I am curious to see what others may carry in their first aid kits. I'm trying to trim some fat on my 10 oz. kit without being overly opptomistic. I am a career Paramedic, so the medical knowlage is in place, however, I tend to have the mindset to be ready for what might happen, not necessarly does happen. Hey, at least I've stopped carrying around a 1 liter I.V. bag and surgical cric kit! I'd really love to see what ya'll carry for maybe a 2-3 day hike, what's worked for you for certain ailments, and maybe even a good war story from the backcountry (those are always fun!). This is list of what I carry so far, feel free to pick it apart:
2- 4x4 bdg 1- 5x9 bdg
1- quick clot 1- mole skin
1- roll gauze 6- butterfly sutures
misc- band aids 1- CPR barrier
2pr- Gloves 1- 14ga. IV cath
2- Triple antibiotic packets
2- sting relief pads
4- alcohol pads
4- Iodine pads
1- small super glue
1- 20cc syringe
Amoxicillin, Benedryl, Immodium, Pepto and Tylenol

this gets discussed often. you might want to "Search Forums" to see what's been talked about in the past (though the search function sure doesn't work very well!).

for starters:
http://www.backpackinglight.com/cgi-bin/backpackinglight/xdpy/forum_thread/12631/index.html?skip_to_post=92597#92597

I just carry a few band aids and some alcohol pads. Also I carry Advil Tums and Gas-x. I may have to put a tube of super glue in my kit I use it at work but never thought about taking it hiking.
BUT for a paramedic I dont think your kit is too crazy since you know how to use it. Maybe get rid of the CPR barrier thing and just carry less of every thing else. Do you NEED alcohol AND iodine?

I would think with your background you would carry what you think you will need and just a little more. I found this site and maybe it will help you out. http://www.whiteblaze.net/index.php?page=med_guide

I personally want to carry as light as possible, but when it comes to first aid and survival kits I think it is best to have what you might need and hope you don't use it; rather than go so light and need something you don't have. I try to pack my first aid and survival kit to be used in conjuction with each other rather than on their own. The Eagle Scout in me still wants to be prepared; Hence, the epi-pens I carry.

Alcohol pads are great for cleaning the dirt and sweat off the area to be covered by moleskin. Then I apply the tincture of benzoate, then the moleskin. Works great on sweaty body part like feet.

My 1st aid kit (2.875 oz) for solo trips of up to 8 days. It never gets smaller than this (too much trouble to unpack and repack). I've only REALLY needed it once....and it worked.

1 Aloksak
3 triple antibiotic packets
2 Tegaderm Self Adhesive pads
2 Moleskin 3x4@
1 20 ml irrigation syringe
3 bandaids
6 alcohol wipes
5 butterfly bandaids
0.2 oz tincture of benzoate
2x2 Imodium caplets
1 needle-nose tweezers
12 Ibuprofin 200 mg @
6 Vicodin
2 Ciprofloxacin

If I'm going to be out longer or going into a "higher risk" environment, I'll increase some of these items and/or add other appropriate items.

Yes, I have prescriptions for the Vicodin and Ciprofloxacin. My doctor is also a long-distance backpacker. I also know when and how to use them, and more importantly, when not to do so.

I also know how to use a suture kit, but I prefer to leave that to the pros. I'll stick to butterflys. My sewing kit will work if I REALLY need one.

Several items in my pack, such as my notebook and pen, bandana, duct tape, and spare guyline, can do double duty as 1st aid supplies in a real emergency.

Edited by wandering_bob on 05/19/2008 20:06:26 MDT.

Thanks for all of the insight guys! Especially the links from Dave and Ross. I looked through all the past forums and couldn't find anything, but alas, there it is!
To Jesse, SUPER GLUE IS THE BOMB! It is great for those less severe lacerations that wouldn't require stitches and on parts of the body, like knuckles and fingers, that are constantly flexing and moving. I know some ERs are using it to close wounds (Although it's probaly made by Pfizer instead of Elmer's and will probaly cost ya $600!) It always sticks (even two fingers together, ooops) and sets within seconds up to a minute. Just clean the cut like you normally would and your good to go. The small sqeeze tube I carry weighs 0.2 oz. It will start to flake off after a few days like a scab.
As for the CPR barrier, it's just one of those things. I carry another small one in a keychain-pouch on my car keys. I've had that for almost 10 years and haven't had to use that either. Unfortunatly, the chance of a CPR save (Spontainious Return of Circulation) is realistic under ideal conditions (less than 6 min EMS response time, AED). One can only imagine being in the back country. However, that wouldn't stop me from trying, there's always that chance that lies somewhere between slim and nothing. Plus the barrier weighs in at 0.3 oz. Thanks again everyone. Keep 'em coming.

Dude if I had 6 vicodin in my pack they wouldn't last me 8 miles much less 8 days...

- alcohol for fuel, sterilization, and emergency mood reassignment (i keed you)
- all sorts of meds, most are mixed up in a sak but i'm familiar with their colors - benadryl, claratin, excedrin (aspirin, caffiene, tylenol), ibuprofen, immodium, pepto bismol tabs, tylenol
- and of course 100 µg fentanyl patches my doctor gave me for headaches - don't worry jesse, I know how and when to use them ;-)
- bit of medical tape and duct tape
- butterfly closures
- cordage (guy lines)
- floss
- hand sanitizer
- moleskin
- tiny tube of crazy glue

Might be other stuff I haven't remembered...
Looking into acetazolamide for AMS - I hear a little coca to chew also works well.

edit: Looking at your list reminds me... I need to find one of those tiny plastic tweezers for my kit. They have come in way too handy for those incessant cholla/cactus spines. Steroidal anti-inflam cream helps as well. Use duct tape to remove (nearly) invisible glochid spines.

Mike, I was curious what the syringe is for? Irrigating what - a blister, massive infections? What about the amoxicillin? I'm not versed on antibiotics, but what would this help with? Sickness from dirty water? Do you bring a whole regimen of the pills and have to keep taking these everyday ow what? Is it fast acting? Seems like it'd only be useful on long (ie. multi week) hikes from the sound of it, no?

Edited by lococoyo on 05/29/2008 18:47:10 MDT.

"Looking into acetazolamide for AMS - I hear a little coca to chew also works well"

By AMS are you refering to Altitude Sickness or Altered Mental Status? And if so, how will a diuretic help for either? Sounds like it will just help to dehydrate you.

But hey, I live about a foot above sea level so I'm not familiar with treatments for altitude sickness. Maybe it's commonly prescibed in mountian regions? I'm not trying to be condisending, I really don't know anything about it.

I don't have it listed, but I have a pair of those little tweezers that come w/ a small Swiss Army knife as well as the scissors from it as well. The thin metal edge on the tweezers is a bit more effective at getting under the skin than the thicker plastic ones.

Irregation is exactly what I use the syringe for. The Amoxicillin is for any suspected infection or sepsis (Fever, nausea, vomiting, diarrhea, weakness, malaise). The recommended dose is (3) 500mg tabs a day for 10 days. I don't carry anywhere close to a 10 day supply. Maybe 2 days- just enough to get the ball rolling on fighting infection until more definative care can be given.

Unfortunatly, It would take 30 tabs for a full corse, which I WON'T carry. I'm sure there are better antibiotics that require less pills (like Z-packs) but this is what I have available to me at the moment.

BTW: Dude! Forget the Vicodin, you have Fentanyl?! You lucky guy! I'm sure as an adult you know your limits for you own meds and how to use them and blah, blah, blah... but be careful- Cause that's some pretty good stuff. As long as you're not like some of these rocket scientist high school kids in my area and decide to eat them you should be in pretty good (actually, really, really good) shape.

Mike

Edited by ekim765 on 05/31/2008 22:22:29 MDT.

I've used acetazolamide for AMS. Not as a treatment, but as a preventative measure. I start taking it two or three days before my trips. The literature says it removes bicarbonate from the body via frequent urination, setting off a chain of events that has a side effect of the body being able to adapt to changes in altitude at a much faster rate than normal via enhanced ventilation.

I've used it twice, and felt awesome on both trips. For me, it has let me drive from sea level to the sierras after work, and start hiking in the morning without loss of appetite or upset stomach.

Very cool. I'll keep that in mind when I get a chance to venture into higher altitudes.

I could conjur up a chain of events that could possibly be negative to losing bicarb from your system (acidosis, purely speculation of course), but it sounds like you've had some really good results and no ill effects from it.

Is it a prescription med or OTC?

Edited by ekim765 on 06/01/2008 15:54:18 MDT.

I'm far from an expert in this arena. However, after advice from my mother-in-law, an ER physician, my kit contains super glue, duct tape, and Benadryl. Nothing more. Make sure the glue is brush-on, it's much easier.

Edited by skruffy on 06/09/2008 23:12:51 MDT.

I will have to dig my kit to list exactly what is in there, but it is basically a customized Adventure Medical UL 0.5 with a final weight of 6 ounces.

I have taken a FA/CPR/AED course here and there, but generally speaking, my first aid kit has more to do with caring for myself. I do not frequently find myself in situations where care of others would be likely. At least not on hiking/backpacking trips. My multi-day wilderness river rafting kit is much more comprehensive.

I do have a few questions if you will indulge us:

- Are wounds that require a 5x9 blg common in non-motorized recreation situations?

- How well does the quick clot work, and when should it be used as opposed to allowing the wound to flush?

- What might one use a syringe for?

I have never carried a CPR barrier because I figure my chance of needing it are very remote.

But really Mike, we would probably learn more by asking you why you carry what you do.

I highly recommend listening to this podcast:

PBP Episode 9 - Shana Tarter - Wilderness Medicine
(http://www.practicalbackpacking.com/blog/)

Until then I had basically been taking just bandaids, antibiotic ointment, and a hand sanitizer. She strongly recommends an irrigation syringe, plastic gloves, and waterproof-breathable bandages that I can't get where I live.

I mostly carry stuff for blisters but I have WFR training so I've been taught to improvise a lot.

Assorted Band-aids, Benadryl, Vitamin-I, Pepto, a little moleskin, alcohol pads, a larger dressing, and maybe some other small things (don't have it in front of me).

My whole gear/body repair kit, with Superglue, needle and thread, weighs a hair over 3 oz.

I don't have any specialized first aid training apart from what school and Scouting provides.

Adam

PS: I'm also curious as to whether acetazolamide is prescription only or not. I'm going out to Colorado for a week at the end of the summer, and since I live at about 1,100 ft I'd love any help acclimatizing as smoothly as possible.

Edited by aroth87 on 06/10/2008 12:31:41 MDT.

From Jason: "I do have a few questions if you will indulge us:"

- Are wounds that require a 5x9 blg common in non-motorized recreation situations?

I've personally used them in many non-motorized incidents. They cover a pretty decent area and are extra absorbent.

- How well does the quick clot work, and when should it be used as opposed to allowing the wound to flush?

No personal experience w/ Quick Clot, my department doesn't use it. I know the Military uses something similar. After reading everyone's replies, this is one of the items I've decided to remove from my kit. I'll give it to a friend of mine, who is an avid hunter. That will save 2.15 oz. itself. Thinking back to some of the more severe lacerations we've treated, even some impressive looking, spurting, arterial bleeds have been controlled w/ a single 5 x 9, kling, direct pressure and elevation.

- What might one use a syringe for?

Irrigation of wounds. It directs water flow better than my hydration tube.

-I have never carried a CPR barrier because I figure my chance of needing it are very remote.

I agree that the chance of needing it is remote as well. Like I said before, I've been carring the one on my key ring for years, never having to use it either. It's one of those mental things I'll have to get over I guess.

-But really Mike, we would probably learn more by asking you why you carry what you do.

I'm pretty knowlagable about treating trauma from the back of an ambulance. On the trail is a different story. I could tell you all of the equipment I'd bring if I was called to an injured hiker, and 30-40 lbs. later we'd have it all. That is why I'm reaching out to those who have a few trail miles under their belts and keep checking out this forum for any new posts. Again, thanks everyone for your comments, critiques and suggestions. Thanks to ya'll my kit has gone from 10 oz to 6 oz. If I knock it down to just treating minor ailments for myself it'll probally go down to 3-4 oz.

Edited by ekim765 on 06/12/2008 14:12:44 MDT.

Rick,

Thank you very much for the link for this podcast. Shana Tarter even talks quite a bit about AMS and acetazolamide for treatment/prevention and it's effects and side effects. It is a prescription med.

Thanks again,

Mike

* Pills (18 ibuprofens, 6 pseudopheds, 4 benedryls, 4 imodiums)
* Duct Tape
* 2 Gauze Pads

Consider adding:

Cayenne Pepper. It's a fantastic pain numbing and blood clotting agent.


Turmeric: It reduces inflammation and swelling.


A 1/4 oz. or so of each can go a long way.




Peter

Edited by pgfogel on 06/21/2008 18:06:40 MDT.

Interested to note in your original post that you carry a 14 g Cannula - what are your anticipated uses for this? Relief of Tension Pneumothorax?, Deep irrigation of wound beds?
I notice also that you no longer carry IV fluids (!) - have seen a couple of interesting reports on PR rehydration therapy using improvised equipment - any thoughts?

Other stuff I carry - two most common sizes of Guedel airway, i justify these with the view that in someone with decreased GCS, they greatly simplify the potential airway management issues, again, any thoughts?

I am, among other things, an army surgeon. I am thus also tempted to bring a lot of stuff with me in my medical kit (if nothing else, it is a hell of a lot easier for me to stock narcotics) but I do try to restrain myself. I manage to do without a needle driver and 3-0 silk, as much as it makes me feel naked.

A 5x9? That's rather large, isn't it? I guess someone might get an open fracture or something, but then you're likely to improvise a dressing out of clothing, anyway. Such a wound would certainly justify ruining your $80 jacket. By far most wounds on the trail are tiny, and just need a 2x2, but a 4x4 (as you have) is more versatile and can be cut down to size. I carry real gauze because it is more versatile than those fake-gauze dressing sponges.

CPR barrier? Well, as you say it is very light... But it is also low liklihood of use, and probably not realistic to expect a save if you are far from an AED. Well, maybe my view is skewed a bit, as most of my codes are traumas not cardiac. Your call. But I'd say just keep your immunizations up to date (especially hepatitis) and know your hiking partners.

Quik Clot?!? Where are you hikng? Iraq? I'd wager that on the trail a massively bleeding wound to something that won't take a touriquet (trivial to improvise) is rare. I guess you just have to do your own risk-assessment, though. And even then I'd recommend one of the chitin dressings (such as HemCon) over Quik Clot. HemCon's are expensive as hell, but you are much less likely to injure the patient than you are with Quik Clot. Quik Clot is VERY exothermic. (And a pain in the a$$ for the surgeon to remove later...)

Conceivably you could do with one pair of gloves. Make the assumption that if you need more than one it will be treating the same injured guy until you can get him to safety, store the one pair in a ziplock (that you brought food or something else in) and reuse it. It is for your protection, after all, not his.

It is low likelihood of being needed, but I carry a 14g, too. It is lightweight insurance against tension pneumothorax if anyone takes a fall, and can be lifesaving. I'd hate to lose anyone to something that easily fixable.

Alcohol AND iodine? If you use an alcohol stove you can do without either, and just use your stove fuel. (This was a nontrivial influence on my choice of stove design.) Or use Purell, if you carry it. Purell is also a handy emergency firestarter...

For multi-use antibiotics amoxacillin is a pretty good one. Many will work. Fluroquinolones are handy, too. Just pick a favorite, and try to tailor it to your location. If you are going someplace exotic I find that the Infectious Disease fleas can be amazingly helpful, and actually quite interested. (Mefloquine Mondays, anyone?)

I keep telling myself to remember "I am not a walking tertiary care center." In the field I do not have an obligation to provide definitive care. I just have to get them to EMS alive.

That said, if I am to be the "medical guy" for a large group of people I don't know very well I tend to bring a LOT more stuff. E.g., anyone who needs an epi-pen should be responsible enough to bring his own and attach it to his pack strap where others can see it, but there are a lot of idiots out there. In such groups I also tend to bring aspirin for AMIs. (Otherwise I bring only 800mg Ibuprofens and 650mg Acetaminophens, so I can double-dose and walk out on a sprained ankle if I must. In truly remote areas I bring a couple of Percocet, for the same reason.) I haven't yet brought my own nitroglycerine, but I always think about it, and I might if I was in a large group in a very remote part of the world. Then I could at least give half of MONA therapy. Hmm, would Percocet count as "M", and let me give 3/4? I'll have to look that up.

Again, my world view is colored by my experience, so I tend to think of trauma. There are several injuries that will kill you quickly, but that are easily treatable in a trauma bay. (Emphasis on "in a trauma bay.") Various lists exist, the "7 Killers", the "Deadly Half-Dozen", etc. I'm sure that you have been taught to think of them. Forgive me if my list differs from yours, but I'm trained to think about these things differently than you, so I haven't looked this up in a while:

Exsanguination
Airway Obstruction
Cardiac Tamponade
Open Pneumothorax
Tension Pneumothorax
Hemothorax
Flail Chest

Exsanguination: This is your Quik Clot or HemCon. I maintain that they are low-utility, and improvising a tourniquet is all you have to know. For a solid viscus injury or other internal bleeding, activate the EPIRB and pray. Have you been taught permissive hypotension, or are you an old-school IV fluid guy? I'd recommend learning permissive hypotension for field medicine. For a pelvic fracture, sheet the pelvis. This is another injury that justifies ruining your $80 jacket.

Airway Obstruction: The knife on my Leatherman Micra is damned sharp, and I have hydration tubing, for my crichothyroidotomy That's the best that I think I can do without hauling a code cart with me.

Cardiac Tamponade and Tension Pneumothorax: There is no body cavity that cannot be reached with an 14g and a good strong arm. I would not recommend that the laity try to do a Pericardiocentesis, but I would sure give it a try as a last resort. Any monkey can learn to do a Needle Thoracostomy just by googling it. (Diagnosing the tension pneumothorax, on the other hand, is a little tricker for a layman.) See, that 14g is multi-use! :-)

Open Pneumothorax: Some tape and almost any reasonably flexible piece of plastic can improvise an occlusive dressing, or better yet a semiocclusive dressing with a flutter valve. So, leave the labels on your water bottle. Or use the cellophane from a pack of cigarettes. I wonder if silnylon is airtight enough to work? Tyvek certainly is.

Hemothorax: Hmm. EPIRB and prayer, again? I guess if I was sure of my diagnosis I always have that knife and hydration tubing to improvise a Tube Thoracostomy, but I wouldn't recommend it to the laity. Who cares about the resulting empyema if you can save his life? Some jackass might decide to sue you, though, so he'd have to be nearly dead before I'd do this. Improvise a Heimlich valve from the finger of your glove.

Flail Chest: Definitely EPIRB and prayer. Usually these are caused by MVAs, and the only wilderness scenario I can come up with is a long fall. In such a case you will probably have more pressing problems than the flail chest. There are those who advocate wrapping the chest, but this really doesn't work and causes a lot of pain, thus leading to splinting and even worse oxygenation.

Another thing you will see on some lists is a Subdural or Epidural Hematoma, but I really can't think of a realistic way to do a burrhole in the field. Nobody really does them in trauma bays, either, for that matter. The neurosurgeons can get them into the OR pretty quick. I guess if I was on-call in some sleepy rural hospital with the nearest neurosurgeon hundreds of miles away I'd give it a shot. I know approxmately where to stick the Black & Decker, after all, and he's going to die anyway, right? But the weather would have to be REALLY bad to preclude a helicopter flight...

Edited by acrosome on 06/30/2008 12:48:18 MDT.

personally, i wouldn't use over the counter superglue on a wound ever - massive skin irritation and death of surrounding skin can be expected. the stuff they use in the ER is different. plus chances are in the woods i wouldn't get it clean enough and the docs would have to remove it when i got home anyway. duct tape or butterflies for me please.

Ian,

I'm not familiar with PR Rehydration, but if you're using the abrieviation "PR" in the context that I'm familiar with then wouldn't that resemble an enema! I'll research it though. If it's valid that means I could deliver up to 3 liters of fluid to a patient... and then buy a new hydration pack.

The IV fluids were before I considered going light,

By Guedel airway, are you refering to a nasalpharyngeal airway (NPA)? Just wondering, not familiar with that brand name.

Wow Dr. Fellabaum! Thanks!

Well, first of all, yes, I admit that I CARRIED the 14g cath for a tension pneumo and could use the finger of a glove for a Heimlich valve. I think I could easily diagnose one in the wilderness, even without a set of ears. Even so, I've come to realize that a long fall would be the most likely cause of a tension pneumo and am probally doing away with this, because prevention is the best medicine and hopefully I won't come across any of those idiots you mentioned. Hey, I guess you never know who you'll come across though. I'd be a little freaked about attempting a Pericardiocentesis in the wilderness. For a street medic that may be a once or twice a career procedure and I'd tend to think it would be a tough diagnosis in the wilderness. But your focus is obviously trauma surgery, mine is to get them to the trauma surgeon.

The quick clot is gone from my list... I'm still a fan of 5 x 9s, just because I know they work and I like my jacket;) I also like the idea of something clean on the wound, at least as a first layer, over a dirty pair of socks. I know the wound will get irrigated and all of that good stuff at the ER anyway, but that's just me.

I also agree that any plastic packaging would work for an occlusive dressing, just in case you're mistaken for a deer!

Alcohol pads- gone.

CPR Barrier- eehh.. I guess a 4x4 would keep the big chunks 'o puke out of your mouth. Mmmm... tasty!

I'm not familiar with permissive hypotension. I've been trained to dump fluid to keep 'em at least 100 systolic or until their blood turns into pink Kool-Aid, which ever comes first.

Thanks again, Doc! You have a lot of info to share, and I'd love to talk about it more but I think we're starting to loose the audience here! Feel free to PM me though.

Take care, and thank you for your service to Our Country.

Edited by ekim765 on 07/05/2008 23:06:56 MDT.

Isn't QuickClot toxic?

I don't know that it is toxic. As Dean had mentioned, it has a nasty exothermic reaction. So, I'm guessing it has been known to cause burns or tissue damage around the wound. He also mentioned that it was a pain in the butt for the surgeon to remove at the OR.

www.z-medica.com/quikclot/index.asp

The bandage that I had was called the QuickClot Sport. The website boasts that it has a cooler, less exothermic reaction (105 F max) and it is contained within a surgical sponge. Of course, this is coming from their wedsite and the do have a product to sell, so take it for what it's worth. The original QuickClot is packaged in a powder form and is meant to be poured directly on to the wound. Maybe this is what Dean was refering to. I could see where that would be a hassle to remove later.

The USMC had reported that QuickClot was either blown away or would not come in contact with the wound during arterial sprays. Sounds like they are refering to the power form here. www.defensetech.org/archives/000458.html. Not sure which form the Military is using.

Dean?

Edited by ekim765 on 07/04/2008 09:56:51 MDT.

Hey-
Love the conversation so far! Thought I'd throw in my cent. I'm a former ski patroller, SAR member, W-EMT, paramedic. (I got off the street, and I'm living in a horrible place right now for the wilderness aspects.)

I struggle at paring my kit down, too. Frankly, I haven't had the heart to weigh it recently. Guess I'll have to when I get home. Many of my trips are 10 days+, and I tend to bring a little extra.

There was a question or two about 5x9s. The most common reason I've seen for needing them "out there" is for knife or wood-cutting slips. Whittling, cut through stick, run knife through leg... On non-weight-conscious travels, a bad coincidence of foot and ax... I've just been taking along a maxipad for major bleeds.

I've always got a couple bandanas for headwear, pot gripper, etc., which do nice double duty as sling/swath, compression wrap, tourniquet, and so forth.

Assorted band aids (esp. knuckle/fingertip). Superglue! Plenty of Benadryl, ibuprofen. Iodine wipes. Usually have some whisky along--hey, it's double-duty! I've taken the "nip a corner off a ziploc" route for irrigation, snagged from my food bag.

Duct tape from the repair kit for... whatever. The heaviest two things are probably an Ace wrap and a partial roll of Coban. (Figuring sprains are usually about the worst I'll face.) The friend I'm normally with is diabetic, so there's usually some form of glucose in the kit.

I've always got one of those tiny space blankets for emergency thermowrap, signalling. Oh, and yes, a 14G.

Aloksaks are great. I really like the Equinox tripper travel bag organizer, though. It weighs 1.6 ounces, and I use it to organize compass, whistle, and all those other random miscellany things along w/first aid stuff.

I have to say that I'm a little suprised (maybe relieved) that I found company in those carrying a 14g. To think, I thought I was just being overly prepared. I suppose the weight of it is trivial if you know why you carry it and how to use it. As Dean mentioned, a tension pneumo, which can obviously be fatal, is easy to treat.

I'm going to have to seriously look at this 5x9 thing since that seems to be an item I've seen come under some scrutiny since I started this post. After all, I too carry a bandana and a pair of clean(er) sleep socks.

Is that maxie pad with or without those little wings? ;)

BTW... I'm partial to Southern Comfort myself... makes my belly warm.

Agree with the nontoxic but otherwise annoying properties of QuikClot. The military version is indeed a powder, but I haven't seen it in a while. We are issuing HemCon bandages to every soldier now, so that if you come across a wounded soldier you just pull his own bandage out of his kit and use it. (On a more morbid note, during Desert Storm I was issued my own body bag, and had to carry it around...)

Brad,
Do you really need an ace-wrap AND Co-Ban? Both will give compression, and the Co-Ban is lighter, if not as durable and not as re-usable.

PR (rectal) rehydration is a well-established technique, and doesn't require sterile IV fluid, though the water should at least be potable. And, yes, it does work just like an enema- the colon is a very efficient water scavenger. (I can't remember how quickly you can give it, but I sure wouldn't dump 3L in at once.) The technique is still taught to military medics, for use in tight situations where they have run out of fluid or angiocaths or whatever. The patient has to be conscious enough to make the effort to retain the fluid, though. Historically it was used a lot in children, who would then have their buttocks taped together. Nowadays we tend to do intraosseous infusions.

[Some medical advice removed, at the recommendation of counsel... :-) ]

I emphasize that everyone makes their own choices, especially in the UL community. As I said, I really have to restrain myself sometimes (before I discovered UL I used to carry an army Field Surgical Kit) and I'm trying to help other enthusiastic would-be wilderness savoirs to do the same. Mike, if the 5x9 works for you, keep it. Hell, I carry a huge, clunky Suunto MC-2 compass because, for me, orienteering is half the fun, and I want a precision instrument. And, as I said, if I'm the "medical guy" for a group I still tend to go overboard. I might even bring ABD pads, let alone a 5x9.

Yeah, the pericardiocentesis is something that doesn't get tried until the patient has died at least once and you haven't got anything to lose. Unless, of course, you have an ultrasound and you see the hemopericardium on the FAST exam- in which case, go for it. (For those who care, FAST stands for Focused Abdominal Sonography for Trauma, and includes a look upwards at the pericardium.)

The kind of cyanoacrylate used most commonly for medical purposes (i.e. Dermabond) is indeed different from plain superglue. It is a high-viscosity formula that you can apply in several layers to make a thick coating over a wound. The resulting cap is sort of rubbery. Normal superglue- and a few cheaper medical formulations- are almost the same viscosity as water. Side-note: don't get superglue on cotton- it causes an exothermic reaction that can start a fire. Voice of experience, there...

I'm sure that others have heard of www.wilderness-medicine.com ? I have never taken one of their courses, not least because they are geared more toward EMS and SAR than physicians, but they sound interesting. I also went to a rather unique medical school that issued me a great book called Wilderness Medicine, that has over 1500 pages and weighs approximately 7.2 tons. Mine is an older edition, but see:

http://www.amazon.com/Wilderness-Medicine-5th-Paul-Auerbach/
dp/0323032281/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1215334254&sr=8-1

I split the URL for justification reasons, so you'll have to cut and paste the two halves. Sorry. Apparently the new edition is over 2300 pages!

It is NOT a book for laymen, and it is expensive, but if anyone here has some medical training and enough of an interest it's a great book. It isn't just about practicing medicine in austere environments- it also describes appropriate hospital treatment for injuries that are peculiar to wilderness, like frostbite, envenomation, plant toxicity, altitude sickness, and dysbarism. And it also has a chapter on surviving wildfires, and one on natural disaster management. There is a WHOLE CHAPTER on wilderness medical equipment, and the justifications for bringing each item, including antibiotics.

I've heard of using maxi-pads as dressings before, so don't hesitate to ask any women in your hiking group if you find that you need one. (And many are self-adherent!) For that matter, I've heard of using tampons to pack bad nosebleeds and gunshot wounds, too. No kidding. It has to be uncomfortable, though.

Edited by acrosome on 07/06/2008 04:23:17 MDT.

My kit weighs 2 oz. Since 95% of my hiking is done solo I carry what I can administer to myself. Butterfly strips, antibiotic ointment, Benadryl, some Moleskin along with a tiny half roll of medical duct tape. As an EMT with many decades of experience I depend upon being able to adapt for emergencies, and realize that in a time of severe trauma it is basically impossible to treat oneself. Some deep cuts and gouges haven't been a significant problem, but shredding a meniscus during an isolated winter hike while days from anywhere was.... but a ten pound kit wouldn't have helped much.

As a mental exercise, i have thought more about the Co-Ban. You can tape an ankle with duct tape, though probably not as easily, and it is much more multi-purpose than Co-Ban or ace. So, just take a little more duct tape.

Of course, this is coming froam a guy who carries a 14g angiocath...

Also, the Medipore tape deserves special mention. (Also called Hypafix, or Mefix.) It is a "fluffy" porous surgical tape that:

A) can be used like any other medical tape
B) can be used as second-string moleskin
C) makes a decent burn dressing by itself

But, of course, it still isn't as multi-purpose as duct tape. Still, I would bring some if I was the 'medical guy' for a large group.

Dean,
I've really enjoyed your insight and expertise here. The Co-Ban thing, I dunno, guess it's just a hang-up for me so far. Ultimately, I like the stuff a lot better than ace wrap. But if I'm on an extended trip, the Co-Ban just wouldn't hold up to repeated on/off for soaking in cold water or whatever, whereas Ace excels. I've found that the Co-Ban works great for actually keeping small "dressings" in place on weird curved places or some articulations. My brain's a bit fuzzy on the name right now, but I think there's either a micro-pore or derma-pore I've used as a great tape for holding in less-than-ideal conditions, but... it is extra weight. One other reason I've carried it in the past was for taping bum ankles and such.

You've got me thinking now. Perhaps this is purely academic, but could using duct tape to tape ankles lead to circulation/perfusion problems? What I'm thinking is that over the course of a day's hiking, feet tend to swell up decently. Ace wrap can expand with that swelling. Tape can't. For sports like B-ball or soccer, the ankle might only be taped a couple hours. I'm approaching this primarily from more of a multi-week trip perspective where there's not really a choice of extrication or backtracking a day. What do you think? Problematic or not?

Ohhhhh... Ouch. When I played soccer, my ankles usually got wrapped with pre-wrap first. My trainer got tired of doing that, and started taping onto the top inch or two of leg hair to encourage me to shave. So maybe ankle-type taping should include a razor of some kind?! :-)

FDA Requests Boxed Warnings on Fluoroquinolone Antimicrobial Drugs

The U.S. Food and Drug Administration (FDA) has notified manufacturers of fluoroquinolone antimicrobial drugs that a Boxed Warning in the product labeling concerning the increased risk of tendinitis and tendon rupture is necessary. Through its new authority under the Food and Drug Administration Amendments Act of 2007 (FDAAA), the agency also determined that it is necessary for manufacturers of the drugs to provide a Medication Guide to patients about possible side effects.

The risk of developing fluoroquinolone-associated tendinitis and tendon rupture is further increased in people older than 60, in those taking corticosteroid drugs, and in kidney, heart, and lung transplant recipients. Patients experiencing pain, swelling, inflammation of a tendon or tendon rupture should be advised to stop taking their fluoroquinolone medication and to contact their health care professional promptly about changing their antimicrobial therapy. Patients should also avoid exercise and using the affected area at the first sign of tendon pain, swelling, or inflammation.

The medications involved in this action are: Cipro and generic ciprofloxacin, Cipro XR and Proquin XR (ciprofloxacin extended release), Factive (gemifloxacin), Levaquin (levofloxacin), Avelox (moxifloxacin), Noroxin (norfloxacin), and Floxin and generic ofloxacin.

Edited by jshann on 07/31/2008 08:57:25 MDT.

I can't tell if you are merely being informative, John, of if you are arguing against fluoroquinolones.

Yeah, that announcement was met with a gigantic yawn by the medical establishment. It's an adverse effect that has been known for a very long time. But EVERY medication has adverse effects- you just have to be aware of them and make educated risk assessments. (Which, arguably, is my entire job.) And fluoroquinolones are probably, as a group, one of the most-used antibiotics at the moment. (Total guess, that, but they are used A LOT.) And most of the tendon ruptures were after taking the drug for weeks.

Fluoroquinolones are great drugs, broad-spectrum, and safe. Don't let the new warning mislead you.

Edited by acrosome on 07/12/2008 11:57:24 MDT.

> Yeah, that announcement was met with a gigantic yawn by the medical establishment. It's an adverse effect that has been known for a very long time.
True, but the Boxed Warning on the packet is a different matter.
Haven't you noticed that many pharmacists stick a large adhesive label over the technical information on the packet, thereby preventing the consumer (the patient) from reading the data? It is almost as though the medical system is telling the the consumer to shut his eyes and just do what he is told.

What we need is a new law banning the obscuring of the tech data on the packet, so the consumer can be more educated. Won't solve all the problem, but it might help a bit.

Dean, hopefully you don't claim to speak for the U.S. medical establishment since you don't live here. Europe can ignore whatever warnings they want to. I tend to respect the US FDA when they speak since I got my M.D. degree in this country.

Cipro is a common antibiotic taken on backpacks. If I was over 60, I'd consider taking something different with that information. As always, the older members of this group should talk to their own physicians about it.

In this country, if you were to prescribe that to a susceptible person after a warning goes out and they incapacitated themselves on the trail or worse, you could have some splaining to do to the local judge if/when they filed a lawsuit.

Edited by jshann on 07/13/2008 04:40:58 MDT.

While I don't presume to speak for Dean I think the point he was trying to make is that while it has now been established that there is an accrued risk associated with fluoroqinolones this had already been suspected. Moreover, it's really in when you use them. Sometimes the risk is worth it, some times it isn't. As doctors it's your job to figure that out for the patient which, most of the time, doesn't know anything about these risks, let alone how to weight the risks.

I would tend to agree that giving anything that could weaken tendons to a person over 60 that is going backpacking is a bad idea. However, giving the exact same thing to a 30 year old 9-5 working stiff that commutes from home and doesn't do much of anything might be the best choice.

Also, to my knowledge, in most countries if you prescribe something to someone and they hurt themselves because of it you, as a doctor, are liable. Not just in the US. Even in Europe. :P

As for the technical data obscuring ban, I would tend to agree. Technical data is important and consumers should be able to clearly see it. If not, why print it in the first place? Problem with that is there are boxes where there is nowhere else to place the label. In this case pamphlets in the box are the best solution. IMHO, IANAL, etc., etc., ad nauseam.

Edited by ahugenerd on 07/15/2008 08:08:54 MDT.

I don't think I saw these mentioned and I carry the ones from a Swiss Army Knife (but not the knife)and have used them for splinters and would think for some debris in a wound.

Do any of the rest of you think these are important and if not, how would (do) you remove splinters?

I agree that tweezers are important. My tweezers are part of my Leatherman micro tool. At 1.7 oz I get a lot of use for the weight. Wouldn't leave home without it!

Micro tool includes:
scissors
tweezers
knife (1.5")
nail file
bottle opener
screwdriver standard
screwdriver for glasses
screwdriver phillips

Other first aid items included
ibuprophen
imodium
anti-gas
assorted bandages
neosporin
insect repellent
sandwich bag for irrigation
duct tape for wrapping sprains
hydrocortizone

Edited by mad777 on 07/29/2008 16:13:53 MDT.

Bob,

At my age I need a magnifying glass to make tweezers work. My compass has the magnifying glass and the Buck 350 pliers work for things like cactus needles. The Buck 350 also has tweezers for splinters and I carry a needle in my repair kit.

I do not build fires and none of my gear is wooden. It has been year since I had a splinter.

I have no idea while Buck quit making the 350.

I love the idea of tweezers, unfortunately many are difficult to use. The ones on my Leatherman micro can come out of alignment (it stays at home). Victorinox ones have a good mating surface for fine cactus, but flex and lose grip on big splinters. Some dedicated tweezers have even given me problems. I often resort to using the tip of a very sharp blade.

I'd like to find high quality tweezers.

Honestly, even though I favor a 1.3" blade (smallest Gerber I know of), I tend to carry a real file and nail clippers. There is a lot of good discussion on keeping feet healthy. Hands are pretty important. Groomed nails help keep the mouth clean and rough nails can snag sensitive tissue.

I rather like the tweezers from the Leatherman Micra. They have good flex but good grip and a nice chiseled tip. Better than I expected. I even used them when I'm at home!

Roger,

Pharmacies are required by law to place a label with certain information on all drugs they dispence, including patient data and the prescribed dosing, thus the stickers. Perhaps there is some sort of system problem that can be improved, but the stickers are not a conspiracy to deceive the public. :-) Also, the actual package insert has much more information than the label, anyway. You just have to be motivated enough to read the insert, so I know that a package warning is better, but you can't have a package warning for everything. That's why the inserts are so long. Most pharmacies give patients handouts about every drug they dispense, too. Mine does. So I don't see an easy solution to the sticker problem.

John,

I also got my MD in the United States. I did my residency in Washington state. My license is in Nebraska. I'm a surgeon in the US Army and stationed in Germany, which is why my profile says "Europe", but I am an American doctor. Look very closely at my avatar. :-)

Knowing the U.S. medical establishment as well as I do, I wouldn't presume to speak for it. We are a bunch of bickering, infighting primadonnas. But the truth is, the FDA documentation change went pretty much un-noticed, as nearly as I can tell. Perhaps you have had a different experience.

I also trust the FDA. They are, if anything, OVERcautious. I wasn't denying that fluoroquinolones carry a risk of tendon injury. I was merely expressing puzzlement about why the US media engaged in all that hype about a documentation change regarding a KNOWN, RARE reaction. (Except of course for the sensationalism they get from implying that everyone who ever pulled a tendon while on Cipro should now be able to sue their doctor.) This isn't Vioxx, after all. I maintain that fluoroquinolones are great drugs. They are not without risk- no drug is- but they are great drugs. Disclaimer- I'm not handing out medical advice or telling anyone to take fluoroquinolones. I'm merely saying that the media hype has given them an undeserved bad rap with the lay public. By all means, everyone should discuss ANY medication that they want to carry with their doctor. I will continue to carry fluoroquinolones in my first aid kit. They are very safe, cheap, broad-spectrum antibiotics that are stable over a large temperature range, and I won't be taking them for weeks at a time.

Rene,

You said "if you prescribe something to someone and they hurt themselves because of it you, as a doctor, are liable."

This is not true! If every patient who ever had an adverse reaction sued their doctor, there would be no doctors. EVERY medication carries risk. You can have a lethal reaction from taking Tylenol- back me up here, John- though the risk is VERY low. You really only have a valid suit in the case of negligence or malice, and negligence has a pretty rigorous legal definition.

Take for example coumadin, which is a powerful anticoagulant that is given to people for many indications. It makes it very difficult for your body to form clots. Thus, if you get a serious cut or are involved in an auto accident you could bleed to death very easily. people have died from nosebleeds while on this drug. Spontaneous bleeding is not uncommon. So, if you had a hemorrhagic stroke because of your coumadin could you sue your doctor? Probably not.

Perhaps this is a bad example, because you probably WOULD win such a suit if the doctor hadn't warned you about the possibility of bleeding, but no doctor would prescribe coumadin without warning patients about this. But almost all medications have lists of possible adverse reactions that are HUGE. It is physically impossible to counsel a patient about all of them. Thus, doctors tend to concentrate upon the common ones and the severe ones when counselling patients.

This is a two-way street. If you never mentioned your basketball or mountain-climbing hobbies to your doctor, he probably wouldn't think twice about giving you a fluoroquinolone. Even then- and I'm going out on a limb, here- I think most wouldn't hesitate to give you a single, short course. We, the US military medical establishment, hand out tons of fluorquinolones to a very athletic and active patient population.

I agree about the Leatherman Micra. Handy widget. I also carry one.

Edited by acrosome on 07/30/2008 04:24:08 MDT.

Now that you mention it again, Dean, being a US Army Surgeon and all, you avatar does resemble Hawkeye from MASH, minus the smoking jacket! ;)

> Haven't you noticed that many pharmacists stick a large adhesive label over the technical information on the packet, thereby preventing the consumer (the patient) from reading the data?

By law in Australia a pharmacist must place a label on all prescription medications with the instructions as well as various other legal requirements. As a pharmacist its not often there is a space left on the box for us to place a label so you place it as best you can. As for obscuring 'technical information' there doesn't tend to be any information on the outside packaging other than the medication name, strength, etc (which shouldn't be obscured by a label anyway).

>It is almost as though the medical system is telling the the consumer to shut his eyes and just do what he is told.

I disagree, again I can only comment on Australia, but all pharmaceutical companies when they are granted licence to sell their products in Australia must prepare a Consumer Medicine Information (CMI) which lists every adverse effect as well as other useful information in a format that a lay person can understand. This is included in many products as an insert or can be given by the pharmacist.

I'm all for consumers being more educated on the medications they take but I think increased counselling is more effective than written information on the box.

Hi Dean. I imagine you are entirely correct in the low incidence of tendon rupture associated with those antibiotics (and everything else you said). I only put it out there for info.

The problem is that in the US, once that kind of boxed warning goes out, it would behoove a US doc to not prescribe it in a susceptible person who would be miles out in the wilderness should the side effect occur. There are too many other antibiotics that can take its place. I myself am allergic to cipro, but that is a crazy story on its own how I came to realize that. Take care.

I decided to look it up for myself. Tendon rupture is occuring in as little as 6 days after starting the antibiotic. Even more proof to avoid that one if over 60 y/o or have other risk factors outlined in the FDA alert. The FDA does not move on issues like this unless it is for public safety. Your mileages may vary.

J Plast Reconstr Aesthet Surg. 2008 Jul;61(7):830-4. Epub 2007 Apr 3.

Management of bilateral Achilles tendon rupture associated with ciprofloxacin: a review and case presentation.Akali AU, Niranjan NS.

Fluoroquinolone antibiotics are increasingly being recognized as a cause of Achilles tendinitis and rupture. We report the case of a 62-year old man who developed bilateral Achilles tendon rupture six days following commencement of ciprofloxacin....

J Med Case Reports. 2007 Jul 23;1:55.

Fluoroquinolone-associated tendinopathy: a case report.Ng WF, Naughton M.

ABSTRACT: Fluoroquinolone-associated tendinopathy is well described. This adverse effect however does not appear to be widely known among medical practitioners. We hereby described a case of ciprofloxacin-associated tendinopathy for which the adverse drug reaction was not suspected initially and the patient was inappropriately reassured and incorrectly advised to complete the antibiotic course. Given the frequent use of fluoroquinolones in clinical practice and the potential for severe disability from tendon rupture, we consider it important to remind your readers of this uncommon but potentially devastating adverse drug reaction.

Edited by jshann on 07/31/2008 08:46:41 MDT.

John,

I'm really not trying to belittle your point. It's an excellent one. Obviously, fluoroquinolones carry a risk of tendon rupture. I'm just saying that it is low, and thus it is not an unreasonable risk to take it for a few days, if you are otherwise healthy, even while hiking. I doubt that we really disagree- we are probably just emphasizing different points, given that you keep mentioning a hypothetical sexagenarian.

So, I'm not denying that there is a risk. MY point was stated in the first sentence of the abstract that you posted:

"Fluoroquinolone-associated tendinopathy is well described."

MY point was that the US media were hyping a relatively inconsequential change to the medication documentation. Thus the "yawn" comment. Does the tendinopathy (and rupture) happen sometimes? Of course! -Rarely. And the FDA did it's job by making the medical establishment more aware of this fact that they should consider when prescribing fluoroquinolones. But then the media blew it way out of proportion, and thus gave the lay public an exaggerated perception of the risk.

I just don't think we should dismiss fluoroquinolones from our first aid kits on this ONE point. Consider the whole picture, and pick what you feel to be the best antibiotic for your needs. If you are young and healthy, and the fluoroquinolone covers the organisms that you are worried about, and you're only going to take it for a few days at most until you can hike out and get to a provider, then I still say that they are great, cheap drugs. They are broad-spectrum drugs with excellent oral bioavailability that don't cause photosensitization like doxycycline or tetracycline (which is annoying when you're outdoors), they don't carry quite the risk of clostridial colitis that clindamycin does, I can give it to people with penicillin allergies (unlike beta-lactams), etc., etc. I can find SOME kind of scary problem with ANY antibiotic.

Can you present a patient that I WOULDN'T give a fluoroquinolone to? Of course! To choose an absurd example: a sexagenarian with a collagen-vascular disorder should not take a fluroquinolone, especially if he is a hiker.

So, personally, I kind of like the fluoroquinolones. I think that most of us can reasonably carry them.

DISCLAIMER- As always, though, clear it with your doctor before you carry ANY prescription drug.

Out of curiosity, John, what antibiotic do you carry, if any? Perhaps you have come up with a much better alternative that I haven't considered. I hope it's not some $1000/dose gorillacillin. :-)

Edited by acrosome on 08/01/2008 07:35:06 MDT.

For those looking into hemostatic agents like Quik Clot and alternatives (since Quik Clot is known to have caused burns in some applications) check out this article: http://www.lawofficer.com/news-and-articles/articles/lom/0403/Clotting_Agents.html;jsessionid=60D316EDCAA75800A73EE2D8C77EFD94

WoundStat is another agent that is said to have better/quicker clotting properties than Quik Clot and Celox; but it is only effective for a few hours, and its use depends on the ability to get to a medical treatment facility (so, at most, a day-hike not far from a hospital).

Dean, I didn't see your post..sorry. I don't carry an antibiotic since I only do week long trips at most. If I got a nasty wound, I'd be heading out of the woods for a local ER. I probably should add one to my first aid kit.

I am a WFR, and I carry a standard Atwater Backpacker First Aid kit...I used to think that all this stuff was mostly unnecessary, until I went backpacking in the Grand Canyon and my friend got 2nd degree burns on his foot from knocking over a pot of boiling water. I was really the first time I used my kit, and we wouldn't have made it with out it. I would also recommend using krazy glue to close wounds, works great! One quick note that its also better to have OTC pain meds, and stomach med when on a trip(you never know when your going to need it).

Edited by IceMan311 on 08/15/2008 12:29:43 MDT.

A little while ago we were talking about taping ankles, and I brought up the point that--taping on hair could potentially hurt worse than the sprain! I then questioned whether we should add a razor to our first aid kits... so the funny thing is, I was going through a wholesalers supply catalog a few days ago and found a 1 gram safety razor. The manufacturer or parent company is Securitas. It's actually a pretty convenient little thing. Mind you, I'm not sure a full-sized razor blade weighs a whole lot more, but still...

Brad,
There was recently a thread on lightweight knives and BPL now sells the DERMA-SAFE folding knife which is in fact a razor. Since I only use a knife in an emergency this will be in my first aid kit and if I use and dull it, it is replacable for only a couple of bucks.

I have a taping quesiton for you: I have read references to the Leukotape but am not familiar with it. Is it that superior to athletic wrapping tape that you would find at a pharmacy?

Brad,

I just found their web site, securitas-inc.com. Too bad they're a wholesaler because I've been trying to find a finger toothbrush. If only there was a retailer around that could carry those (cough, cough... hint, hint BPL) That razor is pretty cool.

"I've been trying to find a finger toothbrush. If only there was a retailer around that could carry those (cough, cough... hint, hint BPL)" -Brad

http://www.rei.com/product/751250

http://www.petsmart.com/product/index.jsp?productId=2752911

Okay, so it's been many months since we last visited this thread. I just went through what I'd been thinking was my "ultralight" first aid kit and weighed all the individual components:

2 maxipads- 0.86 oz
2 bandanas- 2.3 oz (multipurpose)
asst. bandaids- 0.5 oz
superglue- 0.5 oz
ace wrap- 1.8 oz
14G- 0.19 oz
space blanket- 1.74 oz
antibiotic pkts- 0.4 oz
tick puller- 0.25 (used up to 12x/day)
tape- 0.8 oz
razor- 1gm
whisky- sterilization, in food bag

Total weight: 8.94 oz

Call it 9 ounces--that's heavy! If you were to count the bandanas as clothing, the kit weight would be 6.6 oz, but still... Does anyone have experience with kinesiotape? Would that be a good, lightweight option for a bum ankle (longer trip, wetness, etc). Any idea how much the stuff weighs? If I could ditch the ace wrap for something ~1oz that'd be great. That razor should get rid of taped-hair problems.

Anyone else have a surprising revelation about the actual weight of their first aid kit?

Here's mine: http://jasonklass.blogspot.com/2008/12/my-first-aid-kit.html

Edited by jasonklass on 01/14/2009 20:58:02 MST.

I guess I'm horribly unprepared compared to you guys, but I think I have too much.

What I carry:
tweezers (loose, from an old knife)
reading glasses (so I can use the tweezers)
A few bandaids
Neosporin
One square of moleskin
A roll of soft gauze
A roll of athletic tape
A needle and thread (good for fixing things and popping blisters)
A few Vicodin
Lots of ibuprofen
An alka-seltzer (whoops, I used it, need to restock)
A couple of anti-diarrhea pills

Great info here.

What I find funny is that I didn't notice anyone mentioning burn creams. With alcohol stoves and some of the crazy jet burners people have around.... Even a first degree hurts like hell. The creams are like angels trumpeting in the wilderness...

Stephen,

I have gotten a few minor burns over the years. Pretty much just let it blister, then pop it, add antiseptic, and cover with a bandaid or gauze. If it hurts like hell, then take an Advil or Tylenol. Burns are pretty much a non-issue. The minor burns are probably one every five years. Since I already have the stuff for treating blisters, no use carrying burn cream.

This is one of the reasons I don't use a Bic lighter for starting a stove; increases the risk for a minor burn.

I DO carry a small vial of burn cream. An essential component imho.

Cheers

after lots and lots of reading/researching I've started all over with my first kit and ended saving an ounce w/ a much better kit

my original kit looks like the normal small first aid kit- not a bad kit, but certainly room for improvement

old kit- 2 4x4's, 2 3x3's, 1.5 sheets of moleskin, 2 triple antibiotic, asst bandages, ace bandage, roll of gauze, butterfly closures, medical tape, ibuprofen, tylonel, antihistamine, and antidiarrhea - all in a pretty red first aid bag



new kit- I re-used the "medicine" and the roll of gauze, I added a small curved tip irrigator, 2 4x4.5 tegaderm bandages, pack of 10 1/4 x4 steri-strips, two triple antibiotic creams, 3 2g Celox (hemostatic agent), 2' of Leukotape (wrapped around a section of a straw), 2 vials of tincture of benzoin- all in a pretty (waterproof!) 6x9" alkosak :)



old kit 3.7 oz, new 2.7 oz- just by going to the alkosak vs the pretty red bag netted ~ 0.3 oz

I also re-packaged my repair kit and mention it here as many of the items (duct tape, needle, safety pins, alcohol prep pads, super glue) do double duty for first aid- by putting the repair kit in a 3x4 ziplock I saved 0.5 oz (over the leather Chouinard bag) (1.4 vs 0.9)



there are numerous other items floating around in my kit that would probably qualify as first aid, probably foremost of which is the the swiss army classic w/ scissors and tweezers- great little instrument for less than an ounce

btw if anyone is interested I was forced to pick up some of the items (like the irrigator) in multi-piece lots

Mike

Edited by mtwarden on 09/14/2009 20:35:53 MDT.

A small ziploc baggie with the corner nipped off works great for irrigation...

good idea- a play w/ a bitel top would work pretty well too

I'm pretty impressed w/ the little 12cc one- it puts out a fair amount of pressure and you can direct the stream very accurately

A small ziploc baggie with the corner nipped off works great for irrigation...

Not that I have needed to use one yet but two outdoors oriented wilderness first aid classes offered by different organizations have told me that few if any improvised irrigation devices work nearly as well as a syringe designed for the purpose ... 1) not enough velocity and 2) difficulties in pinpointing a small target.

Mine weighs 8 grams (0.29oz)

Curious. Extra weight.
I normally use a (hopefuly) clean handkerchief and a water bottle. Zero extra weight.

Cheers

I had read the same thing concerning pressure- there are several medical reports documenting this (just google high pressure wound irrigation)

we must have the same 12cc irrigator, as mine weighs 8 grams as well :)

Curious... I learned about the baggie trick in a W-EMT class and, I believe, in OEC. Have to nip off a tiny bit of the corner. If you want to carry the syringe, by all means! But if you're trying to cut as much weight as possible and still achieve decent irrigation if the need actually arises... knowledge and improvisation are the kings of backcountry medical "treatment."

no arguments here- knowledge/innovation is indeed paramount in wilderness first aid

that same handy baggie can also be used (w/a little duct tape) as a occlusive patch for a chest wound