Medical/ First Aid Kit

Hi MP,

I recently started taking an emergency preparedness class and its making me realize my tiny medical kit I carry wont actually do anything unless little Johnny gets a thorn in his finger.
I'm looking for this kit primarily for climbing and hiking.
I'm polling to find out a few things.

First what does everyone carry? do you just get an adventure medical kit or the like or do you put a kit together from scratch?

Second what is most important in your kit or what do you carry the most of for real world climbing and hiking accidents?

third, and this might get a little in depth, but what accidents do you see the most of in real world scenarios?

thanks in advance and this information will be passed on to emergency folks to help better prepare for outdoor accidents.

Hey man - good for you for taking initiative for this class, more of us need to step up and be prepared as part of the community.

I carry a small basic kit when out cragging regularly: triangular bandages, compression bandages, benadryl, anti-inflams, tick key, bandages. Basically a small adv medical kit adapted to my area. Mostly for splinting/bleeding control. SAM splints are great, but take up way too much room IMO and I can do the same splinting with a few triangulars and a stick/trekking pole.

Most important: experience. Know how to tell diff between a need for evac vs. not. Head trauma, spine trauma, loss of distal function etc.

You never know what you'll see: I recently came across a guy who took a rock to the eye, and he was casually going to self-rescue. I asked him to see the injury, and he had a clear lac to his globe - ie potentially damaging to his sight, and in the epilogue it was. I had them change course from a casual drive to an urgent care center to a trauma center.

I've seen other injuries in the field, but most common are sprains and breaks. Good splinting technique, as well as good SOAP note skills for the front-country EMS are paramount.

I have a kit that I have pieced together and try to bring with me when I bring a big pack and don't have a monstrous hike in. With a longer hike where I want to go lighter or with multi-pitch, all I bring is a clotting sponge. I am never so isolated that there are not other folks around, and I figure that I can ignore, treat with what I have on hand, or wait for help with anything but a major bleed.
rei.com/product/869098/adve…

For front country climbing my first aid kit consists of:
WRF field handbook & SOAP Note + pen/pencil
1 roll gauze
tape
Ace bandage
Painkillers
some kind of anti-septic
Self-adhering bandage
Space Blanket
Knife
Lighter
Antihistamine + Epinephrine if allergies are present
Most everything else I can improvise. You could even improvise gauze with clothing. Also, you probably don't need both tape and self-adhering bandage.

More important than a comprehensive first aid kit is training. I highly suggest taking a WFA course, at the very least, if not a WRF course. The WFR course also covers rescue management and logistics in addition to the medical content.

The only thing I feel like I'm missing is stiff splinting material like a SAM splint. I dunno if I'd want the weight and bulk of a SAM splint but maybe something lighter and less bulky. When I broke my ankle, my partner used a foam pad that was part of his backpack and it was rigid enough to get me back to the car. Something like this to improvise would be nice. Maybe add some baby aspirin if you're with people with a heart attack risk. Obviously, if I'm climbing something involving a super long approach or backpacking, I'll carry more.

In my experience climbing injuries are mostly skin wounds and impact trauma (sprains, dislocations, broken bones), maybe exposure if you're in the alpine.

Great on you to be thinking about a med kit. WEMT & WFR instructor speaking here who was just in a backcountry skiing accident. (Read about it here if interested)

Hopefully using the information from your course to think about what you would want if a certain accident were to happen. The questions of, what is most likely to occur, and what to carry are both common ones. Here's perhaps a longer answer than you want, but I'm currently stuck in bed rest so here it goes...

I carry different mid-kits based on the activity/season. I'll start with my barebones kit, which I carry when I'm climbing with trusted, trained partners and hoping to go light/fast. It includes:

- non-latex gloves
- 2 5x9 (ABD) Gauze pad
-1 Roller Gauze or ACE bandage
- 1 Cravat
- 4 x 81mg Aspirin (This is the dose for Cardiac/chest pain and is also a painkiller & NSAID)
- 2/3 Band-aids
- 1 Antiseptic

Other things that always come with me to supplement the "med-kit" include, a ski strap, headlamp, extra layer (e-blanket in summer), water and food. Again, this is the barebones kit. This is what I was carrying with my during the accident listed above.

My larger med-kit, which comes with me when I am going on longer, more remote climbs, overnights, places without cell service, when I'm guiding/instructing, or cragging includes:

Bleeding Control Bag:
- Non-latex gloves
- 2 5x9 (ABD) Gauze pad
- 2 4x4 Gauze Pad's
-1 Roller Gauze or ACE bandage

Splinting:
-1 SAM Split
-2 Cravats
-1 Medical Tape

Routine Care Bag:
-5 Regular Bandaids
-2 Butterfly Bandaids (Great for flappers)
-2 Knee Bandaids (Great for, you guessed it, skinned knees)
-Tweezers
-Small Trauma Shears

Meds:
- Aspirin (see notes above)
- Anti-Diaherrea
- Anti-Nausea
- Anti-Histamine
- Benadryl
- Maple Sugar Packet (supplment for oral glucose)

Other:
Headlamp
Mega warmer packet
E-Blanket
Rite in the rain notebook pages
Pencils
Cell phone with NOLS SOAP Note app

Feel free to reach out with questions. Remember that these aren't set in stone bags, and what you chose to carry is based on your own criteria of safety and comfort. Many people will carry less, many more. Many will always have as much as I listed in bag 2. Use the skills from your course to evaluate what is best.

And for building your kit, I recommend ordering a kit or bag from someone like adventure medical. Then add or remove things as needed. It's important to have a well labeled bag so others can find it, and waterproof is a big bonus. Most pre-made bags come over stuffed with things like band-aids etc. that you can remove, and add the things you really need like cravats, that often never come in these kits.

I might have an unpopular opinion. I don't carry a med kit.

If you can fix it with a med kit, it's probably not a life-threatening injury. A watch and rite-in-the-rain notebook + golf pencil are invaluable. I use them for SOAP notes and monitoring symptoms. Clothes and climbing gear (tape, rope, slings, cord) should be enough for you to improvise something to evac someone if you need to. One thing that is nice to have is an irrigation syringe (though you can improvise with a camelbak) so you can start cleaning before you wrap everything up. It also gives you a better assessment of the injury. I have considered carrying a pair of gloves since I'm bound to have cuts on my hands.

Real world accidents? Little stuff: sprained ankles and wrists. Big stuff: decking resulting in broken ankles or head trauma/spine injury.

WFA/WFR courses and experience are far more valuable than the even best stocked med kit. All that stuff is useless unless you know how to use it.

Carry a med kit to make victims comfortable, not to save their life.

In my experience these are the most common medical issues:

1: Thorns/splinters
2: Scrapes/minor cuts
3: Insect stings/bites
4: Sunburn
5: Minor burns
6: Soft tissue injuries (hyperextension, muscle strains)
7: Stuff in eyes
8: Digestive problems/diarrhea
9: Blisters
10: Pain, including headache

Various types of pain is probably the most common complaint for folks my age.

I deal with medical issues thusly:

1: Prevention (just try to use my brain cell)
2: Knowledge of WFA, anatomy, physiology
3: If more than an hour or two from trailhead, pack an appropriate first aid kit
4: Cell phone
5: Hike/climb/backpack with a buddy
6: Ask myself, "What will I do if something bad happens here?"

In 30 years of pretty gnarly adventures I've never had a major emergency. Mostly luck I guess. Be well, my friends.

Adam Fleming wrote:I might have an unpopular opinion. I don't carry a med kit.

Would have to disagree with this opinion. Out of curiosity, have you managed significant injuries in the backcountry without one?

While yes, improvisation is a great skill set to have, the amount you can accomplish by carrying a small med kit, (say less than 75g) can make a huge difference when it comes to management, and can often mean the difference between self-evac and calling for professional assistance. While this idea sounds good in theory, it's quite a different concept when it goes to implementation.

You say, if you can fix it without a med-kit it's probably not life threatening. While this holds true, theres so much you can do with a med-kit that makes keeps a bad situation from going to worse. Consider a broken clavicle, large laceration or broken ankle as common injuries that would require additional resources other than what you have with you to safely self-extricate.

I have a small first aid kit that's always in my bag and a supplemental kit that I keep in my car that I often grab for Search and Rescue Missions or when I'm taking out a large group.

First Aid Kit
Meds- Childrens Benadryl (Chewable so it's faster acting, 2 childrens=1 regular Benadryl) Chewable Asprin for heart attacks, Ibuprofen, Tagamet (to be administered with benadryl for allergic reactions) For international trips I'll throw in a prescription of CIPRO. I keep all these in a pill organizer.
Band-Aids
Climbing Tape
Ace Bandage (The Self Adhering Kind are the best)
Gauze
Epi-Pen (You need a prescription but great to have if anyone if your party has an allergy)
Tweezers
Triple Antibiotic
Alcohol Wipes

Supplemental Kit- (Stuff that could be improvised if necessary so I don't always carry) I fit all this in a gallon size ziplock bag, being clear it is easy too be able to find what you need.
SAM Splint - Really Useful, you can find cheaper generic version on amazon.
Space Blanket
Sawyer Water Filter
Trauma Shears
Cold Pack
Nitrile Gloves
Pocket Mask for Rescue Breathing
Tourniquet (Swat-T is the preferred brand if you are trying to keep things light)
Write-in-Rain Notepad, Pen, and Sharpie
Lighter

Max Forbes wrote: Would have to disagree with this opinion. Out of curiosity, have you managed significant injuries in the backcountry without one? While yes, improvisation is a great skill set to have, the amount you can accomplish by carrying a small med kit, (say less than 75g) can make a huge difference...

Thanks for your comment. I agree, a med-kit can drastically improve how well you're able to treat a patient. Maybe I'm being short-sighted because the for types of injuries I've encountered, a small med-kit wouldn't make a difference. You mentioned what you carry in your barebones kit in a previous comment. Can you elaborate on how you've used those items and how it compares to improvised options? My WFR course encouraged us to use other materials before opening our med-kits, but maybe I took that idea too far.

I'm not going to talk about the injuries I've witnessed on a public forum, but feel free to PM me.

Hibiclens, 4x4 gauze and a roll of tape..after that it's hospital or bust.

Of course a lot more if your backcountry, but still,,get'm out if it's serious

any specific meds for your partners,,,but that's up to them

Stupid simple point I would add: a CHARGED cell phone. If both you and your partner have a cell, turn one of them off, so it's there for later. Leave one on, for a signal for responders, if you are in it deep.

Best, OLH

I was WFR and an advanced life support EMT who volunteered on Teton County SAR as well on the ambulance.

The most serious injuries that I think are likely, which you can address in the field, are:

Broken extremities.
Severe laceration.

I think Max's kit is a pretty good one, and I can look at his list and tell what everything is for. His idea to have modules is excellent - easy to expand or contract the medical supplies based on the activity and how long you will be away.

The only mods I would do to his kit is the following:

3 Sam splints within the group.
Additional ace bandages, cravats,
Steristrips.
Tincture of benzoin
Providone antiseptic.

The reason for 3 Sam splints is for a broken ankle. The rule is to immobilize the joints above and below the fracture (or bones above and below the sprain). The way they do this in the ambulance or on SAR is with a box splint, which is impractical to carry. With 3 Sam splits, you can immobilize the ankle and knee joints to protect the tibia/fibula. I've used this effectively a few times.

I added the steristrips after a discussion with an ER doctor who does a lot of backpacking and other activities. He said that they can be as effective as sutures in repairing lacerations. By using tincture of benzoin (makes the steri strips stick better) and the steristrip you can close pretty nasty lacerations. Used this technique several times and it works great. I recently used it on my girlfriend, saving a multi-$100 trip to urgent care or ER - from my experience the doctor would have sutured this wound. Healed without a scar.

I also started carrying a SPOT device - there are many situations where the only way to address them is to get the injured person to definitive medical care as quickly as possible - and often there is no cell phone service where we all like to recreate.

Max Forbes wrote:Great on you to be thinking about a med kit. WEMT & WFR instructor speaking here who was just in a backcountry skiing accident. (Read about it here if interested) Hopefully using the information from your course to think about what you would want if a certain accident were to happen. The questions of, what is most likely to occur, and what to carry are both common ones. Here's perhaps a longer answer than you want, but I'm currently stuck in bed rest so here it goes... I carry different mid-kits based on the activity/season. I'll start with my barebones kit, which I carry when I'm climbing with trusted, trained partners and hoping to go light/fast. It includes: - non-latex gloves - 2 5x9 (ABD) Gauze pad -1 Roller Gauze or ACE bandage - 1 Cravat - 4 x 81mg Aspirin (This is the dose for Cardiac/chest pain and is also a painkiller & NSAID) - 2/3 Band-aids - 1 Antiseptic Other things that always come with me to supplement the "med-kit" include, a ski strap, headlamp, extra layer (e-blanket in summer), water and food. Again, this is the barebones kit. This is what I was carrying with my during the accident listed above. My larger med-kit, which comes with me when I am going on longer, more remote climbs, overnights, places without cell service, when I'm guiding/instructing, or cragging includes: Bleeding Control Bag: - Non-latex gloves - 2 5x9 (ABD) Gauze pad - 2 4x4 Gauze Pad's -1 Roller Gauze or ACE bandage Splinting: -1 SAM Split -2 Cravats -1 Medical Tape Routine Care Bag: -5 Regular Bandaids -2 Butterfly Bandaids (Great for flappers) -2 Knee Bandaids (Great for, you guessed it, skinned knees) -Tweezers -Small Trauma Shears Meds: - Aspirin (see notes above) - Anti-Diaherrea - Anti-Nausea - Anti-Histamine - Benadryl - Maple Sugar Packet (supplment for oral glucose) Other: Headlamp Mega warmer packet E-Blanket Rite in the rain notebook pages Pencils Cell phone with NOLS SOAP Note app Feel free to reach out with questions. Remember that these aren't set in stone bags, and what you chose to carry is based on your own criteria of safety and comfort. Many people will carry less, many more. Many will always have as much as I listed in bag 2. Use the skills from your course to evaluate what is best. And for building your kit, I recommend ordering a kit or bag from someone like adventure medical. Then add or remove things as needed. It's important to have a well labeled bag so others can find it, and waterproof is a big bonus. Most pre-made bags come over stuffed with things like band-aids etc. that you can remove, and add the things you really need like cravats, that often never come in these kits.

Nice write-up on your accident! Sure picked a scenic spot to crash and burn, with a water tower even.

Anyway, you highlighted a lot of good points, and for those of us who probably won't be prepared to be responders in the way those on this thread are, it still points out stuff like extra layers, food and water. I think most people have no idea how long it will take for anyone to get to them. It is just not at all like calling 911 in town.

Sorry you're stuck, but glad it wasn't worse!

Best, Helen

I "pack along" my EMT/SAR son. :-)

Not trying to hijack thread but rather build on it here. I carry a basic first aid kit but I know my knowledge lacks. I was originally looking at first aid courses but now I'm hearing about WFA courses. How different would they be? What might one include that the other wouldn't?

Thanks for the inspiration to carry something a little more substantial than a day-hike first aid kit. I just picked this up on amazon, seems to cover the essentials.

amazon.com/Adventure-Medica…

After taking 3 CPR and first aid courses, then an additional WFA course, it seems to me that the key is going to these courses on a regular basis in order to become comfortable in a real life situation.

Question to those who include band-aids:
My opinion of band-aids is that they are more expensive and less versatile but perhaps offer more psychological comfort for some, like small kids. Some gauze (especially if you get roller gauze and not pre-cut pads) plus some tape does the same thing and the gauze are more absorbent than a band-aid. Why the band-aid?

Another question:
In my WFR course we were taught to use gauze or maxi pads (depending on the severity of bleeding) plus pressure bandage (ace bandage) to stop major bleeding. I'm hearing a lot about clot-aiding bandages from this thread, which I have never learned about before. What are some of the pros and cons to using these as opposed to a pressure bandage to stop bleeding?

I can see how these might be useful for people on anticoagulants or blood thinners, but it seems to me that stopping the bleeding in the first place would be more effective than to form a clot while blood is still flowing. Am I missing something?

I'm doing a lot of guiding, the band-aids are used often for client care. Yes you can do without them for most peoples purposes I was simply listing out my personal kit. The OP mentioned hiking where they can be effective for preventing blisters, etc. In long distance hiking foot care is king!

There are really two separate things going on here, you have your TRAUMA kit and your COMFORT kit. Trauma is going to be things that will save a life or aid in evacuation of a serious injury, epi-pen, aspirin, benadryl, gauze, quik-clot, trauma shears.

Comfort kit is going to be your stuff like antibiotics, bandaids, tweezers, ibuprofen.

Many of the items are interchangeable between both categories, so I tend to combine them into 1 kit to avoid the need for duplicates.

What you bring really depends on many factors, like length and distance of your trip, difficulty, relevance to terrain, feasability (you might not be hauling your full first aid kit up a multi-pitch) The first kit I listed stays in my climbing pack and goes with me anywhere that pack goes.

DrRockso wrote:I'm doing a lot of guiding, they fall under client care. Yes you can do without band-aids, just listing out my personal kit. The OP mentioned hiking where they can be effective for preventing blisters, etc. In long distance hiking foot care is king!

Okay, I didn't quite get that this was for a guiding context. Although I'm not convinced about the blister treatment.

In my experience, tincture of benzoin plus duct tape has always been enough for blister care. Maybe some mole skin if you're dumb enough to let it get really bad before treating. Better yet, wear footwear that has been sufficiently broken in so you don't get blisters in the first place.

eli poss wrote: Okay, I didn't quite get that this was for a guiding context. Although I'm not convinced about the blister treatment. In my experience, tincture of benzoin plus duct tape has always been enough for blister care. Maybe some mole skin if you're dumb enough to let it get really bad before treating. Better yet, wear footwear that has been sufficiently broken in so you don't get blisters in the first place.

I take it you haven't done much long distance hiking, blisters or at least hot spots are an inevitability for most. Duct tape works good, the main thing is to stop the friction before it bubbles up.

DrRockso wrote: I take it you haven't done much long distance hiking, blisters or at least hot spots are an inevitability for most. Duct tape works good, the main thing is to stop the friction before it bubbles up.

Depends on your definition of long distance. Do 30-40 mile backpacking trips count? Until almost a year ago, I always backpacked in trail runners because my ankles could handle it. Then I broke an ankle and so that one can't handle it anymore. Since then, I've done a 10-20 mile trip and then a 20-30 mile trip in regular hiking boots without any issues with blisters. At one point I felt a hot spot, but a little tincture and duct tape prevented it.

Honestly, it's not that hard to prevent them, just stop once you feel the friction and deal with it. The only reasons to get a blister are stupidity and ignorance.