Outdoor Adventure USA

Due to numerous requests last week, we will devote the net this week to a conclusion of the topic on Wilderness First Aid. This net will concentrate on the construction of a first aid kit that is suited to wilderness travel. As always, this is one of the many preparations we take that is also applicable to non wilderness settings, such as emergency and disaster preparedness, home use, and use just about anywhere you travel.

We will cover several of the container options for your first aid kit, kit components, important storage considerations, supplemental medical information to carry, custom vs pre-made kits, knowledge you must have to properly use certain components, and general first aid kit suggestions. The purchase or construction of your first aid kit is one area where the quality of components should be a first priority. Stated otherwise, this is not the place to pinch pennies. In most cases, when we travel, the first aid kit sees little or no use, but when it is needed, it becomes one of the most important pieces of equipment that we carry. Purchasing high quality components and containers will pay dividends.

We will be posting pictures, recommendations, and links for consideration in selecting the first aid kit that is right for your needs. We know what has worked for us and we would like to hear about your kits and thoughts as well!!!

Suggestions for Kit containers:

1. Pelican cases are extremely sturdy, dust proof, crushproof, watertight, and come with a lifetime warranty (www,pelican.com ). They offer one version of their cases, made specifically for Emergency Medical Services - the model 1500 EMS. It is large enough to hold just about everything a well equipped first aid kit should have. It comes with padded organizers to keep the contents organized for quick access. If you have the room in your vehicle, it is a fine choice. About $190 on Amazon (http://www.amazon.com/1500-Case-16-75X1 ... n+1500+ems ). See picture below.

For those with a little less room in the 4x4, Pelican makes several smaller sizes, all with the same features as the 1500EMS. The next size smaller is the model 1400, followed in descending order by the model 1300 and the model 1200. This allows for a reasonably custom fit to the available space inside almost any vehicle. For reference, see the 1200, below.

Regardless of the amount of training you have received, you will not be able to retain everything. Even health care professionals cannot possess the entirety of medical information necessary to perform their job. This is precisely why there are a multitude of reference materials available for almost every level of medical knowledge. For wilderness travel, I have spotlighted two publications, which are described below and which can be a very useful addition to your first aid kit.

I know this is coming, so I'll address it now. The reference materials to which I will refer below, are not meant as a substitute for proper training and education. They will, however, serve as a supplement, for those who wish to be well prepared for the contingencies of wilderness travel. Wisdom should dictate that one accept the limitations of both his memory and training, and therefore be willing to carry as much information as possible on how to treat the conditions likely to occur in the wilderness.

Although I have settled on these two reference publications, I know there are others. These are an excellent start, however, and should be used in conjunction with your knowledge and training.

1. The first one is "First Aid, Survival, and CPR. The author is and EMT-P and an RN. It is small, easy to store, waterproof and reusable. It is described as a "Home and Field Pocket Guide", obviously because it will fit in a pocket. In addition to information on survival, safety and first aid, there is an excellent list of first aid kit components. It is available on Amazon for about $35.00, see http://www.amazon.com/First-Aid-Surviva ... al+and+cpr . See picture below.

2. The second one is "Medicine for the Outdoors: The Essential Guide to First Aid and Medical Emergency" by Paul S. Auerbach MD. Here is the description that accompanies the book on Amazon:

Since 1986, Medicine for the Outdoors has been hailed as the definitive take-along manual on the subject. Packed with step-by-step instructions, how-to explanations, and practical approaches to outdoor and wilderness emergencies, it tells you the best ways to respond to just about any medical problem when help is miles or days away. Author Paul S. Auerbach, MD, MS, FACEP, FAWM, is recognized as one of the world's leading authorities on wilderness medicine. This 5th edition features major updates to bring you the latest on emerging infectious diseases...the most current drug and dosage information...an increased emphasis on making do with the materials at hand...and much more. Logically organized, easy to reference, and simple to understand, Medicine for the Outdoors may literally save your life. When you're venturing into mountains, deserts, forests, jungles, or out to sea, it belongs in your duffel or backpack!

Provides the most diverse and comprehensive coverage of medical conditions related to the outdoors.
Offers logical and complete explanations of every topic.
Includes numerous drawings and instructions to enhance your understanding of the descriptive material.
Contains recommendations for injury and illness prevention.
Features a comprehensive index that helps you locate answers quickly.

Offers an increased emphasis on making do with the materials at hand (like using a fanny pack as a cervical collar).
Presents the latest guidance on dangerous infections like methicillin-resistant Staphylococcus aureus (MRSA), avian flu, and West Nile virus.
Offers current and accurate drug and dosage information via careful updates throughout.
Provides new safety recommendations on avalanches, forest fires, bear attacks, and more.
Demonstrates how to apply various bandages and splints with the aid of brand-new drawings.

Little more needs to be mentioned about this reference material, other than to underscore how important this book can be. It is available in paperback for about $20.00 on Amazon, see http://www.amazon.com/Medicine-Outdoors ... r+medicine . See picture below.

Pictures of each :

First Aid Kits

Documentation

There are two types of first aid kits - pre-made and custom. Regardless of the direction you take, there are dozens of websites that make recommendations for kit contents. Ultimately, no matter which way you choose to go, consideration of the various recommendations should be a priority. Here is a good starting list of sources for recommendations for kit contents:

1. Mayo Clinic: http://www.mayoclinic.org/first-aid/fir ... t-20056673

2. REI: http://www.rei.com/learn/expert-advice/ ... klist.html

3. Red Cross: http://www.redcross.org/prepare/locatio ... it/anatomy

4. familydoctor.org: http://familydoctor.org/familydoctor/en ... tials.html

6. Wilderness Medical Associates: http://www.wildmed.com/blog/building-a- ... t-aid-kit/

7. Badlands Off-Road Adventures: http://www.4x4training.com/Articles/Saf ... idKit.html

There are many choices for pre-made kits, but some of the very best are those offered by Adventure Medical Kits, see http://www.adventuremedicalkits.com/medical-kits.html . For those so inclined, AMK will also make a custom first aid kit to match your specific needs. AMK offers a kit for just about any activity, including "off-roading". Prices will vary depending on the length of your trip and the number of people in the group. Kits come in a nylon bag with a carry handle and a zipper opening. For all of my hiking trips , I have found the "day Tripper kit an ideal choice. For longer trips and for vehicle use, the Mountain Series are a good choice. From the AMK website:

PRODUCT SPOTLIGHT

Partially, in keeping with our topic this week, we are spotlighting a light. This light is a new product from the Surefire Company, probably known to most for their high quality flashlights. The Titan and Titan Plus are are a couple of dynamite key chain flashlights, small enough to be a permanent part of any first aid kit.

Here are two sources for more information:

1. Surefire - http://www.surefire.com/titan-a.html

2. Equipped To survive - http://www.equipped.org/blog/?p=646 . Doug Ritter has an excellent review.

Light output comes in at a respectable 150 lumens for the Titan and 300 lumens for the Plus model. Both are adjustable. Two features are of great significance:

1 They use the commonly and inexpensive AAA battery

2. They use a new technology which provides a much wider and useable beam. Read more on the Equipped website.

I built my bag on a STOMP medical bag of voodoo. The bag comes loaded with a lot of stuff, a lot of it is usable but I found myself replacing and adding to most of the stuff. The greatest thing is that it's a modular bag, it has many different sections and pouches within the bag, so it lets you classify and organize your stuff. I learned about this bag on this video, and followed the suggestions he gave as well as I adapted it to my needs.

http://youtu.be/CaLfG0PfKPQ

Something in my opinion very importand about a bag or kit, is not only to know how to use it but also be fluent with it: knowing what you have in it and where everything is located. When an emergency arises the last thing you want is to be searching for the something in the bag. So I'd recommend opening the bag often, checking expiration dates and checking for the state of the items inside.

The bag:
The bag has two main compartments, in one I have assessment tools and immediate life saving tools, in the other I have more particular items.

With the pictures following I will note some items people tend not to include that can be very useful.

Assessment compartment:
Me coming from Europe, the first thing I noticed in the States is how underutilized the thermometer is. It's a tool that can be very indicative of something going on underneath. A sthethoscope and blood pressure cuff is very useful too, as well as a pulse oximeter.
A good thermometer that is safe to use with other people is the Vicks Forehead Thermometer. It does require some practice in order to get consistent results, but at that point it gives accurate results without having to put the thermometer in the mouth.

Other items I have in this compartment are sterile 4x4's, extra absorbent pads, trauma bandages, a microlife peak flow meter, a pupil gaugr, trauma shears, sterile water, an ambu res-cue pump suction unit, and a tourniquet.

In the other side of the front compartment I have personal protection equipment (PPE) stuff (gloves, mask, goggles), oral & nassal airways, different sizes of gauzes and bandage rolls, alcohol pads, bacitracin antibiotic ointment, and tape.
The rear compartment is divided into several other compartments.

Medications: Pepto, various glutose gel, nasonex, tylenol, dramamine, anti-itch spray, coldezze, amonia inhalant, airborne, zyrtechm, Loperamide, Actidose-Aqua activated charcoal suspension, emergen-c, iosat potassium iodide tablets and whater purification pills.
In another compartment I have an occlusive halo seal, for sucking chest wounds, a tick remover, bite and sting kit for bees and other small insects, water to help ingest medications, a basic dentistry kit and a paper bag for hyperventilation.
In the little 1.5 red first aid kit I have an assortment of various sizes and kinds of band-aids, moleskin, steri-strip, and other things to cover small open wounds.
In the burns and allergic reactions compartment I keep Spenco 2nd skin, burn spray, hydrocortisone, cortaid and cotton tip applicators.
In the musculoskeletal injuries pouch I have instant ice, various SAM splints, a sling, medicated icy hot patches and triangular bandages.
In the sutures pouch I keep a suture kit, steri strips, sterile scissors, splinter out (highly recommended to remove splinters), antiseptic wash, tape, 2 skin staplers and a skin stapler remover.
In the hypothermia pouch I have several toe warmers that can be applied in key parts of the body, and an emergency blanket.
In the rear I have a C-collar, a big dressing and a pocket BVM, very accessible when oppening the bag.
One thing I'm working on now is placing the tourniquet in a place more rapidly accessible. Right now I have it in the assessment compartment, but I want to somehow attach it to te outside of the bag ussing the molle.

KK6CTT: On-line check-in. I will be monitoring.

I am a fan of the "emergency bandage,'" more commonly known in military circles as the "Israeli bandage" for those situations where a pressure bandage may be necessary. It has a system that when used properly, can help to avoid the whole process of having to use wadding material which gets a little cumbersome when placing a dressing one on one with a patient who cannot help or when administering self-aid. Can be used as a normal dressing or pressure dressing.

https://www.youtube.com/watch?v=wMRklQkfDLE

Note: These do come in different sizes/widths and I have used one on a forearm gunshot wound. Very similar to the old military dressing with improved features (see video above).

Additional video: https://www.youtube.com/watch?v=S2_EU1T-o-g

Having one first aid kit is a must. Having a second kit can be a great convenience. Over 90% of the time I use my first aid kit, it is for a select few things. The first aid kit items I need to treat these few things are far fewer than the main first aid kit and can therefore be placed into a much smaller kit.

In my travels, with family and friends, this 90% consists of band-aids, tweezers, Tums (and Pepto), aspirin (Tylenol, etc.), antiseptic ointment, and lip balm. I located a small container from Sears that is a perfect fit for the side compartment of the 4x4. It is a hard shell case, inexpensive and just big enough to fit all these items (and a few survival things), but small enough to fit in the available space on the door.

Dave and Tom,

I'd like to request a courtesy check-in for myself KD6GCO and John, KN6VL. I should be on the net but I'll be late.

Thanks,