FAK Lightness…of a fashion…

Lighter, more effective, and no danger of forgetting to pack it… what a good idea.  I assume now that you finished the class you recreated your first aid kit based on you new insight.  My first aid kit got seriously trimmed down though a few new things got added like dermabond / superglue.

Bonzo, that means you have to share your all new FAK contents.

It’s in the process of being TOTALLY redone, now… although it wasn’t bad, before.  I’m basically assessing what’s in the bag in terms of effectiveness per unit weight, which is an interesting mental exercise in and of itself.  I’ll post some contents and weights here in the next few days. 👍

Also: for those that don’t have the ability to take the ten-day course…just get SOME training.  Even a three-day Wilderness First Aid course can give you all kinds of good knowledge, and the NOLS handbook on Wilderness Medicine is an excellent addition to any library.  I highly recommend investing in both.

Thanks Bonzo for the reminder.

Someone once said, perhaps here at BPL, that the most important thing we carry into the backcountry are our brains.

You’d rather have me and my 2-ounce FAK encounter your busted body than a Boy Scout and their 2-pound FAK from Walmart.

And you’d rather my MD wife found you, even with no equipment, than me.

Some of the highest-value exercises we’d put Wilderness Advanced First Aid students through would be practical sessions, but with their packs packed for a trip.  So the aluminum pack stays, inflatable sleeping pads and trekking poles were fair game for splints, traction for a broken femur, etc.  Less heroically but more commonly useful – your clothes and sleeping gear for avoiding hypothermia in an immobile victim in adverse weather.

Some of the highest-value exercises we’d put Wilderness Advanced First Aid students through would be practical sessions, but with their packs packed for a trip. So the aluminum pack stays, inflatable sleeping pads and trekking poles were fair game for splints, traction for a broken femur, etc. Less heroically but more commonly useful – your clothes and sleeping gear for avoiding hypothermia in an immobile victim in adverse weather.

Yep.  We had all kinds of fun figuring out how to stabilize limbs without any sort of proper equipment, and how to deal with hypothermia simply by unpacking all of our extra layers and determining where they could go.

Kit weights incoming.

Looks like the existing kit is about 140 grams, somewhat-fully stocked.  I can give an existing list of items if people are interested in hearing it, or I can skip that and just make a revised list as things evolve over the next couple of weeks.

First big change: the addition of a small pair of shears.  Cutting clothing/fabric with a knife is a very nice idea until someone is lying in a bad position, or the clothing layer is tight, or until any number of other factors come into play.  They’re also good for cutting tape if you can’t manage the pinch/rip move.

First big change: medications.  I don’t normally carry aspirin, but I’m going to start doing so in case of mild cardiac issues.  I already carry an EpiPen for my hiking partner, so that’s covered.  I’ll likely add additional diphenhydramine for allergies, and – although I hate to think of it – naloxone, because opiates are a serious issue in my area.  Maybe some pre-blended Tylenol/Advil for the serious pains.

I think I’m also going to address my bandage game: normally I have a few fabric strips, but I think I’m going to shed a few of those and get some additional surgical strips and thin-film dressings.

My FAK comes in at the same weight, after taking a Wilderness First Aid course.  It was pretty good to start with but I did add some tegaderms and different tape.  Includes my blister goods as well.

My FAK comes in at the same weight, after taking a Wilderness First Aid course. It was pretty good to start with but I did add some tegaderms and different tape. Includes my blister goods as well.

I’m including blister stuff, eyeball stuff, tools/widgets, antibiotic cream, hand sanitizer, etc, etc, to provide an all-in, finished weight.  Mine was one of the heavier kits in our class; unsurprisingly, two of our thru-hiker classmates had MUCH lighter kits, although they were well-tailored for the trips in question.

Oh yeah: probably going to throw an ACE wrap into the mix.  I used one of those at least twice a day, most days.  Good for the knee, ankle, wrist, shoulder, elbow, ribs, clavicle, most improvised splints, etc.

Picked up an ACE bandage today – 4″ width – some chewable aspirin, combined ibuprofen/acetaminophen tablets, a few transparent dressings, and a single-use dosage of Narcan.  That last one cost me $35, but if I ever need it, that’ll have been a small price to pay.  Ditching some of the Band-Aids, painkillers, etc. probably makes this a negligible weight change.  Next project: small, lightweight shears.

Might be of interest:

Backpacking Scissors review, including small, lightweight shears.

Backpacking First-Aid Philosophies, followed by a good discussion, though it looks like you are well on your way.

— Rex

$35 Narcan.  Hmm?  20 years ago, a single dose vile was less than $2.  No new research, no new manufacturing issues, no new FDA processes. Just repackaged.  And they say the drug companies are not ripping us off. Same story with the EpiPen.

Thanks, Rex; I’ll definitely check that out!  I have an entirely-new appreciation for shears after having to use them…and after not being able to use them when I needed them.

Arthur, in this case, the drug companies aren’t really the ones at fault: it’s a matter of what insurance handles.  I had a long chat with the pharmacist yesterday on that exact subject; yes, the price has increased – a lot in the past couple of years – but the real issue is whether or not any individual insurance plan covers the cost of the drug.  Ours doesn’t, but to my understanding the majority of plans do.  Most are $10 copays, or less; a great many cover it entirely, so the cost is $0.  That variance in payment doesn’t address the increased cost of manufacturing, distribution, etc, etc, but it does at least throw a little light on where the responsibility lies.

In my ignorance I had to Google “Narcan”…I guess I’m wondering why you would need to backpack with something used “for a known or suspected opioid emergency.”  Where I hike in PA we rarely see others on the trail and I’m confident that none of my hiking partners would be in danger of an opioid overdose.  I know I live a sheltered life, but has the opioid crisis hit the woods?

I know I live a sheltered life, but has the opioid crisis hit the woods?

In a word: yes.

I don’t hike or hang out with people that engage in anything more exciting than the occasional bit of weed, but there’s no telling who I might come across in the backcountry, or what they may be using… recreational, Rx, accidental usage, etc.  Sadly, you can find people at risk from opioids literally everywhere…so for the couple of grams that a Narcan dosage weighs, I’ll carry it.  Same rationale behind an EpiPen; for the weight, it’s worth it.

Thanks – makes sense.  I’m afraid my FAK is focused on my needs and those hiking with me.  I’ve never carried an EpiPen because nobody with whom I hike has allergies that require one.  I should really re-think my kit to consider how prepared I’d be to come across a stranger who needs care.  How many pairs of nitrile gloves do you carry?  I’ve got one pair that, thankfully, I’ve never had to use.  I replace them every other year to make sure they’ll be good when I do need them, but I still only carry one pair.

That’s the problem with allergies, anaphylaxis, overdoses, and even garden-variety trauma; they can strike without warning, notice, or prior history.  And sure, you can’t prepare yourself for everything that might happen, but you can definitely stack the cards in your favor regarding the things that are likely to happen.  Instant assistance medications like epinephrine, Narcan and glucagon are – pound per pound – some of the most effective and powerful treatments that you can carry.

Gloves: three or four pairs… including some that are sized to fit over a light insulating glove if I’m in cold weather.

I now carry one pair of nitrile gloves and several pairs of food service gloves. They are surprisingly durable and don’t register a weight on my scale. They fit comfortably over wool liner gloves and seem like a good choice as a multi-use rain glove on lighter trips where I wouldn’t bring my normal rain mitts or Pogies.

A word of advice. Using Narcan on a person that is not your family and outside of 911 range…and they die anyway…you could be looking at a lawsuit from their family. Be sure you are prepared for that.

I am not too sure good samaritan laws will extend to its use when the standard of care may not be met (immediately calling 911 for medical support, having meds to counter any side effects of Narcan, needing more than one dose to totally reverse, etc). The “patients” family attorney may like to challenge you on that one.

“don’t register a weight on my scale”

you need a more precise scale : )

Narcan…interesting choice. I’m torn as to whether to admire your concern for others or question if you’re packing your fears…on behalf of others! I would imagine splints or poison ivy meds or something for an upset stomach might be more applicable, but the first is too heavy, and the rest not life threatening. is there a med for peanut allergy? that might be more common, given the backpacker diet.

John: In short, there’s no possible way to alleviate the threat of a lawsuit.  In many jurisdictions, people can sue for almost anything at any time; having formalized first aid training and acting within the scope of your practice reduces the likelihood of a successful suit, but there will never be an elimination of risk.  Thankfully, with the three aforementioned substances, the risk of fatal side effects is low.

jscott: Personally, I see no problem with reasonable preparation for events that can be dangerous, should they occur…and having lost a niece to an avoidable overdose, sure, I can call a repeat of that scenario a legitimate fear.  That being said, Narcan isn’t something I can replicate in the field.  I can make a splint out of most anything; I can solve poison ivy issues with soap, water and Benadryl…but a heavy and accidental dose of fentanyl?  I can’t improvise that treatment.  Likewise, I can’t improvise a stopping measure for anaphylaxis – that’s the bad result of a peanut allergy, by the way – so in my mind, it’s not a matter of packing for fears so much as it’s a matter of carrying what I cannot improvise.  And just so we all know what the weight penalty of a Narcan dose actually is: 11 grams.  That’s a penalty that I – and more importantly, the person that may need it – can live with.

Narcan can be had for free or very cheap. Look for local harm reduction groups near you and inquire, they are almost always happy to give it, and training, away to those who want. There are fentanyl tests for r.d. if one is worried about someone spicing up their product. Having lost more than a few friends, including some active and athletic outdoors-loving folks, to accidental (and preventable) od’s I often find myself packing for the worst in that regard too.

Moving on, I regularly re-read my wfa textbook, keep my meds freshly rotated, and bring along a small weatherproof slip of paper which lists the drugs along with descriptions and dosages in case someone is using my kit and I am unable to help. As far as kit goes, it’s pretty basic for lightweight backpacking cept for a few items. I like strength tape (the blue stuff) for blisters cause it sticks wayy better thru wet and gnarly than leuko, and, I carry a blow out kit in my front mesh –tq, some compressed gauze– for traumatic injury. A couple gauze pads, and a packet of poison ivy soap round out treatment for, ime, the most commonly treated trail issues. The only thing I’ve added lately is more benadryl — now 3 days worth — after an unfortunate run in with wasps recently.

Strength tape?  Do tell.  I would like more options than just KT or leukotape.

Good point on other Narcan sources; thanks for posting that.  Also, the $35 it costs me to get is for two doses, so it’s about $17 each; sorry for not clarifying that earlier.