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In earlier articles I've discussed the concepts behind building wilderness first aid kits and suggested specific contents for a small basic first aid kits, small group first aid kits, and for expedition first aid kits for groups of 8-12 people. This week I'll discuss first aid kits designed primarily for basic life support emergencies and carried by Search & Rescue hasty team members, guides, ski patrol, and others who may need to respond to major traumatic incidents, environmental cardiac arrests (lightning, drowning, and avalanche), anaphylaxis, diabetic emergencies, and heart attacks. Note that the patients of hasty team members and ski patrol are typically strangers and emergency communication and transport are readily available. In contrast, guides usually know their patients, may or may not have reliable
Basic Life Support & Emergency First Aid Kits
If you are a guide remember to carry a cell phone, satellite phone, or SPOT for emergency communication in addition to your first aid kit and emergency action plan.
- Consider carrying a simple face mask with oxygen port in warm weather. Purchase and carry in the optional mesh pocket. NOTE: 1. Mouth-to-mouth breathing is effective as long as you can get and maintain a good seal; risk of contracting a disease is minimal. 2. The plastic used in simple face masks is not pliable in cold weather. 3. Face shields are difficult to use and, like simple face masks, the plastic is not pliable in cold weather.
- Two to four maxi-pads—ideally without wings—and 2-4 rolls of gauze for emergency control of severe bleeding. Alternately, carry multiple hemostatic dressings. Note that there is no clear evidence that the use of hemostatic dressings are more effective than gauze. Carry in the pack's interior slash pocket located behind the zippered pocket.
- Trauma gloves for protection against blood-borne diseases. Carry one pair of trauma gloves in a 50 ml Snap Top Nalgene container and medium four loop velcro strip. Note that all types of gloves used for medical protection act to restrict profusion to the hands in cold weather. Consider purchasing a larger size than normal and wear over a thin liner glove for warmth in cold weather; avoid constriction.
- Carry wound cleaning supplies in a second pack or in the internal slash pocket behind the internal zippered pocket. Refer to previous article for a list of wound cleaning supplies. Wound cleaning is not considered a basic life support function.
- 60cc syringe and nasal airway for suctioning the oral airway. Carry in the internal elastic sleeve. NOTE: 60 cc syringes may also be used for irrigating wounds, ears, and eyes as well as giving enemas.
- One 36-inch SAM splint for improvising a cervical collar.
- One to two rolls of self-adhering bandages protected by thin-walled PVC pipe to hold SAM splints, wound packing, and dressings in place. Carry in the large velcro loops.
- One 2-inch elastic bandage for improvising a pressure bandage.
- Carry a minimum of two epinephrine auto-injectors for up 12 group members. You'll need training and a physician's prescription to purchase. Carry in the pack's rear spine pocket. Alternately consider carrying epinephrine in a mini-vial or ampoules.
- 25 mg diphenhydramine (Benedryl®) capsules or caplets for itching associated with allergic reactions and for use in addition to epinephrine for the treatment of life-threatening allergic reactions. Purchase over-the-counter and carry in a 0.25 Nalgene bottle in one of the pack's velcro loops.
- 81 mg chewable "baby" aspirin for treatment of suspected heart attack. Purchase over-the-counter and carry in a 0.25 Nalgene bottle in one of the pack's velcro loops.
- Prescription pain tablets for treating severe pain as prescribed by a licensed physician. 1 or 2 oz wide mouth Nalgene bottles the pack's medium velcro loops.
- Perscription fentanyl lollipops for treating severe pain; medics and advanced practitioners only as prescribed by a licensed physician. Carry in the interior zippered pocket of the Guide Pack or the fold-out zippered pocket in the Expedition Pack.
- Intramuscular or subcutaneous Naloxone for reversing the effects of fentanyl overdose (opioid antagonist with no agonist activity); medics and advanced practitioners only as prescribed by a licensed physician. Carry in the interior zippered pocket of the Guide Pack or the fold-out zippered pocket in the Expedition Pack.
- Oral glucose, glucose tab or GU®, and glucagon (Rx) for treating hypoglycemia in the insulin dependent diabetic.
- WMTC Patient SOAP notes for documenting serious problems. Carry in the pack's interior slash pocket behind the zippered pocket.
- Drug log for keeping track of medication use. Carry in the pack's outside vinyl zippered pocket.
- Oral Rehydration Salt packet for treating moderate dehydration in a severe heat challenge. Carry in the pack's interior slash pocket located behind the zippered pocket.
- Space pen or mechanical pencil for taking patient notes. Carry in one of the pack's spine pockets.
- Extended-range digital thermometer for taking a core temperature. Carry in one of the pack's spine pockets.
- Two-inch safety pin for use during the focused spine assessment. Pin to the outside of one of the inside zippered pockets.