When a Kiss Won’t Make It Better:
A Do-It-Yourself First Aid Kit

by Ronald M. Mann and Myles C. Jones, MD, FACS

Seventy-five miles of backpacking beauty in the high Cascades and not a worry in the world! The immediate future seemed to hold nothing but blue skies and bluebirds for our Scout troop.

We were counting on an unforgettable experience, and we got it. With only a half hour of trail behind us, we were hit with a downpour that soon turned the steep trail into a slippery tightrope. For six days it rained, and for six days we slogged and slipped along that trail, and the experience kept getting more unforgettable with every step.

It was especially memorable for: The boy who slipped into a swift river and was being dragged by the current to a probable death when his head lodged between two tree branches just long enough for us to save him. The boy who slipped and slashed his forearm badly. The two of us who twisted our knees. The two boys who sprained their ankles. The boy who suffered second-degree burns when boiling water was spilled on him. The two boys who developed bad colds. The boy who contracted a serious case of diarrhea. The three boys who developed hypothermia—a dangerous lowering of the body temperature—especially one of them who came very near death as a result.

We started out expecting blue-birds—and maybe a few bruises and blisters if we were unlucky. When the bluebirds flew away and the brickbats started flying, we were very grateful that we had some first aid supplies and knew how to use them. If that boy with hypothermia had died, the hike would now be unforgettable in a way I don’t like to think about.

That hike in the high Cascades was the most accident-laden trip I had suffered through in my ten years of backpacking. It was the exception rather than the rule, and yet every year groups face much worse first aid challenges in the out-of-doors. I don’t want to scare off any would-be campers, but I want to emphasize that we must prepare for the worst case and not the best. I am constantly running into youth groups in the wilderness who aren’t even prepared to fix a blister—let alone deal with a serious accident. Such groups are simply courting tragedy.

First aid begins with proper training. I recommend as a minimum the standard first aid and personal safety courses and the cardiopulmonary resuscitation courses taught by the Red Cross. Those above 15 years of age may also take the advanced first aid emergency care course. A Scout troop can arrange to take one of these courses as a group, and there is no charge except for the materials used in the course. Some of the leaders might also wish to take the EMT (emergency medical technician) or paramedic courses.

The injuries I’ve found to be most common on outings are: blisters, sprains, minor cuts, wrenched knees, fractures, burns, hypothermia, shock, and drownings. Therefore, be sure your first aid training includes these as a minimum. It is also very important to be able to properly diagnose a victim in order to apply the proper therapy—make sure you thoroughly understand the various diagnostic techniques.

It is also essential to have adequate first aid supplies. I have yet to find a ready-made first aid kit that will meet my needs, so I have put together my own, based on my experience in the outdoors. I do not guarantee that my kit contains everything you may need in yours. Your kit should include any additional medications or equipment you need for personal medical problems. Also, specialized activities such as skin diving, mountain climbing, or hiking in unfamiliar areas may require special supplies. Check with a physician or an authority on the sport or area you have in mind.

When you are in the outdoors, there should be one master kit for the group, and each individual should carry, as a minimum, those items marked with an asterisk. Also be sure to include a small, compact first aid manual in each pack. Please don’t read your manual over the victim, however; try to instill confidence, not terror! Any of the following manuals will do nicely:

Mountaineering Medicine—by Fred T. Darvill, Jr., MD; Skagit Mountain Rescue Unit, Inc.; Mount Vernon, Washington

Mountaineering First Aid and Accident Response—by Gross, Harms, Post and Recreational Equipment (R.E.I.); Seattle, Washington

Medical Emergencies—prepared and distributed by the Schering Corporation

Mountaineering First Aid—published by The Mountaineers; Seattle, Washington

Medicine for Mountaineering—by James A. Wilkerson, MD; published by The Mountaineers; Seattle, Washington

Primitive Medical Aid in the Wilderness—distributed by Life Support Technology, Inc.; Manning, Oregon

Emergency Medical Guide—by John Henderson, MD; McGraw-Hill Paperbacks

Pocket Guide to First Aid—prepared by National Safety Council

Your first aid supplies should be carried in a small, sturdy, waterproof container. I prefer a leather toiletry bag. I seal the individual items in zip-lock bags before putting them in the first aid kit.

The left-hand column below lists the items you will need; the center column lists the amount you will need; and the right-hand column explains the use of each item, and, where applicable, the dosage.

Item	Amount	Use/Dosage
AIRWAY TUBE	1	Artificial respiration
*ASPIRIN	12 5-grain tablets	2 every 4 hours for mild pain (to relieve pain or headache or muscular aches)
*ANTACID	24 tablets	For indigestion, nausea, upset stomach, and heartburn
ANTIHISTAMINE	12 tablets	1 every 4 hours for insect bites, colds, or hives (Benadryl—25 mg for youth, 50 mg for adults—or Coryban D)
*ANTISEPTIC	2 ounces	For cleaning abrasions, cuts (Derma 7, Bactine)
*BANDAIDS	Several sizes (6 each)	For minor cuts
*BUTTERFLY BANDAIDS	Various sizes (6 each)	For closing lacerations
CARLISLE (BATTLE) DRESSING	2 to 4 inches or longer	For large, bleeding wounds
*DIMES	Several	For emergency telephoning
*ELASTIC (ACE) BANDAGE	2 (2- and 3-inch sizes)	Twisted knees, securing dressings in place (training in its use is required)
EYE WASH	2-ounce plastic bottle	Any of several brands of sterile wetting solution
*FIRST AID CREAM	1 tube	For cuts, etc. (Neosporin Ointment)
GAUZE FLATS	3 2-inch square flats	For small wounds
HALAZONE TABLETS	12	For treating drinking water of questionable purity
*MOLESKIN	1/2 package	For blisters
*NEEDLES	2 medium	I.V. needles are individually packed and sterile—for removal of slivers, etc.
OIL OF CLOVES	1-ounce plastic bottle	For toothaches (be sure to include some cotton)
PLASTIC, THIN	1 12-inch-square piece	For puncture wounds of chest (Saran Wrap)
*Q-TIPS	10	Steri-Q-Tips for cleaning wounds, eyes, etc.
RAZOR BLADE	1 single blade in guard	Cutting tape and moleskin, shaving hairy spots before taping
*ROLLER GAUZE	2 rolls—2-inch-by-5-yard	For holding gauze flats in place
*SAFETY PINS	4 (2 small, 2 large)	For slings and mending holes in torn pants
*SALT TABLETS	24 (buffered)	To prevent or treat symptoms of heat exhaustion (including cramps) when sweating heavily. 1 to 2 tablets with each quart of water or fluids consumed (Stress Tabs)
*SCISSORS	Small pair	Good quality, small, bandage type
SNAKE BITE KIT	1	Cutter and anti-venom
SORE THROAT TABLETS	6	For minor sore throat
SUGAR CUBES	4	For diabetics
CONSECRATED OIL	small bottle
FOIL EMERGENCY THERMAL BLANKET	1	For preserving body heat (weighs approximately 2 ounces)
*STERI-PADS	3	For larger wounds
*SUN CREAM	1 tube	Solex, Uval, Sea & Ski
*TAPE, ADHESIVE	2-inch-wide roll	For sprains, securing dressings, etc.
THERMOMETER	1 (-40° F. to 120° F.)	For measuring temperature
TINCTURE OF BENZOIN	1-ounce plastic bottle	To hold tape in place and protect skin
*TRIANGULAR BANDAGES	2 (40-inch-square muslin cut on bias)	For supporting arm, protecting dressings, sprains, and stretcher ties
*TWEEZERS	1	For removing slivers, etc. Make sure you get good quality!

Depending on the size of the party and duration of the trip, you may want to increase or decrease some of the quantities of items (salt tablets, bandaids, etc.). Also, I have found it a good policy to carry a small writing tablet (3-by-5-inch) and pencil.

Drugs

WARNING: If you carry any drugs, you should be thoroughly familiar with their use. Consult your family physician and let him explain their limitations, dangers, and directions for use. Further, you should be sure and comply with all federal, state, and local laws relative to their use. These are a few drugs you might need for common injuries or illnesses:

Illness or Injury	Amount/Item	Use/Dosage
BURNS	Furacin pads or tube of ointment	To promote healing and prevent infection (Furacin-impregnated 3-by-9-inch gauze pads or sterile Vaseline)
DIARRHEA	24 tablets Lomotil	For severe diarrhea (one tablet every four hours)
INFECTION	10 tablets Ampicillin Tetracyn	Ampicillin—500 mg, one capsule before meals and bedtime; or Tetracyn—250 mg, one every 3 to 4 hours
SEVERE PAIN	6 tablets Talwin	50 mg, one every 3 or 4 hours

I hope I have not made camping sound like a dangerous activity or the outdoors like a dangerous place. You may spend years in it and never suffer a serious accident, but when you are on foot long miles away from the nearest telephone or transportation and still more miles away from the nearest doctor, your knowledge and your equipment can be worth a friend’s life when the unexpected occurs. That makes it worth your trouble to expect the unexpected. You obviously can’t put a kit like this together on a moment’s notice, so why not begin today? Even if your next camping trip is in the distant future, time goes fast and you’ll be striking out on that beautiful mountain trail before you know it. You’ll go with a lighter heart if you’re prepared.

Illustrated by Phyllis Luch