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Medical Kits

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Medical Kits

Postby philoparts » Tue Apr 24, 2012 6:16 am

Everyone should have at least some sort of first aid kit when out in the backcountry. Since I'm a bit of a medical geek, I tend to carry a wee bit more than others. I personally have 3 kits, a day hike/solo backcountry kit, a multi-day/SAR kit, then my full on jump kit that goes in the car everywhere. Since opinions vary on what a good first aid kit contains, I believe in either building your own or revamping an existing kit. The REI kit is from the Outlet, spent like $24 on it, then added a few items for a light kit. The Conterra kit was just an organizer that sells for $33, and all the contents were added by me. It fits nicely in the outer pocket of my pack, along with a BP cuff and stethoscope. The jump kit was a $120 pre-pack kit that I went to town on. Probably has twice as much in it than I bought it with, but since it stays in my car, its stocked more for "car accident along the way" than carrying up the trail. I've looked at Adventure Medical kits, and think they are well stocked and at a good price. If you want to build your own, I suggest buying a pre-made kit and modifying it to fit your needs.
http://survival.outdoorlife.com/blogs/survivalist/2012/04/10-most-important-pieces-gear-your-first-aid-kit
http://www.outsideonline.com/outdoor-adventure/outdoor-skills/first-aid/First-Aid-Kits.html

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Re: Medical Kits

Postby s2kfire » Tue May 22, 2012 3:03 am

I think a lot of the premade kits are overkill. I think the biggest determining factor in what I would take with me is how isolated I was. Still, I could probably fit everything in a sandwich baggie. My hiking kit is just some bandaids, benadryl, ibuprofen, 1 kerlix, aspirin, if I had EPI I would carry some. Also a high proof grain alcohol. Maybe some quick clot. Finally, Duct tape is the fix all splinting, bandaging, whatever. I would toss the sam splint or any real splinting material other than a triangle bandage maybe. In an emergency situation you can use hiking poles branches or form soft splints from either a jacket sleeping pad or something. I would just hope air transport can access wherever you are for anything serious.
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Re: Medical Kits

Postby Sierra Ledge Rat » Tue May 22, 2012 8:39 am

I think that commerical first aid kits are worthless. Just make your own.

I take supplies for treating blisters, minor cuts and scrapes. Moleskin, duct tape, bandages, Tincture of Benzoin, Steri-Strips and more tape.

Face it - practically speaking you can't (or won't) carry huge first aid kids. So take what you need to take care of common problems.

If your problem is so severe that it can't be fixed with bandages and duct tape, then you don't need a bigger medical kit - you need bivouac gear.
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Re: Medical Kits

Postby ExcitableBoy » Tue May 22, 2012 2:02 pm

The best first aid kit is the one you will carry. A colleauge who teaches MOFA for the Seattle Mountineers and always carries a fanny pack with a trauma kit, even at work. He gets teased plenty, but once while hiking on a popular trail he found an unconcious older gentleman and he and his kit saved the man's life. Vindicated he tells the story to anyone who will listen.

My first climbing mentor was a classic reductionist thinker. (E.g. there are only three types of rock; granite, sandstone, and limestone). He carried an NSAID, a few bandaids, and athletic tape. According to him these could fix anything, and if they couldn't the patient needed a full blown ER. I tend to agree with him, but carry a few more items, more for treating uncomfortable, nagging, wounds than traumatic injuries.

NSAId (naproxen, prescrition strength)
broad spectrum antibiotic
narcotic (Dialaudid(
several aseptically packaged sryringes with sterile saline for irrigating wounds
althetic tape
plastic tape
band aides
gauze pads
gauze roll
alcohol wipes
iodine prep swabs
tweezers,
scissors
special blister pads, and plenty of them

Most of this stuff is left over drugs and kit from visiting nurses from when I had home infusions. The total kit weighs less than 8 oz, yet with the gear I normally carry and some improvisation I can deal with almost any emergency outside of an ER.

I had a serious alpine climbing accident and since we were going light we had nothing in the way of first aid. My partner stopped my bleeding head wound with a fleece head band, slpinted my right arm with a folded Z-Rest pad and a fleece sweather and jammed clean socks in the wound to stop the bleeding (open fracture, radial head sheared off, skin degloved from elbow to wrist. The other hand was shattered in seven places and my left ankle was class three sprained, but it swelled inside my boot and self splinted. We could not have carried enough gauze to stop the bleeding, but the socks and fleece did a perfect job. We self rescued down 1,500 feet of techincal terrain, walked out 10 miles, half off trail, and drove to the E Room. The Docs were super impressed with the first aid job, said my partner must have been an EMT or something. He had never taken a first aid class, just used common sense.
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Re: Medical Kits

Postby s2kfire » Tue May 22, 2012 2:17 pm

Excitableboy, strong work by your friend! And that is awesome you hiked out like that and then drove to the ED! Ledge rat, As far as kit size I am not suggesting you carry bottles of meds. Just enough for your trip. While I agree about treating the small stuff that isn't what concerns me. The medications I have listed may prevent loss of life that may otherwise occur if you did not have them.
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Re: Medical Kits

Postby philoparts » Wed May 23, 2012 9:06 am

Tailor your kit for your activity. The REI kit was modified, the SAR kit I built from scratch. The jump kit is for the car of course. My go-to items are roller gauze and 4X4's. Throw in some diphenhydramine (epi only buys you time to get an anti-histamine on board),ibuprofen, athletic tape and maybe an ace wrap. Steri-strips, Viewguards (its like medical Gore-Tex!!), an irrigation syringe and a tincture of benzoin. I also have at least a few pairs of gloves. "If its wet and not yours, its infectious".
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Re: Medical Kits

Postby s2kfire » Wed May 23, 2012 7:06 pm

Epi solves a multitude of histamine release side effects. An antihistamine simply prevents further histamine release buying your body time to cope with the already released histamine. Epi is a bronchodilator, solves swelling and anaphylactic shock caused by vascular leakage. It is the more aggressive treatment.
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Re: Medical Kits

Postby philoparts » Wed May 23, 2012 9:08 pm

s2kfire wrote:Epi solves a multitude of histamine release side effects. An antihistamine simply prevents further histamine release buying your body time to cope with the already released histamine. Epi is a bronchodilator, solves swelling and anaphylactic shock caused by vascular leakage. It is the more aggressive treatment.


I understand what epinephrine does, and the fact its effects only last 5 minutes on average. Unless someone I'm with has a prescription for epi, its a moot point for considering it in a backcountry kit. Anyone can get Benadryl at the corner store. Epi is a little harder to get your hands on. I'm already trained in IM and SQ injections, as well as autoinjectors, but unless I take a class through the State of Oregon specifically for epi admin, I can't even buy it. Epi buys you time from dying due to anaphylaxis, antihistamines deal with the root problem. If you really wanted to have some sort of epi in your kit, grab a Primatene inhaler, .22mg per inhalation and legal OTC. Only hitch in that is they stopped production end of 2011 because of CFC propellant to reformulate with a non-CFC propellant.
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Re: Medical Kits

Postby MoapaPk » Wed May 23, 2012 9:27 pm

95% of the uses of my first aid kit are for other people who carry nothing. NSAIDS, blister fixes, and tape are the most popular items. I start with about 1.5 times as much tape as I need to stabilize an ankle, then have to replace it wholesale when I have used so much to tape people's blisters.

If people are really allergic to bee stings (or whatnot), those folks should be carrying their own epi pens... and they should tell the trip organizer.

You can get the benadryl quick-dissolve strips-- probably better for someone who is getting a serious quick reaction, since that person will not have to swallow a pill.
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Re: Medical Kits

Postby philoparts » Wed May 23, 2012 9:54 pm

Heh, my kits were designed with the same thing in mind.... the people who carry nothing. When I quit smoking and returned to backpacking and mountaineering, I kept running into people with no gear whatsoever in places they shouldn't have been. Even if it is just a trail off of the highway, if you are not in shape, not properly hydrating, and pushing yourself harder than you should, its a recipe for disaster. And to top it off, people get a false sense of security thinking that if they get hurt, help will be there as fast as in an urban setting. Tell you what, if you twist an ankle on a trail, they're not calling a helicopter in to haul your ass out. You're getting taped up and walking out.

So, my point of starting this thread was to get people talking about what would make a good kit for Joe Blow backpacker, so hopefully that is what people are taking away from it. Unfortunately you can't always teach people common sense, so people are still going to get hurt in the backcountry. And, as my dad told me when I was just a wee lad "Shit happens", we can't always be ready for the unforeseen rock fall, gopher hole, or pissed off moose.
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Re: Medical Kits

Postby s2kfire » Wed May 23, 2012 10:16 pm

Most of what I carry is for myself. While Epi may only "last" for 5 minutes. It reverses the root of the problem and the effects of what it did during those 5 minutes last longer than 5 minutes... If you have an anaphylactic reaction and benadryl is all you have, you will most likely die. I would rather illegally give myself epi than die. The people I am with would probably rather be illegally given epi than die. Benadryl is useless once you can't swallow anyway, unless you happen to have IV benadryl. Quick disolve may work if the person is able to keep their saliva in their mouth. Not everyone knows their allergies. You would be surprised at what helicopters get called to...
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Re: Medical Kits

Postby philoparts » Wed May 23, 2012 10:44 pm

s2kfire wrote: My hiking kit is just some bandaids, benadryl, ibuprofen, 1 kerlix, aspirin, if I had EPI I would carry some.



So do you have and do you carry epi? And if you are such a proponent of epi, why carry the benadryl?
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Re: Medical Kits

Postby s2kfire » Wed May 23, 2012 11:22 pm

They work in conjuction with eachother. I am not saying benadryl is useless in all circumstances. For an allergic reaction it is perfect. However, for an anyphalactic reaction it is basically useless. And no I currently don't have epi, you caught me. For me, it wouldn't be a big deal to get some since I have had a semi severe allergic reaction in the recent past. and have family history of severe allergy. Luckily when I had my incident I wasn't far out. I had taken an anti-histamine (not benadryl) about 45 min prior and it worked for a good while but was shortly overpowered by the ammount of pollen in the air. I never had any airway issues during the even and 50mg of benadryl did the trick at stopping it from getting much worse but it took a full day for the hives and swelling to go away. The ER prescribed me some prednisone and that was pretty much it. I am not gonna lie epi is a little scary to have to result to and is a last result but I would hate to not have it when you are really far from civilization. I am not advocating untrained people go around jamming epi into every person with itchy eye's believe me. Just for myself in my personal kit, I would like to have some.
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Re: Medical Kits

Postby philoparts » Wed May 23, 2012 11:32 pm

s2kfire wrote:They work in conjuction with eachother. I am not saying benadryl is useless in all circumstances. For an allergic reaction it is perfect. However, for an anyphalactic reaction it is basically useless. And no I currently don't have epi, you caught me. For me, it wouldn't be a big deal to get some since I have had a semi severe allergic reaction in the recent past. and have family history of severe allergy. Luckily when I had my incident I wasn't far out. I had taken an anti-histamine (not benadryl) about 45 min prior and it worked for a good while but was shortly overpowered by the ammount of pollen in the air. I never had any airway issues during the even and 50mg of benadryl did the trick at stopping it from getting much worse but it took a full day for the hives and swelling to go away. The ER prescribed me some prednisone and that was pretty much it. I am not gonna lie epi is a little scary to have to result to and is a last result but I would hate to not have it when you are really far from civilization. I am not advocating untrained people go around jamming epi into every person with itchy eye's believe me. Just for myself in my personal kit, I would like to have some.



Hah, sorry dude, just screwing with you. If I could carry epi with me, yes, I would.
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Re: Medical Kits

Postby s2kfire » Thu May 24, 2012 4:34 am

Ha yeah its all good. The funniest part of that is when I had my allergic reaction it was while performing a "rescue" of someone who had injured their ankle. No helicopter was called for this thankfully. haha
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