls self adhering Bandage Tape {2x5 yds and 3x5 yds}
(2) Gauze Pads (4" x 4")
(1) Tourniquet
(1) Scissors
(1) Set, Hemostats and Forceps
(1) #15 Surgical Blade
(10) 2x2 Sterile Gauze Pads (10) Q-tips
(1) Syringes – 3cc and 6cc
(1) Suture with Needle set

8:59 p.m. on July 15, 2010 (EDT)
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Man, Rescue Ranger I would not know what to do with 99.9% of the stuff on your list. But, would be great to have you along on a hike. Just in case.

With my hiking group I worry about heart attacks and strokes more than blisters.

Not sure what to carry for that other than aspirin for that.

We run into a lot of rattlesnakes as well and wonder if there is an antivenin that I could carry and administer.......

Just thoughts.

1:01 a.m. on July 16, 2010 (EDT)
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ha was just about to start this same sorta of thread, I prefer making my own kit and with that I was curious if those of you hear would take a look at it to see if you think im missing or am carrying something unneccesary. It is designed for a 2-3 person trip and is enough to try 2 get us back.

- 2 Large bandaids
- 2 Fingertip Bandaids
- 6 blister bandaids
- 8 regular bandaids
- 10 butterfly closures
- 4 tiny bandaids
- 3 small waterproof bandaids
- 8 tums (little package)
- 12 Bedadryl (25mg)
- 10 Aspirin (325 mg)
- 30 Ibuprofen (200 mg)
- 6 Anti-Diarrheal (Loperamide Hydrochloride) (2mg)
- Sewing Kit (some thread and needle)
- 1 pair latex gloves
- Tweezers
- 5 safety pins
- Fingernail clippers
- Small pair of scissors (medical)
- 2 splinter removal (very light with sharp end)
- Paper thermometer (few grams)
- Neosporin (.5 oz)
- 7 antiseptic wipe/iodine wipe
- 4 Hydrocortisone Cream packets(.9 gram each)
- 2 Burn Cream packets
- Small tube of sunscreen (1 oz)
- 1 quickclot embedded gauze (3.5 in x 3.5 in
- 2 gauze pad (3x3)
- 1 gauze pad (2x2)
- 1 roll of guaze (2”x6 yds)
- Ace Wrap
- 1” waterproof tape
- Moleskin
- Waterproof bag (contains the first aid kit)
Total Weight: 13.125 ounces

1:04 a.m. on July 16, 2010 (EDT)
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btw rescue ranger that is a hell of a list, looks like that could weigh as much as my pack! however you actually know how to use all that stuff 8)

taking things I had no idea when or how to use would be a waste of space and weight

2:28 a.m. on July 16, 2010 (EDT)
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The Med pack weighs about 4 maybe 41/2 pounds without the IV solution in the roll add that to the roll add another 5 pounds, I usually carry my IV fluids and catheters and sharps in one of my sustainment pouches around shoulder height, it’s all in how you dispense the weight and how good your pack rides on you and keeps a good air flow up your back that is why I love my USMC ILBE pack lots of room, plenty of MOLLE points, Kidney belt, self healing zippers, built-in compression straps, top and side load and you can divide the main pack into 2 chambers, and still have a secret hidey hole for your sleep system…the Cadillac El Dorado of the backpack world. But I digress, If I may suggest to you some added items to your kit sir:

Insect sting relief pads

1-1/4"x2-1/2" Povidone-iodine infection control wipe or a 4 oz bottle

Tube Hydrocortisone cream

Hollister Restore Wound Cleanser, Pump Spray, 8 oz

Eye wash, 4 oz

Smelling Salts

Antiseptic Bio Hand Cleansing Gel, 4 oz

Quick Relief Blood Clot Powder
Spray on bandage,

3 oz 2"x4.1 yd. Conforming gauze roll bandage, sterile

2"x3" Heavy woven patch bandage

3/8"x1-3/4" Butterfly wound closure

2"x2" & 3"x3" Gauze dressing pads

3"x4" Non-stick pad with adhesive edges

8"x10" Trauma pad HemCon Hemostatic Bandage -&-4 in. X 4 in

(1) 36"x36"x51" Triangular sling/bandage with 2 safety pins

3"x3" Gauze dressing pad

3"x5 yd. cohesive elastic bandage, latex-free, wrap Heavy woven wit 2 safty pins

1"x3" Flex-Fabric™ bandage Heavy woven Knuckle & Fingertip fabric bandages

2"x5 yd. shelf adhering bandage

1"x5 yd. Waterproof tape

Electrolyte tablets

Irrigation piston syringe and recipe for saline solution (see recipe at end of thread)

(1) Ambu® Res-Cue CPR Mask Kit includes Adult Mask & Infant

Just my thoughts I could always add more...nature of the beast but this will round out your kit very well

How to Make Saline Solution to Clean a Wound

Things you’ll need:

1 tsp. salt

Eye dropper

1/2 tsp. baking soda


8 oz. water Something to stir with

Storage container (i.e.) water bottle

Pot -{Ah cooking type}

Making the Solution:

Step 1

Start a fire or turn on a stove and place the pot on it.

Step 2

Pour in the water and let it heat. Be very careful not to let the water boil.

Step 3

Take the pot off of the heat before the water boils, then pour in the salt and baking soda.

Step 4

Stir until the salt and baking soda are diluted. When finished the solution should have a slightly cloudy color.

Step 5

Take the pot off of the heat and let it cool to "room temperature

Step 6

Pour the solution from the pot into your plastic storage container. You should have approximately 1 pint (8 oz.) of saline solution.

8:28 a.m. on July 16, 2010 (EDT)
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Thanks for the info

1:38 p.m. on July 16, 2010 (EDT)
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Here is an answer to your question on heat stroke, heart attacks and Viper bites For Heat stroke and heat exhaustion please refer to the article I posted June 24 2010 here at Trail space

For Heart Attacks and Strokes in the back country here is a paper I wrote last year for a local Scout Troop.

Also I would like to apologize to anyone who thinks I am using up to much space posting this information, I would love it if we had a back country first aid blog I would even moderate it if everyone was cool with that perhaps we can think and ask if this can be added to our site we could call it “Trail Aid” or something to the like...any who the first article is on Heart attacks, after this I will discuss the treatment on viper bites, and treatment and facts you did not know about administering antivenin these are excerpts from my course work and papers I submitted when I did training in Arizona at the Tucson University Medical Center (UMC) on treating snake bite victims.

Also Noddlehead for a quick answer to your question about bringing an antivenin with you on the trail, cannot be done Bro.

Also the cost per vial is $750.00 to $1000.00 dollars PER VIAL!! Average amount needed 40 vials so $40,000.00 just for the antivenin not counting surgery cost and medical care could run upwards up $90,000.00 dollars for 1 bite! OK here we go!


Heart attack - emergency first aid

Reviewed by Dr Neal Uren, consultant cardiologist and Dr Reginald Odbert, GP

Important: this is a brief guide to the emergency help that can be given in the event of a heart attack or cardiac arrest before the arrival of emergency services. It is not intended as a replacement for a first aid or resuscitation course.

What should you do if someone has a heart attack? If someone has a cardiac arrest or heart attack, there are only a few minutes to act before it is too late. It is vital to know what to do beforehand. To perform CPR (cardiopulmonary resuscitation) and artificial respiration (mouth to mouth resuscitation) effectively, training and frequent practice on resuscitation dummies are essential. First aid courses are offered all over the country at night schools or by voluntary organizations such as St John Ambulance or The Red Cross. How can you tell if someone is having a heart attack? If the person is unconscious:
· Are they breathing? Look at the patient's chest to see if it is rising and falling.

· Do they have a pulse? Place two fingers on one or other side of the person's voice box in their throat to feel if they have a carotid pulse. If the patient has a pulse but is not breathing:
· Could it be because of suffocation? Feel inside the mouth with a finger to see if there is anything blocking it or the windpipe and remove any food or other objects. Provided that dentures are not broken, it is better not to remove them.

· Call for help immediately, stating that the casualty is not breathing, and provide resuscitation (see below) until the patient begins to breathe or the ambulance arrives.

If there is no breathing or pulse, the patient has had a cardiac arrest.

What help is needed? If possible, raise the legs up 12 to 18 inches to allow more blood to flow towards the heart Immediately place the palm of your hand flat on the patient's chest just over the lower part of the sternum (breast bone) and press your hand in a pumping motion once or twice by using the other hand. This may make the heart beat again. If these actions do not restore a pulse or if the subject doesn't begin to breathe again:
Call for help, stating that the casualty is having a cardiac arrest but stay with the patient. Find out if anyone else present knows CPR. Provide artificial respiration immediately (see below). Begin CPR immediately (see below). How to give artificial respirationTilt the head back and lift up the chin.Pinch the nostrils shut with two fingers to prevent leakage of air. Take a deep breath and seal your own mouth over the person's mouth.Breathe slowly into the person's mouth - it should take about two seconds to adequately inflate the chest.Do this twice.Check to see if the chest rises as you breathe into the patient.If it does, enough air is being blown in.If there is resistance, try to hold the head back further and lift the chin again.Repeat this procedure until help arrives or the person starts breathing again.

How do I perform CPR (cardiopulmonary resuscitation)?

See if there is breathing. If not, start artificial respiration as described above. Checking for a pulse in the neck (carotid artery) may waste valuable time if the rescuer is inexperienced in this check. The procedure is:
Place your fingers in the groove between the windpipe and the muscles of the side of the neck. Press backwards here to check for a pulse. If there is no pulse, or if you are unsure, then proceed without delay thus:
Look at the person's chest and find the 'upside-down V' shaped notch that is made by the lower edge of the ribcage. Place your middle finger in this notch and then place your index finger beside it, resting on the breastbone. Take the heel of your other hand and slide it down the breastbone until it is touching this index finger. The heel of your hand should now be positioned on the middle of the lower half of the breastbone. Now place the heel of your other hand on top of the first. Keep your fingers off the chest, by locking them together. Your pressure should be applied through the heels of the hands only. Keep your elbows straight, and bring your body weight over your hands to make it easier to press down. Press down firmly and quickly to achieve a downwards movement of 4 to 5cm, then relax and repeat the compression.

Do this 15 times, then give artificial respiration twice, and continue this 15:2 procedure until help arrives.

Aim for a rate of compression of about 100 per minute. You can help your timing and counting by saying out loud 'one and two and three and four ...' etc. Artificial respiration and CPR should both be performed at the same time If possible, get someone else to help - one person to perform artificial respiration and the other to perform CPR. (This is not easily done without prior practice and it is well worth attending sessions on CPR training to become familiar with the technique.)

The ratio of chest compressions to breaths is 15:2 for both one-person and two-person CPR.Continue until the ambulance arrives or the patient gets a pulse and starts to breathe again.

If the pulse returns and breathing begins but the person remains unconscious, roll them gently onto their side into the recovery position. This way mucus or vomit can get out of the mouth and will not obstruct the patient's breathing.

It also prevents the tongue from falling back and blocking the air passage. Make sure the patient continues breathing and has a pulse until the ambulance arrives If you succeed in resuscitating the person who has been taken ill, he or she may be confused and alarmed by all the commotion.

Keep the patient warm and calm by quietly, but clearly, telling them what has happened. Again, it needs to be emphasized that the only way to provide proper first aid and resuscitation is through learning the technique, then regular practice and guidance. Seek out an approved Red Cross course in your community here is the Red Cross link

After reading the next section It isn't hard to see why rebellious eighteenth-century American colonists placed a rattlesnake across the thirteen stripes of the first Navy Jack flag, along with the warning "dont tread on me."


Allow bite to bleed freely for 15-30 secs.

Cleanse and rapidly disinfect area with Betadine, assuming not allergic to iodine, fish or shellfish.

Remove clothing (pant legs, shirt sleeves, rings and jewelery on bitten side)If bite on hand, finger, foot or toe, wrap leg/arm rapidly with 3" to 6" Ace or crepe bandage past the knee or elbow joint immobilizing it.

Overwrap bite marks. But first, if possible, apply hard direct pressure over bite using a 4 x 4 gauze pad folded in half twice to 1 x 1.

Tape in place with adhesive tape.

Soak gauze pad in Betadine(tm) solution if available and victim is not allergic to iodines, fish or shellfish. Strap gauze pad tightly in place with adhesive tape Overwrap dressing above, over and below bite area with ACE or crepe bandage, but not too tight. Wrap ACE (elastic) bandage as tight as one would for a sprain.

Not too tight. Check for pulses above and below elastic wrap; if absent it is too tight. Unpin and loosen. If pulses are strong (normal) it may be too loose. Immobilize bitten extremity, use splinting if available.

If possible, try and keep bitten extremity at heart level or in a gravity-neutral position. Raising it above heart level can cause venom to travel into the body. Holding it down, below heart level can increase swelling.

Evacuate to nearest hospital or medical facility as soon as possible Try and identify, kill and bring (ONLY if safe to do so) offending snake. This is the least important thing you should do. Visual identification/description usually suffices, especially in the U.S. and in regions where the local fauna is known.

Local symptoms will alert doctors to whether the bite is venomous or not. Bites to face, torso or buttocks are more of a problem. ACE/crepe bandaging can not be applied to such bites.

A pressure dressing made of a gauze pad may help to contain venom. (see Pressure dressing procedure) Antivenom is the only and best treatment for snakebite and you must get as much as is necessary as soon as possible.

Antivenom administration should not be delayed. Up to 20 or more vials of Wyeth ACP may be needed to neutralize the effects of rattlesnake and other crotalid venoms in North America. Protheric’s Cro-Fab™, a highly purified monoclonal polyclonal antivenom may require far less. It is the only antivenom containing specific antibodies to Mojave Type A and B toxins which may be present in North American rattlers other than Mojave Rattlesnakes.


1. Ask staff to contact their designated Poison Control Center Immediately 2. Ask hospital staff, if they are not familiar with snakebite emergencies, to use physician consultants available thru the nationwide Poison Control network.

3. Any additional questions may be directed to: or or more expediently if necessary, at 718-227-6234 or cellular at 347-452-0105.

What Not to Do if Bitten by a Venomous Snake:
1. Contrary to advice given elsewhere DO NOT permit removal of pressure dressings, Sawyer or ACE bandage until you are at a facility ready and able to administer antivenom. As soon as the dressings are released the venom will spread causing the usual expected problems of venomous snakebite. The hospital at this time must be prepared to administer the antidote (antivenom)*

2. Do not eat or drink anything unless okayed by medical sources

3. Do not engage in strenuous physical activity

4. Do not apply oral (mouth) suction to bite

5. Do not cut into or incise bite marks with a blade

6. Do not drink any alcohol or use any medication

7. Do not apply either hot or cold packs

8. Do not apply a narrow, constrictive tourniquet such as a belt, necktie or cord

9. Do not use a stun gun or electric shock of any kind. For more information on electric shock treatment please click on SHOCK TREATMENT

10. Do not remove dressings/elastic wraps until arrival at hospital and antivenom available.

11. Do not waste time or take any risks trying to kill, bag or bring in offending snake *Remember ACE or other wide bandaging must not be wrapped so tight as to cut off systemic venous or arterial circulation. Properly applied such bandages will NOT compromise the systemic circulation.

IT GOES WITHOUT SAYING BUT WE'LL SAY IT ANYWAY...... Never hike camp, work or collect specimens in areas where there are venomous snakes unless accompanied by at least two companions, One to stay with the victim and the other to go get help.

All parties should know what to do. If you come across any snake in the field and don't know positively what it is or isn't, do not approach it, try and examine it or photograph it (unless you have a long telephoto or zoom lens).

Move away from it as expediently as possible.

And now a little clinical information about antivenin

What is Antivenin?

Antivenin (Crotalidae) Polyvalent, Wyeth, is a refined and concentrated preparation of Serum The clear liquid that can be separated from clotted blood. Serum differs from plasma, the liquid portion of normal unclotted blood containing the red and white cells and platelets. It is the clot that makes the difference between serum and plasma globulins obtained by fractionating blood from healthy horses immunized with the following venoms: Eastern diamond rattlesnake, Western diamond rattlesnake, tropical rattlesnake. Phenol, 0.25%, {Phenol: 1. A poisonous corrosive compound obtained by the distillation of coal tar that, in dilute solution, is an antimicrobial agent. Also called carbolic acid. 2. A generic term for any compound similar in structure to phenol (an organic compound with one or more hydroxyl groups attached to an aromatic or carbon ring}. And thimerosal, 0.005%, {Thimerosal: A mercury-containing preservative used in some vaccines and other products since the 1930's. No harmful effects were reported from thimerosal at doses used in vaccines, except for minor local reactions like redness and swelling at the injection site. There was specifically no evidence that thimerosal increases the risk of developing autism or any other behavior disorder. However, in 1999 it was agreed that thimerosal should be reduced or eliminated in vaccines as a precautionary measure. Today, all routinely recommended pediatric vaccines in the US contain no thimerosal or only trace amounts.} are added as preservatives. The product is standardized by its ability to neutralize the lethal action of standard venoms by intravenous injection in mice.1 Dried from the frozen state, the lyophilized serum has a moisture content of less than 1% and is soluble on addition of the diluents contained in each package (Sterile Water for Injection, USP). Antivenin (Crotalidae) Polyvalent, Wyeth (hereinafter referred to as Antivenin) contains protective substances capable of neutralizing the toxic effects of venoms of pit vipers native to North, Central, and South America, including rattlesnakes; copperhead and cottonmouth moccasins, including A. halys of Korea and Japan; the Fer-de-lance and other species of Bothrops; the tropical rattler and similar species); the Cantil; and bushmaster of South and Central America.

Pit Viper Bites and Envenomation:
The symptoms, signs, and severity of snake-venom poisoning resulting from pit viper bites depend on many factors, including, but not limited to, the following variables: species, age, and size of the biting snake; the number and location of bite(s); the depth of venom deposit by the snake's fangs; the condition of the snake's fangs and venom glands; the length of time the snake "hangs on"; the age, general health, and size of the victim; the type and efficacy of any first-aid treatment rendered in an attempt to remove venom and how soon such treatment was applied. In any venomous snake bite, the actual amount of venom introduced into the victim is always an unknown. Even the type of clothing or leg-footwear through which the snake's fangs pass may affect the amount of venom delivered by the bite. Although most North American pit vipers tend to bite and introduce venom superficially, their fangs may get hung-up in the subcutaneous tissues during the biting act and can penetrate deeper tissues during the attempt to release the bitten part. In some bites the fangs may penetrate into muscle. In such cases, the usual local superficial manifestations of envenomation may not appear early in the course of poisoning. In bites by some species, systemic evidence of envenomation may be present in the absence of significant local manifestations. It may be difficult to determine the severity of envenomation during the first several hours after a pit viper bite and estimates of severity may need to be revised as poisoning progresses. It must be remembered, too, that not all pit viper bites result in envenomation. In approximately 20% of rattlesnake bites, the snake may not inject any venom. The local and systemic symptoms and signs of envenomation include the following:

Local Fang Puncture(s):

Swelling – edema is usually seen around the site of bite within five minutes. It may progress rapidly and involve the entire extremity within an hour. More than 95% of all snakebites are inflicted on extremities. Generally, however, edema spreads more slowly, usually over a period of 8 or more hours. Swelling is usually most severe following envenomation by the Eastern diamondback; less severe after bites by the Western diamondback, prairie, timber, red, Pacific, Mojave, and black tailed rattlers, the sidewinder and cottonmouth moccasins; least severe after bites by copperheads, massasaugas, and pygmy rattlers.

Ecchymosis and discoloration of the skin – often appear in the area of the bite within a few hours. Vesicules may form within a few hours and are usually present at 24 hours. Hemorrhagic blebs and petechiae are common. Necrosis may develop, necessitating amputation of an extremity or a portion thereof.

Pain – frequently a complaint of the victim beginning shortly after the bite by most pit vipers. Pain may be absent after bites by Mojave rattlers.

Weakness; faintness; nausea; sweating; numbness or tingling around the mouth, tongue, scalp, fingers, toes, site of bite; muscle fasciculations; hypotension; prolongation of bleeding and clotting times; hemoconcentration, early followed by a decrease in erythrocytes; thrombocytopenia; hematuria; proteinuria; vomiting, including hematemesis; melena; hemoptysis; epistaxis. In fatal poisoning, a frequent cause of death is associated with destruction of erythrocytes and changes in capillary permeability, especially of the pulmonary vascular system, leading to pulmonary edema; hemoconcentration usually occurs early, probably as a result of plasma loss secondary to vascular permeability; the hemoglobin may fall, and bleeding may occur throughout the body as early as 6 hours after the bite. Renal involvement is not uncommon. Mojave rattler venom may cause neuromuscular changes leading to respiratory failure. Since the possibility of a severe immediate reaction anaphylaxis exists whenever a horse-serum-containing product is administered, appropriate therapeutic agents, including a tourniquet, airway, oxygen, epinephrine, an injectable pressor amine, and corticosteroid, must be available and ready for immediate use. Constant attendance and observation of the patient for untoward reactions are mandatory when Antivenin (Crotalidae) Polyvalent (equine origin) is administered. Should any systemic reaction occur, administration should be discontinued immediately and appropriate treatment initiated. The intravenous route of administration is preferred, and probably should always be used for moderate or severe envenomation. Intravenous administration is mandatory if venom-induced shock is present. To be most effective, Antivenin should be administered within 4 hours of the bite; it is less effective when given after 8 hours and may be of questionable value after 12 hours. However, it is recommended that Antivenin therapy be given in severe poisonings, even if 24 hours have elapsed since the time of the bite. It should be kept in mind that maximum blood levels of Antivenin may not be obtained for 8 or more hours after IM administration. For intravenous-drip use, prepare a 1:1 to 1:10 dilution of reconstituted Antivenin in Sodium Chloride Injection, USP, or 5% Dextrose Injection, USP. To avoid foaming, mix by gently swirling rather than shaking. Allow the initial 5 to 10 mL to infuse over a 3- to 5-minute period, with careful observation of the patient for evidence of untoward reaction. If no symptoms or signs of an immediate systemic reaction appear, continue the infusion with delivery at the maximum safe rate for intravenous fluid administration. The dilution of Antivenin to be used, the type of electrolyte solution used for dilution, and the rate of intravenous delivery of the diluted Antivenin must take into consideration the age, weight, and cardiac status of the patient; the severity of envenomation; the total amount and type of parenteral fluids it is anticipated will be given or are needed; and the interval between bite and initiation of specific therapy. It is important to begin administration of the entire initial dose of Antivenin as described above as soon as possible, based on the best estimate of the severity of envenomation at the time treatment is begun, The following initial doses are recommended: No envenomation–none. Minimal envenomation–20-40 mL (contents of 2 to 4 vials) Moderate envenomation–50-90 mL (contents of 5 to 9 vials) Severe envenomation–100-150 mL or more (contents of 10 to 15 or more vials) The need for additional Antivenin must be based on the clinical response to the initial dose and continuing assessment of the severity of poisoning. If swelling continues to progress or if systemic symptoms or signs of envenomation increase in severity or if new manifestations appear, for example, fall in hematocrit or hypotension, administer an additional 10 to 50 mL (contents of 1 to 5 vials) or more intravenously. For severe envenomation, a total of 200 to 400 mL (contents of 20 to 40 vials) may be necessary. There is not a recommended maximum dose. The total required dose is the amount needed to neutralize the venom as determined by clinical response. Snakes' mouths do not harbor Clostridium tetani. However, appropriate tetanus prophylaxis is indicated, since tetanus spores may be carried into the fang puncture wounds by dirt present on skin at time of bite or by nonsterile first-aid procedures. A broad-spectrum antibiotic in adequate dosage is indicated if local tissue damage is evident. Shock following envenomation is treated like shock resulting from hypovolemia from any cause, including administration of whole blood, plasma, albumin, or other plasma expanders, as indicated. Aspirin or codeine is usually adequate for relieving pain. Sedation with phenobarbital or mild tranquilizers may be used if indicated, but not in the presence of respiratory failure.

Technique for Reconstituting the Dried Antivenin
Pry off the small metal disc in the cap over the diaphragms of the vials of Antivenin and diluent. Swab the exposed surface of the rubber diaphragms of both vials with an appropriate germicide. With a sterile 10 mL syringe and needle, withdraw the diluent (Sterile Water for Injection, USP) from the vial of diluent and insert the needle through the stopper of the vacuum-containing vial of Antivenin. The vacuum in the Antivenin vial will pull the diluent out of the syringe into the vial. However, delivery of 10 mL of diluent may not always exhaust the vacuum in the Antivenin vial. If all vacuum is not exhausted, reconstitution may be more difficult. Therefore, either disconnect the needle from the syringe and allow room air to be pulled into the Antivenin vial until all vacuum is released from the container or withdraw the syringe with attached needle from the vial, pull 10 mL of room air into the syringe and reinsert needle with attached syringe containing room air through stopper and repeat, if necessary, to release any remaining vacuum. At the first introduction of diluent into the vaccine vial, it is important for the needle to be pointed at the center of the lyophilized pellet of Antivenin so that the diluent stream will wet the pellet. If the diluent stream is not directed at the pellet but allowed to run down the inside wall of the vial, the pellet will float up and adhere to the stopper thereby rendering complete reconstitution much more difficult. Agitate by swirling, NOT by shaking, for 1 minute, at 5-minute intervals. Shaking causes foaming and if the diluent stream is not properly directed as described earlier, pieces of the pellet may get caught in the foam and will be very difficult to wet. Complete reconstitution usually requires at least 30 minutes. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. The color of reconstituted Antivenin may vary from clear to slight yellowish or greenish. Before each administration, gently swirl the vial to dissolve the contents. Before any Antivenin is administered, an appropriate horse-serum sensitivity test must be done so that, in case administration of Antivenin is subsequently required,

Side effects:
Immediate systemic reactions (allergic reactions or anaphylaxis) can occur whenever a horse-serum-containing product is administered. An immediate reaction (e.g. shock, anaphylaxis) usually occurs within 30 minutes. Symptoms and signs may develop before the needle is withdrawn and may include apprehension, flushing, itching, urticaria; edema of the face, tongue, and throat; cough, dyspnea, cyanosis, vomiting, and collapse. There have been isolated reports of cardiac arrest and death associated with Antivenin (Crotalidae) Polyvalent (equine origin) use. However, serious immediate reactions to Antivenin are rare. In skin-test-negative patients, Antivenin caused a true immediate sensitivity reaction in less than 1 percent of patients. Serum sickness usually occurs 5 to 24 days after administration and its frequency may be related to the number of Antivenin vials administered. The incubation period may be less than 5 days, especially in those who have received horse-serum-containing preparations in the past. The usual symptoms and signs are malaise, fever, urticaria, lymphadenopathy, edema, arthralgia, nausea, and vomiting. Occasionally, neurological manifestations develop, such as meningismus or peripheral neuritis. Peripheral neuritis usually involves the shoulders and arms. Pain and muscle weakness are frequently present, and permanent atrophy may develop If we don't bother them, they won't bother us.

3:05 p.m. on July 16, 2010 (EDT)
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RR, thank you very much! That is a lot of good info. It will take me some time to digest it all and there are some words I will need to look up.

Do you mind if I print it off for the folks in my group?

You get my yes vote for a first-aid topic area.

4:32 p.m. on July 16, 2010 (EDT)
2,590 reviewer rep
1,630 forum posts

The difference between a personal first aid kit and a med kit carried by a paramedic are like comparing night and day.

My personal first aid kit takes care of pretty much any situation I can find myself in until I get get to actual medical care.

First Aid kit:

-quickclot gauze sponge

-military compression bandage and field dressing

-ace bandage

-2in gauze roll

-small roll duct tape

-dental floss

-sewing needle

-6 alchohol wipes

-several doses of alieve, ibuprofen, benadryl, imodium ad, cold and flu med


And thats about it. Several other items from other parts of my pack can double as a first aid purpose, and items in my first aid kit can be used for other purposes as well. Tweezers on my multitool, honey as an antiseptic instead of carrying neosporin etc, i use duct tape and gauze to make a small bandaid etc.

If I encounter any issue that these items in different combinations can't fix then I probally need emergency medical treatment. These items can allow me more than likely to get to help under my own power. In my opinion anything outside of these items is pretty much useless weight, unless you have the medical knowledge and expertise to use.

6:32 p.m. on July 16, 2010 (EDT)
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67 forum posts

Do you mind if I print it off for the folks in my group?

Noodlehead, and anyone else please fell free to print out and use and pass along to your clubs, groups as you please once I post a topic I consider it public domain, but thank you very much for asking. R_Ranger

6:58 p.m. on July 16, 2010 (EDT)
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76 forum posts

rambler your kit looks relatively similar to mine and I agree with what you say about being able to use the stuff and using the things you have as a means to get yourself back to professional help.

there are times that people can carry a kit like ranger but I am not one of the people that would carry the weight and make it as useful as it can be in the right hands.

8:53 p.m. on July 16, 2010 (EDT)
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34 forum posts

Pot -{Ah cooking type}

Sometimes I'll bring some medicinal herb, which has a plethora of uses, but alas it's not always available. :-(

On a more serious note, I bring a dental kit w/ dental anesthetic and temporary filling cement (got it complete at Walgreens) and OTC antifungal cream. Although not life-threatening, a fungal infection (which I've experienced before) could drive me crazy before I could get to a pharmacy.

I conceptually separate a FAK from a "Contingency Kit" which contains survival items I may need, like extra iodine tablets, signalling mirror, and a bit of "cave line" for rigging a shoelace, etc.


10:15 p.m. on July 16, 2010 (EDT)
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15 forum posts

You and the Dr that reviewed your paper need to brush up on your AHA guidelines. The current (since 2005) ratio is 30:2 not 15:2.

Also I noticed you carry an airway kit with the ability to intubate, yet no Ambu bag or alternative (only a CPR mask). Did you plan on blowing down their tube?

Also someone was carrying morphine in their kit, yet I didn't see the reversal agent listed as well?

Folks, make sure you know just the heck you're carrying and how to use it, and be careful taking too much medical advice from a forum. Something as simple as an omission or typo could lead to problems. Get proper training and practice to maintain perishable skills.

1:43 a.m. on July 17, 2010 (EDT)
25 reviewer rep
67 forum posts

The ambu bag should have been listed I don't know how I missed that might have gotten cut when I pasted my post, I agree with you rwd on knowing your limits, I am licensed as a PA (Physician assistant) in the state of Virginia and I am also listed on the National Registry of Emergency Medical Technicians (NREMT) this gives me the ability to dispense certain medicines and do certain procedures in state and out of state, and do procedures that EMT's and Paramedics cannot perform in the field, I do this with the approval of my states medical board and the NREMT board. I am not trying to toot my horn or say woo-hooo look at me, but I am trying contribute to the form as best as I can to enhance the layman’s ability to cope in a emergency situation. As I stated or I thought I did, the large kit I carry, I carry when I am on active SAR missions or when I am volunteering on the AP trail, I state only that each of us has the ability to render aid, some more than others, Do the best that you can in any situation, any aid rendered is better than none at all. In today society people tend not to get involved due to the risk of being sued, as a PA I have to carry my own insurance and keep my license up to date at my own expense, there is very little financial aid for us ask any volunteer EMT, Paramedic or PA. All this is damn well expensive to say the lest, not to mention the minimum yearly training hours which surpass 300+ class room hours and the refresher courses I need to maintain my PA license as current. But also understand I do all this 100% as a volunteer I receive no pay except what I earn in my job with HLS as a cyber cop. my primary goal is to help others and be outdoors and try to ensure others have a positive experience when they are also outdoors. Unfortunately many week-end warriors do not know their limits and they over do it; to say the lest. There are still several things that I did not mention that I carry in my kit; I thought it best not to mention them. If I offended you or anyone else it was not my intention to do so I was trying to answer and contribute as best as I could to the forum. With that said I know not all of us will see eye to eye on things, this is human nature, but I do hope we can all learn from each other. I will continue to post my thoughts and experience to this forum as I see fit and will gladly comment to any open rational discussion. As I stated earlier I am only trying to contribute not trying to insult or be-little any one at all.


But Thanks RWD for pointing out my mis-print on compression to breath ration, I wrote the paper 8 years ago and it was still 15:2 at the time, SO THANKS BUDDY for pointing that outto us , other than that mistake I hope you gained something from this, your input and comments to our forum will always be appreciated and welcomed. I look forward to reading your input on topics here at our site. Welcome to the our community


3:12 p.m. on July 17, 2010 (EDT)
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15 forum posts

For Heart Attacks and Strokes in the back country here is a paper I wrote last year for a local Scout Troop.

Hence my confusion, but I guess you meant wrote 8 years ago.

Also, unless you are Dr. Henrik Omark Peterson, I'm going to have to call you out for plagiarism at best, or being a flat out fraud at worst. A simple Google Search reveals your "paper" you wrote to be text lifted from Dr. Peterson and displayed here, among multiple other places:

Complete with outdated guidelines. I'd advise the moderators of this site to ask for and verify rescue_ranger's credentials as he is proclaiming before allowing him to post any medical advice on this forum. If he checks out, then I suppose it is only his professional ethics that are in question and not his qualifications.

Have a nice day.

May 24, 2018
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