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Adventure Medical Kits
What if your routine cross-country ski jaunt
on the mountain turned emergent and you
were stranded - would you be able to spend
a night out this time of year? Or how about
an incapacitating sprained ankle or illness
during the backpacking trip ¨C how would you
deal with that? Having the right medical gear
is simple and might just save a life. Here
are some tips on where to start preparing or
updating your kit.
General Considerations
Preparing a medical kit requires addressing a
few general issues first. What is the purpose
of the kit? The contents are determined by
the nature of the trip, and the specific injuries
or illnesses most often encountered. My day
kit is mostly a survival kit with fire starters,
rescue mirror, emergency blanket, compass,
knife, cordage, etc. The kit I taking rafting
or camping is my standard adventure medi-
cal kit, with the survival kit included and now
adding more medical supplies. The kit in my
car has contents that would be appropriate if
we got stranded or came upon an accident.
The level of medical training of the party is
another issue. Obviously the people using
the kit need to know how to use its contents
appropriately. A license or degree does not
guarantee adequate knowledge of wilder-
ness medical skills. I might have IV fluids and
injection medications while everyone could
have wound care and basic medications.
Knowledge of what to do is sometimes more
important than the contents of the kit.
The destination of a trip has a big impact
on kit contents. Consider climate, terrain,
altitude, and unavoidable dangers of certain
areas. For example, desert hiking requires
different items than winter mountaineering.
When backcountry skiing I add a metal cup
to melt snow, a Nuwick 120 hour candle, and
small lightweight snow-shovel. Consider
endemic diseases. A
kit for use in America
is different than a
trip to another coun-
try where malaria or
other diseases are
endemic.
The length of trip
determines how much
to bring. I don¡¯t need
a week supply of dif-
ferent medications in
my day pack, but for a
two week camping trip
I need to prepare
2016 April/May
Pg 8 - The Sunshine Express
Health & Nurturing
for a complete course of medications should
they be needed. Consider high use items such
as blister pads versus rarely needed items such
as epinephrine and stock accordingly.
The size of the party is a similar variable as
length of trip, and again requires stocking more
high use items. Even as a kid on adventures
with my buddies, I was generally the ¡°go-to¡±
person whenever there was trouble. So I¡¯ve
learned to prepare for myself and family, but
also recognize that I might be treating others
as well.
Exposure is the amount of time until outside
help can be reached and may greatly influence
the level of care needed and thus the supplies.
From the Grand Mesa I might walk downhill to
a highway in a day, or call a medical helicopter
to fly in, while on a remote river or backpacking
trip you might be days away from help.
Bulk, weight and cost are variables. Include
items with multi-purposes and take a modular
approach to packaging that allows changing kits
without completely repacking. I¡¯ve prepared
small, light kits for as little as $25 and also
spent thousands for huge kits used by commer-
cial companies caring for employees spending
months in remote parts of foreign countries.
Containers and Equipment
Think maximal protection and maximal accessi-
bility. Use containers that are easily located and
allow you to rapidly identify the contents using
labels or visible colors. Divide ¡°mini kits¡± among
party members to
avoid loss of the
entire kit.
The materials in-
cluded reflect the
needed functions. A
fundamental need
is to stop bleeding.
One can use direct
pressure with bare
hand, clothing, or
pressure bandages.
I keep a complete
wound kit for con-
venience with minor
wounds, but for any-
thing life-threatening
or large plan to use
cotton clothing or
other material and
not try to stock huge
amounts of pressure
bandages.
Treating and clos-
ing wounds can be
done with butterfly
bandages, steri-
strips or sutures with
surgical equipment.
Duct tape can be cut
into a very effec-
tive butterfly ban-
dage. Cleansers and
disinfectants, local
anesthetics, bandag-
ing materials and
blister treatment fall
into this category. In
the wilderness, you
should boil or purify
water for cleansing a
wound just like you
would to prepare for
safe drinking.
Splinting is a com-
mon need for a
sprain or fracture.
Prefabricated splints are widely available and I
always carry a light-weight SAM splint. Improvisa-
tion is the key as most anything can be splinted
with a stick and duct tape. Coban, or ¡°vet wrap¡±,
makes a great compression dressing and soft
splint.
Monitoring vital signs is important and a watch is
helpful for checking pulse rate. A thermometer can
be useful. A blood pressure cuff is rarely needed.
Special equipment is needed for administering
medication by injections or IV fluids. Usually in wil-
derness settings more serious life support equip-
ment is not realistic, such as artificial airways,
chest tubes, electroshock, etc.
I recommend purchasing an empty specialty bag
such as a first aid kit, toiletry bag or camp kitchen
bag then filling it with materials. Prepackaged kits
are costly and not usually complete to my specifi-
cations anyway. Most supplies can be purchased at
a pharmacy or through your doctor. I simply drop
my organized bag into an ammo can for water
protection.
Medications
Here is a comprehensive list of different medica-
tion categories to consider: antibiotics, analgesics
(pain killers), anaphylaxis, anti-histamines, anti-
pyretic (for fever), anti-emetic (for nausea and
vomiting), anti-diarrhea, anti-fungal, anti-parasit-
ic, anti-tussive (for cough), cardiovascular, decon-
gestant, dental, dermatologic, diabetes, diuretic,
hemorrhoidal, iv fluids, laxatives, local anesthetic,
muscle relaxant, ophthalmic, otic, rehydration,
sedative, snake bite and vaginal.
About half the medications can be found over
the counter without a prescription. I recommend
speaking with your physician about prescription
medications. I generally meet with a patient for
a short office visit to discuss the various medica-
tions that are indicated and simply write them a
prescription. I¡¯m careful to include ¡°first aid kit
¨C for expedition use only¡± on the prescription and
emphasize the medications are for the patient or
family use only. Giving the medications to other
people is discouraged due to issues such as aller-
gies or medication interactions, and patients have
to use their discretion and accept responsibility if
sharing medication with others.
Remember the old saying, ¡°proper prior prepara-
tion prevents poor performance¡± and once packed
and ready to go I don¡¯t give it another thought
because I¡¯m prepared. Most wilderness medical
emergencies can be handled with a good adven-
ture medical kit, a little first aid knowledge, and
the determination to succeed with grit, spit and a
whole lot of duct tape!
(Scott Rollins, MD, is Board Certified with the
American Board of Family Practice and the
American Board of Anti-Aging and Regenerative
Medicine. He specializes in Bioidentical Hormone
Replacement for men and women, thyroid and
adrenal disorders, fibromyalgia, weight loss and
other complex medical conditions. He is founder
and medical director of the Integrative Medicine
Center of Western Colorado (www.imcwc.com)
and Bellezza Laser Aesthetics (www.bellezzalaser.
com). Call 245-6911 for an appointment or more
information.)
Medicine
In Harmony
by Scott Rollins, M.D.
Advice: Be prepared with appropriate medical kits
as well as plenty of duct tape.