Mt. Whitney Portal Store & Hostel Forums General Mt. Whitney Portal Store Message Board First-Aid Kit Recommendations?

Well, I was going over my first-aid kit last weekend before an snow-shoe overnighter and I began to think whether what it included was a bit inadequate. First off, it's mostly the usual assortment of bandaids, moleskin, roll of medical tape, a few gauze pads, and well since I'm a pharmacist, Lomotil, tramadol, Aleve, Tylenol, and Excedrine (Diamox for higher altitudes). The recommendations I've come across range from everything short of portable defibrillators to bare bones (less than what I take).

I'm looking to put together a first-aid kit that is bit more thought out and complete. What do you recommend?

I often hike alone so I carry things that I think might let me make it out on my own in any but extreme cases. Besides the things you list, I carry a Sam foam splint - it weighs almost nothing; I have duct tape wrapped around my pole handles; heavy duty pain pills like Vicodin or Oxycodon; and a space blanket. (Of course the usual 10 essentials like a whistle, mirror, etc. I don't carry matches because I wouldn't want to be tempted to use them in the wilderness.)

Whut? I would think that "emergency situation" would supercede rules and regs, etc., about using matches in the wilderness. Perhaps I misunderstand...having intimate knowledge of frostbite makes me more than a bit curious.

Terrible fires have been started by people who got in trouble in the wilderness and felt they had a right to start a fire to save themselves. People have lost their lives and their homes in those fires. If I am going to risk my butt going into the wilderness (especially alone) mine is the only butt I have a right to put at risk.

Ok, I got duct tape wrapped around a nalgene bottle, a space blanket, mirror,but can't take any of the heavy pain meds due to a bad allergic reaction so I take the tramadol (Ultram). What type of Sam splint do you carry?

It's a 36 inch. It's marked "to reorder go to adventuremedicalkits.com, 800-324-3517." (I have an Osprey day pack with a mesh back. The splint rides at the bottom between the pack and the mesh and actually makes the pack more comfortable.)

Cool, definitely going to pick one up. Doubt I will notice it one bit in my winter pack (which is an Astralplane ).

I think a basic kit would cover 98% of anything you're going to run into:

a roll of kling (highly recommended); maybe 4 or so 4" x 4"s; band aids; moleskin or 2nd skin; definitely duct tape (obviously not just for first aid); a roll of good athletic tape (Not a big roll); maybe a roll of paper tape to hold bandages in place. A triangular bandage; a tube of antibiotic ointment. Definitely lomatil and something hard core for nausea & vomiting. I've never found ace bandages to do that much good, but a lot of people carry them. I also carry two small orange smoke flares, but remember that a helicopter has to be almost right on top of you before setting it off. They only last about 10 seconds.

I carry a large syringe to get some pressure to clean wounds -- and soap and water is probably as good as carrying betadine or something like that. Maybe overkill, but a thought.

I also carry a stethoscope and BP cuff, but would dump them if my job didn't require it. Never ran into anything where they told me something I didn't already know or suspect (like, you're too sick to be here and we have to figure out how to get you outta here...). Oh, I just got a pulse oxymeter now that the price is down to about $60 on Amazon. Not sure about it yet. I think it only confirms when someone's really got to get out. It's best to compare the one sick person to everyone else in the group for a better idea of what's going on. So far, I'm thinking anything down to the mid-80s is probably OK, though at sea level in a hospital, you'd be in trouble (I'm open to correction on this...).

Sam splint isn't bad, though you should also look at your stuff to see what you can improvise if you need a splint -- foam pad? plastic stays in your pack? clothing and a couple of sticks and tape?. But mainly keep it pretty light and basic (under 1 lb, I would think).

Incidentally, I saw a talk last year by a mountaineering ER doc. He pointed out how critical it was to keep people warm from the moment of serious injury and how quickly people lose heat when they're compromised by injury. He also said that none of the methods to warm people up (hot water bottles; chemical packs etc.) were very effective (though a big fire would be, if possible).

Oh, and I would absolutely carry matches. Absolutely. You can't get truly warm if you can't start a fire. Smoke is also a great signal especially if searching from the air -- it shows up from several miles away as something unusual to investigate. That saved three guys stuck at Roaring River Falls last fall.

g.

Second the athletic tape. Has saved the trip for me several times when a hiker got a bad-enough blister that they couldn't walk, and the moleskin was lasting a few hundred yards before it slipped off.
Just wrap up most of the foot, then cover with the spare slipsock you also carry.

I like George's approach, and would add one thing: the most important first aid item is the user: When I was resupplying the first aid kits for the yachts in my club a few years back, I realized the most important item was a first aid manual: most don't know what to do!

For anyone involved in outdoor sports, the absolute minimum that one should have is a first aid course. These are actually available online, free of charge! You have to pay to get a certificate, but that's not the point! Not as good as in-person training, but better than nothing! However, I'd recommend a higher-level course: Wilderness First Aid, WFR, WEMT. This stuff pays off.

George, I didn't realize how much Pulse-Ox's had dropped! Got one today for $35! Unbelievable! INcluding shipping! Next month I bet they'll be free!

Syringe is not a bad concept, although I think we can accomplish about the same by pouring from about 2-3 feet high. Syringe is certainly less messy! BTW plain soap and water is BETTER than Betadine and other such products....causes less damage to injured tissue. Mom was right!

Kling is great stuff, Ace's generally useless, I agree.

Totally agree with fire-making ability. One of the ultimate survival requirements.

No stove then?

Anyone have an opinion on QuikClot? I've carried it for years but never had a chance to use it.

http://www.quikclot.com/

Mainly a gimmick. We have such things in the ER, I don't remember ever using them, and never in my office. I don't think we stock such things in the Urgent Care Center.

There are uses, but so uncommon as to be negligible for the public.

Ah ha! Since I don't backpack anymore I hadn't even thought about needing matches for a stove. Of course you do.

Where I'm coming from is that there have been terrible wild fires in the Angeles, San Bernardino, and Cleveland NFs in recent years. Some were started by arsonists, some by homeless people trying to keep warm, but some were started by hikers/campers who thought they were in danger and needed to start a fire which then got out of control. If I am right that at least one bystander has died because of a hiker-started fire I still take the position (for myself) that I shouldn't start a fire and endanger other people just because I've put myself in a bad situation.

The danger of getting in trouble in the wilderness is not just an abstract idea for me. I have been hiking, and in earlier years backpacking, for 50 years. In that time I have been in potentially life-threatening situations more than once (5 times that I can easily remember). I consider that is always possible when I go into the wilderness and I try to be prepared. But I don't want to endanger anyone else if I screw up.

I know that a fire might save a hiker's/camper's life. I just don't like the potential trade-off. My decision.

I agree. No matches are necessary for summertime day hiking when no stove is needed. This is also the season when an out of control fire is most likely but when a fire is least needed. At any other time of year or for overnighters I wouldn't want to get caught without a fire making method in hand, matches or a lighter being more convenient than two sticks.

I have only once been in such cold that a fire was necessary to keep my hands warm enough to manipulate my gear.

Something else to toss out there. How often do you check your kit. Refresh the tape, moleskin, etc.

To me the most usefull things are simple

Space Blanket Bivy Sack, Kling, Single Edge Razor Blades, a few water treatment tablets, Tweezers, Moleskin, any other needed things come from my pack or clothing. Thats where the blades are useful to cut up a shirt to make a dressing. Splints from local materials or parts of your pack.

Broke my arm a few years ago alone in the winter and used my kling and leggings to make a splint. (X-paramedic)

burt, understandable sentiment. However, that is generally not the issue....rather, it is the literal ARMY of people who will be deployed looking for you. It is very sobering to read SAR reports of how many people spend how much time to find someone. You can't expect that they won't come for you. They will.

My point of view is that we want to make it easy for them. Lighting an inappropriate fire, in terms of what the fire is, does not lead to don't ever light a fire, ever, no matter what.

You may make that choice for yourself, even hide from rescuers, I guess. However, you may also come upon someone else who needs help, or you may be hiking with someone else. You've eliminated one of the more useful survival techniques, and signaling techniques. Your choice, of course, but on the other hand, if you've not been involved in saving people, you may not know how things can get out of control. I think of it more in terms of preserving options, rather than making a choice about actions in probably unforseeable circumstances. It's nice to have options.

Something very worthwhile reading is "Talus Pile" the newsletter of China Lake Mountain Rescue Group, where they talk about incidents. Sobering.

Here is a report this morning of what I'm talking about, in preserving options:

http://home.nps.gov/applications/morningreport/index.cfm
(by the way, a great site that documents most significant accidents in the national parks)

Dry Tortugas National Park (FL)
Kayaker Rescued, Body Of Companion Found

On the morning of Sunday, February 21st, two campers – a man in his 30s and a Czech woman in her 20s – began a sea kayak trip from Fort Jefferson on Garden Key to Loggerhead Key, planning on returning by 4:30 p.m. At 4 p.m., rangers noticed that they hadn’t yet returned and that there were no boats visible on the water, so began a hasty search for the pair. When the rangers found that the campers were not on Loggerhead Key, they contacted the Coast Guard and asked for an immediate air search, as they had presumably capsized and were now drifting in the open ocean. Rangers conducted a boat search until nightfall and the Coast Guard helicopter from Miami searched by air until 1:30 a.m., but no signs of the missing campers were found. Operations resumed the following morning. The Coast Guard dispatched a cutter, a small boat, an auxiliary aircraft from Key West, and a Falcon Jet from Miami. Incident command was transferred to the Coast Guard’s Sector Key West early that morning. Rangers Ben Brdlik and Dustin Park found the woman’s body about three-and-a-half nautical miles west of Loggerhead Key and outside the park around 11:15 a.m. after running search patterns on the six-foot seas. The search then focused on the area where her body was found and her companion was found alive in the water about a half hour later by the Coast Guard jet. He was about a nautical mile to the southwest. According to the Coast Guard, the kayakers reached Loggerhead Key, but capsized on their return trip and had probably been in the water since 1 p.m. on Sunday. Loggerhead Key is located two-and-a-half nautical miles west of Garden Key. Over half of the trip is over reefs in shallow water with the last mile over open ocean. Crossing conditions are variable and affected by tides, currents, wind and waves. This is a popular trip, and kayakers undertaking it are briefed on the hazards. The couple declined a VHF radio offered by another camper and had no signaling devices. The survivor is a 32-year-old fishing guide from Key West. The woman was a Czech national in her mid-20s who was employed by a property management company in Key West.
[Submitted by Dave Walton, Site Manager]

I think most are looking at this too superficially.

First, you refer to "my" first aid kit, suggesting that one will suffice. I have several. Each is different, and which one I take depends on what kind of a climb I am on. A day hike on a trail; a technical climb; a multi-day winter climb; two weeks deep into the Sierra; or two months in the Himalaya. Even then, I will add or subtract items depending on the details of the climb.

Second, think of working in partnership with the other members of your party. If it seems necessary to be prepared for a cardiac emergency, not everyone needs to carry a sternal saw and a Jarvik-7; one set will do. In CLMRG, we each carry a kit that some would deem rather minimal. Yet in the event of an accident in a party of four, say, pooling four of these minimal kits can be pretty formidable.

Third, you need to think of the first aid kit as a bit player in a larger production. A skinned knee can be easily treated with some antiseptic, a bandage, and perhaps a couple of aspirin—nothing more to consider. But if you carry a SAM splint and heavy-duty painkillers, you are anticipating a more serious injury, and you need to have some plans in mind. Some have touched on this with their suggestions of heat sources and bivy sacks, but I would go further. You need a plan to put into place after you have treated the injuries. Do you have the means to keep the victim comfortable and alive for a long time? A means for evacuation? An example is the ability to fashion a useable litter out of a climbing rope. Communications, in case your party can’t handle the evac? A SPOT of course comes to mind, or a cell phone if you are lucky. A signal mirror or other devices to help in locating you. Did you leave information with a responsible party—what to do if you don’t come home when expected; information on where you went and your contingency plans?

First aid is defined as the initial basic treatment of an injured or ill person. But in the wilderness setting, you must also do certain things (preparation) in advance of the need, and—except in the simplest cases—you need to be able to do certain things (keep safe, communicate, evacuate) after the need.

I have not mentioned any specific items that should be in your kit. There are plenty of ideas out there. Rather, I wanted to suggest that you adopt a larger mindset. That first aid is merely one element in the overall preparation, treatment, and follow-up of a medical emergency in the wilderness.

Hey George - I see where you say down to about 80 with the pulse oximeter is OK. Last summer you checked me and my son after we detoured down to Charlotte Lake because my son was having serious altitide problems going over Glen Pass. You said mine was lower than my son's (but didn't tell me the number), and his reading was about 60, IIRC. I felt completely fine, though. I wonder about that - am I an unusual case, or is the pulse oximeter having accuracy issues?