Carrying Device - One that works best for you, and the environment in
which you travel. Dry Bag/Box, fanny pack, compartmentalized pouch, ziplock
Personal Protection - it is generally a good idea to have these at easy
access. Gloves can be placed in various places in your pack, or on yourself,
such as a lifejacket in a film canister, etc.
Vinyl or Latex Gloves - 2 to 4 pairs per
CPR Mask - or at the very least, a CPR
Airways - dependent on level of training
Wound Care - this is probably the most used portion of the kit:
Bandages - 3" and/or 4" rollergauze that
stretches and possibly self-adhering such as Kling, Curlex, and Coban. Like
ace bandages, care should be given to checking CSM at regular intervals and
taking care not to wrap too tight. They are usually reusable for the same
injury, so 1-2 per person should work.
Dressings - it is a personal preference
to carry multiple sizes of sterile gauze bandages. But it is always easier
to cut a 4" x 4" smaller than it is to make a 2" x 2" bigger. Although not
necessary, different dressings will help make wound care much more
manageable. 2 to 4 per person are minimal.
Non-Stick Gauze Pads - is a great
dressing to use directly on the wound. Wounds tend to "weep", and in long
term care, dressings must be changed. If you have ever removed a regular
gauze pad that has "wept" to the wound, then you will want some non-stick
gauze, such as Telfa. 2 to 4 per person.
General Purpose Gauze Pads - like the
name, they have many uses for wound care, from padding to absorbency.
Generally, these are used more than any other gauze, because of its
versatility. Since these have so many uses, 4-6 per person.
Combine and Trauma Dressing - used where high
absorbency and/or padding are necessary. Larger sizes in these are usually
recommended. Surgipad is the most common. 1-2 per person*
Occlusive Dressings - an excellent dressing when you
want to keep a wound dry in a wet environment. Care must be taken to remove
these dressings during rest periods to help promote healing in a prolonged
context. Examples include Bioclusive and Tegaderm. 1-2 per person*
Bandage Strips - better known as Band-Aids, is really
a bandage with an attached dressing. Strips when used on hands, etc. in a
remote setting will need some help from duct or cloth tape. It is again
important to change these regularly, so bring enough. Usually 6-8 per person*.
Tape - a real necessity. 1" cloth tape is
usually all that is needed in a basic first aid kit. From securing bandages
to closing wounds, cloth tape can do it all. 1 roll.
Duct, packaging and other tapes
make great securing tools for bandages, splints, clothing, etc. Be careful
to watch for constriction and other circulation problems. Instead of
carrying duct tape on a huge roll, great options such as water bottles, ski
poles and lighters have been adorned with it in case of its inevitable use.
Cleansing - a must in any remote setting
needs to be done well and often. What is needed now is Povidine Iodine (PI) used
in a solution with water, to adequately irrigate the wound and surrounding area.
In many kits, PI is in the form of pre-soak pads that pack well, but you need
quite a few to make the proper solution with water (looks like weak iced tea).
Be careful of carrying it in bottles, it will leak. And, in cold environments it
will freeze. There is are some people who are allergic to iodine, so check your
medical history first. Alternatives that have an alcohol base usually have a
tendency to "sting" or "burn" if applied directly to a wound. There are some
good biodegradable camping soaps, as well as medical "scrubs" that can be used
for cleansing around wounds. The most important factor here is copious amounts
of water for washing off residue. A irrigation syringe, 12cc to 60cc, works
great for washing out wounds, as well as, a corner cut off a ziplock, which is
squeezed like a cake decorator. Wound closing is an option when the person needs
to be able to walk or paddle with a minor injury. The risk of infection is
greater when the wound is close, so prior wound cleansing is vital. Butterfly
bandages, Steri-strips, or even cloth tape can be used.
Splinting - is probably the most improvised skill there is. Ensolite
pads, lifejackets, packs, paddles, ski poles, etc. all make great splints. The
key here is to make sure you use the injured's equipment first! There is nothing
worse then watching the helicopter fly away, after a successful rescue, with
your sleeping pad wrapped around a person's unstable leg injury. The two best
commercial splints going for extremity splinting, is the 36" Sam Splint (foam
covered aluminum), and the aluminum wire splint. You will also need a way of
securing the splint to the injured. Ace wraps, Coban, Kling, and triangular
bandages all work well. And, don't forget the duct tape. Remember to watch for
constriction, comfort, and compatibility.
Blister Care - the key here is prevention. At the first sign of a hot
spot, care should be taken. Personal preferences include, moleskin, molefoam,
first aid tape, and duct tape to prevent blisters from forming. Once a blister
forms, the care changes to open wound care, with wound cleansing and proper
Hardware - this the stuff that can make someone a hero for being able to
pull out a splinter, or make an emergency shelter.
Tweezers - The "Splinter Grabber" is the
best for compatibility, followed by splinter (really) tweezers.
Pins - both safety and blanket pins have
multiple uses. Mostly, they can be used wherever material needs to be
secured such as using a sleeve as a improvised sling, or securing a tarp as
Plastic bags - somewhere in your pack,
extra plastic bags is a good idea. Large ziplocks make great irrigators,
improvised glove, or occlusive layer. Big trash bags are perfect for vapor
barriers when wrapping up a patient, emergency shelter, and to put trash in.
Thermometer - in a cold environment, a
hypothermia thermometer covers most needs, and a normal thermometer makes
sense elsewhere. There are many good disposable thermometers on the market,
such as Tempa-Dot, that are also unbreakable. A digital indoor/outdoor
thermometer with a probe is a good resource to tell temp. variations of a
patient who is either immobilized during or waiting for evac, although not
as accurate as a medical version.
Trauma shears - is a good resource for
removing clothing, cutting improvised splints to size, and just about
BP Cuff and Stethoscope - although they
are added weight and bulk, they give the first responder vital signs that
may help tell a big deal from not. Generally, expedition or large groups
have these as part of their major med kits. Some first responders carry only
a stethoscope to help them hear lung, heart, and digestive sounds.
Heat/Cold Packs - again usually carried
in major med kits, these will help in short term context. Water bottles with
warm water, cooled wet towels, filled ziplocks, can be improvised heat/cold
Survival Gear - like an ensolite pad,
they are not generally thought of as part of the first aid kit, but are very
useful in handling an emergency situation.
Mirror/signal device - a compass with a
mirror could save you a scary and painful trip out of the woods because of a
spruce speck in the eye, or help you locate an adventuresome tick or leech.
It can also be used to signal aircraft or other groups, too.
Whistle - long after a human voice gives
out from yelling, a whistle can still be blown. Some groups even have
pre-planned signals, such as river guides.
Flashlight/headlamp - the majority of
overdue hikers are caused from not having a light, or spare batteries and
bulbs. Select a light appropriate to your activity, and that either has a
foolproof switch that won't turn on in the pack, or that the batteries can
be turned around in.
Lighter/ waterproof matches- if you are
traveling in wet, cold environments it is also good to carry a fire
catalyst, such as fire ribbon, or fire gel.
Flagging tape - can be used to give wind
direction to helicopters, making out a bushwhack trail, signaling. Blaze
orange and neon blue seem to show up best on land.
Parachute cord - strong and light, 100'
of p-cord could secure an improvised shelter, build a litter, and even mend
a broken paddle. 10 to 15' of mechanic's wire make a good addition for
Survival blanket - there are 2 good
alternatives here that both accomplish the same job of vapor barrier, heat
reflector, emergency shelter. The fiberglass reinforced Sportman's Space
Blanket holds up to high winds and multiple uses. It makes an excellent
shelter, and when put behind you is an excellent heat reflector from a fire.
The original Space Blanket is a great lightweight alternative that is
compact and light, but impossible to ever repack to original size. This
blanket is reported to be a good emergency replacement if sunglasses are
lost, as you can see through the blanket. The actual UV protection is the
only question. The silver reflective surface also makes a space blanket a
great signaling device.
- the legalities of using medications
should not be taken lightly. Adequate training, written policies and procedures
and medical control should all be considered. The big problem is that it is much
easier to put the medicine in, then it is to take it out.
Topical antibiotic cream - such as
Neosporin, has been proven to promote healing in shallow wounds and help
maintain a good barrier.
Analgesic, Antipyretic and
Antiinflammatories - such as Tylenol, Ibuprofen, and aspirin. It is personal
preference to what has worked best for you.
Antihistamine - such as Benadryl and
Antacid - Mylanta, Gelusil, Pepto Bismol,
Antidiarrheal - Pepto, Keopectate,
Anticonsptipation - Metmucil, glycerine
Antifungal/yeast - Tinactin, Mystatin
Dental Problems - pain relief from clove
Temporary dental filing material such as
dental wax or Cavit
Special Needs and Medications - such as
prescription antibiotics, asthma inhalers, altitude meds, epineherine, etc.
Glucose - liquid glucose in a single use
Oral Electrolyte Replacement Solution -
such as Gookinaid, Gatorade, etc.
Tincture of Benzoin - helps keep bandages
Syrup of Ipecac
General amounts for the usual day trip or weekend trip. If you can not be
resupplied easily, such as a month long expedition or voyage, it is probably
good to triple all these amounts. Program first aid kits that have youth at risk
for clients will probably have more wound care materials than a expedition group
of experienced participants, etc. There are no hard and fast rules to quantity,
only your experience, your training, and your judgment. So, after looking over
your kit, and you don't see "enough" povodine iodine pads, you are customizing
your kit to your needs.
Finally, Putting This All
The First aid kit must be well organized, weather proof, accessible in an
emergency, and user friendly. There are many good ways to approach this concept.
The simplest way to organize is to separate your bandages, dressings, meds, etc.
with ziplocks, or some sort of waterproof dividers. Writing what's in the bag
can help when the adrenaline is pumping, or some people even color code what is
what. Having gloves, pocket mask, and other protection readily available is very
important. Knowing what you can improvise with can also make an accident
situation go more smoothly. Being able to quickly grab the ensolite, duct tape,
and shears can greatly reduce the stress of the moment. Not only is the first
aid kit itself important, it is how easily you can assemble all your resources.
Suggested Personal First Aid Kit List
1 - roll 1" cloth tape
4 - 4" x 4", or 3" x 3" general gauze pads
2 - non-adherent gauze pads
1 - 8" x 7" combine (bulk) dressing
8 - band-aid bandages
2 - 3" or 4" stretch roller gauze
3 - 3" or 4" occlusive dressings
2 - triangular bandages
1 - 4" ace wrap
1 - Sam Splint or wire splint
4pr - vinyl exam gloves
1 - CPR pocket mask w/ 1 way valve or shield
1 - Airways, nasal and/or airway
1 - blister kit (personal preference)
5 - povodine iodine packets
1 - trauma scissors
1 - splinter tweezers
1 - thermometer
1 - med kit (personal preference)
1 - blanket pin
2 - safety pins
1 - 12 to 60cc syringe
1 - 20-30' duct tape