You should probably carry a first aid kit

Greg Daviswrote:

I CARRY SIXTEEN BAND AIDS

THE SCOOBY DOO ONES

Sufficient 

Cornelius Yukon wrote:

SWAT tourniquets, which double as pressure dressings have good application in the civilian world, and are very light and small.

I have used the “SWAT” tourniquets on a few occasions and once even on an actual SWAT officer, they are pretty slick but they do take training, something most lay people will never get.  

The bottom line is 99% of injuries and bleeds climbers sustain will never require a tourniquet.    If you can get the training then great, carry a tourniquet.  I also know how to do a needle thorocostomy and ET intubation but I don’t darts and a laryngoscope with me.   I think people need to be honest about what is practical and what is overboard.   As nifty as the SWAT tourniquets are you can still improvise if crap hits the fan.   I am a firm believer in getting training, using your training and learning how to improvise with minimal tools available.

A lot of good information , I’ve actually been trying to bring something more than a handful of bandaids and neosporian as of late ....I don’t see a lot of mention to what people are actually using to store whatever it is they are bringing , I feel like a zip lock bag is too disorganized but so maybe like a locking Tupperware or something anyone have a favorite container maybe something those of us in the non medial field might not know about?

More to that point like people have said as far as escalation what size of thing should be considered where you say “if your bringing something bigger than ‘x’ your bringing too much stuff , rethink what you’re bringing” 

It's simple, for me. I don't know this stuff, even having had multiple classes over the years, and wouldn't retain it well even if I tried yet again to learn. Too much effort to relearn, and no way to keep in practice.

But?

Damn straight I'll help anyone else who is around to give aid, if something happens and my help is useful. That, I can do. Hold pressure on something, have a head in my lap, quietly talk to the people.... I've even rode along to the hospital with a teenaged car accident victim, as her parents weren't around yet.

Some people are fine when the adrenaline hits, some aren't. Some can distance easily when it's messy and stay functional, others cannot. An EMT I know is fine with other people being a mess. But do a blood draw on him? He's close to fainting, lol! Go figure.

This is one little piece that isn't important....until it is. But, like so much in climbing, we do need to think about the low probability high consequence stuff, and just what we are personally good with. That then needs to be part of the conversation if you are going farther afield with someone.

There are little ways this attitude applies also, routinely. I can't count on my knees to be 100%, or, know when they could just quit. Not likely, but it's always possible. That means my partners need to understand that "do not fall" can't be the go to when it's high consequence, even on approach and descent. I simply have to be roped, or avoid that entirely.

A regular partner is diabetic, other friends are bipolar, all of this is considered every time we even talk about an outing. It's part of the package, same as getting coffee in me in the morning.

Carry a first aid kit, sure, if that's part of who you are. But all the other stuff matters heaps too, especially being real about what you can, and can't, do.

Best, Helen

Nicholas Gillmanwrote:

I feel like a zip lock bag is too disorganized but so maybe like a locking Tupperware or something anyone have a favorite container maybe something those of us in the non medial field might not know about?

I have a ziplock in a small stuff sack.  The ziplock keeps stuff dry, the stuffsack keeps the ziploack from getting beat.  I'm not carrying a lot though... with the bag it's about the size of my hand.  I like having enough stuff to treat a minor cut, plus moleskin, an ace bandage, water treatment, and some drugs.  

The premise being "to keep currently mobile people from become immobile".  Mostly because that's the limit of my medical abilities.

Nicholas Gillmanwrote:

I don’t see a lot of mention to what people are actually using to store whatever it is they are bringing , I feel like a zip lock bag is too disorganized but so maybe like a locking Tupperware or something anyone have a favorite container maybe something those of us in the non medial field might not know about?

I put everything in a 1 litre utralight drybag from Sea To Summit. 

Mark Straubwrote:

My kit:

-Bandages of different sizes and shapes

-Gauze

-Ace wrap

-Alcohol wipes

-Antibiotic cream

-Needle and thread

-Climbing tape

-Electrolyte tablets

-Water purifier tablets

-Meds: Benadryl, ibuprofen, cyclobenzaprine (muscle relaxant), painkillers, caffeine, Azo (for UTIs)

------------

Seems like a lot, but I've used nearly all of these in the field at some point in time and in total it only weighs about 3 ounces.  Slings, tourniquets, and splints can be made from materials at hand so I don't carry dedicated versions.  I've been meaning to add in some Quick Clot but haven't gotten around to it yet.

I'll sometimes throw in an emergency blanket and Inreach device for longer climbs, and I also typically carry a headlamp, knife, and lighter in addition to the above items.

nicely listed down,

I'm also following this kit,  

EDC tools should be more reliable, So I have included one of the tactical flashlights in the incase my headlamp goes dead or power shuts off.  

This goes out to all the paramedics, docs, military medics, and associated professionals...

Would you consider it a good idea to carry a nasopharyngeal airway, or several airways in different lengths?  I've had one medium-to-large airway in my lightweight first aid kit for years, and a selection of small, medium, large sizes in my larger kit.  I was trained to use these when I went through the EMT process as a seventeen year old in New York City in the 1980's (that was an interesting experience!).  I've never really seen them mentioned or emphasized over the subsequent decades, in all the wilderness medicine classes, WFAs, WRFs that I have taken.  It always seemed like a good option if I ever needed to leave an unconscious partner to go get help.  A nasal airway is not secure like an intubation, but could it help?  What do experienced folks say?

Also, let's say that, for my larger kit, that lives in my car, I decided to carry some kind of modern, dedicated tourniquet system.  What is the best available option or options???  This is modern technology for me....I have no experience with these systems, and would need to get some training, and practice.

All best, 

Bruno

Bruno Schullwrote:

This goes out to all the paramedics, docs, military medics, and associated professionals...

Would you consider it a good idea to carry a nasopharyngeal airway, or several airways in different lengths?  I've had one medium-to-large airway in my lightweight first aid kit for years, and a selection of small, medium, large sizes in my larger kit.  I was trained to use these when I went through the EMT process as a seventeen year old in New York City in the 1980's (that was an interesting experience!).  I've never really seen them mentioned or emphasized over the subsequent decades, in all the wilderness medicine classes, WFAs, WRFs that I have taken.  It always seemed like a good option if I ever needed to leave an unconscious partner to go get help.  A nasal airway is not secure like an intubation, but could it help?  What do experienced folks say?

Also, let's say that, for my larger kit, that lives in my car, I decided to carry some kind of modern, dedicated tourniquet system.  What is the best available option or options???  This is modern technology for me....I have no experience with these systems, and would need to get some training, and practice.

All best, 

Bruno

Good question, Bruno.  My short answer is no.

Here's my long answer:

Is there a conceivable scenario where

1) Your partner is not protecting his/her airway, but is breathing spontaneously

2) An oral/nasal airway will be sufficient to keep them alive in your absence

3) Their injuries are such that in the time it would take to get out, get help, wait for help to arrive, wait for help to get to your partner, they're still gonna be stably lying there unconscious with the airway keeping them alive

This scenario is so insanely unlikely, I can say no, the airway wouldn't be useful.  Another way of saying that is "I think there are about 150 different first aid items which you could carry instead which would be more useful for the weight/bulk (and about 130 of those things aren't worth carrying either)."

Thanks Sam--I appreciate your advice.   That's sort of what I thought.  I can't bring myself to jettison the airways I do have just yet, but I might get there.  I guess a second situation I can see these used is for the care/transport of someone with facial injuries, where having the airway might just help them get in a little more O2.  I did once care for an unconscious patient with facial injuries where having an airway might have helped somewhat.  Cool to have experienced folks as a resource.  Thanks again.

Thanks for the info Cornelius--that's just what was looking for--some good, specific advice.  The whole first aid kit question...it's just so broad-ranging.  One distinction mentioned up thread, that I think bears repeating, is the idea of taking supplies to care for a group over a long trip or expedition, or taking supplies for emergencies, or both.  I think most people end up somewhere in the middle, but it does need some intentional questioning/planning.  For example, on a longer trip, things like antibiotics and meds for urinary tract infections are great, while they are obviously not so important in emergencies.  Anyway, I'll look up the SOF-T for the larger car kit. All best.

Bruno. whatever that gizmo is you are talking about (i am completly untrained) how many times did you use it at work? if its your go to rig at work then yes. if not no. think my carpentry tool bags. the kind you wear. some of the younger guys literally have 30lbs of shit in their bags wearing them down all day. this really hurts your lower back in the long run. I have a tape, hammer, razor knife, square, pencils, punch and a chalk line.  If I am doing finish work I ditch the bags and ether wear a cloth apron or just work out of my pockets.. 

I worked 30 years as a fire medic in East LA and South Central LA through the height of the gang wars and also have responded to thousands of shootings, stabbings, assaults as well as major tragic collisions and other traumatic incidents.  While we learned about NPA and OP airways I only ever used an OP on a semi regular basis and most of those were for postictal seizure patients and we removed them as soon as they started coming around.  I only used the NPA once on a gun shot wound to the face where there was so much trauma to the mouth that a OP wouldn’t work but I ended up suctioning and intubating him anyway and left the NPA in.   To be honest in my car first aid kit I used to carry OP’s but I don’t even carry a car first aid kit anymore unless I am going way off the beaten track and the kit is still bare bones.    I think you are most likely going to use some form of airway management for a seizure than airway trauma but that seizure could be trauma induced.   Personally I don’t carry any airway tools, I would just put the person in a left lateral position and keep good airway alignment and that would solve 90% of issues.  

On the other hand I guess I didn’t place that many OP’s or NPA’s because I just intubated anyone with a compromised airway.   But I still personally wouldn’t carry them in my first aid kit, they seem to be the piece of equipment that just gathers dust, and that’s a good thing.   My roll of tape on the other hand gets used all the time, and indispensable piece of kit. 

Kevin Mokracekwrote:

My roll of tape on the other hand gets used all the time, and indispensable piece of kit. 

That is all I need. 

Partners might want last will and testament.

Teton Climberwrote:

That is all I need. 

Partners might want last will and testament.

I’m more like The Jerk.

Hi Everyone-

I picked up on this informative post a few months ago and wanted to chime in. 

When Covid hit the US full force in March 2020 and going to hospitals seemed like a last resort I felt woefully underprepared for first aid situations that may arise at home with 3 small children in the house. I read an article by a special forces medic (sorry, can't find the link) who gave a list of easily affordable and accessible items everyone should consider having on hand in case of emergencies. Think Israeli bandages, Sam splints, etc. 

One of the items listed was Celox Hemostatic Z-Fold Gauze.    

Pre covid I neglected to carry first aid supplies while climbing as I didn't think your typical REI first aid kit would be very applicable to climbing injuries. I planned on taking a wilderness first aid class at some point but never got around to it (I still haven't). Consensus seems to be that first aid is the one thing people are always neglecting when it comes to disaster prep. Anyone can buy an emergency blanket, water filter, etc. but first aid requires a bit more training and commitment.  

When I began climbing outdoors again in the summer of 2020 I started bringing along an Israeli Bandage and Celox Gauze just in case. They both take up very little space and added weight in packs. 

Fast forward to a few weeks ago and the Celox got put to use at the crag. Full details here, but long story short this stuff is incredible. Please consider throwing some in your bag next time you are outside.      

David Carlsonwrote:

Here's the study: https://pubmed.ncbi.nlm.nih.gov/26125163/

"Results: Without a windlass, improvised tourniquets failed to stop bleeding in 99% of tests (79 of 80 tests). With a windlass, improvised tourniquets failed to stop bleeding in 32% of tests (p < .0001). In tests with no windlass, attempts to stop the pulse completely failed (100%, 80 of 80 tests). With a windlass, however, attempts to stop the pulse failed 31% of the time (25 of 80 tests); the difference in proportions was significant (p < .0001)."

I'd imagine youd expect to find more useful supplies in a major city during one of the busiest days than what 2 climbers might bring up with them but I don't know what those improvised tourniquets looked like 

Surely improvising a tourniquet ought to be easy! As someone mentioned up-thread, a sling and carabiner or nut tool could hardly be improved upon. Don't be intimidated by the language: a windlass is a super simple device for improving your mechanical advantage (it's literally medieval). Here's a study that compared the efficacy of three (fairly lame--pencil, chopsticks, and craft sticks) alternatives for improvising a windlass: https://pubmed-ncbi-nlm-nih-gov.oca.ucsc.edu/25771027/ When you think of the alternatives any climber is likely to have in multiples, a functional tourniquet ought to be the least of your worries. The injury that requires a tourniquet on the other hand...

Cornelius Yukon wrote:

It takes a lot of force to compress an upper leg enough to stop bleeding, I don't think many of the lightweight nut tools would survive it for too long. Even SOF-T and CAT tourniquets break under proper usage; not often, but enough for it to be a concern.

But like you said, an injury indicating a tourniquet while climbing seems extremely rare.

If I'm going to carry anything, it's probably SAM splints, ace bandages, and epi pen.

I certainly can't claim personal experience, but the paper I cite used pencils and chopsticks! Not, with a lot of efficacy, but it seems they could make them work. I'll be crossing my fingers it doesn't come to getting that personal experience, but I do have some faith in leverage. ;-)

Where can someone find the Celox Z-Fold for cheap? Sounds like some really good stuff, but quite pricey. It's a bit like the medical grade super glue. Great idea, but few climbers will ever pay that kind of money for a just in case item.

Yannick Gingraswrote:

Where can someone find the Celox Z-Fold for cheap? Sounds like some really good stuff, but quite pricey. It's a bit like the medical grade super glue. Great idea, but few climbers will ever pay that kind of money for a just in case item.

 Amazon here for ~$35 though I'm sure local tactical supply stores carry it as well. After personally witnessing an accident at the crag involving massive bleeding from the head I would strongly argue it's easily worth the price of a used cam.