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Bush Craft: First aid kits

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When an accident happens, you need to be prepared. And the first thing you jump for, after making sure that the area is safe, is a first-aid kit. Although these kits are available from outdoor shops, pharmacies and even some supermarkets, it may well be worth putting your own together.

In my experience, most of these off-the-shelf kits are jam-packed with plasters, bandages, safety pins and not much else. (I bought one, and on getting it home and opening it up, found that it had six triangular bandages!). They should not be viewed as a cover-all-eventualities-kit, but as something of a starter pack. However, the best kits I have found are made and sold by Duesouth. They have a range of kits to cater for all types of activities, the kits are comprehensive in their contents, and are extremely good value for money.

When assembling a kit, I am not talking about a collection worthy of an Intensive Care Unit, but the rudimentary basics which would cover most of the more common injuries you may incur or come across.

I think it is also advisable to attend a first-aid course. There are many different courses available, and when you think about the relatively small amount of money they cost, in relation to being able to fix someone up or save their life, they are a worthwhile investment.

For example, when I go back to the UK for a visit every couple of years, I re-attend a Rescue Emergency Care (REC) first aid course. This course (which is Health-and-Safety recognised and was established by an Accident & Emergency doctor) teaches you how to use a defibrillator, insert IV drips, clear nasopharyngeal airways and sew up wounds, among other advanced first-aid techniques. My kit will therefore include items which other people may not consider carrying.

In regions where hygiene is suspect, carry your own sterile needles and syringes.

Read it before you need it
Most first-aid kits contain a pamphlet, or some sort of guide book showing you the first-aid procedures. Read it before you need it. When a guy is lying on the floor with blood spurting two metres in the air from a severed artery, you do not want to be reading an instruction leaflet on how to stem it. You simply don’t have the time to faff about, and also need to be offering some confidence in you to the person who has suffered the injury.

Off-the shelf kits seldom contain more than a few bandages and plasters. So customise it.

As with any piece of kit you carry, learn how to use it. Improper use of an item could directly or indirectly make a first aid situation worse, or, in an extreme case, even cause death.

The ethos of first aid follows the 3 ‘P’ rule: to Preserve life, to Protect from further harm, and Promote recovery.

Organisation

Before we talk about what a first-aid kit should contain, let’s consider how it should be organised for ease of use. If packed in some sort of order, the contents are easier to find, which saves valuable time in an emergency. The way it is packed will also protect delicate products and equipment.

Colour: Use different compartments or containers for related items. For example, keep plasters and bandages together.

Label: Clearly label each container or compartment. That way, things are easier to find.

Liquids: Pour them into more robust bottles, and don’t forget to label them, including a note of the expiry date.

Protect: Ointments and sterile packaging should be protected against damage from items such as scissors, tweezers, etc. Once you puncture a sterile packaging, the contents become contaminated.

Seal: Soft items must be kept in see-through zip-lock plastic bags to protect them from moisture.

List: Compile a list of items in the first-aid box along with their expiry date.

Silica: Small packets of silica gel in the first-aid box/bag will protect things against moisture.

Kit to carry

When assembling a first aid kit, pack what you feel comfortable with. Even if you pack items which you may not know how to use, there may be somebody at the scene of an accident who does know.

As a broad rule of thumb, include what could loosely be termed ‘general’ items (such as plasters and bandages, antiseptic cream etc.), and any ‘personal’ items that you may need. For example if you are allergic to insect stings, pack an EpiPen or two. The quantities which I have given here are sufficient for a ‘normal’ vehicle first-aid kit. The farther you travel from civilisation, the bigger and more comprehensive the kit should be. (See sidebar list.)

Something else which is useful, and possibly vital, is having available the details of your blood group (it’s surprising how many people don’t know this), as well as emergency contacts, allergies, medication etc. This can be stored on a phone, (which is difficult for people to access), on a piece of paper (which can easily get lost), or on a dog tag or something. Check out www.mekeyicetag.com, who market some useful emergency-wear devices. (I am not associated with them in any way.)

BASIC KIT

Small bottle of Betadine, Dettol or Savlon for cleaning wounds.

2 Melolin wound dressing-pads. These are non-stick, low-absorbent pads used for covering grazes and lightly exuding wounds.

1 box of assorted-sized plasters.

1 box of Steri-Strips/butterfly closures. These are adhesive strips used for closing wounds. Care should be taken when using them to ensure that no dirt is sealed in the wound. The wound should be thoroughly cleaned, and any debris removed first.

1 roll of adhesive tape.

Pain killers – I carry several different types to ensure thatthose who can’t take one, have another option. Always ask if the person is allergic to a specific type of pain killer before you administer it.

Space blanket.

2 triangular bandages.

2 burn dressings.

4 packs of rehydrate/electrolyte.

2 tubes of anti-inflammatory cream.

1 tube of antibiotic cream, or a packet of broad-spectrum antibiotic tablets. On a long trip where a doctor or pharmacy may be days away, there’s nothing worse than having a raging tooth abscess and nothing to treat it with.

1 box of anti-diarrhoea pills, or charcoal tablets.

1 tube of antihistamine cream, and/or pack of tablets.

4 crepe bandages (1x10cm; 1x15cm). These have many uses, including strapping up sprained wrists and ankles, or dealing with a snakebite.

2 eye pads.

Ice-wrap.

Sterile eyewash or saline solution.

1 Disposable CPR face shield.

1 cold compress bandage.

Quikclot – to stem heavy blood loss. Expensive, but worth including (if you can find it; I can’t in Botswana). It was invented by the US military as a treatment to stem bleeding in battlefield wounds.

2 or 3 pairs of M/L surgical gloves (avoid latex as they can cause allergies in some people). Pack them in small Ziploc bags for extra protection. These will be the first item you should look for, so make them easily accessible.

Pack of sterile gauze swabs.

Pair of medical scissors.

Pair of tweezers.

Safety pins.

Packet of Wet Wipes.

Elastic bandages for wrapping sprained wrist/knee or ankles.

Thermometer – non glass to avoid accidental breakage.

Sam splint. This is a strip of thin aluminium covered in an absorbent foam which can be formed around a bone break and held in place with bandages. Failing that, carry a strip of foam sleeping mat.

Neck brace.

Condom – useful for keeping a wound dry.

Dental kit – an emergency kit for repairing dental problems such as a filling which has fallen out.

If you wear contact lenses, pack a few spare lenses and cleaning fluid.

When venturing into countries whose health system and hospital hygiene leave a lot to be desired, pack an assortment of syringes, needles, cannulas, scalpel blades, and suture thread. Or buy a specific kit.
Other useful items you may consider carrying include laxatives, antacid, decongestant for nasal congestion, anti-nausea medication, tampons or sanitary pads (can be used to cover heavy bleeding wounds), cough/throat Lozenges, blister kit, etc.

Review of basic first aid techniques

Remember the acronym DRS, ABCS.

Danger: Check the scene for danger to yourself, the group and the patient.

Responsiveness: Check for responsiveness. Shout “Are you all right?” and tap the patient on the shoulder.

Airway: Open the airway using a head tilt and chin lift, or a jaw thrust (if you suspect a spinal injury).

Breathing: Check for breathing. Look, listen and feel for breath.

Circulation: If there is no sign of life, give adults 30 compressions to 2 breaths, give infants (aged under 1 year) 30 gentle compressions to 2 gentle breaths, give children 30 compressions to two breaths.
Severe Bleeding: Do a visual check and control obvious bleeding.

Attend a first aid course – it could pay dividends.

Tail-end
Although a first aid kit is used only in times of need (it’s a bit like a winch – you are glad it’s there when you need it), it should still be considered an essential part of your ‘kit’ which lives in your vehicle. Don’t keep moving it from car to house, house to car, because one day you will need it and might not have it.

Also, don’t just leave it tucked away only to be opened in times of emergency. A lot of items you may have packed could have passed their expiry date. So get the kit out, check it regularly, and replace the old stock. And if you use an item, REPLACE it immediately. Because the kit may be used infrequently, it is easy to use something and then forget to replace it. Some people include a checklist which they tick off when an item has been used, so they can see it needs replacing. That’s a good idea.

By Paul Donovan

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