What does a decent first aid kit really need ?

[He' s left the building]

Keep the blister info on here I think.

Most 'injuries' outdoors tend to be blisters, sprains, gastro-intestinal illnesses and lacerations/abrasions (cuts and grazes).

Focusing on what is a likely injury therefore suggests our kit should enable us to deal with blisters, immobilise/support joints, assist hygiene and dress minor/major bleeds.

 

[sam_acw]

I agree with Boops on this one.

 

[Sniper]

Boops
Not fatalist in the least, you described a severed femoral artery followed by unconciousness due to shock whilst out in the wilds, and where the femoral artery is severed the body, will bleed out very quickly, within minutes in fact without proper treatment, and just applying a dressing on it's own would in my experience be insufficient to stem the flow without additional pressure. Also to complicate matters the severed artery will most likely retract from the site making it even more difficult, plus the pressure behind it makes it extremely difficult to stem the flow. In town or somewhere easily got to by road you have a chance that a professional can get to you with the right equipment to deal with the bleed but just as important they can also get a line in, to keep the fluids up, thereby reducing the effects of clinical shock. Out in the woods where they may need to search for you, even with a grid reference, will unfortunately, take some considerable time, depending on location possibly hours. Even with medivac or air ambulance, getting it airborne and searching for someone in the woods does not bode well for a quick result in finding you. Far longer I reckon than you would have whilst spewing blood from an arterial bleed, I am unfortunately speaking from experience. Although tourniques are actively banned for untrained folks, I am fortunate enough to know how to use them and have recently updated on this, in this scenario I feel this might be the only course of action, unfortunately there are very few out there can use one safely, and without causing more damage.
Nigeltm
The fluid inside the blister is the bodies own medication which is naturally designed to repair and protect the tissue, by bursting the blister you are removing the very thing the wound needs most to heal itself. If you take the example of inhalation of hot gases or drinking bleach or some such, which will cause the airway to block because of blistering and swelling of the throat therefore the airway, medics do not burst the blisters to get air into the lungs, instead they insert an airway which keeps an open passage for air to get in. I think you would agree that this is much more serious than a restriction of movement to the fingers, so if they don't burst them to save a life then you certainly shouldn't burst them to free up a little movement in the digits, probably better to stop the cause and rest the parts concerned before continuing.
Also bear in mind cooling a blister with cold water when it first starts to form, is a way of reducing the blistering effect.

 

[He' s left the building]

Stopping a catastrophic bleed is far more important than getting IV access. In some cases by administering fluids you may cause harm by increasing blood pressure, which often does not help in some cases of head injury (depressed fracture), and may also disrupt any clotting process for major bleeds (by blowing off the slowly forming clot).

I am in no way suggesting we use equipment such as tourniquets or clotting agents, etc without adequate training, I am merely again suggesting that a pressure dressing is an appropriate first aid item to keep handy when people and edged tools get together.

I am willing to be corrected on anything I have said by someone who is either a HPC registered paramedic or a surgeon

 

[Sniper]

Your absolutely right in that the bleed takes priority over the IV but once the bleeding has been controlled the IV is the next priority for treatment and crucial to the casualties survival. I am only pointing out that the scenario that you gave in your first post was an extreme scenario, in which there is a very high possibility of the casualty not surviving is all. In that scenario then it may be one of the very very rare occasions where a tournique might be used by a properly trained person. I also would think that a surgeon would not be the best person to advise on this scenario as most surgeons will testify, their first aid skills are not usually very current or practised, as their job is normally done inside an OT with their tools and supporting staff around them and not in a wood somewhere with nothing but a small FAK to hand. I am trained to IHDC level, and part of my job is training not only first aiders but also first aid trainers for the British Red Cross, I also train others in Rescus support and oxygen therapy, Moving and handling of casualties, Trauma management and major incident management to name but a few relevant skills, plus I am a duty officer for the Red Cross emergency response management & implementation team for my area and for the UK, therefore I am fairly confident in my level of skills and current knowledge and protocols in first aid procedures without being either a surgeon or a paramedic to be able to speak with some authority on the subject. I apologies if my post has in some way offended you, I can assure you it was not in any way meant to, I am only endeavouring to correct wrong information and answer any queries arising from this thread, perhaps I should leave it to those better qualified?

 

[phaserrifle]

I find that some plasters of various sizes or some plaster tape (basicaly a long plaster you cut to size) are both very useful. most injuries are minor cuts. I also carry a roll of zinc oxide tape, to hold plasters on better. I also have a small bandage for larger cuts, or cuts in odd places where the plaster won't stay put (eg the palm of my hand), a small tube of savlon and a pair of scissors. that's all I realy need for most stuff, It covers minor cuts, and the plaster tape can be used to protect blisters, till I can get back to camp, and some more suitable matiriels (explained below)

admittedly I also bought a larger kit (life venture mountain kit) which has more of the same, plus some proper blister plasters, burn cream, skullache pills, larger bandages, gloves, steri-strips and a small roll of gaffa tape amongst other things. the advantage of this one is that as I often go on camps with scouts, the larger supply of minor injuries gear is useful, as you can guarentee someone else will do themselves a mischeif, and not have an FAK with them. the major injuries stuff is only intended for me to use on myself, or for someone else to use, as I am not a qualified first aider.

 

[He' s left the building]

I apologies if my post has in some way offended you, I can assure you it was not in any way meant to, I am only endeavouring to correct wrong information and answer any queries arising from this thread...

No offence taken Sniper

I'm just a bit wary of taking medical advice from forums if people haven't stated their qualifications, lots of urban myths, etc.

My EMT status is well out-of-date but I still have access to doctors and surgeons, etc in my day job and it is them I get feedback from, ie 'if the first responders had done XYZ then we would have got a casualty in a better condition...' all a surgeon wants from pre-hospital emergency care staff is an immobilised casualty whose bleeding has been controlled and whose body tissues are still perfused with sufficient oxygen to make surgery worthwile.

Way OTT for this thread, suffice to say that if you stick an axe/machete into the back your hand then your immediate first aid actions must be quick and decisive, preferably involving a big dressing! Also worthwhile pointing out that a large dressing will go on a small wound or a large one, but a small dressing will only go on a small wound?

When I was providing medical support to gap-year expeditions, we could guarantee lifting at least one of them in the first few days with 'machete rash' With that and vehicle accidents, urchins in the foot, tree branches in the eyes and diorrahoya (however you spell the sh#ts?!!) it was almost a full-time job!

Cheers

 

[primitiveliver]

I always make sure to have at least one Quickclot package on me. It is really great for large injuries.

http://www.quickclot.com/

 

[Steve M]

I always make sure to have at least one Quickclot package on me. It is really great for large injuries

And really bad if used incorrectly.

 

[Sniper]

Boops
I agree with you that a lot of advise given, even with the best of intentions are often way off the mark and in some cases downright dangerous. Also giving advice on forums is not always taken but as you say it's difficult to know what the background is of the folks giving it.

I've read some really good stuff from the USA about "Quick Clot" and some bad stuff about wounds being burned by it, as I understand it, the trials are still ongoing before a definitive decision is made about it's use over there. I do know that it is only being sanctioned for very severe bleeds by those using it, and not for any smaller and less dangerous wounds, of which most cuts are. Certainly it is not advised over here, in fact it is actively discouraged until the test results are in, as only then will the UK look at it for introduction and use in Britain.

 

[primitiveliver]

If you bleed to death or nearly to death I am not sure burning around the wound should be your first concern. I am not saying it is the only thing I carry and frankly I have never need it for myself. However if you are back county with a large bleeding wound Quick Clot will stop it. I am not sure that Quick Clot is all that controversial here in the USA. If you go to their website you will find that they are starting to market to the average Joe. From taking to people it seams either you know about it or you don't. And if you do you know, then you what the product can do good and bad. There is another product called Celox’s, which is like Quick Clot. I have not had a chance to do my home work on it yet. But I here it is safer and easier to use.

http://www.celoxmedical.com/

http://www.quickclot.com/

 

[Alex UK]

Neither are advised by JRCALC. I think the forces might be using them, but nothing civilian that I have come accross. For the moment, I would not advise either (but if you have to then from what I have read Celox looks safer).

Alex

 

[nige7whit]

I have, in the past, used commercial superglue to close quite serious (bleeding annoyingly) cuts on myself, mainly fingers, but also thigh.

My First Aid kit has lots of stuff... 6 x field dressings, single use bag/valve/mask, OP airways, 5 sizes (2 of each), Sphygmomanometer and stethoscope, blood sugar monitor, foil blanket, Tuff-Cut shears x2, lots of medical gloves, digital thermometer, flashlights, forceps, burn gel, cling film, alcohol hand rub, hi-vis sleeved waistcoat, heavy duty rubber gloves, a few plasters, and some headache tablets. (and the car, that it lives in).

its always worth having super glue for sealing small cuts. and as i only found out yesterday, super glue and cotton mixed together create an extreme exothermic reaction. that is, if you pour super glue onto cotton wool you can start a fire.

 

[British Red]

In light of Warthog1981's recent injury with an axe I've been thinking about the bits and pieces that I usually have in my first aid kits.
The little one in my day pack would have struggled to deal properly with that type of wound and I'm seriously thinking of adding a large field dressing to the kit.

Any other *musthaves* that ought to be in it ?

cheers,
Toddy

Okay, my take and I think, a few points that have been mentioned that are worthy of emphasis

Firstly the point is well made that the kit I need at home, work and "in the field" vary.

My field medical kit serves two purposes. To deal with serious injuries and preserve life until I can obtain qualified assistance. However it also has the purpose to deal with minor problems sufficiently well that I do not need to bring the trip to a premature end. For me at least it is important that I can do both of these things and know the difference.

So what do I plan for.

1) Blisters. Its been covered in a variety of ways on this thread but clearly it needs thinking about. My main purpose is to cushion the area and protect it. I personally like the gel based "second skin" material covered with a large dressing

2) Eyes. Sparks, splinters, branch whips etc. TWO eyes dressings. Why? If you have to cover an injured eye, the other will still move and the eyes move together aggravating the injury. If it is safe and practical its useful to be able to cover both eyes. Either two eye dressings or one of the new "headband" type that covers both eyes is useful. I also like to carry the sealed ampoules of sterile water to irrigate an eye - I've seen a tiny spark spit in an eye whilst cooking. Having one to hand offered quick, safe relief.

3) Cuts - sterisrips, plasters (large), zinc oxide tape, antiseptic etc. I like to have a wound wash liquid to flush cuts with. For decent sized cuts TWO medium (No 8) dressings. One can be used as a pad for the other in a palm cut. both can be used around a protruding object etc. FFD for sure on longer trips and a triangular bandage for elevating slings, support slings, head dressings etc.

4) Guts. Immodium to stop severe upset stomach. Some sachets of doiralyte are much more palatable than whomped up salt in water.

5) Bites, stings, splinters. Needle, tweezers, antihistamine tablets, topical bite relief, Tick hooks are a must

6) Burns Cling film and water gel (dressing or sachet). Water gel is mainly for the normal "hot billy can" moments and is no substitute for proper cooling but it does give relief for small but painful burns

Clearly theres some more stuff in my kit (personal meds, pain relief etc.) but hopefully thats an insight into the general type of stuff I carry (and why)


Red

 

[Sniper]

Red that sounds to me like a good stocked and well thought out level of stuff for the individual. It has a good mix of general use items and I doubt you would need much more than you have got there. I would suggest adding another triangular, extremely useful for fracture immobilisation cos of the width thereby reducing pressure ridges, also a space blanket lightweight and very handy for helping keeping a casualty warm, and lastly paracetamol for pain relief. I personally do not carry eye dressings except in my big kit, I instead carry a couple of small dressings which can be used for eye injuries but also other types as well, and I carry a roll of finger bandage and applicator as it makes dressing a finger so much easier and latex gloves for hygiene plus some safety pins.

 

[Sniper]

If you bleed to death or nearly to death I am not sure burning around the wound should be your first concern. I am not saying it is the only thing I carry and frankly I have never need it for myself. However if you are back county with a large bleeding wound Quick Clot will stop it. I am not sure that Quick Clot is all that controversial here in the USA. If you go to their website you will find that they are starting to market to the average Joe. From taking to people it seams either you know about it or you don't. And if you do you know, then you what the product can do good and bad. There is another product called Celox’s, which is like Quick Clot. I have not had a chance to do my home work on it yet. But I here it is safer and easier to use.

In the US "Quick Clot" is more acceptable but until the trials are completed to the satisfaction of the Brit health authorities then it won't be allowed here so the burn factor is no real concern, however as I understand it when used by folks for more minor cuts the resulting tissue damage is far worse than the original wound, and that is one of the reasons, and IIRC there was some controversy over allergic reactions when first introduced for testing, and although this original setback problem was addressed by the manufacturers there is still some other concerns. Exactly the nature of these other concerns I'm afraid I'm not sure.

 

[British Red]

Red that sounds to me like a good stocked and well thought out level of stuff for the individual. It has a good mix of general use items and I doubt you would need much more than you have got there. I would suggest adding another triangular, extremely useful for fracture immobilisation cos of the width thereby reducing pressure ridges, also a space blanket lightweight and very handy for helping keeping a casualty warm, and lastly paracetamol for pain relief. I personally do not carry eye dressings except in my big kit, I instead carry a couple of small dressings which can be used for eye injuries but also other types as well, and I carry a roll of finger bandage and applicator as it makes dressing a finger so much easier and latex gloves for hygiene plus some safety pins.

Oh theres a good few more bits - gloves of course plus a disposable resus shield on me. a vast variety of safety pins (including latching nappy pins) - although they are more likely to be used on a bust zip etc.. Duct tape is in the bag too but more likely for a boot sole

There are a few little wrinkles I have found useful - wound wash in a squirty bottle for example (pointy top type) - good for clearing dirt etc.

For pain relief I think its useful to have anti inflamatory as well as analgesia but that thats a personal choice. I find a good old crepe bandage very handy too for the odd light sprain.

Tubigauze is great stuff but I find the applicator bulky so it lives at home - excellent for nicked fingers I agree!

I also find a few "lemsip direct" as a useful addition to the normal OTC pills and potions.

I do try to keep my weekend FAK to "paperback" sized - more than that and it becomes an encumberance so I ahd to sacrifice the second triangular - usually have a bandana or scarf if needed though

Red

 

[rik_uk3]

Best not to use commercial super glue on wounds, not good, get something like Dermabond.

Also be carefull with the Imodium, its not always a good idea to just use it if your not sure what is causing your problem, if possible keep hydrated and let nature take its course.

 

[sandbender]

Best not to use commercial super glue on wounds, not good, get something like Dermabond.

rik_uk3 do you have links to pages which discuss the differences? I have read that although commercial superglues and dermabond are chemically different, that chemical difference only serves to make dermabond more flexible not less toxic.

Any info you can post would be appreciated, thanks.

 

[rik_uk3]

rik_uk3 do you have links to pages which discuss the differences? I have read that although commercial superglues and dermabond are chemically different, that chemical difference only serves to make dermabond more flexible not less toxic.

Any info you can post would be appreciated, thanks.

Just do a quick google

I carry Dermabond by choice, standard superglue can create heat which is not good for skin tissue. Any glue should really be a last resort to be honest, for one thing you may be sealing debris etc in the wound.

Lots of people use super glue so use it if you want, I won't though.