Backpacking First-Aid Philosophies

Great stuff Rex. I always thoroughly enjoy your well written and insightful articles.

I just recently re-examined my own FAK and so much of what you mentioned is true that I had to laugh, from the lack of sticky Band-Aids to the discolored meds, so it was long overdue.

The thought of packing a specific first aid kit for a specific type of trip has not generally occurred to me except on a few extraordinary occasions, like a solo trip in Alaska brown bear country for which I brought some battle wound-type blood clotting bandages and powder. I don’t think they make the powder anymore.

On the other hand,  I’ve pretty much always been a type III fun kind of guy so “the usual” FAK that I built covered a fair number of different scenarios at 8.5 oz. Tailoring the kit to a specific upcoming trek shaved that about in half, without leaving out my booklets and cheat sheets (never! That’s stupid light).

I would like to know any real data on most common types of injuries that occur in backpacking. I have seen somewhere that burns and creek crossing accidents are the most common injuries. I wonder if the burns comes more from the car camping crowd and campfires. For an example of a need for data, I have been hauling around a small ace wrap for a decade because I just assumed that twisted ankles would be common when hiking with a backpack. However, never seen or had one. That sort of data would be helpful in customizing the pack to the trip. And BTW, you can buy Celox clotting granules. in 2 or 15 gram packages. Never used it, but I wonder what kind of wound a small 2 gram package would cure that simple pressure would not. Inquiring mind here.

Great article, as. WFA instructor, I would be interested in seeing your Cheat Sheets.  Also would love to see the list that goes along with the FAK picture.  Thx in advamce

Great article!

I very much agree with you statement that a first aid course is primarily for others. Of course it comes handy if you know how to tread your own blisters (or what else). But in my view this is not the important part.

I used to be a scout leader and the children frequently asked me why they would need to learn first aid if I am trained rescue swimmer. They always got the answer you propose: They actually learn it for me! If I am “really” hurt, which I unfortunately have been several times and seen in others, I know from experience that I need help from someone else. The body is most likely in shock and even if you would know what you do normally, it is unlikely that you know then.

So, I send the same statement as you: Please, learn first aid for my sake and I learn it for your sake. It is a social responsibility!

Finally, I practical observation – I strongly recommend to keep track on the “best before date” for medication. That is why I choose to keep it in the blister as the usually have the time stamped upon them. If you repack, you need to keep that information somewhere as it is unlikely that you get a turnover that keeps the meds fresh!!!

Thanks, Rex. I just got WFA certified and enjoyed it so much I’m signed up  for a WFR course in December. My first attempt at a FAK after the class weighed in at 13 ounces. I pared it back somewhat by breaking it into: 1) PPE: A small sack with 2 pairs of rubber gloves and a disposable face shield. 2) Trail Aid: What’s the most likely stuff I’ll want while hiking? (E.g., blister kit, band aids, tweezers, small scissors (in pocket knife). 3) Medicine. 4) Trauma stuff (including syringe irrigator).

For me, breaking it down into these categories helps me to organize my kit. I probably agonize the most about trauma, because treatment requires the heaviest components but also seems the most likely inducer of panic, particularly severe bleeding incidents. Currently I’ve resolved the agony by packing stuff for severe bleeding, but no splints. Would love to hear how others make their cost/benefit decisions.

Like the Claritin reditabs. Will replace with those. Thanks Karl.
Lowell, what cardiac drugs do you take and what kind of catheter?
David, they make Celox clotting granuals and Avitene.
Scott, this is very much about not packing fears and trying to predict accidents that will likely happen on the trail, then trying to find the best weight to benefit ratio. Obviously, there is no perfect answer here. I do not bring things to treat events that are unlikely, take high resources to treat, or have marginal benefit in the field. My kit weighs about ½ pound. For most, that is crazy big, but it has saved many hikes. I have a few left-over skills from my career. I hike with a small group of regulars and I am the 1st aid guy. I don’t pack for random people on the trail, but for my crew. This approach has often enabled us to keep hiking instead of forcing a turn around. A bit selfish, I know. I am not trying to prevent a true SARS call. That’s for the pro’s.
Most of my items are for preventing the hike from being called. Eye patches (have “treated” corneal tears & abrasions). Steri strips, benzoin, leukotape, tiny bit of hibiclens (have closed hand, scalp, face lacerations with good results and no sutures). 20 G needles, scalpel blades with no handle and good tweezers (removed splinters, foreign bodies in hands and feet). 3x clip on magnifying glasses (I’m old). Small ace wrap (never used). Small surgical scissors. Band-Aids, Tegaderm, safety pins and gauze. Gloves. (used often). Comb for removing segmented cactus if in that environment. My skills. (I witnessed a cardiac arrest, did cpr, and the victim/friend bought me dinner 6 days later after a helicopter evac and a defib implanted). High quality waterproof bag for it all.
Garmin inreach and phone linked to it to enable more detailed texting not possible with the 1984 garmin interface.
Meds: Vit I, ondansetron injectable, Flomax, (my history of kidney stones), Benadryl, Diamox, Decadron, Cialis (for HAPE, not what you think. Some people I hike with live at sea level), ab salve, small betamethasone cream, 350 mg aspirin for MI. 1mg Epi and syringe, Toradol injection for pain. (all but the Epi, ASA and Cialis have been used.)
Things NOT taken: CPR mask. Now would only be used for a lightning strike. I have every vaccine known to man other than dengue. I’ll take my chances on getting the few other diseases from the victim. Airways. I did anesthesia and know my way around the airway. Bleeding granules. If I was hunting, I would bring them. Most trauma I have seen are small lacerations and blunt trauma, not big, open, bleeding wounds. My friends don’t bring big knives or saws to impale themselves. No guns in our group. Face shield. I wear bifocals. Triangle bandages, splints. Make due with torn shirts and hiking/tent poles. Cold compresses, emergency blanket, thermometer, blood pressure cuff, stethoscope. I would love to have most of these, but the weight/information ratio is not favorable. Big blister kit. My friends wear good running shoes now and we don’t get many boot blisters. Leukotape covers it if needed. Narcotics, sedatives, or sleeping meds. (in a rare group campsite, I caught someone going thru my pack after talking about first aid, I am sure they were thinking I had narcotics since I had other prescription drugs). Snake bite kits. (obvious) No longer take antibiotics, especially Cipro. We are very careful to prevent GI issues from water and poor hygiene. Again, benefit to risk ratio is poor.
Open for any thoughts.

https://www.goodrx.com/blog/best-non-drowsy-antihistamine-allergies/

Here is an interesting article on why Karl Hafner talked about Zyrtec being a sedative. Of the non-drowsy antihistamines, Zyrtec may be the most sedating maybe because it still crosses the blood-brain barrier.

To each his own, but for me that would be a huge FAK. I don’t even know what half of those drugs are or what they do.
The most commonly used items in my FAK are plain unmedicated Bandaids.

Everything not used gets tossed and replaced annually.
That could be excessive imho. A lot of drugs do have expiry dates, and it is those dates I watch.
Bandaids and safety pins expiry? Nah.

Cheers