Wilderness FAK's in Perspective

[333rm]

Here is a list of what medical items I carry in my Bug Out Bag, which is on me everywhere I go.

1 pair EMT shears
10 pairs nitrile gloves
2 chest seal patches
2 Thin Cinch bandages (4" x 10")
1 triangle bandage
1 tourniquet
2 Epi-pens
1 Quik Clot Combat Gauze
1 Quik Clot Sport 25g
3 tubes Insta-Glucose 31g
1 tube of After Bite Xtra cream
30 Percocet tablets (10 mg)
5 Lidoderm Patches 5%
25 Immodium pills
25 Benedryl pills
6 Claritin pills
25 Advil pills
15 Asprin pills
1 bright orange bandana
2 (3/0) sutures
1 bottle of Afrin (I have bad allergies)
5 sterile combine abd pads
8 sterile 4x4 pads
5 large band-aids
2 knuckle band-aids
6 regular band-aids
12 butterfly bandages
10 packets of triple antibiotic
10 packets of hydrocortisone cream
10 iodine sticks
1 bottle iodine
2 pads of moleskin
6 Burn Gel packets
4 After Cuts & Scrapes wipes
1 small bottle of charcoal
1 CPR mask w/ O2 inlet
60" of 2" Gorilla Tape
1 roll of 1" medical tape

 

[redpoint]

Bare bones weekend trip kit [even up to a week]:

4 4"x4" Telfa Pads [will not stick]
A few packs of steri-strips [used these on my chin once in Tasmania - bad situation]

2-3 5.5"x4" Opsite H20-proof transparent film dressing [AWESOME]
1 seriously absorbent field dressing
1 tensor wrap [also great for pressure dressing]
Several 400mg Ibuprofens AND Several Codeine-based meds: T3s [32mg] or Mersyndol [8mg]

1 Laerdal disposable pocket mask
1 Pair of Nitrile gloves
An asortment of band-aids [different sizes]
1 lightweight emerg blanket
Hypafix breathable tape 2"x24-36" wide [amazing for blister prevention] - great over top of steri-strips

Alcohol swabs
Benzoin tincture swabsticks
Sometimes, I carry a SamSplint
Polysporin
1 sterile scalpel blade

Probably missing a couple of things, but this can handle a great deal of nasty stuff. I double-bag in a ziplock and toss in a lightweight sil-nylon stuff sack. It's actually pretty damn light. Extended, extreme wilderness trips require more gear. Developing country travel even more.

The most important thing is know how to use it. Don't be afraid to break that shit out and practice "situations" and make sure your mates are trained too. It's no good if your buds can't apply FA to you when you need it.

 

[redpoint]

^ I've got a doctor who is a hiker and pretty sure he wouldn't have any problems w/ a small prescription for a FAK- what kind of meds are you talking about- few more potent pain killers- Tylonel 3? better meds than over the counter bendaryl or immodium?

thanks

For people living in Canada, Mersyndol [8mg of Codeine and available over the counter] is excellent stuff.

Also for pill containers, I use tiny Nalgene bottles: they're also handy for kitchen supplies, completely leakproof, and tough.

 

[arijer]

I think most of the bare bones kits listed here are great. as a physician who goes fishing in very remote areas on a regular basis, my needs are different. I have never been on a trip yet where my skills are not needed. Now granted so far on all those trips we could have solved the problem with the sat phone and had a med chopper come and take the patient away but this was much cheaper

I would say if you are serious about trying to treat a infection for at least for a couple of days until you get to civilization (not in the last man on earth scenarion)

FOrget penicillin, its worthless majority of time. The rate of MRSA is increasing all the time even in central and south america. get the following generics

doxycycline - this will cover most upper respiratory bacterial infections, dental infections, urinary tract and skin.

ciprfloxacin - for intestinal infections, urinary tract infections and such.

these two are generic, you can get them at wally world for $4 and will cover a lot more then Pen V K.

These are what i would change in a simple bare bones kit.

for my kit i also have injectable steroids for allergic reactions, epinephrine, atropine and a few other things, but my kit is small doctors bag that goes in my backpack and designed to take care of infections, cardiac arrest, trauma. if you guys are interested i will post a breakdown of the whole pack and why i carry each item.

 

[LUW]

I would say if you are serious about trying to treat a infection for at least for a couple of days until you get to civilization (not in the last man on earth scenarion)

FOrget penicillin, its worthless majority of time. The rate of MRSA is increasing all the time even in central and south america. get the following generics

doxycycline - this will cover most upper respiratory bacterial infections, dental infections, urinary tract and skin.

ciprfloxacin - for intestinal infections, urinary tract infections and such.

these two are generic, you can get them at wally world for $4 and will cover a lot more then Pen V K.

These are what i would change in a simple bare bones kit.

for my kit i also have injectable steroids for allergic reactions, epinephrine, atropine and a few other things, but my kit is small doctors bag that goes in my backpack and designed to take care of infections, cardiac arrest, trauma. if you guys are interested i will post a breakdown of the whole pack and why i carry each item.

I'm strongly against taking antibiotics if you don't have formal training to do so. Even if you know what you are treating and how to treat it, you'll have to haul a lot of supplies if you want to treat it right. There's no need to use local antibiotics in a wound if you clean it right. If you don't clean it right, you can put a bucket load of antibiotic powder over it that it still won't help, so a bar of soap is more useful then dressings with antibiotics or powder antibiotics. The only reason to carry antibiotics to the field is if where you're going is so remote that it would take more then two days to get to civilization and if you know what you're doing (ie, have formal training) and you're lugging the right stuff in enough quantities.

Back in the day I hauled a decent field trauma kit and even snake poison serum (for at least two species, the most comon around our tracking grounds) with all the paraphernalia to use it, but never carried antibiotics. Fortunately the only thing I ever used were band-aids and light pain killers, but it was nice to know I had all the bases covered. The trade off was that I always had the heavier pack, but someone else in the group carried some of my stuff to share the weight.

Parenteral steroids, on the other hand, can be a life saver, and that is one supply you should carry if you want a serious FAK. In theory this is not something to be used by anyone that doesn't know what they're doing, but being frank, it won't do much damage except in some very specific (and rare) situations. Though it's not considered an over-the-counter drug, so it isn't easy for most folks to get it, and you will need syringes and needles.

BTW, despite what many medical journals say, penicillin is still working very well down here for most community acquired infections. For hospital acquired infections things are a bit different, but if the hospital isn't a big center or doesn't have a big ICU you still can effectively use penicillin for a lot of cases.

 

[koyote]

doxycycline - this will cover most upper respiratory bacterial infections, dental infections, urinary tract and skin.

ciprfloxacin - for intestinal infections, urinary tract infections and such.

...

for my kit i also have injectable steroids for allergic reactions, epinephrine, atropine and a few other things, but my kit is small doctors bag that goes in my backpack and designed to take care of infections, cardiac arrest, trauma. if you guys are interested i will post a breakdown of the whole pack and why i carry each item.

I think the antibiotics is something that depends on time out- how long a trip would you recommend before it's worthwhile to have those? I'm thinking a weekend pack trip in a well found national forest area isn't much of a big deal. But a week or more trip out into the wilds north of 45...

I could just ask jessica, and I will.

I'm strongly against taking antibiotics if you don't have formal training to do so. Even if you know what you are treating and how to treat it, you'll have to haul a lot of supplies if you want to treat it right.

do you mean - ingesting antibiotics or a doctor carrying antibiotics in the field?

I'd rather treat with minimum supplies than not treat at all, myself. I understand that a large kit can be pretty hefty- my 'base camp' kit is a 3 drawer tools box! (kids. scouts. dogs. lots of first aid) I used to carry a basic course of steroids in my small hiking FAK because my RAD was nasty, but cleaning my diet has pretty much made me symptom free. a basic set of doxy isn't going to take up more room than that.


Also- it seems that the reference is to pills, not wound powders. I wouldn't bother with antibiotic wound powders either. Really don't see much need for anything beyond the standard soap/water, alcohol, iodine, and dressing aids (silver or tea tree)

 

[EMT_Lee]

On a small trip (dayhike, etc.) I just take a basic set up (bandages, gauze, some pain relievers, etc.) However, on a longer trip, I'll take more. When me and Joezilla went on the island survival trip, I took a pretty large kit. We were isolated, and out for multiple days. I never even had to open the bag, but I took it just in case.

- 50 Burn Aid Packages
- 32 Bandage Strips, 1''x3'' - 2 Tape, Rolls, Adhesive
- 15 Bandage Strips, 2''x4'' - 1 SAM / Universal Splint
- 15 Knuckle Bandages - 1 Cervical Collar
- 15 Butterfly Strips - 1 Blood Pressure Cuff Kit
- 1 Multi Trauma Dessing, 12''x30'' - 2 Emergency Blankets, 52''x84''
- 1 6'' Elastic Bandage - 1 Tourniquet
- 1 Triangular Bandage, 40''x40''x56'' - 1 EMT Shears
- 2 Blood Stopper Kits - 1 Pair of Tweezers
- 15 Sterile Sponges, 2''x2'' - 1 Stethoscope
- 15 Sterile Sponges, 4''x4'' - 1 Scalpel handle, #3
- 6 Abdominal Pads, 5''x9'' - 2 Scalpel Blades
- 5 Eye Pads - 2 Stainless Steel Hemostats
- 20 Pain Relievers - 1 Pen Light
- 10 Triple Antibiotic Packages - 2 Suture Sets
- 45 Antiseptic BZK Wipes - 5 Tongue Depressors
- 6 After Bite Wipes - 2 Airways
- 1 Instand Glucose, Tube - 1 CPR Mask
- 1 Eye Wash, 4oz. - 4 Instand Ice Packs
- 1 Hand Sanitizer, 2oz. - 6 Safety Pins
- 1 Hand Soap - 8 Pairs Latex Examination Gloves
- 5 Ammonia Inhalants

 

[Rotte]

I think the antibiotics is something that depends on time out- how long a trip would you recommend before it's worthwhile to have those? I'm thinking a weekend pack trip in a well found national forest area isn't much of a big deal.

Might be more of a question of availability of medical services than one of time in the field. If you plan on being in a cabin for a month, but medical assistance is only a few hours away, and comm is 5X5, a simple FAK might suffice. But a three hour tour with Gilligan and the Skipper off the coast of Mexico could be a scenario where a "reinforced FAK" might be handy.

Speak with your physician before you go on an extended trip to remote areas. If you won't be close to readily available medical attention, it is completely reasonable to ask your physician about 1) medical risks in the area you are traveling, 2) immunizations you may require, 3) any prophylactic medications you should use for the prevention of indigenous diseases, e.g. malaria, and 4) possible antibiotics for common infections.

Your biggest risk in the wilderness is dehydration. Dehydration contributes to both heat and cold injuries. Dehydration is your number one concern. Now think about Giardia and Campylobacter. At this point these little beasties are just about everywhere in the world. You can almost assume any water source has these pathogens present. They can cause severe diarrhea and dehydration. Often Giardia and Campylobacter infections clear on their own, but a short course of Flagyl and/or Ciprofloxacin could be a life saver.

First and foremost, keep your water clean.

Cool discussion.

 

[LUW]

do you mean - ingesting antibiotics or a doctor carrying antibiotics in the field?

Both.

If you're going to use antibiotics you're talking about at least five days of regular use, so you have to pack enough quantities. If you will be out of reach from civilization for more then two or three days, by which I mean it would take more then two or three days for either you get to help or help gets to you, then, if you or somebody in your group knows what he's doing, and you are adequately supplied, and only then, it could be a good idea to pack antibiotics.

Besides, there is no infection that you could contract in the wild that would kill you faster then two or three days, unless you have some pretty serious predisposing medical condition. And when I mean serious I'm referring to the kind that your physician would strongly argue against you going on a long trip into the wild without the possibility of immediate access to SAR.

And all this is coming from the guy that packed one liter of saline AND ringer solution with all the necessary accessories .
But never antibiotics .

 

[Rotte]

Good points LUW.

And yet for effective prophylaxis of some wounds, say an animal bite, antibiotics should be administered quickly, within a few hours. Sepsis can kill quickly and rapidly. A course of antibiotic doesn't take up much space or weight. Certainly not compared to a bag of LR!

 

[LUW]

Unless you're facing Komodo dragons, fast spreading life threatening sepsis shouldn't be a big concern from animal bites . And even if you do get bitten by that lizard, and you're big and healthy, I seriously doubt you would die of sepsis in less then a week. You would die easier of hemorrhage or traumatic shock if it managed to take a big chunk out of you.

Any bite can get infected, even a mosquito bite, and the amount of damage by that contamination will be directly proportional to the amount of infecting matter that is injected into your system and inversely proportional to your general immune capability. A few other factors also play a part, like closing the wound or not and how fast the infecting matter reaches your blood stream. If the wound is potentially infected or not is not something you should worry about in the field, because you really can't do anything to prevent sepsis unless you're carrying a mother of a FAK - but then it won't be a First Aid Kit anymore.

But independent of how you get hurt, if you THOROUGHLY wash the wound with soap and clean water, and then properly dress it, you're good to go. If you want to address more serous wounds then a field surgery kit (equipment for stitches and other small invasive procedures) would be more handy then antibiotics.

What you need to worry about is carrying gear and supplies that will better your chances of getting to help. Infections and other medium and long term complications are things that only the SAR team and emergency room guys should worry about, or maybe even only your physician when you're admitted to a hospital.

 

[LUW]

Oh, I forgot to comment on something important: prophylaxis. Want to be prepared in that department? Take your shots (tetanus, yellow fever, rabies, whatever you can take and is a concern for the region you are going to) and be in good physical health before you set out.

Besides brains, good gear, big or small FAK and training, that's all you need or can do.

 

[mtwarden]

^ I've got a doctor who is a hiker and pretty sure he wouldn't have any problems w/ a small prescription for a FAK- what kind of meds are you talking about- few more potent pain killers- Tylonel 3, something else? are there better meds than over the counter bendaryl or immodium?

thanks

anyone?

 

[Rotte]

anyone?

Sorry, missed the question MTW. I personally am not a big fan of narcotics because they usually cause sedation and mental slowing just when you need to be sharp. Pain sucks, but you can deal with it. I pack tylenol and motrin. Sometimes aspirin too.

I love benadryl--it also causes sedation, but can be great for bad allergic reactions. Like when you use poison ivy vines to build a shelter and your eyes nearly swell shut.

Epipen is another good med for anaphylaxis.

I'm wary of Immodium or Lomotil: both can slow down diarrhea, but at the same time, diarrhea is your body's defense against GI infections. With these you have to judge the risk of dehydration against the risk of making the infection worse. For bloody diarrhea, Immodium and Lomotil should be avoided and re-hydration is the key. I carry some OTC Immodium, but it's a last measure drug for me.

 

[LUW]

I personally am not a big fan of narcotics because they usually cause sedation and mental slowing just when you need to be sharp.

True.

I'm wary of Immodium or Lomotil: both can slow down diarrhea, but at the same time, diarrhea is your body's defense against GI infections. With these you have to judge the risk of dehydration against the risk of making the infection worse. For bloody diarrhea, Immodium and Lomotil should be avoided and re-hydration is the key.

Double true. Anti-diarrhea drugs are for when you have a presentation to do at work or at school in a couple of hours but instead of rehearsing you're melting on the toilet.

Both examples are not for the bush, where they can do as much harm as good.

 

[nemoaz]

As much of an aid bag as some of you carry, I wonder how you can also bring any camping supplies.

I have GREAT TROUBLE believing that you have actually carried this in the field.

 

[LUW]

What you believe or not about what other people carried really won't add much to the discussion at hand, but what I can say is that I definitively will go lighter on a FAK compared to what I used to carry. Even though I won't do group hikes anymore, so in essence I can be more "egoistic" in terms of gear planning, if I were to go out with a group I still would pack less stuff. Looking back, I think I carried around 1 kg of gear/equipment that I never once used.

 

[koyote]

narcotics aren't for me, they are for me getting someone out. (for example) - I don't carry anything heavy, but I've seen camping trips saved by a couple of tylenol 3.

Anti-diarrhetics are for keeping you from dying of dehydration- not casual comfort. I keep some around, yeah.

Nemoaz: my kit is SMALL, that's one fo the reasons I skimp on bandaids and extra ointments and stuff. Iodine

Part of the OP involves what would translate the minimum kit into a group or long term kit. THAT ain't light. the full boat going camping with the scouts base camp kit we have is a 40mm shell box and 2 x 30 cal boxes. No humping that!

 

[Ramm9]

as a physician who goes fishing in very remote areas on a regular basis, my needs are different....

if you guys are interested i will post a breakdown of the whole pack and why i carry each item.

A breakdown of what your travel bag includes would be most interesting. The MD's I've encountered or observed on relatively remote trips always seemed to have a much, much, smaller kit than I would have expected.

 

[LUW]

Anti-diarrhetics are for keeping you from dying of dehydration- not casual comfort. I keep some around, yeah.

That's the point; they will NOT save your life in case of severe diarrhea. Think about it, if they were that good they would be in use in emergency rooms and hospitals all around the world, specially in developing countries. But they are not used, and in fact, the WHO is against their use as a way to treat diarrhea.