1lb Survival/First Aid kit for scrutiny

[Summit CO]

Here are the contents of my 1lbs super survival/utility/first aid kits:
The battle between ultralight and ultrapreparedness:

First Aid Kit

BSI:
Laerdal CPR 1 way barrier
2pr Nitrile/Vinyl gloves

Bandaids/Antiseptic:
9 Nexcare bandaids
2 2×1.5″ bandaids
1 2×2 Mole Skin
4 alchohol pads
2 benzalkonium chloride pads
1 soap towlette

Trauma:
1 4×4 ActCel Hemostatic Gauze
1 2×4 ActCel Hemostatic Gauze
1 2″ gauze roll
1 5×9 Trauma Pad
3 4x4s
1 2×3 nonstick
5 Butterfly Closures
1 4″ Coban Roll (self adhering ace bandage)
1 2″ Cloth tape roll

Meds/Misc:
2 triple antibiotic ointment packets
10 220mg Aleve
1 antidiahhreal pill
1 2 psuedofed/acetomenaphine packet
1 hydrocortisone cream packet
1 sunscreen packet
1 blistex packet
2 saline/eyedrop singles
1 benzalkonium/lidocaine/aloe cream packet
1 burn gel packet

In the winter:
Half the bandaids/antiseptic

Added when SAR/BC Skiing/climbing/mtb/kayaking:
Pocket mask + extra gloves + OPA (not when solo)
Sam Splint (or anytime solo)
Triangular Bandage
Small Trauma Sheers (not when solo)

Long list but the first aid kit is very light (10oz fully loaded minus shears/pocketmask), versatile, and fits a 1qt zipper ziplock baggie (minus the splint/shears/pocketmask)

Need to add:
Cinch-Tight H pressure dressing, betadine, & 1 more OPA

Survival/Utility Kit:
2 10′ Duct Tape Rolls (1 green, 1 heavy duty)
1 Butane Lighter (Possibly to be replaced with storm lighter)
1 Box Waterproof Matches (To be repalced with beefier version in sealed container)
1 Bottle Potable Aqua (to be replaced with Aqua Mira)
1 48′ 0.18kN 3.2mm Nylon/Poly cord (To be replaced with 50′ 3.2mm 4.9kN Spectra Aircore Plus or 50′ 3mm 14.2kN Technora Cord)
6 12″ zip ties
1 Roll camping TP
1 Space Blanket

To add:
1 10′ 20Ga uninsulated copper wire
1 micro LED light
1 suvival saw chain
4 Safety pins

Weight ~6oz fits in a ziplock sandwich baggie

When not carrying overnight gear and/or in the winter add 2nd space blanket or space bivy

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Elsewhere in/on pack (not included in above kits/weights):
Brunton 26DNL-CL Avalanche 1.2oz Compass/Inclinometer/Mirror
Altimeter or AGC Ascent Altimeter/Barometer watch
WalMart Whistle/Magnifying Glass/miniCompass combo
Halogen/LED Headlamp (may leave at home on occasion once I get the mini LED light)
Knife or Multitool
Usually: VX-5R or GMRS/FRS or cellphone

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This list was meant to cover the basic survival/first aid items I carry not including clothing, food/water, camping gear, etc

For the record I’m a W-EMT-B/IV

Comments/Suggestions?

[Brian James]

Personally I carry a roll of snare wire. Aside from its’ intended purpose, it can be used for quickly and solidly wiring together a lean-to. You can build a stretcher or splint with it too, and make strong repairs to packs and equipment.

In my opinion, I wouldn’t actually set a snare unless it was truly a him-or-me situation.

Brian

[Eric Noble]

I made a key ring out of 12 feet of stainless steel snare wire. That way I always have it with me. My key fob is made of 10 feet of nylon cord. My keys and a Photon light attach to the key ring with fishing swivels. A button compass attaches to the key fob.

I am guessing that the copper wire on Summit’s list is snare wire. Is there an advantage with copper over stainless steel? One disadvantage I can think of is that copper does not resist heat as well. Copper might work better for a snare because of it’s color and potential lack of shine. Electrical repairs might also be possible.

[Eric Noble]

I haven’t tried this but, on the Adventure Medical Kits site under Weiss Advice they tell how to make a one way mouth to mouth breathing barrier out of an exam glove. This might save you from having to carry the Laerdal CPR 1 way barrier. If any one has tried this I would love to know if it is an acceptable replacement for infrequent use.

[Summit CO]

I’ve used copper sucessfull in the past to repair AT bindings in the field. The other purposes for the wire were to be: equipment repairs, improvised stretcher/shelter construction, emergency snare, cooking pot suspension wire, etc.

I chose copper because I remember larger gauges of copper are easier to work by hand vs steel and larger gauges are also less prone to severe kinks. I seem to recall that copper may be more fatigue resistant but I could be mistaken…

The steel would certainly be stronger at equal gauges or lighter for equal strengths. Maybe I’ll get some of each and see if the steel works.

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The glove/CPR barrier is a cool improvision, but truthfully, one extra large latex glove is about the same size/weight as the laerdal barrier (which lives in the cloth tape spool at the top of the baggie) and the laerdal requires no time to improvise.

Additionally, assisted respiration may be required short of CPR and the glove method would be problematic in a pt with an intact gag reflex.

Additionally, I don’t carry latex gloves because of potential for pts with a latex allergy and the possibility of developing a latex sensitivity myself. This wouldn’t work well with nitrile or vinyl gloves because they are not so stretchy.

It is a cool idea that I’ll remember just in case. That site you gave has a few other cool improvised care techniques.

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I may get one of these to see how it stacks up against the extremely bulky pocket mask (though light, its 1/2 size of the rest of the first aid kit)
http://www.esportshealth.com/shop/product.asp?catalog_name=School+Health&category_name=&product_id=Laerdal+Inflate-A-Shield+CPR+Barrier

[Dale Wambaugh]

Good job. I’ve felt out of the UL box for carrying a 6oz first aid kit when I’ve seen others head out with a few band-aids and some duct tape. I haven’t weighed my survival and first aid items together as a group, but I’ll bet it is close whan all the items are considered.

I’ve been a fan of adding a single edge razor blade or two. Another writer here suggested scapel blades and I added a couple of those to my kit. I had found a folding surgical prep razor which some found rather dangerous- and it is easy to cut yourself with it.

With all the wet stuff I travel through, my kit is heavy on fire starters– a few ounces that is. I carry a lighter with 3′ of duct tape wrpped on it and a safety pin with the eye end sticking out from under the duct tape to use as a lanyard loop (suggested by another here). I carry matches and three of the no-blow-out trick birthday candles in a waterproof container and a couple spare Esbit tabs.

Something I haven’t mentioned here because of the weight is to carry a road flare for a fire starter. A 15 minute flare is about 6oz, but it will set fire to the wettest wood around and double as a rescue signal and might even scare off a predator.

Zip ties are really handy and can be tucked into little corners of your gear. Police officers sometimes carry one in their hat sweatband for a back-up handcuff. They can be daisy-chained to make a larger one too. I’m going to add a couple to my kit.

My other survival tool is a Tool Logic SL3 knife with whistle and fire starter. Some of the Tool Logic products are on the funny gadget side of things, but the SL series are decent tools.

[Eric Noble]

Thanks Summit, I hadn’t realized that the Laerdal barrier was so small and light. I will have to add it to my kit.

[Eric Noble]

I also carry the matches and trick candles, and Esbit tabs. I use a permanent match instead of a lighter. A Spark-Lite is used to light all of my stoves (Esbit, alcohol, and propane). I also carry Purell hand sanitizer, which is great for fires. I have a Fresnel lens in in my wallet for fine print on maps and for fires. As an ex-boy scout I am really focused on fire :).

A surgical blade is a great idea. The straw that comes with my FlexAir pillow would make a great handle. Suction and cutting in a single instrument, ha ha.

My multi-tool of choice is the Leatherman Juice S2. I just wish it had a locking blade.

Thanks for getting me to think about this. My first aid kit has not received the same attention as my survival gear. Some first aid classes would be great as well.

[Summit CO]

Dale:

I’ve always felt that lightweight shouldn’t compromise safety. I’ve also seen people rationalize their survival/1st aid kits in the name of weight and they get away with it because they’ve suffered no misfortune in the past and tell themselves they will not in the future. Over the years I’ve found occaision to use most of the things in my first aid and survival kit for one thing or another during my outings (except from the trauma/cpr selection). Often I find myself using basic 1st aid/survival supplies to support others who rationalized their kits away.

I think your single razor idea sounds light and usefull: brilliant!

I like the esbit tabs idea. I used to carry trioxane bars but took them out unless the forecast was particularly wet. Esbit is smaller and more oomph/g than trioxane. Winter carry for sure, maybe summer too.

Fresnel is nice idea… I have a magnifying glass built into my whistle… I’ve never tried to burn somethign with it. Maybe I should test it before counting it as fire starting method #3.

Relighting birthday candles are a great light weight no bulk idea. I’ll probably implement that.

It’s fairly dry here a lot. I’ve thought a road flare would be great in winter but they are so big and so heavy that I’ve left them out (the one’s I’ve see). What do you use and what does it weigh?

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I end up with a heavy buck multitool a lot because it also has the tools I need for ski binding/boot adjustment and repair. It has a fish scaler/saw too. Sure is heavy darnitall.

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YAUFDT (Yet Another Use For Duct Tape): Fire starter. A length of tape will burn very hot. If you crumble a length it will burn for a long logn time. Probably not environmentally friendly, don’t breath the fumes. It is my last resort firestarter before lighting more important or expensive items.

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One of those tiny 1″ .99cent cyanoacrylateblah superglue tubes is great for closing wounds (make sure yo know what you are doing here) and for repairs. I might put one in. I need to get a new postal scale to weigh one.

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Something else to add to your first aid kit: tiny pice of (preferably) waterproof paper with:
Name
Age
Emergency Contact #s
Allergies
Meds
Past Pertinant Medical History

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Medical training

For education I strongly recommend the Wildernest First Responder course (WFR) might cost a few bucks and take a few hours (80 instruction hrs including an overnight or two) but the knowledge is priceless, extremely usefull, and it is very heavy on improvisation for care, treatment, and evac. Many outdoor guiding/ed outfits like to see a WFR cert. It will teach you everything you need to know for companion rescue and professional first response without the time and cost of a WEMT or OEC course.

Barring WFR, a ARC Wilderness First Aid (WFA) and CPR course is a easy one day thing.

The best part of medical training is that its extremely usefull yet weighs nothing. ;-)

[Eric Noble]

Summit, I assume you live in Colorado. I do also, just outside of Denver. Is there a local WFR course you would recommend?

Thanks for the Duct tape hint. I will have to try it.

I bought the fresnel lens from Brunton. It is the size of a credit card and it came with survival instructions and a compass that you float on water. The compass seems dubious, but the cards and lens fit in my wallet really well.

[Scott Ashdown]

I always stick a few tablets to deal with Diarrhoea in my first aid kit. The tablets weigh almost nothing and its better to carry the weight of a few tablets than to lose loads of weight in the wilderness through Diarrhoea. I’ve never been ill with it yet whilst on the trail but there is always a chance and dehydration can be a serious business.

On another note, when were working out pack weight, we exclude, fuel, food and water. I think first aid kits should be excluded as well to help stop those individuals who are so intent to have a lighter pack than the next guy that first aid items start to get dropped. If the weight wasn’t included in the “What does your pack weigh?” debate, people might be less inclined to drop safety.

[Eliza Cava]

I, too, am a WEMT, and am putting together final preparations to embark on a southbound AT through-hike next month. My first aid and bivy kit also weighs close to a pound, and while I may share some of it (blister care, for example) with my brother and hiking partner, I feel obligated to carry most of the weight myself. By becoming a WEMT I feel a certain obligation to care for other, less-prepared hikers I might meet who get into trouble, and I want to have everything my brother and I might need plus a few extra things for unlucky strangers. I wouldn’t be able to forgive myself for attempting to help a stranger who had fallen on a hiking pole, for instance, but failing to do so adequately because I had left behind enough povidone iodine to wash the wound, enough clean, sterile gauze to pack it, and enough spare rope or cord to build a litter. Training does matter, and for me it means that while I may be more prepared than many to assess a problem and improvise a solution, it also makes me aware of the many things I’d rather not have to try to improvise on the fly and in a tough situation. Having volunteered as a street EMT, I know that it is so incredibly nerve racking to be faced with a real emergency that it’s easy enough to forget where the right, highly specialized items are in your ambulance, much less make them all up at the time.

Summit, I figure you have a somewhat similar rationalization in your gear choice. I commend you for carrying a well-prepared kit, and my only advice would be to carry what you feel comfortable with, no more, no less. You might feel fine carrying only 2 5×9’s and cutting them to fit smaller wounds, for instance.

Just my thoughts on medicine in the backcountry.

[Dale Wambaugh]

Ditto on the superglue and anti-diarrhea meds mentioned in another post. I have Immodium capsules whenever I travel. I also add Benedryl, hydrocortisone, triple antibiotic ointment, and ibuprofen to my kits.

Buck once made a tiny multitool called the Buck Mini (model 350) that is much like the Leatherman Micra but with both plier jaws and scissors. You can still find them on Ebay. One of my favorites.

Road flares. The ones I have at home are made by 3M and about 6 ounces. We’ll probably see road flares go away as they are full of nasty chemicals and LED/reflector units are becoming more popular for road use — they sure are more compatible with fuel leaks! There are some small hand-held marine flares but they are expensive. If nothing else, keep your flares in mind if you are broken down with your car in the middle of nowhere and need a fire to survive.

[Summit CO]

Eliza: Right on!!! My sentiments exactly.

Eric Noble: These guys are great: http://www.desertmountainmedicine.com/

[Dale Wambaugh]

My essentials list:

Etowah”Town Bag” stuff sack/backpack “bug-out bag”

Adventure Medical 0.5 first aid kit:
Splinter Picker Tweezers
Safety Pins
Motrin®
Antihistamine
After Bite® Sting Relief
3X3 Sterile Dressings
2×2 Sterile Dressings
Non-Adherent Sterile Dressing (3×4)
Conforming Gauze Bandage
Butterfly Closure Bandage
After Cuts & Scrapes® Towelettes
1×3 Adhesive Bandage
Knuckle Adhesive Bandage
Tape ½” x 10 Yards
Moleskin (7×4)
Tincture of Benzoin
Antibiotic Ointment

Add:
Benadryl
Ibuprofen and/or Naproxen
Imodiam AD caps
Hydrocortisone ointment
Super glue gel
Micro-readers spare reading glasses
safety pins
single edge razor blade

Other essentials:

Aqua Mira in mini bottles
1 liter Platypus with sport cap (back up for water treatment)
3 no-blow-out bithday candles
Strike anywhere matches
Waterproof match case with scalpel blades taped to outside
Cricket lighter with 3′ duct tape and safety pin/lanyard eye
3 Esbit tabs
20′ light braided nylon seine line
Hotel freebie sewing kit
1oz bottle sunscreen
1oz bottle DEET
Gerber Tracer LED headlamp
Micro-light
8 hour white light stick
Spare batteries
Lowrance iFinder Go! GPS
Silva Guide 426 compass on lanyard
Map(s)
Adventure Medical Space Blanket
45 gallon low-density polyethylene garbage bag (rain gear/groundcloth/half bivy)
10 pieces hard candy (spare food)
Bolle PC sunglasses with Croakies
Tool Logic SL-3 knife with built-in fire stick and whistle
Silva key-chain compass
Reflective lanyard (knife, compass and micro-light all on lanyard and looped over belt)

I’ve tried to build in some layers of protection. One is the “bug out bag” concept. If I am crossing a stream or going on a short hike away from camp, the stuff sack/pack can keep my survival items with me. I can also use it if I need to leave my main pack behind due to my own injury to to get aid for another. The other layer is the lanyard with the knife/whistle/firestick combo, a Silva keychain compass, and a Photon Micro-light flashlight. The lanyard is reflective line and in a full loop. It is long enough that it loops around my belt in a lark’s-head knot and it drops into my pocket. If I lose my whole kit, I still have those basics tied to me.

Something I forgot to mention previously for emergency fire starter– alcohol hand sanitizer burns well and sticks to the fuel source. Conversely, don’t use the stuff near an open flame. I remember when someone had a big jug of hand sanitizer at a big company picnic so the food handlers could keep clean. The health and safety manager made them move it far away from the barbeque!

[J R]

Eric Noble
Have you looked into http://www.wildernessmedicine.com ??

They put on a great program.

They also work through the local community colleges as well if you wanted to pick up some academic credit… I know they go through Red Rocks, and maybe others.

My survival kit is the Adventure Medical Pocket Survival Pack

1….. Rescue Howler™
1….. Rescue Flash™ Signal Mirror
1….. 20mm Survival Compass
1….. Spark-Lite™ Firestarter
4….. Tinder-Quik™
1….. Duct Tape [2″ x 26″]
1….. Scalpel Blade [#22]
1….. Stainless Steel Utility Wire [6 ft. of 0.020″]
1….. Fresnel Lens Magnifier [2″ x 3″]
1….. Heavy Duty Nylon Thread [50 ft.]
1….. Braided Nylon Cord [10 ft., 150 lb. test]
4….. Fish Hooks [4], Sinkers [2] and Snap Swivel
1….. Heavy Duty Sewing Needle
1….. Heavy Duty Aluminum Foil [3 sq. ft.]
4….. Safety Pins #3-2″ [4]
1….. Pencil and Waterproof Note Paper [2 pcs.]

This is paired with the Adventure Med Ultralight .5 first aid kit
1….. Aloksak®
1….. Splinter Picker Tweezers
3….. Safety Pins
10…. Motrin (comes with 4, I added an additional 6)
2….. Antihistamine
2….. After Bite® Sting Relief
4….. 3X3 Sterile Dressings
4….. 2×2 Sterile Dressings
1….. Non-Adherent Sterile Dressing (3×4)
1….. Conforming Gauze Bandage
2….. Butterfly Closure Bandage
3….. After Cuts & Scrapes® Towelettes
4….. 1×3 Adhesive Bandage
2….. Knuckle Adhesive Bandage
1….. Tape ½” x 10 Yards
1….. Moleskin (7×4)
1….. Tincture of Benzoin
2….. Antibiotic Ointment)

I also added a small fixed blade knife (Mora), a survival blanket, and 35 ft of mil-spec 550 cord.

This is packed into a “Watchful Eye Design” 9×6 Splash Caddy.

Its not an amazing system, but I found that it has the most important items, for the most likely situations, that a solo backpacker is likely to encounter.

Trying to buy the parts individually (which can be done) often costs more than buying the kit, and it was my opinion that the items chosen for these factory kits were many/most of the same items I would choose for my own kit. So, why argue?

YMMV

[Summit CO]

Nice kits Dale and JR!

I found 1/2″ plastic first aid tape not so usefull… I’d probably rather have 5 yards of 1″ cloth tape than 10 yards of 1/2″.

Something you should ask yourselves: What do you plan to use to stabilize/support fractures and sprains?

ETA: 1 pair of nitrile/vinyl/latex gloves is really good to have if you every have to treat another person. Wet sticky fluids not belonging to you are no fun, neither are blood born pathogens .

[Jay McCombs]

I think its cool to have all that stuff but realistically do you think you’ll ever use it and if so will it do any good. For example the CPR mask. How long do you think you can assist ventillation vs. how long is it going to take to get help? If you can do effective CPR for more than about 5-10 minutes my hats off to you. I’m all for people having masks in their car, on their key chains, etc. but I question the value in the back country. Especially since most full arrests will be traumatic and the chance of surviving a traumatic full arrest is very nearly 0.

All the bandaging supplies are nice but extra clothing could just as easily be used. Even so you could get by w/.5-.25 of the stuff you’ve packed. Trauma sheers, etc, etc. I just don’t see the value. The reality is, beyond minor emergencies in the back country proximity to rescuers who can evacuate you is far more important.

[Dale Wambaugh]

“What do you plan to use to stabilize/support fractures and sprains?”

Bandanas, clothing parts (long sleeves and legs from silkweight base layers are great), fleece, insulated vest, belts and pack straps, sleeping pads, trekking poles or tent poles, sticks, water bladders, duct tape and pack frame sheets.

Once upon a time I had some extra large bandanas but I haven’t been able to find replacements. The usual ones aren’t big enough to use like a triangular bandage. I’ve seen a lot of synthetic scarves in thrift stores, but one of my primary uses for a bandana is for a pot holder and I’m not getting a synthetic scarf anywhere near an open flame.

[cary bertoncini]

I think in the high sierra cpr/ventillation after lightning strike could be useful, though I wouldn’t let lack of a face mask stop me from giving someone cpr ;)

[Dale Wambaugh]

Full CPR in the back country is problematic. If someone’s heart stops, they are going to need immediate professional medical care. CPR is great until the medics get there and defib and/or continue it on the way to the hospital, but you won’t sustain someone for hours with CPR or “restart” their heart. Regardless, I would still administer CPR. Rescue breathing is different. I do agree that a mask is more of a convenience, particularly if someone isn’t bleeding from the mouth.

Here is some interesting on CPR and EMS response from http://www.americanheart.org:

“Cardiopulmonary Resuscitation (CPR) Statistics

There are no reliable national statistics on CPR because no single agency collects information about how many people get CPR, how many don’t get it who need it, how many people are trained, etc. Many studies have examined CPR in specific communities. While they show varying rates of success, all are consistent in showing benefits from early CPR.

These statements are fair generalizations:

Early CPR and defibrillation (de-fib”rih-LA’shun) within the first 3–5 minutes after collapse, plus early advanced care can result in high (greater than 50 percent) long-term survival rates for witnessed ventricular fibrillation (ven-TRIK’u-ler fib”rih-LA’shun).
The value of early CPR by bystanders is that it can “buy time” by maintaining some blood flow to the heart and brain during cardiac arrest. Early bystander CPR is less helpful if EMS personnel equipped with a defibrillator arrive later than 8–12 minutes after the collapse.
Sudden cardiac death (S.C.D.)

Sudden cardiac death from coronary heart disease occurs over 900 times per day in the United States. The risk in adults is estimated to be about 1 per 1,000 adults 35 years of age and older per year.
Sudden cardiac death in the young (people less than 35 years old) is much less common than in adults, occurring in only 0.5 to 1 child per 100,000 per year.
A review of published studies that report initial heart rhythms during cardiac arrest in children indicates that the majority (40–90 percent) have asystole (a-SIS’to-le) or pulseless electrical activity when first evaluated. However, ventricular fibrillation or ventricular tachycardia (ven-TRIK’u-ler tak”eh-KAR’de-ah) is found in about 7–14 percent of all children in cardiac arrest in the prehospital setting.
Automated external defibrillators (AEDs)

AEDs are computerized devices that are now about the size of a laptop computer. They can be used by healthcare providers (such as Emergency Medical Response providers) and by lay rescuers. They are attached to victims who are thought to be in cardiac arrest, and they provide voice and visual prompts to lead rescuers through the steps of operation. AEDs analyze the victim’s heart rhythm, determine if a defibrillation shock is needed, then prompt the rescuer to “clear” the victim and deliver a shock.
Lay rescuer AED programs (also known as Public Access Defibrillation or PAD programs) train lay rescuers such as security guards, police and firefighters in CPR and use of an AED and equip the rescuers with automated external defibrillators (de-FIB’rih-la-torz).
The first out-of-hospital defibrillation device weighed 110 pounds; today they weigh less than 8 pounds.
Increased survival with CPR and AEDs

Studies have repeatedly shown the importance of immediate bystander CPR plus defibrillation within 3–5 minutes of collapse to improve survival from sudden VF cardiac arrest.
In cities such as Seattle, Washington, where CPR training is widespread and EMS response and time to defibrillation is short, the survival rate for witnessed VF cardiac arrest is about 30 percent.
In cities such as New York City, where few victiims receive bystander CPR and time to EMS response and defibrillation is longer, survival from sudden VF cardiac arrest averages 1–2 percent.
Some recent studies have documented the positive effect of lay rescuer AED programs in the community. These programs all ensure adequate training, and a planned response to ensure early recognition of cardiac arrest and EMS call, immediate bystander CPR, early defibrillation and early advanced care. Lay rescuer AED programs consisting of police in Rochester, Minn., security guards in Chicago’s O’Hare and Midway airports, and security guards in Las Vegas casinos have achieved 50–74 percent survival for adults with sudden, witnessed, VF cardiac arrest. These programs are thought to be successful because rescuers are trained to respond efficiently and all survivors receive immediate bystander CPR plus defibrillation within 3–5 minutes”

[J R]

“What do you plan to use to stabilize/support fractures and sprains?”

“Bandanas, clothing parts (long sleeves and legs from silkweight base layers are great), fleece, insulated vest, belts and pack straps, sleeping pads, trekking poles or tent poles, sticks, water bladders, duct tape and pack frame sheets.

Ditto.

At that level of response, especially for a solo backpacker going as light as possible, improvisation and multi-use of supplies is the name of the game.

I also occasionally carry (usually tied around my head or neck) an olive green military “tri-bandage” which is a large triangle of cloth what can be used for multiple purposes – however I find that to be a convinence mostly.

[Summit CO]

The Importance of Self Rescue vs Professional Rescue

As a member of a SAR team I know the importance of getting a professional rescue… but I also know the difficulty involved… sometimes SAR is busy with another mission. Sometimes it is too risky to deploy a team. Sometimes you are are beyond the ability of SAR to reach you easily. You should be prepared to effect as much self rescue as reasonably possible. If your self extrication fails you need to be able to hold out and stabilize until rescue can be effected by oustide parties. How long until they even know? Do you have a radio or phone? Are you in communication range? Will rescue not come until you are overdue? (hopefully you left an itinerary and check in times).

With good communications and helicopter deployment here, a SAR medic can be to you in 30 minutes! Can you help stabilize a yourself/a critical pt until then? What about an hour? What about a lot longer?

Is My Kit Extra Large?
You’ll notice that several items in my kit are removed depending on the activity. My proclivity towards higher risk act ivies and my involvement with SAR is the major reason that I have a significant trauma component to my first aid kit. If all I did was class 2 and occasional class 3 summits and trails, I’d carry significantly less. That is all a lot of people do and they are happy and nay not need the beefier trauma compenent.

Trauma sheers are very rare… usually only come along for SAR, kayaking, maybe BC skiing.
Pocket mask/OPAs come along only for SAR, BC skiing, kayaking, extended trips above treeline in the summer.
SAM splints comes along only for activities where extremity injury is likely and improvisation would be troublesome: SAR, BC skiing with snowboarders present, longer treks with heavy packs, going solo.
Coban is so usefull and multipurpose… especially if you have to do wound care/check circulation on the immobilized area! It is also better than anything else for strengthening and supporting an ankle/knee/wrist/elbow while still leaving it mobile.

The rest of the trauma kit is multiuse and light probably even to a gram counter (I’m an ounce counter). I prefer not to improvise trauma dressings from my probably otherwise needed and often pricey clothing. However, I’ll be more than happy to tear up the patient’s clothing as needed.

Bandaids because infections suck and they reduce pain and further injury, speed healing, etc.

Meds/packets are extremely small and extremely light even to a gram counter… and then you consider the great relief and use they can deliver especially from such a small package.

As for the need for CPR/Barriers… rescue breathing

Here are just a few backcountry maladies off the top of my head that could require rescue breathing: progressive phase of most types of shock, closed head injuries, lighting strike victims, near drownings, near suffocations, severe asthma, severe anaphylaxis, severe hypothermia, certain c-spine injuries, some seizures, HAPE, HACE, severe smoke inhalation, temporary airway obstruction combined with unconsciousness, etc etc etc…

Those are some pretty darn good reasons to carry a CPR barrier. If I find you on the trail and you aren’t breathing, you probably aren’t going to get any more than two rescue breaths from me unless I have barrier or mask (unless I know you and like you a lot). If you already have blood/vomit on you, I might not give you 2 rescue breaths. I don’t intend to catch a life long, possibly fatal disease trying to save you. Also, the thought of someone puking down my throat while I breath for them is somewhat unappealing. So, I carry an extremely small/light barrier at all times. I carry a mask when the risks are higher.

You’ll want a barrier when you consider that without one, statistically, the chance of exposing yourself to disease is about equal to the chance of saving their life.

The same theory is behind having a pair of gloves. I’m not touching your blood/vomit/feces/urine with my bare hands.

Backcountry CPR
As for CPR in the backcountry, it all depends on what happened to them. Not all arrests are from blunt trauma (which has a near zero save rate). Most avalanche fatalities are suffocation/CO2 toxicity (then trauma, then hypothermia). I have a friend who performed CPR for 45 minutes on one of his friends who bought it in a slide. Most river deaths are drownings. Two weeks ago, we had a guy fall into a lake and drowned during an MI! I would imagine most mountaineering deaths are hypothermia and shock followed by massive blunt trauma. Backpacking? I have no stats but I’d wager MI, hypothermia, and shock are at the top. The Wilderness Medical Society protocol for wilderness CPR is 30 minutes, less if provider will be endangered.

[J R]

Well, sounds like you got your gear figured out in accordance with your likes and wants and needs.

Your talking plenty about stabalizing people and so on and so forth… but if someone is solo and not breathing, they are NOT going to be effecting “self rescue” anytime soon. If someone is bleeding so bad they cant wait 30 minutes for SAR to come pick them up, then they have bigger problems than keeping their t-shirts clean and in one piece. And theres lots of anti-biotics out there that you can slather between the cut and the wrap to get home. If your really worried about it after that, go get a shot of penicillian.

[Dane Burke]

Summit CO wrote: “If I find you on the trail and you aren’t breathing, you probably aren’t going to get any more than two rescue breaths from me unless I have barrier or mask (unless I know you and like you a lot). If you already have blood/vomit on you, I might not give you 2 rescue breaths. I don’t intend to catch a life long, possibly fatal disease trying to save you. Also, the thought of someone puking down my throat while I breath for them is somewhat unappealing.”

That sounds like grounds for a negligence lawsuit to me. Also keep in mind that if you begin to provide care you are legally required to continue…ie if the patient starts vomiting during CPR you can’t just stop. Sounds like a good case for carrying a CPR barrier, right?

Interestingly, the national EMT-B textbook states “there are no documented cases of disease transmission to rescuers as a result of performing unprotected mouth-to-mouth resuscitation on a patient with an infection”.

I consider a CPR barrier invaluable in any situation requiring rescue breaths, but the chances of actually needing one in the wilderness is practically zero. What are the odds of having to perform CPR on some one in your day to day life…one in a million? How about on the trail, when you see much fewer people (potential victims) than in the city…one in a billion?

Sure if you’re on a SAR call you’d better bring BSI equipment, but otherwise it’s only there for your mental comfort…to satisfy the “what if..?” part of your brain.

[Author]

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