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Splinting is a common need
for a sprain or fracture. Pre-
fabricated splints are widely
available and I always carry a
light-weight SAM splint. Im-
provisation 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 im-
portant 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 medica-
tion by injections or IV fluids.
Usually in wilderness settings
more serious life support
equipment 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 specifications anyway.
Most supplies can be pur-
chased at a pharmacy or
through your doctor.
2019 December/January
Pg 6 - The Sunshine Express
Health & Nurturing
medical 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 wilderness medical skills. I might
have IV fluids and injection medications while ev-
eryone could have wound care and basic medica-
tions. 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 Nu-
wick 120 hour candle and small lightweight snow
shovel.
Consider endemic diseases. A kit for use in Ameri-
ca is different than a trip to another country where
malaria or other diseases are endemic.
The length of trip determines how much to bring.
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 included reflect the needed func-
tions. A fundamental need is to stop bleeding.
One can use direct pressure with bare hand,
clothing, or pressure bandages. I keep a com-
plete wound kit for convenience with minor
wounds, but for anything life-threatening or
large plan to use cotton clothing or other mate-
rial and not try to stock huge amounts of pres-
sure bandages.
Treating and closing wounds can be done with
butterfly bandages, steri-strips or sutures with
surgical equipment. Duct tape can be cut into a
very effective butterfly bandage.
Cleansers and disinfectants, local anesthetics,
bandaging 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.
Adventure Medical Kits
What if your routine cross-country ski jaunt
turned emergent and you were stranded -
would you be able to spend a night out in the
mountains? Or how about an incapacitating
sprained ankle or illness during the backpack-
ing trip - 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 wil-
derness medical 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 take
rafting or camping is my standard adventure
I don¡¯t need a week supply of different
medications in my day pack, but for a
two week camping trip I need to prepare
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 vari-
able 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 when-
ever 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 a local trail 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. In-
clude 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 thou-
sands for huge kits used by commercial
Medicine
In Harmony
by Scott Rollins, M.D.