Wilderness First Aid Kit

Survive Outdoors receives many questions over the years for contents of a medical kit. These kits that we carry into the wilderness vary on 1. Length of expedition or trip, 2. Expertise and ability to use the contents and 3. Amount of people in your party for your hike, camping time or outdoor expedition.

I now have one main Medical Kit or actually roll out container which is my supply hub. I then take from that supply hub and pack smaller kits based on where I am going and with who. For myself since I am medical I also want to know the medical history of my fellow travelers and what I may need to cary extra as well as are they carrying their own meds. The vast majority of you will not need to do that and should carry the basics.

The medical kit you do carry should be water resistant and at best water proof. It should not be over packed and it should be practical. For example everyone seems to carry a medical tourniquet like the CAT or RAT and it may never be used however that one time you need it, well it could be life saving and it does not take up much room. On the other hand carrying sutures for a weekend trip is NOT necessary as on weekend trips you are usually less than 12 hours from an urgent care or emergency room. Basic pressure bandage and you will be good to go.

Survive will not address prescription pharmaceuticals as this will be targeted for the layperson and/or the first responder individual. Please be advised the individual with minimal knowledge who presents with hubris is just as dangerous in the wilderness as the “Johnny Rescue” individual who is an EMT or paramedic or even a Physician who goes overboard with treatment. I strongly encourage 1. Knowledge, 2. Experience and 3 CALM when approaching wilderness injuries. Too many injuries have been exacerbated with bad decision making, poor implementation and over zealous intervention.

Basic Outdoor Supplies for Wilderness Medical kit

Survive will list basic supplies which I am sure will not be exhaustive and there will be some left out. Please feel free to contact me with your suggestions. I always learn from everyone I run into despite 40 years in the field. Always listen to others and their experiences.

1. Epipen and/or Epipen Jr. If anyone in your group has a history of severe allergic reactions to bees, wasp etc this is a MUST to have and carry. There is no other alternative besides injectable epinephrine and even I rarely carry a vial with syringes. The outcome of not carrying an epipen is death. Carry the epipen. Get the script from your health care provider.
2. Bandaids various sizes. Not a must. Yes, not a must. You can carry some 4X4 gauze and cut them down to any size and have some medical tape. You now have made your own bandaid and reduce another item in your kit.
3. Gauze. As previously mentioned. I carry 4X4 gauze and can always cut them down for various size wounds.
4. Tape. Medical tape, paper tape ( easy on the skin and hair) and duct tape.
5. Telfa, Adaptic, Xeroform are all non adhering bandages. You can use vaseline with gauze and make your own if you like also.
6. Topical antibiotic BACITRACIN. I do not use Neosporin or Triple antibiotic ointment as about 10% of the population is allergic to the Neomycin in the ointment. Our clinic carries NO Neosporin.
7. Steroid cream OTC hydrocortisone cream. Your hiking or camping group will thank you. A dab of steroid cream after an insect bite or sting will help tremendously to reduce itching and initial allergic response. Also great for early stages plant dermatitis.
8. Pain medication, Anti-inflammatories ( Acetaminophen, Tylenol and Ibuprofen Motrin or Advil). Tylenol 500 mg two tablets every 6 hours as needed no more than 3 grams in 24 hours which is 6 tablets. In children dosed by weight. Ibuprofen 200 mg tablets. Maximum dose is 3200 mg in 24 hours. You can take up to 800 mg which is prescription strength. Please be advised Ibuprofen has been implicated in patients causing a stroke or heart attack specifically if the individual has a cardiac history. Also recent studies show for pain relief 800 mg showed no particular increase in pain relief from 400 mg but it did increase side effects for example stomach bleeds, nausea, rash, headache and constipation among others. In severe situations where you may have severe pain ie: fracture or severe sprain it is safe to take ibuprofen and Tylenol together and that does work excellent as a pain reliever. Also caution should be used with ibuprofen if one has a history of Asthma. Ibuprofen is known to exacerbate an asthmatic episode. One does not need that in the outdoors.
9. Diphenydramine Benadyl.  Benadyl has many uses and is an excellent antihistamine.  Helpful with allergies and a first line med in Hymenoptera stings. Bees and wasps. It will cause some drowsiness so important when hiking out or if in a mountain scenario to use with caution and it will effect your coordination. Also in liquid form is a better than average anesthetic and I always carry some liquid Benadryl in a small bottle. If a child or adult gets a laceration it works well as a numbing agent when applied on gauze then onto the wound.
10. Histamine 2 blockers. Pepcid or Tagamet Famotidine and cimetidine are used effectively for gastric acid reduction however when combined with Benadryl or even by themselves they work well for allergic reactions to stings as well. Any allergic reaction and are safe to take with Benadryl.
11. Loperamide Imodium Ad. Although good to have in your med kit arsenal it must be used sparingly and use common sense when taking it. Loperamide slows the motility in your intestine hence slows diarrhea. In water bound infections most will not display diarrhea till you’re home. If you have diarrhea on the trail and it is from a water Bourne source it is probably from a virus which should only last two days three at most. Of course some are more severe. As a rule of thumb I tell patients do not take Loperamide if, you have blood in your stool, fever 102 or greater, or combine with sever vomiting. You will most likely not have a thermometer so here is a crude way of finding out your temperature without a thermometer.
12. Know your base resting heart rate.
13. For ever degree your temperature goes up your heart rate will go up ten beats a minute.
14. If your average resting heart rate is 80 and your pulse at rest is 120 your temperature should be around 102.7. Oh and please no comments that you normally run low at 96 or run high temperature at 99. There are so many variables in getting a temperature it would be too long to list.
15. Aloe Gel straws. Not a must but nice and light weight to carry and great for burns. Take some plastic straws and pour aloe gel ( even from the actual plant ) into the straws. Burn the ends with a lighter and place in small plastic bag. They last forever and a good med kit addition.
16. Irrigation Device. Personally I do not carry a string but a plastic bag instead. Fill that bag with water and snip a small hole in the corner. You now have an excellent irrigator which last much longer than a 60 cc syringe and not as bulky.
17. Trauma Scissors. Very helpful in cutting bandages, cloths and even sticks for splits. They will also cut a SAM splint.
18. Forceps. Important for splinters and ticks
19. Cotton tipped applicators. Not a must however helpful for eye lid sweeps ( refer to medical video ) also good for removing foreign bodies out of eyes.
20. Steri-Strips and Benzoine.  An excellent mechanism for closure of wounds. Benson tincture is applied making the skin more adherent for the stern strips.
21. Ace Wrap, Co-Ban, Medi-Rip Co-ban and Medical-rip are brand names for bandages in roll that cling to itself. They can come in different colors and are ingenious for bandaging and applying splints. I can easily go without Ace Wrap and use the Co-ban instead. Ace Wraps for sprained ankles are worthless. Yes that is what I said. They help for getting sympathy that you are hurt other than that they do not supply enough restraint to the joint to help. They can have a function for adhering splints though and work well for that. In forty years I have never used an Ace Wrap for an ankle or wrist sprain even in athletic injuries and they all have done well. I have even treated some semi-pro and collegiate athletes.
22. Aspirin ( chewable 81 mg). Every med kit should have Aspirin (ASA). If aspirin came out today it would be prescription only. It is that good and can be used for a variety of issues. It is the mainstay for first line treatment in a potential cardiac event. Four chewable tabs have been show to be valuable in decreasing the formation of a clot in a potential heart attack scenario. DO NOT TAKE an aspirin daily without talking to your health care provider.
23. Honey. Honey packets from any restaurant are very helpful and I try to keep a few in my kit. Some good ones are from KFC. Place them in a plastic bag just in case one breaks. Honey is excellent for wound care as it lowers the PH and indirectly increases oxygen release but also making the wound not conducive for an infection to set in. Also good if someone has diabetes and thinking and not eating well drops their sugar levels. Not bad for a snack also.
24. Sam Splint. A movable splint made with aluminum and covered in usually orange and blue soft plastic molding. They can be cut and molded for stabilization for fractures, sprains and strains. Very lightweight but can be bulky.
25. Afrin Nasal spray with oxymetazoline. The main active ingredient in Afrin is oxymetazoline which is a vasoconstrictor.This works wonders when trying to pack a nostril due to a nose bleed. Take some gauze or cloth, cut it in small strips and soak in the nasal spray. You do not need much. Pack the nostril and voila. The pressure helps stop the bleed plus the vasoconstriction properties of oxymetazoline also helps stop the bleeding. When sprayed on gauze or even directly in the wound it will nicely stop bleeding so you can assess the damage. I use this on children as the blood will stop or slow down and decrease their anxiety. By using some oxymetazoline to slow down bleeding, Benadryl liquid to numb the wound and topical bacitracin, then bandage and transport to urgent care or the ED, By the time the child reaches the health care provider the wound is numb, decreased bleeding and it makes the experience much more pleasant for the child.
26. Gloves. Cheap and takes up minimal space.
27. Forceps for splinters and ticks
28. Sunscreen
29. Safety pins. A multitude of uses. Please see First aid kit video
30. Sharpie to document time of meds given, vitals, and notes.

Extras

For the non medical hiker, camper, hunter and outdoor explorer I have been willing to help set up your medical kit in the office. I have had many individuals come in and update vaccinations and depending on where they are traveling to outfit them with prescription steroid cream, broad spectrum antibiotic, epipen etc. This depends on their medical history, and length of travel.

Extras for my medical kit and once again it depends on length of stay and area traveling to I will carry an eye numbing drop Tetracaine and some fluorescein strips for looking for abrasions in the eye, antibiotics, pain medication, syringes, lidocaine and suture material. All of the above mentioned are only for trips in the backwoods and for a week or longer.