When we are working or playing in the outdoors, the remote environments presents certain complications that would compound an otherwise simple injury in an urban environment: A greater likelihood of injury A greater severity of injury Longer term care for the casualty because of our distance from definitive care.
We are in the habit now of attending specialised First Aid training courses for remote environments which help us prepare for these complications. Similarly our First Aid kits should also be adapted. The contents of a First Aid kit should be determined by its intended use. To that end it is usually better to make up your own kit rather than to buy an 'off-the-shelf' product. To decide what is to go in your first aid kit you must ask yourself the following questions: Who is this intended to treat? How you treat yourself may be very different to how you treat colleagues or people in your care. As a rule medications should never be given to anyone but yourself. Are there many people in your care or do you work with small groups? What am I likely to encounter?
The most common injuries are often the simplest: cuts, grazes, sprains and strains. Stock your kit accordingly. In the outdoors the injuries can be more 'environmentally specific'; Walkers will invariably get blisters. Paddlers are likely to catch sunburn. Cavers are likely to encounter grit and foreign bodies in their eye and open wounds. What is the environment I am in? In hot environments you want to be prepared for heat stroke and dehydration. In the cold you will need to prepare for hypothermia. Abroad you may consider stomach upset to be the most likely ailment. Will your kit need to be waterproof or crush-proof? The Bare Minimum Simply by being in a remote or industrial environment, the probability of a serious injury is increased as is the severity of that injury. As a bare minimum always have at decent sized trauma dressing and a pair of 'Tuff Cut' EMT shears to hand, be they in the glove box, buoyancy aid, jacket pocket or rucksack lid. In terms of life-threatening-injuries, Serious Bleeding is the most significant risk in industry and in the outdoors. The First Care Israeli type trauma dressings are ideal for these environments: Double shrink wrapped, they will last much longer languishing in the bottom of your rucksack or kit bag than conventional plastic wrapped dressings. They are purposefully designed for significant blood loss, much larger than traditional First Aid dressings.
Their wide, elasticated bandage also provide enough support to protect a wrist, ankle, elbow or possibly knee injury. The Ouch Pouch On most occasions there is little need to carry a full first aid kit considering the likelihood of an injury and the type of injuries one can expect to sustain. In many situations a small, lightweight 'Ouch Pouch' is preferable to an large, cumbersome or complicated kit. This type of kit is intended to stop serious bleeding, protect minor bone/joint injuries and provide a few extras to manage longer term wound care. This style of kit is favoured by Bushcrafters who encounter frequent nicks and grazes and Adventure Racers who are happy to sacrifice the luxuries in order to move lightly and quickly. Antiseptic solution- 25ml sachet Cleaning wipesx 4 Cohesive bandage- 6cm minimum Gauze swabsx 5 Non-adherent dressings( e.g. Melonin)5cm x 5cmx 2 Non-adherent dressings 10cm x 10cmx 2 Plasters- assorted Saline solution -25ml sachet x 2 Steri-strips - 6mmx 2 packets Tincture of Benzoin(also known as Friars Balsam, a sticky brown resin with antiseptic properties that is applied to the skin before steri-strips to help their adherence. Especially useful in hot, sweaty environments). Transpore tape- Stronger and easier to use than Micropore Zinc Oxide tape The Personal Kit We are frequently asked what should be in a generic First Aid Kit for outdoor activities.
This recommended list was produced and tested in consultation with a Mountain Rescue Team member, an Accident Emergency trauma specialist, a Mountain Guide and a Level 5 Sea Kayak Coach. It is a versatile combination of small and light yet functional and practical. Everything inside has been thought out and tested. It has been designed to cope with as much as possible using as little as possible. But remember - practicality must dictate. It is unlikely that any first aid kit will be able to deal with every possible situation and even more unlikely that you would be able to carry such a first aid kit!
Accident Casualty Cards Antiseptic solution -25ml sachetx 4 Burns dressing- at least 10cm x 10cm Cleaning wipesx 4 Cohesive bandage -6cm minimum Duck tape Tuff Cut Shears Gauze swabs- 5cm x 5cm x 5 Gloves Iodine dressings ( e.g.Inodine) -10cm x 10cm x 2 Light stick Needle Syringe- A wide bore, blunt needle (i.e. 18G 'Pink' Mixing Needle) and a 20ml syringe is used for wound irrigation. Non-adherent dressing -5cm x 5cm x 5 Non-adherent dressing -10cm x 10cm x 5 Plasters -assorted Saline solution- 25ml sachets x 2 Blunt/ Sharp Scissors- 'Nurses scissors' with one blunt and one sharp tip. Steri-strips -6mm x 2 packets Steri Strips -3mm x 2 packets Surgical blade -#20 is a usable size and shape. Tegaderm- 2 (Tegaderm is an advanced dressing; it is a thin, stretchy, flexible and low-adherent plastic film which is ideal for covering wounds on traditionally awkward places such as knuckles, jawline, elbow or places which experience constant movement. Being transparent it is ideal for monitoring wounds without having to repeatedly expose them.) Tincture of Benzoin x 2 Transpore tape Triangular bandage Tweezers Waterproof pen Wound dressing -Trauma bandage as above. Zinc Oxide tape Group First Aid Kit If you are responsible for a group the Personal Kit would not be suitable given that it is designed for one person and may contain medication. With large groups you need to prepare for serious bleeds and bone / joint injuries. The emphasis is on practicality so stock up on cheap, absorbent dressings and bandages for immobilising injuries. Accident / Casualty Cards Antiseptic wipes Cling film Conforming bandages Gloves Non adherent dressings Tuff Cut Shears Triangular bandages Wound dressings Zinc Oxide tape Waterproof Containers For watersports, a waterproof container is essential. There are a few options. BDH containers are relatively cheap and can be made more water resistant by using a wide rubber seal that is available, however they are not waterproof and the small, transparent, ones do crack. The larger, black containers are much more durable. Roll top bags are more expensive but much more waterproof and being soft they are easy to stow in bumbags or in kayak cockpits. Pelicases and Otter Boxesare the gold standard. They are completely waterproof and very strong but they are significantly more expensive. We have recently discovered Aloksaks and have since been testing our First Aid kits in these bags. They look like standard resealable plastic bags but are much more durable and about as water tight as they come. These are our thoughts. What are yours?
