First-Aid Lite
by Andy Dappen (fact checked by Dr. Mark Shipman)

When trying to rid your pack of unnecessary pounds, the normal first-aid kit is worth putting under the microscope. With some scrutiny it’s actually pretty easy to shed nearly a pound of first-aid weight and a liter of first-aid bulk from your kit. Being rid of little-used items is a calculated risk – there may be rare occasions when one or two items you want may be missing if you follow the advice below. On the other hand dramatically lightning up your pack in all areas so that your total load is 20 pounds for an overnight trip versus 35 pounds will help you in many ways. You’ll not only travel farther and faster, you’ll travel this distance with less likelihood of injury because your balance will be better and you will be less fatigued — hence less likely to make a careless misstep. So while the recommends below may leave you slightly less prepared for emergencies they’ll significantly reduce the odds of incurring injury. Welcome to yet another of life’s many gray zones.

The One Tape

The one item I now always carry for injuries, whether I’m out for a trail run, a long rock climb, a several hour day hike, is a partial roll (amounting to five or six feet) of Leukotape P. This tape, made by BSN Medical, is the best thing going for dealing with blisters (the adhesive is amazing), small cuts (make band-aids from strips of tape with a little toilet paper added where you want gauze), larger cuts (cover the wound with gauze , paper towel, or cloth and secure this firmly in place with wraps of tape). More about this tape.

One Plus One

For slightly longer trips where I want more first-aid versatility to dress cuts, scrapes, abrasions, and punctures I add a few feet of Cover-Roll Stretch rolled up on itself. This is extremely versatile adhesive bandage and is also made by BSN Medical and uses the same, super- tenacious adhesive that’s used by Leukotape P mentioned above. This product is slightly wider than the tape, breathes better, has a slicker surface, and stretches. You can cut band-aids and wound dressings of different sizes by adding a coined-sized dab of paper towel, cloth, or gauze, to the sticky side and then pressing the bandage over a wound. You can dress virtually any small wound this stuff and know it’s going wear well for days.

A Stitch In Time

For longer trips when I’m going to be out several days – and especially if I’m climbing, mountaineering, or backcountry skiing where the odds of incurring a more serious wound are greater than when hiking a wide trail, I add a suture kit to the mix. This adds a few light needles with suture thread and a hemostat for driving the needle. Of course you (or someone in your party) needs to know how to suture if this addition is to be of any value, so don’t add these supplies if you or one your partners don’t know how to suture a laceration.

Anti-Infection

For day trips I don’t worry much about antiseptics – I’ll rinse a wound well with water in the field, cover it, and treat the wound with antiseptics or ointments once home. On multi-day trips, bring a few antiseptic swabs to help disinfect wounds after washing. Also a small tube of antibacterial ointment is recommended — dab some ointment over the wound while dressing the injury.

Pill box

On top of what is needed for wounds, for long day trips and overnight trips I usually add a mixture of pills to the kit. These help deal with a number of minor and major emergencies. I usually carry the pills in old-style, 35mm film canisters. While I suspect medical professionals will advise against this, I mix several pills together in one film canister but mark the canisters well so I won’t confuse which pills are which. I usually carry:
⦁ Ibuprofen. General pain reliever. Reduces fever. Reduces swelling in infection, injury, and sunburn.
⦁ Pepto-Bismol pills. If you end up with digestive ailments and/or ‘the runs’, this will usually get you back to the trailhead.
⦁ Diphenhydramine-Benadryl-Antihistamine. Use for allergies and anaphylaxis. Helps for itching, nasal and sinus congestion, nausea, sea sickness, insomnia, and anxiety. Well tolerated for a wide spectrum of activity and use. Causes drowsiness, which can be a good thing if you need a sleeping aid in the backcountry.
⦁ A prescription pain reliever for moderate to severe pain. These are controlled substances and hard to get. If you’re traveling abroad, keep the pills in original containers as proof you’re not peddling drugs. What I carry tends to be left over pills from the surgeries of friends or family members. Two recommended options: 1) acetaminophen with oxycodone (e.g., Percocet) 2) acetaminophen and hydrocodone (e.g., Vicodin). Both of these can be combined with ibuprofen (ibuprofen will help swelling more). Both can cause constipation and/or upset stomach, so take them with fiber and lots of water.
⦁ Cyclobenzaprine or Flexeril (RX). These muscle relaxants are good for acute muscle spasms –whether the spasm is from injury or a personal tendency to spasm. If you have a history of leg, back, or neck spasms, carry one of these. (Keep in mind that Flexeril can cause significant drowsiness).
⦁ An anti-diarrheal agent such as Imodium.

Double Duty

Lots of backcountry ails, like this one, have no solution other than time…or a helicopter.

Finally for longer trips, some of the other items I pack have first aid applications. The extra Arno and Voile straps I have in my repair kit to fix any number of equipment meltdowns can be used with ski poles or sleeping pads to splint an injured limb. Or they can hold shirts and apply pressure to large wounds to reduce bleeding. The soap in the cooking kit can be used to clean wounds. The scissors on my knife can be used to cut bandages. The duct tape along for repairing gear can also be used to dress wounds or keep bandages on…

In the end having a really lightweight but functional first-aid kit depends more on what you carry, not how much you carry.

This article was originally published on 7/15/15.

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