My first responder med kit

Here's a gear list that's the second best thing to dating a doctor.

If you’ve been even slightly medically trained, you know that the most important thing in your med kit is knowing how and when to use what’s in it. For disaster preparedness, long road trips or backcountry adventures, skip the “advanced first aid.” Either date a doctor or save up for a course in wilderness medicine, practiced by professionals in harsh conditions with limited resources available or when definitive care is more than two hours away.

Ten 12-hour days of intensive indoor/outdoor training with other gearheads like me will earn you the pocket-size Field Guide to Wilderness Medicine from Wilderness Medical Associates. Printed on tearproof, waterproof stock with lots of blank SOAP notes, it’s worth its weight in gold. But it only costs ounces in your med kit. Clip on an ultrafine-point Sharpie and tuck it into a lightweight, user-friendly travel bag that opens wide, like the medium shoe cube from Eagle Creek Travel.

Then add, in order of critical importance:

• 10 pr. latex gloves 
• Working watch with second hand 
• Ambu mask (for CPR) with oxygen port. Bonus: goes in the dishwasher! 
• Big, honkin trauma shears like those carried by the Germans. Don’t be shy! They should cut through motorcycle leathers, heavy denim, Cordura and Hypalon like butter. My Big Shears will even break a car window. 
• Angler’s hemostat with grippy handle. Avoid the "classic" design with thumb and finger loops--too fussy for medical work or gloves. I use both the Ultralight and 6" pliers by Rising, the best I've ever come across.
• 4-8 Super Plus tampons, 3-4 @ 24” clean cotton bedsheet strips and 1 chemical clotter pak to staunch bleeding 
• Oval non-locking carabiner in case you need to use one of the cotton strips as a tourniquet
• Battery-powered ring cutter, screwdriver and battery 
• Second pen—a mini Sharpie—to mark on patient’s body 
• Snack-size Ziploc that contains emergency sugar for diabetics. It’s most effective when delivered under the tongue. Hard candies are not advised for the unconscious. I use squeezable gels like Clif Shot and Honey Stinger. 
• Thermometer 
• 1 package medical gauze—does not need to be sterile. Replace this every time you use it up. 
• Small roll veterinary/equine tape (cool colors, strong, tearable and self-sticking) 
• 4 safety pins for making arm slings out of the victims’ own shirts 
• SAM splint 
• 2 mini SAM splints for fingers/toes 
• Small Ziploc labeled OUCH POUCH in big letters that kids and stressed-out victims can read. Fill an inner Ziploc with a small tube of Neosporin--or my personal go-to "antibiotic," Sovereign Silver--and a variety of labled Bandaids (“Spider Man,” “Sponge Bob”). Add a small package of Second Skin or moleskin for blisters. Stock the ouch pouch with ibuprofen and Tylenol in both child and adult dosages. Add homeopathics if you know how to use/dose them safely. I keep my OTC meds in labeled blood tubes. Get them from your doctor. Finally, round out the ouch pouch with a dental repair kit, 2 little packets of sani-wipes, 1 poison ivy treatment, 2 bug repellent, 1 sunblock, 1 lip balm, a special screwdriver for repairing eyeglasses and 1 set of foam earplugs. All this needs to fit in a small Ziploc! 
• Second small Ziploc clearly labeled ALLERGY/ATHSMA that contains an inhaler and extension tube, Benadryl (adult, child dosages) and 4 Epi Pens (2 adult, 2 child). Unless you are trained to administer the Epi pens, you must let the victim give herself the shot. Life-threatening attacks of anapyhlaxis can recur in 10-minute phases. Always be prepared to administer a second dose of Epi. Keep backup Epi Pens in the refrigerator and check the labels regularly. Replace immediately on expiration date. (NOTE: For those trained to administer norepinephrine, a combination of syringes and vials works better and is also more economical. Get these from your doctor, and make sure you carry and label a sharps container for spent needles.) 
• Third small Ziploc labled WOUNDS/TRAUMA that contains a pair of serious tweezers, a medium syringe for cleaning wounds (you can also use a Camelbak filled with drinking water and fitted with a clean mouthpiece), a topical numbing agent and appropriate pain medication. NOTE: know what pain meds you are legally authorized to administer to yourself and others, and know when to use them and in what doses. When traveling with Rx medication, you MUST transport these drugs with the prescription labels attached. 
• 2 oz. best whiskey in a BPA-free travel bottle for broken hearts 
• Stethoscope—aim for the best possible balance between weight, sensitivity and price but do consider the gold standard Valiant II from the folks at Big Shears 
• 2-4 lightsticks to mark the location of multiple victims 

Maintenance: remember to check your med kit frequently to make sure batteries work and used items are replaced.

When 15 reps of the 12.-oz curl
 are prescribed

Alpine variation: To save weight, ditch the deluxe shears and replace with a rescue knife like Gerber's Hinderer or the Assist by Spyderco, which is the lightweight knife I use. Ultralight alpine options are available. Whatever you buy, it needs a snub-nosed serrated blade. Then check: is your hemostat too heavy? Tell everyone on your trip to remove all rings, then leave the ring cutter behind. See what extras you can take away from Ziplocs 1-3—but still carry enough supplies for everyone in one med kit.

Now try to cram all this stuff into a smaller bag. If it doesn’t all fit, do 15 reps of the 12-oz. curl and try again.


Finally, do you travel with duct tape? Or better still, gaffer's tape? How do you get anywhere without it? Here are a few more reasons to mend your foolish ways. Duct tape stops major blood loss. Slap it on an open lung puncture wound, help the victim to breathe and save a life. Duct tape stabilizes sprains, tears and strains so victims can walk to advanced care. Plantars warts covered permanently in duct tape go away as fast as they do with any other fancy treatment. And duct-tape alone addresses blisters as well as any other method. Plus it fixes all your broken stuff. Duct tape is the bomb. Gaffer's tape is even better because it leaves no sticky residue. In the backcountry, wrap some around your water bottle or your trekking poles.

For small jobs you will need a pair of small scissors like those found on most mini multiools.

I’ll wrap up this long post by offering my favorite mantra, also known as The First Law of Day Hiking: Prepare For Darkness. It applies to real life, too. Darkness falls. Accidents happen in the dark. Medics can’t work holding flashlight. Buy a light headlamp, like my favorite E-lite from Petzl.

Now get out there, fully prepared to do some good!

(For those of you interested in books on great field medicine, I first published this Facebook note to recommend Diana Souhami's book Edith Cavell, a biography of the English nurse executed by the Germans for spying in Belgium during World War I.)