I pride myself on having an excellent and well stocked first aid kit, but it's way too big, and I could use some input on which items to remove. The kit is completely self assembled, but uses an AMK 'Backcountry' container, which currently measures roughly 10"x7"x7.5", including the significant bulge. This is fine for the house or car, but for backpacking, camping, and even dayhiking, which are the primary uses for this kit and where it would most likely be needed, it's huge. After my sleeping bag, it's probably the largest item I carry, and also one of the heaviest(although I'm not concerned about reducing the weight). I would like to keep the same container but decrease the bulk, mainly the bulge of that last dimension.

I've tried to make this suitable for a wide range of conditions, with a main focus on treating minor and major trauma, and some minor medical conditions. As it will be used on some multi-day trips(generally a week or less) I want to have enought supplies to treat mild to moderate injuries and change dressings for several days. I should note that I will often be travelling with relatively inexperienced people, who of course tend to have more avoidable injuries and need the kit far more often than myself. I've also included a few items that are more
survival than first aid oriented, but they take up minimal space.

I've spent a lot of time going through the inventory, trying to streamline it and remove superfluous items. Currently I can't think of anything I would remove that would significantly reduce bulk without compromising the kit's usefullness(except for the sawyer extractor, which I do remove depending on the circumstance). I really do need to reduce the bulk of this kit, as it reduces how much of my own and group gear that I can carry, and it usually gets left behind on day hikes, including segments of backpacking trips. Of course it is sometimes the subject of ridicule from friends, but these are the same people who either never carry their own kit, carry a cheap kit they've never opened, or whose idea of a first aid kit is a couple of bandaids and bottle of tylenol. The inventory is below:


Dressings & Bandages
4 - gauze 4x4 8ply
3 - gauze 4x4 12ply
3 - gauze 2x2 8ply
2 - eye pad
3 - Teflon dressing 2x3
2 - Spyroflex dressing
1 - WaterJel burn dressing 4x4
1 - WaterJel burn dressing 4x16
1 - Xeroform petrolatum dressing
1 - 5x9 compress
1 - Trau-medic field dressing
1 - Pkg. Molefoam padding

2 - 4" gauze roll
3 - 3" gauze roll
1 - 2" gauze roll
1 - 4" adhesive elastic bandage
1 - ace bandage
2 - triangular bandage

1 - roll paper tape
1 - roll plastic tape
1 - roll duct tape

10 - butterfly closure strips
5 - foam band aids 3/4"x3"
7 - foam band aids 1"x3"
4 - foam band aids minis
4 - foam band aids spots
5 - fingertip band aids
5 - knuckle band aids
4 - waterproof band aids, assorted


Topical Meds
12 - benzalkonium chloride wipes
12 - povidone-iodine pads
18 - alcohol pads
2 - Bactine antiseptic/analgesic wipes
12 - triple antibiotic ointment
8 ml - Bactine (BZK/lidocaine 2.5%)
18 ml - silver sulfadiazine cream RX
3 - cotton tipped applicators

4 - burn gel w/ 2% lidocaine
1oz - aloe gel w/ .5% lidocaine
4 - sting relieve swabs
2 - sting relief pads
11 - hydrocortisone 1% cream
2 - Tecnu ivy skin cleanser
6 - Ivarest lotion (calamine/benadryl)
1 - tea bag

2 - eyewash 15ml
1 - saline eye drops
2 - Celluvisc eye lubricant

2 - ammonia inhalant
2 - benzoin tincture swab
2 - Quik-Clot 1.75 oz hemostatic agent


Tools & devices
Trauma Shears
Penlight
Pen/knife
tweezers
nail clippers
magnifying lens

venom extractor
SAM splint
tongue depressor

Misc
2 - Slide lock bags
2 - condoms
2 - coffee filters
3 ft2 - HD aluminum foil
4 - chlorine dioxide tabs
1 - iodine tabs(50)
6 - NaCl packets
dental floss
lip balm
superglue
1 - pr. latex gloves
1 - pr. nitrile gloves
1 - pr. foam earplugs


Meds
Qty Drug Usage Dosage Max dosage Expiration
~25; 3(2) ibuprofen 200mg anti-inflammatory, analgesic 1-2 per 4-6 hrs 6 tabs/1200mg per 24 hrs 6/04; 11/07
~30 naproxen sodium 220mg anti-inflammatory, analgesic 1 per 12 hrs, 2 @ first dose 3 tabs/660mg per 24 hrs 10/07
~10 acetaminophen 300mg/codeine 30mg RX analgesic 1 per 4 hrs 6 per 24 hrs 11/02
1(2) aspirin analgesic 1-2 per 4 hrs 12 per 24 hrs 5/04
4, 6 diphenhydramine HCL 25mg antihistamine 1-2 per 4-6 hrs 12 per 24 hrs 7/06; 3/08
~10 Zyrtec 10mg RX antihistamine 1 per 24 hrs 1 per 24 hrs 6/04
8 Pseudoephedrine HCL 30mg decongestant 2 per 4-6 hrs 8 per 24 hrs 4/08
~12 chlopheniramine maleate 2mg/
phenylephrine HCL 5mg/acetaminophen 162.5mg antihistamine/decongestant/analgesic 2 per 4 hrs 12 per 24 hrs 11/02
8 loperamide HCL 2mg anti-diarrheal 2 @ first loose stool, 1 per additional loose stool 4 per 24 hrs 5/05
12 bismuth subsalicylate 262m anti-diarrheal/ upset stomach 2 per ½-1 hr 16 per 24 hrs 2/06
7(2) calcium carbonate 420mg antacid 2 per 2-3 hrs 19 per 24 hrs 3/08
2 dimenhydrinate 50mg Dramamine 4/02
6(2) electrolyte tabs treat/prevent dehydration 1 tab w/ glass H2O 10 per 24 hrs 1/07
1 50g electrolyte powder treat/prevent dehydration dissolve in 1 liter H2O
1 tube glucose paste treat hypoglycemia ingest orally 8/03


Sorry for the long post, I have a bad habit of doing that. Also the meds section may be hard to read, I just pasted it from the word file I use for my inventory.

Looks like a pretty good kit, instead of downsizing though, have you thought of splitting it? Keep all the single items in the kit, along with some of each of the multiple items and put the rest of the multiple items in a dry bag to be carried in your main pack (call it a reserve). You've stated that the med.s/dressings are meant to last several days, you don't need to pack them along on a day hike, but you'll have them in the bottom of the main pack as a back-up in case you ever find yourself in need of them, sort of the same principle as a combat load in web gear, and reserve supplies tucked away in good ol' A.L.I.C.E.
Just my two cents

Troy

I was on limited duty at the end of my military days and drove the infirmary van all over the Bay Area ( <img src="/images/graemlins/tongue.gif" alt="" /> never give a shorttimer a van, gasoline credit card and unsupervised duties <img src="/images/graemlins/tongue.gif" alt="" />) My corpsman bunkmate suggested I carry an aid kit, seeing as I often transported patients and even supplies of drugs which saw me drawing a .45 from the armory. So off we go to the decommissioned WW2 cutters tied up waiting scrapping. My kit was certainly splendid, and proved itself one day when 3 cars collided just outside our base. Our people rushed to help and my kit got a rather bemused look from Captain Smith, a ringer for Ozzie Davis. "Uh Kav, why do you have an amputation bone saw--- and HEY! this is nice old Solingen quality, chuckle ,chuckle" and it was casually slipped into his lab coat along with a whole pile of other treasures. later on we assembled a modest kit that slipped under the seat instead of the .50 cal ammo can. My point is, if you know a EMT , trauma nurse or M.D. have them go through your kit. The temptation to have a triage unit when evacuation is key is just to great for all of us. The base chaplains heard of my scrounging and swapped me a messuza, dayglo Virgin Mary and Saint Nicholas medal for a complete ship's chaplain kit- in sterling silver. The breakers bought 2 good cutters, but little else after we distracted the base watch detail <img src="/images/graemlins/grin.gif" alt="" />

Is that an entire roll of duct tape? That seems rather excessive, if so. It's both bulky and weighty. If you really feel you need it, get one of those smaller flat rolls they sell now, which is still probably more than enough for a week.

The 12 tubes of antibiotic is also quite a bit. A very thin amount is all you need and as long as there is a bandaid/bandage over it, it should remain sanitary. Not that they take up much room - but 4 is a LOT. Even with multiple large wounds if you use the right amount that's still plenty. If the concern is open packaging, get one of the mini-size tubes instead.

I know you have dressings meant for changing, but there sure seems to be a lot of it. Maybe take out some of the bigger pieces or one of the bigger rolls. Or start thinking about multiple use. How about a small stack of bleached hankerchiefs or plain white undershirts in a ziploc or vacuum sealed bag instead? Useful for bandages, guaze, hankies, sun protection, warmth, shelter, etc. Plus you could pack those elsewhere and they could still be used for large trauma.

Maybe also consider a spray form of antiseptic and some saline wash - you can't really use pads on a deep puncture or tear, and that many pads is a lot of packaging that goes to waste because you rarely use all the antiseptic for a small scratch and it just evaporates - forcing another pad later on for a dressing change.

I don't see anything in there for sutures. A scalpel blade and handle might be a nice compact addition/substitution for a pen knife too. Potassium pills might not be a bad idea either. And maybe reduce the penlight to something like this: http://www.amazon.com/gp/product/B00006R...mp;amp;n=228013

I also agree with Wildcard - maybe go for a couple or 3 smaller packs. Keep the common use items in a small accessible kit and stow the rest attached to your main pack. Take the kit apart, put aside the 10 most bulky items. See if you *really* need the 5 biggest or if you have adequate substitutions. That should help considerably. You already mention that it's too big to carry for small trips, so maybe even put together a small kit that sits in the big kit. Or just take it down to 2 equally sized kits so you feel prepared for the weeklong trecks with both, but have ample supply in 1 bag for a day trip.

Just like anything, it can't help if you don't have it with you, and if it's cumbersome, you are less apt to take it. Plus, I'm not sure how many dressing changes you are going to want to make on large trauma. As long as it's a clean wound, it's probably better to leave it sealed against the elements. But check with a doctor on that one! I'm just guessing.

OH! Almost forgot. If you have a few smaller packs, you can make someone who didn't bring anything share carry duty. Plus, that's just good sense in case a group splits apart, etc. And it provides an excuse to train others in first aid and get them thinking about preparedness.

While it is not exactly the same target size, downsizing my first aid kit was the primary issue in this post. Perhaps you could pick up a few ideas. Certainly I got some good suggestions.

-john

Very Nice kit for starters, now lets get crackalackin
-the 4x4's-8 ply are fine, carry more of them and skip 2x2, you can always fold a 4x4 in quarters
-4x4 folded liek a 2x2+eye pad
-take about 3-4 3" gauze roll and thats it
-bandaides, well stick wiht regular size and maybe knuckle-i find the cloth ones to be the best myself, and skip that mini stuff....takes up too much space and is basicallly useless for most applications
-tape-stick with silk cloth and carry one 3" roll.you'll find it more usefull and can be split to form other sizes
-creams/ointments-carry half the number of each-how ofter do you ever use every drop you carry on a single trip, here you could if you want just keep betadine(small bottle ?), maybe tube of silvadene,a dn skip the rest
-alovera, stick kill, -nice but not top priority,and are only a minor temporary fix for their intended use
-hydrocortisone-carry about half that
-technu is nice but advoidance is much lighter weight, as well as tiny bar of soap will remove the ivy oil just as simple(bewae of spreading while washing with anything!)
-ivarest-benadryl capsuels are effective and much lighter or you could use one of your lidocaine pads
-eyewash-2 tips here small bottle of PLAIN saline, not cleaning solution from your eye care professional feels good , as well it is normally free as a sample if you just ask, second, unless the water your carrying on your trip is just to filthy to drink you are already carrying your eye wash-right?, ie. hold that camelback up, squeeze the bite valve and go to washing!
-eye lube...........really needed?
-amonia inhalent, unless its a "fainting due to mental response to stress" amonia isnt going to really help anyone, course it is virtually light as air so your call here
-quick clot...........moderately effective.......but if you cant stop it by direct pressure/elevation/pressure point-quick clock is like thowing a hand full of sand in the ocean
-penlight-not needed if your already carrying a led on your edc key chain or regular flashlight
-SAM splint-EXCELLENT choice by the way!
-why condoms , chlor tabs, iod tabs in your FAK?-just your place to carry??
-aluminum foil-i know several uses for the stuff medically, but most all of them are improvised other ways just as easy.........your reason for carry as a part of your FAK?
-stick with nitrile only for your gloves-why take the risk of latexy allergies?but i would bump up these to 3-4 pair
-meds, some interesting choices, i can see some of them good for more long term senarios, i guess here its a personal preference thing,-i would carry at least 2 adult 325mg dosages for possible chest pain type event
-antihistamines-nice for "trips" but not really a first aid item, also here pick one general antihisamine and stick with it....your doubling up on several of the same principal meds here
-tylox-considered a controlled substance-be careful whom has acess to these
-limit yoru tylenol to 1000mg/24 hr
-watch yourself on the electrolyte pack in "24 hours" dont want to trip the scales the other way and by hyperkalemic or hypernatremic!
-all in all a nice well thought out kit, a few item you could consider adding-scalpel blade, safety pins, small bottle hand sanatizer,cpr shield(microshield),20cc syringe would be nice for wound flushing, tegaderm dressings are handy too
-figtree

Good points all! I really gotta take that EMT class soon. I'm probably better off than most folks, but that kit makes me really think.

A couple of other points:
- Maybe think of including an EpiPen.
- A smaller diameter syringe could serve as a airway tube for Emergency trach
- Plain saline can take over for the eyewash stuff and help flood wounds. Multiple use is good.
- chewable (baby) aspirin - I didn't see this on the list, maybe I missed it. Heart attack/stroke is probably the most life threatening except for head trauma or arterial/internal bleeds.

Man, I gotta get a pack like this. <img src="/images/graemlins/smile.gif" alt="" />

"emergency trach"?

You haven't even taken an EMT class, and your FAK stock considers the possibilty of doing surgery in the field?

This seems unwise to me.

Alex

Chris - I spent a couple years as a volunteer EMT. It was with my college EMS squad, so admittidly I didn't see all that much action, but I know my stuff pretty well. Actually I've learned more about treating minor injuries from research and my own experience than from my EMT work(and our equipment was pretty basic anyway, no fancy non-adherent dressings, and the only antiseptic we carried was alcohol and iodine pads).

Massacre - The duct tape is a mini roll I wound around a Q-tip with the ends cut off, and much smaller than those flat rolls. The antibiotic ointment is in individual packets, which are more sanitary and they all take up much less space than a single tube of antibiotic. Hankerchiefs are not sterile and much bulkier than a comparable amount of gauze, and a few undershirts would be almost as big as my entire FAK. I do have some antiseptic spray(bactine), which I transferred to a mini spray bottle(similar to the ones used for cologne samples).
As far as general dressings, there are only 7 4x4s, 3 2x2s, 1 5x9, and 2 eyepads(now that I think of it, I'll drop one eyepad). That's really not much, especially for a major trauma or smaller one requiring several changes. There are other specialized dressings, including a non-stick dressings, spyroflex, and burn dressings, which serve a different purpose and are not interchangeable with gauze.
For bandages, there are 6 rolls of various sized gauze, which is more than enough for any single injury, but I wanted enough for several changes. Keep in mind that depending on the location, and perhaps severity of the injury, the entire roll may be needed. I think I will remove 1 or 2 of the smaller rolls. The adhesive-elastic and ace bandages can both be use for pressure bandages, but the adhesive one is more durable and waterproof, ideal for major bleeding, and the removeable and reusable ace bandage is more suitable for sprains. Perhaps I'll remove the ace bandage, since sprains and strains are not critical, and it is one of the bulkier items.

I don't know why you think sutures belong in a first aid kit, but I have no intention of including them. I am nowhere near qualified to use sutures, and even if I was, it would be probably be inappropriate to use them in the field(there have been many posts on this forum regarding the use of sutures).
I'm not sure what you mean by potassium pills, or what they would be used for. Please elaborate.
The penlight currently in there is a streamlight stylus. A photon would be better and more compact, so maybe I'll eventually replace it with one, but for now I can't justify the cost.

I should also add that dressings should ideally be changed at least every day. When a wound is first bandaged, you won't be able to apply an antiseptic if there is even a moderate amound of bleeding, so changing the dressing after bleeding has stopped allows you to do so. Changing the dressing regularly allows you to keep the wound clean and apply fresh antiseptics, assess the severity and the rate of healing, and ensure that local circulation isn't being cut off by the bandage.Leaving on a dressing that is soaked in blood or otherwise moist is never a good idea.

JohnN - Thanks, I'll take a look at that thread and let you know if it gives me any ideas.

figtree - thanks for the suggestions, I have a few questions and comments, in no particular order.
You say that quick clot is ineffective, do you have much experience with it? I've read otherwise.
You mention that a scalpel blade would be nice to have, what medical purpose does it have for first aid use?
I consider a cpr shield a waste of space, if someone needs cpr in the middle of the woods then they're probably dead, and in any case I can perform cpr without a mask. The two pairs of gloves are pushing it as far as I'm concerned, and I may even take those out. When I worked as an EMT I wore gloves often, but when I'm with some friends hiking somewhere my priorities are a bit different. The chances of getting infected from exposure on unbroken skin are fairly low, especially if I wash my hands afterwards.
The benzalkonium chloride towlettes or alcohol pads serve the purpose of hand sanitizer, and are much more compact(and I normally carry hand sanitizer seperately as part of my dump kit).
The eyewash is 2 small 15mL single use bottles of basically saline, although they also have potassium phosphate, not sure what for. I figured it would be easier on the eyes than plain water, especially water that may be questionable, since even filtered and/or treated water may have irritating pollutants, and the sterility is a plus.
I consider the antihistamines very useful, even potentially life saving, as it can provide some treatment for allergic reactions. Not as good as an epipen, but a lot better than nothing. I have both diphenhydramine and zyrtec because there is a big difference in strength.
What are you referring to by '2 adult 325mg dosages'?
The penlight is redundant to my EDC photon, but I like the idea of my FAK having all important items in itself.
The condoms, chlorine, iodine, and aluminum foil are mainly there as redundant survival supplies, although the condom could be used as a tourniquet.
Keep in mind I want this kit to be able to treat a variety of minor injuries as well as serious ones.

massacre(again) - I've thought about getting an epipen, but I don't have a prescription and it's way too big for the kit anyway. If I had an RX I would get one and carry it seperately.

Thanks everyone for the input, so far I've decided to remove the following items:
1 eye pad
1 3" gauze roll
bactine wipes
mini and spot bandaids
ammonia inhalants

possibly iodine tablets
possibly ace bandage
possibly tounge depressor

Not much, but it's a start. Let me know if I can clarify anything.

I probably won't split it into multiple kits, since removing all the extra items really wouldn't make that much of a difference in size. Most of the multiple items are small packets of various topical meds. What I've done sometimes is take out the trauma dressing and quickclot, along with a micro kit I also carry which basically has a few antiseptics and a couple bandaids, and use that for dayhikes.

Don't get too excited about the tracheotomy... My tender half is a doctor and worked in an ER for 5-6 years, never did a tracheotomy. One of her friends is also an anesthesiologist and never did a tracheotomy either. We see a lot of those in the movies, but very rarely they need to be performed... even less in a non-hospital, first-aid scenario.

Just my opinion. I wouldn't bother gearing-up for a tracheotomy for a first-aid kit. <img src="/images/graemlins/cool.gif" alt="" />

By potassium tablets, there are two possibilities. One is a potassium supliment to help replace the least common component in electrolytes. We get plenty of salt normally.

More likely, it is those things that the DoE thinks might make a difference if you arewithin ten miles from a nuclear reactor. Potassium iodide work by adding a degree of protection to your thyroid if you are in a irradiated area, but you have to be taking them before exposure for them to be any good. The "anti nuke" pills really aren't worth much if you ask the other nations with nuclear power and decent medicine (IIRC, niether the Japanese, Brits nor the French issue them to thier civilian population, and they all use percentagely more nuclear reactors than we do), and definantly aren't worth the cost and bulk in a field first aid kit.

Great kit, but I have the same problem with carrying too much. As others mentioned, look at double duty for the bulky stuff. Don't sweat the multiple changes of dressings though. If it is bad enough that you are changing that much dressing, you should be evacing instead. Carry enough to treat minor stuff that wont pull the plug on the trip, and enough to handle the triage of a major event that requires evac.

Side note, while I don't carry sutures, I do carry steri strips. I have used them to close up minor facial wounds and others that tend to pull apart. Little risk of infection is paramount though.

Bill

Fair enough to both posts. I mentioned it for this person's kit, which - to me - seems pretty well stocked, not for my own kit. I also mention it because it could still be used primarily as a small irrigation tool - and the smaller diameter gives it the other option. I don't think I'd be doing this without some training - and I doubt a basic EMT course would touch this.

It's interesting to note that just because one doctor in one ER didn't perform this in 5-6 years that it doesn't happen. I watched a ladder fall on an animal's throat on a farm once, where it slowly suffocated. It was gruesome - and I wouldn't want to see that happen to a person if I could prevent it. Doctors also have access to intubation equipment and my guess is that it was probably used more than a few times in that 5-6 years. That requires a great deal of experience and knowledge and is - from what I understand - pretty tough to do in the field.

It was for the electrolyte. My brother has a heart condition and when his K levels drop he needs this, so it came to mind. There have been some other postings on this recently.

As for the Hankies and T-Shirts - I was thinking multiple use and in a jiffy, a brand NEW chlorine-washed, plastic-packed shirt could be cut into a fairly sterile dressing. And it could be packed somplace other than the FAK - I probably didn't mention that part, and it may not make sense when carrying something this complete. Good point about the antiseptic on an fresh wound requiring multiple dressings.

We're pretty much saying the same thing. <img src="/images/graemlins/smile.gif" alt="" />

It does require some training and knowledge and there is a big risk of damaging tissue if you do it wrong. You're ahead of a lot of people if you're are aware of the procedure and have even a vague idea on how it is performed, but I hope you will never ask yourself the question... "darn it, should I cut?" <img src="/images/graemlins/grin.gif" alt="" />

Getting back to the tracheo, it is of course performed on occasion for cancer patients, using anesthesia, etc... , what I meant was that it very rarely performed in a "OMG I need to cut this patient's throat right now, hey, you, come over here, can you hold this person down for me while I do it please" -type scenario. <img src="/images/graemlins/grin.gif" alt="" /> <img src="/images/graemlins/grin.gif" alt="" />

Actually, I believe that the UK does issue iodine tablets to civilian populations. Not generally, but at least in the vicinity of HMNB Devonport.

eeph

Hehe... undeniably so. I was pre-med before I went off into computer land, and I still have a desire to study all that stuff, so yes, I have read through the procedure and I seem to even recall it being on a TV show - E.R.? M*A*S*H? Something like that... I'm pretty certain it's not going to be anything like the idiot tube makes it out to be, but if someone I know gets their throat broken, and I'm all that stands between 2 minutes to lights out, I would probably be willing to give it a try, even with the little I know. I figure it might buy some time, even if they never talk again - they might live.

One other thing, I've also been shown (basically) how to do it by my Martial Arts instructor, a Sherriff's Deputy and PT instructor with a lot of EMT training. In a self-defense situation, the throat is a nice target, and saving the life of the mugger you beat up probably goes a long way in court.... <img src="/images/graemlins/tongue.gif" alt="" />

lose the Sawyer extractor it is no longer considered the proper treatment of snake bite.

It seems you have too much of almost everything especially the meds.
get rid of all the tiny bandaids. fewer rolls of gause.
12 antibiotic ointment; this is almost unnecessary carry 3.

Improvise more; the eyepad can be made from other items in the kit like a 4x4 sterile pad folded over.

3 differnet ways to wash out your eyes?

There is a lot of stuff you don't really need.

I have really dropped the size of my FAK I have planned for falls, burns, cuts, heart and lung problems. I use quick clot (urgent QR) it has an antiseptic mixed in with it. I use it all the time and love it I have stopped an arterial spurt with it. I filled a small pill bottle full of it to save on bulk, 2 4x4s and some curlex, a tampon (I use it for large wound care), nitrile gloves and a CPR shield (I some times work on unknowns). Mylar bag of drinking water (not for drinking), burn cream, benadryl, albuterol, aspirin (I like aspirin instead of Tylenol incase of heart problems), Ibuprofen, dental floss and needle, and tempdent
nitrile gloves
cpr mask
mylar dirnking water (not for drinking)
burn cream
benadryal
aburital

Bill - There are many minor injuries that are nowhere near life threatening that still require daily dressing changes. For example a large abrasion or a moderate sized burn or laceration. The bleeding would be easily controlled, but they still need to be kept clean with fresh antiseptics and dressings.
A couple of years ago my bike hit a pot hole and flipped on it's side, and I skidded a couple of feet with my bare arm against the pavement, and it left one hell of an abrasion. It wasn't too painfull and certainly not a major injury, but It was pretty messy and leaked lymph fluid for the next few days. It's not hard to imagine something like that happening when falling down a steep rocky trail, for example. If that happened ona backpacking trip and I didn't have plenty of guaze, it would really suck. I would not want have to rip up expensive clothes to make a mediocre bandage. And an injury that's larger or with more bleeding would require even more dressing and bandaging. I can easily imagine a scenario where a non life threatening injury on a multi day trip would require all the dressing and bandages in the kit, and a lack of them would result in either premature cancellation, or more likely, inadequate treatment(that could result in infection).
Even if the wound is relatively clean, when backpacking the dressing will likely be getting dirty and sweaty. If properly cared for these injuries do not have to cancel a trip, and it would be a shame to cancel a trip just because there isn't enough gauze in the FAK.

By the way, is there a difference between steri strips and butterfly Closures? As far as I know they serve the same purpose.

Massacre - there are electrolyte tabs and powder in the FAK which contain potassium.
Chlorine washed shirts kept in a plastic bag would be clean, but nowhere near sterile. Everything around us is covered in microorganisms, and unless something is completely sealed is is immediately exposed to contamination. If you boiled a shirt for 10 minutes or so immediately prior to application, it would be close enough to sterile, but that's not exactly the most practical solution.


It occured to me that I should explain the difference between a bandage and dressing, for people who may not know. A dressing is something sterile applied directly to the wound, like a 4x4, and a bandage is something used to hold the dressing in place, and is not necessarily sterile, like a roll of gauze. A rule of wound care is that you should tape bandage to bandage, not bandage to skin(in other words, avoid applying tape to skin of possible). Tape applied to skin can be painful when removed and does not stick as well, especially if the patient is perspiring. Generally to properly dress a wound, you cover the area with gauze dressing(after cleaning and applying antiseptic if bleeding is controlled, and possibly non stick dressing), then secure that with a roll of gauze, which is either taped or tied closed. This is more comfortable, stays on better, and provides much more protection for the wound than simply taping on a piece of gauze, and allows the use of a pressure bandage if necessary. I apologize if everyone already knows this, but in my experience some people just don't understand this. The point I'm trying to get across is that dressings and bandages are not interchangeable, and it's important to know the difference.

Can you elaborate on the sawyer not being considered propoer treatment for snakebites? One of the reasons I included it is because it can supposedly alleviate symptoms of many insect bites as well.

There is only one way for washing out the eyes, the eyewash. The others are ampules of eyedrops(1 saline, 2 artificial tears), which only contain a few drops each. Although I do plan on replacing the celluvisc with a different kind, it's way too thick.
I think I'll drop the antibiotic ointment to 9 or 10. Remember the kit will be used for groups of about 6 for up to a week, I want enough for several minor cuts and scrapes and something more serious requiring dressing changes, such as I described above.
I will drop the tiny bandaids, and 1 of the 3" gauze rolls, i don't think I can drop any more bandages without compromizing the FAKs intended purpose(which is probably very different than the FAKs of other people here - we each have our own criteria of what we expect our FAK to handle).

I know some of the items are for dealing with very minor, even convenience issues, but that is part of the purpose of the kit. It's not only for life and death issues.

Great kit, UrbanSurvivalist. Good on you for thinking ahead & being prepared. For your stated uses, I would suggest the following to help reduce the kit's bulk:

- drop the 2x2s & eyepads; 4x4s can be made to work here
- drop 1 of the triangles; carry extra safety pins for improvisation
- too much tape; carry stout 2" silk or cloth tape, & some duct tape
- drop the QuikClot. If it's so bad that other measures won't work, and you're hiking/whatever, the patient is screwed
- drop the penlight & penknife. You should already be carrying a headlamp & a pocketknife.
- drop some of the meds; your med list looks like you're trekking in Nepal for a month
- drop the petrolatum dressing; any piece of plastic will work as an occlusive

Think first aid and not long term care, only carry enough to deal with scrapes, cuts, bleeding and other problems that might arise. Don’t carry overly specialized items like eye pads and fancy dressings. Things like Xeroform dressings are meant more for long term wound care and while Waterjel burn dressings are nice Telfa and burn jel will do the job. Telfa pads can also be used as and eye pad. One roll of Transpore tape or cloth tape will work in almost every situation. Avoid turning the fisrt aid kit into a survival kit or equipment repair kit. Stri-strips and a small 20 cc (or 10 cc) syringe are useful for wound care and not on your list. Vacuum packed bulky cotton dressings are also available.

Interesting websites to look at are www.chinookmed.com

http://www.adventuremedicalkits.com/ (.7 and .9 kits)

http://www.utahmountainbiking.com/ (first aid section)

http://www.aeriemed.com/ (level 1 and 2 kits)

Dressings & Bandages
0 - gauze 4x4 8ply
2 - gauze 4x4 12ply (big pads can be cut or folded into smaller pads)
0 - gauze 2x2 8ply
0 - eye pad
1 - Telf dressing 2x3
2 - Spyroflex dressing
0 - WaterJel burn dressing 4x4
0 - WaterJel burn dressing 4x16
0 - Xeroform petrolatum dressing
1 - 5x9 compress
1 - Trau-medic field dressing
1 - Pkg. Molefoam padding (moleskin is less bulky and can be layered)

0 - 4" gauze roll
0 - 3" gauze roll
2 - 2" gauze roll
1 - 4" adhesive elastic bandage (Coban does it all)
0 - ace bandage
1 - triangular bandage (with 2 large safety pins)

0 - roll paper tape
1 - roll plastic tape
1 - roll duct tape (10 feet at most)

2 - butterfly closure strips (add stri-strips)
2 - foam band aids 3/4"x3"
4 - foam band aids 1"x3"
4 - foam band aids minis
0 - foam band aids spots
4 - fingertip band aids
4 - knuckle band aids
4 - waterproof band aids, assorted


Topical Meds
4 - benzalkonium chloride wipes
0 - povidone-iodine pads
0 - alcohol pads
2 - Bactine antiseptic/analgesic wipes
1 - triple antibiotic ointment (not every owie needs antibiotic, consider double antibiotic instead, some people are sensitive to neosproin)
8 ml - Bactine (BZK/lidocaine 2.5%)
0 -18 ml - silver sulfadiazine cream RX ( this is an antifungal med that is not useful for 1st aid care)
1 - cotton tipped applicators

4 - burn gel w/ 2% lidocaine
0 - 1oz - aloe gel w/ .5% lidocaine (duplicates burn gel)
0 - sting relieve swabs (duplicates pads)
2 - sting relief pads
2 - hydrocortisone 1% cream
2 - Tecnu ivy skin cleanser
2 - Ivarest lotion (calamine/benadryl)
1 - tea bag

2 - eyewash 15ml (an irrigation syringe and clean water will work in a 1st aid situation)
0 - saline eye drops
1 - Celluvisc eye lubricant

0 - ammonia inhalant
2 - benzoin tincture swab
1 - Quik-Clot 1.75 oz hemostatic agent (try the smaller QR hemostatic agent packets)

Tools & devices
Trauma Shears (small folding scissors like those from the AMK Blister kit work great)
Penlight (use a small led squeeze light)
0 - Pen/knife
tweezers
0 - nail clippers (use before the hike)
magnifying lens

0 - venom extractor
SAM splint (splints are easy to improvise using material on a typical back packing trip, foam pads, clothes, etc.)

0 - tongue depressor

Misc (don’t make the 1st aid kit your survival kit)
1 - Slide lock bags
0 - condoms
0 - coffee filters
0 ft2 - HD aluminum foil
4 - chlorine dioxide tabs
1 - iodine tabs(50) (carry 10)
0 - NaCl packets
dental floss
0 - lip balm (carry this in a pocket and have others carry their own)
0 - superglue
0 - pr. latex gloves
1 - pr. nitrile gloves
0 - pr. foam earplugs


Meds (1st aid is not long term care)
carry small doses (like two or three) of asprin, antihistamine, analgesic and antidiarrheal meds.

Qty Drug Usage Dosage Max dosage Expiration
8 ibuprofen 200mg anti-inflammatory, analgesic 1-2 per 4-6 hrs 6 tabs/1200mg per 24 hrs 6/04; 11/07

0 naproxen sodium 220mg anti-inflammatory, analgesic 1 per 12 hrs, 2 @ first dose 3 tabs/660mg per 24 hrs 10/07

4 acetaminophen 300mg/codeine 30mg RX analgesic 1 per 4 hrs 6 per 24 hrs 11/02

1(2) aspirin analgesic 1-2 per 4 hrs 12 per 24 hrs 5/04

4, 6 diphenhydramine HCL 25mg antihistamine 1-2 per 4-6 hrs 12 per 24 hrs 7/06; 3/08

0 Zyrtec 10mg RX antihistamine 1 per 24 hrs 1 per 24 hrs 6/04

0 Pseudoephedrine HCL 30mg decongestant 2 per 4-6 hrs 8 per 24 hrs 4/08

0 chlopheniramine maleate 2mg/

0 phenylephrine HCL 5mg/acetaminophen 162.5mg antihistamine/decongestant/analgesic 2 per 4 hrs 12 per 24 hrs 11/02

4 loperamide HCL 2mg anti-diarrheal 2 @ first loose stool, 1 per additional loose stool 4 per 24 hrs 5/05

0 bismuth subsalicylate 262m anti-diarrheal/ upset stomach 2 per ½-1 hr 16 per 24 hrs 2/06 (this is Pepto-Bismol and not really needed for 1st aid)

2 calcium carbonate 420mg antacid 2 per 2-3 hrs 19 per 24 hrs 3/08

0 dimenhydrinate 50mg Dramamine 4/02

0 electrolyte tabs treat/prevent dehydration 1 tab w/ glass H2O 10 per 24 hrs 1/07

1 50g electrolyte powder treat/prevent dehydration dissolve in 1 liter H2O (water and snack foods work well)

0 tube glucose paste treat hypoglycemia ingest orally 8/03 (use a small packet of sports gel instead

I use these vacuum packed gauze rolls. In the package they are a little smaller than a raquetball. When opened they are as voluminous and fluffy as a 4" roll of Kerlix. Great stuff.

First aid kits can be quite personal for sure. One thing you could do is compare your kit to a commercial version of a similar size.

Experts are now saying that the extractor used on snake bite causes more harm than good. It does not remove much of the venom and can possibly harm the tissue. I think it was published in the 2004 "Annals of Emergency Medicine"; I saw it in Dr Weiss' book.

You will find some folks are allergic to the triple antibiotic. I am, so I may be biased. I had a reaction, thought it was some weird infection and saw a doctor. She said to quit putting whatever I had been on the wound because it was an allergic reaction. The doctor said to clean the wound with soap and water and "leave it alone".

Amen to that! You might want to cover the wound to prevent infection (dirt, etc.).

Nice to see all the various insight to this post. For some more feedback to my original reply here it goes: Quick Clot does work, but it like anything else has its limitations, and its a [censored] to clean out of wounds (later down the trail), a scalple blade barely weighs an ounce, but if any version of a minor surgical senario arrises, at least you have clean sharp instruments (ie. lance wound, trach, dig out the splinter from hell-but again these are for the advanced practitioner so its up to you ), gloves-well waht if your not taking care of your friends and its on the side of the road/trail-that extra pair (i say 3pr) would be nice espically if you need to change them during your treatment-lets face it if you've just stopped a nice arterial bleed and have that under control, your gonna be soaked, so why not toss in that back up pair, a few ounces of glove weight is a lot less than the weight of a disease like hiv or hepatits., cpr shield-a micro shield is light weight ...but its up to you ultimately, but if your the one trying to revive that inferior MI, or choking senario-look out for the "vomit to follow!" SAM splint someone mentioned is easy to improv-true, but when you need a plint you can ask for a better one -and considering the weight is not an issue period and they can even just line the bottom of yoru kit or backpack, why not use one..........some times you DONT want to go destroy your pack to make a splint for a simple ankle fx or minor greenstick fx. Sawyer extractor not longer top choice for snake bite.........well there are several research articles out on this , but it still could prove valuable if applied immedately-the theory is that you'll do damage to the tissue by the venom being suspended in the tissue during suction-this is true but if there is the slightest chance you could help reduce the envenomation in any bite or sting...............it couldnt hurt to try............and when i think of the places i could possibly be (senario) when i may be bitten.........if im lookig at 2-3 day walk out...........you better hope ANYTHING may lessen the impact of a severe bite/sting

I imagine you can wash and reuse bandages in the field, but it's not practical to recycle dressings. Do they fall apart if you try to boil them?

I like and use the same multplicity of meds that treat the same thing. Especially pain meds. Some people can take one kind but not another. By having different kinds doesn't mean you are carrying more total but gives you flexability.

I agree with some to much tape.

As to rolls of gauze. Their function is to hold the bandage in place. While the bandage that is in contact with the wound must or should be sterial thge dressing does not need to be and most gauze rolls are not. I would chuck them and go with 2 ace bandages. Either a pair of 2 inchers or a 2 and a 4. The one not in use can be washed for future changes. If you realy ned semi-sterilization you can boil them. And if you vacume pack them it will greatly reduce the bulk. They can then do double duty for sprains and the like.

What no vacume packing machine. Put them in Ziploc type bag. Place on the floor. Put a book or board over the bag. Then sit on the whole mess. Once you have squeezed out the air seal the bag. The poorman's vacume packing method.

You might think about the Leatherman Micra as a replacement for the trama shears and penknife. While not as good it is a more compact package.

Nail clippers would go in be more of a personal care item than a first aid item. If you want one it goes elsewhere.

Most everything else has been covered by others.