I'm planning a thru-hike of the Pacific Crest Trail(2,650 miles from the mexican border to the canadian border), and trying to lighten my pack weight. I have no intention of going 'ultralight', since being prepared and being ultralight are pretty much mutually exclusive, but there is certainly room for me to lighten my load while still being prepared.
Right now I'm trying to lighten my first aid kit, which currently weighs 34oz, over 2 pounds! After my backpack, it's the single heaviest item on my gear list. I've already gone over everything in it and tried to remove the excessive items, but I would like some feedback from others. Just for comparison, the "first aid kit" that most thru-hikers bring consist of a tiny zip-lock with moleskin, a few band aids, and some Tylenol.

My goal is to be prepared for both major and minor medical situations, and have enough supplies so that I don't need to leave the trail or resupply early because I run out of materials to treat a non-severe injury.
My kit is built from scratch using the container from AMK 'weekender' kit. The bag itself is fairly heavy, and I think the easiest way to cut a few ounces is to replace it with a lighter, perhaps sil-nylon bag. However I love the organization of this bag- the layout and the clear plastic pockets are perfect for me. I haven't yet found a lightweight case with similar organization, and I would appreciate any suggestions.

The first thing I would like to do is get a lighter case if I can find a suitable one, then work on trimming down the contents a bit. I'm also seriously considering skipping the First Aid book(5oz). It's a great book and in important item, but it's heavy and I'm pretty skilled in first aid(I've had EMT and recent WFR training).

edit: I've posted some pics, but I can't figure out how to attach the inventory file(pdf). I used the file manager, but its not showing up, can someone tell me how to post the file?

If it's a pdf, you should be able to copy and paste it.

It's tough to make suggestions without knowing what's on the list, but off the top of my head I'd find the longest part of the trip in which there is no potential to resupply. I'd pick the halfway point in that part and try to determine how long it would take me to get to civilization if something went wrong or rather how long I think it would take in different scenarios.

That's just off the top of my head though. I'll be interested to see what's in your FAK now, and what you end up with.

About 25 years back I rode part of the PCT in a group with several pack mules along. I probably wouldn't skimp on First Aid supplies as you are a long way from help if something goes wrong and it's pretty rough country as well.

Here's the inventory, copied and pasted. The original document is laid out in a more compact and organized way:

Dressings & Bandages
1 - 5x9 combine dressing
4 - 4x4 gauze pads
2 - 2x2 gauze pads
2 - 4x4 non-stick gauze dressing
1 - 3x4 non-stick dressing
1 - 3x9 petrolatum gauze
1 - 1x8 Xeroform petrolatum dressing
1 - Spyroflex dressing
1 - 2nd skin burn dressing
1 - large sheet moleskin
1 – package molefoam

1 - 2"gauze roll
2 - 3" gauze roll
1 - 3" elastic bandage
1 – 3½" roll vet wrap

2 - fingertip band aids
5 - knuckle band aids
5 - foam band aids
5 - fabric band aids
2 - waterproof band aids
2 – Medipore pads(gauze band aid)

1 - Steri-Strips ½"x4" 6ea
1 - closure strips ¼"x4" 10ea
2 - benzoin tincture swabs3

1 - flat roll 1" cloth, ½" paper tape
1 - roll duct tape

Topical Meds
6 - benzalkonium chloride wipes
3 - povidone-iodine pads
1 - povidone-iodine swabsticks
6 - alcohol pads
5 - triple antibiotic ointment


6 - lidocaine/BZK/aloe wipes
3 – burn cream w/ lidocaine
1 - benzocaine sting relief pads
2 - After Bite ammonia pads
4 - hydrocortisone cream
2 - Ivy-X ivy cleansing wipes
2 - Ivarest lotion (calamine/benadryl)
2 - blistex
1 - moisturizing lotion
1 - surgilube
2 - celluvisc eye drops
1 - eye wash

1 - Temparin dental filling material2
1 - tea bag (for oral wounds)
1 - Quik-Clot hemostatic agent1


Meds (expiration)
6 - ibuprofen 200mg 2ea (11/07)
1 - aspirin 325mg 2ea (11/09)
1 - acetominophen 325mg 2ea (3/09)
5 - electrolyte tabs 2ea (1/07)
2 - antacid tablets 2ea (3/08)
6 - bismuth subsalicylate (2/06)
6 - diphenhydramine 25mg (3/08)
2 - loretadine 10 mg (11/08)
4 - loperamide HCL 2mg (1/05)
2 - pseudoephedrine 60/diphen 25(11/07)
6 - Milk Thistle extract(2/10)
6 - caffeine 200mg (5/05)
1 - Sugar packet

6 – azithromycin 250mg (5/2010)
10 – ciprofloxacin 500mg (12/09)
11 – Prednisone 10 mg(9/2010)
7 – acetominaphen 300mg/codeine 30mg


Instruments
Trauma shears
forceps
Sterile needle
irrigation syringe
CPR barrier
Venom extractor

Misc
L.E.D. light
magnifying lens
6 - H20 purification tabs
2 - sterile bags
1 - red biohazard bag
4 - safety pins

First Aid Manual
2 - SOAP Notes



P.S. I know many of my meds are expired, no need to remind me of that


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I'm no expert but that sounds like pretty good advice to me.

I seem to recall the UL FAK is duct tape, some cotton and 4 bandaids... and some people leave out the bandaids.

I think your kit is well provisioned for a worst case scenario. But to be realistic, you can drop some of the meds, some of the specialty bandaids (make do with the ones you keep),the eyewash kit (use water), most of the OTC stuff and all of the "serious burn" items and still be fairly well equipped. I would imagine parts of the trail are close enough to some towns to get resupplied if need be. I will profess a lack of knowledge about this trail (East Coaster) but can't imagine you will be out of cell phone range if something serious happens.

Also, will you be going with someone or solo? You can always break the kit in half and each take some of everything.

Consider using heavy duty ziplocks to relace the case. Perhasp sandwhich bags for the different compenents and then a nylon ditty bag to hold the smaller bags. Not as nicely organized but a lot lighter. I would also organize smeallables in separate bags that can go in your bear container/bag easily.

For your container, consider sewing up a light weight bag yourself, copying the features you like.

Go over your contents very carefully and thoughtfully; you are definitely carrying more than is necessary (Spiroflex and 2nd skin?), but you can make the best decisions, since you know your training and skills.

You might consider slimming down the kit when you are in the more "populous" portions of the trail, as opposed to the wilderness stretches. I doubt you need the book - a crib sheet with a few notes should work quite well and I am not sure that even that is necessary.

Improvisation should be your watchword.

Here's my personal opinion of what you can do without, based on my decades of long distance solo backpacking and paramedic experience, by way of editing your list:

Fancy FAK cases and bags are nice, but a ziplock or aloksak bag offers major weight savings.

Consider dual use items: a SAK with scissors and tweezers substitutes for trauma shears and forceps, a foam pad for splints and c-collars, bandanna for triangle bandage, etc.

An ace wrap or duct tape works just as well as roller gauze and medical tape.

Replace some of the larger dressings with a Cederroth Bloodstopper or a military battle dressing.

A baggie with water and an iodine swab, and a pinprick hole, when squeezed irrigates as well as syringe.

You get the idea.

The areas you will be traveling in aren't that wild, harsh or remote. If you are on trail and need help, someone will probably amble by in a day or two, or within hours on the more popular sections.

Good luck and have fun!

1 - 5x9 combine dressing
4 - 4x4 gauze pads
2 - 4x4 non-stick gauze dressing
1 - 3x9 petrolatum gauze
1 - Spyroflex dressing
1 - 2nd skin burn dressing
1 - large sheet moleskin
1 - 3" elastic bandage
1 - 3½" roll vet wrap
2 - fingertip band aids
5 - knuckle band aids
5 - fabric band aids
2 - waterproof band aids
1 - Steri-Strips ½"x4" 6ea
1 - closure strips ¼"x4" 10ea
2 - benzoin tincture swabs3
1 - roll duct tape
3 - povidone-iodine pads
5 - triple antibiotic ointmen
4 - hydrocortisone cream
1 - Temparin dental filling material2
1 - tea bag (for oral wounds)
1 - Quik-Clot hemostatic agent1
6 - ibuprofen 200mg 2ea (11/07)
1 - aspirin 325mg 2ea (11/09
2 - antacid tablets 2ea (3/08)
6 - diphenhydramine 25mg (3/08)
10- ciprofloxacin 500mg (12/09)
11- Prednisone 10 mg(9/2010)
7 - acetominaphen 300mg/codeine 30mg
4 - safety pins

Urban, the inventory list showed up as a download on my computer next to the 2nd pic. sounds like you have everything, and organized (not me!!)