Introduction
Whether you are traveling alone, taking part in an expedition, or responding as a member of a search & rescue (SAR) team, you will need a first aid kit. What you should take and how you should package it depends on many things. There is no generic first aid kit. Here are a few basic concepts that you will need to know in order to begin building a first aid kit that will meet your needs. Make sure your expedition has a well thought out and, if possible, tested Emergency Action Plan including emergency communication.

Size & Weight
The type of activity or expedition defines the amount of weight and space available for your kit (e.g.: a sailboat can carry more than a raft and a raft can carry more than a climber etc.). The longer you are from "help" generally the bigger your first aid kit will be; consider resupply(s). The level of training of the medical "officer" will limit how much invasive equipment or Rx drugs you can carry. Have each expedition or team member complete a thorough medical form; you may need to add special equipment or drugs to your kit. Pay attention to any allergies. If your experience in wilderness medicine is limited, consider carrying our Wilderness Medicine Handbook. Also consider carrying our Weatherproof Patient SOAP Notes to thoroughly document your assessment and treatment.

Expedition versus SAR team Kits
First aid kits used by expeditions are conceptually very different from those used by Search & Rescue teams. Expeditions hope that they will NOT use their first aid kits and adhere to the principles of improvisation: they limit specialized items, focus on multipurpose equipment, and adapt expedition gear for medical uses (splints or litters). As your ability to improvise increases, the size of your expedition first aid kit decreases. Rescue teams know they WILL use their equipment and often carry specialized gear with them rather than scavenging their personal gear for improvisation.

Packaging
Packaging is extremely important. Well thought out organized packaging protects valuable and irreplaceable equipment. It permits fast and easy access to emergency gear without "vomiting" kit contents everywhere. Critical concepts to organization and packaging are:

• Use different colored compartments or packs. DO NOT use plastic bags as pack or compartment substitutes.
• Clearly label each compartment or pack: In many expeditions each expedition member carries their own personal care kit (blisters, sun screen, OTC meds, personal Rx meds, minor cuts & scrapes, etc.) leaving the expedition first aid kit for emergencies and minor trauma (more serious wounds and unstable injuries). This helps ensure that the expedition first aid kit is complete when it is needed.
• Laminate a contents list for each pack and indicate the intended use for each item.
• Seal soft goods in plastic to protect them from moisture. Use individual mini zip-locks or "Seal-a-Meal" freezer type packages.
• Tubes break. Repackage ointments into one and two ounce (or larger depending on group size) wide mouth Nalgene® bottles.
• Liquids leak. Package liquids in one and two ounce (or larger depending on group size) narrow mouth Nalgene® bottles.
• Use a weatherproof drug log for ALL medications so that you know who is using them and why. The log should include space for the patient's name, drug name, administration route, dose, time, and reason/diagnosis.

Training
Train your expedition or team members to use your kit. Until they are trained only you know why you assembled the kit as you did. Without specific training most people will not know how to use the equipment you have so thoughtfully assembled. Restrict access to compartments or packs that members are not trained to use.

Compiling a Possible Problem List
An effective first aid kit is built from a comprehensive possible problem list. Divide your list into Basic Life Support or Major Trauma, and Minor Trauma, Environmental, and Medical problems. Choose the problems that you will likely encounter and prioritize them. Once you are satisfied with your possible problem list, compile a list of first aid supplies needed to treat them; carry more of the stuff that you WILL need. In remote areas where urgent evacuation is difficult or simply not possible, you may need additional assessment and treatment supplies. Within the United States a physician consultation and prescription is required for all Rx drugs. Click here for a pdf file copy of this article including specific content and organization suggestions.

An intramuscular injection of epinephrine combined with an oral antihistamine is the treatment of choice for life-threatening anaphylactic reactions that occur in remote settings. Legal issues aside, the purpose of this brief post is to review the options available to outdoor programs who wish to carry epinephrine into the field. There are currently four available. All have been used successfully. All have their advantages and disadvantages.