how do I choose the right first aid kit?

let's assume I want 5 days trek, 3 person kit. The kit must have bandages for large wounds.

The right first aid kit for you depends upon your training and experience. Get training first and you will have the answer to your question. Generally, your first aid kit should contain those things that are hard to improvise (sterile dressings) and will be light on those items that can easily be improvised (splints). Much will depend upon the specifics of your circumstances and the environment.

At a minimum, obtain American Red Cross Advanced First Aid. Even better is W-EMT or similar, but training is the first essential.

I agree with hikermor. Also, your kit will differ based on how far you are from help. A kit for stabilizing serious injuries when you're 15 minutes from help is very different than one where you're 15 days from help.

Agreed. A kit is far secondary to training ( and a refresher course.) And much depends on who goes, when ( season) and terrain.

You could start with on off the shelf kit like AMKs .9 Ultralight and then customize to your needs and to that of your companions. I just posted my own FAK in another thread and my emphasis is on tayloring to suit my needs.

Kits are one thing, training is another. "The more you know, the less you carry." - Mors Kochanski. I have some Wilderness First Responder training but unfortunately I haven't renewed. I will probably just get WFA cert. for my next go around. With training AND experience, you will know what makes the best kit for your own needs and activities. But if you or your companions don't have FA training then a small simple off-the shelf kit is your best bet. Carrying something you don't know how to use is just dead weight.

I already had first aid training.

Some manufacturers organize their kits by the number in a party and the length of the trek. The Weekender is advertised for a group up to six people and trip duration of seven days. This has material for a large wound, like you asked, including material to clean and close it: povidone iodine, 20cc irrigation syringe and wound closure strips.

Some of the features I like about this one is it has 3" x 4" non adherent dressing as apposed to 2" x 3", EMT Shears and 1" tape as 1" tape is easier to work with than ½ tape.

I have no affiliation. I have bought a number of their products over the years.

Jeanette Isabelle

you might look at Chinook Medical (no affiliation)... that's where I got my trauma supplies for my range kit

Most commercial kits are good, but take into consideration your situation, training, location and group size.

...And don't forget to store it in a water-proof way..even a ziplock is good

The Boy Scouts of America have been camping outdoors for a LOT of years. Here are the two current recommendations for first aid kit contents:

Personal First Aid Kit - carried by an individual
6 adhesive bandages
2 sterile 3"x3" gauze pads
1 small roll of adhesive tape
1 3"x6" piece of moleskin
1 small bar of soap or small bottle of alcohol-based hand sanitizing gel
1 small tube of triple antibiotic ointment
1 pair of scissors
1 pair of disposable nonlatex gloves
1 CPR breathing barrier
1 pencil and paper

Patrol/Troop First Aid Kit - carried by a small group
1 2" roller bandage
2 1" roller bandages
1 roll of 1" adhesive tape
24 alcohol swaps
1 box of assorted adhesive bandages
2 3"-wide elastic bandages
12 sterile 3"x3" gauze pads
4 3"x6" pieces of moleskin
2 packets of gel pads for blisters and burns
1 tube of triple antibiotic ointment
4 triangular bandages (40"x28")
1 small bar of soap or small bottle of alcohol-based hand sanitizing gel
Scissors
Tweezers
12 safety pins
1 splint
6 pairs of nonlatex disposable gloves
Protective goggles/safety glasses
CPR breathing barrier
Pencil and paper

Again, I tend to think of several small kids; EDC, bigger for backpacking, and a full box for home & car. The key is knowledge and training, tho. get a book, an app and take a class.

what they are telling you sounds frustrating - but it's right. the only thing that matters is what you can do with the first-aid gear. Otherwise having it there is of little use. So it boils down to training and experience. you can pack your own from any local pharmacy - if ou know what you want.

your best bet is to get a few basic items and don't go overboard for your first trip. chances are that you won't see much more than a sprained ankle and some sunburn - or chapped lips (OK maybe not sunburn at this time of year). you need to start taking some first-aid classes. skip the Red Cross classes ... they don't teach the real stuff any more.

good luck,
Pete2

I carry two small kits, one for trauma that is always on me, and one for the booboos that are more common but not an emergency. You can get away with a small trauma kit if everyone with you carries one with the most important stuff. You do need to take care of the minor cuts and scrapes, but they are not life threatening and can wait a few minutes. The trauma kit is accessible in seconds and always on me, in fact it has become part of my EDC.

Pete is absolutely right - you probably won't have to deal with anything beyond blisters, scratches, and sunburn - routine problems that are easily solved by a few bandaids. Sprained ankles do happen, and unfortunately demobilize the victim. It is also true that you can't usually differentiate between a sprained and a broken ankle in the field, so basically you treat them all the same.

At this point, your planning will pay off. The question isn't just about your FAK - that neat little bundle of goodies you have assembled, but your entire response to an injury that keeps one or more of your party from walking out. Essentially everything at your disposal becomes potential items for treatment- Improvisation is all important.

What would you use for a splint? Usually very fine splints can be improvised (We once did a great cervical collar with a piece of blue foam pad and duct tape). Aluminum pack stays can be pressed into service - on some of my packs I have actually drilled holes at the ends to facilitate their use for this. You need to look over your entire kit and think how you would improvise various items.

Most discussions of injuries always admonish you to treat for shock. This is fairly easy in an urban setting, but can be tricky out in the woods. There will be a delay of at least a few hours, if not a day or so, before your casualty can be transported. Can you keep this person stable for that period? You may need to basically set up camp right there. Can you do that? How will you feed everyone if that is necessary?

Basically you need to plan before hand as to how you will deal with a major injury. Different groups in different kinds of terrain will adopt widely varying strategies, but you should consider everything from immediate patient survey and treatment, to notification and requests for outside assistance, to eventual recovery of the victim. Prior planning prevents poor performance.

Yes and no. I could carry more now that I know more/have higher medical authority. But, I don't - mainly for practical reasons. No point carrying intubation gear if I don't plan on putting someone on a ventilator, right?

Sometimes, the more you know, the less you should carry.

Pick basic stuff. Blisters, minor bleeding (I gaurantee you'll get more use out of bandaids than trauma pads), some 4x4's, some tape, some neosporin. If you feel like an ACE wrap and a trauma bandage, fine. Otherwise, I'd leave 80% of most kits at home.

If someone stops breathing 20 miles from the trailhead, you're SOL. If you want to try CPR for a while, fine, but that person likely won't be walking out of there. Burns don't need burn dressings, just clean dressings. Bandages can be left in place while you evac someone if it's a decent bleed/laceration/burn/etc. Some cord and a few sticks makes a decent splint; a solid branch a passable crutch.

I carry a AMK 0.9 or some little thing. I threw in 1 ACE, 1 trauma bandage, and a pair of scissors. I've rarely used anything but neosporin or bandaids. If something bad happens, I'll be improving.

It all depends. CPR for example - CPR on a coronary 15 miles up the trails is a losing cause; CPR on a hiker struck by lightning however will save his life more often than not. So don't throw that arrow out of your quiver.

I carry about a pound and a half of dedicated first aid supplies, based on what I need in the event a Scout goes down - I can't in good conscience treat them with an AMK 0.9 and band aids. Its the first aid supplies that I also carry that are improvised from my hiking gear that can make the difference long term - the neck collar traced on my blue pad, ready to cut out and wrap around his neck to help immobilize his spine; the rest of the blue rest pad to use to pad his arm or leg fracture; clothing to cushion splints; my hiking poles for splint materials; warmth, warmth, warmth, to stave off the effects of shock. That sort of thing. Add it all up, you can and should carry a lot more than whatever fits in your little bag with the first aid cross on it.

It depends on what you know, or what you're ready to treat.

I've always made my own kits. But then, I was an ambulance paramedic for many many years (expired/retired now).

You can save money by not buying tons of sterile dressings. A few sterile 4x4's backed up with some sealed packages (but not sterile) 4x4's can save some money. Back in the days when I worked on an ambulance, we had Kling and Kerlix for bandaging materials (everybody hated the Kling, but it was much cheaper than Kerlix). Now-a-days there's this neat stuff called Coban. You will go broke trying to buy much of that stuff from a pharmacy. Buy it from an online horse supply store instead. 1/4 the price for the same stuff, and it comes in more cool colors and sizes for horses! And those individual packs of Tylenol or Advil doses that come in pre-made first aid kits are expensive. I just use a very small bottle and stuff it with my own Tylenol and Advil (and Benedril and Sudafed, etc.) You're not supposed to mix meds together in the same bottle - I always told my patients that - but of course I do it myself. The day I can't tell a Tylenol from an Advil from a Sudafed by looking at them is the day I shouldn't be wandering out into the wilderness anymore either.

Seeing this thread made me go and restock my home kit/medical supplies. Much of it was outdated (including a bottle of hydrogen peroxide that had turned back into water, haha). $100 later and I'm restocked.

Not to mention, I cleaned out my bathroom, so now I can easily find everything (regardless of whether it's in the kit or not).

The only thing I have to do is talk to my doctor about getting a script for an EpiPen. I don't really need it for anything in particular, but having seen someone go through Anaphylaxis years ago I would feel a lot better having one available to me.

i did not read thru all of the posts about this but my answer,which is like some others i would guess,is not but a kit but make your own.
on my first wilderness canoe trips i had everything,and i mean everything.big skin scrub pads,suture stapler,wads of 4x4's and even larger,enough band aids for a Scout troop..so on.the kit in two zip locks and a plastic lock box was at least 4 by 8 inches and heavy.i carried the silly thing in my pack where of course it would be safe and hard to get too!!
now i just have Quick Clot and a Army wound bandage in my day bag where i can get it fast.a couple band aids,Neosporin and eye wash are in the day bags mesh outside-top pouch.in the pack i have meds that have been talked about here and some back up small items that i may use up like band aids.
working in a hospital i did pick up some ideas one of which was rather than try and sew up a wound put a 4x4 over it and warp up in a elastic bandage,now you would use those self stick wraps,and get to a hospital.at the hospital they wanted to move the wounded person out of the ER to a ward where the work would be done.
first aid is very tricky and outside of taking a known pain med or stopping bleeding i would not try anything as it might make things worst---think about trying to splint a busted bone only to move it and have a bone splinter cut a artery!!!

"think about trying to splint a busted bone only to move it and have a bone splinter cut a artery!!!"
This is why you splint a broken limb in the position you find it.
Don't move it any more than you must to get the splint on.

Severly deforemed and angulated fractures often pinch off blood vessels, compromising circulation to the limb distal to the fracture. What is generally taught these days in WFR and WFA classes is to attempt to use very gentle traction to move the broken limb into (more or less) normal anatomical position, prior to splinting. This is generally more comfortable for the patient and has better outcomes, particularly if transport to a hospital is delayed. However, if you meet resistance when you try to traction into position, or the movement causes extreme pain, then splint in the position found.

Splints should immobilize the joint above and below the fracture. For example, for a broken forearm, you might want to use a SAM splint to imobilize the the wrist and forearm, then support the splint with a "sling and swathe" to also immobilize the elbow. Splints should be well padded and easy to adjust to account for swelling. Check CSM (circulation, sensation, and movement) distal to the fracture both before and after splinting. Frequently check CSM distal to the injury, since swelling can cut off circulation after splinting. If over time you find CSM is becoming compromised, then you need to adjust the splint to maintain circulation.

Sorry, I had to get rid of the wall o' text.

In theory, I agree - lightening and cold water drownings sometimes do come back. But overall, nearly pointless. Like I said, even if you get them around, it's going to be a PITA to get them out of the back country.

If I was responsible for a bunch of scouts, I might take more. Or more likely, break the kit into modules that I spread around and make part of the troop-level equipment.

Like others say, a class, and make your own. Then carry it around for a bunch of hikes and see what you see.

A few things I've added to my commercial kits:
Exam gloves
Tiny fauxton type lights
SPF chapstick
folding knife - small, but locking

I am of the opinion that most purchased first aid kits are gimmicks. Figure out what you use as far as first aid stuff goes and buy some of that. Add some things you rarely if ever use like some blood stopping pads.

My personal favorite for stopping bleeding is either a hanky or a towel of some sort. You probably already carry one in your pack for the more common uses so no need to add extra crap. I have a clean hanky and a pack towel in a baggy in both my fanny pack and my day pack.

Duct tape or electrical tape works every bit as good as white adhesive tape. I have some of both wrapped around a pill bottle that I keep my fire kit in.

I am not a fan of carrying stuff that one may not even know how to use effectively.

Irrigating a wound does not require anything other than a water bottle that you already have.

IMO, sterility on the first aid products is highly overrated. The environment you are in is not sterile so while clean is a good idea, sterile bandages probably don't serve a necessary purpose.

A volunteer fireman I know who is an EMT and has been one almost as long as IL has had them told me a few years ago he had never personally seen anyone come back with CPR and no one else on his small department had either. AEDs do work well though if you can get it done very quickly. Usually you only have a few minutes where they are going to do much good. But they are just too heavy to cart around.

The reaility is that most people cannot sustain CPR for more than a few minutes anyway. It is just physically too taxing to the rescuer.

This is something that is not emphasized in most CPR classes. My CERT trainer, a highly experienced fire captain, said he had witnessed seven truly successful recoveries - the patient eventually walked out of the hospital - spread over 300 incidents. Personally, I am 0 for 2, but I am glad I have the capability to render aid. CPR is way ahead of back pressure- arm lift, its predecessor in emergency resuscitation.

Personally I'm 2 for 3, so perhaps more optimistic than most. But personal stats are meaningless. WFR told us to try CPR resuscitation on lightning victims, so yes, I'm going to max out on trying to bring them back if ever I encounter a lightning victim. Also I would put the entire CPR effort into context. I performed CPR on my wife - no issues with that, that was one of my success stories. I hang out with Scouts, I hike with them, counsel their merit badges, counsel their eagle projects, watch them grow up, know their parents - there is nothing that could keep me - short of two broken arms - from a vigorous if fruitless effort to rally all available scouts to save the life of one of our friends lying in front of us. Damned if I'm going to quote the known survival rate to a grieving parent and abandon hope before even beginning.

Statisically speaking the specific experiences of highly experienced FD folks may or may not map to actual survivability across very large populations, or even to very specific contexts like lightning strikes. I think that's where WFA / NOLS advice comes from about lightning victims, in the wilderness context, and not in urban or rural survival rates. As I understand the fire rescue stats, AEDs have really given survival a bump in the stats, and for good reason; and CPR education and training have helped too, in urban-suburban contexts where the EMTs are arriving within minutes and not 20-30 minutes after. And the focus on compression only resuscitation may also give an overall bump, if only because it restores a bit more circulation while shorting the patient on oxygen a bit, as long as EMTs arrive with their panopoly of drugs. Those drugs give the patient the best odds.

ETS is an incredible source of information. Never ceases to amaze..... BTW, what was the success rate?

First responders are generally at a disadvantage from the get-go because some time has already passed between when a cardiac arrest happens and when they show up and begin CPR. Every second counts.

However, a large prospective observational study published in 2010 by the folks in Phoenix who were among the vanguard of advocating compression-only CPR observed that among adult cardiac arrest victims outside of a medical setting who had a layperson perform CPR (traditional and compression-only) survived to hospital discharge 7.8% and 13.3% of the time, respectively. Unfortunately, out of the 4,400 cardiac arrest victims they tracked over 5 years, 2,900 victims did not get any CPR at all (at least by lay bystanders).

We might presume that there could've been another 200-300 "saves" over that time if all of them had received CPR of some sort.

Edit: actually, on second thought, that's an overestimation. About 5% of victims who did not get any CPR survived to hospital discharge so more bystander CPR would not save that many. So maybe half of my original estimate that with compression-only CPR. Still, if that saves someone you love, even one more save is significant.

Do something beats do nothing.

Can argue stats all day long,just like caliber.

What matters IMO is there are people successfully revived walking among us so I say do it.

Might get lucky with CPR,without it you wont for sure.

When it comes to CPR, I've been trained and really don't care what the stats say. I'd never forgive myself if I didn't try. I use the same rule for CPR as I do for first aid, as long as it's safe for me (and my kids, if I happen to have them with me) I'll do what I can.

That's precisely the way I feel.

Isn't it interesting that we have focused on an aspect of urgent first aid whose application primarily requires skill and training, and very little equipment (essentially none if you know the victim really well). It's what is inside your head that counts; the stuff in the little box can be very useful, but it is not nearly as important as your knowledge.

I would assume most in health care would agree.

I've lost track, but somewhere between 5-10 saves in around 100 arrests. Most were witnessed, in-hospital arrests. In the field, maybe 2.

As for how long you can do CPR, it too varies. One person performing solo, I would assume short times- probably because you get so winded. But I've personally done compressions over 30 minutes. Can't comment on the quality of them towards the end, and it is quite a workout!

I am just glad someone FINALLY mentioned DUCT tape!!! A cornerstone of my first aid kit.
I too agree to get trained get comfortable with your skill set and run some senarios AND of what you would want on hand. I was a W-EMT/ Life Guard while I worked for a youth camp, and the "Golden Hour" will dictate a lot of what you feel is necessary for your kit. Less than an hour from hospital/professional help, vs. hours or days. Communications ("coms") and trip planning becomes critical in extended distances from help.


All good input. Ironwood

Ive seen hour long codes and brought em back....then died in 8 hours,Im not much for extended codes.

As for %,wow,your experience is low,we bring back about what,a third at least witnessed in house codes.

Boy do numbers vary.

As for viable,long term survival after,that number is pretty low for us too.

But some do,so Im still a firm believer you try.

I once did compressions back when the rate was around 70/minute. Guy had a sawn ganz and PA pressures read 40/20 (it was so pretty I had a coworker run a strip of PA and EKG,as pretty as if it was his own heart),and the man did survive,and we didnt do the crushing compressions we do on this latest AHA guidlines.

My point is,no matter how you do it,some times it just works.Does NOT have to be latest text book perfect per guidlines to be effective.

I think the phrase is "First, do no harm".

Sometimes the patient needs a little less of Johnny Hero - sometimes nothing may be better than the best any bystander can do.

If my heart stops I hope bystander Johnny Hero at least tries while 911 is enroute.

I know if your heart stops in front of me and Mrs we will be all over you instantly,not making a judgment call on should we or shouldnt we.

Ive made that call after a code is finished in retrospect,but never to not start short of rigor mortis or do not resuscitate order if someone collapses.

OK,once at an accident scene when the guys brain was all over the road.It was pretty clear he wasnt going to live without a brain,or be revived.

"sometimes nothing may be better than the best any bystander can do."
True, But I'll leave That decision to A. competent medical authority or B. God.

Sometimes God has delegated the decision making authority to you. You are His instrument and the buck stops with you....

I think what we are talking about here is the very human tendency to take action ("do something!") in the face of an emergency. A classic case would be a hurried, unprofessional extrication from, say, a wrecked automobile, without a thorough examination of the victim. This often leads to very bad consequences that could have been easily avoided by more thoughtful action. Again, it isn't the gadgets in you hot little hands, it's the stuff in your brains that counts.

So true.

I'm reminded of a lawsuit within the past few years. A woman in a traffic accident claims she was paralyzed (or it was made more severe) when a rescuer (actually, was it her friend?) pulled her out of the wreck and dragged her away (the phrase "like a ragdoll" seems to stick in my memory). IIRC the rescuer claimed that she feared a fire or explosion, but the first responders did not find any particularly hazardous situation when they arrived on scene. I have no idea what happened to that case.

Actually, I think we talked about it on ETS back then, too. Anyway, we don't know the reality of that situation, but certainly doing less or nothing very well could've been the best course to take in that situation.

Actually the first rule is 'Don't put yourself in danger.'

We called that "is the scene safe?", then proceed to step two, I suppose as with all protocals changes in time, so perhaps wording change? We're not using turniquets anymore either

Ironwood

While most of us civilians are not likely to need them, tourniquets can be lifesaving in certain circumstances. They are now commonly used, with good outcomes, by the military in combat in SW Asia. Circumstances outside of combat where a tourniquet would be indicated are probably rare, but it is still a worthwhile skill to have. See When To Use Tourniquets, by Dr. Johnson of Wilderness Medical Associates for more info about their use.

In Wilderness First Aid; we're allowed. But that's a very rare, very specific circumstance available to a trained group.

My mini-kit

band-aids
gloves
dressing
meds
tiny fauxton light
usually in a ziploc