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Backpacking Light

Pack less. Be more.

You are here: Home / People / Interviews ("Faces") / Lightweight First Aid and Trauma Kits: Perspectives from a Mountain Rescue Medic

Lightweight First Aid and Trauma Kits: Perspectives from a Mountain Rescue Medic

by Emylene VanderVelden on August 6, 2019 Interviews ("Faces"), New Features, Wilderness Travel Skills

Introduction

This article features an interview with a Canadian Mountain Rescue Medic, focusing on how to assemble lightweight first aid and trauma kits for backcountry travel.

Invariably, when I release a new trip report with my gear list, the forum has at least one person ask: ‘what is in your first aid kit?’ Though, I am generally savvy with emergencies, (I did spend a fair bit of time with emergency services and have certainly been a patient more than my share of times) I am not a doctor, a nurse or a paramedic. Though I have taken many medical courses, I am long since expired on most of the relevant certifications, except basic first aid. I am perfectly capable of administering basic medical care to myself and packing my own kit. However, I balk at doing either for anyone else if I can possibly avoid it. I am evasive about answering the question to say the least.

Disclaimer

I will start with a relatively generic disclaimer: no one can tell you what to put in your kit. You are the best person to evaluate your needs based on your own skills and medical liabilities. That said, insight from a medical professional is a great place to start. In my case, I built my kit around ideas I got from my family doctor (he’s an outdoor enthusiast), an ER nurse friend of mine and my physiotherapist. I took wilderness first aid and have had a fair amount of experience either managing an emergency as a responder or being a casualty (I’m a pinch accident prone.)

I do, however, believe the question of ‘what goes in your first aid kit’ begs an answer; a very good answer from a current professional (read: not me.) And, if you don’t use your skills, you lose them and the certifications expire.

Candidate Search

To that end, I decided to find a professional to interview. I needed someone not only with medical experience, but also with outdoor experience (and preferably emergency trauma experience). Odd combination, which I put on the back burner for several years.

My search for a perfect interview candidate, accidentally ends one afternoon. As I stand in a line for a desperately needed cup of coffee, a stranger walks into the line behind me. Uncharacteristically, my, typically introverted personage introduces itself.

Turns out, my extroverted alter ego made friends with Michael. Michael is an avid kayaker, canoer, mountaineer and backpacker. On top of all of his outdoor pursuits, Michael is a paramedic and firefighter in the mountain community of Clearwater County, Alberta, Canada. Some time later, Michael and I part ways and I realize he’s going to be my interview subject to help us answer the question, ‘what goes into your first aid kit?’

The Interview

A few months later, I meet with Michael for the interview. He’s tall, athletic with a boyish, unassuming charm and an affable grin. He is an obvious introvert, but with an air of confidence and intention.

Em: So what goes into a mountaineering paramedic’s kit?

Michael: I think experience as a paramedic tells me more about what isn’t important in a kit than anything else. Most life-saving tools and interventions come down to training, quick thinking and thousands of dollars worth of bulky electronic equipment. None of these are possible in a physical first-aid kit.

People shouldn’t fool themselves into thinking that loading up with a lot of dressings, bandages and splints will make a positive outcome more likely than loading up with knowledge of injuries and illnesses and the techniques for managing them.

Em: What is in your head is more important than what you carry.

Michael: It’s funny, now that I’m thinking about it, me being a paramedic probably allows me to weed out a lot of items more than it has me adding a bunch of items. I carry a few different things than a first aider, but a lot less of the common things. Improvising is easier when you understand what is going on and what the objective is.

For instance, people get hung up on items of wound care needing to be sterile. I know better…Clean is preferred but sterile is not a necessity. I always say, a dirty sock stuffed in a wound is still better than hypovolemic shock.

Em: In the backcountry,  is there really such a thing as sterile? Most medical personnel I know would debate how ‘sterile’ conditions are in hospitals. There is contaminated, clean and clean enough to do surgery. If you aren’t a surgeon, the last one is irrelevant. Humans are relative germ factories. Is there any case where you would be seriously worried about clean dressings?

Michael: Large area burns, deep or full thickness burns, that is. Infection can happen fast when you lose a large portion of skin. That’s the main reason I add roller gauze to my kit, they come sterile.

Em: What is a common item you would eliminate from every backcountry first aid kit and why?

Michael: Instructions (on how to use first aid supplies). [laughing] Ok, I’ll give a real answer… Probably most of the tensor bandages and triangular bandages because they’re bulky and can be easily substituted with other things. Most kits seem to throw in a lot of them. I keep a couple if I have the luxury of room.

And I also toss the stupid little CPR face shields. They don’t work. Especially for a layman first aider. An actual CPR face mask would be optimal but are larger.

Em: And really how often are you going to be giving yourself CPR or traveling with someone you are afraid to give CPR? If you are giving CPR, it is most likely to be someone you are traveling with. Most people (maybe everyone) I backpack with could bleed all over me and I wouldn’t worry about it.

Michael: Exactly.

Em: What is one thing no kit should be without?

Michael: Duct tape. [laughing] Actually, no first aid kit should be without a user with a prevention mindset. Basically, no kit should be without brains. Always remember the brains!

Em: What’s a weird item in your kit most people wouldn’t think to put in, and what is it for?

Michael: Well, you’ll laugh… Condom, [laughing] its an emergency water container, waterproof bandage (fingers, hands), use it for its elasticity, crude glove, waterproofing for a firestarting kit (they stretch a surprising amount). Never actually used one yet for any of those though. Just seemed logical. They’re tiny and multifunction. Always a good thing to have in first-aid or survival kits.

Em: What do you look for in a first aid kit case?

Michael: Waterproof or water resistant, easily recognizable or marked as first aid, (might be sending someone else for it) and something that allows easy, even one handed access, without having to dump out all the contents. Most commercial options fit the bill but lots of other options too.

Em: I prefer to toss my meds in craft baggies from the dollar store and label them. I usually toss them in an old pill bottle afterward to prevent them from getting crushed. Is there a better method?

Michael: Same, I used to use mini bottles but never had a problem with them getting crushed in baggies. I do keep them organized separate from everything else in a mini nylon sack or designated pouch in the kit.

Em: I just dumped a pile of pink powder out of my kit the other day. Pepto doesn’t do well in baggies apparently. I used to always use a bottle then switched to baggies and switched back to bottles again.

Michael: You can still take the powder form. [laughing] I only have one tablet per bag so it doesn’t matter. The harder tablets I double up. The bags aren’t really robust enough to be opened and closed repeatedly anyway.

Em: Is there anything you think is an absolute no-no to toss out of your kit?

Michael: Never leave behind the meds. They’re basic meds but can still really improve a situation, and you can’t improvise them. Rapid fluid loss is really bad. Symptom control can’t be overstated when presented with diarrhea or vomiting.

Em: Same thing with hard tools like scissors?

Michael: Yeah, tools are the basis for improvising. Or at least, necessary for improvising.

Em: I know a lot of people think, ‘I’ll improvise a tool if I need it’, which can be done. However, it can cost precious time when it counts. Somethings cannot be improvised well either. Also, most people do a terrible job of improvising when they or a loved one are in pain.

What about antibiotics?

Michael: Antimicrobials would be a good idea for a long term trip, for treatment of various bacterial, viral, or protozoal infections, especially when you’re potentially a long time from getting out. Azithromycin (Z-Pak) is not effective against giardia, but a good choice for a wide variety of other bacterial infections.

Having the meds to treat high probability illness is always a plus. However, keep in mind that even quick recognition and treatment of, for instance, a bad case of giardia (with drugs such as Flagyl, tinidazole, etc.), diarrhea and other symptoms will continue for up to a week, for a lot of people. It’s very hard to “knock out” diarrhea fast and very easy to aggravate it. Even after treatment, dehydration will continue to be a serious safety concern, in a lot of wilderness settings where strength and endurance is required. Therefore, certain otherwise fairly benign illnesses, like giardia – in certain settings – would be cause for aborting a trip, if that option is open and depending on severity of symptoms, security of your position and available resources. (I say that having never suffered a case of it myself).

If you have no other choice or are in a good enough position to push through, having the right meds will indeed save you a lot of anguish.

The Kits

Now the brass tacks, what are the contents of Michael’s kits? Michael works on a sliding scale, he starts with a universal consideration kit and combines with items for the next size up kit. This strategy makes it easy to organize as each kit size addition can be stored separately but combined to make a larger kit when needed.

Additionally, meds are kept in a separate list and section of the kit to make using, replacing and ensuring expiration dates are valid easier. The amount of meds in the kit is determined by the length of the trip and the individuals on the trip. Everyone should be aware of what personal meds are needed by their adventure mates and where they are if the meds may be needed in a life-saving intervention (epipens, heart medications and inhalers etc.)

Universal Considerations (Day Trip +)

My universal considerations for every kit (the list may get long but most of these are light and small items):

Editor’s Note: links to specific products are not necessarily links to the exact products in either Michael’s or Em’s kit, but are representative of the types of products that are popular choices by members of our community.

Item Purpose/Importance Amount Approximate Weight
fire starting kit hypothermia/shock prevention 1 16 g (.6 oz)
blade or small knife digging out splinters, controlling callouses, useful multifunction (think tiny, sharp and narrow blade, not wide like razor blade) 1 14 g (.5 oz)
duct tape Splinting, wound cover, fire starter 4’ (1.5 m) 12 g (.4 oz)
super glue makeshift stitches for small wound closures, gear repair 1 tube 2 g (.1 oz)
needles splinters, gear repairs, blisters 1 large, 1 small .25 g (.0 oz)
electrolyte dry mix dehydration treatment 2 servings 25 g (.9 oz)
water purification tablets dehydration prevention 4 2 g (.1 oz)
zipties splinting, gear repairs 3 4 g (.1 oz)
100 quick calories (running gel, etc) hypothermia/shock prevention 1 50 g (1.8 oz)
elastic bands dressing cover securement, useful, multifunction 5-10 2 g (.1 oz)
plastic ziploc bags ice pack, dressing cover, kit 1-2 9 g (.3 oz)
condom waterproof bandage cover, glove, etc. 1-2 4 g (.1 oz)
blunt tip shears or seatbelt cutter for cutting clothing and old bandages 1 small 14 g (.5 oz)
tweezers splinters, ticks 1 4 g (.1 oz)
safety pins splinting, dressings 2-3 4 g (.1 oz)
blister balm, powder or chalk blister prevention 1 package 4 g (.1 oz)
antibiotic ointment wound care 1 small container 10 g (.4 oz)
consider: glow sticks for larger kits signalling, long term and night vision friendly light source, marking a patient or location in darkness, marking important equipment or rope 2-5 24 g (.9 oz)

Commentary:

Michael: Between that and the gear you would be carrying, that covers a bunch of small annoyances as well as splint building and major bandaging, so you can toss out the splint materials and bulky triangular bandage (substitute with clothing).

Em: I actually don’t carry a blade, I carry nail clippers with a sharp pointed file. It’s one of those tools I cannot replicate on the fly and serves a crucial and practical function in a pinch.

Michael: I hadn’t thought of that one, it makes pretty good sense.

Em: I like the seat belt cutter though, great idea. I also saw Victorinox is making a “blister pack” of tools about the size of a credit card called a SwissCard Lite which pretty much covers everything. It’s light and compact, but it’s also heinously expensive. Neat tool for backpackers on an unlimited budget.

  • Approximate Total Weight: 7oz (200 g) (with glow sticks)
  • Approximate Total Size: 1 Quart Ziplock Bag or Smaller

Minimalist Kit (2-3 Days)

Michael: I’d then work up from there to your most minimalist kit which would add some wound care supplies but only enough for isolated trauma (a single deep laceration, a single bad burn, a single broken bone) as any multi trauma in the wilderness environment is going to require improvisation anyway – unless you travel with a trauma jump kit.

As your trip length increases, the kit gets larger to account for higher potential and repeated use.

So in the most minimalist kit (solo, light 2-3 day trip) I would add:

Item Purpose/Importance Amount Approximate Weight
compression dressing large wounds, blood loss control 1 Medium 10 g (.4 oz)
band-aids small cuts 10 assorted 6 g (.2 oz)
blister pads or moleskin blisters 2 sheet or 10 pads 6 g (.2 oz)
tegaderm dressing securement 2 4 g (.1 oz)
alcohol swabs dressing attachment, cleaning wound site to ensure adhesion 10 10 g (.4 oz)
gauze wound dressing: particularly eye injury dressing 1 2×2 2 g (.1 oz)
bandage tape or IV tape dressing securement 1 small roll 6 g (.2 oz)
steristrips small wound closure 6 2 g (.1 oz)
tensor bandage minor sprains, longer term treatment 1 small 20 g (.7 oz)
roller gauze large, deep burns 1 small 6 g (.2 oz)
nitrile gloves wound treatment 1 pair 10 g (.4 oz)
afterbite swabs insect bite treatment 2 5 g (.2 oz)
burn gel or medical grade lubricating gel minor burn treatment small packet 4 g (.1 oz)
  • Approximate Total Weight: 3 oz (91g)
  • Approximate Total Size: 1 Quart Ziplock Bag

Medium Kit (3+ Days 2+ People)

In my next largest kit (a multi day backpack with another person, for instance), I’d add:

Item Purpose/Importance Amount Approximate Weight
tensor bandage major sprains, longer term treatment 1 Large 25 g (.9 oz)
roller gauze large, deep burns, multiple days of dressings 1 Large 12 g (.4 oz)
gauze all purpose dressing 1 4×4 4 g (.1 oz)
compression dressing large bleeding wounds 1 additional 10 g (.4 oz)
bandage tape dressing securement, multiple days of dressings 1 additional 12 g (.4 oz)
band-aids minor cuts, multiple days of dressings 10 additional 6 g (.2 oz)
alcohol swabs dressing attachment, cleaning wound site to ensure adhesion, multiple days of treatment 10 additional 10 g (.4 oz)
10ml syringe wound flushing, tick removal and tick container (just plug opening after) 1 9 g (.3 oz)
emergency blanket or bivy hypothermia prevention/treatment 1 90 g (3.2 oz)
afterbite swabs insect bites, multiple days of treatments 2 additional 5 g (.2 oz)
burn gel minor burns, multiple days of treatment 2 additional 8 g (.3 oz)
antibiotic ointment wound care, multiple days of treatment 1 additional 10 g (.4 oz)
abdo trauma pad head wound/open skull fracture, open abdominal injury, any large wound dressing. (Especially open skull fracture, important to distribute pressure over large area, not directly over wound site, which is why Abdo pads work well) 1 small 4×6 9 g (.3 oz)
  • Approximate Total Weight: 7.4oz (210g)
  • Approximate Total Size: 1 gallon Ziplock bag or smaller

Commentary

Michael: And by the way, the tick removal with a syringe is a ‘Michael field special.’ You don’t want to squeeze a tick when removing and you also want to save it/them for testing.

It’s something that I’m starting to take more seriously as I know a few people now that have contracted Lyme disease from local tick bites. It’s pretty much a North American wide thing now. Just to qualify that it’s not a well known method. There’s special tweezers too.

Em: Any reason you don’t toss your emergency blanket out? Most backpackers who practice ultralight skills want to throw them out because they have sleeping bags etc.

Michael: I don’t bother chucking it because I’m not watching my weight to that extent. If I was watching the grams, I’d only carry it on single day hikes. No reason to keep it if you have a sleeping bag other than redundancy’s sake.

Em: You are also out climbing for longer days where the bigger kit goes, but the sleeping bag doesn’t?

Michael: Yup, when I’m with other people especially. My climbing partner doesn’t carry much in the way of first aid. In that case, I bring the bigger kit which contains the emergency blanket.

Large Kit (Multi-day, Multi-person, Paddling)

In the largest kit I’d carry (multi-day paddling trip), I’d add:

Item Purpose/Importance Amount Approximate Weight
abdo trauma pad head wound/open skull fracture, open abdominal injury, any large wound dressing 1 large 8×8 18 g (.6 oz)
gauze pad wound dressing: particularly eye injury dressing, additional days of dressings 1 additional 2×2 2 g (.1 oz)
gauze pad all purpose dressing, multiple days of dressing 1 additional 4×4 4 g (.1 oz)
roller gauze large, deep burns, multiple days of dressings 1 additional 12 g (.4 oz)
SAM splint Splinting major joint or skeletal injury 1 130 g (4.6 oz)
alcohol hand sanitizer cleansing hands, fire starter 1 40 g (1.4 oz)
triangular bandages longer term major injury or wound care 2 16 g (.6 oz)
vial of rubbing alcohol dressing attachment, cleaning wound site to ensure adhesion, multiple days of treatment 1 17  g (.6 oz)
  • Approximate Total Weight: 8.4 oz (239g)
  • Approximate Total Size: 1 Quart Ziplock bag and 1 Gallon Ziplock bag or smaller

Commentary:

Michael: These aren’t exactly what my kits look like, but would be reasonable, minimalist kits for an intelligent first-aider, in my opinion.

Em: Any reason a backpacker shouldn’t toss the SAM splint?

Michael: The biggest kit is the one that goes on the long term, remote trips where it may be several days or weeks before help gets to you and you may need to have every advantage getting yourself or partners out. You might need typical items used as splint materials as crutches or their intended purposes in the long term.

The SAM is versatile. They make good neck braces and can be incorporated into bulk dressing for rib fractures. You can always cut it in half to save weight  and space but still have a small amount of rigid splint to work with.

Em: Yeah, I could see the problem with using a makeshift splint out of existing materials (ice axe, trekking poles, tent poles) you are already carrying, because you may need those items during the course of a long self-rescue.

Baseline Meds

For meds, I always have the following for myself (and are a good baseline for everyone):

Item Purpose/Importance Amount
ibuprofen anti-inflammatory 2 – 10
acetaminophen antipyretic 2 – 10
Diphenhydramine antihistamine 1 – 8
gravol analgesic 1 – 5
pepto bismol tablets antiemetic 1 – 5

Comprehensive Meds

In my bigger kit I’d add:

Item Purpose/Importance Amount
epinephrine (+administration tools) anaphylaxis 1
ASA cardiac emergencies 2-3 tablets
Ventolin/Atrovent bronchospasm 1

Commentary

Michael: I can’t really give weights or amounts on meds, I can give a basic idea but it depends on who is on the trip and what the individual needs of the users are. I have some more sophisticated administration techniques and tools than a standard first aider as well, but I haven’t included those in the list.

IMG 0079

Michael at work in Nordegg, AB, Canada

Summary

From my experience as a first responder, and I’m sure Michael would agree, no one can tell you exactly what to put into a first aid kit. Other paramedics, doctors, nurses and emergency responders will be able to add unique items and items they have found effective in the past.

As someone who practices ultralight backpacking, I can say first aid supplies make up a reasonably small percentage of my base weight (10-20% for me at 10lbs or less) and I would rather cut weight from somewhere else. I’ve been in some tight jams, on and off the trail and its one place I do not like to skimp.

One thing all responders will tell you is “take your brain with you.” Sometimes intelligence means leaving behind things which are unreasonable for the situation you are entering. Sometimes using your brain, means backing down from things which have too high a risk profile, or taking an alternate route and not getting into a first aid situation in the first place.

You cannot always avoid first aid though, and it is important to have it ready for worst case scenarios, even when going ultralight.

To that end, I encourage every backpacker to acquire some meaningful first aid education: e.g., wilderness first-aid, search and rescue, first-aid, and safety courses throughout their journey of traveling light.

Disclosure

Updated September 15, 2018

  • Affiliate links: Some (but not all) of the links in this review may be “affiliate” links, which means if you click on a link to one of our affiliate partners (usually a retailer site), and subsequently make a purchase with that retailer, we receive a small commission. This helps us fund our editorial projects, podcasts, instructional webinars, and more, and we appreciate it a lot! Thank you for supporting Backpacking Light!

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  • Aug 6, 2019 at 10:25 pm #3605031
    Emylene VanderVelden
    BPL Member

    @emylene-vandervelden

    Companion forum thread to: Lightweight First Aid and Trauma Kits: Perspectives from a Mountain Rescue Medic

    This article features an interview with a Canadian Mountain Rescue Medic, focusing on how to assemble lightweight first aid and trauma kits for backcountry travel.

    Aug 6, 2019 at 10:37 pm #3605034
    Dena Kelley
    BPL Member

    @eagleriverdee

    Locale: Eagle River, Alaska

    Enjoyed. I’m in a local SAR group and am always interested in the perspectives of others who do this, as I’m relatively new to it. Thank you for this article.

    Aug 7, 2019 at 9:35 am #3605078
    Roger Caffin
    Moderator

    @rcaffin

    Locale: Wollemi & Kosciusko NPs, Europe

    Once you have checked the breathing, stopped the bleeding, and maybe immobilized the limb (or whatever), what is the next step?

    Sit down, take a deep breath, get the stove out and make coffee. For the victim, strong coffee with sugar ‘on doctor’s orders’, even if they normally don’t take either coffee or sugar. And yes, we HAVE done this at times (like more than a few times).

    Chers

    Aug 7, 2019 at 10:54 am #3605079
    David P
    BPL Member

    @david-paradis

    Thanks for posting this Emylene! I like how Michael stresses knowledge over just adding more to your fak. What good are all those tools without the ability to concoct a plan of action to implement them effectively? Stripped down true medic kit- i have actually decided to Add a few key items from your interview after reading, my 2oz med kit is going to swell a bit, but not that much!

    @roger- do you think that one or two of those 100 calorie gel packets with 50mg caffeine would be as effective as actual coffee for the victim in a situation like you’ve been in? Sometimes I just take those and not coffee grounds…

    Aug 7, 2019 at 11:13 am #3605081
    Roger Caffin
    Moderator

    @rcaffin

    Locale: Wollemi & Kosciusko NPs, Europe

    do you think that one or two of those 100 calorie gel packets with 50mg caffeine would be as effective as actual coffee for the victim in a situation like you’ve been in?
    No, I don’t think so.

    First of all, hot coffee is a lot different from cold energy gel, even if the gel contains caffeine. A hot drink going down your throat is just … different. Better.

    But just as important is the action of sitting down, thinking, and letting the shock go past. You can keep going despite the shock – for while, but it is better to relax and let it pass. The sooner you let it go, the milder will be the reaction.

    At the risk of being banal, injuries injure, but shock can kill.

    Cheers

    Aug 7, 2019 at 12:06 pm #3605084
    David P
    BPL Member

    @david-paradis

    Thanks for that. Good to know!

    Aug 7, 2019 at 12:46 pm #3605088
    matthew k
    Moderator

    @matthewkphx

    Coffee seems like a good way to put STOP (stop, think, observe, plan) into action. It also signals to the patient that they are in a safe enough place that we can take ten minutes to boil some water and have a drink. I can also see it being a good routine when traveling solo and something happened. Great idea. Thanks, Roger.

    Aug 7, 2019 at 1:46 pm #3605095
    Chris R
    BPL Member

    @bothwell-voyageur

    Re. not worrying about blood contamination. What about encountering an injured stranger on the trail or another camper injuring themselves? Certainly been known to happen.

    Giving caffeine to a patient. Potential for masking changes in vital signs?

    Aug 7, 2019 at 6:23 pm #3605121
    Dena Kelley
    BPL Member

    @eagleriverdee

    Locale: Eagle River, Alaska

    We always carry hot chocolate in our SAR group. Roger’s right- a hot drink is enormously comforting. And sugar is a must, whether it’s treating shock or hypothermia or low blood glucose. I carry decaf coffee, also, and some cider packets. Caffeine might cause an aberration in a patient’s vitals, but we look for that anyway. The first set of vitals you take, and even the second, can often be garbage because the patient can be in ASR -acute stress response, either sympathetic (anxiety) or parasympathetic (fainting) – and it can look like shock when it’s not. On the flip side, if they really are in shock, you’re going to see their vitals trending regardless of whether you add caffeine or not. I don’t think, personally, that I would choose to give a patient caffeine (at the dose regular coffee contains- decaf coffee and hot chocolate contain negligible amounts)- mostly because I really don’t want to potentially add anxiety or a faster heart rate. But a hot, sugary drink- definitely. And Roger is right, also, that the fact that you’re willing to do something like that is a strong indicator to the patient that they are stable and you’re providing patient comfort on both a physical and a psychological level.

    Aug 8, 2019 at 12:30 am #3605155
    Paul Wagner
    BPL Member

    @balzaccom

    Locale: Wine Country

    I used to lead coaches meetings for youth soccer with a fellow coach who was an EMT. He always suggested that the most important part of a FAK was a cell phone to call some who knew what to do.  The gear is definitely secondary to the expertise.

    Aug 8, 2019 at 12:54 am #3605157
    David Thomas
    BPL Member

    @davidinkenai

    Locale: North Woods. Far North.

    I also like the emphasis on knowledge over gear.  And, yeah, dressings and triangular bandages are over-stocked in commercial first aid kits because they’re cheap and harken back to Scout first aid training. And, yes, those stupid little mouth-to-mouth masks are harder to use than direct face to face.

    But like Michael said, a few basic drugs are potentially very helpful and you can’t fabricate or improvise those.  Except maybe by making a willow bark tea.

    Hot chocolate, sure, as a break in the action and a pause for thinking.  But the 100-calorie gel pack is smaller and lighter than any stove/pot combo and can be given in for more settings.

    I tweaked a little on the “Most people (maybe everyone) I backpack with could bleed all over me and I wouldn’t worry about it.”  If everyone’s intimates were alway disease free HIV/ Syphilis / etc would never spread.  Two people I’ve hiked with were looking pretty bad in 1995 and then a lot better in 2000 but never told me they were HIV+ but based on the timing of their sickness, their recovery, and being in higher-risk group, I have my suspicions.  Point being: you never know.

    The recommended SAM splint is pretty versatile and fairly light, but I recommend you also practice with your CCF or inflatable sleeping pad to improvise an air splint.  You have to keep checking it hasn’t gotten too limp or too high in pressure as temperatures and elevations change, but you can splint a wide variety of broken limbs more comfortably that way than with sticks and cordage. Also, examine any internal-frame packs with aluminum stays in them – those are fabulous because you can bend them to fit a particular limb but they’re stiff enough to provide a lot of support.

    Aug 8, 2019 at 2:09 pm #3605227
    David P
    BPL Member

    @david-paradis

    Shock treatment- The cider packets sound yummy dena! I may opt to toss in some cinnamon and Orange Peel chamomile tea with some honey or sugar… soothing aroma, calming herbal properties… depending on the severity I might add some compassionate touch in there (shoulder, foot, hand, scalp massage) if ever faced with the situation…

    great tips for splinting David , thank you ! Got me thinking how else to multipurpose the stays in my pack…

    Wound Care- this is kind of a minor aside but personally I just use soap and water to clean wounds and then Vaseline when dressing wounds instead  of Antibiotic Ointment.  This was recommended to me by my Dermatologist after recent cancer surgeries and also my wife (who is an RN) says that hospitals don’t routinely use hydrogen peroxide or antibiotic ointment any more. Because of the nature of my work I have become fairly proficient at wound care. I will keep a minor wound covered and moist with the Vaseline for 3 or 4 days usually changing dressing once a day… especially important at work or in the backcountry to prevent infection also reduces visible scarring.  Hypafix is an indispensable part of my FAK- in the realm of dressing retention I have found none better

     

    Aug 8, 2019 at 6:33 pm #3605247
    Dena Kelley
    BPL Member

    @eagleriverdee

    Locale: Eagle River, Alaska

    FWIW in WFR training they told us it’s cool to use neosporin around a cleaned wound or even a light coating on the bandage that dresses the wound (also you can lightly coat bandage with iodine) but not IN the wound. Bacteria love an anaerobic environment so by sealing the wound with neosporin or vaseline you can actually create the perfect warm, moist, airless environment in which bacteria will thrive. You want to keep the wound moist but also allow it to breathe. This was actually a huge take-away for me from the class because I have always been one to just fill up the cut full of neosporin and toss a bandaid on it, and apparently that wasn’t the right thing to do, ha.

    Aug 9, 2019 at 12:05 am #3605285
    David Thomas
    BPL Member

    @davidinkenai

    Locale: North Woods. Far North.

    My physician wife recommends something (Neosporin, vaseline, whatever) to keep the wound edges moist during healing.  Otherwise, more of the margins will dry out, die, and the healing and resulting scar will be over a wider area.  I managed to successfully reattach the tip my thumb after a distracted-vegetable-slicing incident while backpacking in New Zealand with only Bandaids, Neosporin and trying to keep it as clean as I could.

    Aug 9, 2019 at 12:08 am #3605286
    Greg Mihalik
    BPL Member

    @greg23

    Locale: Colorado

    If someone in the group is taking anti-coagulants (including 83mg aspirin) they need to come with CELOX Rapid or you should carry it to stop serious bleeding.

    CELOX works independently of blood clotting factors, and is fast compared to compression alone. It could take “bleeder” well over 30 minutes to get things stopped otherwise. CELOX is sterile and can remain in place until secondary treatment.

    https://www.amazon.com/Celox-Rapid-Z-Folded-Red-Packaging/dp/B07RQN7QXY/ref=sr_1_14?keywords=celox+rapid&qid=1565307896&s=gateway&sr=8-14

    Aug 9, 2019 at 12:11 am #3605287
    David Thomas
    BPL Member

    @davidinkenai

    Locale: North Woods. Far North.

    In addition to the over-the-counter pills mentioned in the article, on a more remote trip or with a larger group, I like to have:

    • a topical antibiotic cream (see above),
    • a steroid cream for insect-bite / poison oak itching,
    • sunscreen, and
    • an anti-fungal for athlete’s foot.

    I get mini professional-samples of them in very small tubes because they’re compact and light, correctly labeled in their original packaging, and the stuff still on patent and prescription strength is the latest, most powerful stuff.  It helps to know lots of physicians or at least be on good terms with your dermatologist.

    Aug 9, 2019 at 12:13 am #3605288
    Greg Mihalik
    BPL Member

    @greg23

    Locale: Colorado

    Neosporin is contra-indicated for about 20% of the general population. I, being in that group, develop small blisters at about day 5 of application.  Mupirocin 2% is a better option.

    Aug 9, 2019 at 1:13 am #3605296
    John S.
    BPL Member

    @jshann

    Nm

    Aug 10, 2019 at 3:44 am #3605481
    Greg Mihalik
    BPL Member

    @greg23

    Locale: Colorado

    ^^^^

    … provided an antibiotic is not needed.

    If I gash myself in the woods I’ll go with an antibiotic. When I start developing a staff infection under my pack straps I’ll go with the antibiotic. Petroleum jelly by itself won’t get the job done.

    Aug 10, 2019 at 4:20 am #3605488
    Roger Caffin
    Moderator

    @rcaffin

    Locale: Wollemi & Kosciusko NPs, Europe

    If I gash myself in the woods I’ll go with an antibiotic.
    Why?
    I just stick a BandAid on.

    The probability of picking up a harmful bacterium in the wild must be utterly microscopic compared to the probability of picking up one in, say, a hospital.

    It sounds like a misuse of antibiotics.

    Cheers

    Aug 10, 2019 at 3:37 pm #3605511
    David P
    BPL Member

    @david-paradis

    I gash myself once a month at work, often I’m very dirty or covered with some nasty product, thorough irrigation of  the wound and some soap is way more important. Antibiotics are never “needed” they kill the good bacteria along with the bad and the bad bacteria can become resistant to it, it is a worldwide healthcare issue right now. Bacterial antibiotic resistance. But to each their own.

    And regarding letting a wound “air out” or “dry up”

    Aug 10, 2019 at 9:46 pm #3605550
    Roger Caffin
    Moderator

    @rcaffin

    Locale: Wollemi & Kosciusko NPs, Europe

    Vaseline eh? Interesting idea. My wife carries a tiny pot for her lips: I will try it one day. Simple is better.
    Thanks.
    Cheers

    Aug 20, 2019 at 10:35 am #3606838
    Emylene VanderVelden
    BPL Member

    @emylene-vandervelden

    I love the coffee idea but agree with the risk of changing vitals. On caffeine I can exhibit an (asymptotic) arrhythmia. I sometimes hike with a former cardiac patient who can’t have caffeine with  prescription meds. In reality though, use what you have. Most first aiders make amazing splits and wound dressings but are terrible at taking vitals.

    I completely attest to and support the psychological benefit  and reassurances of the action of making a ‘cuppa’ of anything. A warm beverage has benefits for cold, shock, and mental acuity.

    One of the best pieces of advice I got from a wilderness first aid course was to actually get a panicking or passive bystander to make the hot drink. It calms the bystander, gets them out of your hair with a basic task, and gets them actively participating in emergency management. Thereby mitigating or preventing a secondary shock casualty.

    Aug 20, 2019 at 10:52 am #3606839
    Roger Caffin
    Moderator

    @rcaffin

    Locale: Wollemi & Kosciusko NPs, Europe

    One of the best pieces of advice I got from a wilderness first aid course was to actually get a panicking or passive bystander to make the hot drink.
    There are not too many suggestions which get me to take my hat off, but that is one of them. Very clever indeed.

    Cheers

    Apr 24, 2020 at 2:49 pm #3642920
    Bendrix B
    BPL Member

    @bendrix

    Wound care and warm beverages:

    Vaseline is good, easy to apply and carry.  I’ve found that unflavored Chap Stick is better.  Its a bit harder to apply but it last a lot longer and creates a better barrier from both outside intrusions and the migration of moisture and oil from your skin.  It will quickly relieve the pain of cracked skin, dried out by cold dry air (here in the Northeast) or desert air.  On one trip a guest developed a fissure of the sphincter, probably from the common experience of not being able to defficate in a strange place, then finally releasing an larger, harder stool than normal.  You may be disgusted or laugh, but its a real thing.  The anus is a dangerous area to have an open wound as it is regularly exposed to a high bacterial load.  I instructed the guest to mash some Chap Stick between finger and thumb until it was soft, then apply it liberally to the fissure.  The fissure healed in a few days.  I’ve since recommended that to others which similar results. Anyone who’s experienced a fissure will know how hard it is to keep one clean and heal it.

    A warm beverage that is very beneficial is warm water and honey.  I’ve not encountered anyone alergic to honey.  It has a pleasant taste and lots of calories.  If you are dealing with hypothermia, blood loss and other injuries, dehydration is present and must be addressed.  The calories will cause the body to warm.  It takes a lot of calories to warm a 160lb human who’s core temperature has dropped.  I always carry honey packets in a hard container.  You can’t carry honey in a squeeze container or one with a small mouth cause honey gets very hard even at 50F, and impossible to squeeze out.  The packets are easy to peel open in any temp, but they are fragile hence the hard sided container.

    I like to carry an Israeli Bandage  because it is the most versatile tool for staunching bleeding and simultaneously pressuring a wound.  We use axes in camp, and the young guys (20s) always show up with big sharp knives the purchased for the cool.  Cuts are always a problem.  Sever cuts could be life threatening and a fool with an axe can put it through a foot in a heartbeat.  So can a weary, sleep deprived pro.

    Michael’s advice that the most important tool is the knowledge you have is the best advice there is.  Where to get it?  I don’t think you can achieve an adequate education in wilderness medicine from a book.  I’ve got a bunch.  The best education is hands on, using the supplies, acting out scenarios where you must think and act under pressure in unexpected circumstances.  You can do that at SOLO in New Hampshire – http://www.soloschools.com  SOLO teaches regular courses ranging from a three day Wilderness First Aid to a multi week Wilderness EMT. The price is reasonable, and the first time you need what you learn, dirt cheap.

    We get used to being in contact with people and emergency services.  Our society generally expects there to be help available immediately at the push of a button.  We are backpackers and we search out solitude.  Don’t expect that cell phone to work when things go wrong.  Even if it works, don’t expect help to arrive soon, and if the weather goes to hell, maybe not in time.

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