Building an Emergency First Aid Kit

One of the most difficult things I find in preparing to go outdoors is downsizing the amount of medical stuff I take with me.  I know this probably sounds crazy, but it’s true!  I have essential oils and herbal medicines from bug bites to nausea and narrowing my pack seems to take an act of Congress.  But no worries, here’s a guide to help us all pack a little lighter and only the necessities.

The Bag

This is probably more important than the contents of your bag because, quite frankly, you’re going to need somewhere to put your things.  Choosing the right bag is essential to building the right kit.

large-red-bag

Keep in mind that this might change over time.  For example, I have many, many, many bags.  Seriously, I do!  One small bag I have holds 10 herbal medicine tinctures of 2 oz each and some basic first aid supplies.  The second, larger bag I have contains about 8 herbal medicine tinctures, 4 salve containers that measure 2 oz each and a lot more room for things like a suture kit, trauma dressings, a combat tourniquet, chest seal, a chest decompression needle, trauma sheers, adhesive bandages, and tampons….that’s right tampons!  I never leave home without them.  But we’ll discuss more below as this is actually an important item for every medical kit!

The Box

Is a tackle box medical kit more your style?  Tackle boxes offer many different options and are an excellent choice for the right person.  Personally, I use keep a large bin in my Jeep and inside are a few different sized tackle boxes that each serve their purpose

tackle-box

Purpose of the Bag

Deciding what size bag you’re going to need comes with a few things to consider, including what purpose your bag will serve.  When I traveled to Uganda to serve the children we support through Wellness Warrior, I knew I’d be in the back country where exposure to bug bites (malaria), snakes, stings, bad water, diarrhea and exhaustion would be strong possibilities.  I also knew that things can be rough in certain areas of the country, so I wanted to be able to take care of myself if we ended up injured and 4-8 hours from a hospital.  Keep in mind, just because you see a hospital doesn’t mean surgery is an option.  There’s always the possibility of having to be transported hours to get the right care when you’re in the back woods.

Although I had been to Uganda many times before, designing this bag was really important to me.  So, I started with the above info and got creative.  I decided I needed a bag I could sling over my shoulder, to carry with me all the time.  Our main mission was to provide natural medicine to the children of the orphanages we support, but to also impact the community and bush villages with the remedies we carried.  I wanted the sling bag because I could easily open it to administer aid to others, but also have my personal allotment, if needed.  Turns out that the bag was a perfect combination of design and practicality because I used it every day!

The sling bag measured about 7″ in width, 9″ in height and about 6″ deep.  It had a separate pocket inside to keep the trauma dressings and suture material separate from the herbal medicines.  The front had a small pouch that I was able to keep a nice variety of essential oils in for quick access.  We had a few large suitcases that contained the main sources of our essential oils and we restocked, as needed

I chose to fill the bag with herbal medicines used for infection, diarrhea, toothache (infected tooth or gum), sour stomach, nausea (the driving on back roads can be extremely rough!), insomnia, antivirals and antibacterials.  The essential oils I chose were melaleuca (tea tree), frankincense, lavender, orange, eucalyptus and lemon (used for malaria).  These were kept in the smaller pouch in the front of the bag

Personal Protection

Gloves! – An absolute must if you’re going to ever be in a situation where you’d come into contact with another person’s blood or body fluids.

  • medical-glovesNitrile gloves protect against body fluids and disease and are easily accessible
  • Sterile gloves (for suturing)
  • Natural rubber latex – be careful as some people have an allergy to natural rubber or latex

Mask – surgical masks are light weight and easy to carry and store so they make a great addition to any first aid kit.  If space is an issue, feel free to skip this one though

Wound Care Supplies

Tweezers – an absolute must!  Tweezers can be helpful in so many different situations and no medical kit should be without them.  They are great for removing debris from a wound to helping to close a wound

Magnifying glass – if you’re going to invest in tweezers, invest in a small magnifying glass to help you see the little things you might miss while cleaning a wound.  Not to mention they can also help you start a fire, if needed

trauma-shearsScissors / Trauma shears – cutting clothing in the field is pretty common as is cutting thick bag straps or pieces of plastic.  I favor trauma shears, but scissors of a high quality stainless steel work well

Safety pins – another absolute must for so many reasons from using them as they were designed to pin things together to pulling jiggers out of feet.  True story!!  When I was in Uganda, we used safety pins to pull little sacs of parasites called jiggers out of people’s feet.  Then, we’d clean the safety pin and attach it to their clothing so they could remove them immediately and not wait until they got an infection.  Safety pins are also great for removing debris from wounds

Tampons – don’t only serve for the obvious purpose, but tampons are incredibly absorbing, tightly packed cotton.  I purchase the small organic tampons that don’t have an applicator.  I find these are the easiest to transport as they take up very little room.  I like the organic ones because they have no harmful chemicals, like bleach and formaldehyde

Syringe – 60cc is best and if you can get it with an irrigation tip over a needle tip, all the better.  If you purchase with a needle tip, just keep in mind that you can (usually) unscrew that needle (with the plastic cover still on it).  You’ll want to keep the needle in a safe place in your kit as you may need to use it in the future

Cotton tip swabs – easily remove debris from a wound

Antiseptic solution – comes in wipes, swabs and tubes that can be crushed for easy use. If you want to fill your kit with all natural supplies, consider the essential oils you’ll have in your kit as great antiseptics

Non-adhesive dressings – usually petroleum or oil based.  Use with caution one people with sensitivities.  Use this directly on the skin then cover with a dressing and bandage.  Is perfect for burns where keeping the skin moist will help decrease pain

Skin Injury Prevention

moleskinMoleskin – is a great way to prevent blisters but to also cover them once you receive one, just know you’ll most likely tear the skin (if not already torn) once you remove the moleskin.  Moleskin is soft on one side and sticky on the other, allowing it to adhere to your body

Duct tape – is my choice tape to pack in a small kit.  I pull a length of about 2 feet from the roll (don’t tear it off) and wind it back over itself.  This way I can pack a good amount of tape in a small space.  I use this in lieu of moleskin since moleskin is more expensive and duct tape does an equal job.  You can also use duct tape to prepare a splint or make a bowl to purify drinking water, so it has many uses in your medical kit!

Broken Bones

Broken bones are an interesting subject.  In my vehicle I carry a traction device that allows for more advanced care of a femur fracture.  It’s lightweight enough to carry into the back country if I will be out for a few days climbing or caving and the risk of injury is great.  Otherwise, I keep it in my Jeep and will send someone to grab it, if necessary

Athletic tape – works wonders to hold splints in place.  Athletic tape is easy to tear and can be applied directly to the skin.  Great for shin splints, broken bones and keeping bandages in place

Trauma Supplies

Because you never know where you’ll be when you need it, I always keep a little zip lock bag filled with adhesive bandages.  Here’s a few of my recommendations to keep in your medical kit:

gauzeGauze bandages – great for cleaning and wrapping a wound.  Bandages provide excellent absorption and can be used to stabilize a broken bone.  You can easily find a series of sticks to provide the backbone of your splint, then use the gauze wrap to secure the sticks to the limb

Trauma bandages – trauma bandages or “pads” as they are commonly known, are extremely good at absorbing blood and other bodily fluids.  They can also be folded to apply a firm pressure and held in place with a roller bandage (below)

ACE type bandages that come in roller form – these roller-type bandages are excellent for helping to secure a limb or hold a dressing (above) in place

Triangle bandages – are wonderful for splinting and absorbing body fluids.  They can be used as a feminine pad, to make a sling, dress a head wound, or as a drape during field surgery or suturing

Splints – come in a variety of shapes and sizes from bendable fingertip splints to large-limb splints that when a little water is added, will harden in about 10 minutes to the equivalent of a plaster cast.  Bendable foam splints can also be used as a neck brace, so there’s no going wrong in picking the right equipment for you pack

Bleeding Control

tourniquetTourniquet – tourniquets have gotten a lot of press since the Boston Marathon bombing.  Prior to this unfortunate event, tourniquets had seen their place in the emergency setting, but had slowly been removed based on unsubstantial data backing up their effectiveness.  I think now every trauma practitioner agrees that tourniquets save lives.  I carry a variety of tourniquets with me.  From simple pieces of rubber band to actual combat tourniquets that can be placed over large limbs, like the thigh.  Regardless of which type of tourniquet you choose, your medical kit shouldn’t be without one

Blood clotting agentcelox – some blood clotting agents are available my prescription only, whereas others are available over the counter.  Blood clotting agents are available as granules for pouring into a wound, clotting fibers like gauze, and bandages designed to wrap around the wound.  The mechanism of action is based on the presence of hemostatic agents which clot the blood.  Some clotting agents are absorbed by the body, but others need to be removed in a surgical environment

Wound closure

Butterflies, skin glue, sutures and staplers are some examples of wound closures that you should consider carrying with you in your medical kit for various reasons.  If I am just hiking during the day and could realistically be at an emergency department in two hours from injury, I’ll only carry butterflies with me.  If I’m in the back country two days from “help”, I’m going to carry a suture kit with me.

Butterfly closures – are applied topically to close a (cleaned) wound so that the wound starts to heal and infection is reduced

Skin glue – seal a small wound together.  Works great for wounds that are deep as well but where the sides of the wound come together easily.  Can always use a butterfly closure or adhesive bandage over skin glue

suturing.jpgSutures – placement requires advanced knowledge and practice.  It is recommended that the wound be as clean as possibly and the environment as sterile as possible.  Understanding that field medicine doesn’t always allow for this presents it’s own unique challenges but nonetheless, it’s worth noting that a clean drape, sterile needle (should be sterile if you’re pulling it directly out of a suture kit), suture thread (again, sterile if not previously opened), and tools to assist with cleaning and closure are important to have on hand.  When learning how to place sutures, consider the material you’ll be using and try to match it as closely to human tissue as possible.  Using raw chicken breasts, with and without the skin attached, and bananas with the peel  are good places to start to learn proper placement

Staplers – are great options for people with little to no training in suturing, which might be required during an emergency situation.  Obviously you’ll need to have the stapler on hand, but it’s pretty easy to figure out once needed.  The stapler is placed over the wound edges and just like back in 4th grade, you pierce the two pieces together for closure

Physicians typically follow a 12-hour rule for wound closure, meaning if you lacerated yourself and don’t close the wound within 12 hours, the physician may decide not to suture it closed, for risk of infection

A little note on suturing and stapling, I’m not advocating that this is the right equipment to be used by untrained persons, simply making the point that in an emergency situation, you may not have another choice.  I have taught classes to groups of people using uncooked chicken breasts (with and without the skin) because the skin very closely resembles that of human tissue.  I’m an advocate of being prepared!

Medications

When engaging in outdoor sporting activities, it is always a good idea to first know what possible threats you could encounter.  Not only do you want to understand things like the weather (even from 100 miles away or more), but you’ll want to know the terrain you’ll be traveling through and what types of animals or insects you may encounter to the type of water-borne diseases that could be present in the water you will be drinking.  Knowing these things will help you prepare the “medicine” part of the pack you’re building

herbal-medicine-photo

Antibiotics – to treat bacterial infections

Antifungals – for fungus, candida and yeast

Antivirals – for viral infections

Allergic Reaction – antihistamines are used to treat allergic reactions.  Epi pens are available by prescription and used to treat anaphylactic shock, or an allergic reaction that has compromised the airway and caused breathing to be difficult.  Epi pens can be life saving!  I make it a point to always have one on every trip I am on

Diarrhea – can ruin a trip.  Most diarrhea is caused by drinking contaminated water, which is why purifying water is so important.  There are many ways to purify water in the wild

Insect bites – can be bothersome, but unless you’ve been bitten by a poisonous snake or bug, the bite is more of a nuisance than harmful and the swelling and pain should resolve itself in a few days.  For serious bites, including rattlesnake, evacuation is necessary

Pain – can be incredibly difficult to endure in the back country.  Having the appropriate pain medicine can be critical during an emergency

Personal Medications – don’t forget to bring the common medicines you use at home, especially if they are required in order for you to stay healthy

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