Podcast 131 – Ultralight First Aid Kit Strategies

Share some unique medical scenarios you’ve had in the backcountry and what you did to resolve or address them.

I learned a few weeks ago that the mini tube of superglue I carry in my med kit for large gashes can also repair a snapped fishing rod and keep my trip afloat.

I’m not sure if this counts as unique…

A couple of years ago, on the last day of a walk, I was joking around with a friend, and mis-stepped – right off the edge of the duck-board track. Split my nose and lip on the edge of the board.

As I was recovering enough to get up, I was running through the contents of my pack in my mind, trying to come up with something I could use to hold to my nose and mouth to soak up the blood and keep a bit of compression on as we walked out (5 hours).

It wasn’t easy! I don’t carry ‘extra’ clothes and nothing cotton. I could have used a wound dressing, but I didn’t have a really large one, and couldn’t have kept washing it out as I walked. I ended up using a light cotton sling from my first aid kit.

I have frequently read comments like ‘don’t carry a sling etc, just use spare clothes’. What spare clothes? My alpha direct hoody, apex jacket, socks, not-cotton undies 🙂?  I have lightened and ‘syntheticisised’ my gear too much!

I still carry that sling (been washed). Oh, and needed multiple stitches in nose and lip.

Megan, sorry to hear that, it sounds rough!

A couple years back I crossed a bridge over a creek that had some boards rot out leaving behind a few nails sticking straight up.  I was worried someone might not see them and step on one or get impaled if they slipped so I grabbed a rock and started hammering them flat.

Of course I slipped and put a big gash in my forearm.    I always carry a few extra dried out baby wipes that I use for any dirty jobs that I don’t want to subject my buff or lightload towel to like blowing my nose (chronic issue), wiping down tent stakes, washing my cook bag, and many more.  Wrapping my arm in a few of these and holding them down with a small wrap of coflex from my med kit kept the bleeding under control until I could make it out.

I like these dried out wipes because they always get consumed and aren’t single use items in my kit that only get used in emergencies.  They also weight pretty much nothing.  I carry 1 per day +1

I’m having a hard time finding some of the items on the list at a reasonable qty/cost.  Such as: 0.36 ml dermabond mini, 1×2″ hydrogel pads, tincture of benzoin.  Any specific recommendations?

Bob: I use single use superglue rather than dermabond.  they aren’t as “pure” as dermabond and sometimes sting a bit, but work well enough.  I am pretty sure the last time I replenished my benzoin and hydrogel pads they were less than $5.  What sort of prices are you seeing?

Mark: I just started an internet search for those items I didn’t have – not extensive research.  As I understand it, Ryan has a couple band-aids, but plans to use the gauze and hydrogel pads along with the leukotape to fashion bandages as needed.  I don’t have experience with the tincture of benzoin, and mostly see it in larger bottles.  Maybe the 1×2″ hydrogel is not as common as the larger sizes.

TBH…I should probably not worry about the per-unit cost on Amazon because they may just end up expiring unused like my old ones, and I don’t need that many.  I should just buy something locally so I can see the expiration date.  In any case, I’ll check what I can find at CVS or Walmart.

FYI…I did just find somethings on the NOLS store: https://store.nols.edu/collections/first-aid-supplies

Including the Benzoin Tincture – 5 pack for $9.99

besides local drug store see if there are are “prepper” stores near by. We used to have one a mile or so from my home which had a great selection of first aid supplies at reasonable prices.  The other thing is to develop friends with EMTs / nurses in urgent care (hopefully not as a frequent patient)… sometimes a few items of a specific size might fall out of the back of the truck :)

The other thing is to develop friends with EMTs / nurses in urgent care (hopefully not as a frequent patient)… sometimes a few items of a specific size might fall out of the back of the truck.

One of my housemates works in IR at the local hospital; I get most of my single-serving supplies from her, because a lot of the stuff that they pull for procedures literally has to be thrown away if it’s not used.  That seems wasteful – and it is – but it’s all for reasons of sterility; I don’t know the exact nature of the rules, but I understand the intent.

For those that don’t have a friend in healthcare: group purchases can really help out with things like benzoin and Dermabond…and I really do suggest using medical superglue over the standard stuff.  Normal superglue has some nasty stuff in it, but medical grade superglue…well, okay, it also has a lot of nasty stuff in it, but it’s safe nasty stuff according to people that know more about it than I do.

Moving on: here’s my quick list of stuff that I now carry that I didn’t expect to carry.

• Tick tools of some sort; preferably the twist-and-pull variety, because they’re not only easier to work with in thick hair or fur, but they seem to engender calm on the part of the person with the tick.  I’ve found that if I pull out some tweezers for anything, people tend to act like I’m holding a cutting torch; if I take out my cute lime green tick tool that looks kind of like a cartoon dinosaur and say “Oh, no worries, I have a tool for that!” they just kind of chill out and don’t even realize that they’re supposed to be panicking over getting a weird disease from the offending parasite.
• Kinesiology tape.  I don’t use it for what it’s intended to do – come to think of it, I’m not even sure what that is – but it’s a hell of a multi-use tape.  It’s the best blister-prevention layer I’ve ever found, it’ll bond to hair-covered skin pretty well, and the stretchy effect means that it’ll even hold a light compression dressing in place if need be.
• Dermabond, as mentioned earlier.  I carry a few single-use dispensers, plus an extra if I’m with my dog; it’s the best repair material I’ve found for injuries to high wear areas like fingers, palms, feet and paws.  It’ll also fix equipment, as someone else mentioned.
• The best band-aids I can find.  I’m all thumbs when it comes to putting them on, so I make sure I have backups.  Right now, I’m using some hydrocolloid dressing models that seem to work really well for most injuries and burns, and which stick like crazy…and I’m all about things being entirely too adhesive, because that means I don’t have to deal with getting another one out and trying to get it on someone’s finger (usually mine) without accidentally sticking it to itself and wasting it.
• Saline packets and an irrigation device.  Most of the injuries I’ve seen are both very minor and very dirty…so I try to have a way to gently pressure-irrigate them.  Syringe, modified SmartWater bottlecap, whatevs; doesn’t matter as long as it works.  I’ve seen too many stubbed/cut toes, torn paw pads, sliced-open-on-a-muddy-oyster-shell heels and scraped knees turn semi-nasty from infection to not try and clean them out as best possible when they happen.
• Sanitary/menstrual pad.  I can’t even tell you how many times one of these has come in useful.  Unexpected/early/heavy cycles, serious gashes that needed a big, absorbent dressing on them, or even a smaller cut that just needed something vaguely absorbent and non-adherent; they work for all of it.  It’s rumored that I once pulled out a panty liner for a WEMT that was working on an injured eye and needed something to pad it with.
• Cheap nitrile gloves.  Two pairs.  Weighs nothing and keeps the ick to a minimum.

I’m sure there are other things, but those are the ones I can think of off the top of my list.  Most of them are pretty light and they’ve all been consistently useful, so I don’t see a reason to not carry them.

This are great posts and a shoutout back to Ryan for the modular approach! I have a small EDC kit for convenience when traveling, and also separate Hike/BP and travel kits, which have all been separate.  I’m now planning to take the EDC kit everywhere and will only duplicate items in the other kits that require bigger quantities in the Hike/BP and Travel kits.  I may not take the hike/BP kit for day hikes – we’ll see.

I’ve added some things that weren’t on the original list, like Steri-Strips in lieu of Dermabond.  I have carried an OTC glue before, but it almost always dries up – I may add back the Dermabond – especially since I plan to take my pup along soon. I definitely have the tick key and may also add the Kinesiology tape, dedicated irrigation device and pad.  @Bonzo – thanks for the what/why/how details.

Here is my EDC FAK (~ 3.6oz) :

Meds:

• Acetominiphen (Tylenol) 500 mg
• Diphenhydramine (Benadryl) 25 mg
• Ibuprofen (Advil) 200 mg
• Loperamide (Immodium) 2 mg
• Loratadine (Claritin) 10 mg
• Pseudoephedrine HCl (Sudafed) 12 mg
• Thera tears

Tools

• Emory board
• Finger nail clipper
• Safety pins
• Scissors
• Single use toothpick and dental floss
• Tick key
• Tweezers

Wound Care

• Analgesic wipes
• Antiseptic wipes
• Band-aids (various)
• Hydrogel (hydrocolloid) blister pads
• Leukotape – 1″ x 3′
• Steri-Strip (suture strips)
• Sterile gauze dressing pads (various)
• Tincture of benzoin
• Triple antibiotic ointment packet

My hike/BP FAK (~4 oz) includes more of some of the above items, as well as:

• Albuterol Sulfate Aerosol (Inhaler) 90 mcg
• Aquatabs
• Pencil with flagger tape wrapped around it
• Post-it Notes
• Comb – for removing cholla
• Sterile gloves
• Moleskin

I have a few things to source, but the exercise gives me peace of mind for my next hike, trek and travel!

I’ve added some things that weren’t on the original list, like Steri-Strips in lieu of Dermabond.

I carry a few Steris as well, because they have a different use in my kit, compared to Derma.  Steris can pull a wound together and use tension on the skin surface to hold it closed, which Dermabond can’t do, and they can also be removed if needed.  Derma is great for linear cuts that need to be sealed up – hands, feet, paws – and that won’t require a dressing change.  Come to think of it: Derma isn’t always good for seeping wounds…but regardless, I’m glad some of my stuff helped you out.  I have a bunch of other items in the kit, but it’s probably the same stuff that everyone else carries – possibly excepting lightweight shears – so I didn’t go into any of that. 👍

Might seem to go without saying but trust me (paramedic here) it does not:  If you use self-created pouches for meds as many of us do, please label them with the name of the drug and the mg amount of each tab (i.e. acetaminophen 250 mg) along with the exp date. You can use brand names instead if you like. But even though you know what they are, you may forget in crisis/pain, and other folks might not know. Especially if you carry unique-to-you meds as well. SO many people know what Tylenol looks like so don’t label it, and then are not actually sure after the fact what they took or how much because they were very stressed. In cell range someone can look it up but…not if not. If a problem persists beyond one dose, keep track on that notepad. It really helps when picking someone up, knowing what they have already had since rescue meds can interact with common over the counter items.