First aid kit contents

[Dan Magdoff]

I will agree that hydrogen peroxide is no longer recommended for wound care. Its kills off any living cells. This means it will kill off any bacteria in a wound, but it also means it will kill off any healthy living tissue that is helping the wound bed heal. It can be used in emergency situations, but should only be used one time to initially clean the wound. If it is used repeatedly to clean a wound, it will take a very very long time for the wound to heal. The best method for cleaning a wound is with sterile or CLEAN water. If you need to clean a wound purify the water by filter, boiling or chemical treatment. ideally you should purify it, and if you can also use chemical treatment. Then irrigate the wound with high pressure water…use LOTS of water. best wound be an irrigation syringe or squeeze water bottle. Poring water over the wound will not suffice. In the ER, we use well over a litter of water to irrigate a small laceration. So the best course of treatment is to irrigate with large amounts of clean water and apply a clean dressing. Then keep it clean and dry. An antibiotic ointment like Neosporin will not help with an infection. it is good for keeping a barrier over a wound and to promote healing and minimizing scarring.

As other said, don't take antibiotics until they have been specifically prescribed to you and for the specific infection you currently have.

Lastly, I think it should be noted that a first aid kit and the treatment you provide to yourself and others should only go as far as you are trained and feel comfortable doing. if you aren't trained to suture a wound…don't do it, which means you have no need to carry sutures.

Along with that…I think its a good idea to have some type of basic first aid training if you are going to be isolated in the backcountry and especially if you are hiking with others. Do most people on BPL have some type of basic first aid training?

[Mike W]

>> In the ER, we rarely will prescribe abx for an infected wound until we culture it, determine what is growing and then decide the best abx for the specific organism <<

Dan – I think this shows that you live/work in another world (the ER/Hospital)…

Most of us don't go to the ER for a simple infection. If I go to my Doctor or a medical clinic, they rarely send a culture off to a lab. Most Doctors can't get a lab result anywhere near as quickly as the ER since they don't have a lab as part of their clinic. The Doctor prescribes the most suitable antibiotic based on his knowledge and the odd time they have done a culture they say they will call me if they need to change the prescription (I've never been called).

Typical BPL over-reaction with these types of discussions (antibiotic use)… always seems to go sideways.

I mentioned that I carry a prescription antibiotic for infected blisters or similar skin infection. My doctor knows I won't be treating lung infections, intestinal bugs or other people! I make the intended use very clear to my Doctor and he thinks carrying an antibiotic for blister infection is a good idea. He actually said the antibiotic that he prescribes would not be used in a serious (life threatening) infection, so he's not worried about me developing a resistance to it.

Maybe not for everybody but as I've related in my earlier post, I've had a bad experience that an antibiotic would have resolved, so now I carry a half ounce insurance package.

[Dan Magdoff]

To each there own I guess. Just be careful with abx use, and I would be a little curious/ cautious as to why a provider would not culture wound infection. Obviously respiratory and GI issues wont be cultured…but there are sooooo many different possible infectious organisms for a wound, a culture really is needed….regardless, as Rex mentioned, overuse and misuse of abx has become a major issue, not just in the US, but world wide. I still say that proper cleaning and care of any wounds should almost completely prevent any need for abx treatment.

[Bob Gross]

"if you aren't trained to suture a wound…don't do it, which means you have no need to carry sutures."

A backpacker friend of mine had no first aid training beyond the typical Red Cross 8-hour class. He went out on a long solo trip and then managed to find deep snow in a talus field. His foot punched through the snow and into the void below where a sharp granite rock ripped open his leg. With no help around and a long journey to get out to safety, he decided to cleanse and suture up his own leg wound using ordinary needle and thread. He managed to limp out for a few days and got home, then removed the remaining bits of thread from the healing wound. Two days later, he saw a doctor about it. The doctor wanted to know which emergency room doctor had sutured the wound, because it was done so neatly.

–B.G.–

[Ben Smith]

I think one should consider what they know how to treat as much as what injuries may occur.

There is no point carrying splints, triangular bandages etc if you can't use them.

Then there's the consideration of whether to carry only the things you can treat yourself with (if hiking alone) or whether to carry enough to help others you may find in danger/injured.

You could easily end up carrying half an ambulance.

Carry what you feel comfortable with.

[Jeremy and Angela]

On the wound closure topic, if the wound is sufficiently deep or under tension closing it up can create a nice oxygen-free pocket inside. This is a Bad Thing in terms of infection risk, and a case where leaving the wound "open" (but still dressed) would be appropriate. I was taught the traditional wet-to-dry gauze method, but I understand there are more modern (and less painful) options available.

[Ian]

"if the wound is sufficiently deep or under tension closing it up can create a nice oxygen-free pocket inside. This is a Bad Thing in terms of infection risk"

That's interesting. I realize some bacteria are anaerobic but this wasn't covered in my WFR class years ago. Looks like it's time for a recert and to update my knowledge in this area.

I think bottom line is ABCs first and infection control second. Obviously we all want to try and do both at the same time but if your artery is shooting blood over my shoulder, sorry pal but I'm packing that wound with my skanky bandana if nothing else is available and we'll worry about your antibiotic drip once medevac dumps you on the roof of the ER. This is obviously different that the scenario you're painting here though so just making an observation more than trying to be contrary to what you’re saying.

[Nick Gatel]

Mine is pretty minimal. Years ago I got rid of everything I never used.

[Dave @ Oware]

Athletic Tape-blisters, badly sprained ankle, over dressings.
4×4 gauze- cut open knees, smashed finger tip
neosporin- eye infection, cuts, chaffing, cracked lips, barber's itch.
clown white- sunburn, chaffing
2nd skin- burns, blisters
Bandana- dislocated elbow, twisted ankle, improvised sunglasses
Ibuprofen-fever, sore knees, headache
peptobismal- food illness, diarrhea (better than lomotil in my opinion)
oral rehydration solution (water, sugar, salt) – diarrhea, hyperthermia, over exertion, hangover

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