Wilderness FAK's in Perspective

I keep a tiny FAK in my wallet- a 2x2 gauze pad, two regular size bandages, pack of steri-strips, some triple antibiotic cream in a sealed coffee straw and a small pair of tweezers (from SAK)

my hiking FAK contains a couple of tegaderms, a couple of steri-strips, some Celox, small roll of gauze, a couple of triple antibiotics, some leukotape and benzoin (blister control), "meds"- ibu, acet, benardyl, immodium, tweezers and a small irrigator- high pressure irrigation is a very important step in treating wounds

all goes into a alokosak

new1staidkit.jpg


my repair kit contains a bunch of items that double for FAK use- duct tape, needle, safety pins and yup- superglue :)

repairkit.jpg
 
I'll add that for longer trips or overseas jaunts I'd add a few antibiotics to the kit (ask your doctor): Ciprofloxacin, Flagyl, and maybe Azithromycin. Some Dicloxacillin for superficial wounds might be a good idea.

Epi-pen could come in handy too.

A roll of Coban (self adhesive bandage) might be useful also.

Damn the list could be endless....

OK, I narrow it down to tweezers, duct tape, and Cipro.
 
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Wow MtWarden, that's an old school Chouinard sewing kit, before Yvon sold it and it became Black Diamond.

Are the Tegaderms used for treating sucking chest wounds? I've used them for that but you need to make sure that you wipe off the wound really well, so you might want to throw some 3x3 or 4x4's in there so you're not wasting roller gauze and then back up the Tegaderm with some duct tape. The adhesive in Tegaderm is excellent for dry skin, but it's not the best for sweaty or bloody skin. If this is a dedicated kit for gunshot/knife/penetrating wounds then you might want to think about something like a Bolin Chest Seal (better than the Ascherman), as it has a great adhesive plus a one way valve to relieve some of the built up pressure.

With Celox too, it looks like your kit is set up as a Blow Out Kit. If that's the powdered Celox then you'll find it more effective if you open up a 4x4, pour it in between the layers and then pack the wound. If it's a high pressure wound (such as a femoral bleed out) then the powders are often quickly washed away. Celox and QuickClot both come in sponge form that are much more effective than the straight powder forms.
 
Wow MtWarden, that's an old school Chouinard sewing kit, before Yvon sold it and it became Black Diamond.

Are the Tegaderms used for treating sucking chest wounds? I've used them for that but you need to make sure that you wipe off the wound really well, so you might want to throw some 3x3 or 4x4's in there so you're not wasting roller gauze and then back up the Tegaderm with some duct tape. The adhesive in Tegaderm is excellent for dry skin, but it's not the best for sweaty or bloody skin. If this is a dedicated kit for gunshot/knife/penetrating wounds then you might want to think about something like a Bolin Chest Seal (better than the Ascherman), as it has a great adhesive plus a one way valve to relieve some of the built up pressure.

With Celox too, it looks like your kit is set up as a Blow Out Kit. If that's the powdered Celox then you'll find it more effective if you open up a 4x4, pour it in between the layers and then pack the wound. If it's a high pressure wound (such as a femoral bleed out) then the powders are often quickly washed away. Celox and QuickClot both come in sponge form that are much more effective than the straight powder forms.

no roll gauze at all, all pad :)
 
yeah that is an old kit :)

just my hiking FAK- the tegaderms replace the 4x4's I used to carry, they can be cut to size as well- I've used them a few times- skin must have been dry as they stuck like the dickens :)

for work I carry a TacPac and a CAT- I've heard good things about the sponges- I should look into them
 
To address a couple of points brought up by others (and this is just my experience so YMMV):

Superglue works great on flappers (avulsed skin, very common with climbers), but I would be hesitant to use it on anything deeper. I read some where that it contains something nasty that is not found in the medical versions of it. With that said, I've used it on tons of flappers with myself and I'm still alive. Burns during application though.

Coban is good stuff, but you should be aware that in high heat it kinda melts into a mess and finding the end to unroll it becomes an exercise in frustration (this is easily remedied by slipping a piece of paper under the end to keep it seperated from the rest of it so that it can be pulled off and unrolled) and in really high heat (think Iraq) it becomes useless. The other thing is that it doesn't stretch much at all, so you need to be careful to not cut off circulation and you need to check circulation often. I personally avoid it because of these reasons and go with compression bandages with velcro (you can buy them that way, or buy an Ace bandage and sew some male velcro on the end) or SWAT-Ts. If you want a cheap alternative to Coban go to a feed and supply store and get Vet Wrap instead. Same thing, usually much cheaper and comes in all sorts of pretty colors, including yellow and orange, so it could double for marking gear, signalling, etc.

Gauze pads: I prefer 4x4s because they can cover small and large wounds and really don't take up any more room than a 2x2 or 3x3 (they don't take up more room because all of these different size gauze pads are the same thickness, but the 4x4s are taller in your pouch, so they don't really use more space as their is usually extra space higher in the pouch and the bottom of the space is usually packed due to gravity, if that makes any sense) Yes you can use multiple 2x2s for a larger wound but then you have to overlap them and use much more tape (instead of taping the edges you have to tape the edges and the center). This takes more time and requires more bandaging to be used up from your kit (Two to four of the 2x2s versus one 4x4). Also, if you need to you can cut a 4x4 into four 2x2s by cutting it into fourths. This gives you the ability to double, triple, or quadruple the thickness of the bandage for weeping or heavily bleeding wounds, again saving more bandaging.

Just food for thought.
 
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To address a couple of points brought up by others (and this is just my experience so YMMV):

Superglue works great on flappers (avulsed skin, very common with climbers), but I would be hesitant to use it on anything deeper. I read some where that it contains something nasty that is not found in the medical versions of it. With that said, I've used it on tons of flappers with myself and I'm still alive. Burns during application though.

Coban is good stuff, but you should be aware that in high heat it kinda melts into a mess and finding the end to unroll it becomes an exercise in frustration (this is easily remedied by slipping a piece of paper under the end to keep it seperated from the rest of it so that it can be pulled off and unrolled) and in really high heat (think Iraq) it becomes useless. The other thing is that it doesn't stretch much at all, so you need to be careful to not cut off circulation and you need to check circulation often. I personally avoid it because of these reasons and go with compression bandages with velcro (you can buy them that way, or buy an Ace bandage and sew some male velcro on the end) or SWAT-Ts.

Gauze pads: I prefer 4x4s because they can cover small and large wounds and really don't take up any more room than a 2x2 or 3x3 (they don't take up more room because all of these different size gauze pads are the same thickness, but the 4x4s are taller in your pouch, so they don't really use more space as their is usually extra space higher in the pouch and the bottom of the space is usually packed due to gravity, if that makes any sense) Yes you can use multiple 2x2s for a larger wound but then you have to overlap them and use much more tape (instead of taping the edges you have to tape the edges and the center). This takes more time and requires more bandaging to be used up from your kit (Two to four of the 2x2s versus one 4x4). Also, if you need to you can cut a 4x4 into four 2x2s by cutting it into fourths. This gives you the ability to double, triple, or quadruple the thickness of the bandage for weeping or heavily bleeding wounds, again saving more bandaging.

Just food for thought.


Solid points kage. I keep 4x4's and 2x2's on hand. I don't have Coban (F'n duct tape always works), but I think it would be worth having. Your point about Coban's lack of elasticity is worth keeping in mind though--always check pulses at extremeties after applying a dressing/bandage.
 
In my experience the regular plastic and fabric bandaids do suck, but the foam 3M brand actually sticks fairly well and moves with your skin.
 
True dat, Rotte. Make sure to leave fingers and toes exposed on whatever you're bandaging or splinting so that you can check capillary refill or do a prick test.

I've seen some enthusiastic but inexperienced people do some crazy stuff with Coban (but with Ace Bandages too) and when you dig the hand out of the wrapping to check the cap refill the fingers are purple and mottled. Not a big deal on the 15 minute ambulance ride to the hospital, but a very big deal when you're 2 days from definitive care on the trail.
 
Remmmm,

In my limited experience pretty much anything labeled 3M is solid. All of my band-aid type bandages are Nexcare 3M.

Actually I didn't start carrying band-aids until I had kids. Works better than a lollypop sometimes. Also I found that when I was mountain guiding and I was asked by a client for a band-aid and I didn't have one they would seem to lose confidence in me and my abilities. I could treat their HAPE, relieve a tension pneumothorax, evac their unconscious body from a mountain in a self-rescue, etc. etc. etc. but if I didn't have a Snoopy band-aid for their boo-boo then they would look at me funny. Apparently bandaid = competent in some minds. So I bought band-aids for my client kit.
 
To some of you experienced guys, what's the best antiseptic for cleaning wounds in the field?

I carry a little spray bottle of bactine and also a small tube of betadine. I've used the bactine several times, but never broke out the betadine as I guess I didn't think it was worth the mess for the small cuts I've dealt with. I saw Chlorhexidine wipes listed by someone above and googled it. It sounds really good, but the only actual products I'm seeing are for dogs :confused: And I don't think Kage mentioned an antiseptic at all when talking about cleaning and dressing a wound??
 
A 10% solution of betadine is pretty good, but I usually just use old fashioned soap and water. Lots of clean water. I keep a few Iodine wipes handy for really dirty cuts or abrasions, but I'm not aware of any solid evidence that they are any better than cleaning with water.

I'm not sure chlorhexadine is a good idea for open wounds.
 
To some of you experienced guys, what's the best antiseptic for cleaning wounds in the field?

I carry a little spray bottle of bactine and also a small tube of betadine. I've used the bactine several times, but never broke out the betadine as I guess I didn't think it was worth the mess for the small cuts I've dealt with. I saw Chlorhexidine wipes listed by someone above and googled it. It sounds really good, but the only actual products I'm seeing are for dogs :confused: And I don't think Kage mentioned an antiseptic at all when talking about cleaning and dressing a wound??

That's a tough one because advice like that that you can take to court costs money.

I'll tell you the three things I use, in what order, and how.

Alcohol,hydrogen peroxide or clean running water and soap if available (- surface wound cleaning on large abrasions and really dirty wounds. (this isn't used all the time)

Iodine- either the strong stuff in the eydropper (my preference) or betadine. ON the wound, AROUND the wound, in the wound again.I love iodine. EVERY SINGLE INFECTED CUT I HAVE HAD I forgot iodine. and on several I DID use bacatracin type stuff.

colloidal silver or tea tree oil on dressings that are going to have to travel. like, if I'm still slugging through mud and rain and muck for 6 miles to get back to a trail head.
 
Hey Remmmm,

In various kits I carry alcohol wipes, benzylkonium chloride (BZK) wipes or povidone iodine wipes.

Alcohol wipes are also flammable, so they're duel use as a firestarter. They hurt when applied to wounds, so when treating children and pain-sensitive adults it can be a problem. It also dries out a wound.

BZK wipes are what I learned to carry for cleansing animal bite wounds during my Wilderness First Responder classes. It's broader spectrum and very effective for animal bites.

Povidone iodine can be nasty stuff and can quickly destroy cells in strong concentrations, so should be used carefully, although the wipes are 10% (I believe). I throw a few of these into a 1 quart ziploc when pressure irrigating wounds.

The best thing to clean a wound is soap and water. I've been given that info from a ton of sources, including 18B's, PJ's, Army PA's, ER docs, ER nurses, from Wilderness Medical Associates and NOLS. Carry an eye dropper bottle of Dr. Bronners and you're covered.
 
My simplest first aid kit is:

1) A field dressing
2) Some zinc oxide tape
3) Betadine or iodine
4) Some sterile gauze pads
5) Some ibuprofen or similar pain killer

This covers me for 99% of the stuff I get into. I do like to tape a field dressing to most of my medium and larger knife sheaths that way it's handy if or when the cut occurs. The ibuprofen is mainly for the occasional dehydration headache I can get when forgetting to drink enough.
 
The best thing to clean a wound is soap and water. I've been given that info from a ton of sources, including 18B's, PJ's, Army PA's, ER docs, ER nurses, from Wilderness Medical Associates and NOLS.

Dude, I'm bettin' we know some of the same people....
 
My wife keeps a product we call "vet wrap" for our horses. It is a self adhesive, elastic ace bandage on a roll. Comes in bright colors too. I keep a roll in my smallest FAK. I am sure there is something comparable intended for humans.
 
I found some info about FAKs and BOKs I put together for some friends. Much of the info is redundant as I have a basic kit (see beginning of this thread) I expand upon depending on the situation and need. I'll break this into a few posts to make it easier to read and absorb.

Note that these are all portable kits. My home kit is beyond ridiculous and has so much more and also has tons of highly specialized medical gear. These kits are based more towards outdoors use and car use.

I'm kicking around the idea of writing an adventure travel book and this infor will be included. The info is free so take from it what you will.


First Aid Kits (general advice):
• If you make your own kit it will be cheaper and you can buy higher quality components than usually come in pre-made kits.
• If you buy a pre-made kit, good ones with high quality components are available from Adventure Medical Kits (who also make kits for travel to 3rd World countries with syringes and sutures…many 3rd World countries reuse needles and have very limited availability), Chinook Medical (also make kits with needles) and Pro Med Kits. The advantages of pre-made kits include convenience and nicely laid out cases, but usually at a much greater cost.
• If you make your own kit you can buy empty cases from the above named companies or you can just throw it into a Ziploc freezer bag, which is cheap, lightweight, waterproof, dust-proof, and see-though so that you can find what you need quickly. The disadvantage is that it is not as durable as clothe and your kit won’t be as neatly organized, although you can organize it further by using smaller Ziplocs and breaking the kit up into components: Bleeding, Fractures, Medications, etc..
• Practice using the kit so that you are familiar with its components and all of their multiple uses so that you can actually use them in an emergency and while under stress.
• When traveling abroad, all medications should be in their original unopened packaging or with their prescription if they’re prescribed and consider getting a doctor’s note explaining why you need these meds. All of this will go a long way towards getting you and your meds through customs without you being arrested as a drug smuggler.
• Www.band-aid.com has a simple but good first-aid guide that you can download for free. Take it to an office supply store and have them shrink it down, laminate it and bind it so that it fits in a 1-quart Ziploc freezer bag.
• The Ultralight Trauma Kit listed next is usually what I carry (car, backpack, office desk, camping, traveling, etc.) with more or less of each component depending on its intended use. Always keep this kit with you everywhere you go. You never know when you’ll need it and it isn’t helpful left back at the hotel when you’re injured at a remote set of ruins or have been stabbed on the streets. This is enough medical gear, paired with your knowledge and ability to improvise, to get you through 1-2 medical emergencies before needing a resupply. All of this will fit into your Over-the-Shoulder-Bag or cargo pocket so that it is always with you…so always have it with you!!!
 
ULTRALIGHT TRAUMA KIT (ULTK):
-Packed in an Aloksak or 1-Quart Ziploc Freezer Bag
-Trauma/Combo/ABD Pad: 4x6 or 5x9 highly absorbant pad for major bleeds
-(1-2) Roller Gauze: H&H PriMed compressed gauze, 3-4" Kling
-Compression Bandage: 3-4" w/ Velcro or SWAT-T
-Triangle Bandage:
-(4-6) Dressings: 3x3 or 4x4
-Duct Tape: Gorilla Tape brand duct tape-more durable and stronger than medical tape
-(2-4) Safety Pins: large
-1-Quart Ziploc Storage Bag: for pressure irrigation
-(2+ pr.) Nitrile Disposable Gloves
-CPR Shield

Optional for Gun/Knife Wound (situation and training dependent):
-Hemostatic Agent: Celox
-Tourniquet: SWATT-T, TK-4
-Occlusive Dressing: Bolin Chest Seal, Tegaderm, petroleum dressing or Ziploc and duct tape
-3" 14-gauge Catheter: for needle decompression
-Nasopharyngeal Tube: 28 French
-Surgical Lubricant: foil packet



EXTREME ULTRALIGHT TRAUMA KIT (XULTK):
-Hemostatic Agent: Celox
-Emergency Combined Bandage: Tactical Medical Solutions Olaes Bandage or H&H H-Bandage
-Tourniquet: SWAT-T, H&H TK-4
-Nasopharyngeal Tube: 28 French
-Surgical Lubricant: foil packet
 
I keep a tiny FAK in my wallet- a 2x2 gauze pad, two regular size bandages, pack of steri-strips, some triple antibiotic cream in a sealed coffee straw and a small pair of tweezers (from SAK)

my hiking FAK contains a couple of tegaderms, a couple of steri-strips, some Celox, small roll of gauze, a couple of triple antibiotics, some leukotape and benzoin (blister control), "meds"- ibu, acet, benardyl, immodium, tweezers and a small irrigator- high pressure irrigation is a very important step in treating wounds

all goes into a alokosak

new1staidkit.jpg


my repair kit contains a bunch of items that double for FAK use- duct tape, needle, safety pins and yup- superglue :)

repairkit.jpg


yo Magnussen, throw in a muslin triangle sling with 2 -3 safety pins! you never know when you need to sling an arm or wrap a foot/ankle/knee :thumbup:
 
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