Thanks to you both.

Not sure about that one. I’ve taken shears on airplanes and to disney world and nobody said shit. There’s no way in hell they would have let a knife fly, regardless of size. I did have to forfeit them in an ED intake. They did not care that they were TSA compliant. And it didn’t help my case to state if you were being enough of an asshole to get stabbed with a blunt pair of shears then you deserved it. He did laugh though and let me have them back when i left.
Leatherman and benchmade both make really good strap cutters that would be in my mind a better alternative than a knife to a pair of shears. But my experience is limited to cutting BDUs off of mannequins in training lanes and one live patient with a motorcycle jacket that I used my raptors on.

tag, thank you for this

Great kit and write up. Mine is similar with the addition of a TQ and decompression needles.

Coban is awesome.

I would put in stuff that is more likely to be used for everyday things that can go south:
Steri strips/wound closures/butterflies
Benzoin pads
Alcohol pads
Povidone/Iodine Prep Pads
ABD Pads
Not Paper Tape but the good tape
Telfa Pads
Tegaderm
Moleskin or foot protectant
Small good penlight with clip for hat
Small first aid book

If she wears glasses, an extra pair

I like coban and have some in my kit, but I’d probably swap a roll out for some ace wrap.

Ace wrap is great for bandaging dressings, providing pressure, or compression for a musculoskeletal injury.

If you can’t manage a knife without cutting the patient, carry the scissors.

AND a knife.

My former employer furnished me with both. And a full tank of petrol, and a few other cool bits.

I bet I can expose the wound faster with the knife.

I no longer work for a liberal executive. So if I encounter an injured person, I’m free to leave them to the consequences of their own bad decisions and social situation.
No more handling kooks from atop the dumpster at McDonald’s.

I would imagine most of them copy-pasted their policies from other places.

Thanks!

@juslearnin please do this if you have some time. doesnt have to be super detailed, even a quick overview would be awesome.

looks like pain, pain, alergy, nausia, diarrhea, antibiotic, antibiotic, antibiotic, antibiotic.

why 4 different antibiotic's?

Good thread, I'm putting together a kit now.

In my current backcountry kit:

trauma shears (often in lieu of a knife)

sunscreen (a guide asked me if that's really a first aid item; we were on the move, and that branch of conversation was overcome by some other direction of conversation; fair enough question; so, I'll call it zeroth-aid, as are the two other clutch items after this)
chapstick (this can be used as sunscreen in a pinch; think nose, ears, etc)
nail clippers

athletic tape (the breathable type; have had really bad experiences with nonbreathable tapes)
leukotape
coban

nitrile gloves

aspirin
acetaminophen
ibuprofen
benadryl
imodium tablets
antacid tablets

nyquil capsules
vick's vapor rub, either in the smallest ziplock bag size, or small, repurposed plastic container

alcohol prep pads
gauze pads 2x2" and 4x4" and a roll of gauze
bandaids and butterfly closures
(liquid bandage, this one is on the fence about go/no-go for the backcountry kit; I've found it really helpful with dogs)

neosporin

liquid tears, the really viscous stuff

thermometer

(fingertip pulse ox meter; again, on the fence for go/no-go; depends on length of time /distance into the backcountry; I have some doubts about effectiveness in cold weather or higher elevations)

(chemical handwarmers, seasonal)

(for longer trips, prescription antibiotics)


Things that probably should be in the kit, but aren't

- thin CPR shield

- elastic wrap w/ velcro (I had a fantastic wrap that I carried and used for years; it's only a quirk of misplacement that it's not in the kit)

- flexible splint (my previous climbing packs had internal parts that could be used for very effective splinting, so I shed the weight of the purpose-made splint; my new packs have less favorable components for cannibalization, so the purpose-made splint should return)

- epipen

- suture kit (I've gotten away from this; don't know why; I'll say it's to save weight, but that's a cop out; I've used them before; I've looked at my friend's skull; I was able to treat it effectively in the backcountry; somehow; memory gets real foggy because of my own skull injury that followed)


I bias more towards maintenance over trauma.  Things that extend the ability of forward motion; allow for a holding pattern; or, allow for ambulatory return.  It's always an uncomfortable balance of weight/probability/consequence.  At a certain point, a trauma becomes extraordinary, something that requires outside rescue; cannibalization of gear; brutal cannibalization of gear; loadshed; et cetera.

My backcountry kit is two parts.  (1) The above-mentioned, and (2) A pared down, core subset of the above-mentioned that will go up on a climb.

I'm glad this got bumped.
It keeps reminding me that I need to root through the big bag I have, cull the crap in it, and restock with usefll items.

I have an old Army combat lifesaver kit from many years ago along with household items that really need to be consolidated and updated.

That is a pretty good, practical list.

Different antibiotics work better (or not at all) depending in the type of bacteria.

Tag. Great read so far. I have some stop the bleed kits but haven't a boo boo kit yet. The OP and other posts are helpful. Thanks

why 3 pain killers? I could see maybe 2, but all three major brands?  and why no naprox?

The aspirin is probably for chest pain

You can alternate Tylenol and ibuprofen to manage fevers without causing liver damage from excessive Tylenol

ok thanks. good to know.

While some recent studies indicate ibuprofen is superior to acetaminophen for fever reduction, you only have to see it not-work once to get the idea of splitting the tablet count in half to have an alternative product.   Also, some people may have GI sensitivities to ibuprofen.

Aspirin would be for suspected heart attacks.  This is something I've never seen, nor hope to, but it seems to be a recurring theme in the med kits of climbing guides.

And, I'm glad I wrote it down, because that kit just ended up in someone else's pack a couple weeks ago, and I'll never see it again.

Thank you for a great post.

Thank you Doc...Great informational thread, and one I was going to be researching...I especially appreciate the video help...

I hate to beg, but this is extremely important information, and if you have any more advice or recs on stuff to put into a full home kit, a car kit, SXS kit, and a backpack kit, I am all ears...Have most of this, some will be implemented into my kits going forward...

Thanks again

If your trauma sheers suck then you need to remember they are disposable and get a new pair instead of being a cheapskate. Or buy the leatherman folding trauma shears.
OP in your own kit do you have things like LMA, AED,  chest seal?

OST also you can use a health savings account to buy this stuff.

Tag

i just read this weekend that color can cause tendon and arterial ruptures. as someone allergic to penicillin i’ve been researching what antibiotics to pickup for meds. i have taken keflex before.

you’ve got antiemetics, antibiotics, nsaids and antihistamines listed. what are your thoughts on adding an epipen?

Bit of an update on the above....

1. When my old med kit drove off in someone else's car last year, I replaced a lot of stuff with generics.  The generic Nyquil was ineffective when I handed it out to someone in a refuge up in the Alps.  Maybe a higher dosage would have worked, but that ship has sailed.  Going from 2000 feet to 12000 feet in tens of minutes, immediately booting out with sustained activity, followed by an impromptu 2 night extension on what was supposed to be a day climb ... that'll play hell with your sinuses and such.

2. The Vick's Vapor Rub that normally stays in my Part 2 of my backcountry kit (the multiday extension of my basic kit, Part 1) ... well, the Vick's has now earned it's spot in my Part 1, one-day, basic kit.  Owing to the abovementioned unplanned overnights at elevation.  I moved it into my Part 1 basic kit as soon as we got down, and when we went back up on the Italian side for another climb, that stuff was heaven-sent for nighttime use.

2(a) I put stuff like Vick's Vapor Rub, and hand sanitizer in small, snack size ZipLock bags to save on weight.  These things will only last about 6 months in those ziplocks before all the high vapor pressure stuff bleeds out of the bag, so plan accordingly if you are using non-standard packaging ideas like that - and also realize it's probably a linear decay to the near-worthless state at that six-month point.

2(b) Also understand the implications for aromatics when you are in higher activity/danger bear areas.

3. Hand sanitizer.  I forgot to list that in the original list, but it's something that goes in with, and then separated out from, the basic day kit.  Not getting people sick is easier than dealing with them when they are sick.

Excellent thread!

Good post from an ER doc.  I've seen a lot of excessive first aid kits.  Nothing WRONG with carrying lots of stuff you'll never use...if you want to.  But why?  I think a lot of people in the survivalist world think that when SHTF, they will be using their huge kits to fix people.  In reality, you and I use a first aid kit to preserve life....the surgeon will be the one who actually saves it.  Yes first aid kits can be used for minor injuries like burns and cuts.  Bandaids, antibiotic ointment, and small bandages and tape will handle those things.  You and I can fix minor stuff.  Major stuff needs a doctor.  For example, if someone you are treating needs a chest seal they will also need a surgeon.  The chest seal preserves life so that the surgeon can hopefully save it.  Tourniquets are great to preserve life but to save it, if you need a tourniquet you'll also need a surgeon soon after.  

Small, well stocked kits that you know how to use everything well are far better than a first aid kit stocked with stuff you aren't qualified to use.  

Best thing you can bring to a remote area is....a good doctor.  He or she, if they are competent, will know what extra stuff is needed for that particular location of the world and the potential threats you all might face.

I also prefer shears over a knife for multiple reasons.  A good knife will work but shears are MUCH better.

I'm going to need a bigger pouch for a surgeon.

This is awesome

Disclaimer:  I'm not an expert so everyone needs to research themselves and ask a doctor.  For a hot tropical, poor country:

Iodine in a small bottle:  You want to get wounds dry so a scab forms.  So like road rash the key is to keep it dry and use Iodine to help prevent infection.  Neosporin or some of the anti biotic gels here in the US would prevent scab formation.

Small packets of ORS:  Once you get diarrhea, start on this quickly.  Between the heat and humidity, energy levels can drop big time and these packets should be widely available out there.  In fact, taking ORS and drinking lots of water everyday is probably a good idea.  It just raises your energy levels and reduces the risk of overheating.  Good for hangovers too.  Maybe buy a bunch of pedialyte stateside.

Jock Itch Cream (small tube)

Cipro:  you mentioned it already, I agree.

Doxycline(?)

Anti Malarial:  I've taken Larium IIRC, and looking back on it, I think I'd rather just risk getting malaria.

It may be easier/cheaper to procure some meds in country, rather than the US, though there is the risk of counterfeits or low quality meds.

Off Topic:  If you're there for a while like months and will be driving motorbikes/scooters/etc consider buying a basic certified helmet (not flashy or anything) stateside.  Helmets abroad aren't very good.  I know not a first aid kit, but important.  Wear decent shoes while riding and always long pants.  Don't dress like an American (no bright colors, shorts), stand up straight and walk around aware, be polite but don't engage with people on the street (long story).  Use common sense.

@juslernin

Always good to see these topics come up, thanks for posting... Redundancy is good...

When you say that, do you mean you pour it out of the bottles they come in and into the snack bags?

Yeah.  It may sound silly, but I do it for reasons of weight, form factor, and divisibility.

I double up on the ziplocks.  The snack bags are pretty light duty.

But, in doing so, the stuff does become more perishable.  I burn through stuff enough, though, that it's not that much more to keep up with.

In a perfect world, everyone's got his own stuff. But, reality is that some stuff needs to be divided and tossed around to either your own partner, or others you meet along the way.

Tag

I'm going to have to second this.  One single pill of Cipro put me in a wheelchair for a year and basically ruined my quality of life for ... well it's been 3 years and I'm still all messed up.  Heart, allergies, tendons, joints... everything is still wrecked from a single dose.  Extremely slow recovery. Personally I would rather die than experience even a single dose of Cipro or Levaquin again.  As a result of the cipro trauma I am also now also allergic to ALL antibiotics and can't even eat regular meat (have to buy expensive antibiotic free stuff).  

That stuff should not be given to anybody. It is reckless and dangerous to include in a first aid kit.  The FDA has advised that it not be used as a first line treatment and has their strongest black box warning on it.  I was prescribed it for kidney pain by an asshole ER doctor who ruined my life because he was too lazy to accurately diagnose me.

Wish someone had told me the risks.

Everything else in this first aid kit looks pretty solid.

Off the shelf super glue and medical glue are different chemicals.

If you want to do this - and understand the indications and contraindications in using it - get the actual medical cyanoacrylate glue, like Dermabond.

Fuck that, I'm getting me some JB Weld and super stretched Ace bandages

Agreed