Which first aid kit?

[Nate Ward]

So which first aid kit are you taking?  I’m not going to build one from scratch, will add what I think I’ll need, just need a good base to start with. Been looking at the Adventure Med Kit Mountain Weekender and the REI Backpacker Multiday.

[Rex Sanders]

It depends. How much first aid training have you had? How much risk are you willing to take? How long will you be out? What kinds of trips will you be doing – easy weekend trails in the summer, or extended winter sufferfests? How many other people are you supporting – are you the FA “expert” on a larger trip?

Also a good rule of thumb – don’t take something you don’t know how to use.

Based on older threads, many on BPL carry kits under 8 ounces, often far less, in part by improvising with other items in their pack. Which they’ve learned to do from Wilderness First Aid or Wilderness First Responder courses.

The AMK Mountain Series Weekender at 31 ounces might be overkill. I’d definitely ditch the case and repackage many items into lighter Ziplocs, etc. I’d repackage the REI Backpacker Multiday First-Aid Kit too.

Another interesting source of FA kits is WMI/NOLS: http://store.nols.edu/Store/pc/NOLS-Med-Kits-c20.htm

— Rex

[David Thomas]

“Tell me how to save weight on my sleeping bag, but it has to be made from 1978-era Polarguard.”

First Aid kits are the worst benefit-to-weight if you use off-the-shelf kits except maybe a 8-inch-bladed Rambo knife.

Having taught First Aid, CPR, Advanced First Aid, and Wilderness AFA to 2,300 people and having practiced something out of every chapter of the Red Cross First Aid book in the wilderness (except Emergency Childbirth and Nuclear Radiation), I agree with everything Rex said above.  Bring only what you know how to use, study & practice to do more (bandage, splint, keep warm, make cool) with things you have with you.  The most I ever bring*

4 to 8 waterproof bandaids, Leukotape (10 to 20 inches), tweezers, small mirror (if solo, and not on your compass), small scissors (don’t create more injuries with a razor blade), small blade (SAK Classic addresses blade, scissors, and tweezers plus nail file in 21 grams).

Drugs (knowing when to use them and the contraindications): Benadryl, Imodium, Tylenol, Advil, Aleve, Aspirin – that might be 4 of each on a weekend trip, twice that on a longer trip.  Small, professional-sample sizes of an anti-fungal lotion and an antibiotic lotion.

I’d far rather you took a Wilderness Advanced First Aid course and happened upon me with your usual backpacking equipment than, without training, you try to use REI’s biggest First Aid kit on me.

*we did bring much more on a GCNP private rafting trip, but (1) due to communications issues and helicopter access, it is potentially a very remote place, (2) the boat still floats regardless of how large the FAK is or how much beer you bring, (3) with two MDs along, for reasons of marital harmony, I wouldn’t want the wife or the SIL to feel “naked” without many of the drugs they routinely use in town and (4) we had MDs along but other groups don’t, so we anticipated and experienced helping other groups with medical issues.

[Nate Ward]

What I’m looking for is a base kit to take to Philmont. Something I can customize to meet my needs, no i don’t need a surgical bag nor do I need three band-aids and duct tape!  The previous trips we had an EMT that took care of this….now they are requiring two WRFA qualified people and I’m one of them..just wondering what y’all have used

[Aubrey W. Bogard]

Nate,

Since this is the Philmont forum, please confirm that you are asking about a kit for the entire crew (?).

It’s my understanding that due to the “smellables” concerns, a single kit is more common at Philmont as compared to individual kits.  Please correct me is this is not so.

[Nate Ward]

Each person on my crew will carry their own personal FA Kit for personal care…I have never seen a need to put a bandage on small cut/scrape FOR a boy (didn’t say I wouldn’t monitor the situation) that is how they learn….I will be carrying a larger kit for major emergencies and resupply of the individual kits if necessary (never had that happen, but could)

Just wondering what other crews ideas on their kits are….

[Bruce Tolley]

@Nate

For our trek each Scout had a personal first aid kit. For the crew kit, we took the AMK 0.9 kit with the contents sorted and some augmentations: mini CPR mask, Duck tape, Leukotape, other blister stuff.

Per Philmont policy we had two folks trained and certified in Wilderness FA.  Philmont is not in the usual sense a wilderness area.  As you know, at Philmont you are always a day’s hike from some staffed camp, you can sometimes get cell coverage to call the Philmont emergeny #, and you are surrounded by jeep roads so rescuers can come to you. IMO you are most likely stabilizing a victim from a sprain or fracture and planning a quick evacuation. (This is why they tell the adult leader to keep a copy of the grid map so you can tell Philmont exactly where you are.) The most common injuries in Philmont are sprains and joint injuries arguably from insufficient training and too heavy packs.  Then there injuries from lightening strikes when crews ascend the high points during thunder storms.

[Roger Caffin]

For Philmont, given that the boys will all have their own bag of band-aids (Check!), a roll of 2″ surgical tape (eg micropore), some Butesin Picrate burn cream and a mobile phone is about all you should need. The rest you can improvise, up to the point where you use the phone.

I have never seen a ‘useful’ commercial FAK. They come in clumsy heavy cases and contain everything the selection committee thought you might conceivably need on the moon. Remember: you are NOT trying to substitute for SAR or an EMT.

Cheers

[Rex Sanders]

Nate wrote:

now they are requiring two WRFA qualified people and I’m one of them

You requirements are much clearer now. The simple and legally-defensible answer is to find a kit that most closely matches the recommendations on pages 12-14 in the American Red Cross WRFA guide:

http://www.redcross.org/images/MEDIA_CustomProductCatalog/m49440095_WRFA_ERG_9781584806295.pdf

— Rex

 

[Dean F.]

To a certain degree you will always end up making your own first aid kit, anyway.  So you may as well embrace it and start from scratch.  This is because eventually everything in the kit expires, and at different times.  So you end up replacing them as you go anyway, and switching some items, etc.  Especially drugs.

So, pick the one that comes with the prettiest stuff sack.  That’s exactly why I bought this one:

Now I just re-use the sack, which as it turns out is actually quite light.  I figure that it’s handy having it be official-looking, in case you’re ever hurt and someone else has to find your kit in your bag (though that is still a damned low-probability event).

Of course, yes, if this is a group kit for a troop of scouts then you should probably get something more comprehensive… :)

[Ken Thompson]

.

[Bruce Tolley]

@ Dean

Good point on the bright yellow bag. Actually the probability to need or request someone else either to carry the group first aid kit or to find it in someone else’s pack is not zero on a Scout outing.

I assume that original poster is the adult leader. Philmont crews can have as many as twelve participants two of which have to be adults. While Philmont is a Scout “High Adventure” outing, some of the youth and adult crew participants might have done only the three required training hikes before coming to Philmont and are relatively inexperienced (especially when compared to those who post on this site).

If the worst case happens, the adult leader needs one person (or two) to administer first aid and another person (or two) manage the rest of the group.  Almost all of the maladies that have occurred on my trips (dehydration, mild altitude sickness, non specific pain in abdomen) did not need anything from a first aid kit, DIY or otherwise, but did need careful management of and a lot of communication with the injured Scout, the Scout’s parent if present, and the rest of the group.

[Roger Caffin]

Almost all of the maladies that have occurred on my trips … did not need anything from a first aid kit,

Good point. Often that way.

cheers

[ed dzierzak]

The “Guidebook to Adventure” – part of the information Philmont sends out to crews lists the following for a first aid kit:
25 Assorted Band-aids
Blister Kit
10 Gauze Pads 4×4
Antihistamine (Benadryl)
1 Tape 1”x 5 yards
Disposable Alcohol Wipes
1 Elastic Bandage 4”
Triple Antibiotic Ointment
Hydrocortisone Cream
CPR Barrier Device
Tylenol
Triangular Bandage
Ibuprofen
Small Scissors
Antacids
Throat Lozenges
Medicated Foot Powder
Tweezers
Non latex gloves
Ziploc bag or small Biohazard bag

The most important item is between your ears.

I’ve been on several treks at Philmont and, while it’s nice to have all that stuff, the most we’ve used was a few bandaids, Tylenol/ibuprofen, blister kit, and scissors. All this stuff fits in a 5x7x2 inch bag. Small and not heavy.

I’m quite happy to have NOT used the CPR barrier device…

Each participant should have their own, small kit, mainly to deal with blisters.

[Dale Wambaugh]

I started win an AMK 0.3 and added meds. my aim was to get some handy packaging and create a limit for how much stuff I was going to carry: if I can get it in the bag, it goes. Without that limiting factor, I would probably have a 1 pound kit!

After using the compresses in the kit and finding them next to useless for a typical head injury (someone did a face plant), I replaced them with larger ones.

Make sure you have some butterfly bandages, moleskin and other blister stuff, and I really like the self-adherent tapes like http://solutions.3m.com/wps/portal/3M/en_US/3MC3SD/Wound-Care/Products/Wound-Care-Supplies/~/3M-Coban-Self-Adherent-Wrap-1582?N=7569539+3294518914&rt=d . That tape works really well for wrapping around forehead, hands, feet, elbows, etc. Super for dog’s feet too.

I carry Orajel to use as a general topical anesthetic. It’s an old dancer’s trick for blisters and other foot pain.

[David Thomas]

Looks like we’re just going to disagree in the pre-packaged versus DIY FAK debate.

So I’m going to go on a little different tack, since this is a Boy Scout trip (on which I first learned first aid, knots, camping skills, etc).

Whatever you decide to bring for the first aid kit you might have to USE, consider what supplies you will bring so you can TEACH and the boys can LEARN.  In that context, I’m all in favor of bringing ACE wraps and official triangular bandages and rolls of gauze so the boys can practice, in the woods, how to use those items, and see how it works for a victim to hike, eat, and sleep in an arm sling, etc – all while no one is actually injured and in pain.  Then, having developed some skills with those easiest-to-use materials, transition to achieving the same goals (warming, cooling, immobilization, wound care, etc) by improvising with materials you have with you anyway.

One of the biggest lessons I felt we taught in Wilderness Advanced First Aid was how very hard it is to move a totally helpless person, even on a manufactured litter.  Moving them across the room isn’t bad, if it is a big, empty room, and you have six people and one or two more 6-person teams for relief!  But just navigating a wide, indoor stairway (far more predictable and stable footing than a trail!) is eye-opening and, for me, really brought home that (1) you should get the victim to shelter while they are still semi-ambulatory and (2) if they are unconscious, you aren’t going ANYWHERE over a few meters until the helicopter or a massive SAR callout shows up.

P.S. whoever is most sure evacuating someone is easy – put them in the litter!

[Dean F.]

You would need an awful lot of ACE or other elastic bandage to get enough compression on more-than-trivially bleeding wounds. Or at least more than most of us would call UL. You just have to suck it up and hold manual pressure for a long time. Of course, my definition of “trivial bleeding” probably differs from most. When people ask my usual hiking partners’ plan in the event of injury they usually answer “we pack a surgeon.”

I have often been livid at ER providers for calling me for “uncontrollable bleeding” only to find that they just kept heaping (now blood-soaked) gauze on the wound. Doesn’t work. Neither does CoBan, or Kling, or whatever your elastic of choice is. The “Israeli Bandage” that the military uses does work pretty well for anyhting that doesn’t deserve a tourniquet, but relies upon a lever and you must know how to apply it correctly. It’s a heavy single-use low-probability item though so it’s not really a great choice for UL hikers.

And then of course there’s Combat Gauze. If there is one thing that US military is up to speed on nowadays it’s field trauma care, though our injury patterns differ from most, and having crazy people at the helm of UH-60Qs does help with evacuation.
:)

[Roger Caffin]

If you really want to learn a bit more than First Aid, try vetting horses and sheep for a few years. They get caught in barbed wire, savaged by dogs, can’t tell you what’s wrong, and horses at least are a lot stonger than you.

Cheers

[Dean F.]

Stronger than you? Try a Ranger with mental status changes and PTSD. There’s a reason we disarm them at the door. :)

[JVD]

I’ll definitely go with DIY for first aid kits. I know there are a number of threads on this topic, and this being the most recent, here is my combination first-aid-and-repair kit. Happy to have comments.

Typical trip: 3 to 7 days. Rocky Mountains or Utah/CO canyon country. Alone or with 1 or 2 others, including kids. I also take this on dayhikes alone or with grandkids.

Top row, left to right: gloves, BZK wipes, Neosporin (repacked in baggie), bandaids, butterfly closures, small sterile pads

Middle row: pencil and note card (for recording incident details), Aqua-heal blister/burn pads, meds (acetaminophen, ibuprofen, diphenhydramine (Benadryl), lopramide (Immodium), bismuth salicylate (Pepto-Bismol), leukotape strips on peel-off backing, tincture of Benzoin ampules, 4×4 sterile pads

Bottom row: duct tape, tweezers, sewing kit, matches and small candles for fire-starting, Micropur water purifier, patches for mattress and tarp, whistle, SAK Classic SD knife (last 2 items carried in pants pocket)

Weight: 191 g ( 6.75 oz) including whistle and knife. Size: fits into sandwich-size ziplock baggie

 

[JVD]

Sorry, I realized this is probably in the wrong place. I hadn’t noticed this was the Philmont forum. There are probably other things to consider for scouts.

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