My Wilderness First-Aid Kit

The first aid kit that I carry into the wilderness probably looks different than most people would expect.  It is like one carried by a war fighter, being trained as a Navy Corpsman though that makes sense.  Working the outdoors, I have found that very few people carry first aid kits with them and those that do almost always do so as a reactionary measure-they personally have been hurt in the past.

Either they themselves have been hurt and needed aid provided to themselves, or they have been a part a rescue mission of others and seen firsthand the need for a few basic supplies.

Everyone else, the few that there are, are either Tackleberrys that like carrying equipment or have been through enough training or heard enough compelling testimony to see the need for first aid capabilities. 

I have the advantage of training and years of experience rendering aid.  That means the equipment that I might select could be different than someone who isn’t as experienced of trained.  Not knowing what to do with a piece of equipment would make carrying it pointless. Like any skill, the more practiced you are with something the more that you can do with less.

I like to carry multi use items, purpose-built items are limiting in their capabilities, they are often made to compensate for a training/skill deficiency.  These dressings and items are often good though in situations were a type of injury is commonly seen. And the weight and space can be justified. 

Other purpose-built items are worth it because the work so much better than home made items such as tourniquets and occlusive dressings.  If the risks of getting injuries treated with those devices is at present than they are usually worth being along. 

A rundown of my personal kit, where I am not functioning as the medic for a group is:

• Tourniquet
• Shears
• Rolled gauze
• Ace wrap 4’
• Duct tape
• NPA with lube packet
• Cravat (triangle bandage) with safety pins
• In a plastic one-quart freezer bag
• Space blanket
• Tweezers
• Gloves

Now this might seem like a lot of equipment, especially to the ultralight crowd.  There isn’t much that the ultralight crowd can be told though to motivate them to take safety measures and that is their prerogative.

I understand that several of these items can be improved from clothing, but I also know that hypothermia is an under rated threat to an injured individual.  I also know that these items will pack nicely in a quart freezer bag.  These items will take care of most treatable medical emergencies.  It isn’t set up well for “comfort” items like band aids and aspirin and moleskin.  I use duct tape for moleskin usually anyway. These items can be added to your kit as you see fit.  The same with nitro, epi-pens, inhalers, etc.  As specific situation is exactly that specific, so don’t place yourself in a box. 

I try to structure the equipment that I carry around realistic threats, distance to restock/more advanced kit, group size, and space/weight considerations.  If I’m fishing next to the car I need this equipment in my immediate possession than if I’m hiking back for two days with a group. 

I, for one, do not want to carry more than necessary. I have memories from Iraq of another corpsman running out of bandages after an ambush and needing to use one of my aid bags.  That stuck in my head, having enough equipment for the job; which can translate into me carrying more gear than is necessary, far too often.  I find that a quart sized aid kit in my backpack doesn’t take up too much unnecessary space.  And very little weight.  I don’t carry it ready for immediate deployment on a chest rig like I would in a law enforcement or military setting because it seems to me like the risk is that great. I could be wrong though. 

The tourniquet is a purpose-built piece of equipment, and I have seen arguments for its removal from the list.  I know that I can make a tourniquet out of the other items in the kit and cloth.  I also know that it is extremely difficult to spot the flow of blood with one purpose-built tourniquet and almost impossible with an improvised one.  So, I’m willing to carry the extra weight.

Shears are safer than knifes for cutting though there are techniques to get around this, but I like to be set for success, and I don’t know who will be using my kit to save me.  For trimming a bandage to size, cutting clothes off they are a handy tool to have.

Rolled size is one of the most useful pieces to have in a first aid kit in my opinion.  They are the most useful tool for packing an open bleed, wrapping a wound, pressure dressing, securing an impaled object.  The list of uses goes on, making a band aid with a small piece and duct tape.  Bleeds, wounds, splints, debriding a wound I use this item on most every injury.

The four-inch ace wrap coupled with the rolled gauze makes a great pressure dressing, sprains, and strains, are wrapped, splints can be secured, and if needed they can also be packed into a massive bleed.  This is an important component to all my kits.  I like this size because I find the two inch rolls a little size to really wrap an ankle and the six-inch size is a little ungainly.  The advantage of a larger size is that it can be cut to make two ace wraps or to be cut to size.

Duct tape, everyone is familiar with this tool, it works better than medical tape.  Mole skin doesn’t stay on your foot if you have more miles to cover, duct tape will last longer.  Sealing that plastic bag to occlude an open (sucking) sucking chest wound requires duct tape, medical tape has never worked in my experience.

A nasal pharyngeal airway NPA, is the most useful tool for keeping an airway open if someone is losing consciousness or are mental altered, especially if you must move them over the backcountry.  In my experience I have found them to be enough for almost all injuries, advanced airways are good options to have available for the medics, but an NPA is usually enough.  More advanced options can have more complications, steeper learning curves and the OPA, oral pharyngeal airway tends to come dislodged during movement and can cause as many issues as it tries to solve, avoid at all costs in the backcountry unless some one is on a board.  Plus, this can be applied to yourself and is the only airway option that I am familiar with that can do this.

The cravat, it’s more useful than for making a military bandana like platoon or Rambo.  It is the classic triangle bandage.  It can be used to make an improvised tourniquet, sling and swath, covering for a dressing, it can also be used to pack a wound like a roller gauze.  This is the one item that I will remove first if I’m trying to save weight, that’s if I have a purpose-built tourniquet available.

Believe it or not the plastic bag is useful as well.  Any penetrating wound to the chest can’t be packed but needs to be sealed with a plastic barrier and taped on all sides (some places recommend three sides creating a one-way valve, but that never sticks, I’ve never seen anyone make it work in practice, I haven’t been able to either) this is to block air from entering the plural space and collapsing the lungs.  It can also be used to tape over eviscerated bowls to prevent them from drying out.

Space blankets are important because hypothermia has happened to every trauma injury that I have worked on, no matter how hot it is outside. The middle of the summer in Iraq and they get cold once their level of consciousness changes.  The ability to stay warm is important to survivability.  It wasn’t stressed as much when I first went through training, but I (we ) noticed that as medicine has been perfected and having to wait or deal with extended evacuation times, that hypothermia is a major issue.  The short story here is that you should have a plan to deal with hypothermia.

Gloves throw a couple pairs in there, I put one inside the other to make pairs. 

I also like to bring tweezers along, they’re small and digging throngs out of the dog, kids, me makes everyone a lot happier.  The medical ones are garbage for this task, I would get some from the women’s health and beauty section of the store, they work so much better.

This is a basic kit, I keep more equipment in the truck, or bring more along to address more concerns if I plan on going deeper into back country or on a longer trip.  If I am packing for a tactical environment then the contents change slightly as there are people actively trying to put holes in my and others bodies, that is the subject of another article.

-Joe