Not sure why you are leaving out the oral rehydration salts? Are local salt and sugar available? Check out the Zinc Supplements too. Treatment for dysentery requires plenty of ORS. Just stopping someone up with Lomotil can be a hazard, especially in children. You will notice no Lomotil or Pepto in the WHO treatment below.


"Diarrhoeal disease is the second leading cause of death in children under five years old, and is responsible for killing around 760 000 children every year. "


"Key measures to treat diarrhoea include the following:

Rehydration: with oral rehydration salts (ORS) solution. ORS is a mixture of clean water, salt and sugar. It costs a few cents per treatment. ORS is absorbed in the small intestine and replaces the water and electrolytes lost in the faeces.
Zinc supplements: zinc supplements reduce the duration of a diarrhoea episode by 25% and are associated with a 30% reduction in stool volume.
Rehydration: with intravenous fluids in case of severe dehydration or shock.
Nutrient-rich foods: the vicious circle of malnutrition and diarrhoea can be broken by continuing to give nutrient-rich foods – including breast milk – during an episode, and by giving a nutritious diet – including exclusive breastfeeding for the first six months of life – to children when they are well.
Consulting a health professional , in particular for management of persistent diarrhoea or when there is blood in stool or if there are signs of dehydration.


http://www.who.int/mediacentre/factsheets/fs330/en/

Just curious, what is the level of first aid training of the recipients of this kit? That is the most important component of any FAK.

As you read in Nurse Mike's post, “rehydration fluids [can be] fabricated from diluted fruit juice and salt.”

You said:

The "Simple Solution" - Home made Oral Rehydration Salts (ORS) Recipe

Preparing 1 (one) Litre solution using Salt, Sugar and Water at Home

Mix an oral rehydration solution using the following recipe.

Ingredients:
Six (6) level teaspoons of Sugar

Half (1/2) level teaspoon of Salt

One Litre of clean drinking or boiled water and then cooled - 5 cupfuls (each cup about 200 ml.)
Preparation Method:
Stir the mixture till the salt and sugar dissolve.

While I do take what the World Health Organization says seriously, putting a bottle of zinc tablets in the first aid kit may not be an option. If we agree that including Oral Rehydration Salts in the kit is better than making something with what is on hand in a village, this is what I consider using:

http://www.chinookmed.com/cgi-bin/item/1...---------------

I can put two of these packets in a kit without removing anything. If I need more, I can remove the instant cold compress. At least six ORS packets can fit into that compartment, likely more. If diarrhea is a problem, I believe this would be a good tradeoff.

Jeanette Isabelle

Sometimes there is a nurse but most of the times there has been no medical professionals so include gear a layman can use.

Jeanette Isabelle

I've known a lot of people on "water pills" due to heart failure. They all require supplementation with potassium. The DIY formula does not include potassium, but the Chinook packets linked to do. Lack of potassium can cause serious heart problems.

We use "salt substitute" which is potassium chloride, for our "table salt." Bananas (I know, not packable, but may be locally available) are a super source of potassium. Something to be kept in mind.

It seem to me that it would be simple to add the salt substitute/potassium chloride to the DIY formula, but in what amount is slightly confusing--- I think a bit less than 1/2 the amount of salt.

Note: standard sugar is 50% glucose, and the Chinook mix has 20 grams of glucose, so you would need 40 grams of table sugar to equal it. Glucose tablets (in the diabetic section at the pharmacy) typically have 4 grams of glucose per tablet. This might be another option to include in your considerations.

It might be a good thing to do. Salt substitute is not expensive, and small packets of the proper amounts of salt, sugar and potassium could be made up at home and sealed with a small vacuum sealer.

Another (or additional option) is to include several "recipes" for rehydration fluids. If it a problem, even for one person, they are going to need more than a few packets. Use of locally available DIY ORS components seems the best long term solution.

Hi Jeanette .... sorry I'm late to this party! Some thoughts from reading the thread.

Coban isn't really interchangable with ACE wraps. There's just not enough tension in the coban. Though arguably, it's not all that useful if you already have ACE wraps, or some tape. Think of it more as gauze with a little stretch (like the elastic in underwear) - snug, but not tight. I'd say use either coban or gauze rolls, but leave the ACE wraps. One thing about coban - it can't pull double duty as a bandage, like a gauze roll could do.

For space concerns, not sure your budget or time frame, but you can buy compressed gauze rolls. or, if you have access to a Food Saver, potentially vacuum wrap the gauze and gauze rolls. That might buy you some space.

I'd ditch all the packets of antibiotic ointment and just throw a tube of neosporin or bacitracin in, and call it good. If needed, it can be applied with a clean rag, bandage, finger, etc, and rubbed onto the wound. Plus it'll probably have more applications per unit size.

Ditch the burn cream. Nothing bacitracin or neosporin doesn't cover. If the burn is bad enough, cover with a dry bandage and evac.

Use a manual thermometer. Digital things have a tendency to break or have batteries die or be misplaced. Or honestly, skip it. You can tell if someone is febrile by touch, and really, does the number matter much in the middle of no where?

I tend to agree with some others on skipping Imodium/loperamide. If you're holding in the GI bug causing diarrhea, you potentially worsen the disease process. As long as a person can keep up with hydration, diarrhea isn't usually life threatening. Just really inconvenient.

Ditch the alcohol pads. 1, you're not giving shots, and 2, they're not anything that soap and water won't do. Consider ditching the sting relief pads. Not sure what's their active ingredient, but a tube of After Bite should work for most folks (available at most grocery stores). I think it's essentially vinegar.

I would hesitate to bag gloves. You can roll them up and make little "burritos" of them. Lie 2 gloves on each other, one slightly higher. Rolle from the fingers to the cuff. The slightly "higher" cuff can fold over and hold the roll together. Slightly faster, and less material/bulk, than bags.

Why medicine packets, instead of a bottle? a 50-pack of benadryl in a small bottle doesn't take much room, versus 25 2-packs of benadryl. Ditto other meds.

CPR Shield is nice, but honestly if someone dies out there, they're likely to stay dead out there. Save the space, but if it makes people feel like they 'tried everything,' then go ahead and put it in.

As for bleeding control, quick clot, TQ's, etc. If there's a bad bleed, you can never have enough gauze. A few 4x4's, 2 gauze rolls, and 1 or 2 5x9's will be gone in a heartbeat. It may be worthwhile to have a small trauma kit set aside, but again, may be budget prohibitive.

have your missionaries ask their docs for prescription meds. I assume most of them will be needing anti malarial drugs, right? You can also talk to the local Public Health dept about vaccines/meds that would be needed.

The gauze rolls have a compartment just for them. Compressing the rolls will not save space. The gauze pads can be compressed if I had access to a food saver; how much space am I saving if I did?


There are compartments just for cream/ointment packets. Removing packets and replacing them with a tube would not save space, it would reduce space. The only purpose I see in removing burn cream packets is to make room for more antibiotic ointment packets.


What about Diotame (Bismuth Subsalicytate)? Does it stay or go? If it stays, how many packets do I include in relation to other packets of medication?


There are only twenty-one antiseptic towelettes. Thirty-six alcohol pads fit into two compartments. Those two compartments can be used to hold ten more packets of medication if I go that direction. Are there situations in which alcohol pads can be used in place of antiseptic towelettes to stretch out the limited supply of towelettes?


The only purpose in removing the sting relief pads is to make room for five more packets of medication.


There are compartments which only hold medication packets, alcohol pads or sting relief pads. Antiseptic towelettes are too big for these compartments. Therefore, removing packets and replacing them with a bottle would not save space, it would reduce space.


What is a TQ? What would you suggest with space and budget in mind? If I do not add the thermometer as you have suggested, I will save $4.51. That $4.51 can be applied to trauma supplies.

Jeanette Isabelle

TQ= tourniquet.

I would think a 3" Ace bandage would be cheaper and more versatile than a TQ. TQs are fairly easy to improvise. Again, this all leads back to the level of training of the end users.

While Tums has some antimicrobial properties, it is NOT considered an antibiotic. So, it's good for heartburn, and might help a little for diarrhea, but I'd just as soon take it out and leave it up to each traveler to get their own prescriptions. Don't think Tums will cure an E coli or cholera infection.

Re alcohol and antiseptic towlettes. I'd take out both. While they have their place, I don't know that they aren't more useful than soap and water for the things you'll be doing. "The solution to pollution is dilution," so don't be afraid to copiously irrigate wounds, assuming blood loss is controlled. Add in more benadryl or tums or something. Tylenol, motrin, butterfly bandages, something.

TQ's are easy to improvise, as Hikermor said, if you know what you're doing. If not, the CAT-T and SOF-T are the current recommended ones by the US military, but they're pricey. I don't have experienc with other brands.

Do those medication compartments come out? Or are they permanently molded? Can you cut the dividers with a pair of scissors? I know that some meds can come in very small bottles, but you're right in that it's probably easier just to stick with individual packets if you're stuck with a pre-mold box. That's why I prefer a bag

Compressing gauze can save a LOT of room, particularly if you have Kerlix brand gauze rolls. Think of going from roughly 2 inch diameter to 1 inch diameter, and a little loss of height. It can probably double your supply, possibly triple if you really pack it tight. Same for the gauze pads.

BTW, I don't know if you mentioned, are the gauze pads individually wrapped? If so, I recommend swapping out for bulk pads. Relatively clean (shrink wrap or throw in a sandwich ziplock to keep clean), and sterility doesn't matter much for bleeding control; it's more a concern afterwards. You can fit more for the space that way. Kind of hard to describe, but I found this picture to show the relative size of 2 compressed rolls: http://i30.tinypic.com/w7fpde.jpg