First aid kit contents

>> I worry about infection as well, but it will take some time for an infection develop and most likely you would be off the trail by the time that happens. <<

You might want to re-think that one. I always carry a prescription antibiotic ever since I had a problem on a 4 day trip. I noticed that a small cut on my shin went bad on the second day of my trip. Didn't even notice the cut the first day, it was insignificant, so it didn't get covered or treated. Second day it started to swell and feel hot and by the third day I had a serious infection underway.

The surprise to me was that by the third day, my ankle was swollen and I could hardly get my hiking shoe on and the last ten miles on the final (4th) day was difficult. The doctor said the infection in my shin was causing fluid to pool in my foot and ankle which is why I was having so much trouble. He said I was lucky I didn't wait another day as I may have been in serious trouble.

So a half ounce prescription provides some additional treatment for infected blisters, cuts and bites if they happen to go bad. Ask the pharmacist to write the expiration date on the prescription. Most of the ones I buy are good for two years.

The other thing I've added recently is more band-aids. Don't go cheap here (weight wise) because a few lacerations over the period of a week long trip can use up a lot of band-aids if you really need to keep the wound clean and covered.

The issue with carring perscription ABX is that they are organsim specific. Not any old abx is going to treat any infection. SO it would be luck of the draw that the abx you are carrying with you will work for your infection you have. In the ER, we rarley will perscribe abx for an infected wound untill we culture it, determine what is growing and then decide the best abx for the specific organism.

Band aids….ya I carry lots of these. Mainly because the edges of my finges always get very dry, crack and bleed at high altitudes. I dont buy the cheap ones either, I like the cloth ones over the pastic ones.

On the topic of snake bites…I hope most know that the snake bite suction kits are no longer reccomended for use, they can actually cause more harm than good, and have not been prooven to be effective in extracting the venom.

Infections are one of those ounce-of-prevention things from my point of view. It's much easier to use just a dab of triple antibiotic ointment over a cut/scrape right from the beginning, and avoid an infection all together. Trying to clear one up after it's started is no fun, whether one is on the trail, or suffering back in the comfort of their own home. One of those tiny packets can be folded over and taped shut so it will last for many applications.

I've also grown pretty fond of vinyl electrical tape for most bandage applications. It will seal up pretty well, and stretches to fit awkward knuckle situation, as long as you're mindful not to get it too tight. And it's multi purpose as well.

Speaking of agony, if you ever spend three days barely being able to see out of a watering swollen eye that you can't keep open, and not being able to sleep with it closed, from having a bug fly in it that you can't get out, a small mirror might make a justified addition.

A lot depends on who you're hiking with as well as what problems you expect to encounter. Much of my trail time these days is with our Boy Scout troop, so I end up carrying a fairly heavy first aid kit to deal with aging leaders and exuberant boys. So glucose tabs, extra ibuprofen, burn dressings and extra moleskin all come into the picture. I carry a lot less when I'm out solo.

Ya good point….abx ointment packets would be a good thing to have. But remeber that a dab of ointment doesnt replace having to properly clean and dress a wound.

AS far as things in the eye….a flushing syringe could help with that, and maybe even a morgan lense…but thats may be getting a little much for a basic first ad kit…

" and maybe even a morgan lense…but thats may be getting a little much for a basic first ad kit…"

… especially when you consider the gallon or so of flushing solution.

Being an ER nurse is double edged sword ….

haha very true about the large amounts of fluids needed to flush with a morgan lense…..in a pinch I was thinking you could use a 20ml syringe over and over again to flush the morgan.

band-aids: This is a comfort item. I prefer an SUL band aid (Scab).

2×2 gauze pads
4×4 gauze pads: I carry two large non-adherent gauze pads.

antiseptic wipes: You should have some sanitizer. This is not needed.

Surgical glue: I personally don't think this is necessary. You should have a small amount of supper glue in your repair kit.

sutures: I can see this used as a multi-use item (sowing/repair kit). Plus they hardly way anything.

Finger splint: This is a comfort item. Mother nature has billions of splints sprouting from the ground.

tape: Duct tape should already be in your backpacking kit. This item is not needed.

gauze wrap
kerlix wrap: I have no idea what these are, but they sound like comfort items.

ACE bandage: I don't think it is needed. If a TRUE emergency occurs where this is needed we all are wearing some type of stretchy synthetic clothing where it can be torn/cut and used as an ACE bandage.

Benadryl: Yes, you never know what you may be allergic to.

Ibuprofin
Imodium: Sure why not. It is almost as light as air.

Tape: You should already have duct tape.

mole skin: It is a nice comfort item to have.

10cc flushing syringe: A water bottle can perform the same function. Not needed.

To me, First Aid is a way to make sure you or someone else doesn't die before they can seek proper medical attention.

Id agree that a lot of those items are comfort….but part of backpacking is being comfortable and enjopying yourself. If you have a nucense cut on your finger or some bad blisters on your feet, it could really make a trip much less enjoyable. I think there are two ideas to first aid….actual emergency care, and that care of minor issues. Additonally, treating the minor issues right away can prevent them from turing into bigger issues.

6th video down

gauze wrap/kerlix wrap: I have no idea what these are, but they sound like comfort items.

A long ribbon of absorbent gauze, often used as a wrap to cover a wound. Probably most useful if you need the extra absorbency* or to build support** around an impaled object. If I need to use this it means something went very wrong, as otherwise a bandaid or steri-strips should suffice. (Sometimes you can substitute tape and a gauze 4×4 instead.)

* You can swap in a cotton tee or bandana, but most synthetic hiking clothes don't do well in terms of absorption.

**An exercise that ends up using far more rolls than you're likely to have on you. Again, a cotton tee might suffice.

"Again, a cotton tee might suffice."

Wait a second! In the hypothermia class, they taught us that Cotton Kills. Now you are telling us that it is a lifesaving item. I get so confused.

–B.G.–

Only the weak, Bob. Cotton only kills the weak.

Real Men(tm) do like Wim and self-regulate.

Two main things to consider. You want to take care of cuts and burns. Second you want to be ready for a couple of bad things.

A couple of 2x2s, and 4x4s, some duct tape, with small amount of hydrogen peroxide will handle almost all lacerations or burns. Antibiotic ointment has been shown to not be very effective in preventing infection. A good scrubbing with clean water, couple of drops of hydrogen peroxide (goes a long ways if you are careful) and clean 2×2(s) or 4×4(s) topped with the cleanest piece of material you have. Can all be wrapped with strip of stretchy clothing if needed. a 2×2 and piece of duct tape is just as good as a bandaid. Alcohol based hand cleaner (Purell) works well also.

For the bad things, systemic infections, GI infections, and allergic reaction/anaphylaxis are the big three that can be somewhat treated. Everyone should carry a few benadryl. Will take care of most minor allergic reactions, and help in a more serious reaction. If you have ever had a serious allergic or anaphylactic reaction in the past you should consider carrying an Epi-pen. Lifesaving. I agree with a previous poster that normally you wouldn't start an antibiotic until the bug is identified, but if you are three days out a good broad spectrum antibiotic (probably best is a cephalosporin) is probably a good thing. Wash your hands and treat your water to prevent Giardia and other GI bugs. Won't know you are infected until it "hits" A couple days of flagyl will help you get back to civilization.

So here's my suggestion:

3- 2x2s, 3- 4x4s, small bottle of Purell (in kitchen kit), small bottle of hydrogen peroxide, 5- 25 mg benadryl, 3 days of a broad spectrum antibiotic, and three days of flagyl. If you have a history of serious allergic reaction or anaphylaxis carry an Epi-pen. Couple of ozs at most.

I had about 2' of duct tape on my trekking poles and used it all on my heels during a 3 day trip. I don;t think it would hurt to pack a couple extra large bandaids since they don't really weigh much. Doesn't hurt.

> small bottle of hydrogen peroxide

I've been told repeatedly, and read repeatedly (EMT postings), that hydrogen peroxide is no longer recommended for wound care. Perhaps someone with credentials would like to comment?

I pared my kit down to things I can handle- so lacerations, blisters, sprains, headaches, allergies. So I've got analgesics, allergy pills, my Rx meds, assorted bandaids, superglue, a Quikclot sponge, moleskin, Newskin, antibiotic ointment, a burn patch, duct tape, tweezers, nail clippers, a needle, and a SAM splint. My kit is stored in a 1 qt ziploc with room to spare (except for the SAM splint, which doesn't fit and I keep in a separate pocket).

Carrying gear to treat injuries that will require an evac doesn't make sense to me, so I don't. If someone has a major injury and isn't ambulatory, I will do what I can to keep them comfortable and from going into shock, but I'm not going to try and set a compound fracture or do any minor surgery. I have no medical training. Those are the instances where we'd push the button on the PLB.

"Speaking of agony, if you ever spend three days barely being able to see out of a watering swollen eye that you can't keep open, and not being able to sleep with it closed, from having a bug fly in it that you can't get out, a small mirror might make a justified addition."

I'm no a med pro, but like Delmar have heard/read that Hy Perox is not recommended for wound care. Neosporin is, see for instance http://www.mayoclinic.org/first-aid/first-aid-cuts/basics/art-20056711 .

Neosporin is wonderfully multi-purpose. The ointment works for chafing, is a fix for nasty backpacker armpit odor, etc.

In my WFR class it was taught that H2O2 was now discouraged, under the reasoning that it may damage healthy tissue and slow healing. For me, purified water is the easiest and lightest option as it can generally be created on the spot.

That said, this Medscape article on wound irrigation notes the literature is somewhat mixed in this area. There doesn’t seem to be a large difference between saline, potable water, or 3% hydrogen peroxide in terms of reducing bacterial count, and evidence that hydrogen peroxide slows healing is not consistently present.

"I do carry (seperately from my first aid kit) some body glide and goldbond powder for any chafing or crack rash."

I am a big fan of Goldbond and what it does to reduce monkeybutt, swampass, et al but after reading stories of bears being attracted to peppermint Dr. Bronners, I started visualizing a bear dragging me out of the tent by my daddy-parts so have since removed it from my daily outdoor ritual.

My kit is pretty minimalist and is designed to stabilize and immediately evacuate. I haven't weighed it in a while but I think it's around 3-4 ounces:

*Roll of sterile gauze to pack a wound. If I needed to apply a pressure dressing above it, it would be from non-sterile sources found in my kit. Same for splinting material, tourniquets, etc.

*A few 2×2 gauze

*Triple antibiotic in sealed straw. I'd irrigate the wound with sterilized water squeezed through punctured PET bottle lid.

*A few safety pins

*SAK classic

*Moleskin (for kids/can't remember my last blister)

*Duct Tape (on trekking poles)

*Trekking poles can be used as a traction device or as part of a splint

*Benadryl

*Advil

*Advil PM (clearly marked so not to exceed daily max of Benadryl)

*Imodium (which reminds me I need to replace it. Saw yesterday that it expired in 2011 oops!)

*A couple Band-Aids

*Edit to add- steristrips

When I'm with my nephew: Epi Auto Injector and extra Benadryl

When hunting, backpacking during hunting season, or around things that go boom in general: Quick Clot (Soon to be replaced with Combat Gauze… keep forgetting to), a few rolls of sterile gauze, Asherman Chest Seal and/or petroleum jelly impregnated gauze and enough plastic and tape to treat both the entry and exit holes for a sucking chest wound.

Item I'll add this year: better tweezers and maybe a tick key

Honorable mention dual purpose item: Mirror on Suunto MC2 to remove crap from eye and check the undercarriage for ticks.

David, I'd never heard of using Neosporin against "backpacker odor"! Another multipurpose item–I'll try it on my next trip!

I reserve antibiotics for very serious health situations where I know they will help. Since I have no way to know if Antibiotic X will treat Malady Y that I experience in the back country, I don't have antibiotics in my first aid kit. I plan to evacuate if I think I'm getting infected. I have evacuated for an infection, and probably will again.

Taking an oral antibiotic is not risk-free, either for you or for your friends and family when you return.

– Antibiotic resistance is becoming a world-wide health crisis – because we're overusing antibiotics.
– When you take antibiotics, you kill off healthy bacteria that you need, at least for a while.
– Studies show that people are 2x-3x more likely to get other diseases in the weeks after a round of antibiotics.
– Even broad-spectrum antibiotics don't work on every kind of bacteria.
– No antibiotic works against viruses, and a lot of mystery infections are caused by viruses.
– If you fail to take the full round of antibiotics, you can leave behind antibiotic resistant bacteria in your body to infect again. Now you are really screwed, and you can infect friends and family with antibiotic-resistant bacteria.

Don't even think of taking an antibiotic you haven't had before, or giving an antibiotic to a someone that they haven't had before. And that means the exact kind of antibiotic, not just "well it's sorta like penicillin, so it's all good". You may quickly be dealing with reactions you can't handle in the back country. I had a serious reaction to an IV antibiotic in the hospital, that they didn't figure out until it almost killed me.

Sorry for the soap box, but our national attitude of "taking antibiotics can't hurt, might help", is literally dead wrong.

— Rex

Rex, I don't think that the discussion was so much about oral antibiotics. It was more about topical antibiotic ointments. There are some on the market with a mixture of different antibiotics to hit a broader spectrum of typical infections. I don't see much wrong with applying an ointment like that against typical skin wounds.

On the subject of oral antibiotic (pills), the only time that I carry something like that is when I am going to some third-world country and I will be a long way from any sort of professional medical care. In that case, I carry Bactrim (oral, for GI problems). Basically, if I had some GI problem that wouldn't get solved by Immodium, then Bactrim would be the next step. So far (knock on wood), I haven't had to go past Immodium.

–B.G.–