Medical Moment: Packing a First Aid Kit

Medical Moment: Packing a First Aid Kit

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Dr. Dan Hehir, Chief of Medical Staff, Board Certified in Emergency Medicine

Dr. Dan Hehir, Chief of Medical Staff, Board Certified in Emergency Medicine

 Dr. Dan Hehir answers this week’s question:  What should I pack in my First Aid kit?

Telluride is a community of people who participate in a multitude of dangerous outdoor activities and who enjoy foreign and exotic travel. Unfortunately not all outings go as planned. In the event that someone is injured or ill you will be glad you prepared a First Aid kit ahead of time.

I’m often consulted by people those trying to assemble First Aid kits. Having a one that is well thought out and up to date is important for everyone.

While your First Aid kit should be modified according to your particular activities, your medical training and your personal medical history, there are some basics you should keep on hand and add to as needed.

I have three First Aid kits, although one is a very comprehensive and large kit geared for a medical professional. This kit is overkill for most people, so we’ll concentrate on the two smaller kits I’ve assembled.

The smallest kit in my First Aid quiver is my lightweight kit that lives in my backpack for skiing, biking and hiking. This is what I consider my true First Aid Kit.

This First Aid kit is for day outings and the purpose is to be light and portable while still capable of addressing some of the most common, life threatening, and uncomfortable problems that you may encounter in the backcountry.

Beware of making this kit so light that it doesn’t serve much purpose, or so big it’s often left behind. Successfully assembling this First Aid kit necessitates balancing these two tendencies.

My kit is a small, one pocket envelope. It’s lightweight and simple. The first goal of this kit is to address life threatening problems that may arise. In reality, there are very few life threatening conditions that arise in a backcountry setting that are amenable to immediate and effective treatment. The first is anaphylaxis and likewise, I always keep an EpiPen in this kit.

I also tape a couple of Benadryl tablets and some prednisone tablets (an oral steroid) to the EpiPen kit. In the event of an anaphylactic reaction from a bee sting you can use an EpiPen followed by the oral medications.

The next class of supplies I carry is for treating wounds. This kit includes: sterile gauze, a syringe for irrigating dirty wounds, anitibiotic ointment and some coban wrap.

In the event of an open wound you can use direct pressure to control and stop bleeding, wash the wound out, and wrap it. Sutures can wait until later if needed at all. It is easy to make dressings out of extra clothes and a knife so I don’t carry much else except some sterile strips, and skin glue for wound closure if needed.

Orthopedic injuries are very common in the backcountry and I do carry a few things for this, namely a SAM splint and an ACE wrap. It is easy enough to fashion a splint out of materials that you may be carrying though so don’t overdo it here.

As far as medications go, in this small First Aid kit I carry an EpiPen, Benadryl, prednisone, ibuprofen, a narcotic pain medication, a muscle relaxer, and Ondansetron (Zofran), which is used for nausea. In this kit I also carry aspirin and nitroglycerin in case I need to help someone having a heart attack. I also carry protective gloves and a CPR mask.

And that’s essentially it. It’s a very compact kit, but it can be useful for the most common events in the backcountry and it’s small and light enough that you won’t mind bringing it along.

I do think that one of the most important things that you can have when someone is hurt in the backcountry is plenty of warm and dry clothing. I consider my down jacket one of the most important safety items that I can have.

 Now, for my home First Aid kit. This kit is less mobile and much more extensive.

I start with a larger, multi-pocketed commercial kit and add to it. This kit comes along on road trips, camping trips and rafting trips where weight is less important.

Many companies make commercial kits and I have found the kits available from Adventure Medical Kits to work well as a place to start and add to.

In this First Aid kit, I keep extensive wound care supplies, topical antibiotic ointment, and suturing supplies available (not applicable to everyone’s kit, mind you). I have plenty of gauze dressings and adhesive bandages of several sizes. I also have an extra SAM splint and plenty of ACE wraps for fractures and sprains.

Medical supplies that can be very helpful include: plenty of protective gloves, a stethoscope, a thermometer, a pen and notepad, scissors, splinter forceps (one of my most used tools), cavit temporary tooth filling, and of course, duct tape.

This kit also includes several medications and may vary depending on the nature of the trip I’m taking or the personal medical history of my traveling companions.

The core of the kit medications include: ibuprofen and acetaminophen (both essential and available in kid friendly form to treat pain and fever), an EpiPen with Benadryl and prednisone taped to it, an antacid, a non-sedating antihistamine for allergies, an albuterol inhaler, a stool softener, a glycerine suppository, hydrocortisone cream, antibiotic ointment, aspirin, nitroglycerine, over the counter treatments for for diarrhea, nausea and vomiting, a narcotic pain medication, a muscle relaxer, and an oral glucose tablets for low blood sugar.

On a longer trip, a foreign trip or an excursion with a lot of people, I may add antibiotics as needed. These usually include antibiotics for skin, urinary, respiratory, and gastrointestinal tract infections.

One last note is that medications expire over time and this is especially true with EpiPens. Therefore it’s important to go through your kit at least once a year and to replace expired or used supplies.

Editor’s note: The Telluride Medical Center is the only 24-hour emergency facility within 65 miles. As a mountain town in a challenging, remote environment, a thriving medical center is vital to our community’s health. 

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