Echoing Tango61’s recent post, and in response to JimShaw’s call for more post addressing the basics, this post addresses how to become prepared to perform first aid in the backcountry. It is based on my own experience (Boy Scout, former EMT, for CPR trainer) and the comments of others. I am not a doctor, and this post does not provide specific medical advice for medical care – it is about being prepared to act when things go wrong.

1) Get a class. American Red Cross, American Heart Association, Boy Scouts, NOLS.

2) Failing a class, or combination with one (better), get a reference and practice. Some references could include:
a. Boy Scouts: Handbook, Fieldbook, First Aid Merit Badge booklet
b. Mountaineering First Aid: A Guide to Accident Response and First Aid Care
c. American Red Cross – First Aid: When Help is Delayed
d. James Wilkerson's Medicine for Mountaineering
e. Any other current handbook on first aid

* Currency of your references matters here. The state of practice in medicine changes over time as doctors learn more about the human body and how to fix it when it breaks.

3) Build a kit that utilizes what you've learned. A kit MIGHT include items from the list below. The list below reflects my own kit, which I am constantly refining. However, first aid kits are a very personal decision. Some backpackers are comfortable carrying much less and others prefer to carry more – I am somewhere in the middle. Remember that you have to know how to use what you have, or it is just extra weight. Similarly, additional knowledge can (within limits) make up for not having a specific item.
a. CPR Mask (Microshield)
b. Rubber Gloves
c. Triangular bandages - 2; these things are all purpose for splinting and bandaging (esp. for big wounds).
d. Ace bandage – (I replaced one of 3 triangular bandages with this b/c I tend to roll ankles)
e. Some roller gauze, 2"
f. roll of two inch tape
g. 4-10 4x4 gauze pads, depending on how long you stay out. Cut these down as needed to deal with cuts, burns, etc.
h. pack of band aids
i. small tube antibiotic
j. personal medications
k. pain meds (Tylenol, Motrin - remember that they do different things and have different side affects, so I take some of each)
l. anti diarrheals (Immodium AD) - one to two courses
m. cold medicine (pills) - usually Sudafed
n. Benadryl
o. Moleskin (for blisters)
p. alcohol wipes (kind you use for prepping injection sites)
q. soap (a better disinfectant than alcohol wipes)
r. tweezers
s. Small nail/bandage scissors (need to cut down moleskin/gauze pads)

*others on this site have suggested a sewing needle for popping blisters, chap
stick, a nail file, and various narcotic painkillers. All of these ideas have merit, and are worth considering based on your own level of training/knowledge.
**Remember to pack all this stuff in zip lock bags or the first time you get caught in a shower you’ll be replacing gear.

4) A minimum kit should address the basics of first aid: Airway, Breathing, Circulation (includes heart and bleeding), Deformities (broken bones), and possibly Extrication (getting the victim to definitive care). There are limits to what you can/should do for each of these, but a good first aid course will address each of these points, and what some of the practical limits are.

5) Note that improvisation based on your own personal knowledge will be key to treating serious injuries. A trained paramedic is NOT around the corner, and you can’t carry everything you might possibly need for the worst injuries. This is why a course, planning ahead, doing additional reading, and continued practice are important.

6) Most basic first aid courses aren’t going to address the use of over the counter (OTC) medications well, and laws in many states prevent you from prescribing medication to others unless you have the proper certifications. Think about OTC medications the same way you would at home, but remember that a pharmacy is not around the corner to get Motrin when you’ve overdone it, and that you really will have to carry everything you put in your pack.

Sincerely

Steadman