First Aid Kit and a bit more…

I've had several first aid instructors tell me that a standard red nylon open-like-a-book first aid kit is pretty smart. You can quickly zip it open, and then everything is visible there right in front of you. It is unnecessary to dump everything out on the ground. Along those lines, I have one large one (for groups) and one small one.

The nylon kit protects your first aid items from weather and wear. Most of the commercial kits are constructed to be heavy-duty, but you could probably make your own out of lighter weight materials.

–B.G.–

Medical authorities are agreed that the Sawyer Extractor is not only a waste of time but actually injures tissue (blood vessel walls are rapidly weakened by the venom). I'm really surprised that that your first aid class suggested it; the one I took 1 1/2 years ago said absolutely not–as does my son-in-law the ER physician (who did his residency in southern California and treated lots of snake bites).

The size of the first aid kit really depends on the size of the party. For a large party (greater chance of someone's getting injured) you'd want most or all of this stuff. For one or two people, probably not. The class I took demonstrated how many of these items can be improvised from what's at hand (for example, irrigation syringe and/or gloves from plastic bags, etc.).

You have a nice list but some things may not be required. I'd suggest you take a look at Mike Clellands! YouTube page and the Dinky Stuff/First Aid videos as well as Steve Greens' page (Only the Lightest) and especially video 27. The more you research, the more neat stuff you'll find. But you just gotta ask yourself if you can or will need most of it. I just made a new FAK with some survival stuff in it and it is not quite finished but will be between 6-7 ounces including a .8 ounce Leatherman style multi-tool with scissors. I took a lot of tips from this website and those I noted above. In my opinion, everybody should have their own, but if you are in a large party or with unfamiliar campers, you may need a few more things or just more of the same that you already carry. For example, I take 10 of aspirin/ibuprofen/benedryl and though that's probably over kill for me, it is very very light and I can share if someone else needs. Hope this helps.

Fisher Space pen cartridges do not freeze. I carry a bullet pen. They come in other configurations or you can retrofit other pen types to take a Fisher cartridge.

ETA: I removed the wrist strap from my watch and attached it to my pack strap with a bit of omnitape. I can check it easily but don't have to wear it.

Many of us that have taken WFA classes have REDUCED the size of our kits because we know how to improvise instead of taking specialized items. Now if you're talking going with a large group, you'd likely take a larger kit since you might be the default "medic" and there's greater chance of injury with more people. Otherwise, what would expect to come across that you wouldn't be prepared for in your solo kit?

…

The difficulty with FAKs is the "what if" factor, and how risk adverse a person is. The other part is the kind of activity. Backpacking, mountaineering, or climbing present different risks, IMO.

For over 30 years I carried a rather large FAK in a nylon zip bag. A few years ago I got rid of everything I never used, and then reduced the quantity based on what I had used in the past. Also, I usually hike alone. If I hike with someone else, then their FAK is their responsibility. The end result is rather minimal, about 1 ounce for a trip of up to 1 week.

Disclaimer: I am first aid/cpr certified, but have never taken a wilderness first responder course

One thing I did when pairing down my FAK was considering the possibility that I would actually need to care for more than one person, and if I did, it is likely someone else will also have a FAK. Also, how long do I really think I'll need to take care of that person. If there is an emergency we are heading for the closest trailhead/ranger station/civilization. Most likely that would equate to a day at most, usually less.

With the above mentality, you can at least cut down on the amount of items you take.

For example:

4×4 gauze pad – Do you need 3? Take 1 and use cloths if you come across a wound larger than that. At that point you're likely to have bigger concerns than sterility, and once you're out of the woods so to speak, you'll have plenty of wound cleaning and antibiotics available. Cut the single in half for long cuts/gashes.

3" roller bandage – do you need the whole role? Use one to treat a hypothetical wound, add a little extra and cut it off. Re-roll it and re-package

Irrigation syringe – use water bladder hose, water in a ziplock with a pinhole?

Athletic tape – Again, do you need a whole roll? Take some off and re-roll it like you would duct tape.

Cravat – A 36×36 silk bandana is the exact size of a triangle bandage when folded on the diagonal. It is also multi purpose. Pot holder, rag, dust mask, sun block for neck, etc.

Scissors – Don't you carry a knife already? A light fixed blade could also come in handy if you need to cut poles for a stretcher, make a crutch, make a replacement tent stake…

Antibiotic cream – I prefer several single serve packs to a single tube. This item is likely to get used the most for minor cuts, etc. The aluminum foil packs probably weigh less than a tube, and you can replace what you use instead of carrying a half used tube. Also, use a double antibiotic instead of triple as some people are allergic to neomycin which causes a reddening around the wound that could be misdiagnosed as an infection.

Latex gloves – Again, multiple pairs? This isn't an urban disaster you're responding to. 1 pair should suffice, and use nitrile as some people are allergic to latex. Nitrile is stronger too.

Sawyer extractor – Get rid of it.

Thermometer – get rid of it.

3mm cord – If you already carry some spare cord, or you have cord for hanging your food, then you don't need this, it is redundant.

Again, this is just my opinion based on my mind-frame and some things I've been told by doctors and emergency personnel. I'm no doctor.

4×4 sterile gauze pads 3ea / Why 3 of these? They're not very absorbent.
3" gauze roller bandage 1ea /Ditch this, you have an elastic bandage.
bandaids (various sizes) small zip lock /How many? Put them with the gloves
60cc irrigation syringe 1ea /That's a BIG syringe. Great for a pulmonary embolism, but I don't see a needle to match. Maybe go to a 20ml, and refill it a couple of times
1" athletic tape 1 roll /I like this too
elastic/compression bandage 1ea /Chances are the one you have is useless, esp if it's pink. I REALLY like the SETOPRESS 10cm (4") lymphatic compression one.
cravats 1ea /Is this a triangular bandage? Not a big fan, but add safety pins if you keep it. In fact add safety pins anyway
moleskin 1sheet /You have athletic tape. Ditch this.
folding scissors 1ea /I'd prefer a SAK. Or the scissors from a SAK card
povidone iodine 1oz (does this freeze) /Not sure about the next three. This has a short shelf life, so I tend to take Medipulv powder. Can't use the Medipulv to prevent BO though!
Single antibiotic cream 1 tube (does this freeze)
single cortizone cream 1 tube (does this freeze)
latex gloves several pairs in small zip lock /I prefer nitrile. They're tougher, but not as stretchy. I don't normally plan on doing (complex) surgery on the trail though. I take three singles, just in case one breaks. They're to protect me, not the accidentee, so if there's eight casualties, I'll wipe my gloves clean on the first one's pants before going to the next one. They make great washing up gloves when it's cold.
signal mirror 1ea /I like this. Never seen a helicopter find a lost person yet. This would help
sawyer extractor bit kit 1ea /Never read any peer reviewed article that shows these work. Seen a few that say they don't. Not suitable for adders.
thermometer 1ea (in a protective case, should this be mercury or mechanical) /Not sure how this will change your treatment, unless it's a low reading one for hypothermia. Remember, for hypothermia, it goes in the butt. Never stick a low reading thermometer in your own mouth……you just never know.
various over the counter meds small zip lock /Supermarket, not pharmacy meds.
3 mm cord 15' /Not sure why this is in the FAK
SOAP notes 2copies /I think you'd probably do better with an assessment prompt sheet, to remind you what to check, and how often. Instructors make this look easy, but they've done it a lot.
mechanical pencil /I like a 2" pencil stub, or a mini Sharpy. That way you can write details on their expensive Goretex jacket before the chopper carries them away.
watch (I absolutely hate wearing a watch so is it ok to leave this in the first aid kit and check the batter every so ofter or should I get over my hatred of jewlery and just start wearing one) /Your choice on this one.

Mary, Good point, he didn't actually discuss extracting any poison at all, that must have been a carry over in our booklet that just needs to be deleted.

Spelt, I like the idea of sewing the watch to the pack. I am going to have to give that some thought. I would have to leave the strap on it because there could be a time when I need it on my person instead of my pack.

Michael, My main possibility for use of this kit, and the reason I took the class, would be in larger groups as 1 of 2 instructors with 8-12 students for a winter mountaineering school. I understand improvising and as my knowledge grows my kit will change. I see this as an initial first aid kit to help me through realistically cuts, sprains, and minor health issues. I still do need to be prepared in the instructor setting for more sever situations. Sorry I should have stated that in the beginning.

Mike, Thanks that is great, I am not comfortable with prescription medicine, and handing it out to victims at this point. Our instructor recommended the same thing, as well as an eppy pin. I don't have a regular physician, so I think that could be problematic, but I am also just not comfortable with that now. I could see in the future when I have more confidence in the situations I am most likely to come across adding prescription medication. I like the dry sack good addition thanks.

Rod and Nick, thanks these comments help a lot.

I have updated the list up top.

It is, I was told in my WFA class, illegal to dispense any meds, even OTC meds, to others if you are not a licensed medical professional. People who need epi pens need to bring their own. Epi pens can cause severe heart problems in older people, another reason you shouldn't try to use them on someone who doesn't have one of his/her own.

Being a Full Time Paramedic for over 30 years I can tell you you will never use some of that stuff. Lose the 60 cc syringe and get a 10 cc if you absolutely need one or go lt wt and use a ziploc with a hole poke in it. Most of the time you will be using bandaids and moleskin for large groups. I know that from being a Boy Scout leader since 1989. In fact you will use more meds than anything else. My wife and I use a lot of tylenol and motrin on trips. Get the antibiotic ointment in the small foil packets instead of tubes. Another item you may want to get is some steristrips and tincture of benzoin ampules for cuts that need to be closed up. They work like a butterfly but stay on a lot better. If you want something to use for large cuts to soak up the blood get 5×9 dressings or cheap route- kotex pads. I agree with what Nick said on his suggestions too.

Mary over the counter drugs are illegal to give to others, however if you speak with a physician and they prescribe a stronger pain killer, or an eppy pen for you to distribute per the directions they give you that is legal. Only in a situation in which you are trained. So for us, wilderness first aid is considered more than one hour from a hospital in the wild.

Doug thanks, you are second to recommend tincture of benzoin, that must be the wonder drug for feet.

Dispensing prescription drugs is illegal if not licensed, but sharing tylenol (an OTC drug) is not illegal. You should not encourage a higher dose of any OTC medication than that on the label.

And here's what's in mine:
Materials
benzoin tincture
2 non-stick Telfa pads
4 tiny pouches antibiotic ointment
6 steri-strips
1 roll athletic tape
1 roll 3M Durapore (cloth tape, more versatile than bandaids)

Meds
ibuprofen
pepto
benadryl
sudafed
meclizine
claritin and allergy eyedrops (during allergy season only)

Crossover from hygiene kit
mirror
tweezers
soap
antiseptic wipes
vaseline
cortisone cream (I have chronic eczema, so this goes wherever I do, but it's also good for generic skin inflammations)

Other
Knife and scissors (on multitool)
Large (36"x36") bandana

I am not wilderness first aid trained, I have generic first aid, CPR, AED, and whatever I picked up in life guarding classes.

For emergencies, my training has always been focused around keeping people alive and preventing further damage until help arrives. With that said, the basics I do know are not concerned with sterility. Elevation and pressure don't require a first aid kit. While head and neck injuries are possible on the AT, I don't think anyone would recommend carrying a full backboard at all times. Or an AED for that matter. CPR weighs nothing. The biggest benefit I've seen from all first aid/emergency training is the ability to take a deep breath and conquer the panic.

With that in mind here is my kit:

Emergency:
Cellphone/whistle (call for help)

"Boo Boos:"
band aids
advil
neosporin
cortizone (bug bites)
duct tape (break, sprain, gashes, or just plain blisters)
Disposable thermometer (check for fever and hypothermia)
immodium
antacids

There is an added danger on the AT from any injury that immobilizes the victim, in that exposure and shock are more dangerous than the injury itself. Even on a day hike, carrying enough clothing too keep yourself warm without moving (and spend the night if really needed) is my standard. Yes my winter day pack can weigh more than my summer overnight if it's wicked cold. Whenever I go out I ask myself "If things go wrong and I can't move, will I be alive when a search party (or another hiker) finds me?" So on an empty trail, or in the winter, I keep a tighter "call by" time with whoever I left my itinerary with.

Edited to add a conclusion:

I sort injuries into two types "I've got this" and "You're gonna need a real doctor." I feel that having a beefy first aid kit can push people into treating things they are not qualified to treat, and adding danger by making people think they don't need a doctor as long as they can limp their way out of the woods. Even if you give someone stitches they should still see a professional ASAP and that means bailing out, not "finishing the trip."

…

Burns are somewhat common.
I always carry this for burns:

http://www.google.com/products/catalog?hl=en&q=2nd+skin&gs_upl=2096l2800l0l3755l8l5l0l0l0l0l274l1133l0.1.4l5l0&bav=on.2,or.r_gc.r_pw.,cf.osb&biw=1213&bih=888&wrapid=tlif132319698738110&um=1&ie=UTF-8&tbm=shop&cid=5954359950722858177&sa=X&ei=PmLeTvqOGoyEtgfiwJWvBg&ved=0CIwBEPMCMAI#

(Sorry, couldn't get the link to work)

Works amazingly well.

"Dispensing prescription drugs is illegal if not licensed, but sharing tylenol (an OTC drug) is not illegal. You should not encourage a higher dose of any OTC medication than that on the label."

John I think that is the exact opposite as I was just taught this weekend. I will double check my notes. The reasoning I believe is that with a doctors permision and direction you can give out x medicine at x dosage. I guess they could say over the counters at x dosage are ok.

"burns are somewhat common.
I always carry this for burns.

Works amazingly well"

WHAT works amazingly well Larry ?!

Sorry, couldn't get the link to work. Here is the URL:

http://www.google.com/products/catalog?hl=en&q=2nd+skin&gs_upl=2096l2800l0l3755l8l5l0l0l0l0l274l1133l0.1.4l5l0&bav=on.2,or.r_gc.r_pw.,cf.osb&biw=1213&bih=888&wrapid=tlif132319698738110&um=1&ie=UTF-8&tbm=shop&cid=5954359950722858177&sa=X&ei=PmLeTvqOGoyEtgfiwJWvBg&ved=0CIwBEPMCMAI#

Jeremy, so they told you that you could give everyone prescriptions but not tyelenol?..lol. What state was the course in? They may have misquoted you.

My wilderness first responder latest edition states just what I said…that you CAN share OTC meds but you CANNOT share prescriptions. Sierra Club leaders (at least in Dallas) are asked to give NOTHING to NOBODY.

I just read closely what Buck Tilton wrote in his latest edition WFR book, 3rd ed. On page 256 he has a note that reads, "The administration of any drug falls outside the scope of practice for Wilderness First Responder. These drugs are recommendations to discuss with your personal physician." Then a few sentences later he states, "Administering nonprescription medications, such as diphenhydramine and ibuprofen, at their recommended doses, is a lawful, and if used wisely, acceptable practice."

So, Buck is giving conflicting advice or there is a typo in his book. He should have added the word "prescription" in his NOTE or he is using the word "drug" to mean prescription meds. Either way, it's not clear in his book what he means exactly. I fault his editor.

Would be interesting if someone like Dean Fellenbaum posted what they take on a solo trip.

I can't find anything about prescription or nonprescription drugs in my booklet. I did find a reference to where I wrote down "if possible concussion don't give any meds" Maybe I misunderstood giving out OTH meds. I don't see the harm in giving an adult tylonol or advil if they acknowledge that they have taken it hundreds of times in their life and just ran out or forgot it.

I do, absolutely remember the talk about getting a prescription for a more advanced pain killer or eppy pens, because our instructor was very careful not to recommend a specific pain killer other than to say go see your doctor about what drug to carry and what the dose should be… I have no interest in carrying meds other than the basic over the counter stuff so I let it go in one ear and out the other. There was WAY too much other information I was trying to retain.

The class was in New Jersey by the way. Could be the problem, most backwards state I have ever lived in.