Supplementing Store-Bought First Aid Kit

[Unfrozen Caveman Lawyer]

So I purchased the following light-weight first aid kit from REI for use backcountry skiing:

http://www.adventuremedicalkits.com/....9&product=119

The factory contents are as follows:

Bandage Materials
3 Dressing, Gauze, Sterile, 3" x 3", Pkg./2
2 Dressing, Gauze, Sterile, 2" x 2", Pkg./2
1 Bandage, Conforming Gauze, 3"
2 Bandage, Stockinette Tubular, 1" x 4"
1 Bandage, Elastic, Self Adhering, 2"
2 Dressing, Non-Adherent, Sterile, 3" x 4"
5 Bandage, Adhesive, Fabric, 1" x 3"
3 Bandage, Adhesive, Fabric, Knuckle

Bleeding
1 Gloves, Nitrile (Pair), Hand Wipe
1 Trauma Pad, 5" x 9"

Blister / Burn
22 Moleskin, Pre-Cut & Shaped

Duct Tape
1 Duct Tape, 2" x 100"

Instrument
1 Splinter Picker/Tick Remover Forceps
3 Safety Pins

Medication
4 Ibuprofen (200 mg), Pkg./2
2 Antihistamine (Diphenhydramine 25 mg)
6 Diamode (Loperamide HCI 2 mg), Pkg./1

Other
2 Aloksak Waterproof Bag, 6" x 9"

Wound Care
1 Tape, 1" x 10 Yards
1 Syringe, Irrigation, 10 cc, 18 Gauge Tip
1 Tincture of Benzoin Topical Adhesive, Vial
6 After Cuts & Scrapes Anethestic/Antiseptic Wipe
1 Cotton Tip Applicator, Pkg./2
3 Triple Antibiotic Ointment, 1/32 oz
1 Wound Closure Strips, 1/4" x 4", Pkg./10

As stated, the use is backcountry skiing, so weight is an issue. Rather than start from scratch, this appeared to have some good stuff so I purchased it as a good starting point. The issue is I don't really know what I can scrap and what I should replace (or get more of).

Disclaimers:

1. Weight is an issue

2. I am somewhat on a noob on first aid (though thinking of taking WFR course), but not a total idiot. However, when you say "CPR mask", would be good to know which brand/size as I don't know that level of granularity.

3. Things I have generally thought of adding: (i) couple more pairs of Nitrile gloves; (ii) CPR mask (not sure what kind); (iii) couple more packets of pain killer; (iv) couple more packets of benadryl-type drug for allergic reactions; and (v) some more wound cleaner.

4. Things I was going to get rid of: (i) duct tape (as I already have this wrapped on both ski poles, but probably not bag to keep a little extra); and (ii) syringe.

5. Are shears necessary if I have a multi-tool?

Any thoughts on the above or other mods/additions, subtractions are welcome. I just want to modify this store-bought back as appropriate.

Thanks.

EDIT: I would also generally like to use this for hiking/climbing/paddling or other activities. Main purposes being bc skiing and hiking, but would be good to know if any suggestions are *solely* for ski-related injuries/issues.

[haydukelives]

x2 x2 x2

[Fenris]

The waterproof breathable clear shit that they put over wounds (I can't remember the brand names, but I can check in an hour when I go back to my WFR class. I've actually got some of this shit stuck to my arm, but it doesn't have a brand name on it.

Possibly switch the triple antibiotic ointment for double antibiotic ointment. Apparently more and more people are reacting to the third chemical.

Self adhering bandages (Coban, CoFlex, VetWrap) is the shit.

A couple of aspirin for stuff that ibu won't help with (teeth).

Get a Conterra or similar big cpr mask because some CPR masks aren't designed to survive altitude and temperature changes too well.

Do you really want to shove you pocket knife under tape that's wrapped around you own ankle? More than a couple of people have cut their anchillies that way in WFR courses, let alone in the woods.

For wound cleaning, drinking water in the syringe at high pressure works pretty damn well. Keep it because when you decide you want it, basically nothing can replace it and actually get high pressure.

Do WFR if you can. It's a little redundant for me, because I've done OEC, but the difference in protocols and the few extra things that one set of training can do and the other can't is pretty significant in the long run.
More if I think of it.

[AKbruin]

An emergency blanket, which is quasi-first aid related, could come in handy and is pretty light. (I also keep a lot of survival stuff in my first aid kit too like a whistle, matches and tinder, a spotting mirror, etc.)

My REI first aid kit comes with a little book on how to deal with various injuries. I actually have found it quite useful, but I don't know much about first aid either.

The things I've used in my hiking/skiing first-aid kit: (1) moleskin and scissors to cut moleskin; (2) pain killers; (3) bandaids; and (4) gauze and bandaging for a twisted ankle. I've never had to use it for any serious mishaps though. (Knock on wood.)

[Unfrozen Caveman Lawyer]

The waterproof breathable clear shit that they put over wounds (I can't remember the brand names, but I can check in an hour when I go back to my WFR class. I've actually got some of this shit stuck to my arm, but it doesn't have a brand name on it.

Yeah - would be good to know the name. I think I know what you are talking about.

Possibly switch the triple antibiotic ointment for double antibiotic ointment. Apparently more and more people are reacting to the third chemical.

Self adhering bandages (Coban, CoFlex, VetWrap) is the shit.

A couple of aspirin for stuff that ibu won't help with (teeth).

All good recomendations. Will check out at walgreens.

Get a Conterra or similar big cpr mask because some CPR masks aren't designed to survive altitude and temperature changes too well.

Thanks - totally noob on these (although know CPR).

Do you really want to shove you pocket knife under tape that's wrapped around you own ankle? More than a couple of people have cut their anchillies that way in WFR courses, let alone in the woods.

I think my multitool has scissors, but they probably suck thinking about it now. Would cut bandage, but definitely not clothing, etc... for serious issues.

For wound cleaning, drinking water in the syringe at high pressure works pretty damn well. Keep it because when you decide you want it, basically nothing can replace it and actually get high pressure.

Do WFR if you can. It's a little redundant for me, because I've done OEC, but the difference in protocols and the few extra things that one set of training can do and the other can't is pretty significant in the long run.
More if I think of it.

Syringe weighs nothing, so may as well keep it I guess. Good point.

I definitely will take WFR at some point - having the time is the issue. Prob this summer.

Thanks - great response.

[Unfrozen Caveman Lawyer]

An emergency blanket, which is quasi-first aid related, could come in handy and is pretty light. (I also keep a lot of survival stuff in my first aid kit too like a whistle, matches and tinder, a spotting mirror, etc.)

My REI first aid kit comes with a little book on how to deal with various injuries. I actually have found it quite useful, but I don't know much about first aid either.

The things I've used in my hiking/skiing first-aid kit: (1) moleskin and scissors to cut moleskin; (2) pain killers; (3) bandaids; and (4) gauze and bandaging for a twisted ankle. I've never had to use it for any serious mishaps though. (Knock on wood.)

Thanks AK. I actually already have emergency blanket, matches and firestarter (cotton balls soaked in vaseline.... $$$$ - also dryer lint is pretty good). I wasn't listing that above - but I do keep those small items in the 1st aid kit (other than blanket).

At the end of the day, these only go so far. I had to deal with severe head trama working in NC during college - these are worthless other than gloves and some attempts to stop blood. Cell phone with coverage is much more helpful in that situation.

[LightRanger]

UCL,

Fenris covered much of what I'd say. I'd add:

Superglue (for closing wounds... generic is fine IMO, but I know medical grade exists)

Find a blister treatment method that you like rather than going with stock moleskin... there are tons of options

Maybe a SAM Splint (should be able to substitute a blue "shorty" ensolite pad for this on longer trips because you should be carrying one anyway, IMO... they have short ones at REI for like $10)

Echo the serious pain meds... I've been carrying six vicodin, but my mom says she has some norco lying around, so I'm going to start carrying those

I think it'd be sweet to get a hold of some diamox if you're going high... I've heard docs are generally pretty cool with giving you some if you tell them what it's for... I've yet to determine this for myself

I'm in the same boat as you and would like to take at least a WFR class in the next year or so (if not a one-night-a-week semester-long JC EMT course).


Edit: In terms of other "emergency" gear I'm carrying the other stuff you are too, but I REALLY want to get a Spot. Those things seem really really cool.

[LightRanger]

Here's some more stuff:

http://telemarktalk.com/phpBB/viewtopic.php?t=32957

http://telemarktalk.com/phpBB/viewtopic.php?t=29718

http://telemarktalk.com/phpBB/viewtopic.php?t=27059

[VC]

x2 Sam Splint, Arm, leg, neck, finger you name it. They rules

[SeatownSlackey]

The waterproof breathable clear shit that they put over wounds (I can't remember the brand names, but I can check in an hour when I go back to my WFR class. I've actually got some of this shit stuck to my arm, but it doesn't have a brand name on it.

Yeah - would be good to know the name. I think I know what you are talking about.

I think they're called tagaderm but don't always listen to the RN wifey as well as i should.....

[Unfrozen Caveman Lawyer]

Thanks to all. Scutski - good stuff in those links.

[Julio]

UCL,

I think it'd be sweet to get a hold of some diamox if you're going high... I've heard docs are generally pretty cool with giving you some if you tell them what it's for... I've yet to determine this for myself

The problem with diamox is you have to take it for awhile before you need it. If you already have symptoms, it's too late. And it makes beer taste funny.

SAM splints are cool, practice a bit before you need to use it.

Vet Wrap is awesome. Lots of pretty colors here... http://www.amazon.com/Gifted-Horse-T.../dp/B0002V47L0

[Kai]

My 2 cents:

An emergency blanket is useless. It will not protect you from wind or from rain (it's so light that it just flaps around, and doesn't have enough "memory" to stay wrapped around your body.) Spend the extra $4 and 1 and a half ounces and get an emergency BAG. The bag will actually keep the wind and precip at bay. The blanket will just make you frustrated. Add a lighter and some tinder, and you've got the basics for shelter and warmth.

Don't bother with a SAM splint. Bring some duct tape (which it looks like your kit already has,) and you can fashion a very effective splint with the duct tape and your sleeping pad or pack frame.

Skew your first aid kit towards the types of medical issues you are likely to encounter and which you are able to do something about.

Blisters: Best blister remedy by far is the Band-aid advanced healing blister cushions. These used to be only available in Europe (called "Compeed" over there) but now Band-aid sells them.

http://www.drugstore.com/products/pr...71&catid=10579

Spenco (second skin) sells a similar product that is also very good.

http://www.spenco.com/2ndSkin_2.shtml

These are better than moleskin etc. They stay on longer, provide better cushioning, and less friction. Use them, and you will not go back to moleskin.

Minor cuts: a couple of band-aids and some neosporin ointment. (looks like your kit has this covered)

Burns: packet of burn gel. (really does help ease the pain)

Major external bleeding: This is one of the few truly life threatening injuries that you can actually treat effectively in the backcountry. For this, you will want the trauma pad (that's in your kit already) and I would also highly recommend a clotting agent. Celox seems to have the fewest liabilites (some of the others generate a lot of heat) and is relatively inexpensive and light.

http://www.amazon.com/Celox/dp/B000NCUEZ6

For large lacerations, superglue is hard to beat for closing wounds. However, typical superglue that you buy at the hobby or hardware store contains chemicals that irritate and inflame skin tissue. It will work for closing the wound, but is not ideal for promoting wound healing. I recommend biting the bullet and buying some DermaBond superglue that is actually formulated for use on human skiin. (at $40, it will cost you more than you probably paid for your REI kit.) Some proxi strips are also a good idea. They work better than butterfly bandages for holding skin together.

Your kit has a LOT of bandage materials. I would keep the 3x3, the 3x4, and ditch the rest.

You can either keep the syringe, or ditch it and improvise. There are other ways of improvising wound irrigation (poking a hole in a plastic bag, etc.) None of these improvised methods work as well as the syringe, but in my experience, they work well enough. Add a small vial of Betadine disinfectant. This will help with wound cleaning.

As for medications, take aspirin (helps for altitude issues.) Keep the ibuprophin (good for reducing swelling, joint inflamation, etc.)
Also add some prescription pain meds if you can. Tylenol with codein is a good, all around pain killer. Just remember do NOT use prescription pain killers in the event of head injuries, as most of them will exacerbate cerebral swelling. For a broken leg, however, some Rx pain meds are going to be much more usefull than an handfull of motrin.

Here is what I take with me on a typical backcountry trip:

2 Aloksack waterproof bags (protects the contents and can be used for mxing up a sterile solution for irrigating wounds)
Band Aid blister dressings
Dermabond surgical glue
Proxi strips
Sterile military trauma dressing (unfolds to 6" x 6"; for big wounds and major bleeding; can double as a sling)
2 band aids
2 large Sterile Gauze Pads
Celox clotting agent
Morphine tablets oxicodone tablets, and vicodin tablets (for SERIOUS pain)
Ibuprophin (relieves swelling associated with sprains and the like)
Buffered aspirin (best all around analgesic, helps to combat altitude sickness, and improves circulation.)
Small roll of 1" medical tape (hundreds of uses)
Small vial of of betadine (for cleansing wounds)
Packet of triple antibiotic ointment (neosporin)
2 Antiseptic towlettes
Packet of burn gel

Total weight for this kit is 5.5 ounces.
I also carry duct tape, which can be pressed into service as a first aid item

[LightRanger]

Kai, that's great information.

Proxi-strips = steri-strips, no?

Also, IME generic superglue hasn't irritated anything, but I've only used it on minor hand lacerations. Does it depend on individual sensitivity?

[Fenris]

Yeah - would be good to know the name. I think I know what you are talking about.

OP-Site and Tegaderm, and Dukal Transparent Semi-Permeable Dressing for a generic version.

Mask: http://www.patrollersupply.com/equipment/item_434.asp
It's a little more expensive and bigger than just a face shield, but it won't shatter at cold temps and high altitudes like one of mine did. Ok, it didn't quite shatter, but broke enough to become unusable.

Celox and similar are cool stuff, but some of them worry me because they are seafood based. And I react to all seafood including crustations and freshwater stuff (Except for tunafish from a can mixed into something else, wtf). Stiff use it on me if it's between an allerigic reaction and having to get out the wet vac, but don't bust it out for anything that isn't playing supersoaker. Ok enough ranting.

Ya superglue is good, just be careful where you get it.

[Kai]

Kai, that's great information.

Proxi-strips = steri-strips, no?

Also, IME generic superglue hasn't irritated anything, but I've only used it on minor hand lacerations. Does it depend on individual sensitivity?

I don't know if proxi-strips are the same as steri-strips.

I have experimented with a number of these type of wound closure strips. The proxi strips seem to stick better than others I've used, and work reasonably well even without preparation of the skin with benzoin or other adhesives. Steri strips might be just as good, I don't know. I've been using Proxi strips for years now, and haven't tried anything else out for a while. There may be something better out there, but if there is, I don't know about it.

Yes, the super glue sensitivity is probably minor for most people, but I do know it is a problem for some who are allergic to the regular hobby glue (me, for example.) It's probably not a serious issue, however, I like having the best tool for the job, and Dermabond is definitely superior in this case. The high price tag may not be justified, however, for many folks who aren't as allergy sensitive as I am.

[LightRanger]

Pretty sure they're the same, steri-strips require tincture of benzoin though, so I think proxis are probably better. Good to know on the superglue. Since I haven't reacted, I think I'll stick with my generic.

Good thread.

[Unfrozen Caveman Lawyer]

Kai - SUPER helpful. Thanks a lot. I definitely have some mods to do to the kit, but this is exactly the type of info I was looking for.

Thanks.

[Core Shot]

bump 678

[skinnyskier]

My $.02: prepare for the whole scenario, not just the injury itself. It's very, very hard to evacuate someone who can't ski. If your buddies can't get you up a snow slope and down the other side, or keep you warm where you are, you could die from hypothermia after a broken leg. So, shelter in place gear and/or a self-rescue kit are pretty key here, even more than the actual first aid kit contents. A Silnylon guide tarp and perhaps a sled kit are WAY more likely to be useful than a CPR mask.

For example: a member of our group had a generalized siezure with a prolonged post-ictal phase while skiing back to the hut in BC. The weather was good and CMH sent their lunch bird, so we were sorted withing 30 minutes. We still needed a bivvy sack and extra layers, plus a snow saws to trim branches for a heli spot. Nothing from the first aid kits was needed.

And another: a Nelson skier hit a boulder with his kneecap skiing the Whitewater resort sidecountry in late afternoon storm conditions. It took ski patrol and SAR 6 hours to evacuate him. He only needed splinting supplies, extra layers and a bivvy sac.

[Viva]

3. Things I have generally thought of adding: (i) couple more pairs of Nitrile gloves;

What's with the gloves, planing on giving BC rectal exams?

If friend is bleeding severely, I'm going right in and helping out. Fuck the gloves. Those things go bad pretty quickly, too, as I recall, so you'd have to replace them at least once every 12 months.

Maybe find some small blunt-tipped curved scissors for cutting off clothing, old bandages, loose/damaged tissue, etc.

Maybe too much weight for you, but my (large) self-made first aid kit contains a small eye wash thingy and a bottle of eye saline. You can use agua instead of saline and then it don't weigh so much.

[Sinecure]

Next time you are at the Doc's, steal a couple of tongue depressors. They make great finger splints and don't weigh much. Although if you have a SAM splint and surgical scissors, you can cut a finger splint from the SAM splint (SAM splint is just foam with some alu inside so you can cut it to any shape/size you need).

I keep a baggie in my 1st aid kit that has some gloves and a couple ABD pads (giant gauze). Its called a "bloody bag" and is the first thing I grab if there's lots of blood. I used it this summer when I came on a bike accident near the mall. That way I can grab it without getting blood on other stuff.

Extra gauze is good. I like having some of the non-stick kind for abrasions so you can clean/cover it but still remove it painlessly when you get back to the car/camp/cabin and want to do a more thorough job of dressing the wound.

Keep the syringe. They're great for irrigating/cleaning wounds. A small bottle of contact lens solution is great for cleaning wounds as well as helping a buddy with his contacts.

If I knew how to suture a wound I'd keep some suture material and a needle, but I don't know that yet (yeah, I'd figure it out quick if it were life or death).

Viva, if its your relative no gloves is OK. But otherwise, gloves are a good idea. Plus they make clean-up much easier. And while most folks think AIDS is the main reason for gloves, Hepatitis is a more important reason. Lots of people have Hep and it lives outside the body for a long time. AIDS in blood will only live outside the body for a short time. Hep will still be around and infectious days later. Besides, if I'm skiing or biking, my hands are probably not too clean. I don't need to make a person's injury worse by touching a wound with my filthy hands. Gloves are cheap and good.

I have boxes and boxes of nitrile gloves at my house if any Bay Area Mags want to stop by and take some.

[farmer]

First Aid: Advil, benadryl, T3's, moleskin, tape, scissors (those "crash" scissors that paramedics use are great, the shitty little ones in your pocket knife aren't)


Last Aid: Ice Axe

[char]

Can anyone speak to the usefulness of clotting products like Celox on something like a chainsaw wound?

Do these products make more of a mess than they are worth?

[johngenx]

What's with the gloves, planing on giving BC rectal exams?

If friend is bleeding severely, I'm going right in and helping out. Fuck the gloves.

Not everyone you might be lending aid to is a friend. I've assisted people I have never seen/met prior to the incident.