FIRST AID
Knowing how to provide first aid when help is not immediately available is of course an essential skill for any outdoor enthusiast or traveler. Here are my recommendations:
Indispensable pocket size first aid guide
1. GET THIS BOOK – with or without training, this $6 pocket-size back country first aid guide, written by one of the founders/leaders in wilderness medicine, is an indispensable resource - skewed towards the outdoors, it provides general info on generic first aid situations as well. Great for multi-day back country trips, in your car, go-bag, home kit or when traveling in other countries. Concise, well organized, valuable info at your fingertips.
2. GET TRAINING– If you can, sign up for a basic first aid course with the Red Cross. Better yet, if you can spare a weekend – sign up for a Wilderness First Aid (WFA) course from SOLO. Fantastic organization, founded by the author of the book above. The National Outdoor Leadership School (NOLS) also offers similar courses.
3. MAKE A SIMPLE FIRST AID KIT– there are a lot of off-the-shelf first aid kits available (you could do fine with one of these good off-the-shelf kits and build it out if you don’t want to make your own) but I’m generally not a fan of them -there’s usually a lot of superfluous/redundant stuff, missing items, or not enough of others, so I like to make my own and I have different ones for different situations. The basic one below that I recommend will fit in a quart size zip-lock bag – and you may even be able to squeeze in some of the additional items I discuss below. Furthermore, buying boxes of some of these items will enable you to make multiple kits (home, car, go bag, day pack, etc.). If you want to get a sturdier bag with organizing pockets, this empty, this FA pouch will hold all of the items below and then some. The list below is basic - what I consider the bare minimum - of course you can build on it if you want to customize your own or have larger ones for car, home, boat, multi-day trips, etc.
· Gloves
· Band aids (one size)
· Several kinds of gauze pads
· Tape for the pads
· Antiseptic
· Antibacterial ointment
· Ace bandage
· Small EMT scissors
· Tweezers
· Antihistamine
· NSAID and Aspirin
· Bottle of hand sanitizer
GLOVES – the most important first step in administering first aid is establishing scene safety for you the rescuer and this includes creating a barrier between you and any potentially infectious substances. Buy a box of these or steal a pair the next time you're at your doctor's office ;-). HACK: To keep these less bulky, cram a pair into small pill bags which are very handy for other items as well (like other medications, keeping your mini-bic lighter dry or carrying tinder)
Carry 15- 20 BAND AIDS – get a box of the 1” x 3 “size – trust me, this will cover almost all of your needs - YOU DON’T NEED MANY DIFFERENT KINDS OR SIZES OF BANDAIDS. This is one of my main criticisms of off the shelf first aid kits. It’s easy / takes a minute to make butterfly closures out of duct tape or medical tape for example.
GAUZE PADS - Pack maybe three or four maybe three or four 4x4 gauze pads, (you can fold these to become 2 x 2 sized), have three 5 x 9 surgical pads for significant bleeding (It may be easier / cheaper to buy all of these at your local drugstore than online). Remember direct pressure on a bleeding cut is generally the best way to stop bleeding. If you want to spend the money, these bandages with a chemical clotting agent in them are small profile/light weight but add extra firepower to your ability to stop significant bleeding - Highly recommend having some of these on hand (Note - when trying to stop bleeding, if necessary, keep adding bandages on top of each other instead of removing the previous one - this helps enable clotting). Having a roll of gauze to keep bandages in place generally works better than tape.
TAPE - Carry a small roll of cloth medical tape for the pads – HACK you can wrap this around a pen or other gear item to save space. You can also use duct tape.
ANTISEPTIC - people like alcohol pads and iodine, however they sting - I recently switched to Bactine gel or generic – this stuff is great - it’s an antiseptic / wound cleaner however it doesn’t sting and in fact has lidocaine in it so it helps ease the pain of the wound or can temporarily stop itching (great for kids!). The bottles are too big for an outdoor kit however - I found a small tube for sale at my local CVS but can't find it online but these wipes have the same antiseptic in them. Another option is to carry these iodine swabs - convenient and easy to use. Slightly heavier bottle of 2% iodine tincture works great as an antiseptic and HACK you can use it to purify water (5 drops per quart).
ANTI-BACTERIAL OINTMENT - Bacitracin or Neosporin or generic – Remember they don’t clean a cut – it’s not an antiseptic – it’s supposed to be for protecting against infection after you clean the wound as thoroughly as possible. HACK If you don’t want to carry a bulky tube, buy a box of these small packets and throw a few in your kit.
ACE BANDAGE – the rule of thumb for treating any musculoskeletal injury (sprain, strain, bump, etc.) is R.I.C.E. – Rest, Ice, Compression, Elevation. An ACE bandage is great for treating these kind of injury’s, or holding a gauze pad in place/ works as a pressure bandage, and can help someone with an injured knee /ankle hike out to the trailhead.
SCISSORS- Carry a small Pair of EMT shears – if people injure themselves in a way that you can’t readily assess or treat the injury without removing clothing or gear – these shears cut through all clothes, seat belts, nylon straps, rope, even metal- certainly way more useful and burly then anything on a multi-tool.
TWEEZERS – definitely carry a pair of slanted / flat -tipped tweezers for splinters and ticks – in my experience much better than pointed ones for grabbing - but it’s ultimately preference.
ANTIHISTAMINE - I like Chewable Benadryl or Chlortrimeton (or generic) because it's easy to give kids - you can double up on the dose for adults. Whatever you buy, make sure it’s an antihistamine - having one on hand helps manage lots of other non-life threatening allergic reactions that are common place (hay-fever, rash, hives, etc.), however food allergies and some insect stings can potentially cause anaphylactic shock that can close your airway/ kill you and antihistamines can help mitigate its severity (epi-pens are first line of defense). Note that drugs like Zyrtec and Claritin won't work for anaphylaxis.
NSAID – Non-Steroidal Anti-Inflammatory Drug - At the moment I like ibuprofen – to help manage pain or fever. Carry enough for managing several days of symptoms. If you have kids, you may want to bring children's versions.
You should also carry a few 325 mg Aspirin pills on hand - it can be a life-saver for people experiencing first symptoms of a heart attack - if someone in your party is having symptoms (and there are no contraindications for them taking aspirin! ) they should chew (not swallow) one regular-strength (325-mg) aspirin pill that is not enteric-coated and chug a glass of water. Alternatively, have at least 4 low-dose chewable aspirin pills which taste much better, especially to a patient in distress.
HAND SANITIZER- having a travel-size bottle with you serves many purposes - first of all it can help you and your party avoid transmitting illnesses on your trip. Also, it’s useful for sanitizing small cuts, tweezers, or other items (like if you're going to use your knife to eat food after you've used it to clean fish or game) and HACK it can be used as a fire starter.
OTHER ITEMS TO BUILD OUT YOUR KIT(S)
So, those are the basics, other items you may want to carry - some are bulkier - or put in your home, car, boat, disaster, or go bag kits include the following:
Triangular bandages are super useful and versatile - you can make slings, improvised splints, compression bandages, tourniquets, etc. with them. I cary one in my back packing and car kits.
Instant cold packs - very important treatment for any bumps, strains, or sprains (RICE!) – the quicker you get ice on an injury the faster it will heal so having these handy makes a difference. Debatable as to whether it’s worth the weight and bulk to carry into the backcountry but good to have in your car / home kits.
A lightweight, portable SAM splint - super light but has a range of uses if someone strains, sprains or breaks something - I have one that lives in the bottom of my big back pack just in case.
Small syringe for irrigating a puncture wound (with purified water) - see NSAID section above.
Carrying moleskin on longer hikes is great to have - if someone develops "hot spots" you can prevent them from turning into blisters. If someone gets a blister, you can use this to pad around it.
Having a needle along to drain a blister (sterilize first with hand sanitizer or flame) is not a bad idea either. HACK - you cans use the safety pin that comes with the triangular bandages as a needle.
A slim, light weight, and cheap Face Shield will guard against infection from bodily substances when administering rescue breathing / CPR.
Iodine tincture - A good antiseptic, even if it stings, but bulky and redundant IF you have bactine/ alcohol / other antiseptic EXCEPT that you can also purify water with this (5 drops pe quart / half hour ) helpful as a back-up to your water filter, and also if you want to make sure you have sterile water for irrigating a wound with your syringe.
Having a bottle of betadine solution handy in your home or car kits for disinfecting wounds is a good idea. Too big for day pack.
SEVERE BLEEDING
While I don’t carry these items in my day pack or even backpacking kits, I have them in my boat, house, and car and I definitely take them along when hunting (I made a trauma kit that has the items below plus more surgical pads, quick clot sponges, gloves, and EMT shears that lives in my car / I bring hunting). If you have severe bleeding, these items (still relatively light weight if slightly bulky) can be life-savers when used properly. Practice using them first (or at least watch the instructional video’s I’ve linked to ) so you’re not trying to read directions while you or your pal is bleeding out.
This Israeli military compression bandage is fantastic for stopping severe bleeding on limbs or (unlike tourniquets) on trunk wounds (abdomen, chest, back, etc.) Learn how to use it.
Z Gauze with hemostatic agent - This stuff from quick clot is great for packing a wound and stopping bleeding.
In cases of severe bleeding on a limb, tourniquets applied above the cut (between it and your heart) are a last-ditch but sure fire way to stop blood loss – there were several decades in the emergency medicine field when they were frowned upon but in part because of experience and research from the Iraq and Afghanistan wars they are back into use. This SWAT tourniquet is well reviewed and is light and relatively easy to use – Here’s how to use it. Alternatively, bulkier and a bit more expensive, but arguably easier to use effectively is a CAT Tourniquet - carried everywhere by first responders. Learn how to use it. You can also make an improvised tourniquet with a bandanna or triangular bandage and a stick or pencil/pen.
OTHER MEDICINES YOU MAY WANT TO CONSIDER CARRYING
Antacid / Alka-Seltzer / Pepto Bismol for managing nausea / gastro-intestinal issues.
Imodium – if you get diarrhea, in general as long as you can manage dehydration, its’ best to let your body take the time to purge whatever bug is in your pipes. How ever you may not have the luxury of staying put / passing time and have to move from where you are in which case these pills will enable you to do that. Note that they don’t cure what is ailing you, they simply bind you up.
Hydrocortisone cream – this stops itching of all kinds and can manage many other skin problems.
Electrolyte tablets to manage dehydration
Prescription pain killers and antibiotics - talk with your doc about your options - if you're going on a multi-day trip and someone gets really hurt or sick and help is at least several days away these can be really helpful at managing pain or possible infection.
Region specific medications – of course if you’re traveling to a developing country or area check first about what you may need to bring.
THINGS NOT TO PACK:
Snakebite kits (these range from completely useless to potentially harmful),
30 kinds of exotic band aids (reiterate: one size will (usually!) work for everything)