First Aid Items never used...

10:19 a.m. on October 30, 2018 (EDT)
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In my constant reevaluation of my backpacking kit I often look through my first aid kit and think what items I could make do without and improvise from something else.

One of those is an elastic fracture/sprain bandage with velcro that I always carry but felt that I could make do with another piece of gear or two to create a splint. Never pulled the trigger on that though and now I don't regret it.

Last weekend I slipped on a granite outcrop taking a photo and naturally put my arm out to break my fall. Knew immediately I had done something bad to my wrist. The pain was enough to cause some nausea. I know I could have rigged something up even through a fog of pain, but I was definitely appreciative of the ease of using the wrap one handed to immobilize what ended up being a fractured wrist.  A quick wrap, some water a snack and pain meds, and the walk out was much improved and faster. I even stopped for a couple more photos once things stabilized!

I'll keep my first aid kit the way it is...

11:48 a.m. on October 30, 2018 (EDT)
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Ouch. Thanks for the story.  Every time I pare down my first aid kit I rethink and put it all back.  Safe and lucky so far but ya never know.

5:12 p.m. on October 30, 2018 (EDT)
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I camp with a dentist, who as you can imagine has the entire Mayo Clinic stashed away somewhere in his pack.  His first aid kit must weigh north of 2 pounds.  My only serious BC accident happened while fetching water.  I  slipped on some lake side driftwood, slick from getting washed by wavelets that occurred with the daily sundowner breeze.  I fractured my forearm.  I herd it pop and that distinct quality of pain that set in told me: yep, I f'd up.  You could see a crook in my arm at the break, and it was swelling as I walked the 30 yards back to camp.  So my buddy breaks out his kit and produces a sling.  Nice concept but it was too small.  I eventually pulled it off as it was causing more pain than it relieved.  Then he pulls out a pharmacy pouch with enough meds to facilitate acquiring a chemical dependency over the span of a weekend outing.  Thanks, but aspirin is all that is needed for the inflammation, and as long as I keep the limb quiet, the pain is akin to a minor toothache.  Mind you this was a comminuted fracture with a slight displacement, and eventually required installing a plate to stabilize and heal.  Maybe if I had to walk out on a bad ankle I would be more receptive to the meds, but as it were the risk of a worse injury from a drug induced fall on a rugged High Sierra trail far outweighed the perceived benefit.

So my buddy runs off to collect the rest of our group.  I could hear the agitation and urgency of their conversation as they approached.  Upon their return they start informing me of my options:

  1. Chase down a outfitter we chatted with the other day, and get them to evacuate me on horseback.
  2. One member of our group jog out (~16 miles) to the trailhead and summon SAR to helicopter me out.

Jeez, not only must I endure my folly, but I also have to mange those hysterical about me.  I told them to chill - I never use that term but it fit the circumstance.  We were having none of that!  I told them at the very worst case we would bear hang my pack high, and I would walk out in one day.  I could retrieve my pack at the end of summer.  But even this was an over-reaction IMO.   

I told them THE plan was to complete the trip as originally planned, that this is not an emergency necessitating heroics or where time is of the essence.  I will walk out with the group, carrying my own pack.  I'll only need help tying my boots and shouldering my pack.  For effect I also added someone has to volunteer helping me with toilet activities.  I was joking, but the dismayed expression this produced was priceless!  Oh my how I digress!

So we went about the rest of the trip.  Sleeping with an unset break was somewhat distracting, but I missed being able to fish more than anything else.  I just went about my business tucking my arm like a bird would a wing.  I was affected far more by the realization of the inconvenience I was going to face for months back home, than the immediate discomfort and debilitation.  But I must temper my story, as I have a high pain tolerance.  I once went rock climbing with a "tweaked" wrist only to find out later when the pain persisted, that I had fractured it six weeks prior. 

I guess my whole point is to provide a contrasting POV to Phil's comments.  In fact my first aide kits consists of moleskin, aspirin, and meds I take daily, prescribed for various age related health issues.  Perhaps I'd also carry nitro glycerin or an epipen if I needed these items.  In other words I carry very little in the way of things specifically classified as first aid items.   Instead I make do with other items in my kit and what's on hand:  super glue, epoxy putty, duct tape, boil-disinfected clothing articles, sleeping pads, tent poles, straps, rope, toilet paper, plastic bags, Swiss army knife, sewing kit, whiskey, tree limbs - you can fix just about anything except a miscarriage with these items.  So I encourage folks to consider paring back on their first aid kit if they are looking for an easy way to shave some weight, as long as they can contrive alternative solutions for each item excluded, with other gear on hand or residing in the terrain.  After all the most important first aid item is between our ears.

Ed 

6:43 p.m. on October 30, 2018 (EDT)
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Sorry to hear about the injury Phil. Learning to not catch yourself when you fall is hard. This should help you remember next time :)

I go through my FAK and my bag of potions (bug dope, sunscreen, body lube, etc) before trips where weight might matter to make sure I'm not carrying stuff I'm not likely to need, but the base kit has remained the same for years. Most of it doesn't get used on each trip, but often something comes in handy. Much of it doubles as my repair kit and sees more use that way. Makes sense to carry an easily accessed cache of emergency stuff whether it is body or gear that breaks down.

6:51 p.m. on October 30, 2018 (EDT)
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One often applies a sling to a forearm X, but only after splinting the arm - the splint is critical.  That sounds like inept FA...

The basis of my FAK is a couple o elastic bandages - incredibly versatile and often applied in SAR incidents. Absolutely agree that much can be improvised from other gear.  I once taught a FA course to an Explorer post.  During one session everyone brought in their packs and we improvised the night away through various scenarios...

8:26 p.m. on October 30, 2018 (EDT)
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All good points and as usual an interesting discussion...couple of thoughts and clarifications. My pain meds are extra strength tylenol...same reason as Ed - a clear head is priority one. I have splinted a badly sprained ankle with an internal frame pack stay and part of a foam pad and walked out about 10 miles - improvising is key to backcountry first aid.

My point is sometimes an item is a bit easier than improvising, and for me the 0.7 ounce wrap is one I'll continue to take as it has many uses. It was always more a volume thing than weight for me as my whole first aid kit is 4 ounces. Keeping it handy in my outside pack pocket was also helpful.

Ed - I wouldn't recommend your approach to fractures in the backcountry to others (you have enough experience to make those decisions though) - difficult to assess the severity of an injury so something like a fracture or major sprain is a trip killer to me (see the other current thread on turning around).  I'll leave and come back another day. More surprising to me is the 50 lb pack guy recommending paring down the first aid kit!:)

12:41 p.m. on October 31, 2018 (EDT)
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I have also encountered situations where everything in my FAK was used and applied and we were using unsterile dressings, etc. for a short while.  Not an issue unless you encounter a full fledged SAR situation.

1:01 p.m. on November 7, 2018 (EST)
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Agree Phil. Sometimes it's easy to look at a piece of gear and feel like it might be too specialized, and that you could improvise the same with other gear. I struggle with this also. Looks like you made the right choice. I've gotten concerned more with life threatening injuries more than superficial ones, and have been adjusting my FAK. 

November 13, 2019
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