Podcast 80 | Backcountry First Aid Kits

[Backpacking Light]

Companion forum thread to: Podcast 80 | Backcountry First Aid Kits

In this episode of the Backpacking Light Podcast, Ryan discusses ultralight first aid kits for backcountry use.

[Bill Budney]

Good way to look at it; bandage vs band-aid. For years I’ve carried duct tape, a couple of individually-wrapped sanitary napkins, sanitizer, and antibiotic (medihoney). I can treat many kinds of wounds with that combo. Plus a variety of tablets, similar to your list. Every once in a while a tampon comes in handy for other members of the group.

I love your irrigation syringe. Gonna add that. (also handy for seam sealing)

[Matthew / BPL]

Any thoughts on Tegaderm as wound dressing material? NOLS WFA introduced me to this material. I now carry a couple feet off of a 4” wide roll. I like that it is waterproof and allows observation of the wound.

[Sharon Bingham]

I didn’t hear a mention of constipation in relation to abdominal pain. Maybe it’s not very common, or maybe there aren’t good solutions for it. But I know it’s an issue for some in the backcountry – especially with often limited access to roughage (fresh fruits and veggies). I am one of those people particularly susceptible to this issue – not just because of that, but due to some health issues that also make me more prone (I doubt I’m alone in this lol).

But constipation can cause all kinds of abdominal pain issues – including gas not being able to move, which can feel a lot like appendicitis. It can also cause nausea, etc.

If this isn’t a first aid issue, because you wouldn’t carry anything to treat it specifically, it seems like it would still be worth a mention in a first aid discussion that discusses abdominal pain – along with any tips on how to better avoid it (if any exist), similar to the discussion on diarrhea and bathroom hygiene.

Great podcast and timely topic. I was just going through my first aid kits the other day!

[Jeff McWilliams]

Constipation:  Man, my problem is usually the opposite of that.  When I did 8 days on the JMT last year I was remarkably regular.  Filling a cathole was usually part of my morning routine.

[Jeff McWilliams]

Using sanitary napkins as wound dressing:

I’ve encountered contradictory information on the efficacy of them as a wound dressing.  The problem is that the material in a sanitary napkin or tampon wants to suck up all the surrounding liquid, and that this action inhibits the natural clotting ability of blood in a wound, as it actively pulls the blood out of wound and into the material.

Maybe it’s good for other uses, but as a wound dressing, I think I’d prefer QuikClot gauze, despite its expense.  In terms of effectiveness, it’s probably lighter to carry one or two 3 inch x 2 foot QuikClot gauze dressings to get the job done rather than several maxi-pads.

 

[John S.]

Sharon, you could try a fiber supplement or crushed bran cereal flakes (what I use) added to oatmeal or other foods.

[David D]

Sharon, after some uncomfortable trips last year, I researched this a fair amount and came to the following conclusions.

Possible causes of constipation while backpacking:

• A diet heavy in cured meat
• Insufficient water intake
• A high fat diet
• Too much or too little fiber
– Needs vary but ~ 10-15g fiber per 1000 calories is typical

Laxatives can lead to dehydration (and diarrhea). I avoid them when not having access to indoor plumbing.  MiraLAX is more gentle by drawing water to the stool but takes 24 to 72 hours to work.

Figs, dates, raisins and nuts are high in fiber, chia seeds are a fiber bump.  A higher fiber diet can take a while for the body to adjust to so  don’t introduce too much fiber too quickly.  Try it at home first, before the trip. Drink lots of extra water.

 

[Bill Budney]

Fiber isn’t necessary, although suddenly changing your fiber intake is going to surprise your gut microbiome. Any sudden changes in diet can do that; results range from diarrhea to constipation.

High fat diet? That doesn’t sound right to me. Fat is one of the keys to lubricating stools. Of course, suddenly changing your fat intake: See above.

Water, salt, and sufficient fat (not necessarily excessive fat) should do the trick.

 

Jeff: Yeah, Quick-Clot may be better for actual dressings. Or non-stick gauze. I haven’t used Tegaderm, but that might be a good suggestion from Matthew. I’m more thinking about multi-purpose stuff that is easy to carry. Sanitary pads are tiny highly absorbent sponges; useful for cleanup and prep, or as pads in a pinch. Get the little ones; no need for the huge kind. They may not be ideal dressings, but they are better than a t-shirt or bandana. I have also been carrying dehydrated cloths for similar purposes.

[David D]

From a John Hopkins clinical dietician:

High-fat foods ― those rich in oil, butter and grease ― can contribute to constipation

[Bill Budney]

Dieticians, heh. She also thinks you need fiber, which is clearly untrue. Fat is necessary to prevent constipation.

It’s the sudden change that is troublesome rather than the food itself.

[Bill Budney]

* clearly untrue -> incomplete information

I meant, “not true for everyone”. Low carb dieters generate large amounts of beta-hydroxybutyrate that feeds the same beneficial gut flora that are otherwise fed by butyrate fermented from fiber. Whether or not that is a complete picture is unknown; we actually know few real facts about the billions of bacteria in our guts.

In other words, fiber is more of a hedge. It won’t hurt you (probably), and many people like some. Just make changes gradually.

I’m just saying that there are not hard rules about it that apply to all. Diet is highly individual. And your billions of friendly passengers get a vote, as well.

 

[Sharon Bingham]

Oooh! I forgot about Chia seeds! I already like to use those in overnight oats…The bran flakes are a great idea as well – another great fiber source I often forget about.

I also have found the laxatives I have tried to cause more problems than they solve.

I did wonder (and maybe someone here knows): do veggies that have been dehydrated or freeze dried offer the same or similar fiber/roughage action as they would have when fresh or fresh cooked? Just thinking about it, it seems like they would – but not everything works the way I think it would intuitively… Hahaha.

[Bill Budney]

Maybe not the same, but similar, yes.

Too much dried fruit can easily upset your usual balance. Plenty of fiber there; sometimes too much.

[Matthew / BPL]

May I suggest a Larabar or two per day to keep things moving? Delicious, high calorie density, small, cheap, very short ingredient lists… Good stuff imo.

[John S.]

Matthew, which Larabar flavors do you like?

[Matthew / BPL]

I have strong opinions on this topic! Lemon and cherry are delightful. Apple is tolerable. The limited edition pineapple/coconut was amazing. I think the tartness masks the date flavor well.

I find the chocolate chip and related flavors to be foul but ymmv.

[Sharon Bingham]

Huge fan of Lärabar! The company has a great origin story as well.

I was surprised how much some of their flavors taste pretty spot on with very limited ingredients.

Cashew Cookie is one of my favorites/go to’s.

Lärabars are another great idea I hadn’t thought of (but should have) with their high date content.

Thanks!

[Glen L]

“Oooh! I forgot about Chia seeds!”

 

Sharon chia grows wild in our Sonoran desert country. We see it near trails and washes. They have been blooming for several weeks now. When the heads dry you just turn them upside down, shake them out into your hand. Took this photo at the end of March. However our most used FAK item is a pair of Silver Gripper tweezers. Lol

 

 

 

[Sharon Bingham]

That’s awesome! I didn’t know that it grew wild in AZ.

[AK Granola]

I always bring ginger tea as well as dried ginger. Great for tummy upset, bowel issues of either extreme, nausea, and the dried ginger also makes a nice sweet snack. And the tea is nice after dinner, for digestion. I would recommend trying it for constipation (or just have your gall bladder removed, that works great for a permanent solution!).

I have to admit my traveling pharmacy is more substantial than most but I have used every item on one trip or another, either for myself or others. It’s still under 4 ounces and compact in a quart ziplock bag. The only thing I’ve ever really not had when I needed it were enough bandaids when a fellow traveler got bad blisters on both feet; we used everyone’s kits to patch her up.

I bring just a few of: loperamide, percocet or vicodin, tagamet, neomycin, burn gel, cortisone cream, alcohol pads

I bring quite a few: acetaminophen, aspirin, benadryl

Other things: eye drops, various bandaids, tape, a bit of gauze, 2nd skin, bleach drops (taped shut so I don’t mistake it for my eye drops!), tweezers

Tale for the ladies: my mom told me a story of a remote trip she took well after menopause. She hadn’t bothered to bring any feminine hygiene supplies because she hadn’t needed any in years. Suddenly, a week out from civilization, she started bleeding again! No one had any supplies for her. She ended up using an extra pair of socks, and rinsing and drying them. Since I heard that story, I do always have some pads in my first aid kit!

I heartily agree with Ryan’s advice to take a wilderness first aid class. Learning to use items already in your pack as splints, slings, etc. was very helpful. Thankfully, I’ve never needed any of it. But knowledge is the lightest weight first aid item. (I need to retake that class!)

[Todd P]

Hi, I am having a hard time locating the following items that Ryan listed at the end of his podcast

* First Aid scissors – Suggestions on make and size

* Tensore (Or was it Tensure) Robinson adhesive in the small glass capsules

And then I am looking for a suggestion of how NOT to take the whole huge roll of Leuko tape. How do you all carry that?

And does anyone carry an old school ace bandage? Or is that now replaced by the Leuko tape.

Thanks in advance everyone.

[Bill Budney]

* First Aid scissors – Suggestions on make and size

I believe he meant “bandage scissors” (also called “trauma shears”). They are available at any pharmacy. It is just scissors with blunt ends to avoid damaging skin, while being sharp enough to cut fibrous gauze, tape, and clothing. Prices vary; the inexpensive ones are often lightweight. Real medics and EMTs might carry fancier scissors in holsters.

* Tensore (Or was it Tensure) Robinson adhesive in the small glass capsules

I believe you are referring to Tincture of Benzoin (at about 18:07 in the podcast) in small vials. It isn’t adhesive itself; it is an adhesive-helper. It cleans skin and preps it for adhesive. Leukotape sticks pretty well without the benzoin, but a few ampules weigh almost nothing (about 3 grams each, including sterile wrap).

And then I am looking for a suggestion of how NOT to take the whole huge roll of Leukotape.

The method commonly attributed to Andrew Skurka is to stick a length of Leukotape to release paper (the non-stick backing paper from sticky labels). Trim the release paper to the size of the tape. This gives you individual strips of Leukotape that do not lose their stickiness by re-rolling tape around some object.

And does anyone carry an old school ace bandage?

Sure, carry what you know how to use and think you might need. Rolled gauze can often make the same bandage at lighter weight, but elastic is convenient for adding compression. I carry self-stick medical tape for similar purpose; it is lighter than elastic.

[Glen L]

The biggest kit we carry is this one. It has a good number of useful items including a gauze bandage, some butterfly closures and a dram of tea tree oil that makes the best antiseptic that we have ever used. Your tape goes around the case. It also includes some repair items too. This is the absolute largest kit we take.  The scissors are Swiss Army replacement that one can buy separately. Weight control be saved by leaving the hard case but it keeps everything from getting smashed and provides a place to wrap the tape.

[Todd P]

Hey Billy. Thank you so much for your reply to my questions. You were most helpful.  I figured I did not hear correctly on the  Tincture of Benzoin. So that was great that you clarified what was said.

Happy Trails to you,

Todd

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