The injuries and illnesses you are most likely to encounter dictate the contents of your hiking medical kit. While not fancy this kit will allow you to effectively treat a variety of issues on the trail. Note, I’ve never found a truly effective treatment for blisters once you have them, other than PREVENTION! Also, I used to carry a Sawyer Extractor but dropped it after reading several articles questioning their effectiveness.

Small spray bottle of rubbing alcohol for feet
3” Ace Wrap
3” Roll of Kling Gauze
X5 1” plasters (cloth)
X3 knuckle plasters (cloth)
X3 fingertip plasters (cloth)
X2 3” plasters (cloth)
Tube of antibiotic ointment
Tube of antifungal cream
X30 ibuprofen
X6 Imodium
X6 Stool softener
Splinter picker tweezers
1 roll of 1” cloth medical tape

While not necessarily part of a medical kit do not forget sunscreen and insect repellant.

Cheers,
W-W

Short answer - Carry less. Study what other thru hikers carried.

My FAK is on the right side of this photo (not in the packages) I'd modify it for longer hikes - More of the meds.

My hiking survival/ first aid items

cloth tape
1 pad
barrier mask
Tylenol
pepto tabs
chapstick ( spf 30)
alcohol swaps
2 sizes of band aids
the Blue splotch is barrier gloves

The whole thing is carried in a vinyl 5x8 envelope.

Think situationally - what could happen on your hike up the PCT. Aside from the usual - trots, sunburn, bugs etc (carry appropriate meds and precautions) -

First aid self-administered - blisters, twisted ankle, broken ankle, cuts, scratches. Wraps, duct tape, knuckle bandages, and I like a roll of waterproof tape besides. For blisters I recently used 2nd Skin for the first time, its really good stuff, worth the weight and replaces moleskin. Depending on how far your PCT sections are, carry enough to bandage yourself for that duration, resupply when you use your FAK.

First aid for others - you encounter another hiker, whose heart has stopped. CPR barrier? CPR is next to useless in a wilderness setting. Drop it. Activate your PLB to initiate a SAR body recovery, pitch camp, and pray for his spirit to join the great march to the heavens, which are all around him at that point. Help is coming then.

- you encounter another hiker who has taken a fall down the trail. Bleeding, unconscious, possible head trauma, but breathing. What do you need? More than a 4x4 and alcohol swabs, pack a roll or two of kerlix to wrap her wound(s), treat shock with warmth by putting them in a sleeping bag, etc, hit the button on your PLB and/or go or send for more help.

Are you worried about bee stings and allergic reactions ranging up to anaphalaxis ? I am, at least when I'm hiking with Scouts. I carry a primatene mist inhaler + benadryl to attempt to treat severe anaphalaxis, and any Scout with a confirmed allergy must carry an epipen or better yet a Twinject (two doses), their trail buddy must know where its packed, and how to use it.

And so on like that. Cover what you know you can treat, cover what you might conceivably expect. That should determine your FAK and weight if you ask me. Last I checked I'm currently sitting at ~23 oz for all hikes and outings.

NOLS (nols.edu) puts together some pretty good minimal FAKs and components, you can review and build your own, or buy from them. Everything is a bit of a compromise up a trail on a long hike, but I really like things like their green soap pads and their irrigation syringe (too small according to some, but for cleaning wounds on the trail it works). Steri-strips and the adhesive are the bees knees for gaping wounds, you have the training for those.

A gallon freezer bag really does work, should hold it all.

And in case you haven't got one yet, **don't forget a PLB for when the stuff hits the fan.** This doesn't count as your FAK weight. 10 oz of preparedness right there. If you can't justify the weight, think of all the other crap in your pack that cannot signal for you own or someone else's rescue within 24-36 hours, and toss some of that.

Oh boy, I love FAK threads...
You're worried about weight, yet you have individual blister paks of meds? Take them out and toss them into small baggies (you can "dime bag" size at a regular pharmacy - enough for 4-6 pills).

Ditch the SOAP notes. You're worried about documentation? Really? If you're that worried, write on the patient's forearm or something.

Biohazard bag? You plan on carrying around a full red bag once you've used it? Gauze burns. Blood dries.

I'd drop the purification tabs, simply b/c I've never had problems with a filter or boiling. Not that it saves much weight.

Bye bye CPR barrier. How long do you plan on the blow-blow, pump-pump? Until someone comes upon you, gets out to call a ranger, and they get in to find you? If you have a heart attack on the PCT, you've pretty much come to an end. Sorry, but at least it's a great place to die.

Why another flashlight? I assume you have one already.

Prednisone? Pray, tell. If you have asthma, OK I can see that. Otherwise, what are you trying to do with it?

Caffeine tabs? Again, why? Lighter than coffee or tea? Headaches?

I'd dump the bismuth (liquid) and stick with the pill-form antacids. More doses per weight. Drop the electrolyte tabs. Too much redundancy in the anti-histamine department (Benadryl, loratidine, pseudoephedrine/diphenhydramine). You pretty much just packed 3 antihistamines.

Keep the After-Bite. Add more. Trust me, I've done most of the PCT in California (not at the same time). I'd ditch the eye wash and use water if you need to rinse your eyes. Ditch the surgilube - again, why do you need it? I'd also ditch the benzyl-cholor pads. In fact, I'd probably ditch all of that section, except the Neosporin. Nothing soap and water wont' fix.

Ditch the paper tape, it won't stick well enough to stand the trail. The 3M "plastic" type tape works amazingly well (I've had it stay on for 2 days holding bandages on blisters while hiking) if you feel the need to carry something besides duct.

I'm not a fan of band-aids, but I suppose they're light.

Probably OK on the bandages. I'd fiddle with them to my taste, but you've got a decent variety. I might add another gauze roll though. Non-kerlix type.

HAVE A PHENOMENAL TRIP!!

Here are my cuts. I've done 500 miles of the AT and many more out west, and hiked with Glen van Peski, who's done more than 5,000 miles with a base pack weight under 10 pounds.

Ok Ok
Here's my 2 Cents.

DROP LIST

Most of the members have addressed the majority of the issues.
I agree fully with the multi use theory

Tape-stick with one

tools-think SAk/multitool

Extractor-bee/scorpion use is still a possiblity

iodine-stick with simple pads-no need for pads and sticks

Ivy anything-stay on the trail and out of the weeds

dressings-think simple, skip 2x2 and fold a 4x4, telfas are nice but are not life and death
-probably one simple vaseline gauze dsg. should suffice

no real need for sting pads......they are ok, but not that spectacular really (personal use verified)

antibiotics-zithro is quite broad spec. think of it as a simple first line med..........you could drop the cipro in theory, if you being tech. about it.......consider Flagyl for (Gi bugs)

steri strips-stick with one medium size

gauze/ace-sorta multi theory here as well......maybe 2-3" and one 3" ace??


-just a few thoughts from years on the trail/in the field and ED/CC and now OR

But Hey, I you wanna go PREPARED, who gives a crap-take as much gear as you feel like totin' !!

I see two types of kit here.

First aid, and long term or second aid.

The first aid is for keeping you from dying in the first few hours
of illness/accident.

The second aid is to enable your to keep functioning and in as
near a state of comfort as you wish to be.

A pure first aid kit could leave a lot of that stuff out.
Duct tape, telfa pads, and aspirin can get you a long way.

However, something like an eye infection or a poison oak rash over
much of your body can end your trip for comfort reasons. I like to
keep things in a resupply box that may not be needed the whole trip, adding them when the yellow jackets come out, or I will be
down low enough to get into poison oak etc.

My advise is not to trim to much. I went on a 92 day canoe trip and believe me a good first aid kit was well worth the weight. If you never require it the weight was always to much to carry. When you need it every bit of it is worth a bag of gold coins.

It's easy to say, "All you need to bring is ..." or "You can leave behind ..."

It's also easy to say, "Man I can't believe that guy didn't bring along ..." after reading a headline. Hindsight is always 20/20.

For the extractor, bring the Sawyer Extractor DR recommends here:

http://www.equipped.org/medical.htm#BitesStings

FWIW and YMMV.

All I am qualified to say. Carry on.

EDIT: Just adding some comments, not neccessarily replying to previous poster.

Bruce: I think there is a bit of a difference in carrying a big kit in your canoe and carrying on your back. I think a 2-lb is too much for backpacking especially if one can restock once a week. Something in the 4-6 oz might be all he needs. I don't agree though that one of the two hikers should carry the FAK. It should be split rationally so that both have at least a minimal use kit.

urbansurvivalist: There are a few things I would eliminate right off the top. Items should serve dual purposes when you are carrying everything on your back. Toss that white tape in favour of your duct tape in your survival supplies. Teabags can be obtained from your kitchen kit. Bring only as much moleskin as you need - prior experience should tell you if you actually use it, again duct tape can double for moleskin for some people. Trim the meds, bring only what you really find useful and that you respond to. Instruments? have you much experience with the equipment? CPR barrier - how well do you know your hiking partner, you may not really need it. What are you protecting yourself from? Venom extractor (even a Sawyer kit which is the best of them) can be deep sixed IMHO.
Separate LED light - should be part of your ordinary gear. Water purification tabs - don't your already have a main method of purifying your water.

In short, trim out the stuff you are already doubling up on with the rest of your kit. Reduce the quantities using your best judgment and then split the kit into 2 for you and your partner.

One thing you could do if you decide to carry a full kit - after your first week or two on the trail reevaluate your entire pack. You may find that you really don't need and/or haven't used a good deal of your kit and pare down. Mail the rest to a buddy or to yourself at home or to a General Delivery address further up your route so that you can grab it later.