Medkit recommendations

Posted by: Cstolworthy

Medkit recommendations - 01/31/10 12:22 PM

So here is what I have so far on my list for a med kit. I prefer over packing when it comes to the med kit. I would appreciate any recommendations you have of things to add, or things that I can do without.

Scalpel Blades
Moleskin
Alcohol Swabs
Iodine Swabs
Ibuprofen
Needle (sewing)
Needle (stitches)
Silk Thread #2
Imodium
Antibiotics
Benadryl
tweezers
hemostat
scissors
magnifying lens
gauze bandage roll 4"
gauze patch 4x3
gauze patch 2x2
butterfly bandages
regular bandages
antibiotic ointment
after bite wipe
fingernail clippers
medical tape
Ace bandage
Ziploc bag
Saline Mix packets
Hydrocortizone cream
super glue
Posted by: oldranger

Re: Medkit recommendations - 01/31/10 01:22 PM

Just offhand, I would ditch the hemostat, the stitching paraphernalia, probably the superglue, and the iodine swabs. I would throw in another Ace bandage. Meds are tricky and I usually minimize any that aren't for personal use.

The real questions are, in what circumstances are you carrying this kit, and what is your level of training? Answers to those will help us develop a better response.
Posted by: gorge_medic

Re: Medkit recommendations - 01/31/10 03:57 PM

Unless you're going on outings that involve long evacuation times (measured in days, typically), antibiotics aren't needed for soft-tissue injuries; good wound cleaning (see the recent discussion topic) will prevent most infections.

Think about adding acetaminophen; NSAIDS work well for swelling and inflammatory pain relief, but will inhibit blod clotting, and Tylenol or something similar provides a good alternative.

Ditto oldranger regarding your wound closure supplies; closing a wound early can actually increase the risk of infection, and the types of wounds that DO need to be closed early need a skilled practitioner with experience suturing. My wound cleaning kit has some simple tools like tweezers and a clean toothbrush for really cleaning wounds well.

To echo oldranger, what you pack depends a whole lot on where you are, how long you'll be out, what you expect to see and the level of medical training you have. Medical training is by far your best tool in an emergency; thankfully, it's also the hardest to forget at home!
Posted by: OregonMouse

Re: Medkit recommendations - 01/31/10 06:55 PM

Unless you are a trained MD qualified to do surgery without use of an anesthetic, I suggest you leave the surgery stuff at home. Unless you are one of those unusual persons not incapacitated by severe pain, you won't be able to use it on yourself, and you'll probably get sued if you use it on somebody else!

Your list and my comments (based on a very thorough mountaineering first aid course and yearly updates from my-son-in-law-the-ER-physician):

Scalpel Blades--not unless it's a substitute for your knife
Moleskin--some prefer duct tape, but I use this a lot.
Alcohol Swabs, Iodine Swabs--you don't need both. Don't use iodine on someone else; they might be allergic, like me.
Ibuprofen--Acetamenophin might be better, as gorge_medic points out.
Needle (sewing)--should be big enough to thread dental floss--I hope you're flossing while on the trail; restorative dentistry is extremely expensive, as I well know! grin
Needle (stitches)--leave home. See gorge_medic's post
Silk Thread #2--Use dental floss for gear repairs; don't try to stitch a wound.
Imodium
Antibiotics--not unless you're qualified to prescribe them
Benadryl
Tweezers--fine point to grab splinters or a tick's head
Hemostat--are you a qualified surgeon?
Scissors--knife works fine for me, but most of us have scissors on our pocket knife.
Magnifying lens--I have to take really strong reading glasses (for the detail on contour maps), so I don't take; otherwise probably a good idea if your closeup vision isn't good.

Gauze bandage roll 4", gauze patch 4x3, gauze patch 2x2--You don't need all this gauze! I take several non-stick 4" pads and a sanitary napkin, by far the best compress for severe bleeding (as recommended by my mountaineering first aid instructor).

Butterfly bandages-can make out of duct tape or regular bandaids. Again, see gorge_medic's post about not closing wounds
Regular bandages--do you mean bandaids? That's what I use the most!
Antibiotic ointment--1 or 2 of the "individual" packets--I take only because I invariably get tiny scratches on my hands which tend to get infected. I don't use it, though, unless actual infection sets in. I get long lectures from my-son-in-law-the-ER-physician about overuse of antibiotics.
After bite wipe--who do you expect to bite you? Don't hike with him! laugh If for insect bites, a paste of baking soda or the cortisone ointment listed below works fine.
Fingernail clippers--redundant; use scissors or knife.
Medical tape--Try duct tape which you should have anyway for repairs
Ace bandage--Try veterinary wrap instead; it's a lot lighter--it can also be used to hold bandages on a limb (what vets use it for). Available at any farm store. You can reinforce it on the outside with duct tape if it needs stiffening.
Ziploc bag
Saline Mix packets--if you use a sports drink mix anyway (IMHO a good idea), you don't need these. It should be an electrolyte replacement mix, not just salt!
Hydrocortizone cream--baking soda paste works; I take baking soda anyway as a dentifrice. One individual packet is plenty.
Super glue--If you can stand the pain, but only for tiny cuts/blisters, not for big stuff (see gorge_medic's post)

Items omitted:
Duct tape--the universal fix-it item, should be one of the "ten" essentials.
Antifungal ointment
A few antacid tablets

Above all: A good first aid course, preferably mountaineering first aid! It will teach you to improvise from materials at hand so you don't have to carry all that stuff that there's at most a 0.5% chance of ever needing.

Most places I backpack, somebody is bound to come along within a few hours. I strongly recommend sticking to popular trails or going with an experienced group if you're a beginner. If you're backpacking alone in a location miles off-trail where nobody would come along for many days, you probably should take a Personal Locator Beacon with you.
Posted by: oldranger

Re: Medkit recommendations - 01/31/10 08:44 PM

With respect to OM's comment about bandaids being used the most, I like to carry a separate stash of bandaids in my wallet. About 90% of the time that is all you need. Someone gets an owwie, you whip out your wallet, extract a bandaid, and offer to kiss it to make it well (the last step is entirely optional and is not covered in any recognized first aid curriculum - we are on our own here).

The thing is to keep the minor injury in perspective. You don't have to break out the humongous FAK just for a scratch with a bandaid handy in your wallet. Works in the office as well as in the woods.

Your FAK should be interated with the other materials you will have at hand. It is interesting that we are not mentioning splints, which may well be needed. They can usually be improvised easily from materials at hand (pack stays, hiking poles). A little thought and preplanning is helpful here.
Posted by: phat

Re: Medkit recommendations - 01/31/10 11:17 PM

Originally Posted By Cstolworthy
So here is what I have so far on my list for a med kit. I prefer over packing when it comes to the med kit. I would appreciate any recommendations you have of things to add, or things that I can do without.


I reduce your list to:
Quote:

Alcohol Swabs
Imodium
Benadryl
tweezers
gauze patch 4x3
gauze patch 2x2
antibiotic ointment
butterfly closures


I'd then add:

1) mini swiss army knife with scissors and tweezers.
2) Duct tape
3) band-aids (fabric and waterproof)
4) acetominiphen and naproxen
5) Small tube of antifungal ointment. (athlete's foot on moist tired feet in a long hike sucks!)
6) small and large blister band-aids
7) Body Glide or equivalent chafe/blister prevention.


And then you're pretty much at what I carry. I'd never stitch anything up in the field, and I aint a doctor. If I need a bandage or splint, out comes the duct tape, and one of my sleeping shirts gets hacked up with the scissors.

just about the only things I ever use out of that kit are the blister bits, duct tape, band aids, and antibiotic/antifungal ointment



Posted by: phat

Re: Medkit recommendations - 02/01/10 04:27 PM

Originally Posted By OregonMouse
I take several non-stick 4" pads and a sanitary napkin, by far the best compress for severe bleeding (as recommended by my mountaineering first aid instructor).


I've also heard this reccomendation, and ya know, I'm no shrinking violet, and yes I have been sent into the store to buy them for both the ladies in my house...

But man, I just think of how much I picked on bigfoot about his kilt, boy I'd never hear the end of that one.. I'll just stick to a few extra 4x4's

Realisticly, you need a few bits of sterile gauze to dress a bad wound. the rest of the stuff soaking up the goo really can be anything, hence, a wound properly cleaned with a pad on it, and bandaged with a shirt hacked up will do just fine - at least to get yourself out and get real medical attention.

Posted by: Eric

Re: Medkit recommendations - 02/01/10 04:51 PM

+1 What OregonMouse said with one exception, replace alcohol swabs with benzalkonium chloride towelettes. Benzalkonium chloride is an antiseptic that can be used directly in a wound. It doesn't sting and doesn't kill the cells around the wound like alcohol will.
Posted by: OregonMouse

Re: Medkit recommendations - 02/01/10 06:15 PM

Phat, two male mountaineering first aid instructors were the ones who recommended the sanitary pads!

Since the pad resides inside the stuff sack in which you carry your first aid kit), nobody is going to see it unless somebody slashes an artery, in which case the spectators will be too panicked to care! I've never used mine for first aid purposes except in our first aid "final," a field trip in which one of the "victims" had a compound fracture of the thigh with arterial bleeding. Very realistically done! The field trip was the most instructive part of the course. Lots of ketchup and excellent acting!

The alternatives would all be a lot heavier and probably less absorbent.
Posted by: phat

Re: Medkit recommendations - 02/01/10 08:22 PM


Yeah, and next time I break open my first aid kit when it takes a ducking I'm sure I'll get that fresh all over feeling and want to run through fields of daisys just like on TV.... I mean TV doesn't lie on the beer ads so I can trust it...Obviously I can't lose on that one wink
Posted by: Jimshaw

Re: Medkit recommendations - 02/01/10 08:56 PM

phat
might be worth carrying just to get that fresh feeling and run through Daisy's.
Jim
Posted by: phat

Re: Medkit recommendations - 02/01/10 09:21 PM

Originally Posted By Jimshaw
phat
might be worth carrying just to get that fresh feeling and run through Daisy's.
Jim


Quite true - I love gettin' my whole Opus the Penguin thing going in alpine meadows..



Running through flowers *is* awesome.. smile


Posted by: Cstolworthy

Re: Medkit recommendations - 02/01/10 09:38 PM

Thanks for all the input!

After reading all the posts I have a revised list. I have taken first aid classes, CPR certification, etc. My hiking buddy is a medic in the army. So we both have skill in using the items (he more than me obviously). He agrees that he would almost never try and stitch someone up out in the field. He would just bandage them and get them to someone who is more certified.

I will be pretty much sticking around the rocky mountain range, and the Uinta mountains for now. I will always be hiking with a friend, and we aren't planning much beyond a few miles over easy / moderate terrain. We just want to find our rhythm before doing much.

Anyway, here is my revised list:

benzalkonium chloride towelettes
Imodium
Benadryl
tweezers (fine point)
gauze patch 4x3
gauze patch 2x2
antibiotic ointment
butterfly closures
mini swiss army knife with scissors and tweezers.
Duct tape
assorted band-aids (fabric and waterproof)
acetaminophen and naproxen
Small tube of antifungal ointment.
moleskin
magnifying lens
sanitary napkin
baking soda packet(s)
veterinary wrap
ziploc bag

antacid tablets

Posted by: OregonMouse

Re: Medkit recommendations - 02/01/10 10:35 PM

I'm glad you have the training; the best first-aid equipment is what's between your ears! goodjob

I'd suggest getting the little individual envelopes of ointments, not a tube. I know they're supposed to be single dose envelopes, but I can get 3-5 applications out of each. Lots lighter than tubes, and you'll never use up even a partially full tube in your first aid kit before it expires. If you can't find them locally, you can order from minimus.biz (also a great source for foods and condiments in individual packages).

The other thing I've found helpful are various sizes of tiny ziplock bags. They are available at craft stores, usually near the beads. I use these for pills (again, no use carrying the whole bottle; one or two days' maximum dose is plenty). I type up labels on my computer (including directions and expiration date) and put them inside each bags\ with the appropriate pills.

Once a year I go through my first-aid kit and replace any meds that are due to expire in the next year, bandages whose wrappers are getting yellow with age, etc. After each trip I replace anything I've used during that trip. I've found it's best to do this right after the trip so I won't forget!

If you regularly take any prescription meds, see if you can get your pharmacist to put enough for the trip in a plastic bag with the prescription label on it. Of course, don't forget to take them with you!

I'd love to go back to the Uintas some time; I haven't been there since a memorable trip when I was 11! Have a great time out there!
Posted by: BrianLe

Re: Medkit recommendations - 02/02/10 02:21 AM

This seems like a pretty complete kit to me ... more complete than what I carry, FWIW. To "complete" the picture, you might weigh that collection of things and see what you come up with.
IMO it's always a balancing act of trade-offs: if we weren't willing to trade lower-odd risks against weight savings, we would all be carrying huge and heavy medkits.

I note that you have tweezers listed but also a small knife that has tweezers.

Do you carry a sewing needle?
I haven't read the entire thread here, but do you have an irrigation tool or plan? (my approach is to use the tube from my platypus to force a stream of water out for irrigation)

Anyway, looks like a well thought-out list to me.
Posted by: Cstolworthy

Re: Medkit recommendations - 02/02/10 09:35 AM

Quote:

I note that you have tweezers listed but also a small knife that has tweezers.

Yes I have them listed twice. Honestly I have never found the tweezers in those types of knifes useful for much other than getting out large(ish) debris, splinters, etc. The other tweezers are there for smaller items where more control will be needed.

Quote:
Do you carry a sewing needle?

I am still thinking about it, just for gear repair etc.

Quote:

I haven't read the entire thread here, but do you have an irrigation tool or plan? (my approach is to use the tube from my platypus to force a stream of water out for irrigation)

That is what the ziploc will be used for. Fill it with water and puncture a hole in it to irrigate a wound.

Posted by: OregonMouse

Re: Medkit recommendations - 02/02/10 04:44 PM

The sewing needle is also useful to remove the little splinters that I invariably pick up during backpacking trips. Seems strange, because I never build a campfire!
Posted by: phat

Re: Medkit recommendations - 02/02/10 08:43 PM


I used to take fine tweezers, but got good enough with the repair needle and Swiss army tweezers I' don't bother anymore.