What do you carry for First Aid?

[Max Dilthey]

I'm sure I'm not the only one. I bought a backpacking lightweight first aid kit, threw it in my bag, and never thought about it again. I always have it, but I don't question it.

What exactly is in your First Aid Kit for an extended trip? I want to go through mine, take out stuff I'll never use, and add more of what I might need often. However, not sure exactly what to bring.

-Do I really need insect sting stuff?
-How well does Celox powder work? Should I bring a lot?
-Is medical tape any more useful than duct tape?

Thanks!
-M

[Jake D]

advil is in the white/blue tube, moleskin sheets and tiny 2" scissors not pictured but included. this year i'm exchanging the triangle bandage for a 3" ace bandage as it can be used for more things.

Celox aka quickclot i'm pretty sure works pretty well but burns like crazy from what i've heard.. i'd only use it if elevation and pressure aren't doing it.

White athletic tape can be useful. that plasticy "medical" tape is useless as it doesn't stick very well.

[Adam Rothermich]

Mine is also pretty basic. The things I use the most are bandaids, moleskin, and Tylenol. My wife is allergic to ibuprofen, which is what I used to carry.

In addition to that stuff I carry some Benadryl, athletic tape, a couple different sized dressings, a pencil and some paper, a tiny pair of scissors, and some gear repair stuff; needle and thread, duct tape, safety pins. I also carry an Epipen because I'm allergic to sunflower seeds. When I pack my own food its not a problem but its best to be prepared. And on longer trips or when hiking with a group I throw in an Ace wrap and a pair of nitrile gloves.

Take a look through your kit and see what you actually know how to use. I've seen suture kits in some of them, personally I wouldn't be able to use it so I wouldn't carry it. I think the insect sting stuff is more to make the pain tolerable, not to treat any other symptoms.

Adam

[A W]

no krazy glue?

[David Thomas]

I concur not only that if you don't know how to use Xxxx (such as sutures), then leave it home, but would also point out that ou usually shouldn't suture in the field (this from my wife, an MD). Since you can't properly prepare and clean the wound, it's not ready for suturing and suturing is fine to wait a few days will they're at the hospital. Close it up, physically, to minimize bleeding and further contamination, but there's no need to being going all Rambo on your hiking companions, cool though it may seem.

Back to the OP's Q:

I go pretty darn light. Mostly my first aid kit is in my head – how to diagnose the problem and then find a solution with the materials at hand. You can sterilize a cloth in boiling water although bright sunlight would do a lot (or hot wire your steripen!). You also have to improvise on the big, important, life- and limb-saving stuff anyway. You're not going to have a traction splint for broken femur or even a good splint for broken arm unless you know how to use your hiking poles to crate traction on the leg and your inflatable sleeping pad to make an air splint.

Take a wilderness first aid class that includes AT LEAST two practical sessions – victims with scripts, helpful with make up on as well. You will feel like you've been through the wringer, but you'll also be much more ready when something bad does happen. I'd have students bring their packs packed for a normal trip and THAT was what they had to use to treat the injuries and illnesses they encountered.

a bandaid or two, some adhesive knit (for friction) and moleskin (for pressure points). Benadryl (and knowing when to use it) is probably the single most useful drug (hives, sleep-inducer, reducing nasal congestion,anaphylactic shock, etc. Some NSAIDs Some Imodium if they have the runs and some Ex-Lax if they need to.

We "packed for bear" on a private Colorado River trip. Serious drugs, fast-clotting dressings, sutures, hypos, I think there were two IV set-ups. And two MDs. Partly that was figuring that in addition to our 16 people for 16 days, we might encounter other parties with older, sicker or less well prepared people and we (especially the two MDs) would feel horrible not being able to help out more. The biggest issue was jock-itch-of-the-chest due to wearing wet clothes and life jackets in warm weather for 12 hours a day. To others, I'd recommend a little more topless sunbathing to let the UV in sunlight beat down the fungus.

Edited to add: First aid tape? Just wrap duct tape around your water bottle. It will "manscape" you when you remove it, but you won't do that until you're back in town. A fair number of hunters up here just bring duct tape and super glue to be used as a bandaids and sutures. And other repairs as needed.

[Michael Ray]

My wife is an RN +CPR/First Aid instructor, which means she insists on making my first aid kit and the resulting weight is about 2 pounds too heavy. I indulge her and pack it, and pull out everything but the bare essentials once I'm at the trailhead.

Alcohol wipes
Some bandaids
Bacitracin
Ibuprofen/Aspirin
tweezers
Blister care

[Eric Lundquist]

Jacob's blog has a pretty good write-up on what he carries in his kit.

Hike It. Like It.

Mine's fairly similar with the following additions.
– A small needleless syringe for wound and/or eye irrigation.
– Some prescription based pain killers (Tylenol 3).
– Emergency stash water purification tablets (About 3 tabs I think).
– Elastic Bandage wrap.

[Bob Gross]

A personal first aid kit is kind of personal. Everybody's should be a little different and even change a little from time to time. You really need to think about this.

1. Everybody goes to different places, so there are different risks, so the first aid kits are different. Somebody in Alaska might need to do first aid for a brown bear mauling. The guy in Florida doesn't need that. The person in Arizona might need to prepare for snakebite, and the one in Alaska doesn't need that. The guy climbing Denali doesn't need most of that, but he does need things specific for cold, burns, and blisters. Go to a third-world country like Nepal, and you better be able to self-administer treatment for waterborne illnesses. Some people are on trails and have one set of risks. Others are off trails and have a deeper set of risks.
2. Everybody has a different concept of what a first aid kit should contain. Some people load it up with chapstick, sun cream, water treatment, and stuff, and those really aren't for first aid. Some want their first aid kit to contain only enough stuff to keep a victim alive, and very little more. Some people don't even put bandaids in their kit, because they know that a wound small enough to be covered by a bandaid probably isn't large enough to kill you. Of course, if the wound gets severely infected, the story changes. Some people know that they get ankle sprains, so they better have a good elastic wrap to bind that up.
3. Some backpackers go out for only two or three days, so they do not pack long-term remedies. They figure that they will be back to civilization soon to get some care there. The backpacker who is out solo for a week or two at a time needs to think about long-term remedies. Antibacterial ointments come to mind.
4. One of the standard backpacker injuries happens when the backpacker is attempting to step over a tree across the trail, and he manages to impale his leg on a jagged branch sticking out of the trunk. I've never done that, but I've seen others do it. How would you treat that? If the wound is deep, there is a risk of bad infection.

A friend of mine was going out solo into the Sierra Nevada Range for more than one week. He was postholing through some late snow, punched through into a hole, and tore up his leg with a deep gash. Once he got the bleeding stopped (you did bring some sterile gauze, didn't you?) and the wound cleaned out with drinking water, he did temporary suturing with his ordinary needle and thread. By the time he got to a doctor over one week later, the doctor checked his work and approved. Many backpackers could not have done that.

Personally, I carry only about one yard of duct tape, and it is more for gear repair than for first aid. I've found some medical tape and some athletic tape that I really like. Pills can be good, and they don't weigh much.

I was trekking in Nepal, and I was up around 14,000 feet when I sustained a painful muscle injury in my diaphragm. Fortunately, I had some prescription-strength painkillers, and that got me through the next day or two.

–B.G.–

[David Thomas]

>"I was trekking in Nepal, and I was up around 14,000 feet when I sustained a painful muscle injury in my diaphragm. Fortunately, I had some prescription-strength painkillers, and that got me through the next day or two."

My wife broke her arm in Nepal, at 16,000 feet and hiked out in 2 days on OTC Ibuprofen. But then, she's tougher than I am.

Beats 10,000 years ago, when you'd only have some willow-bark tea to take the edge off.

[Bob Gross]

"My wife broke her arm in Nepal, at 16,000 feet and hiked out in 2 days on OTC Ibuprofen."

You could have offered to carry her out.

Of course, maybe that is how she broke her arm in the first place.

–B.G.–

[Max Dilthey]

When I was bike touring, I spent 30 days with a first aid kit. I used about 10-15 tablets of Aleve between myself and my two travel partners, and that's it. I fell three times and scraped up my elbow, both knees, my hip, my calves, etc. Each time I just ignored the road rash. I also got Poison Ivy and literally hundreds of insect bites, and ignored that as well. So I think my tolerance is high enough to ditch thinks like insect sting treatment. I'm going to put a couple of tabs of Benadryl in and learn how to use it.

I'm going to take out the Celox powder; I'd rather just keep wounds elevated and cover them well.

After hearing about impaling on a branch, I'm adding in an ACE medical bandage because I have been injured by branches before; that seems like something I can reasonably prepare for. It would be useful to know what the best way to prevent infection would be. I already carry a needle-less syringe for my Sawyer, so I can irrigate a wound, but other than getting sterile gauze over the deep wound, should I coat the edges in Neosporin or something?

I'm also adding wound closure strips, since I don't want to give myself stitches in the field. I feel, personally, that I could, but I wouldn't want to when wound closure strips will likely do the job.

I wonder, is there a spray-on or rub-on ointment that kills bacterial infections and fungus? For particularly nasty wounds. I never, ever, ever want to get a blood infection out in the wild.

[Max Dilthey]

Scratch my medical questions. I'm just going to invest in a Wilderness Survival course this spring. This isn't the place to get a crash course in treating serious injuries.

So far, I travel with people who know advanced first aid. I'm never out far from home without some knowledge in our group.

[Jeremy and Angela]

Here are some items you might not have run across; I pack one or two each for messier wounds or burns.
– Steri-strips (alternative to sutures)
– hydrogel pads (burn dressing)
– transparent semi-permeable dressings
I also tuck in a pair of gloves, some gauze, and an irrigation syringe. I've never tried/used insect sting stuff; I have a general policy of not waving at stinging insects.

I'll second the recommendation for taking a class. The easiest way is probably through your local REI; they partner with WMI to offer them on a fairly regular basis.

re: hemostatic agents:
The older forms often caused burns and the powder was difficult to remove from wounds. You will probably only need something like this if you nick an artery. If you must carry it, I suggest a modern variant that doesn't have the burning/mess issues (e.g. QuikClot Combat Gauze).

[CW]

I carry a blister kit, a few ibuprofen, a few acetaminophen, a few loperamide, and some steristrips. Few = varying amounts depending on trip length.

The only time I carry more is on guided trips as part of a group kit.

I did carry a larger personal kit before I became a WFR, but paired it way down after learning to improvise with what I already had.

[Bob Gross]

"I'm just going to invest in a Wilderness Survival course this spring."

Most of the time, the survival courses deal with keeping yourself alive without any injuries.

If you really want to learn first aid for the wilderness, then take the Wilderness First Responder class. It gets pretty intense.

–B.G.–

[Max Dilthey]

Thanks Bob, that's actually what I meant. Whoops!

[CW]

If you don't want to spend the extra money, aren't leading groups, aren't on a SAR team, etc., WFA is quite sufficient for most people.

[Roger Caffin]

Contents, in order of importance:
Knowledge
Training
Experience (harder to get)
Bandaids (6-8)
Micropore tape or equivalent
Toilet paper
Clean handkerchief
Butesan Picrate (burn cream, a few grams)
BFI (Bismuth Formic Iodide, maternity antiseptic dusting powder, a few grams)
Fabric torn off a shirt or other
2-3 safety pins
Mobile phone

Cheers

[Bean]

I think mine is probably lacking in a few areas. I use to carry a lot more, but so far I haven't needed much else and dropped a bunch of stuff.

For a trip over a week with no easy bailouts, I usually carry something like this:

*Leukotape – (also for gear repair)
*Tincture of Benzoin – (in old Visine bottle)
*Zinc Oxide cream -(Andromocao)
*Second Skin burn pads
*Sterile pads -(2)
*Mole skin – (thick and thin)
*Alcohol swabs -(4-6)
*Alcohol wipe -(2)
*Anti-diarrhea pills -(2 days)
*Advil Cold & Sinus Caplet -(2 days)
*Ibuprofen -(enough for daily max use if at altitude)
*Little bottle of a few left over Vicodin, Hydrocodone and Tramadol

Part of that kit, but kept elsewhere:

*Style Leatherman with scissors and tweezers.
*Biodegradable liquid soap
*Alcohol for stove (if I'm using an alcohol stove)

A lot of the "medication" I carry primarily if going with my girlfriend, as offering her pills of some sort will usually keep her happy when something is ailing her that we can't do a lot about at the time. I've also learned to pack a couple tampons just in case she miscalculates her needs or when Aunt Flow is coming for a visit. I've had to dig into this reserve more often than you'd think.

So, if you run into me and need first aid treatment, I'll probably just offer you a pill of some kind and be of little use beyond that.

[Bob Gross]

Once about 35 years ago, I took a standard first aid class to prepare to become a Sierra Club trip leader. The instructor was also a backpacker, so he taught us some relevant stuff. Through the class, he kept telling us to put this or that into our first aid kit. At the end of the class, we asked him for a comprehensive list of what really belongs in a group first aid kit for a small group going out on a backpacking trip for several days. He told us that it would be unlikely that we could find a commercial kit that had all of the right stuff, or if we did, the kit would be expensive. So, we each chipped in some bucks, and the instructor went to the medical supply house and purchased stuff in bulk quantities to make it cheaper. We cut up some old bed sheets to make our own slings and things.

Now, those kits were good, but that was 35 years ago. Nowadays, the ultralight backpacker can probably get by with 10% of the weight of what we had back then. Still, some stuff will go stale after a while, so you need to maintain your kit periodically. Even aspirin goes stale.

–B.G.–

[David Thomas]

When I do bring prescription drugs and creams, I love professional samples. It helps that I live with an MD, but when you or a loved one goes to the GP, Dermatologist, etc, they can ask, "my husband/wife/father is a backpacker and would really appreciate the smallest tube of anti-fungal / cortisone / antibiotic / cream you could recommend". The samples are (1) free to them, (2) free to you (they aren't pharmacists, they can't sell it) (3) always the newest stuff (still on patent with a high mark-up), (4) labelled, unlike some plastic straw you've heat-welded shut, and (5) really tiny – 1 to 2 grams of cream.

Even if you're not sleeping with a physician (and before I was), I found I could present a reasonable, small-quanity list to an provider (like from the appendix in "Medicine for Mountaineers" – xerox it, reduce the quantities, and legible cross off the narcotics) and get scripts to take to the drug store. Crossing off the narcotics will immediately elevate you in their mind to someone reasonable, because – good grief! – half the calls that wake me and my wife from bed are some addict claiming, "the dog ate my Oxycontin". Instead, tell them you think for reasons of safety, theft, and international borders, you don't want narcotics but ask them to advise you on the safe upper limits of over-the-counter NSAIDs.

>" I've also learned to pack a couple tampons"

30 years ago, I was driving with three lesbian friends into Boston for a Lily Tomlin show. On MassPike with no stores around, one says, "Ooh!, Does anyone have a tampon?" and another says, "Ahhhhh, no, but I think I need one, too." And I open my glovebox and take out half a dozen. It takes a few minutes for anyone to comment how weird it was that only the guy was prepared, but I pointed out that the emotional angst of 28 days prior made it REALLY easy for me to remember.

Which reminds me: a condom. It makes a handy one-fingered glove to remove an impacted stool. It also is excellent for preventing the original, sexually-transmitted disease – pregnancy (for those trips you might be making with straight women).

[Mike W]

>> Some people don't even put bandaids in their kit, because they know that a wound small enough to be covered by a bandaid probably isn't large enough to kill you. Of course, if the wound gets severely infected, the story changes. <<

I've learned the hard way with both of these… not enough bandaids and a small cut that went bad quickly.

I have started packing a lot of bandaids after a bad encounter with barnacles on a week long trip. Barnacle cuts can become infected really easily so I covered them with bandaids and antibiotic ointment but I ran out of bandaids on the first application (multiple lacerations). I ended up having to cut up duct tape and a gauze pad and make my own bandaids… it worked out OK but when you figure that a bunch of bandaids weigh next to nothing, it was a real hassle to have to improvise.

I also carry antibiotics with me so that I can treat infections caused by cuts and blisters. I once had a small cut on my shin turn bad on a 4 day trip and couldn't believe how fast the infection took hold. On the last day of my trip I could hardly get my shoe on because the infection had caused my foot to swell. If I'd been out any longer I would have been in serious trouble.

[Bean]

>>I ended up having to cut up duct tape and a gauze pad and make my own bandaids… it worked out OK but when you figure that a bunch of bandaids weigh next to nothing, it was a real hassle to have to improvise.<<

I don't know if it was the most researched move on my part, but something maybe to look into if you're using a lot of bandaids.

I dumped bandaids because I really liked the "bandaids" I made with Leukotape and gauze pads, and I believe the zinc oxide adhesive they use on Leukotape should have antiseptic qualities. Actually, I don't even bother with the gauze, but just slap the tape on as my bandaid.

Added bonus, is Leukotape so far has proven more durable for my gear repair than duct tape. So, I stopped carrying duct tape and bandaids. Although, I've yet to try and patch anything holding water or air with it, so I can't really testify to how it might patch somebodies leaking air mattress. I've so far only used it to patch ripped clothing, and to of course tape up hot spots on my feet. As far as the clothing I patched, I have a shirt that has been through the wash several times and the tape is still holding.

[Roger Caffin]

> Actually, I don't even bother with the gauze, but just slap the tape on as my bandaid.
Playing around in the workshop with lathe tools and milling cutters, I sometimes knock some part of my hand against an edge. Good tools are sharp! I don't mind the cut, but the blood is a nuisance. Ah well, a length of paper masking tape …

Cheers

[Simon Wurster]

My trips these days average 2 days in the northeast, 3 seasons, solo, never more than a stone's throw from civilization. I look at first aid as task-based:

Little boo-boo: Hydrogen peroxide, maybe a band-aid
Big boo-boo: Sterile gauze, maybe hydrogen peroxide, maybe Neosporin
Burn boo-boo: Lanacaine
Poo-poo boo-boo: Immodium AD (generic)
Belly boo-boo: Papaya enzyme
Pain, head: Acetominiphen
Pain, joints/muscle: Ibuprofen
Pain/Nighttime: Tylenol PM

I always carry a tiny spray bottle of HO, so it's my go-to wound disinfectant, has many uses. The Neosporin and Lanacaine are repackaged into an empty contact lens case, then labeled on the caps and the bottom (ask me how I learned that). Other items I always carry:

Cough Drops (used sometimes in the mornings for sore throats)
Mirror (all things eye related)
Magnifying Glass (part of Tic tool with tweezers)
Tic Tool

New for 2013: 2 prescription pain pills, just in case.

[Author]

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