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="" />