Hi All
For the summer I will be working as a canoe guide in northern Manitoba (canada). I will be leading trips ranging from 6 to 11 days. Most of the time the only access will be by plane but we are equipped with sat phones for emergencies, ranging beyond our knowledge.

This kit here is my PERSONAL kit, the group will use the group kit. I am a avid canoer who has lots of back country millage. My training includes standard First aid CPR level C. I have read two wilderness medicine books and i plan on revising them again.

I am looking for feedback, on 1) making the kit smaller (i have a hard time zipping the pack)
2)Stuff thats missing
3) anything else you can tell me
Thanks

Here are some pics of the kit spread out and packed up.

http://www.flickr.com/photos/26465100@N04/?saved=1

Here is a list of the contents

First aid kit

Bandage

1 Triangular
1 self cling 5 yard bandage
3 X 2” 5yard gauze roll
assorted size and shape bandaids
12 assorted size gauze pads
2 pressure bandages for serious wounds
2 rolls athletic tape
1 roll medical cloth tape
duct tape
Elastic tension reusable bandage
Moleskin
3M steri strip (stuture)
Alcohol prep pads

Tools

Scissors
Nail clipper
Thermometer
EMR Sheers
Safety pins
Scalpel and blades
Space blanket
Pen
Sharpie

Other
2 pair gloves
1 barrier device CPR
Book Wilderness and Travel Medecine by Eric Weiss
Matches
Small travel tube toothpaste

Meds
1 dose Clarithromycin (mild antibiotic)
1 dose Ciproloaxcine ( stronger antibiotic)
2 epipens
1 dose Celecoxip (prescription pain killer)
Tylenol extrastrenght
Peptol bismol tablets
Baby asprin (blood thinner)
Tincture of iodine (disinfectant small wounds)
Tooth ache gel
Benadryl tablets
Flu meds (antihistamine)
Purell
Flamazine (silver sulfadizine cream for bruns)
Bactroban ( mupirocin ointment 2%)
Polysporin
Nasonex (saline spray for sinus infections)
Vasoline
Baby powder
Water sterilising tablets

Good thoughts - here's mine

Add a 12 or 24 pack of OTC antihistamine for adverse reactions

drop triangular bandage and replace with a tee shirt or a tyvek one

drop scissors - shears will handle same duties

replace matcher with mini-bic

Related - where do you carry your edc/ fak?


Teacher

PS toothpaste??

I think it looks good. Might add more gloves and tweezers.

Nasonex ain't saline, it's Momethasonefuroate, which is a prescription corticosteroid.

And TeacherRO:



May I ask why?

a few tips.

-think carefully through your Rx meds.........be safe from lawsuits

-simple OTC meds can cover most people's needs

-flamazine?-i would pass on in favor of bacitracin, less risk of allergic complications (from sulfa)-=use this for cuts scrapes and burns

-why baby powder-if dryness is a problem, Goldbond is better, and or plain cornstarch powder

-black tea bags can help with a tooth ache
-you noted 1 dose of 2 antibiotics, well that is a start, but again careful with dispensing any Rx that isnt prescribed for that person, and one dose in any form is useless for the most part
-bulk up more on bulky dressings and gloves
-thermometer give or take..........
-
-add a SAM splint
-one pair of scissors is plenty
-for multiuse and space limitations, consider coflex bandage and back off the multi rolls of tape
-instead of various sizes of anything..stick with 4x4 and fold or cut to shape,
-maybe swap iodine and alcohol for one bottle of betadine
-pick one simple size bandaid
--add tube of crazy glue (multiple uses!)


-anyway this is just a start............hope this helps

Jim,

I defer to your training and judgement -- my reasoning in that a large triangular bandage is a space waster - and assume the group kit has one.

Teacher

It might be duplication, but the group has their kit and Vader wants his own; it may as well be complete.

I like figtree's idea of going with all 4x4's and sticking with OTC meds. Other than that it looks good to me, a SAM splint would add require a lot more space. With your training, you are in the best position to know the most likely hazards and requirements for this kit.

I don't see the point in sticking with OTC meds if this is his personal kit and he has the medication for himself. Am I missing something? Also, anyone who thinks any over the counter pain med is strong enough in a REAL accident has not been in one (and that's good). Just my 02 on the matter

Hi Guys

Thanks for the help I appreciate it. The kit is for my personal use only so I will keep the Rx medicine.

Also are two epipens and over kill? I'm debating because outthere a plane might only show up in a couple hours but your reaction is there now...

Ok i will remove the triangular it is big. I will also consider the 4x4'

Baby powder is going out. Yup is was mostly for keeping fit dry/preventing trench foot.

Also thanks fr correcting me on nasonex i wanted to say saline nasal mist (0.9% sodium chloride solution) my mistake.

THanks for the help I really appreciate it:)
vader

The problem with other than OTC meds is that they are for someone who's name is on the bottle. Sure, if you have a medical condition, your prescription drugs should have a place in a personal FAK, but I'd check the legality of carrying prescription pain medication in place of OTC Motrin. $.02, what's legal?

"...Also are two epipens and over kill?..."

I would have to say no, two is not overkill. I carry two, and neither my wife nor I have ever had an alergic reaction. I have seen people with a severe reaction though, and I don't ever want to go there. They are pretty small, and don't weigh much, so go for it...

Russ - This is his personal kit... he's not handing them out to other ppl.

Which means to me that if doesn't have a prescription for pain meds it would be best to stick with OTC (Motrin, Aspirin and Tylenol).

Sorry, he never stated where he was getting them from I just `assumed` they were `scripts in his name.

My thoughts:

Bandages
More 4x4s, less roll gauze
knuckle and fingertip bandaids
less tape, lose the cloth tape, keep athletic tape
add Sensi-Wrap Self-Adherent Bandages or similar (like sticky ace wraps)
? Blisto-ban

Tools
Add Uncle Bill's Sliver Grippers

Other
Drop matches, add Bic (? Mini-Bic)
? toothbrush (have toothpaste)

Meds
Celecoxip (RX, but not considered controlled in US - less hassle if questioned)
Bactroban or Polysporin, not both
? temp filling kit

How long is this kit to provide for? A single dose of the antibiotics may cause more harm than good unless a pharmacy is less than a day away.

I don’t see the prescription meds for personal use as an issue for personal use. The prescription med police are not going to come out and dig through your pack. If you are the only one using them the others in your party may never find out unless you tell them. And antibiotics and real pain killers work where OTC pain meds do almost nothing.

I was in a motorcycle accident years ago and have lived with the pain every day, and I would have to take a whole bottle of aspirin pills to do what 2 real pain pills do.

The real pills could make the difference in allowing you to do what you need to do. And a few antibiotics could easily fight off an infection from a nasty cut before it becomes a real problem.

Hey Vader! Greetings from Saskatchewan.

I don't know if they company you are going to work for requires it but the general standard for assistant guides is a 40-hr Wilderness First Aid course. For lead guides the standard is an 80-hr Wilderness First Responder course. The standard FA course (16-20 hr) doesn't go into enough detail and is geared for the urban environment. I learned TONS (TONNES?) last year while on my WFR course mostly because we dealt with well over a hundred medical and trauma scenarios. Being able to think a bit sideways (the gut pain in your female patient might not be an appendix but rather a tubal pregnancy she didn't know about!) Wilderness is defined as being more than 2 hrs from advanced medical care.

Once you've taken an advanced FA course, you will have a good handle on the type of first aid kit should be in carried for the group and what type you may wish to carry on your person. As far as the meds go - make sure you check with your prescribing physician and legal counsel that you can issue to anyone else but yourself. It may be OK for yourself but unless you really know how to diagnose other's medical needs, then giving drugs to others has some real legal issues.

CANOES !!--yes--yes!!..when i think about that part of
Canada and add a canoe to it i come up with hypothermia..
i would add lots of matches and firelighters and space
blankets--for all the canoe tripping i have done i have
never seen any medical problems that needed more than a
band-aid or asprin..if someone is so sick they need more
i would fly them out asap..

2 epipens overkill? No, unless your trip out by helicopter is very quick. Suppose the benadryl dosage taken after doesn't help soon enough with the airways then 3 or even 4 doses would be required during an EVAC. BTW, on my course we were shown how to get that extra dose out of an existing used epipen by doing some minor surgery on the pen itself. And if these pens are for personal use then make sure you carry ON YOUR PERSON and your other guide(s) have a spare one or two in the group kit. If somebody has to make a 300 yd dash back to where you last left your pack and your epipens, then you might be in trouble.

+1 on the WFA course, even the shorter 20 hour (weekend / recert) course is good for focussing your FAK and treatment. I think you've got a good kit, as long as you think through your other gear and anticipate splinting a broken arm or leg - for that, having *several* triangle bandages available to tie and immobilize the limb can be good, otherwise you get to wave bye bye to the helicopter as it makes off with your patient and splint (probably a thermarest pad) and all your canoe ties.

In our course we found that the SAM splint was not as useful except for arm splints. And while I pack a thermometer too, I have yet to use it to diagnose anyone. They're either hot or cold and pretty obvious at that. ymmv

Also on the epipens and bee stings, consider the liquid or quick dissolving strips of benadryl now available. You will need two epipens, and the window of opportunity to administer benadryl between them could be short. Hopefully they can chew - just in case, pack some liquid benadryl ampules that you can open down their throat. On the epipens, our NOLS WMI instructor said they carry ampules of the medicine separate from the injector, so they have a bunch of medicine without the cost ($75 each) of the epipen. Your company can call and ask NOLS about that, and see if your referring doctor can set you up. But it all comes back to medical training...

When I carried Epi-Pens, 2 of them, it said that if there was not an improvement in the symptoms after 5 or 15 minutes (can't remember) then the second pen should be administered. As a side this is similar to chemical warfare dosing protocols. All that said...two is the minimum to carry.

I would suggest reading "Wilderness Medicine, Beyond First Aid" by Dr. William W. Fogery, if you haven't already. It's excellent - in fact I have the lead review up on amazon for "Wilderness Medicine."

As it's your personal kit - meds wise, carry what YOU use

I'll second "why scissors and shears" BUT will also say, make sure the group kit has backup

"two is one, one is none"

My "Backup" scissors in most cases is the small pair on my leatherman

I ASSUME you'll be carrying a multitool

Get rid of some of that tape, Duct and paper med. tape will do it all.
IMO dump the asst pads and carry the roll gauze.
Kotex pads make a great bandage.
Why take baby asprin when you can take regular asprin, just cut them.
A few more gloves would be nice.
A small light for your 1st aid kit.
Possilily something to flush crap out of someones eye?
Mag. lense.
needles for slivers.

Paper tape (micropor) is very, very bad tape for a FAK. It just won't stick to anything, especially in a wet enviroment (canoe guide). You can never have enough tape.

The gauze rolls aren't really used directly on a wound unless it's a very large injury, because they stick to a wound so it's very painful to remove it.

Normally you have a gauze pad that's on the wound which is fixated using a gauze roll or tape.

Ow, and kotex pads make reasonable improvised bandages, but since he already listed 2 pressure-dressings I think kotex a bit redundant (unless he also wants to use them if there are females in the group).

HI Gang
THank you for the replies I did post a similar thread somewhere else but did not get as much input as here!!! THis is great

THe advanced first aid course is an excellent idea, I amm actually speaking to my supervisors about it. But I will definetly have the 80 hours course for next season. (its nice to see some canadians on the forum too!!)

Also good call on the liquid tablets for benadryl they will be going in!

On an other note what is your input on trench foot (there seems to be a lot of stuff out there not to sure what is right).

Vader

Yeah well, a lot of people are registered to both ETS and Zombie Squad.

from what i understand to get real trench foot you need to
be in cold water not moving around much for a long time.
as in a filthy fox hole--canoeing around for sport you should
be able to care for your feet every nite..what some people
think as trench foot is just city feet in wet boots getting
blisters.

...Also, I'd pack all this in a pelican case or similar. Canoe trips get wet and wet FAK gear is pretty awful.