Reducing One’s First Aid Kit

[Ken Helwig]

I am trying to reduce my volume of what is in my pack. One thing that I always have too much of is my first aid kit. What do others put in their kits? Curious.

[David Wills]

For solo, its really quite shameful. I definatley follow the 'only bring what you know how to use' guideline. For a 4 day trip i have 4 bandaids, a tiny vial of neosporin, 6-10 alcohol wipes, duct tape, and 4 benadryl. I have yet to run out of anything (knock on wood).

[Steve Thompson]

I carry more than David, but much, much less than I used to. 7 band aids, small tube polysporin (since you can use this in your eye without irritation), 3 big sheets (4×4?) spyroflex, roll of breathable plastic first aid tape, and a couple safety pins.

For meds I carry 7 doses of each: benadryl, 12hr sudafed, advil, immodium, bisacodyl, meclazine. Steve

[Sam Haraldson]

My current list is as follows:

Arnica oil, duct tape, ibuprofen, moleskin, tea tree oil, super glue, Band Aids, Purell.

[Don Wilson]

For short trips I take ibuprofen, a knife and some duct tape. Plus a needle and thread.

For longer trips, I add immodium, some butterflys, maybe some antibiotic cream.

I experiment with foot care stuff – but mostly I don't carry too much of that.

Most frequently used items – scissors and ibuprofen. On long hikes with 15 hour days I find the ibuprofen to be a help when I'm a little sore or stiff.

This would be a good article idea, similar to this week's article on knives and sharp items.

Don

[Brett .]

Similar to the article on knives, I have reduced what I carry, based on what actually gets used.
Here is my current list

Survey:
Nitrile Examination Gloves
Antimicrobial Hand Wipes

Applications:
Sting pads
Bandaid plus antibiotic/analgesic

Medications:
Acetaminophen
Ibuprofen (arylpropionic NSAID)
Asprin (salicylate NSAID)
Psudoephedrine (decongestant)
Multi-vitamins
Diphenhydramine (sleeping pills)
Loperamide (diarreha)
Cough drops
Katydyn micropur tabs and coffee filter in ziplock

Bandaging:
Sterile dressing, 4×4 or 3×3 or 2×2's
Bandages, Strip & Knuckle
Cotton Tipped Applicators (Q-tips)
Bandage, non-woven, adhesive knit

Since I hike in small groups, and carry this kit every day when not hiking, it gets a lot of use from friends and strangers alike, and has relieved a lot of suffering. For me, the anti diarrhetic has been worth its weight in gold.
Total weight of the kit is about 120grams.
When hiking, it goes in a bright orange GraniteGear XXS airbag with my hygeine kit and repair kit.

[James Pitts]

I carry ibuprofen, a few cloth band aids (not the plastic ones), duct tape, and a tube of super glue.

[EndoftheTrail]

Acetaminophen
Ibuprofen (arylpropionic NSAID)
Asprin (salicylate NSAID)

Why three different types of pain killers? Just curious in the general sense — do you find each type more effective in some areas while ineffective in others? No need to answer if personal…

[Brett .]

Ben, I'll try to answer that question; it's not personal at all, those three drugs all have different effects, warnings, interactions, and symptoms on which they work best. Keep in mind my medical education comes from books and wikipidia (@_@)!.. Anyway, asprin is good for fever, mild pain, inflamation, and thinning the blood. Ibuprofin is good for the first three only. Acetaminophen is good for fever and severe pain, but not the other issues. The first two are NSAIDs, which can damage stomach linings, and can be hazardous for asmatics or people with stomach ulcers, or open bleeding wounds, etc.
Acetaminophen on the other hand can be bad for the liver, so I wouldn't offer it to someone with partial liver failure (for example last Saturday night on a company sponsored drinking binge, my co-worker suffers from partial liver failure, but had a splitting headache.. so gave him the other two).
Also, carrying both types allows me to treat more severe pain without overdosing on NSAIDs, by giving one dose each of NSAID and one non-NSAID. Thats the combo I'd take to get back to the trail head with a sprain/fracture, god forbid..
Oh, just remembered, Ibu. is the best of the three for dysmenorrhea (womens cramping), and my GF occasionally wants one for that.. I could go on and on.. no ibuprofin for pregnant women, no asprin for bleeders, etc.. you get the idea.
Funny thing is; I rarely need any of this stuff for myself!

[Stuart Burke]

I wanted to add a few comments to Brett's based on my limted pharmaceutical knowledge. Taking an NSAID (ibuprofen, naproxen, or aspirin) and acetaminophen together is a great way to deal with moderate to severe pain without using a narcotic pain killer. As far as I know taking two NSAIDs at the same time is not reccomended. The other thing I would like to mention is maximum 24 hour dosage for these drugs. For ibuprofen the maximum 24 hour dosage is 2400 mg and is usually given as 3×800 mg doses every eight hours or 4×600 mg doses every six hours. The maximum 24 hour dosage for acetaminophen is 4000 mg and is usually given as 500 to 1000 mg doses every four hours. Keep in mind that all of the maximum doses I have just listed are for people with normal kidney, liver and gastrointestinal function.

NSAIDS and acetaminphen are wonderful drugs but all too often people think that because they are OTC they are harmless and have no side effects. At the hospital I work at we see an acetaminophen overdosage about once a month and if they are not caught early enough all you can do is watch them die as their liver shuts down.

[Stuart Burke]

Here is what is in my first aid kit:

4 butterfly bandages
2 sheets of moleskin cut in half
4 regular bandaids
6 "bandaid brand" waterproof bandaids
10 alcohol wipes
4 loperamide (immodium)
6 naproxen (aleve)
6 diphenhydramine (benadryl)

I should probably leave the butter fly bandages at home because I have never actually used one in the ten years I have been carrying them but I figure 4 of them probably weigh a tenth of an ounce. I have had really good luck using "bandaid brand" waterproof banaids on my feet for hot spots instead of moleskin. On the trip I went on last weekend I had one of these bandaids stay on my foot for 9 hours despite my feet being soaked from an all day rain.

[Bob Bankhead]

First aid kits are like any other emergency supplies – 100% dead weight in the pack – until you really need it, and then it's worth its weight in gold.

How much to carry depends on several variables: How long are you going to be out? Solo or in a group? Injury and rescue potential for the terrain in which you hike? Personal prescription needs and availability of refills? Degree of personal risk you'll assume (that's a biggie).

I can jury-rig most major first aid stuff from what I regularily carry. However, there are a few things that are unique and must be carried, like a wound syringe to thoroughly clean out a wound before treating it. I also combine foot care with my first aid kit. My kit weighs 4 ounces for a 14 day solo trek.

2 Moleskin – 4 x 5 (foot care)
6 Alcohol wipes (foot care)
1/2 oz tincture of benzoate (foot care)

2 Triple antibiotic (0.5 grams @)
1 Wound syringe
2 Tegaderm self-adhesive dressings
4 Butterfly bandages
4 Bandaids (1 x 6)………………..gotta try the waterproof variety
3 Q-tips
12 Ibuprofin – 200 mg
8 Vicodin – 5/500 – (Rx)
4 Immodium (2×2@)
2 personal prescription meds
1 pair disposable gloves (in case I have to treat YOU)
1 ziplock baggy

For the uninitiated:

Tincture of benzoate – makes your skin sticky. Ever try to get moleskin or bandages to stay on places like feet where both moisture and abrasion are on-going?

Tegaderm – the trade name for a soft flexible gel-like self-contained bandage for larger areas (similar to 2nd Skin) but self-adhesive. Mine are 2-3/4 x 3-3/4 inch

Vicodin – a prescription medication for really serious pain management. I go alone and it can be a long walk (crawl) to help. To get a Rx, it helps if your doctor is also an experienced hiker.

There have been times when I truly wished I had had Compazine with me too, but that's another story.

Note that you can get most common OTC meds in small travel packs of 2 at airports, convenience stores, and the like. They are more expensive that way, but other than Ibuprofin, how likely are you to need a full bottle of those things in your home?

Wandering Bob

[Phil Barton]

Let's see. I just pulled my baggy from the storage box. It is much smaller and lighter than it once was. I am usually with a small group, 2-4 hikers. I carry a different gallon Ziploc sized kit when I'm hiking with Boy Scouts. The whole sandwich baggy is about 2 ounces before adding Hydropel.

My kit includes:
6 Band-Aids, various sizes
2 Compeed dressings
1 x 0.9g pkg Neosporin
1 x pkg Steri-Strip
2 x 3"x4" non-stick pads
1 x latex examining glove
1 x Pro Tick Remover
4 x Gaviscon tablets
4 x Benadryl tablets
4 x Immodium
4 x Loratadine (antihistamine)
2 x 0.01 fl oz vials Celluvisc eye wash/lubricant
Small number of ibuprofen and acetaminophen
Few feet of Leukotape (duct tape irritates my skin too much to use on my feet)
Usually some Hydropel
Safety pin used for attaching thermometer to pack

There are a few other multi-use items that play into first aid. From my water treatment, Aqua Mira provides clean water. I carry a few drops of Dr. Bonner's soap that helps with wound cleaning. My bandana provides a compress, bandage, pot holder, sun shield, or a towel. A signal mirror helps with self-treatment. A butane lighter can sterilize the safety pin for draining blisters. Leukotape can be used in place of duct tape. Long sleeves, a hat, and sunscreen eliminate the need for burn treatment and more analgesics. Beyond all that, our party can improvise many tools when required.

The most used items of all this are the tick remover, the eye wash/lubricant, and band-aids. I am using the Hydropel regularly now with great success.

[EndoftheTrail]

Thanks for the insights, Brett and Stuart.

[Wayne Teipen]

Just a quick note to consider on the use of Aspirin as an analgesic: In the medical arena, it is pretty much no longer used to control pain because of the rise in use of other drugs with less dangerous side affects like the COX-2 inhibitor NSAIDS. You will mostly only see Aspirin used to treat thrombosis (blood clots) in myocardial infarction (heart attack) because of it's blood thinning effects. It also carries a high risk of eroding the mucosal lining of your digestive tract with chronic use and taking it on an empty stomach. So, unless you are traveling with hikers at high risk of heart attack or blood clotting, I would recommend leaving the Aspirin out of your kit. And, if you do carry it, carry the enteric coated variety. For me, I carry Ibuprofen and Acetamenophin for pain control.

[James Schipper]

Not to be argumentative, but aspirin is an NSAID. All NSAIDs have a risk for peptic ulcer disease. Aspirin will work just a well as other NSAIDS for pain control with similar risks. I use naproxen (Aleve) because of its longer half life. Enteric coated aspirin doesn't reduce the risk of ulcers, it just decreased stomach upset somewhat. Anyone at high risk for ulcers or with previous ulcers should probably stick with tylenol.

[Sarah Kirkconnell]

I'd hedge that I am one of the few that carries such an intensive kit with me. I cut my weight elsewhere. On long trips I often use much of my 1st aid kit up (I carry a lot of blister care). 1/4 of my kit is meds for both the kid and I. I take it pretty seriously though. At 14 ounces, my kit is HEAVY. But that is ok to me. Since I do often use the items in it, I see it as worthwhile weight.

[todd]

Sarah,

I'm glad you aren't compromising what works for you and gives you peace of mind!

Todd

[Wayne Teipen]

Thanks for the correction/clarification, James. Aspirin is indeed a NSAID and my knowledge of the data is somewhat outdated. The earlier data on COX-2 inhibitor NSAIDS (such as Ibuprofen) showed a decreased rate of ulceration compared to Aspirin (whose COX-1 suppressing action is irreversible.) Some of the more recent data appears to be less optimistic or inconclusive at best depending on what study you look at (and which pharmaceutical company supplies the grant in some cases.) The same is true for Enteric Coated Aspirin. While earlier studies show that the acid resistant coating allowed the aspirin to pass further down the digestive system before being fully digested and theoreticly sparing the mucosal lining of the upper GI system, more recent studies contest those findings. I, however, still plan on using Ibuprofen as opposed to Aspirin based on the fact that I have clinically seen many patients with GI bleeding d/t long term Aspirin use and none that I am aware of being caused by Ibuprofen. Perhaps that is due to the fact that a large majority of patients that I see have cardiac disease and many other co-morbidities and as such have Aspirin as part of their daily Rx regimen. I realize that that's not real scientific but it makes sense to me. I think the key is using either in moderation for acute aches and pains if you can't avoid using them at all.

[James Schipper]

Ibprophen is a non-selective COX inhibitor, just like aspirin. COX-2 selective inhibitors include Vioxx (now off the market) and Celebrex. Vioxx was pulled due increase risk of MI, though really the risk was small and only apparent in people taking high does of the drug on a daily basis (ie a rhuematoid arthritis study and a cancer study). COX-2 selective inhibitors do decrease the risk for GI bleed, but this is also only clinically relavent in people on high chronic dose of NSAIDS. Aspirin's COX inhibition is irreversible (which is what makes it useful for platelet inhibition in coronary artery disease) and this theoretically could confer a higher risk of GI bleeding. Clinically they seem to have equivalent bleeding risk at equivalent anti-inflammatory doses. Low dose aspiring for cardioprotection (81mg)doubles the relative risk of GI bleed, but this only translates into an absolute risk of about 1 extra GI bleed per thousand patient years of treatment.
The bottom line is that if you are not at high risk for peptic ulcer disease it really doesn't matter much what you use.

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