First Aid Kits

[rcwild]

I am Looking for your input here. What items do you consider essential in a Canyoning first aid Kit? Do you carry any strange items in your first aid kit? If so what and why?

Thanks for your input,

Scotty

[rcwild]

Scotty,

Thank you for introducing this topic. First aid kits are an often-overlooked topic. Probably because they aren't as "cool" as our technical gear and we (hopefully) don't use them very often.

I actually carry two separate kits. One I call my "boo boo" kit. It contains a basic assortment of bandaids, antibiotic cream, ibuprofin, tweezers, 4x4 gauze pads, etc. I carry the boo boo kit deep in my pack inside a waterproof container.

The other kit is my serious emergency kit. I carry it where I can get at it quickly. It contains latex gloves, trauma shears, a couple of "blood stopper" bandages, a "sam splint" (that can also be used as a c-collar), a 60cc syringe with plastic tip and surgical tubing extension, and a CPR mask. The blood stopper bandages come sealed in plastic. I seal the latex gloves and CPR mask using a vaccuum seal-a-meal appliance; not to keep them dry, but to keep them clean.

The items in my serious kit were chosen to deal with ABCD -- Airway (syringe), Breathing (CPR mask), Circulation (CPR mask and bloodstoppers) and Disability (c-collar) -- and to facilitate examination (gloves and shears).

Rich

[rcwild]

Scotty,

I carry a first aid kit only in two situations. The first is when I'm doing extremely technical stuff in a very remote location with difficult rescue access. In that case my first aid kit consists of a roll of duct tape and a narcotic pain med (usually in tablet form, sometimes an injectable). If you want the logic behind that, e-mail me.

The second situation is when I have a legal 'duty to act'. That would be something like a client-guide or a responder-patient situation. In that case my first aid or 'jump' kit would depend on too many factors to discuss here. If I were to take along a basic kit, it would be something like the kit Rich describes in his post.

Dave Black

[rcwild]

Dave,

Since attending your course to recertify my WFR, I made a couple of changes to my serious kit. I replaced the surgical tubing with a naso airway like you suggested and added three sizes of oral airways. I forgot to mention in my original post that I also carry an ACE bandage, primarily for use as a compression wrap.

I tend to carry my "serious" kit all the time, but the "boo-boo" kit only when I am out with students or rendezvous participants. Nothing in the boo-boo kit will save anyone's life; only make them more comfortable.

I am very curious about your duct tape and pain killer approach, so I will write to you directly with the question. It occurs to me, though, that the contents of a first aid kit or any type of rescue kit will depend a lot on the skill and experience of the user. An inexperienced canyoneer will carry a dozen or so carabiners; while an experienced canyoneer will know how to improvise with less than half that number. Not having your first aid skills and experience (and less ability to improvise), I need to carry more supplies in my first aid kit.

Rich

[cbare]

I do not do allot of serious canyoneering and climbing, mainly rappelling off of buildings and some rappelling off of cliffs. With that in mind, I am able to carry a rather heavy and extensive medical kit. I imagine serious climbers will be concerned about weight. In any event, I will cover some of the essential items I carry. When I set up a kit I always stock according to the ABC's. Airway, Breathing, Circulation. Airway is most important, so I will start at A.
A: Oral Airways (J-Tubes) hard plastic device inserted into an unconscious person that keeps the upper airway open. Do not put into a conscious person. (gagging & throwing up) Buy a few different sizes and learn how to use them, they are a life saver. Nasal Airways, small flexible tube inserted into the nose that helps maintain the upper airway in a semiconscious person. Be careful about a nasal airway and severe head injury, people have put nasal airways into a person's brain through an internal fracture of the skull base.
B: CPR microshield type mask to breath for someone. Bag Valve Mask devices work better, but are large and prone to fail in the great outdoors. A 14-16 Ga IV catheter that can be quickly inserted in the chest of a person with a collapsed lung to help relieve air build up. Internal chest injuries are common with blunt chest trauma from falls. Warning, only carry if you are properly trained to use. A plastic bag and medical tape to cover open chest wounds.
C: Quick Clot (tm) Field dressing. Sterile pre packaged military type dressing that is covered in blood clotting factor 7. Quickly stops bleeding from some of the nastiest injuries you can imagine. SAM splint, a flexible splint device that can mold to secure many fractures, can also be cut and molded to from a cervical collar. A couple triangular bandages to go with the splint. Survival blanket, keep the casualty warm. Hypothermia makes people more prone to bleeding. Trauma scissors to quickly gain access to severe wounds under clothing.
These are the essential supplies, other goodies such as, IV bags, intubation tubes, blood pressure cuffs, and thermometers are great but take up space and add to weight. Never forget proper training and injury prevention. A well trained medic can assess a persons pulse, skin condition, and breathing without any devices and tell if shock is present. Work smarter not harder.

I hope this helps, email me with any questions or comments.

Thank you, Chris Bare (cbare)

[lateknight]

I hate to bring everyone down, but as an "experienced medic" as someone put it earlier, you have to be realistic about these kind of situations. Keep in mind that you have to figure out a way to extract this patient from the situation. Assuming that you're in the middle of a canyon, far from any road or cell tower figure probably at least 2 to 3 times longer than it took to get there. If your patient is in respiratory or cardiac arrest, a full day of CPR simply isn't realistic. While I'm new to canyoneering, I do have extensive climbing and backpacking experience. When I pack first aid gear, I pack for bleeding control and fractures. The SAM splints mentioned above are great and do work as good c-collars. The military "blood stoppers" are good as well. I also carry Steri-strips, available at most drug stores. As far as telling people to buy OPA's or NPA's and carry those, I would caution against that unless they have proper training. I do carry a CPR mask with me, but manual airway maneuvers are just as effective as airway adjuncts in the short term, which is really the only period of time you'll be doing CPR. Hope this helps. Just keep in mind that you have to decide what you can and can't treat in the backcountry and you simply can't treat a patient with a compromised airway without risking injury to the healthy members of the group.

Patrick

[mtthwlw]

I am Looking for your input here. What items do you consider essential in a Canyoning first aid Kit? Do you carry any strange items in your first aid kit? If so what and why?

Thanks for your input,

Scotty

As a beginner I'm probably not uber-qualified to answer this, but I feel fairly comfortable with the first aid kit suggestions made in Mountaineering:Freedom of the Hills (7th ed.) on p. 494.

Some of the "strange items" include a kotex pad-- a cheap thing to carry that will absorb a lot of blood. They suggest that as an alternative to a Carlisle dressing.

I put it all in a small dry bag that I've drawn a cross and written "first-aid" on the side with a sharpie.
:titanic:

[coati]

Hypothermia seems like a potential problem for canyoneers, especially if someone gets injured and has to stay overnight in a slot. i carry firestaring materials and an emergency blanket. My emergency/first aid kit along with a tiny esbit stove fits inside a .4 liter mug I can use to heat liquids.

Instead of a signal mirror I have a broken piece of a compact disc. Cheap, light and indestructible -- takes up no space at the bottom of the mug. It's not exactly first aid material like the topic header suggests, but appropriate for emergency situations.

[DJ Meding]

Be careful with what emergency blanket you carry. Some of them are so cheap that they rip easily and are not of much use. An emergency bivy sack is about the size of half a role of TP but is really tough and has multiple uses.
Also a simple large plastic garbage bad has multiple emergency uses. Couple that with a small candle and you have shelter and a heat source.
CD is good for signaling but watch those sharp edges. Also how did you get a broken piece of something that is indestructable? :2thumbs:

[coati]

Be careful with what emergency blanket you carry. Some of them are so cheap that they rip easily and are not of much use. An emergency bivy sack is about the size of half a role of TP but is really tough and has multiple uses.
Also a simple large plastic garbage bad has multiple emergency uses. Couple that with a small candle and you have shelter and a heat source.
CD is good for signaling but watch those sharp edges. Also how did you get a broken piece of something that is indestructable? :2thumbs:


Yeah, the old-style mylar emergency blankets were very fragile. Adventure Medical Kits makes one out of a more durable material, both blanket and bivy sack style.

You're right about sharp edges on the broken CD. I figure that might come in handy for a field amputation.

[mountain man]

Bump

Decided to bump this up after talk about this at Bogley & Yahoo forums

:popcorn:

[Parker]

Does anyone carry meds? These sometimes make a slightly miserable trip a little more barable to finish. cardiac arrest and apnea to me are more 'trip is over' tragedy. for the common headache, sprian, fracture, bee sting or poison ivy, I like to have Ibuprofen , Benadryl, and Epi.

[scooter]

I almost always carry Ibuprofen and Benadryl. Is there a good place to get something like an Epi pen? When my son was allergic to eggs we always had one around, but it was a prescription. Is there an non-prescription option out there for "just in case"?

[DJ Meding]

Don't forget the Imodium. Nothing can kill a trip like a bad case of the s----. It can also lead to more serious problems like dehydration.

[cougarmagic]

Scooter, you should be able to get an epi pen from your doctor easily, if you explain why you want it. In my experience, they aren't too concerned about people having them. Reminds me that the one I have is currently about 2 years past its expiration date...I should probably do something about that!

[Rocketman]

Two in our family are allergic to bee stings. We have two Epi pens. One in the pack and one in the large first aid kit in the car. Easy to get from a doctor.

Keith

[Parker]

most docs will prescribe an injectable Benadryl and an epi-pen if you just ask (and if it is your normal doc). Make sure that if you have kids you are getting their dose.

[Seth]

I'd like to know what people think is the right weight for the first-aid kit. For most people there is probably a range, for other's I'll bet they carry what they carry and don't care. But If you could guesstimate on the weight and percent of pack weight of your first aid kit that would be interesting.

I carry what rich called a boo-boo kit, ibuprofen, baby wipes. It weighs maybe 1/2 lbs. That is probably about 2% of the weight of my pack.

[charlybldr]

I'd like to know what people think is the right weight for the first-aid kit.


This question (like many) begs the answer "it depends". :devil:

My medical training does not go far beyond WFR. And I am a firm believer in "lighter is righter". Hence, I don't typically carry much.

First, I clearly understand my abilities (or lack thereof) and that in a remote backcountry situation, there's not a whole lot I can do for a serious injury beyond insuring ABC's and keeping the patient comfortable until help arrives. Second, I understand that because of my finite medical training and the small size of the first aid kit I carry, there is a limit to how much medical service I can perform and so take precautions to avoid injury in the first place.

So, my ultra-light kit is more in line with Dave's "narcotic pain relievers and duct tape" approach. It contains items to treat minor cuts, scrapes, bites, burns and blisters, including disinfectant and anti-biotic ointment. A SAM splint for its multiple uses. Some white "coaches tape". Half a dozen single serve ampoules of sterile eye drops. Water purification tabs. A small "tool kit" which includes a tiny Swiss Army knife (blade, file, scissors, tweezers, toothpick), fire starter (Bic lighter/ferrocerium rod/short steel hacksaw blade). And a handful of meds: Aspirin, acetaminophen, NSAID's (naproxen and ibuprofen), Benadryl, Imodium, antacids and a handful of RX pain meds (Vicodin, Percocet, Dilaudid). I have about three meters of duct tape wrapped around my waterproof barrel and the SAM splint rides in the flat "foam pad" pocket in my pack. Sans SAM splint and duct tape the above kit packs into a small, red, nylon pouch 5.5" x 4.5" x 1" and weighs ounces. With it I can treat a myriad of minor injuries and discomforts and/or keep a patient comfortable overnight, up to a couple of days until the cavalry arrives. If I am going out with a larger group and there is no one in the group with a higher level of medical training than me, I carry a fleshed out version (larger quantities of included items) of the above kit stuffed into a plastic jar about 5" tall and 4" in diameter.

Equipment normally carried that can be pressed into emergency or medical service augments this considerably and includes: 1" tubular nylon webbing, canyon rope(s), dry/warm clothing, hat and gloves, pack (elephant's foot) paddle jacket and wet suit. I like Dave Medding's idea of a small bivvy sack (large plastic garbage bag?) as an emergency bivvy can be damned uncomfortable, particularly for an injured person.

But most importantly, I clearly understand the scope of my abilities and realize that although I will try my damndest, there is little I can do to treat severe trauma other than insure ABC's and stabilize and comfort the patient until help arrives. Without the knowledge and experience to use it, carrying a large medical kit is nothing more than "first aid theater" and only puts you at a disadvantage by making your pack heavier.

[prometheus]

while I am new to canyoneering being prepared is something that I kinda pride myself on learning to be better at. my 1st aid kit has been changed regularly since I carried my first BSA issued kit. At 40 ive refined it a touch.
IBU
Imodium
Benidryll
(scripted pain med)
quik clot dressing large
super glue (with common sense to guide you superglue will close many small cuts that might otherwise need sutures(always consult a doctor upon your return)) hospitals call it dermabond btw
multiple self adhisive bandages I like cloth backed
duct tape
NPA (while some would doubt its need picture your face planted partner with busted teeth and smashed nose triing to breath as he regains consciousness) to many places to learn how to use one they are very simple.....at a time like that better to beg forgiveness than permission
moleskin
and thats about it, for me I take a script daily (1 pill) so I keep three days worth in there also. it all fits pretty small pack and is not very heavy even kept it in water tight box. with exception of quick clot nothing needs to be sterile, improvise dressings clothes, infection is not a large concern even with help a day or two away if you r concerned pack a broad spectrum antibiotic or two. remember we are just trying to make it easier until help can be reached or arrives we are not a MASH unit :)

[TommyK]

Something to point out about bringing an NPA. In EMT classes you are taught to never use an NPA for someone with head/face trauma. An NPA could easily find a path into the brain on a trauma patient. An OPA could be used in this case as long as one knows how to properly insert it without causing additional damage. In most cases, positioning the person's head via a head-chin-lift or a jaw-thrust maneuver will be the best course of action.