Advisor's FAK for Philmont?

[Bob Shuff]

What do you recommend for an Advisor’s First Aid Kit for Philmont?

Most scouts should have a good solo FAK in their packs as part of their 10 essentials, but I see some here on BPL pushing to be as efficient as possible by leaving behind some redundancy.  I expect each scout will have band-aids some blister treatment and their personalized meds.

Philmont’s recommendation is as follows:

Recommended First Aid Kit Items
• 4″ Elastic bandage
• Acetaminophen (Tylenol or Panadol)
• Adhesive tape 1 inch x 5 yd.
• Ana-Kit (if needed)
• Antacids (Tums, Rolaids)
• Antibiotic ointment (Mycitracin, Terramycin, polysporin)
• Antihistamine (Benadryl)
• Band-aids (assorted sizes)
• Barrier device for resuscitation
• Chapstick
• Chemical ice packs
• Cold caplets
• Disposable alcohol wipes
• Foot powder
• Gauze pads 3″x3″
• Ibuprofen tablets Insect repellent (containing DEET)
• Latex gloves
• Moleskin or Molefoam
• Needle
• Oval eye patch
• Safety pins
• Scissors
• Second Skin
• Side cutters
• Small bar of soap
• Steroid cream (Hydrocortisone. Cortaid, Lanacort)
• Sunscreen lotion (25 SPF or above)
• Thermometer
• Throat lozenges
• Triangular bandage
• Tweezers

This seems like a lot for a group FAK when each crew member has some of this.  What do you recommend?  How much does your Crew FAK weigh?

Thanks,

Slbear (Bob)

[Roger Caffin]

A list designed by a committee.
I find that extremely excessive.
My 2c
Cheers

[Bob Shuff]

Hi Roger

How much does your First Aid Kit weigh?  Note if your kit includes non-medical items – I see a lot of people here including matches, knives, etc., in with the band-aids and ibuprofen.  For boy scouts those are a different “essential.”

Would you carry more if you were leading some younger or less experienced hikers on an extended backpack?  My crew will be 11 or 12 scouts and adults spending 11 days/nights on the trail together, with no trail-town resupplies.  I expect that any significant medical need provide an opportunity to restock the basics.

BTW…totally agree this is excessive.  I’m curious if the rangers check any of this prior to hitting the trail, and what other BPLers carry as adult advisors.

[David Thomas]

That does seem like a lot.  I’m big on improvising slings and bandages (versus dressings) in practice sessions and in real life.  e.g. I’d rather have a inflatable sleeping pad to air-splint a broken arm or leg than a purpose-built air splint (upper arm, lower arm, lower leg, which size, etc?) or even a wire splint (does someone make 1/4″ x 1/4″ “hardware clothe” in ALUMINUM?

I would add to that list:

more safety pins (cause I’d leave out some sling materials)

a mini-Bic lighter (sterilize a needle, back-up fire starter).
a small tube of anti-fungal cream (for athlete’s foot and various forms of jungle-rot that can form between toes).

Leuko tape (better than moleskin for friction blisters), can replace some or all of the first-aid tape.
A Victorinox Classic: 21 grams, $5 for a TSA-seized one, has tweezers, a blade and SCISSORS (using scissors instead of a blade is the best one to avoid more injuries!).
“EMT snips” can function as a side-cutter for clipping a fish hook barb off (except maybe not for my 8/0 halibut circle hooks).  The Classic scissors can cut tape, gauze pads and trim mole foam.

From that list I would drop:
Chemical ice packs.  They don’t do much, for long, considering their weight.  A wet bandana cools indefinitely and you already have it along.  Fuel alcohol could also be used to cool the skin but keep away from ignition sources.
I’m not sure what “foot powder” is for (I don’t listen to AM talk radio).  I do change and fluff up my socks every 10 miles, letting the other pair dry out.

The side cutters.  It’s not WWI and you’re not “going over the top” at dawn tomorrow to cut barbed wire.  Everything else the Classic’s scissors or the EMT snips can handle at a lot lower weight.

Barrier-method for mouth-to-mouth: Really?!? you’d pull a Scout from being face-down in a pond and then wait another 37 seconds to rummage through the FAK and get the mask out and ready?  I wouldn’t.  I’m not an inner-city EMT working on street people with the mask I keep on my person at all times.  I’d start mouth to mouth right away.
oval eye patch: form out of other FA materials or items of clothing.

Second skin is great for a third degree burn or a blister that has been rubbed raw.  I don’t bring it on solo or family trips (we’ve trained everyone to call out their “hot spots” early and often), but I did when I was leading trips.

That’s a fairly thoughtful selection of OTC drugs.  I’d add Imodium (Loperamide) for diarrhea.  Hopefully they’re all in 2-pill packs and not in bottles of 50-100 pills each.

Arguably the biggest benefit of the antibiotic lotion is just as a lotion that keeps the skin and wound edges moist so they don’t dry out and die.  And it helps keeps the dressing from sticking to the wound site.  I successfully reattached my fingertip (and altered my fingerprint) during a New Zealand backpacking trip with such lotion and a fresh bandaid every 12 hours.

[TAG in AZ]

Yes, this is probably too much stuff.  I would eliminate anything that is redundant with things that are carried elsewhere.  For example, the crew should have scissors, sunscreen, soap, foot powder…and so on.  On our trek, the adult advisors attended the Wilderness First Aid course, so we carried the the extended FAK.  We built our kit for extreme cases only — with the input of the WFA course instructors.  The assumption was — everyone will take care of small aches and pains (headache, blisters, etc.) and we will only pull out the big kit if something goes really wrong.

The good news is…we never opened our FAK.  I’m glad we carried it.  But, honestly, Philmont is not as remote as it seems.  You are often within a short distance of a staffed camp and the backcountry communication is amazing.  Your goal should be to stabilize a patience and then get help from the staff.

[Roger Caffin]

Hi Bob

Our FAK for trips up to 2-month long weighs 120 g. That does include a spare mini-Bic but does not count a Ventolin inhaler (40 g) which I carry for myself. This has been enough for decades of real life.

Would I carry more with kids? No, but I would make sure every kid had his own FAK, including any meds he was known to need. Other adults – no, because they are adults.

Cheers

[David Thomas]

Something to remember on a backpacking trip, in a crowd of strangers, or an airplane cabin, is that modern humans are walking pharmacies.  My MD wife often gets called for medicals on plane flights and has found “Does anyone have valium to help a kid in a seizure?” gets about 40 flight-attendant call buttons ringing.

[Roger Caffin]

Can I add one item which is not really part of the FAK, but which should figure very prominently in this discussion: a very simple minimal mobile phone with NO apps at all. Here in Oz you can get two sorts of mobiles in this class: short range ones (OK for kids at school to ring mummy) and ‘country’ ones. The latter have a noticeable antenna sticking out for longer range.

Do not attempt to play EMT in the bush: get professional help.

Cheers

[Bob Shuff]

You guys are thinking along the same lines as I am. I’ll take another shot at this list and repost.

On some treks out here in SoCal I’ve started taking some Poison Oak wash/ointment, because it’s so prevalent in the local mountains.  I haven’t had to use it (so far).  Benadryl is part of the treatment, but I’ve been told this is a good compliment.  Should I worry about Poison Oak, Ivy or Sumac at Philmont?

[Aubrey W. Bogard]

As lead advisor and one of the WFA-trained adults, I carried a NOLS Med Kit (the 5.0 version if I remember correctly).  I also provided all crew members with an individual FAK in a ziplock bag with a few band-aids, some Leukotape, a few ibuprofen…  These individual boo boo kits were very light and compact and prevented pilfering of the group kit.  If I were to do it again, I would want a lighter and hopefully much more compact group kit.  My WFA instructor, who had been on multiple Philmont treks, showed us the kit that he carries, which I believe started out as one of the Adventure Medical Kits Ultralight/Watertight kits.

What I carried for a Philmont crew was quite different than what I would carry for my own family, because not all Scouts have the same level of maturity to give me confidence that they would avoid injury or illness.

[Roger Caffin]

not all Scouts have the same level of maturity to give me confidence that they would avoid injury or illness.

Perhaps I am too old and heretical…
If they injure themselves, make sure that they don’t die, but let them suffer from the injury. Ah – and tell the parents that this WILL be the rule before they go on the trip. Possibly even get them to sign off on it.

There’s molly-coddling, cossetting, and the American Way …

Cheers
(ducks for cover)

[Aubrey W. Bogard]

Thanks for the feedback Roger.  I stated my reasons for my choices; I’m not advocating them for others.

[Roger Caffin]

Hi Andrew
Mistake me not: it can be important to get opinions from many different people. The opinions are all valid, even if very divergent.

Cheers

[Bob Shuff]

“molly-coddling, cossetting, and the American Way…”

I’m speechless, because I don’t know what that means.  Sounds British. :)

There’s definitely value is learning from the suffering due to your mistakes.  I agree also that reliable communicatuos, in my case an inreach, and professional help is better than carrying around an EMT”s gear kit if things get serious..

I’m going to push the scouts and adults to carry meds and treatments that they use, and really just have a few extras.  I’ll probably have everyone show their kit at one of the shakedown hikes before we go.

When I took WFA last summer I remember it being more about teaching scenarios, with the FA treatment protocols being fairly standard, I.e. Stop the bleeding, clean the wound, cover, hydrate, stabilize.  Anything serious, get help.

I’m not planning to treat anyone else’s blisters, but if a scout who has never experienced this needs help, I can explain what to do and give him some supplies if his own kit is insufficient.

I’ve reduced my own kit over the years, but still have a ways to go.  We will have 3 adults so If I carry the communicator,  someone else can carry the extra meds, or blister treatment.  How does that sound?

[BlackHatGuy]

“The opinions are all valid, even if very divergent.”

Or even somewhat deranged….

[Roger Caffin]

Hi Bob – Sigh – yes, British English. I like your idea tho’.

Doug – that is one of the nicer things people have said about me for a while …

Cheers

[Bruce Tolley]

Bob:
Remember at Philmont is not really a wilderness backpack because you are never more than a few miles from a staffed camp with EMTs with full FA kit (and almost all the Ranch is accessible by jeep).  So you do not need in my opinion a lot of stuff in your kit. Your main job will be risk management , to know exactly where your crew is at all times, and have a plan for self-rescue or rescue.

Use Philmont as an opportunity to get several folks WFA trained, perhaps one or two adults and one or two Scouts.

But back to your original question. For our crew, I took a scrubbed and personalized Adventure Medical Kit Ultralight 0.7 plus a small blister kit.  The main malady to watch for is dehydration. The folks who come inadequately trained will hit a wall on day 4 or 5, get really exhausted and increase their risk of accident or injury. I saw lots of folks (mostly adults) on crutches in base camp which I suspect was the result of inadequate training combined with too heavy packs.

[Roger Caffin]

Hi Bruce

Curiosity only, about the crutches: sprained ankles? Big boots as well?

Cheers

[Brad P]

I agree, that list is from a committee and too extensive.

I like the idea of each crew member having a small, basic blister/wound care kit in a Ziploc bag. For something simple and with trained supervision, they could treat their own minor cut or hot spot. They are learning life skills.

Some people are allergic to latex, so non-latex gloves might be a better idea.

Do you get parents to sign an approval for administering the OTC meds? I don’t want to get sued because some granola parents treat everything with essential oils.

[Bruce Tolley]

@ Roger. I saw a lot of crutches.  The one adult leader I knew in another crew complained of knee problems.  There were many fully loaded 65, 70 and 75 liter packs on the trail. Many folks look at their itineraries and plan to use heavy hear for a 65 or 75 mile trek. But since you get re-supplied every four days and the commissaries at the staffed camps also have batteries, bug spray, sun block, isobutane canisters, etc,  you are really doing a chain of shorter hikes with resupply.

@ “list from a committee”  I agree that the list is too long but we need to remember that the BSA moves 1000s of Scouts through Philmont every summer from varied backgrounds so the tendency is to err on the side of caution. I met a lot of crews that the only backpacking they had ever done was the three training hikes to prepare  to Philmont.

@ administering OTC meds. The last time I read the BSA safety materials for adult leaders, the administration any meds to a Scout was strongly discouraged. Scouts should bring and know how to administer their own OTC and prescription meds.

 

[Brad P]

It looks like you need to have OTC meds listed on the medical form as authorized to give to the scout. Makes sense.

Medication Use in Scouting

[Bob Shuff]

good catch Brad P on the OTC meds.  I thought there was a generic release of OTC meds on the ABC forms or our troop’s registration form, but I can’t find it.  It would seem that we should add the standard drug meds to the B forms or otherwise make a separate release form with the lost of OTC drugs that the advisor will have on-hand.  I only have one son – aged 15.  He has allergies, so he takes Benadryl, and occasionally Claritin, but has otherwise rarely take OTC drugs.  Maybe only for a fever or cough.  I’m expecting adults to take vitimin I (Ibupropen) daily, but most teens I know don’t take pain killers or anti-inflammatory drugs even when they are sore from sports.  As far as I know!  Maybe we live a sheltered life or I’m just oblivious?

[Roger Caffin]

I’m expecting adults to take vitimin I (Ibupropen) daily,
They are mad to do so. From Wikipedia alone:

Adverse effects include nausea, dyspepsia, diarrhea, constipation, gastrointestinal ulceration/bleeding, headache, dizziness, rash, salt and fluid retention, and hypertension.

Infrequent adverse effects include esophageal ulceration, heart failure, hyperkalemia, renal impairment, confusion, and bronchospasm. Ibuprofen can exacerbate asthma, sometimes fatally.

Cheers

[Bruce Tolley]

Remember that the “guide to medication” is referred to as a tool in the Guide to Safe Scouting. The overarching principle is stated in the Guide to Safe Scouting, namely “Remember that the taking of prescription medication is the responsibility of the individual taking the medication or that individual’s parent or guardian.”   There were a couple of times I agreed to carry the meds for a Scout but if the parent thought the Scout was not responsible enough to take his own meds, I had the conversation about whether that Scout was really ready for a high adventure outing.

[Brad P]

They are mad to do so. From Wikipedia alone:

Adverse effects include nausea, dyspepsia, diarrhea, constipation, gastrointestinal ulceration/bleeding, headache, dizziness, rash, salt and fluid retention, and hypertension.

Infrequent adverse effects include esophageal ulceration, heart failure, hyperkalemia, renal impairment, confusion, and bronchospasm. Ibuprofen can exacerbate asthma, sometimes fatally.

You can find similar issues for just about every medication (just listen to the scare warnings in ads). Some people certainly have problems with ibuprofen, but not everyone does. Also, short term use of a medication is different from people who take it every day of their lives.

I don’t take it very often, mostly as a fever reducer, and I’ve never experienced a single side effect. My wife, too.

If you do have side effects, then certainly try something else.

Turmeric has mixed reviews as a natural anti-inflammatory. Our scoutmaster said many of his pains from his Army days went away after he started taking it.

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