Med kit

I've been listening to a lot of Sharp End podcasts lately 

Anyways, it got me thinking about my med kit: 

If you started with a med kit, which one do you like for climbing specifically? If you made your own kit, what are the contents?

Did you augment it with any additional items? Did you take anything out?

Does your kit change for single vs multipitch?

Does your kit change for local vs backcountry?

I’ve used various med kits but like to add a roll of Leukotape for blisters and a few pieces of Tenacious tape for patching puffies or holes in other gear. 

I have a bunch of different variants that I put in various hiking/biking/climbing bags. I don't carry anything on route.

The core components are:

• A few adhesive bandages (i.e. band-aids)
• Handful of ibuprofen 
• 2" rolled gauze
• 4x3 non-stick gauze pads (usually 2)
• 3 latex gloves (a pair, plus a spare if one gets damaged)

From there I'll add to different kits:

• More gauze pads (2x2 or more 3x4)
• 3 or 4" rolled gauze
• Assortment of adhesive bandages
• Ace bandage
• Antibiotic ointment (in the little pouches)
• Steri-strips
• Super glue (a trick I've gotten from a friend but haven't done myself, and doubtful I ever would, but who knows in an emergency)

Important lesson learned: Be sure to get the non-stick gauze, after a bike crash and urgent care visit, they were picking regular gauze out of the crash-wound on one of my friends and it was quite painful.

Things I've considered adding:

• Better curated medicine (anti-histamine and similar) 
• Triangular bandage
• SAM splint (though I usually have enough junk to improvise 
• Quick-Clot

(Also in the pack, but not in the first aid kit is a mylar blanket)

I think there have been a couple of good threads like this, you may be able to find them with a search.

I made my own kit.  It's always in my pack and I do carry it on things over 2 pitches.  I have fewer of the bulkier things in the post above, like ace bandages.  Since I make my own tape gloves I always have a roll of wide athletic tape with me, I've used that for ankle turns over my sock.  Tape seems more versatile than ace bandage. I have more drugs - codeine, antihistamine, sudafed.   I do carry 2 quick-clot packs and I do carry a 4 OZ sterile saline bottle.  I once had a very sharp rock roll into my shin which created a deep and very bloody cut.  I used the saline, the quick clot patch and my athletic tape.  At the ER, they said it was such a good job they really didn't need to do anything.  They recleaned it anyway for liability, and stitched it up.

I keep quick clot on me while I'm working in trees. Brings a lot of peace of mind having it on me. I don't carry anything for rock climbing trips, though. I should put some in my rock climbing pack.

Here's what I take when I'm on a climb in the mountains.

For cragging, it's generally just some tape and ibuprophen.  

Ibuprofen, a few strong prescription pain killers, tape, 3 yards of duct tape, a knife, a plastic bag, that's about max for me.

I take the same med kit everywhere. I was able to work out what I liked during a WFR course. It's simple but a lot of it will be helpful when you need it. 

1) athletic tape. Rolled ankles, use to make bandaid. Use this one tons. 

2) gu packet for hypoglycemia

3) hemostatic dressings (quickclot) 

4) trauma shears

5) assorted sizes of gauze

6) duct tape

7) small ziplock bag

8) triangle bandage

Sometimes for bigger days I'll include other things, like a commercial tourniquet or extra splint making material.

I bring one of those adventure medical kits (the .7 one) that I've added quick clot, a lighter, duct tape, and extra band aids too plus a sam splint. I always bring it whenever I go climbing. The biggest thing I'm worried about is falls and having to stabilize an ankle so having the sam splint is great for that, also taking any kind of WFA/WFR course is always worth it imo  

EMT/ ski patroller here. I've never found a prebuilt kit that really made sense to me. Why do you need 15 bandaids? 2x2, 3x4, AND 4x4 gauze pads? 3 antiseptic wipes and 2 alcohol pads? Just bring 4x4 and cut it to size if you need to (which you won't). Non-stick gauze pads and tape make waaaay better bandaids than a real bandaid, and why bother with antiseptic wipes AND alcohol pads? Just makes your inventory a pain.

I second the WFR course, that's honestly the single best thing you can do for you and your partners. Second is an Inreach Mini, the sooner you activate SAR the better your outcome will be and how often are we out of cellphone service?

I view my first aid kit for single/double day outings as:

What is likely to happen to us, and what do we need to:

A. Get us back to the car so we can drive home or to a drug store and get the stuff we need

or

B. Keep someone alive long enough for rescuers to show up

Rinse a cut off with drinking water, and the true cleaning (soap&water, antibiotic ointment) can wait 8-24 hrs so no sense lugging that around. Afterbite sting relief? Ya sorry bud your gonna be itchy until we get back to the car. And so on. The more stuff you have in your kit the more digging and looking around you'll do when it's time to use it so the trimmer you can keep it the happier you and your patient will be.

My personal backcountry ski first aid kit is the most comprehensive:

Gloves, rubber dishwashing gloves are best cause they won't tear but they take up more space than nitrile gloves. Bring a few pairs or nitriles because they *will* tear

1 pair trauma shears

1 orange CAT tourniquet (Stop buying black! We aren't tactical, there's no need. Orange is harder for EMS folks to miss if you forget to write "TOURNIQUET T: 9:53" on their forehead)

1 4" Israeli Bandage

2 rolls 3" gauze 

2-3 4x4 gauze pad 

1 or 2 bandaids

~8 steristrips

1 18" Sam splint 

1 pkg triangle bandages for a shoulder sling

1 small roll med cloth tape 

1 emergency blanket

1 CPR mask

1 nasophayrngeal airway sz 28 for an unconscious patient (this is an EMT/patroller thing)

1 pkg honey for diabetic emergencies

1 pkg electrolyte solution 

1 dose benadryl for anaphylaxis (epinephrine is what this person needs though) 

1 dose baby aspirin for cardiac events

1 dose Ondansetron (EMT thing, anti-nausea that's nice for head injuries)

800 mg Ibuprofen/1000 mg tylenol. We call this a "pain bomb," studies have show when taken together like this it has similar analgesic effects as opioid pain killers

Sharpie with duct tape wrapped around it

With that stuff I can fix anything that is fixable. I typically take way less when climbing just because space is at much more of a premium so sticks can replace the SAM splint, climbing slings can replace a tourniquet, etc.The odds of traumatic bleeding while climbing are super low. Realistically any medical situation is going to be from a nasty fall or rockfall so splinting, head trauma, and pain management are my main concerns when climbing. For those of you carrying prescription drugs, remember that it is technically illegal to roll around with prescription drugs out of their labeled container. Probably wouldn't ever be an issue unless you're getting busted for weed in Monticello, UT and they wanna throw the book at you.

I'll usually bring nitrile gloves, a space blanket, Ondansetron, pain bomb, tape, CPR mask, and 1 pkg roller gauze with me climbing if it's more than 3 pitches, or a long approach. That's fist sized and can do pretty much anything I'd want to for what you're likely to see while climbing. If it's a quick approach I often won't bring anything because I'm pretty good at bodging stuff together with sticks and jackets, and that'll get us back to the car.

Feel free to poke holes in anything I've written about here and ask any questions too. I want to improve and help others improve as much as possible.

Feedback on what I've seen in the thread:

For those of you carrying Quikclot, make sure it's the gauze and not the powder. The powder causes pretty significant tissue damage. 

Consider ditching anything you don't need to get back to the car where you can then drive home or go buy the right stuff. So wound wash is really just 4 - 8 oz of sterile water that you'll never drink, use drinking water in the moment and then clean it properly with soap & tap water when you get home. 

Nitrile Gloves: bring several pairs, like 3 pairs would be good. They *will* break or tear, and people are gross. That's cool you helped that guy with an arterial bleed 20 years ago, bummer you got HIV from him tho.

This thread has perfect timing, since my sister just got me a Ultralight Medical Kit.5 for my bday. Now I can go through it and add anything it may be missing.

Big difference between what you carry for outings close to home vs expedition etc. For outings close to civilization (big days close to home, trips to well developed countries with good medical care etc) my med kit is:

1. Athletic tape

2. Narcotic pain killers

I find any injury is one of two things: booboos you can tape up to keep going, or serious injuries that mean you're getting out of there fast as possible. If it's the latter, you aren't going to treat, you're stabilizing and self rescuing or calling for one. You can't carry enough med equipment while climbing to meaningfully treat someone in the field, but you can improvise a lot with some tape and the gear and clothing you already have. 

For expeditions (backcountry or international) where medical treatment is less available/you want to hedge against ending the whole trip for a more moderate illness or injury it really comes down to what you actually have the training for. The first thing to run out is GI meds - those Pepto tabs are money. I usually take suture because if you know how to sew you can save a trip home/to the hospital. Super glue is killer too - if you want to be fancy buy the vet grade derma bond on amazon. Also a fan of the simple 14 gauge needle for pneumo decompression - not a top injury in the backcountry but could happen in a serious trauma and a really simple procedure to relieve a life threatening condition. Add in your standard OTC meds like IBU, Tylenol, and Benadryl (agree with above you need epi for serious anaphylaxis but maybe you can crush it and go sublingual and get lucky...). SAM splints are pretty nifty, so if there's room. I also like dexamethasone, not just for AMS but in a head trauma without near term tertiary care could come in handy for cerebral swelling. Something to secure an airway is nice, if you're carrying all that an NPA is easy to toss in and probably as far as you want to go (even the lightweight intubation kits are bulky, criching is simple but unless you've practiced...)

I'm sure some of the above is beyond WFR training, and ultimately an inReach is probably your most valuable med kit at that level.