Advisor's FAK for Philmont?

Everyone has their own FAK with the basics and personalized to their needs. We have backcountry crew kits that are taken out each trek to supplement their individual kits if help is delayed but the boys carry them – adults don’t carry crew gear ;) Everything easily fits into a gallon ziplock:

• SAM Splint
• 2x triangle bandage/cravat
• 2 2×2 gauze
• 2 4×4 gauze
• 1 sports roller gauze (the stretch/stick to itself stuff)
• 3 butterfly bandage
• Occlusive bandage
• 2 single use
• CPR shield
• tape
• liquid benadryl
• glucose
• Imodium
• electrolyte tabs
• burn cream
• Neosporin
• alcohol wipes
• gloves

I don’t feel like it’s the kitchen sink but do feel like it is enough to supplement individual FAKs if help is delayed. Sure, there could always be a situation that you aren’t prepared for – but we can’t roll out to the wilderness with a fully stocked trauma center. ;)

I carried too big a kit in 14. Think 2lbs ish.  All I ever used crew wide was some Lukotape, baidaids, scissors, neosporin, and maybe a few doses of OTC pain/fever/swelling reducer.

The one thing I did not regret carrying is a purpose made TQ. While the odds of needing one are minimal, the stakes/consequences of not having one are significant. I know improvised ones can be made quickly, but the model below is super good and super quick to use.

https://ratsmedical.com/

FWIW.

I used to carry a Sam’s splint in my FAK. Then in one of my WFA classes we learned how to use tape and slices from a sleeping pad to make a splint with and without augmentation from pieces of a hiking pole. So the Sams splint is now somewhere in my garage.

Thanks Brian Crain.  This is really useful – as you say not the kitchen sink, but with some thoughtful additions.  As Bruce Tolley mentions, I used to carry a SAM splint when I was training to lead Sierra Club hikes, and I think we practiced with one at WFA, but mine is in my car FAK, and doesn’t come with me on the trail any more.  After years of planning small family or solo trips, I’m still adjusting to the crew mentality, i.e. safety in numbers.  The few things I remember best from WFA about first aid kits is first only have gear you are trained to use, second, know how far you are from first responders, and obviously know your crew.  Then tailor your kit to the scenarios that a group of normal scout FAKs won’t cover.

I’ll have to go over my WFA notes, because I believe I jotted down some things, like a tourniquet and a dressing with clotting capabilities, that I did not have before.  They showed us splints and chest seals and semi-lightweght litters, but I think that’s going too far.  Most scenarios will be to stabilize in place and send/wait for help.

A few questions:

1.  How much does this crew kit weigh – can you snap a pic?
2. How many gloves do you include?  I remember the EMT at WFA saying that “a pair” is 3 gloves – one often fails.
3. I haven’t seen liquid benadryl except for the child dosages.  Is there an adult liquid formula?
4. I’ve asked these last questions in other threads, but don’t think I’ve seen an answer – do you need to worry about ticks at Philmont?  How about Poison Oak (or Ivy/Sumac)?

Thanks all for your help.  I can see making up some of these kits for our backpacking boxes, which are otherwise mainly for cook gear.

Bob

Our group kit weighed less than a pound and was based on the AMK 3 day small group kit. Since one of the other advisors had gloves in his personal FAK, I thought one pair was enough. I think liquid benedryl is the benedryl branded anti itch cream but I am sure Brian will tell you what he brought. I did not see any ticks, I saw maybe two mosquitoes. I do not know whether there are deer ticks that carry Lyme disease at Philmont.

My crew did all of its training hikes in tick country of the California Coast range or the Sierra Nevada so we had long pants, long sleeve shirts and most if not all of the crew had treated their clothes with permethrin. There is no poison oak.  The trails are very well maintained and AFAIK cross country travel is prohibited.  You are only perhaps 5 or 6 hours by foot from a staffed camp at any one time, and you will have in places cell phone coverage. So in terms of first aid, I think the way to think of Philmont is to prepare your Scout crew like you would a 3 or 4 night trip to your local mountains.  I assume you have seen the BPL articles about Philmont such as https://backpackinglight.com/philmont/

Thanks Brian, David and Bruce.  This is very helpful.  Thanks for the feedback on ticks and poison oak.  I have a permethrin pants and shirt I use as may main hiking clothes, and a treated headnet that weighs almost nothing – these will go to Philmont with me.  Thanks also for the link to the article.  I may have seen it, but had forgotten since I started planning this trek in earnest.  It’s a little dated in some areas, but inspiring none the less.

I’m looking seriously at the SWAT-T in place of a RAT or CAT tourniquet – I didn’t know I had all these options.

I found my notes from WFA training, and found the following (with some new comments):

• Bound Tree for first aid supplies (nothing if not comprehensive – I’m more likely to use Amazon/REI)
• Cure All: 2 tps baking soda, 4 tps sugar, 6 oz water (I should have taken better notes – cure for ?)
• Pair of gloves = 3 gloves
• Liquid Benadryl (hat tip to Brian – my son has nut allergies, but had moved on to Benadryl tablets; I think this is faster acting)
• Antibiotic cream (should have taken better notes – as opposed to ointment like  Neosporin?)
• Steristrip instead of butterfly sutures
• QuikClot (seems like you can get 25g or 50g – would work well with SWAT Tourniquet as a dressing)
• Fruit rollups or sugar chewables for hypoglycemia
• Halo Seals (Brian – Is this like the Occlusive bandage from your list, or you have something smaller?)
• Aspirin for first aid kit in addition to Tylenol and Ibuprofen
• LukoTape (better than duct tape?)
• Tincture of Benzoin (I’ve never used this)

I’ve started a spreadsheet for our Crew FAK, which is something I instinctively do when I get serious about it.  My pack weight spreadsheet will have take a break for awhile  :)  Full disclosure and credit – It’s based on Brian’s list, but I’ll tweak it with some of the above comments and feedback from the other crew advisors.  Under 1 lb sounds like a good goal, and I like the 1-gal ziploc.  I’ll post it at some point here.  I’m open to other feedback in the meantime.

Thanks again -Bob

Check with all parents first!
Some people are allergic to all NSAIDs and can suffer toxic shock and death if given them. This includes Aspirin and possibly the other two analgesics mentioned (unsure as not common in Oz).

Cheers

It’s not just a matter of checking with the parents, all medication, even OTC has to be approved on the scout’s medical form or you should not give it to the scout.

Ah – of course.

Cheers

Just saw this on the web, so it must be true…

https://gearjunkie.com/diy-first-aid-kit?mc_cid=ac79f4336b&mc_eid=d4e57dfea1

Blimey!
Cheers

Bob

Tincture of Benzoin. this is often part of folks blister kit since after application it dries and creates a stisurface for the tape to stick to.  Since Leuko tape is so sticky, I am not sure you need both. My crew was no super lightweight but the heaviest pack was perhaps 40 lbs, and we had just one blister the whole trek.

Not sure which part caused Roger’s reaction, but my favorite quote would be: “On family trips, I’ll sometimes take …(… occasionally a suture kit) for lacerations that aren’t trip-ending but really should be closed ASAP.”  I’m picturing Rambo stitching up his arm with the kit from his knife.  Now picture your dad doing that to you as a young teenager on the trail!

In general, though, I think this article (and the ER Adventure Racer) gets it right:  “My take on a first-aid kit is to manage the minor stuff that can prevent you from finishing but isn’t life threatening or truly a trip-killer.

Major injuries aren’t ever going to be adequately managed in the backcountry and require an extraction of sorts. For these incidents, you really want to keep the patient warm, hydrated, and prevent them from bleeding out.”

I’m picturing Rambo stitching up his arm with the kit from his knife.
Now picture the ensuing lawsuit when the parent of the injured Boy Scout finds out that Rambo decided to do the surgery himself, rather than calling for a trained medic.

Cheers

Since the meds have to be on the form, is it a good idea to give parents a list of potential OTC meds to specifically discuss with their doctor during the physical and put on the form? We haven’t done that, so the only meds on our scouts’ forms are prescription meds.

For instance, tell the parents to ask about the following medications (including generic substitutes) with the pediatrician. If you and your pediatrician approve, put it on the form.

Neosporin.
Ibuprofen.
Imodium.
Benadryl.
Pepto Bismol.
Bonine (Specifically for Sea Base).

This would cover the Boy Scout rules and legal aspect.

What type of injury would necessitate a  tourniquet? A pocketknife to the fermoral artery?

Neosporin.
Ibuprofen.
Imodium.
Benadryl
Pepto Bismol

I would add 2 more OTCs to this list: Claritin and Acetaminophen (Tylenol).  Both are relatively safe for kids, although most of our crew would be classified as adults for medication dosages anyways.

We’re not doing Sea Base anytime soon, but we do go to Catalina for summer camp and backpacking, and I have Dramamine in my personal FAK for the ride over and back.  It’s a relatively short ride, but can be choppy.  I used to have my son take half a Dramamine as a preventative measure before leaving for Catalina when he was younger.  I don’t think he would usually get sea sick on his own, but when one kid starts, it tends to spread immediately.

I’ve heard Bonine does not cause the same drowsiness as Dramamine, but have never tried it.  I never even thought about Scouts having air-sickness, but maybe I’ll add one or the other to the list to be complete.

Do you find the Pepto Bismol get’s used at Philmont?  Maybe the food is not appetizing or as a side affect of altitude?  We live at near sea level, and even with preparations I’ve heard of others from our troop having altitude problems with headache and loss of appetite in the first few days.  I hear this is common is one of my biggest concerns.  Hydration – hydration of course, and pre-emptive Rx can help if you know you have this problem.  We’re planning some shakedowns in the 8500-11000′ range in the weeks before traveling to Philmont so crew members can see if they feel any affects.

Bob

“….pre-emptive Rx can help if you know you have this problem.” Are you referring to altitude sickness? Philmont base camp is about 10K. Most of the itineraries have slow ascents and low mileage for the first couple of days.  Some of the crew will be sucking wind, but I have not heard anything about crews experiencing altitude sickness.  If you are worried about acclimatization, your crew can arrive a day early and acclimatize at base camp. Consult a medical professional but I think the high risk of the side effects of the prescription drugs would outweigh the mild risk of altitude sickness.

I’ve used Diamox in the past.  I haven’t decided if I will this time.  I’ve heard first hand accounts of the headaches, loss of appetite and fatigue.  I experienced the fatigue affects on a snow camp on Mt. San Jacinto.  We will arrive a day early as well.

Bob I led a wilderness mountaineering trek on Mt Shasta for my troop where I contracted with Shasta Mtn Guides to run the whole thing. On our first night on the mountain, while we were cooking dinner in the Sierra Club hut at Horse Camp elevation about 8K, one of the adults fell asleep/ passed out. This adult was a daily trail runner.

Given my BSA HAT and WFA training and I suspected altitude sickness.  We fetched the Shasta Mtn Guide professional guide in (Eagle Scout!). He asked two simple questions: when was the last time you urinated. When was the last time you drank water. The answer to both questions was “at breakfast.”

Philmont Base Camp elevation is NOT 10,000 feet.

The Tooth of Time (which looks down on base camp) elevation is 9,003 feet.

Base camp is about 6,700 feet.

@matthewkphx

I would recommend one.  ~60,000 Americans bled to death in 2018 and ~2 million worldwide.  Most common reason was injury or trauma.

It only takes about five minutes if untreated to “bleed out”, but after the 1st minute of blood loss (20% of volume) you face hemorrhagic shock (you shut off, hopefully your buddy is there to assist you). 2 minutes in 40% loss, fatalities start and it gets worse as the percentage of blood loss increases.

Injuries that can cause you to bleed to death include in order of frequency:

#1 crush injuries from car, bicycle accidents or a heavy object falling (rock, tree limb, falling gear, etc)

#2 gunshot wounds (animation) and blast wounds (shrapnel an exploding propane stove canister, etc)

#3 stab or puncture wounds from a needle or knife or puncture wound from falling into a tree limb, or being punctured by a falling branch, trekking pole or being stampeded or gorded by animals or bite and claw injuries (Mountain lion last month) from bears watch Revenant – it has most of the injuries we are talking about.in one scene

#4 hematoma (a collection of blood, such as a clot, outside of a blood vessel)

#5 cuts or abrasions to internal organs (cracked ribs tearing into organs)

#6 cuts or lacerations to the skin (from walking through a glass door or going through a windshield or an extremity going through the glass (more common).

#7 blunt force trauma from impact with an object (falling from height and impacting the ground). Slipping in a river crossing  and current carrying you at speed into rocks (usually head injury, which is a nasty bleeder)

I always carry one, my experience in Afghanistan in 2003 was a life lesson on the value of a good tourniquet and medical kit with everyone trained on how to use it.  They only weigh ~3 ounces and you can get a good one for around $20, I like the orange ones which cost little more, but could provide you faster acquisition in an event. Think of a tourniquet as cheap life insurance.

Source: https://www.healthline.com/health/bleeding-to-death

A large handkerchief and a stick make a very effective tourniquet. Applied after someone grabs the limb with two hands and squeezes.
Been there …

Cheers

“shrapnel from an exploding propane stove canister”

Interesting example, since I’ve seen that happen at a Scout Camp (no human injuries, but some holes in tents, mostly from campfire cinders).  I’d recommend a bit more supervision around petro-chemicals than we had the 1970s.

@davidinkenai

i used that example as I have also seen a freestanding canister “cook off”. Exactly why I now use remote canister stoves like the Kovea Spider and recommend it for scouts

@rcaffin

a large hankie does work.  Glad you made it!