First aid kit

[BillyBlade]

Dreadhead; ref: antiseptics and solutions, there is a brief guide on good old Wiki

Antiseptics


That said there is a growing fashion away from Antiseptics in remote areas, certainly the more potent solutions because antiseptics 1) can cause cell damage 2) can inhibit healing.

In hospitals, saline solution (clean but slightly salty water) is being favoured for all but the dirtiest of wounds (contaminated material or bites (animal or human!)).

Another reason for the move away from antiseptics is that in a hospital setting it is easier to keep a wound clean; this is much more difficult in the outdoors. A wound which has been treated with strong antiseptics can be more susceptible to infection if it is 'too clean' because the skin's natural, good, bacteria has been removed leaving an open portal for infection to enter.

Soapy water will do the job (I read somewhere but can't find the original source that clean water can remove up to 40% of infection). Here is a slightly different link to some evidence.
http://www.ncbi.nlm.nih.gov/pubmed/15995106


Ideally you would flush the wound out with 'high pressure irrigation'. For this use a 20ml syringe (or lager) with a wide-bore needle. Something like an 18g (pink) 'mixing needle'. Mixing needles have blunt tips as opposed to needle for injection so there is less chance of a sharps injury or injecting the water into the flesh. If you have it, try and get 1.5 Ltrs of clean water flushed over the wound.

http://www.sciencedirect.com/science/article/pii/S0361112476801608
http://www.journals.elsevierhealth.com/periodicals/yjacep/article/PIIS0361112476801608/abstract

I hope this helps. Long story short: Keep it simple - clean water and plenty of it! I am writing an article for the website on wound cleaning and will post a link when done. If anyone has a strong opinion on the above, please feel to comment - either publicly or by PM.

HTH

Agree with all of that. I moved onto carrying sterile water (bottle of contact lense solution) and a syringe to flush out wounds some time ago. The move was based on advice from a paramedic.

All good so far

 

[21st century pict]

1x 4” Haemorrhage control bandage
1x Quikclot granules
1x 300 Meg aspirin
1x Resuscitation face shield
1x plaster (what a luxury)
This is the FAK I carry in my day sack lightweight and compact.
I won’t use super glue again, got infected and I had it burst it open to let the s**t out. It looked like I had pocked my finger in to a tomato I was nearly greeting just thinking about it.
Well you know what they say a little pain never hurt anyone.....What a lot of S**T...

 

[BoonDoc]

1x Quikclot granules

Get Celox instead. If you are in North America then get Combat Gauze. I have used Quickclot in anger. It works *if* you have trained well with it.

We are no longer teaching in for the UK military. The Celox is far superior, doesn't get hot, hard to screw up and easier to use. I have yet to not have it work.

 

[21st century pict]

Cheers Boondoc.
Sorry my mistake, don’t know why I said Quikclot it is the Celox i have.
But nice to know someone is on the ball.
Ps hope that Jon Young's Guide to Tracking is good just ordered a copy...
Later Bro.

 

[BoonDoc]

Cheers Boondoc.
Sorry my mistake, don’t know why I said Quikclot it is the Celox i have.
But nice to know someone is on the ball.
Ps hope that Jon Young's Guide to Tracking is good just ordered a copy...
Later Bro.

Cheers, brother. JY also comes to the UK a couple times per year. If you google Jon Young and nature awareness you will come up with some options.

 

[Scots_Charles_River]

Did a 16hr Emergency Aid in the Outdoors course last week, guy said to put a small bit of gutter/duct tape in. He has used it lots over the years instructing and in a MR team.

 

[bronskimac]

Don't want to re-open the whole "laymen shouldn't use it" argument but how is it best to use Celox and what type is the most versatile to keep in a FAK? I would only use it if it is obvious that bleeding to death is the only other alternative.

 

[Graveworm]

Don't want to re-open the whole "laymen shouldn't use it" argument but how is it best to use Celox and what type is the most versatile to keep in a FAK? I would only use it if it is obvious that bleeding to death is the only other alternative.

The easiest and best of these are the gauze types (Not the "T-Bag" types). The newest Z fold Quikclot combat gauze has the edge at the moment just from ease of use and size of package but Celox also make one which works in the same way.

The advantage is that you use them like conventional gauze; pack or cover the wound and hold on with direct pressure for at least 5 minutes. Their use is indicated only when you can't control exanguinating extremity bleeding by direct pressure or use of a tourniquet, so a tourniquet is a much higher priority than haemostatics. They have their uses but they are not a silver bullet and only slightly better than pressure with normal gauze, they add most value when you can't maintain pressure.

If it helps I have just uploaded the latest PHTLS advice on haemostatics HERE

 

[BoonDoc]

Don't want to re-open the whole "laymen shouldn't use it" argument but how is it best to use Celox and what type is the most versatile to keep in a FAK? I would only use it if it is obvious that bleeding to death is the only other alternative.

I teach this subject for the BATLS course in the MoD. What I tell the lads going over to the sandbox is that you can use Celox anywhere for anything. Just don't stuff it into the chest, head or abdomen. It was originally designed for catastrophic bleeding that cannot be stopped with a tourniquet.

I have used Celox and Combat Gauze on catastrophic bleeds. They both work, but I found that Celox fills the wound cavity a little better.

Bottom line. Use Celox as you would any gauze product. It just has a little extra "pixy dust" to help stop the bleeding.

 

[BoonDoc]

I have just uploaded the latest PHTLS advice on haemostatics HERE

Graveworm, thanks for this PHTLS document on different catastrophic agents. It should be read by all who carry any of the products. Interestingly enough, the researchers found out that normal gauze with direct pressure for five minutes worked just as well as the haemostatic agents.

I remember a course that I taught with some Scandinavian SF guys. At that time they were not allowed to have haemostatic options and just stuffed 12 rolls of gauze into a bullet wound. They stopped the bleeding.

 

[Martyn]

Don't want to re-open the whole "laymen shouldn't use it" argument but how is it best to use Celox and what type is the most versatile to keep in a FAK? I would only use it if it is obvious that bleeding to death is the only other alternative.

It's not "laymen" that shouldn't use it, it's people that dont know what they are doing shouldn't use it, which begs the question, if you have to ask what to use, where and when, then maybe you need to get some training in first? Then after your training, you probably wouldn't use it, because you would now know that you dont need to use it.

 

[bronskimac]

Well from reading around and the contents of this thread, it appears that packing the wound and applying continues pressure for 5 minutes is likely to be as effective in most cases. So the thread has been worthwhile for me. I'll add some more dressings to my FAK.

 

[rik_uk3]

Well from reading around and the contents of this thread, it appears that packing the wound and applying continues pressure for 5 minutes is likely to be as effective in most cases. So the thread has been worthwhile for me. I'll add some more dressings to my FAK.

Some here have been saying that all along

 

[TheFirstAidSupplier]

Very interesting to read the chat on what you guys consider essentials for first aid kits!

 

[missamor]

I've adapted my first aid kit from the advice on ARRSEpedia:

Its contents are:

Plaster Strip
Antiseptic Cream with local anaesthetic (Germolene)
Petroleum Jelly
Ibuprofen
Loperamide Hydrocholide Tablets (Generic Immodium)
Antihistamine Tablets (not non-drowsy ones)
Bites and sting cream (savlon brand)
Antiseptic wipes
Emergency Blanket
Safety Pins
Tweezers
Scalpel & Blade
Scissors
A few large adhesive Dressings
Cheap whistle

and a little laminated card with the contents on it (which I copied this off!)

I've also got a plce medics webbing pouch which comes with me in group situations or when axes etc are involved and is basically a much more standard kit packed full of bandages, ffd's and a few ice packs.

Hi your kit full of most useful things
Thanks.

 

[ajbennett]

Hi
Personally, as well as most of the kit you mentioned in the original post, I carry a needle & thread. I have always suffered really badly with blisters on my feet, moleskin is good, but depending on the blister location, not always possible to apply. Once a blister has formed I sew a small length of cotton into the blister bubble, leaving the end hanging out to keep it 'drained' - yeah, nice, but it stops it from bubbling again. I cover with a plaster. Seems to work well until I reach civilisation again - obviously it's important to have a sterile needle - also doubles up to repair holes in your socks -ha!

 

[ex-member BareThrills]

This has been a most informative read so many thanks for sharing your kit and to all the other contributors with other info. The only thing im failing to find is the iodine solution and iodine wipes. Is iodine a prescription only medicine?

 

[Wayne]

http://boundtree.co.uk/first-aid/wound-cleansing/cleansing-solutions

this is what i have in my med pack.

 

[bushblade]

This has been a most informative read so many thanks for sharing your kit and to all the other contributors with other info. The only thing im failing to find is the iodine solution and iodine wipes. Is iodine a prescription only medicine?

You can get the povidone Iodine from most chemists, they will need to order it in for you. I got my last lot from Sainsbury's pharmacy just under £5 for 500ml. It used to be under the brand name of Betadine but is now only available from Videne it's the antiseptic solution you want.

 

[bushblade]

I've since altered this kit again to include 2 of the opsite flexgrid dressings as I'm finding these extremely versatile. I pulled a good sized chunk of skin off my hand climbing and using these dressings was able to be back climbing in 2 weeks. I've also swapped the elastoplast waterproof dressings for 3M aqua 360 as these seem more breathable and are more flexible so stay put longer.

1. 1 pack of 5 gauze swabs 7.5cmx7.5cm. - Cleaning wound site, applying medications, padding dressings.
2. 2 pantiliners - Blood absorbing compress for wounds prior to dressing.
3. 1 Opsite Flexigrid - waterproof breathable film dressing ideal for burns and grazes.
4. Dressings pack:-
   3 large compeed blister dressings
   2 small compeed blister dressings
   Elestoplast cut to size fabric strips x 3
   2 packs of steri strips
   3 elestoplast waterproof dressings
   3 Melolin 5cmx5cm pads.
5. Cotton buds (Q tips) - applying medications, aids in removing foreign body from the eye.
6. 10ml syringe with 18g needle stored inside - wound irrigation using clean water/iodine solution.
7. 4 x Savlon antiseptic wipes - cleaning of minor wounds and hands.
   8 x Alcohol swabs - cleaning of tools prior to blister draining/ splinter removal, cleaning of skin prior to blister dressing.
8. Fixings:-
   5cm wide flat packed roll of Transpore tape by 3m - Securing dressings, improvised butterfly sutures, blister prevention (over hot spots), stays put when wet.
   3.5cm wide roll of Metolius brand finger tape (zinc oxide tape) - Securing dressings, strapping of sprains and strains.
   Mr Bump cohesive bandage 5cm wide - securing dressings, strapping of sprains and strains, reusable, good when frequent dressing changes are needed.
9. Medications:-
   2 x Benadryl Acrivastine capsules - allergy relief.
   8 x Ibuprofen 200mg - Pain relief, anti inflammatory, can be taken with Paracetemol for additional pain relief.
   8 x Paracetemol 500mg - Pain relief, fever reduction.
   6 x Caffeine 50mg - Pain relief, temporary relief of tiredness.
10. Povidone Iodine (10% available iodine) in 10ml droper/application bottle - antiseptic, antibacterial, antifungal, mixed with clean water for wound irrigation (approx 10 drops per cup of clean water), water purifaction (8-16 drops per 1litre).
11. Friars Balsam (tincture of benzoin) in 5ml dropper/application bottle - topical antiseptic dressing for minor wounds and mouth ulcers, topical adhesive for dressings and steri strips, add a few drops to hot water and inhale as a decongestant.
12. Victorinox classic and safety pin - scissors, tweezers, toothpick, nail file, small blade.
13. 1 pair nitrile gloves - can also be used as improvised mouth to mouth barrier.