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Thursday, May 23, 2013

What's in a first aid kit - Human

Today we are going to evaluate a mix of human and horse first aid kits.  The kits are ACTUAL kits in use, NOT theoretical "best case scenario" kits.   I did not modify or evaluate the contents prior to blog in order to make them look better or worse....... :)

The intro post to this subject is here

This post kept getting longer and longer....and longer so it's been split into human and equine.  This post covers the human side. 

Backpacking kit
Limitations: kit needs to be small and portable and light.

-Reduce pain
-Stabilize major injury so I don't die
-Make it possible for me to continue walking/hiking in less than optimal conditions
-Address more minor injuries so they don't become major ones along the course of a trip
-Improve my chances of survival away from civilization, at a weight and size that means I will actually put the thing in my pack.

Because it is a backpacking kit, I do have some items that are more "survival" included that have functions beyond medical.  I think that is appropriate considering the goals of the kit.

Total weight: 7 ounces

In a ziplock
- mirror: for signalling, catching attention, and for looking for ticks and cactus spines in hidden places....
- small feminine pad/liner: for bandaging
- inhaler: because I've been in situations where I got into respiratory distress due to an exercise induced asthma, so this is worth it's weight for me. True, it's never happened during a backpacking trip (only after a 100 mile endurance ride) but it was scary and not fun, and I didn't have an inhaler on hand.
- bandaids: mostly because I get bloody torn cuticles that could potentially get infected.
- Safety pins: can be sanitized and used as needles.
- wet fire: my emergency tinder
- crazy glue: to fix equipment and cracked skin/fingertips. Or stick a bandage on if I really needed to.
- matches: backup, in its own ziplock inside this ziplock.
- Sewing kit: 1 needle, one darning needle in a piece of closed cell foam with quilting thread, and waxed floss wound around.  I also have a suture needle with swagged on suture that I have removed from the packaging since it won't be used in sterile situations.  This is stuck in the foam with the other needles.  The sewing kit is in general meant for repairing equipment and for improvising with equipment in an emergency, not for stitching anything biological.  Although one of my classmates pointing out I could ligate a vessel if needed, which is true.

All of this is placed in a small ditty sack that also contains
- Ace bandage: in it's own ziplock to keep in clean, which will help it retain it's stretchiness. This item has been used more than once, although not by me :).  It can be a day-saver for a hiker with knee pain that has to go down hill. 
- Clot pack: small.  It was suggested to me by someone that has actually used these to make sure I got the type that is an actual pack, not powder. 
- Medicine: Ibuprofen, anti-diarrhea, aspirin, benedryl, Vicodin in a small ziplock.   Total is about 1 oz.  (included in the 7oz figure above). 

 Optional: In the winter time I'll carry a myler blanket (adds 1.5 ounces).  If I'm hiking by myself, backup water treatment (1 oz) is included. 

Other items that have been in the kit in the past that I no longer reguarly carry are
- moleskin
- tweezers
- epipen

Other thoughts: I've put a lot of thought into this kit and decided what is likely to be used, what can be used in the back country, what the capabilities are likely going to be of me and those around me in a situations, and worst case scenarios.  I've looked at other people's kits and their rational for each item and then made some personal decisions.  There's always room for improvement, but I comfortable with the kit right now. 

Car kit
Limitations: kept under the seat of the car.  Gets hot in the summer, so anything in it has to be fairly heat stable.

-Acute injuries (bleeding, swelling) that may not need further medical attention
-Minor hurts (headaches, cuts, insect bites etc.)
-Make everyday life a bit less painful

I got this kit as a gift from my mother and I think this is one of the better kits out there.  I can picture me using most of the items, and I've been able to replace items as they have been used.  

 Nice compact kit that lives under my seat

An assortment of bandaids and gauze bandaging and teflon etc.  I think feminine pads+ace bandage make better emergency bandages than dealing with a teflon pad that is always too small and tape that won't stick, HOWEVER from this assortment I've been able to deal with bleeding cuticles, cracked finger tips, minor cuts, seeping poison oak patches etc. 

Packs of Advil and Tylenol.  As I've used the meds I've replaced them with the similar packets because they are clearly labeled with doses and directions. Repackaging pills from larger bottles, would be cheaper, but I would lose the ability to toss this kit at someone that needed something from it and have everything be self explanatory and for them to be confident in what the pills were, expiration dates, storage conditions in the packaging etc.  This isn't my primary "go to" location for meds when I'm away from home.  I carry a separate, small "kit" with me in my backpack that contains NSAIDs etc for my personal use in a small altoids tin

I've added moleskin to the kit - holds up better than duct tape in the heat and can help protect a wound like a blister from further damage.

Scissors and forceps.  Both are pretty useless.  Scissors aren't sharp enough, forceps aren't pointy enough. The Scissors will work OK if needed.  Although a good knife and a needle would do everything that even better. :)

Roll of cotton gauze good for tying stuff on to various body parts

Gloves.  NOT sterile.  Good for human medicine where there might be blood.  But don't put them on and think that you can now touch stuff that you couldn't with your barehands because you are somehow "cleaner".  Because you aren't.

LOTS of little cleaning wipes.  Remember that the alcohol ones are useful for sanitizing hands etc.  The soap ones are good for cleaning wounds.  Don't use peroxide and alcohol to clean wounds!!!!!  Soap and water.  Even just copious amounts of water if you don't have soap is better than alcohol!

A roll of tape - that will never stick to what it needs to stick to.  I promise

Neosporin - the packets are great!  Except when you only use half and want to save the rest for later.  Than it leaks all over your kit.  Better to just buy a small tube and leave in here IMO

Blistex packet - I don't use lip balm often but if someone was desprete maybe this would be a nice thing to have - but if I use it out of the kit I probably won't replace it.

Packet of sunscreen - Same situation as the lip stuff.

Burn gel: Same as the sunscreen and blistex packet.  Nice for it to be there, but not integral to the kit and won't replace if it gets used.

Cold compress: YES!!!!!  Now here is something truly useful that I would totally use (and replace) as necessary.

Other Thoughts:
After reviewing this kits, one thing that this kit does NOT address that would probably be useful is the ability to stabilize a more major wound well enough that further medical attention can be sought.  This kit does not contain compression bandages, a clot pack, or any "wrapping" type bandages needed for more major injuries.  This is truly a minor injury kit that meets my stated goals - which are reasonable for the types of things I will encounter in my day to day life associated with my vehicle. Adding stuff to this kit would add bulk and size and increase the chances that I wouldn't take it with me - I swap this kit between vehicles that I drive so that I'm maintaining a minimum of kits.  Having to maintain a kit for each vehicle instead of just one is something that would fall under the "good intentions" category, but wouldn't actually happen.....

In general, it's a good, useful kit that doesn't go overboard and stuff that I will never need (and thus cluttering up the kit and keeping me from being able to find stuff), that has a few "fluff" items.  It would be frusterating to deal with a major injury with this kit, BUT it does it's job well if you stick with the intended goals of the kit - make everyday life a bit easier and less painful when you are less prepared than you ought to be. 

Random human internet kit

For the purposes of this discussion, I decided to use an REI kit.  I tried to find a mid-level kit that wasn't too over the top, but also put some serious thought into treating something beyond minor cuts and bruises.

I settled on this one, which is designed for 4 people over a 5 day trip

Here are the contents with my comments

  • All contents are packed together in a zippered nylon case; clear vinyl compartments let you easily identify the items you need (Yeah!!!!!  I really like that about my car kit, and is why I use a clear ziplock for my backpacking kit.  Clear and organized is so important when you want something quickly)
  • Comes with "The Wilderness First Aid Manual" by Dr. William Forgey for quick reference while on the trail; also includes an accident/evacuation record (Eh.  Your most important piece of equipment is your brain and you should thoroughly study this before the accident.  I'm ambivalent about this - but it's also because of my background and experience.  I'm likely to read it and then leave it home, but maybe it would be useful depending on your group.  I left the little instructions in my car kit because I'm not worried about weight, and that way someone can educate themself if they are trying to treat something on themselves, or heaven forbid, someone else)
  • Treat wounds with five 3 x 0.75 in. adhesive bandages, five 3 x 1 in. adhesive bandages, 4 knuckle adhesive bandages, 4 fingertip bandages and 4 butterfly closures (I'm more of a fan of more generalized bandages that can be adapted to more situations, than carrying so many specialized bandages that will probably degrade before they are used.  *shoulder shrug*.  IMO a feminine pad/liner, regular bandaids, and a teflon square pad or two are more than adequate)
  • Also includes four 2 x 2 in. gauze pads, three 3 x 3 in. gauze pads, a 3 x 2 in. non-adherent pad, a 4 x 3 in. non-adherent pad and four 4 x 4 in. sterile top sponges (So.........sterility is relative and has an expiration date so I'm not THAT impressed with the 4 sterile items. I've never found gauze pads that useful and they just stick to stuff, I like teflon and feminine pads - although you can use gauze to pack a wound.  I think sitting down and deciding how you would bandage various wounds and in what circumstances you would use different bandage materials could be useful when deciding on different components and what you want available to you.  Why not just include everything under the sun?  Because when you want/need a teflon bandage and you have to sort through stacks of gauze pads you aren't going to be happy. )
  • Two 4 x 3 in. pieces of moleskin, a 9 x 5 in. abdominal/pressure pad, a 4.1 yd. x 2 in. stretch gauze roll, a 10 yd. x 1 in. roll of tape and a 2 in. elastic bandage (Moleskin is appropriate, as is the pressure pad.  The stretch gauze is very useful, as is the elastic bandage, although an argument might be made that these 2 items could be redundant - like the gauze versus bandages, do your research on why you would choose one over the other and decide whether you want both. How about the tape?  I've never ever ever gotten medical tape to stick to ANYTHING I wanted it to stick unless I was at home dealing with clean skin and I planned on sitting on the couch all day and not moving.  So......I tend to choose other tape options :)
  • Prep and care for wounds with 3 antibacterial wipes, 4 triple-antibiotic ointment packets, 3 sting relief wipes, 3 povidone-iodine wipes and 1 antimicrobial hand wipe (I would TOTALLY increase the hand wipes.  Just one????????? Compared to the gazzillion wound wipes????????
  • Medications include 4 Nutralox® mint antacid tablets, 4 Proprinal® ibuprofen 200mg tablets and 4 Cetafen® acetaminophen 325mg tablets (I'm totally biased here since I have never had to take an antiacid, so it's never included in my first aid kits.  But maybe you have a different opinion.  Ibuprofen - Good.  Acetaminophen - Good, although my choice is aspirin, and I don't like Acetaminophen, but I think your choice of these sorts of drugs is personal preference and any specific medical conditions you might have.  I know there is mixed recommendations about the anti-diarrheal pills, but after considering them, and the consequences of being in the backcountry with uncontrollable diarrhea, I've decided to include them in my kit so I at least have the option :)
  • Also includes 2 Histaprin® diphenhydramine 25mg tablet and 1 pill vial and label (This is benedryl - Good.  Although I would bring lots more......especially for the amount of people/days this kit is for.  Although I come from a family where lots of us have pollen/grass allergies and we are taking for more than just contact rashes etc.  At somepoint I will camp in a meadow on a trip and not be able to BREATHE because I'm so stuffy.)
  • Equipment includes 3 safety pins, a pair of latex-free medical gloves, bandage scissors, splinter forceps and a 10 x 8 in. resealable waste bag (safety pins - good.  Forceps - assuming they will do as described and actually grab a splinter.....good.  Waste bag - really good idea!!!  Backpacking I usually have enough bags I don't need to add a seperate one to the kit, but that would probably be an excellent item to add to my other kits (car, horse etc.).  That way no potentially biohazard waste is left laying around, or contaminating some trashcan.  Bandange scissors?  Wouldn't put in a backpacking kit.  Maybe in a horse kit.  And.....gloves.  See previous comments about gloves.......Good especially if another person is bleeding.  But doesn't necessarily mean you are sterile or even clean.  Please don't go probing any wound I might have with those gloves you just pulled out of the first aid kit......
And now for your thoughts!!!!!!

Horse kit is coming - but I actually need to go to the stable and see what is in my kit.  I can't cheat by just trying to remember - the point of the post is to do actuals, not what I think is there or the "ideal". 

I hope none of my meds are expired.  That would be embarrassing.....

1 comment:

  1. Okay here is a list of my med kit. It's not complete as stuff is strewn about multiple packs right now. Again the main pack is carried with me for car trips and car camping. I dump a lot when I'm camping and have to carry it in.

    I recently picked up a new back to consolidate everything:

    And the list (plus what I can remember that I need to put back in the bag)
    * Pens / sharpies / notepad (very useful if you come across a car accident)
    * cloth / paper / other tape
    * 2x compression bandages (I love them so much)
    * extra sidearm magazine
    * high intensity glowsticks (night accidents(
    * flashlight
    * leatherman
    * scalpel + extra blades
    * suture kit
    * antiseptic cream
    * orajel max strength
    * benzocaine spray max strength
    * water treatment
    * liquid bandage
    * tweezers
    * paracord
    * iodine tabs
    * sam splint + finger splints
    * scissors
    * 2x mylar blankets
    * dextrose powder (for hypoglycemia)
    * betadine + alcohol wipes
    * bandaids
    * butterflies
    * steri strips
    * gauze pads and rolls
    * ammonia inhalents
    * nitrile gloves
    * vetrap
    * pulse ox finger meter (just because I have it and it fits)
    * toilet paper from MREs
    * thermometer
    * acetaminophen, ibuprofen, benadryl
    * imodium and prescription intense anti-diarrheal
    * morphine, oxycodone, muscle relaxers, rx anti-nausea
    * proof that I have an rx for all of those
    * puke bag
    * extra ziplock bags
    * cold pack

    In my car I also keep a military shovel / pick combo, portable CB / weather radio, wool blanket, swedish firesteel, more mylar blankets, pocket chain saw, winter gear, more water purification, flares, extinguisher, etc.

    Since I often drive in remote places or go camping on a whim I try to keep most everything either in my car or in a pack ready to go. I often have friends ask if I want to head out and go camp with 15 minutes warning.

    That really looks like a lot of stuff, but it fits into that pack I linked, and the car stuff fits around and in my spare wheel.


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