Thread: Supplementing Store-Bought First Aid Kit

This thread is very helpful, thanks guys. UCL, did you ever finalize your supplementation of the "ULTRALIGHT & WATERTIGHT .9"? Would be curious as to what you ended up removing/adding.

cravats, aka triangular bandages, can sub bandanas or clothing, but having one or two is helpful, they are small and light

Lou Dawson had a good writeup about his Denali med kit put together. Might gleen some stuff from there. Search his blog over at wildsnow.

I added super glue, a maxi pad (crazy blood absorption), and a flask of Patron to mine.

Just bumping this thread as I'm going through my kit prior to the start of the season. Anyone else want to chime in with what they have in their kits? To be honest this stuff has been as helpful around the house with myself (almost killed myself in Tahoe 2 years ago with a large laceration from a window) and heading out and about with friends who appreciate me worrying about their well being. Critiques are definitely welcome.

Shelter & Warmth
- Fire starting kit (Vaseline soaked cottonballs & bic lighter)
- Emergency bivy

Tools & Additions
- Syringe (Cleaning wounds, great for getting at precise spots with more pressure to clean)
- Scissors
- Duct Tape
- Medical Tape
- Extra seal bags for mixing water with salt to sterilize wounds
- 2x Cravats for slings, holding together wounds, and creating an emergency tourniquet (Use my bandana? Nha, it's gross)
- Safety pins for holding things together

Wound Care & Burns
- Regular bandages for normal cuts
- Neosporin for mitigating infection
- Burn Gel
- Band-Aid Avanced Healing for Blisters
- Dressings of all sizes for small cuts to large lacerations to help dress the wound
- Salt (I mix it with water in a bag to clean the wound or laceration with the syringe)
- QuikClot (clotting agent for large lacerations)

Medication
- Diphenhydramine (Allergies and helps sleeping at night, I use these in conjunction with Ibu's a lot)
- Ibuprofen (Joint, inflammation, headaches, anything)
- Aspirin (Helping with teeth pain, altitude problems, circulation)
- 8x Percocet 5/325 (Big pain, monster pain, won't be using for head injuries, Vicodin makes me sick, plus the strength of percocet trumps)

While it's light and doesn't take up much room, you could do without the salt. Water on its own will do just fine for wound cleaning. There have actually been trauma studies showing equal incidence of infection following wound cleansing with water or saline.

I'm not a doctor or EMT, but I've heard talk from a lot of them about this. QuikClot is a major pain in the ass once you're in the hospital. It's like spraying insulation foam into the wound, and cleaning it out is a bitch and can make it a lot harder to do the real patching up. Heat was also an issue but I guess the 2nd generation version is supposed to be better.

If it's the only way to not bleed out, obviously it's a good thing to have, but if there's a more traditional way to get the wound patched up, it's generally a better idea to avoid the QuikClot.

A decent pair of EMT shears isn't the worst idea. CountyComm (really cool site, by the way) has some for $7 that are supposed to be pretty decent. http://countycomm.com/premshears.html They've got a mini version as well if you need a smaller set.

Originally Posted by Max Archer

I'm not a doctor or EMT, but I've heard talk from a lot of them about this. QuikClot is a major pain in the ass once you're in the hospital. It's like spraying insulation foam into the wound, and cleaning it out is a bitch and can make it a lot harder to do the real patching up. Heat was also an issue but I guess the 2nd generation version is supposed to be better.

If it's the only way to not bleed out, obviously it's a good thing to have, but if there's a more traditional way to get the wound patched up, it's generally a better idea to avoid the QuikClot.

A decent pair of EMT shears isn't the worst idea. CountyComm (really cool site, by the way) has some for $7 that are supposed to be pretty decent. http://countycomm.com/premshears.html They've got a mini version as well if you need a smaller set.

The QuikClot I carry is the newer version ... this is what I read when I made my decision to throw in 2 QuikClots to my kit "They came out with a better product that comes in the form of gauze that is impregnated with kaolin, a substance that causes the blood's own clotting cascade to begin and is much easier and cleaner to use. There in no "heat" generated at all. It is now offered in several types of packages and forms." - from http://www.m4carbine.net/showthread.php?t=58793

Anyone know of a good place to order medical supplies such as gauze, celox, tape, band aids and the like?

A lot of good stuff on that site, thanks man, ended up finding a lot of things to supplement what I'm currently using...

http://countycomm.com/stormproofmatches.html - Matches
http://countycomm.com/matchcase.html - Hold cotton balls and matches or any other random stuff
http://countycomm.com/firestarter.html - Fire Starter

Medical Supplies
http://countycomm.com/twezr.html - Tweezers
http://countycomm.com/premshears.html - shears
http://countycomm.com/compactshear.html - shears
http://countycomm.com/luberinge.html - 12cc syringe

Random
http://countycomm.com/pilotflask.html - flask
http://countycomm.com/ganyanaknife.html - knife
http://countycomm.com/torqkey.html - screw driver

Hi,

I am a MD/anaesthetist and know enough to be dangerous

some random rambling and my 2 cts.

I have pondered what to take along but came to the conclusion that short of carrying a full on extended EMT kit, it really does not add much.

for minor stuff.. most everything will do. for major stuff most of the stuff you add does not do much..

The things you can try to effectively manage with more major trauma are: hypothermia and to some extent bleeding. And working on getting the @*(^@ out of there!

That said.. the only way to ''manage'' major trauma in the field is knowing what can be done effectively.. you don't need a first aid kit to reduce a femur fracture. You do need a strong stomach and a momentary indifference to the amount of pain of the patient (hard if it is your buddy screaming!).
Wrapping a pelvis with ducttape could be a lifesaver , but only if you know how to do it without making it worse.


I would stick to keeping it very simple. Invest in knowledge: it you know what you want to achieve (within the severe limitations you have) you can improvise most things.

Brown ( the nasty kind that sticks) medical Tape, combined with Ducttape will provide pretty much the basis for most needs, most everything else you already have or can be found : splinting, wound closure.(better carry a bit more. you can improvise a effective spine board with two skis and a roll of duck tape. A foot long piece will not be enough.. think half a roll )It does not need to be pretty. it needs to be effective. use whatever you can find or spare.

a bit of cloth tape is probably better than ducttape for patching wounds of bendy bits (fingers, heads) as it can stretch a bit

Bleeding:

While there is nothing wrong per se with fancy clotting bandages, tabotam, surgicell etc etc. you have to keep in mind what you goals are. First aid. Not liver surgery.

Bleeding= apply pressure. ( don't put anything in/on which reacts , it sucks later) . Rinse then let it bleed a bit, then.. apply pressure. (unless there is something severely wrong ,something that is unfixable anyway) it will clot!no looking if it stopped allowed! keep pressure for min 10-15 minutes then tape firmly). You need a bunch of gauzes or multiple quick bandages (army surplus..). (In an emergency anything will do.. don't worry about infection too much. as long as you make it to a proper doc or clean it well within 8 hours it will not matter all that much. The human body is very good at this). If you have a bloody hole.. stuff gauze (a ladies tampon works well) in (wound-packing) apply a bandage/ducttape very firmly . thus you need enough gauze to work when it goes bad. but a extra wooly hat or whatever will do as well.

I'll go one further.. any wound that will not respond to properly placed firm pressure will need a surgical solution (ie.. unfixable in the field, damage control only. apply pressure, elevate limb, compress artery.. as a very last resort use a tourniquet.. Try get the #^$@ out of there). Everything else IMHO is BS.
Shure Kaolin will work.. but so will just waiting a bit and pressure. That said it is perfectly fine to use it will not harm anything.




Do keep you tetanus shots up to date. Get Hep-A+B shots ( nice for trips abroad too)


Dermabond: Not a fan. Expensive and you need to know what you are doing or you make very bad scars or glue yourself to the subject (no joke..). just use a bit of brown tape in strips with notches cut out.. cheap and more effective.


Rx:

--Painkiller. I'd suggest Ibuprofen 600mg (anything smaller ? you don't need it. don't give to a severely bleeding person as it impairs clotting, same goes for asperin), paracetamol (works well in combination). After that you're basicly in the morfine regions ( i.e. in deep shit), A personal but probably unpopular view is that pain while evil, will not kill you. However; a severe drop in blood pressure after adequate painkillers will, if you do not have the means to get it back up again (IV fluids, knowledge). As you are possibly dealing with a person that is just hanging on, taking away stress might NOT be such a good idea.


In my experience effective painkillers (something like s-Ketamine + benzodiazepine) in an effective dose does require a person with more than rudimentary skill to manage safely.

--Antihistamine and dexamethasone is a good idea to have. If somebody has a severe allergic reaction this is pretty much the only way to sort of manage it in the field. If somebody has a history of severe allergy. YOU need to know about it and where he/she keeps his/her autoinjector and how it works (one try only..).

NOTE: an epipen or equivalent is meant to keep you alive until the antihistamines and steroids kick in.. it will not last forever ( actually not all that long.). YOU STILL NEED TO GET TO A HOSPITAL ASAP. (as you still can have massive swelling of the airways requiring intubation and ICU treatment, and after the adrenaline/epinephine wears off it is back to huge blood pressure drops)

--Altitude sickness/HAPE. know what to look for.. and get the ^%$@ down if you suspect things are going pear shaped early. RX's are a stopgap and should not be needed.

--Immodium... yup. As shitting uncontrollably is just so uncool..


SO:
0) Noooo 1620 inverted super wallabees off a gnarly cornice if you do not have a medivac heli ready and a trauma centre to go with it. Repeat after me.. this is not a TGR film shoot ..
`
1) Basic survival gear (i.e. decent knife, fire starter, emergency bag), + knowledge
+ basic tools (for fixing or even demounting bindings)
Heavy duty Condoms without lube make a very effective bag/water carrier

2) Leave a rough plan/itinerary with next of kin ( so they know where to go look in case of emergency). Keep your cellphone warm and numbers for getting out of shit on speeddial.
3) Read up on basics of emergency medicine. + learn proper CPR ( and practice).
If you go really far into the back country (waaaay back, or expeditions) do a good wilderness medicine course and bring the real stuff along.

4) KISS !

I know this is all hardly rocket science and obvious. But I would just stress that packing more stuff in will NOT help much if you not do some basics right.

^ good, no actually a great post.

Thought provoking point about the pain meds.....

Originally Posted by JRiph

Hi,I would stick to keeping it very simple. Invest in knowledge: it you know what you want to achieve (within the severe limitations you have) you can improvise most things.

Definitely agree with you here. I took a WFR class, supplement it with reading, and take a WFA class every two years. The only problem is without first hand doing and repetitive practice it's hard to become instinctual about a lot of medical treatments

Originally Posted by JRiph

I'll go one further.. any wound that will not respond to properly placed firm pressure will need a surgical solution (ie.. unfixable in the field, damage control only. apply pressure, elevate limb, compress artery.. as a very last resort use a tourniquet.. Try get the #^$@ out of there). Everything else IMHO is BS.
Shure Kaolin will work.. but so will just waiting a bit and pressure.

I do understand your point here. When I sliced open my entire under arm (picture below) and sliced a vein in my hand they just kept flushing it out with water, moving me around for x-rays without ever attempting to close the wound, I was of course ordered to keep it elevated. The large slice under my arm within the first hour or two stopped bleeding without much pressure applied but the small slice on my hand was a vein. It wouldn't stop and required surgical suturing that I'm in no way able to do in the field. For me, the idea is to grab QuikClot to help stop the major bleeding that I experienced but with a ruptured vein what good does it do right?

Even in a Dozen More Turns (Found here http://www.tetongravity.com/forums/s...tch-this-video)

I guess I'm just largely disturbed by major bleeding and in situations noted above would like to have QuikClot Gauze (kaolin) in addition to regular gauze laying around at my disposal to help mitigate the situation until help arrives.

Originally Posted by JRiph

--Painkiller. I'd suggest Ibuprofen 600mg (anything smaller ? you don't need it.

Any reason to NOT bring 200mg tablets? Don't they work the same as 600mg if they take three? I usually crush 2 200mg tablets and let them ingest 2 200mg tablets regularly when someone has sprained or really whacked their leg after a bad spill ... I'll throw in an antihistamine or two if it's before bed to help with sleeping

Originally Posted by JRiph

1) Basic survival gear (i.e. decent knife, fire starter, emergency bag), + knowledge
+ basic tools (for fixing or even demounting bindings)
Heavy duty Condoms without lube make a very effective bag/water carrier

2) Leave a rough plan/itinerary with next of kin ( so they know where to go look in case of emergency). Keep your cellphone warm and numbers for getting out of shit on speeddial.

3) Read up on basics of emergency medicine. + learn proper CPR ( and practice).
If you go really far into the back country (waaaay back, or expeditions) do a good wilderness medicine course and bring the real stuff along.

Good stuff, thanks

Hi,

I got a bit carried away.. hehe.

Rx: milligrams are miligrams so it really does not matter if you only have 200mg. but expect to use 400-600mg.

bleeding: a smaller vein when properly compressed will probably stop bleeding at some point. In general. A hole of more than 0.9mm will not clot even with a fully intact clotting system . so hence the pressure pressure mantra..

If you have stuff to suture.. you either find the bleeder and tie it, or if you can't really find it..use some large stitches grabbing nearby tissue and that tying that (compression again). if you don't have that.. just grabbing the tissue between fingers and compressing will do the same.

I would suggest packing several pairs of gloves.. blood is messy.

they can also be used for making effective finger tourniquets..

cut off a finger of the glove and put on the injured finger. poke a hole in the end an roll the top back to the base of the finger..(a rubber ring)

and it will magically stop even arterial bleeders (while this is not too great for the finger it will work for at least 30-45 minutes without all too many ill effects (remember.. the other choice is to bleed for 30 minutes..) btw arterial bleeders.. ( ie. sprayers) will not stop when elevated. just compress the sides of the finger. it will stop bleeding. then find something to tie it or use the glove trick..


Don't go poke the polar bear in the eye,

Femur trauma is approx 1,5 liters of blood loss.
Pelvis trauma.. (hence my note 0) is a high probability killer and requires a skilled trauma surgery team to handle well . Open book Pelvis trauma will tear the big veins at the back wall resulting in exsanguination pronto.

Most everything can be fixed later ( you have to make it there first ) but for a few things..

Major head trauma. and really big bleeding ( external ) or internal.

so wear a helmet and don't huck stuff blind
.

Priorities!!!

The most difficult thing bar none!.

0) Don't get yourself killed or injured while trying to help.. the last thing you need is a second casualty. the extra 10 minutes to arrange a prober belay is worth it..

1) Try to access the level of shittyness..say hello.. (if speaking..good, if not ..bad).
a speaking or screaming person is actually is better shape than a silent one). note funny stuff.. (legs crooked, red stains). Don't move the Pt. yet try to find out where it hurts ( poking works best..asking not allways). Straighten a really crooked leg.. (90 degrees)by pulling and moving. impaled/staked? don't pull it out! shorten maybe but never pull out!.

manage what you can in 5 max. 10 minutes. (don't rush we are in a hurry).

2) Call for help. state nature of injuries after you take 30 seconds to calm down first (my buddy male 25yrs has fallen of a 7 meter cliff, he is now concious but his upper leg is bent funny and his chest and abdomen are very painfull.. you don't need to speak medical but try to be clear.. they will know it is serious shit when they hear this as well ).

Needless to say knowing where the @% you are is very helpfull (where..? I'm on a mountain with bitching powder..does not really help).

3) manage stage 1 further.. improve bandages, spine stabilisation. can you move?. and is it considerably faster ? ( do you have a sled nearby..) it is easier and faster to pick up at the trail head.

If you have proper spine stabilisation in place (love duct tape!.. but climbing skins stick quite well as well..) and have a means to move.. get moving.!! In all practicality there is not much you can improve things where you are. The number ONE priority is the get the ^%@$ out of there to where you CAN impove stuff. Low blood pressure etc etc is all moot at this point.. (less blood pressure = less bleeding..) . This tactic has sadly been extensively combat proven.


If moving is out of the question ...
arrange for a as much warmth and shelter as possible.

make a fire .. ( doubles a signal for when the bird or SAR party comes to pick up).
can you be reached where you are ?

think about plan B AND C.

4) Pray to you chosen deity

Also Knowing when to quit the party is the key to seemingly minor injury.. : if somebody takes a dive and lands on a treestump with his chest or abdomen..and does not seems to feel very well after a while ( or keeps complaining of pain.. Arrange for a quick getaway.. it might be just broken ribs...or a ruptured spleen). AS we have established you can't do all that much on site your, number two priority is to get injured person the &@%^out of there .. safely.

well end of sermon.

Ergo..what you really need is plenty of tape and a good multitool.

Very good post(s) ^^^^^^. Interesting that this thread got bumped, because since I originally posted this thread, I have taken a largely similar approach to yours through eduction (although I really still want to get my WFR), decision making and taking what really matters.

The most striking balance for me has been when climbing (especially alpine climbing) as I have found myself a massive weight weany and counting grams in that scenario. So that first pushed me to re-examine my "as modified" store-bought 1st aid kit and what would really render significance in a "fixable and move on" situation v. "stabilize, bail and get help quick" situation.

At this time, my emergency/first aid kit is generally as follows:

1. Cell Phone & Partner With One - both turned off to conserve battery power and not interfer with beacons. In the Tahoe Basin at least, there is generally good coverage. In the Eatside or when Alpine climbing, I leave it at home (as no service).

2. PLB - when hiking or ski touring (in particular, deep ski tours). Notwithstanding the weight, I take this alpine climbing as they are generally pretty committing, 2 partners and fairly remote in the Sierra.

3. Fire Starter - flint, some strike anywhere matches and cotton balls/vaseline.

4. Emergency Bivy - Usually only take this ski touring, as for alpine climbing, we both have big belay jackets regardless.

5. Compass/Map

6. Ibuproffen & Perchoset - the later not to be used with a head injury.

7. Benadral or another antihistamine - for allergeric reactions if anyone has a history. If not, I leave this at home. Only a couple of tablets.

8. Duct Tape - almost all light wound issues can be fixed with this and some sort of layer you already have.

9. Gauze - I do take some gauze, but not a ton. Just for bigger bleeding. Usually duct tape itself will do the trick. Major bleeding, I am using a layer (e.g., R1 hoody) I am already carrying in my pag with cord and lots of pressure. Etc..

10. Second Skin - for long ski tours, to go under the duct table for blisters.

11. Nylon Cord

12. Immodium - for long tours for disgestional issues. Same for alpine climbing.

13. Basic Repair Kit & Skeletool - depending on skis v. climbing tools.

Beyond that, I have really felt I can ditch the rest. Bandaids and other cut repair - IMO I can get there with duct tape.

Sticky worthy this is, hmmmmmmm?

Paramedic / W-EMT chiming in... JRiph really nailed it, so "what he said" plus this...

As JRiph said, KISS (Keep It Simple, Stupid) is one of the best things out there. After I got my WEMT I went a bit crazy on the medkit as people in this thread have done, but after working prehospital and playing around in the backcountry, I realized that most of the "stuff" in medkits is not worth bringing. Here's what I bring:

Training & Experience - Knowing first aid/ being an EMT/Paramedic/MD is great, but is just scratching the surface. You also have to know how to improvise, and know what tools will allow you to improvise the most. You also have to know when to improvise, ie "stay and play" and when to "load and go". This is my main concern with medkits like the one's mentioned in this thread. Having too much junk is not only complicated, but will encourage people to "stay and play" trying to make a perfect fix for something that they should have just patched up fast and gotten moving. The other side of the experience coin is being familiar with the local conditions, and SAR/Evacuation capabilities where you are adventuring. Is there cell reception? What is the weather going to be for the next couple days (ie can you afford to "camp out" even with all the emergency bags in the world if it's going to drop to -30F?) Can SAR fly at night? Do they even have a helicopter? How far away is the helicopter? Is it only staffed until or after March/April? If rescue is not an option, what kind of terrain (avy), how many stream crossings, do you have ahead of you? Is it better to go back the way you came or to keep going the same direction? This kind of prior knowledge is what is going to allow you to make the best decisions. Those types of decisions will have a much larger impact on how well a situation turns out, than a safety pin or extra bandaid will. Also be an expert with your gear, know how to clear snow from your skin glue, how to jerry rig your boots/bindings, because you are usually heavily reliant on those things to get you out.

Supplies - As someone said, think about your biggest threats. hypothermia, dehydration, hemorrhage, hypoglycemia are what I see as the biggest problems that you can readily do something about with the proper supplies.

-Cell Phone/Spot - Know it's limitations, reception, battery life, etc. Many times texts can be sent even though you can't make a call.
-Warm Synthetic Puffy (emergency bag/bivy too if you really want) Arcteryx Dually Parka = spendy, but it's the shit
-Warm hat & Neck gaiter - The best heat saved to weight ratio of anything out there.
-Multitool - Among other things, the saw can be very useful for cutting pine boughs to put under you as insulation or fire. I like the Leatherman Wave.
-Water - Lots of it. Drink it, irrigate wounds with it (Think twice about getting your buddy soaking wet in the cold BC though - might just be best to brush it out, tape it, and run)
-Food - Obviously you can live a long time without it, but a hypoglycemic episode can turn a 1hr slog into a 5hr slog, and it doesn't just happen to diabetics. Keep a couple gu's or shotblocks or swedish fish in the kit.
-Bloodstopper This is an ABD pad with 4" rolled gauze with a million possible uses, mainly stopping major bleeding via direct pressure. You can wrap it around an extremity a couple times, then twist it with a stick/pole to make a tourniquet. You can make a sling/swath out of it. Kind of like a tri bandage but better.
-Athletic tape - No need for bandaids, cut off a chunk of your shirt/long undies/bloodstopper, tape it, and go. Many other uses.
-Duct tape - Blisters, gear fixes, etc. Need I say more? It's not meant for long term application to skin, but it significantly reduces friction, that's for sure.
-Medications - As JRiph said, NSAID's work great in combination with tylenol, but be prepared to take higher than normal doses. Ibuprofen = 600mg, up to 1000mg. every 4-6hrs. I prefer Naproxen (Aleve) because I've been told it's more effective, and it also lasts 8-12 hrs, or double Ibu. (440-1100mg) Don't go too crazy, or take for days/weeks at a time, because NSAID's can reduce bloodflow to the kidneys to the point of killing them. Tylenol - 500mg, maybe 1000mg if you're a big dude, but dont go crazy, tylenol OD is a very effective way to die. As JRiph said, avoid the NSAID's if significant bleeding is involved, even internal bleeding. Keep in mind that pain is not that bad (not just coming from a medic, but a person who has broken several bones in the BC). I have access to narcotics, but refuse to carry them in the BC. Not only can they drop a person's blood pressure, but they can induce allergic reactions, and most important to me, they impair your thought process at a time when you need to be able to make clear decisions. Narcotics don't numb the pain, they just make you care less about it. They also make you careless about other things.
-Fire starter - as much as I hate the stupid "10 essentials", if you're going to be in a treed area, and might possibly have to spend a night, I think you'd feel pretty dumb if you didn't have something to make a fire with. Keep in mind that your time might be better spent pressing on and getting the fuck out of there, or making a decent shelter from the wind.
-Headlamp - Going with the theme of enabling yourself to get out as opposed to fixating on bandaids, a good headlamp with full batteries, and an extra set of batteries should always be in the pack. I like the Zipka by petzl for it's size.

I don't carry a CPR mask, because I'm not going to be doing extended CPR in the BC. Yes, if someone is dug out of an avy, I'm going to help, but in that case, clearing the airway is the biggest concern, and most of the time I would be doing this on people I know. If a person in the group was HIV/Hep B/TB positive, I'd think differently. Also remember that once the airway is clear, hands only CPR does move air. Not as much as rescue breathing, but enough, from what I've read and seen. Granted, an avy victim is a special case that would probably benefit more from rescue breathing than your average cardiac arrest pt, but don't get carried away with rescue breaths if there is no pulse.

Modify your kit to the conditions, location, and people. Does someone have an allergy? Bring 2 epipens and benadryl. -30F? Bring more insulation. Way out there? Bring some stuff to fix your gear, because a gear problem will turn into a medical emergency in deep snow. Someone said that they found their kit useful at home. Keep in mind that while it is nice to have a ton of different bandaids and stuff to perform good wound care at home, unless you're on an expedition, or more than a day or so from a hospital, you probably shouldn't get too carried away with wound care in the backcountry.

Also, don't be a dumbass: Hypothermia is a serious problem, and while you may think that you're tough because you can just keep hiking with 3 baggy jackets and 2 pairs of pants hanging off your ass, while you drench yourself in sweat, you're just a ball of ice waiting to happen. First, you're dehydrating yourself, and second, you're getting all of your warm clothes wet. If you get hurt, and can't move for a bit, you've not only killed the insulating capability of your clothes, but you've made sure that you've got enough water in them to keep the evaporative cooling going until you're an icicle. Learn how to manage your layers.

BTW the clear dressings people are talking about are 3M Tegaderm (also come in other brands) and are nice to have around the house. I hate to get into actually teaching medicine in a first aid kit thread, but as for wound care at home: debride with copious amounts of water (if you can drink it it's good to use) and do a final rinse with a .5-1% iodine solution, alcohol, or hydrogen peroxide (don't leave any in the wound, just flush it and blot dry with sterile gauze). If it's a surface abrasion, triple antibiotic can decrease healing times, so use it, and cover with a bandaid (you can keep it open to air too, or alternate). If it's at all deep, i've been told that triple antibiotic can lose it's antibiotic properties after a short time, and the goo in the wound will actually foster bacterial growth. Just clean deep wounds EXTREMELY well, and then use Steri Strips, combined with tincture of benzoin to make them stick really well, to close the wound, making sure to line things up as well as you can. If you need to make it waterproof, use a Tegaderm on top of the steri strips.

Sidenote: JRiph mentioned straightening really crooked extremity fractures. I've been taught to only straighten them if they are a) getting numbness/tingly, or have no pulse at the end of that extremity (ie the artery/vein/nerve to that limb is being impinged on by the deformation) or b) it is preventing removal/rescue of the patient. If you do try to straighten it, make sure you first pull (strong) traction, then try to move it.

Glow Stick-If the Heli is out at night with Night Vision. What you want to do is tie your glow stick ti three feet of string and spin it around your head. It can be seen for miles with Night Vision Googles.

Here is a story where they found a little girl with the little rope one around her neck....

http://menlopark.patch.com/articles/...e-search-party

Seriously think this should get a sticky here on the forums, tons of useful information

As it is the beginning of the season and this stuff could be of use

maybe it is a good idea to edit this thread into a short condensed version and then repost it as a sticky with a title that fits better..

i don't know if anybody minds some copy pasting and some editing ?

Just to bring this up again as I've been researching OTC pain meds and here is what I found on the interwebs and just with general experience. Let me know if anyone has anything different to say/answers to some of my questions.

Aspirin (Bayer) - Good for circulation, high altitude sickness, and tooth pain. Why is it good for tooth pain specifically and not the others, is that because because it's an anticoagulant? Aspirin is also NSAID to help reduce swelling

Ibuprofen (Advil) - Helps with swelling because it's a NSAID, generally lasts 2-4 hours for me

Naproxen (Aleve) - I find Naproxen to do the same job as Ibuprofen just only better and over a long period of 8-12 hours. Great right before bed if you're muscles are sore or if you've had a sprain and you're about to sleep but need the swelling to reduce

Acetaminophen (Tylenol) - Works as a pain blocker, doesn't actually reduce swelling like the above 3 NSAID's do. I'll generally take this in combination with a NSAID if I'm experiencing a lot of pain aka migraine/tension/sinus headaches or if I had a bad injury and I'm out of prescription pain meds. Percocet (oxycodone), Vicodin, and all the rest of the prescription pain med's pair the dose with acetaminophen

A few other things I use if I need some extra oomf
- Diphenhydramine (AKA Benadryl) as a sleep helper if I'm in pain and need to sleep
- Caffeine pills also help get the medication to my headaches faster, I'll usually take this with acetaminophen/aspirin

I think a SAM Splint is the biggest thing you're missing out of that pack. That and duct tape will get you home pretty much every time. Everything else is filler for the little stuff when you want to ski after you slice your hand open on your edges or whatever.

Oh and make a t-shirt roll. Take an old shirt, that isn't holey and cut it into a 3 inch continuous strip. Makes a great sling/bandage/dressing/jizz rag.

Also I fall into the camp of leaving severe fractures alone. When I broke my ankle if anyone had tried to reset that sucker I would have beat them so hard their mother would have felt it. I crawled out happily.

Given the negligible weight penalty (0.25oz?), a couple of needles in different sizes + thread + dental floss belongs in any emergency/repair kit IMO. When it's cold, an awful lot of adhesives stick poorly. Granted, it's very unlikely that you're going to sew someone up, but for fixing clothing or securing a bandage it's super useful.

Originally Posted by brice618

I think a SAM Splint is the biggest thing you're missing out of that pack. That and duct tape will get you home pretty much every time. Everything else is filler for the little stuff when you want to ski after you slice your hand open on your edges or whatever.

Oh and make a t-shirt roll. Take an old shirt, that isn't holey and cut it into a 3 inch continuous strip. Makes a great sling/bandage/dressing/jizz rag.

Also I fall into the camp of leaving severe fractures alone. When I broke my ankle if anyone had tried to reset that sucker I would have beat them so hard their mother would have felt it. I crawled out happily.

Funny - I always carried a Sam Splint and only had to use it once: Driver and I were touring, and he was in alpine boots like a nut b/c the place we went to is a very short approach. Well on the exit there was a long burnt-out road that we had to walk. Easy in Dynafits - his alpine boots, not so much. So hence the Sam Splint custom shoes :





Worked pretty well actually!

Another Bump...

My wife just sent me this article on the manly survival uses of a tampon - staunching large puncture wounds is only one.

http://artofmanliness.com/2012/06/05/survival-tampon/

Another use not mentioned - hand it to whoever starts to whine on the trip...

Good bump.

How less effective is 2-3 year old Ibuprofen?

A couple of things that come in handy for guiding, not seen on the list anywhere: pepto bismol, chewable kind. So many things can make yer tummy hurt- this stuff works. Load up on it for foreign trips.

Double underscore the tampons; can be helpful for women clients, for altitude-induced surprise periods, or for persistent nosebleeds, which I see a lot in folks new to altitude.

I also carry Cavit for dental issues as I lost a crown at a Himalayan base camp, many many moons from the dentist.

and a big help for closed blisters is called New Skin- paint it on and it toughens the underneath nicely. Burns like hell if blister is open, that's a no-no.