Clever First Aid Kit Ideas?

1:59 p.m. on May 10, 2010 (EDT)
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I can't stand store-bought first aid kits. They are getting better but who wants a kit with only four 250mg tylenol pills, a huge manual in fifty languages and a space wasting bag? I'm interested in what some of our more senior members include in their kits. The more creative and multi-purpose the better. I carry this in a gallon freezer bag:

About twenty bandaids

Fifty each of advil, tylenol and aspirin (their generic, equivalent)

A dozen anti-diarrheal pills

A blister pack of allergy pills

Duct tape

Four big gause pads

A suture kit from the vet supply store (hope I am man enough to use it)

Antiseptic wipes

A wad of cotton swabs (Q-tips)

A big chunk of moleskin

One QuickClot package per person

Tweezers

Fingernail trimmers

Matches with a few vaselene-soaked cotton balls

If I am traveling with a dog I also bring:

Baby socks for sore doggie feet

Pliers for porcupine quills

A gun (I won't euthanize my best friend with a rock)

8:19 a.m. on May 11, 2010 (EDT)
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I imagine my reply will raise the hackles of most; I don’t think a first aid kit is of much use. I take aspirin and moleskin, but otherwise most items in a kit are comfort related, and IMHO optional.

Band aids: I rarely use them at home; If I had a bad slice of a finger tip toilet paper under duck tape from my repair kit would work fine.

Pills: When I get diarrhea, otc pills are no use. Besides the reasons I get the trots are viral illness or bad kitchen hygiene, one which is easily preventable, while the other will have more serious problems than the runs.

Allergy pills are probably good for those with that problem.

Gauze pads: Use toilet paper instead. Suture kit: Use duct tape butterflies. If you are hurt bad enough to consider sutures, you should probably get back to town.

Antiseptic wipes: I’ve always used soap and water on my wounds, then air dry.

Q tips: Use toilet paper.

Quick clot: For what? Let it bleed, that’s nature’s way of cleansing the wound.

Tweezers, nail trimmers, and scissors: On the Swiss army pocket knife.

Matches: I thought this was a first aid kit. Use lighter from cook kit.

Baby socks: If your dog gets sore feet, he’ll need more than socks. Rough trail can do a lot of damage to a city pooch’s paws. Best toughen up your best friend’s feet with short jaunts over rough terrain of a couple of weeks prior to your outing, if the itinerary is over rocks and crud.

Pliers for quills: If your dog can’t be trusted to keep a distance from the critters, you will have a bigger issue with poisonous snakes. Besides, every I owned would snap at me if I tried to (painfully) remove quills. That is what vets are for.

Guns: If you are considering shooting anything short of a rampaging grizzly, perhaps you should reconsider camping. If you let your pooch get into such a predicament, or he lacks the skills to avoid such demise, then you shouldn’t bring him along in the first place.
Ed

10:25 a.m. on May 11, 2010 (EDT)
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50 each of Tylenol, Advil, and Aspirin? How long you plan on staying out?


10 bandaids

small tube of staphaseptic

small gauze roll

2 gauze pads

alcohol wipes

hand sanitizer

duct tape

super glue

Chiggerex

electrolyte pills

6 Tylenol pills

2 gear compression straps

1 pair rubber gloves (in case I need to work on someone else)

Leatherman


I put all this in an old Sawyer first aid bag that way everything is kept well organized and it wont wear out in 2 months like a freezer bag


Best wishes...

11:18 a.m. on May 11, 2010 (EDT)
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Ed,

I suppose I take a different point of view since I am taking groups out. The QuickClot is for the hemophiliacs (yes, we get kids who are that) and those on blood thinners (had one in my Climbing Instructors course last weekend). Those folks you can't just "let it bleed".

In 3rd World countries, the kit I take adds sterile syringe and several sterile needles in their original sealed packages (one fellow on my 2007 trip, not in my party, to Tanzania had an abcessed tooth - I gave him the syringe and 2 needles for his trip to the local witch doctor, er, I mean, dentist - at least that's what the sign on the "dentist's" hut said - the dentist's syringes looked "less than clean", if you get my drift).

12:06 p.m. on May 11, 2010 (EDT)
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I wouldn't recomend TP instead of gauze pads. Sterile gauze pads are made to not stick to a wound. TP is not sterile and can become embedded in the healing wound, causing infection or a need to reopen the wound to get it out. Gauze and bandaids weigh virtually nothing, you only need a couple, not the whole box. To each their own though, do what works for you.

3:12 p.m. on May 11, 2010 (EDT)
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So I was a medic in both the army and air force so I carry a couple things others may not carry and maybe sometimes a little too much but I'm also sensitive to weight. I had to carry my medic field bag plus what everyone else had to haul around so you learn to be sensitive about the weight of things lol.

Day Pack (All this fits into a smaller dry bag or zip log bag):

- Standard Bandaids and antibiotic ointment

- 25 Ibuprofen and Tylenol

- Small pack anti-diarrhea meds

- 6 4x4 Bandage

- 2 4-inch gauze roll

- 2 compression bandages (left over from my field kit in the army lol)

- 2 hemcon patches

- mole skin

- hand sanitizer

- tweezers

- duct tape

- Bug Spray


Overnight Pack (dry bag with items inside separated into small zip locks):

- Everything in the day pack in greater quantity depending on duration and number in my group.

- SAM Splint

- Latex Gloves

- Anti-histamine (Benadryl)

- Trauma Scissors

- alcohol/betadine wipes

- stethoscope and blood pressure cuff. (yah most of you can ignore these unless you know what to do with them)


I used to pack my M-4 with me but they didn't let me keep that :) so the critters out there will have to fear my size 12 foot or I'll use my size 12 feet to haul ass lol.


So a couple comments for some of the other things posters have mentioned:

- Nobody should be too "man" to carry some band-aids and antiseptic wipes and use them. There is really no excuse. They weigh nothing and its your first line of defense. I can tell some nasty stories about little cuts that got very ugly because they were ignored. Or if all you have is some My Little Pony band-aids and you can't bring yourself to use them use some super glue - they used to use that stuff in Vietnam to seal up wounds - amazing stuff.

- Avoid the toilet paper unless you have nothing else. It's a mess and breaks down too quickly to act as a good bandage\ barrier.

- "Let it bleed" isn't a good philosophy for out in the woods. Wash it off, even with clean water and put a bandaid\bandage\superglue\ duct tape on it.

- Don't leave home without the duct tape. Can't count how many things you can do with duct tape medically and that doesn't even count fixing broken gear. No brainer.

- I would agree with not being a fan of the "kits" although they are better then not having a kit.

- don't rely on others for your stockpile of first-aid kit supplies - bring your own.


Josh

11:54 p.m. on May 11, 2010 (EDT)
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I find the idea of not taking at least a basic tailored first aid kit highly irresponsible, unless you are within an hour of help and going EXTREMELY ultralight.

I cannot help but think that anyone with this attitude has little or no medical training, and is therefore a burden to himself and others. It is only a matter of time until someone will have to help an unprepared person, as I have on a couple of occasions. Both times it was the old "5% of information is dangerous", meaning that the individual wasn't fully aware of the implications of the potential hazards of their situation.

How would it be if you came across somebody 5 days out with, say, Amoebic Dysentery and didn't have a supply of Metronidazole to help them. One is then forced into the moral obligation of either going for help or personally effecting a rescue.

Also, if you are taking aspirin (a blood thinner), and cut yourself significantly, the amount of toilet paper (umm, what???) required would be significantly more than the size and weight of a small dedicated first aid kit.

I am not suggesting packing a fully loaded First Response Paramedic Kit by any means. I weigh up each situation as I see fit and take all perceived precautions to make sure both myself and my party return safely. A friend was very thankful that I'd packed strong painkillers after dislocating his shoulder in very remote backcountry. Without them, he would have become hysterical and put the party at risk on the return journey.

There are obviously countless stories of near misses and the like. I am just saying that for me, the bulk and weight of a dedicated medical kit is at the very least reassuring, worst case, life saving. I make no apologies in saying that anything less is verging on arrogant and downright foolish.

9:22 a.m. on May 12, 2010 (EDT)
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Paully, very good points and agreed. I suspect both of us have a few pharmaceuticals in our packs :) .

Saying that I typically avoid travelling with any controlled substances, especially those Class II categories, to avoid any uncomfortable questions, especially in federal parks :)

Also very good point on the Aspirin, I actually had that in my original post but I removed it so as not to get to "technical" but many folks aren't aware of the blood thinner aspect of Aspirin. So for folks who aren't aware of it blood thinners prevent your blood from coagulating so you end up bleeding more (whether internal or external bleeding) - probably not desirable in most situations :). Just leave the aspirin at home. Tylenol for the general pain - Ibuprofen for the body\joint aches.

btw is Metronidazole over the counter or do you still need a prescription for that? I typically don't carry that (I don't think I even have any) but then again I have water purification that kills the little pests (hopefully lol).

I suggest to anyone going on any extended outings to take a first aid class, you can get them through the red cross and its just a couple hours for a night and it could save your life.

Anyway sorry to go slightly off topic from first aid kits to first aid treatment but the kits don't matter much if you don't understand how to use them and why you should have certain things in the kit.

Josh

11:23 a.m. on May 12, 2010 (EDT)
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This is an interesting thread guys,

A few things that I bring which I haven’t seen above are a bottle of DEET and a bottle of sun cream which always get more use than the plasters, and for the benefit that I get form these two the weight is simply not an issue.

One more unusual thing that I pack in my first aid kit is some hard sweets that have a long shelf life and won’t melt from the heat of the sun. (I usually look for Werther’s Original or something like that.) Then when I need the benefit of a first aid kit (ie some one is injured) the sweets give a little moral boost to the injured person, and in the case of when my 4 year old niece cut herself when she was visiting I think the sweets somehow had more healing power than the plaster!?!

1:21 p.m. on May 12, 2010 (EDT)
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Hey Josh,

I also thought I was getting off topic, but if the bait is set I'll jump on it.

Anyway, I'll only carry gastro intestinal type meds in the tropics or if there's a history of these ailments in the areas where we're going. I was just using this as an example. I try to research any possibilities beforehand and tailor the kit/s accordingly.

I don't know what the laws are like in the U.S but in Australia we can get pretty much anything we need otc or else I go through a G.P mate that specializes in travel medicine. If you clearly outline your plans then there shouldn't be any dramas, particularly with your background.

As I'm in Asia most of the time I usually get the, let's say, more colorful pharmaceuticals from local suppliers. I like to support local industry.

I pack a custom wound management kit (size varies) regardless of the situation and a small First Aid book is also worthwhile . If I go down I'd like to know that someone else knows, or at least has some idea of what to do. I label everything idiot proof.

Your comment about short First Aid courses is spot on. There's no point packing anything unless you know how and when to use it.

8:14 a.m. on May 13, 2010 (EDT)
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My first aid kit contains the following. I carry a small canvas pouch that was my first aid kit in the military.

- 1 compression bandage with quickclot imbedded and field dressing

-Depending on duration of trip 10+ Tylenol, and 10+ Alieve/naproxen. As these can be taken together if needed.

-Epi-pen

-4 doses of Benadryl

- 4 doses of Imodium AD

-ACE wrap

-1 2 inch gauze roll

-latex gloves

Other items in my survival/pack repair kit can double as first aid supplies if needed like sewing kit, hand sanitizer, duct tape etc

For those that say they dont need Benadryl or an Epi-pen, I hope you do never need it. But truth be told, you can go your whole life "not being allergic" to any number of things and then all of a sudden you are stung by a bee and go into anaphalactic shock. These items can save your life, whether it is a bee sting, spider bite, exposure to a plant, or a rattlesnake bite. Seriously, is a 3$ pack of benadryl worth your life? An Epi-pen is more expensive but lasts for a few years. And I never carried one until a camping trip a few years back when a good friend of mine had a brush with death from a bee sting. If I would not have had Benadryl It would not have turned out well.

11:18 a.m. on May 13, 2010 (EDT)
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Great amount of discussion here. Been thinking of revisiting my first aid kit lately and this is going to help.

Thanks for the input everyone.

12:07 p.m. on May 13, 2010 (EDT)
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I find the idea of not taking at least a basic tailored first aid kit highly irresponsible, unless you are within an hour of help and going EXTREMELY ultralight.....

This brings up two points -

1. In my opinion, and something I push hard in the Climbing Instructor, 50-miler, and winter camping courses I teach, EVERYONE who is going to be more than an hour from help should take a wilderness first aid course, or better, a wilderness first responder course, and renew it every 3 years (the duration of the card).

2. If you do not know how to use it, do NOT put it in your first aid kit. This is especially true of prescription meds. It is all too easy to make a mistake.

The training (and currency) is FAR more important than the first aid kit. Basic Red Cross First Aid and CPR is not adequate if you are more than an hour from professional help. And in many cases, it is not adequate even less than an hour from help.

WFA courses are typically 2-3 days, while WFR courses are 7-10 days, and usually include some special sections related to particular activities (high angle rescue, white water/swift water, etc.). The best ones are accredited by the Wilderness Medicine Associates (the MD wilderness medicine society). Last time I looked, there were 5 or 6 accredited groups. The easiest one to contact is Wilderness Medicine Institute (WMI), a division of the National Outdoor Leadership School (www.nols.edu). They offer courses all over the US in fairly convenient locations.

How far is "one hour from help"? It is closer to civilization than you might think. Last weekend, at Castle Rock State Park (Santa Cruz Mountains in California), a man came running up to the group of Climbing Instructor candidates I was teaching, saying someone had fallen. Now Castle Rock is only 3 or 4 miles in a straight line from the towns of Saratoga and Los Gatos, about a 30 minute drive up the winding Hwy 9 and along Skyline Drive. The fall was another mile from the parking lot. One of my assistants and I handed the candidates over to the other assistant trainers and headed for the incident. The woman had been perhaps 5-10 feet off the ground bouldering, fallen, and landed on a rock on her back, plus striking her head. We were able to contact CalFire (the fire-fighting and emergency state agency). They have a station on Skyline not too far away, but usually there is no cell phone coverage once you get away from the parking lot (and it is iffy there). It was still another 45 minutes to get CalFire there with a backboard and "wheel" (they have incidents in the backwoods here all the time) and the victim out to a helicopter landing for LifeFlite to take her to the hospital. If the incident had happened farther into the park, for example at Cal Ledges or the Waterfall, it could have been 2 or 3 hours. Castle Rock is a fairly heavily used day-hike park, almost an urban park.


The image is loading her on the backboard. Luckily, there was no bleeding. However, when there is a potential spinal or head injury, you should ALWAYS immobilize the person right away. The climber's partners had not done so when my assistant and I arrived.

2:33 p.m. on May 13, 2010 (EDT)
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As always great info Bill. After researching their site (WMI) and my local red cross chapter site, I can get my WFA here in town (Colorado Springs) and for about $65 less (not including the cost of a tank of gas and an overnights stay) through the red cross. In your opinion what is it that makes WMI courses advantagous as opposed to the same WFA course offered by my local red cross chapter? Is it really that significant? Just curious what I may be missing. Being in the Pikes Peak region I'd like to think the red cross instructors here are well versed in wilderness first aid, as opposed to somewhere in Kansas (no offense to Kansas :) )

I found it odd how the WMI courses (at least here in Colorado) were all taught outside of the major cities, a couple hours drive away. I don't understand their reasoning behind that. Perhaps they are looking for that real wilderness setting to stage their real life setting training scenarios.

Just some thoughts I had before I registered.

Anyhow, thanks again for the info. I clearly need to get my wilderness first aid training up to speed!

3:06 p.m. on May 13, 2010 (EDT)
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Bah they probably had the winter courses in the big cities and I just missed em I bet. Anyway, didn't mean to hijack the thread.

Back to clever first aid kit ideas...

6:05 p.m. on May 13, 2010 (EDT)
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Ed,

I suppose I take a different point of view since I am taking groups out.

Bill S:
I expected you would see things differently. Given your instructor pursuits, your obligations place responsibilities on you that go way beyond those a guy out with his buddies deals with. As you note, training is more important than what’s in a kit; something that was on my mind too, but did not initially mention since the thread focused on kit contents. One should always go into the wilds having the wherewithal to operate self-contained, exercise self-rescue when possible, and know how to prepare and expedite an evacuation when outside agencies are involved. I agree with all of your points.

_________________

Paully said:

I find the idea of not taking at least a basic tailored first aid kit highly irresponsible... ..I am just saying that for me, the bulk and weight of a dedicated medical kit is at the very least reassuring.

Paully:
For the sake of this topic, I'll ignore the personal flames :)

Do not confuse ingenuity and resourcefulness with a lack of responsibility. Likewise being reassured is not the same thing as being prepared. I am sure anything one can address with the nominal first aid kit can be equally addressed by the resources I bring along on the trail, unless, of course you happen to bring an expeditionary or EMT kit that contains stuff most people don’t even know what it is (Metronidazole for example). BTW, should I come upon someone who managed to get themselves into a predicament requiring outside assistance, of course I have no problem with providing whatever the assistance they need. It’s happened, and I am sure I’ll encounter someone in need again.

Aspirin may be a blood thinner, but rest assured if one has a cut serious enough to fret over such a matter, they have an emergency demanding an evacuation, and direct pressure is going to play a more important role in staunching blood flow than gauze, aspirin, or anything else you can grab from the normal kit. So the bit about the hazards of aspirin is overstated; no one ever bled to death from aspirin.

Paully: While your friend with the dislocation was comforted by your meds, administering strong pain killers introduce at least three risk factors to the situation, all more serious than the original injury:

1) The victim could have an allergic reaction to the pharmaceutical, in which case, time, not comfort, suddenly becomes the critical issue. It is much preferable to be managing a broken something than anaphylactic shock. Excepting extreme traumatic injuries such as closed head trauma or extensive burns, most physical injuries can wait, withstanding the attendant pain, while with severe allergy reactions time is of the essence, and no remote evacuation is quick enough in such a situation.

2) Meds compromise a safe self-rescue. Your friend could have stumbled as he floated homeward in his comfortably numb narcotic fog, and end up with an even more serious injury than the original crisis.

3) Meds complicate managing shock. If your friend has a serious enough injury to require meds for pain, there is a likelihood he will also have a shock reaction to the injury. Meds will aggravate this serious condition.

Arguing about pharmaceuticals is a red herring in any case. None of the first aid seminars I’ve attended recommend you prescribe narcotics to anyone. That level of first aid is beyond most of us, and one reason why expeditions to the more remote areas of the planet prefer to have a physician along on the team. I have experienced three shoulder dislocations (city sports injuries), once broke my arm three days from a road head, and sustained numerous other breaks and owies on other occasions. I can attest from these experiences, that pain killers in the back country is an optional double edged sword, and unless you are properly trained, most would argue your seat of the pants dispensing of meds is more risky than my approach to these situations. As for medical hysteria, the pain substantially subsides after a while. No one ever died of pain from a shoulder dislocation, broken arm, etc.

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I wouldn't recomend TP instead of gauze pads. Sterile gauze pads are made to not stick to a wound. TP is not sterile and can become embedded in the healing wound, causing infection or a need to reopen the wound to get it out.

About Gauze versus TP:
As for toilet paper getting stuck up in a scab, the same thing happens to me every time I have used gauze on wounds. There is nothing magic about gauze in that regard; it is absorbent, and as the blood saturates it, then dries, the gauze becomes part of the scab, just as any other absorbent medium would, including toilet paper. Also, while TP (and most manufactured commodities) may not have been subjected to a formal sterilizing procedure, they are more sterile than most examining rooms where the wound is eventually treated.
I am not against gauze out of masculinity issues, it is just they are redundant, and become one more thing taken along when part of the reason I go camping is to simplify life.

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Epi-pens, Metronidazole, suture kits, etc:
At some point this debate departs from the practical, and becomes theoretical, if not sophomoric. Should one carry around an epi-pen (epinephrine), just in case, regardless no one in your party has a history of severe allergies? I can tell you as one who has such allergies you can not self diagnose the first occurrence until it becomes an all out emergency, and the side effects are bad enough you certainly don’t want to be administered epinephrine unless it is necessary. Should one bring along clotting factor, when camping with friends, none of which are hemophiliacs? At some point bringing stuff along just in case you encounter someone else’s situation is ludicrous. I am surprised no one mentions bringing a space blanket (it's part of my survival kit). Or how about a satellite phone, since it would be less volume, lighter, and cover a broader range of situations, than bringing emergency tampons, quinine for malaria (just in case:) ), insulin, nitroglycerin, West Nile virus vaccine, rabies vaccine, a defibrillator, a stretcher, x-ray machine, extra food to cure world hunger, and a FEMA disaster response unit. Really! Old timers got a lot done with spider webs (that’s what they use for band aids in the remote third world), TP, bailing wire, and duct tape. And if any weekend warrior comes at me with a suture kit, they risk an injury to themselves! Tape butterflies are sufficient to close many surgery wounds, there is no need to play Dr Frankenstein with my body.

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Are there pragmatic exceptions to my argument, that first aid kits per se are unnecessary? Yes. Bill S. makes most of these points. Trip guides will have special obligations and require a more extensive kit, while kits for exotic locations appears to be beyond the scope of this thread's focus. Expeditions have their own special circumstances, too, with the content of their kits governed by the trip duration, hazards, and medical training of those in the group. But the vast majority of domestic camping medical calamities can be mediated without the contents of a typical first aid kit, and those incidents requiring more are usually beyond the expertise of the normal Joe. BTW: This isn't just some crackpot idea I hatched while smoking the good stuff. This topic actually came up on a multi-day trip shared with a dentist, an emergency room physician and an emergency room nurse. They all were of the opinion most of the contents first aid kits provide far more psychological support than medical, and these kits are largely justified by their commercial merchandising value, than effectiveness to manage a medical situation. Oddly enough they also brought along all sorts of pills...

In any case I stated my opine on first aid kits would draw fire, and I welcome examples that indicates the recommended first aid kit for domestic trips can address something most campers cannot deal with adequately, given other resources already on hand.
Ed

6:08 p.m. on May 13, 2010 (EDT)
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a few things i bring:

-surgical scissors with a blunt end - much easier to cut tape or moleskin than a knife.

-small roll of waterproof tape to secure gauze pads, if needed.

-a bunch of alcohol pads, good for cleaning out dirty wounds before bandaging and using neosporin.

-whoever said immodium, +1. rarely used, but it can be a big help.

-bottle of potable aqua. i hate the taste and prefer a filter, but it's a good backup if the filter fails.

8:47 p.m. on May 13, 2010 (EDT)
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Will,

The WMI courses (and most of the other certified organizations) are taught in rural locations because that's where the students are headed. The Red Cross locations (and courses by WMI, even) on university campuses don't have the same feel to them (although the course I took at Stanford, which had wilderness MD and ER interns doing the role playing out under the redwoods on campus got reallllyyy realistic!). The Red Cross WFA courses have historically ended up being extensions of their "call 911" courses, according to people I know who have taken them or are instructors for them. They are good, but are more "Front Country" oriented. Still, the Red Cross WFA courses are a big step beyond the standard First Aid and CPR courses they teach.

what-worry,

One of the major emphases in the WFA and WFR courses is improvisation. You do not need to take a SAM splint, when you have a sleeping pad, branches, etc which can form the basis of a perfectly fine splint, for example. A padded hip belt from a pack makes a great cervical collar. Eric Weiss has a great little shirt-pocket sized book (A Comprehensive Guide to Wilderness and Travel Medicine), chock-full of ways to improvise many of the contents of the prepared first aid kits (this despite the fact that he is one of the chief advisors and principals in Adventure Medical Kits, one of the Big 2 in wilderness-oriented first aid kits). It even includes instructions on performing a cricothyroidotomy in the field (surgical airway - I hope to never even be tempted to try that one!) . Appendix B is a very thorough discussion of various possible items to include in a wilderness first aid kit, including the pluses and minuses of many prescription meds. His Wilderness 911 book also has lots of improvisational ideas.

Your last post sniffed at a lot of things that were suggested for a wilderness first aid kit on a trip with your buddies. Do you really know your buds' medical conditions? I am continually surprised by how many people keep their conditions secret (fear of embarrassment?), even from close friends (and sometimes even from spouses!). And a lot are in denial of even serious conditions. I had the experience of hiking with a group of adults, when a quarter mile from the car, one of the group, John, stumbled and leaned against a tree. He claimed to be all right, though clearly he wasn't. Eventually, it turned out that he had been painting his house and fallen off a ladder while painting the second floor eaves. He had suffered a concussion, and his doctor had told him to not do anything really challenging for at least several months (I found this out from his 18-yr old son). The group decided he needed to go to a hospital right away, which he argued strongly against, even though he was having a hard time standing up. One of the group, his best friend, and his son basically marched him the quarter mile back to the car and drove him to the hospital, while the rest of us continued on our 3-day backpack. In the hospital parking lot, he adamantly refused to get out of the car and go in - "I'm just fine!" After the rest of us returned home, we each got phone calls from him threatening us if we ever mentioned the incident to anyone.

With the scout groups, we are supposed to have a medical history form provided to us by the parents and for extended trips, signed by a doctor. From time to time, I have gotten surprised to learn about serious things not on the health form ("forgetting" to mention that the kid needs his inhaler or is diabetic is all too common). Geez, mom and pop, your kid is at risk - don't you want us to be aware so we can take appropriate action. When we find out and ask the parents why they didn't have it noted on health form (sometimes they went to a different doctor for the signature). Sometimes the answer is "none of your business" (excuse me??) and sometimes "if you knew you might refuse to take Sammy on the trip."

Point is, all too often you really do not know what's going on with those other people on the trip.

2:17 a.m. on May 14, 2010 (EDT)
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Again you are right; people may choose to keep vital health issues secret. I once went on a guided Alaska trip where the service had us complete a very extensive medical history survey. One clown wasn’t going to miss out on the trip, so purposefully didn’t report an abscessed tooth. Wouldn’t you know, it broke the first day away from base camp. This disrupted the schedule as two other people had to accompany him on the glacier back to base. He was flown out two days later when another group was dropped off. The notion that one should be prepared for emergencies others refuse to disclose or consciously disregard is unreasonable. They will force your hand in most every case, and impose the consequences on others. You usually can only accommodate with an evacuation or other uninviting Plan B response.

As for my friends, I am pretty sure about their medical secrets, considering what else I do know about them. If anything I am their liability from a medical standpoint, me being the oldest, and most busted up. When I arrange trips, I inform newbies to our group that they are responsible to supply items specific to their personal medical issues, such as insulin, epi-pens, Prozac, whatever. Beyond this, there is only so much you can reasonably prepare for. I don’t bring snow shoes into the Sierras in July, and for the same reasons I don’t carry rattle snake anti-venom, anti seizure medicine, or a satellite phone. Context is principal in determining what constitutes reasonable preparation. Guide services were responsible on most of my high altitude trips for bringing the primary first aid kit; however, we did piece together expedition kits of our own when self guiding similar jaunts. But those are exceptions, here on the 48, one prepares a kit for the sundry hiking or climbing trip, if for no other reason, it would weigh too much to bring splints and all the trauma paraphernalia in a first responder’s field kit. Hence the resourcefulness I allude to and you plaintively describe; a lot of first aid can be dispensed with the stuff already on hand, that knowledge and resourcefulness are the critical items to successfully address any emergency.

One item I bring when solo hiking may surprise those finding my opinion contrary. I bring two red smoke flares. Why? Sure, mirrors and whistles help get attention, if you need a rescue, but search and rescue people tell me red smoke flares are by far the easiest to see from a plane or helicopter. And while I can build a really smokey fire, it isn’t nearly as effective when it comes to screaming SOS.
Ed

6:28 a.m. on May 14, 2010 (EDT)
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@whomeworry, they're not flames mate, I know of a few people that agree with your approach and that's fine with me unless it encroaches on me or my party. I took your outlook to be mocking those of us that put medical preparedness high on the list. If I got it wrong then fair enough.

As soon as I posted the comment regarding Dysentery treatment I thought that it would be taken out of context as it's not a common problem in the U.S. I used this merely as an example as it's a frequent issue where I travel. The point being that if there is a prevalence of something then prepare for it.

As for the use of pain medication, there is a vast difference between making someone comfortable and having them in a narcotic induced stupor. It's correct that general first aid courses will not condone nor recommend the use of Schedule/Class 2 pain relief, but being a somewhat more dedicated forum, I thought that those here would be open to a more thorough approach. Anaphylactic shock aside, if someone has adverse reactions to pain relief then just stop giving it to them.

My No.1 product for wound treatment is Mepilex Border. They are sterile, absorb large quantities of exudate (wound ooze), come in various sizes, weigh next to nothing, will not stick to a wound, protects the wound and can be left on for up to a week. I have also used them to bind open wounds. They are available otc. Oh, and any left over can always be used for toiletry requirements, haha.

9:54 a.m. on May 14, 2010 (EDT)
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Really enjoying this thread.


@bills Very good point on WFA classes. I know that my military training was\is very different then civilian EMS training for example so its probably a logical extension that a standard first aid is going to be different then a wilderness first aid class (and more appropriate). Now that wilderness rescue would indeed be a very interesting course to take if i had the time. Unfortunately my medic/rescue days are far behind me - I'm a software developer now lol.

@Paully - As soon as you said Australia the medication comment made much more sense. Some nasty bugs in that part of the world :)

@whomeworry

Or how about a satellite phone, since it would be less volume, lighter, and cover a broader range of situations, than bringing emergency tampons, quinine for malaria (just in case:) ), insulin, nitroglycerin, West Nile virus vaccine, rabies vaccine, a defibrillator, a stretcher, x-ray machine, extra food to cure world hunger, and a FEMA disaster response unit. Really!

lol you had me chuckling - reminded me of my first training exercise - if I could fit the proverbial kitchen sink in my pack I probably would have. But it goes back to having some at least minimal training (First Aid \ WFA) so you understand what equipment is appropriate, what is overkill, and what is just not appropriate unless your role is ems\rescue. In the end you work with what you have, you use your head and don't panic, and hopefully everything works out for the best.


Josh

3:25 p.m. on May 14, 2010 (EDT)
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Something that I include in my first aid kit when my daughter comes hiking with me is a small container of calamine lotion and/or hydrocortisone cream. She gets huge welts when she gets bit by mosquitoes and either of these will help with the itching. They're also good for the rare instance when she gets poison oak/ivy. I'm not a big fan of benadryl though because it causes drowsiness. Even the topical benadryl makes her drowsy.

I've been thinking about carrying a snake bite kit, but I'm not sure if that's necessary. Any thoughts on this?

7:48 p.m. on May 14, 2010 (EDT)
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... if I could fit the proverbial kitchen sink in my pack I probably would have....

But I DO carry my kitchen sink!


This is a 10 liter foldable water bucket that I take for filtering water (carry it 100-200 ft from the edge of the stream or lake, of course, per LNT principles) or for gathering snow for melting during winter backcountry ski or snowshoe tours, etc. 5-7/8 oz. I got it for free (more or less - won a pack full of goodies, mostly useless, in one of the very few drawings I have ever won - the pack the stuff was in was the other main item that proved useful).

8:06 p.m. on May 14, 2010 (EDT)
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.....I've been thinking about carrying a snake bite kit, but I'm not sure if that's necessary....

The typical "snake bite kit" (the slash and burn variety, which has a razor blade and suction cup) does more harm than good. The old tourniquet approach resulted in many amputations from the blood being cut off from the arm or leg, so that the limb died. And no, the remedy shown in so many Westerns (drink a bottle of whiskey) doesn't work either. The Sawyer "super-sucker" has been shown to also be of no real use. Paul Auerbach used to recommend it, but the latest edition of his 11-pound Wilderness Medicine compendium has removed the recommendation. Here is an article about snake bite kits in general and the Sawyer in particular.

Note that pit viper bites (rattlesnakes, copperheads, moccasins) are handled differently from elapids (coral snake is the only one in North America, but a large fraction of Australian snakes are elapids). Statistically, the majority of bites in the US are not fatal. Of course, if you are the "winner" of that lottery, your heirs will be unhappy. The best advice if you get bit is to get to a hospital ASAP with minimal bodily movement (not easy, unless the ambulance is right there) and get antivenin.

Then again, when I got bit (at age 16), the snake died, and I'm still here, still full of "venom" {8=>D

8:15 p.m. on May 14, 2010 (EDT)
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@whomeworry, they're not flames mate.. ..Oh, and any left over can always be used for toiletry requirements, haha.

No harm Paully, and touché, perhaps I should stock Mepilex Border instead of TP. (But will it leave me feeling clean and fresh?) :)

I did not mean to take aim at those fascinated with first aid stuff. There are two kinds of med-heads: Those really into the rescue thing. Nothing to disrespect there, too bad we all can't find hobbies so constructive. The other kind are folks who are actually niche gadget freaks. I need a bigger hook before poking fun with such a gadget head. Now if you said you also bring a ham radio - just in case - well that one would be more than I could resist. No, my point was most people buy kits because they are lead to believe that is the "responsible" thing do, mostly due to companies that sell the stuff. Its a guilt trip marketing technique used also to sell diamond rings, Valentine roses, and Father's Day neck ties; however, the responsible thing to do is know how to address an aid situation using all the resources at hand (stoves, pack frames, freeze dried food pouches, and yes, TP), or for that matter preclude the scenario from arising in the first place when possible.

I still don't agree on the pain meds, however. Perhaps we visit different terrain. I know when I have enough pain killers to take the edge off a twisted knee or hip pointer, I lack the coordination to safely tackle the steps frequently occurring along California mountain trails. Parts of these trails are difficult even sober, where a stumble could send you tumbling down a rocky slope, or launch you over a cliff. Doing them doped up AND with a pack would be even worse.
Ed

8:19 p.m. on May 14, 2010 (EDT)
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And no, the remedy shown in so many Westerns (drink a bottle of whiskey) doesn't work either.

Darn Bill, you keep ruining my secrets! Now I have to come up with another excuse to my wife why I always bring Johnny along on every camping trip.

Ed

2:41 p.m. on May 16, 2010 (EDT)
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Good thread. It has opened my eyes as to what I need to add or remove from my kit. I usually take about 8 tylenol, ibuprofen, and naproxen [aleve]. With that I have:

20 band-aids

1 roll of gauze

latex gloves

tweezers

disposable scalpal

compression bandage

anti-bacterial ointment [neosporin]

iodine wipes (I think they clean better than the alcohol ones)

hand-rolled-flattened duct tape (takes up less room than a full roll)

and a couple of the heated hand warmer pocuh-things.

I put all of this in a waterproof zipper pack that my backpack's rain-fly came with.

I have recently removed the snake/insect bit kit from my aid kit. From the sounds of it, they can be more trouble than they are worth.

D

9:53 a.m. on May 17, 2010 (EDT)
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I absolutely agree that Quikclot should be part of any emergency kit. I happen to use blood thinners and it is the only product that I've found that is easy to use and works extremely well. The gauze packs don't take much room in my kit and I have had occasion to use Quikclot on several occasions both on myself and on friends who were with me when they suffered a bad cut. However, your comment that it just for hemophiliacs or blood thinner users is limiting and the uses for the product go far beyond those specialized groups.

Any group in the bush needs to be prepared for worst case scenarios. I have taken many canoe trips in the Canadian bush country where help is not available. Quikclot had not been invented when I was involved in that activity, but it would have been a God-send to have had it when someone buried an ax in his foot, or slashed their hand with a knife. Stuff happens when you are out in the backcountry and my personal kit always has Quikclot in it.

7:41 a.m. on May 18, 2010 (EDT)
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Quikclot.. ..would have been a God-send to have had it when someone buried an ax in his foot, or slashed their hand with a knife. Stuff happens when you are out in the backcountry and my personal kit always has Quikclot in it.

Your medical condition noted; if someone slashed open their hand wide open, or buried an axe in their foot, it is going to take a lot more than quick clot to stem the bleeding, something more akin to stuffing the first aid manual in the wound. Wise crack aside, do not underestimate the effectiveness of a duct tape closure and elevating the affected limb.
Ed

8:50 a.m. on May 18, 2010 (EDT)
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Madera said:

Quikclot.. ..would have been a God-send to have had it when someone buried an ax in his foot, or slashed their hand with a knife. Stuff happens when you are out in the backcountry and my personal kit always has Quikclot in it.

Your medical condition noted; if someone slashed open their hand wide open, or buried an axe in their foot, it is going to take a lot more than quick clot to stem the bleeding, something more akin to stuffing the first aid manual in the wound. Wise crack aside, do not underestimate the effectiveness of a duct tape closure and elevating the affected limb.
Ed

Whomeworry, have you ever used quickclot or seen it in action? It most certainly will stem severe bleeding like the examples given. As well as many other injuries. Quickclot + a compression bandage will stop almost any form of bleeding including loss of limbs. If you doubt how effective it is go take a visit at Walter Reed Army Medical Center and ask those men and women if they would still be here today if it hadn't been for quickclot. There is a reason that the casualties in this age's battles are much lower, obvious is body armor, but the 2nd is medical advances such as quickclot.

I have seen it in use, in actual application, not lab tests. And I swear by it. Have it in your kit, costs anywhere from like 5-15$ and its one of those things that you may very well never need. But that one time you do, you or a friend/loved one will be able to live to tell the tale some day.

People can say just use direct pressure and other well known first aid techniquies. But if your 30 miles in on a trail in the middle of nowhere, no cell service, you need to save yourself. I am not saying quickclot is the only thing that will stop bleeding by any means, just that it is an extremely valuable tool and weighs almost nothing and costs little.

6:12 p.m. on May 18, 2010 (EDT)
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..quickclot.. ..most certainly will stem severe bleeding like the examples given... ..take a visit at Walter Reed Army Medical Center and ask those men and women if they would still be here today if it hadn't been for quickclot. There is a reason that the casualties in this age's battles are much lower, obvious is body armor, but the 2nd is medical advances such as quickclot.

Regardless what the victims think, according to the military the reason for the high survival rates today is quick evacuation.

According to my emergency room physician friend quick clot will not stop arterial bleeding, especially from clean cut wounds produced by knives and axes. The primary mechanism stemming blood flow from such wounds remains mechanical interventions like stitches, butterflies direct compresses, etc. Quick clot is used to stop residual blood loss. The challenge stemming arterial bleeding is similar to the challenge BP faces trying to stop that deep ocean well leak; an artery pumps blood with enough pressure to squirt across a room. Any clotting agent applied would get ejected before it had the opportunity to work under that situation. The blood flow must first be reduced to a trickle by other means, in which case blood loss is no longer a immediate mortal threat.

Sure, observing a bad cut suddenly stop bleeding by whatever means appears a dramatic testimony, but keep in mind bleeding cuts look a lot more serious than they generally are. Very very few people will ever see a cut that bleeds a cup of blood, let alone one that potentially will kill you if not for prompt mitigation, thus the scope of cuts we all think are serious are only serious from a psychological and infection standpoint.

There are documented accounts of Tour de France cyclists who had fingers completely severed in racing accidents, who got up and completed that day’s stage without any first aid, then continued racing the subsequent days after receiving some stitches and bandages. One actually had two fingers severed. I can imagine if this was a camping incident all the fellow campers would be sprinting for their quick clot kits, when the victim can just apply a direct compress, with the need for evacuation predicated by sepsis, not blood loss.
Ed

7:57 p.m. on May 18, 2010 (EDT)
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@whomeworry, Wow mate, you really like to go to the edge when trying to prove a point.

How about you keep on the aspirin, duct tape and toilet paper whilst the rest of us use some of the more modern medical advancements. Agreed?

Why one would maintain the use of non-sterile applications, staunchly arguing in favor of them, when far more suitable alternatives are readily available is beyond my comprehension.

Thankfully, judging by the comments here, few people subscribe to the same self styled "ingenuitive" slapdash First Aid.

9:04 p.m. on May 18, 2010 (EDT)
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Thats why quickclot is made into sponges and compression bandages. And you apply it directly to the artery and not to the wound itself when possible. So I guess the best way to say this is, if you know how to properly use quickclot i.e. follow the instructions, it works quite well. And everyone keeps saying use a direct compress...., what in the bloody heck do you think people do? Pour quickclot on a wound and walk away? You apply quickclot then a direct compress, or use a compress that is saturated with quickclot. Quickclot is a tool, and when used properly is extremely effective. It would take you alot of rolls of toilet paper to accomplish the same thing I am afraid.

3:23 a.m. on May 19, 2010 (EDT)
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Thats why quickclot is made into sponges and compression bandages... ..It would take you alot of rolls of toilet paper to accomplish the same thing I am afraid.

And therein is the value of training. If you are going through rolls of gauze or TP, you are not doing something right. As my doc friend indicated, it is the physical compression that stems the serious bleeding, the clotting factor is of secondary importance. Keep in mind hospitals need to completely stop blood flood, and they use such tools out of the need for expediency. They did all this back in the day before clotting agents were available. In the field we do not need to stop blood loss, we need only manage it such that accumulated loss does not aggravate an emergency. That is why it is called first aid.

In boy scouts we had a scout who like schlepping around a bowie knife. He fell one day and buried it midway down his thigh. It was a gusher. Severing a femoral artery is a very serious emergency. We stemmed the bleeding with gauze, compression, pressure points, and elevating the limb. A runner was sent out at first light the next morning to summon authorities. It was messy, but he lost more blood in the first five minutes before remediation, than he lost over the next sixteen hours ending in the emergency room. The proof is in the pudding; no blood transfusions were required.

I am just saying my experiences lead me to believe clotting factors are optional for most people’s kits. Given the odds, I’d pack an air split for ankle injuries before stocking a clotting kit, since I’ve seen more than a dozen sprained or broken ankles, but only two serious cuts on the trail. Our minds play games with us. We fixate upon aviation disasters, yet aviation is the safest mode of transportation by far. I think we are the same when it comes to medical emergencies. We fixate over the specter of a bloody gory accident, the likes of which few will ever see, let alone be forced to deal with in the wilderness, yet no one seems inclined to prepare for the more common broken ankle. I take smoke flares with me when I solo in the mountains, which most think is eccentric if not goofy. After all what are the odds you will ever need to attract the attention of a search and rescue effort. To each his own.
Ed

8:33 a.m. on May 19, 2010 (EDT)
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It's an extremely effective tool, nothing more. It works wonders if you use it, but if you don't and only use first aid practices that will work too. Your example of a scout troop is exactly why I brought this up in the first place. You don't have someone to help you when your alone and miles and miles from help. If YOU can't stop the bleeding from a serious wound YOU are going to be in a world of hurt in a hurry. Accumulated blood loss from a wound adds up if you can't get yourself to help. Why not make it no additional blood loss and not take chances? It costs little, and takes up next to no room, most packs are the size of a credit card, some a little bigger if made into a bandage, but then you wouldn't need to carry a regular bandage either.

This is pointless it seems. I am not going to waste any more time arguing about this when your adament about not bringing it and using toilet paper. To each their own.

7:37 p.m. on May 19, 2010 (EDT)
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..Your example of a scout troop is exactly why I brought this up in the first place.

The scout I reference is a poor example supporting why one prepares thusly for a solo trip. That scout shouldn’t be carrying such a big knife in the first place, should not have strapped it to his belt in line with the front of his leg, and shouldn’t have been bouldering like a wild monkey, which lead to the actual accident. As OGBO stated, most serious accidents result from a sequence of poor judgments. If one makes the chain of mistakes that scout made leading up to his injury, then one should not be soloing at all.

..You don't have someone to help you when your alone and miles and miles from help. If YOU can't stop the bleeding from a serious wound YOU are going to be in a world of hurt in a hurry. Accumulated blood loss from a wound adds up if you can't get yourself to help...

The problem with being stuck for days out in the wilderness with a serious cut is not the bleeding, it is sepsis and exposure. You can stem blood flow and survive a week before any loss would be critical, but you are more likely to die before that from infection, or exposure if the injury immobilizes you away from shelter. Again, given the choice, I’ll take along flares and a space blanket on a solo outing before I take a clot kit.

..This is pointless it seems. I am not going to waste any more time arguing...

This exercise is pointless if this is only about me or you, but it isn’t; it is an exchange of ideas, some of which others may be considering for the first time. Also this isn’t just about clotting agents, it is about risk management. Face it, soloing into no man’s land has a risk element no amount of preparation will mitigate. Accepting this realization is the best way to mitigate becoming an emergency. Bringing along clotting agents on a solo trip sounds like a good idea, but like a life vest on a submarine; both provide a false sense of security in their respective settings. Clotting agents will do little good if hurt that badly while soloing, especially if the objective is self evacuation. Such injury predicates the injured minimize moving about. Exertion and physical jostling are sufficient to disrupt any scabbing action relative to an arterial wound. The best bet managing these risks lies in not what you take along, but in limiting solo journeys to trails that get regular use, and relying on flagging down a passersby to go summon help. If going into the boonies where others are unlikely to pass along, best leave the axes, hatchets, or guns at home, since they lend themselves to severe injury, not to mention are unnecessary. Likewise exercise great caution whenever wielding a knife, and for that matter, just getting around and about, as complacency is the biggest risk factor while soloing.
Ed

10:28 a.m. on May 28, 2010 (EDT)
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I saw a video on You-tube of what they did with the severed femoral artery of a pig. It will most certainly will stop an arterial bleed and is very effective on almost any wound. I've used a number of times on severe gashes and it has worked as expected every time. That video made a believer out of me. Remember, this is the new Quikclot gauze, not the granualar stuff that was first issued to the military. The military now carries Quikclot "Combat Gauze" which is what they used in the video. I checked both the Quikclot.com and Z-medica.com sites and they have a wealth of info about their products. I suggest you take a look.

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