Archive for May, 2009

Northern Tier First Aid Kits

Sunday, May 31st, 2009

Our Wilderness First Aid Class has generated some discussion about what is the perfect first aid kit.  I have been asked for my views and advice for those planning a kit for their vehicle, for day hikes and for the upcoming trip to Northern Tier.  Let me start by saying that there is no such thing as a perfect first aid kit.  Any first aid kit is a series of compromises, informed by the intended use of the kit.  Rather than try to define the perfect kit, I will share some of my views as to essentials for kits for various uses and allow the reader to apply their own judgment to help them decide what is right for them.   I will start with the Northern Tier kit.  It needs to be sufficient to sustain a crew of up to 9 traveling by canoe for a week in the boundary waters of Minnesota and Canada.  It not only needs to have contents that will permit a response to a serious accident in a remote area where help may be delayed, but should also have what it takes to deal with the everyday cuts, scrapes, aches and pains the crew will encounter over the course of the week.  The first place to start is the list of requirements for first aid kits published by Northern Tier.  Regardless of my opinions, they have set out certain requirements, so having everything their list is the place to start.   

Space and weight are at a premium.  The canoeing environment demands a fully waterproof bag.  Even though the kit may be placed inside another waterproof bag or pack, the importance of keeping the kit dry suggests to me that it be afforded double protection.  That being said, if it is to be stowed inside a pack, the pack can be relied upon to provide abrasion resistance, so the waterproof bag might be one of the very lightweight ones now commonly available.  Here comes a compromise:  A first aid kit is supposed to be readily accessible in an emergency.  If you have a kit in a waterproof bag in a pack, is that going to impair your access to it when seconds count?  My view is that if somebody is going to die over a few second delay in getting to the first aid kit, they probably are not going to make it in any event.  The critical steps to saving a life don’t require anything in the kit.  Assuming you are willing to forego a breathing mask for CPR and sterile gauze for the first attack on an arterial bleed, so you can afford a few seconds getting to the kit and avoid the risk of losing everything to wetness. Here is the list of items on Northern Tier First Aid Kit.  I will give my comments below each item. 

Band Aids, flexible type/water resistant There are the traditional type stips and fully waterproof types that completely seal the wound and don’t let anything in or out.  For the former, I like the flexible fabric style.  For the latter, I have no preference.  I have some concern about fluid and perspiration causing a sauna effect inside a waterproof dressing, so I would only use one if I was confident the wound would get wet from the outside without it.  I would have more regulars than waterproof, but would carry some of each to Northern Tier.  You could go through a lot of these during a week at Northern Tier for cuts and blisters, so I would pack plenty to permit frequent dressing changes.  I would have each participant have 5 in their personal kit and have 25 or 30 in the crew kit.   

Knuckle and Fingertip bandages These are fancy band-aids that are easier to fit and keep on the spots indicated.  In a pinch, you can get by without them.  I would have no more than 10 and the more I had, the fewer regular ones I would take. 

4” x 4” Gauze Pads These are the holy grail of a first aid kit.  Remember that sterile dressings are something that cannot be improvised in the wilderness.  I would have 10 or more and would probably fill whatever extra space I had in my kit with extra 4X4s.  Put them in a ziplok.   

Butterfly Skin Closures or Steri-Strips I carry steri-strips, but remember you will need the tincture of benzoin to help them stick.  Also remember that  Red Cross procedures say don’t close a wound, since you could close in the bacteria and get a nasty infection.  If you can’t scrub it, I would not seal it.  I would carry 3 packages of Steri-strips.  They are light.  Be careful when you open the package, because there are a lot in each package and you can keep them clean and use them later if you have to. 

3” or 4” Ace (Elastic) Bandage I would take no more than one or two.  They can be reused.   

Waterproof Tape I would take a roll.  You can use duct tape if you run out. 

Moleskin or Spenco 2nd Skin This is another product you can run through a lot of on a trip like this, especially if people do not have good, well fitted boots.  Maybe 4-5 sheets in the crew kit and a sheet in each person’s personal bag. 

Tincture of Benzoin This is an antiseptic, but more importantly, it is like a primer for skin that allows bandages like steri-stips to adhere better.  I like the small single use ampoules and would have 4-5. 

1” or 2” Roll of Gauze I am not sure I have ever seen 1” gauze.  Even 2” seems narrow to me.  I like the vacuum packed 4.5 “Kerlix” clone product sold at Rescue Essentials.  I would have 2 or 3.   You can use this if you run out of 4X4s.   

Tweezers or Forceps These are important for splinters.  I use some very small ones from Brigade Quartermasters.  They give the best purchase on a splinter of any I have ever seen and they can clip onto a zipper pull. 

Scissors I would take a standard pair of “paramedic scissors.”  They are cheap and can cut anything. 

Tegaderm Dressing This is the 3M version of a large waterproof (but said to be breathable) band-aid.  It can seal off a moderate size cut.  I think they are pretty slick and would have a few, especially for Northern Tier.   

Latex or Nitrile Gloves I would have no more than one pair and would not have latex.   

Safety Pins, Large Size A few can come in handy for all manner of things.  Remember if you have triangular bandages, there are normally 2 packed in with each of them. 

NewSkin (Antiseptic Liquid Bandage) This is essentially a liquid glue that can be brushed on to a minor cut or scrape to seal it off from the outside environment.  It is waterproof.  I like the idea of something like this for minor problems in a wet environment, but would not use it on anything that might need stitches. 

First Aid Manual If you need to read the book on the trail, I think you are in trouble.  If they make us have one, I would say pack the lightest and smallest you can find.  Maybe one of the little cards from Rescue Essentials. 

Rescue Breathing Mask (disposable) This is the politically correct way to do CPR in this day and age.  If I had to cut weight and bulk, this is the first thing to go in my kit.  If you want to satisfy this requirement, get one of the little plastic shields.  I think they are worthless, but don’t take up much room. 

Thermometer (disposable) I am not sure why you need one, but would go for light and cheap. 


Acetaminophen (Tylenol, others) I would have a bottle of 100.  Maybe more.  Think about how many people you have and how many they can take in a day and then think about how long it would take to run out if a lot of people were taking them for aches and pains. 

Ibuprofen (Advil, Motrin, others) I would have at least a bottle of 100 of these too.  In canoeing class, they called it Vitamin I and recommended taking it before and after paddling.   

Hydroxyzine (Benadryl, others) I would have a card of these capsules. 

1% Hydrocortisone Cream (Cortaid, others) I would have a full tube.  If you get a decent sized rash, you can use a lot in a week. 

Antifungal cream or spray I guess the same goes for this, although I have never used any on a camping trip. 

Foot powder Medicated powder is magic stuff, as we learned at Sea Base.  I would have a big bottle in the crew kit and a small one in each personal kit.  It makes you feel better and keeps chafing from turning into a nasty rash. 

Antibiotic Ointment (Neosporin, others) I would have a full tube.  If you get a kid with a big scrape, you can use a lot of it. 

Soap and/or waterless hand sanitizer There is nothing like soap to clean something and kill germs.  We will have plenty of water, so washing with soap should not be a problem.  If I took hand sanitizer, it would be a small pocket sized bottle. 

Sunscreen, SPF 15 or higher I would have a big crew bottle and personal bottles for each crew member, especially if they are fair skinned.  Remember, some people don’t need it and others are literally toast without it. 

Lip Balm (Chapstick, others) I consider this personal gear.  I am not going to share it, which can spread herpes.  Maybe have a spare tube or two in the crew kit if somebody loses theirs. 

That is the end of the items on their list.  Here is what I think they missed: After sun/sunburn gel (aloe) 

Somebody is going to get a sunburn and you need something to help provide some relief. Providone Iodine pads. 

These are antiseptics for cleaning a wound.  I would not consider steri-stripping a laceration without cleaning with this stuff first.  We used a lot at Sea Base as an antiseptic for a scout who had a chronicly infected scraped knee, later determined to be staph infection.  After cleaning with this, we put on the triple anti-biotic ointment.  I would have 10 or 20. SAM Splint 

I would have one. Immodium. 

You need this is somebody gets the runs. Pepto-Bismol or similar stomach ache remedy. 

Figure out what your crew likes and take something for stomach aches.   Emergency Blankets. 

They are small and light and come in handy.  I would have a couple in my kit.  Also, if you get some guy down who is wet or in the mud and you need to keep him warm, do you want to sacrifice your sleeping bag, or even his?  Save the bag for when you have him dried off and stabilized. Assessment forms. 

If you can remember everything, then plain paper would work, but if you need the prompts, take a few. I am sure there are a few more items I might think of, but these are the main ones. 

New Troop Website

Tuesday, May 19th, 2009

Troop 641 has a great new website at

My Review of Essential Gear Guardian Signal Light

Sunday, May 17th, 2009


The Guardian signal light is lightweight, bright and easily seen during your (or your dog's) favorite outdoor activities—just clip it on and go!

Great on Paper, Terrible in Practice

TX Outdoorsman Houston, TX 5/17/2009

1 5

Gift: No

Pros: Small

Cons: Not Waterproof if off

Best Uses: Backcountry Camping

Describe Yourself: Avid Adventurer

What Is Your Gear Style: Comfort Driven

Bought on Friday, returning on Monday. Bought as a PFD light since listed in Paddling Safety Gear. Seemed great – rated waterproof to 300 feet, small size etc. However, this device twists to turn on and to engage the o-ring, you have to twist it down all the way, so it is only waterproof when it is on. First time in the water, the clip came off the PDF attachment point as I was re-entering a canoe, but I caught it and put it in a PFD pocket. On Sunday, it was wet on the inside. Turned itself on once in the pocket. Don’t bet your life on this. Should not be listed as paddling safety gear.


Source for First Aid Equipment

Tuesday, May 5th, 2009

I teach Wilderness First Aid and keep our troop first aid kits up to date.  I have been very impressed with the equipment, prices and service at a company called Rescue Essentials  I have placed several orders with them and they are always prompt and responsive.  The same SAM splint REI sells for $16.00, they sell for under $10.   I really like the fact they sell sterile gauze rolls in a vacuum sealed package which takes only a fraction of the space a traditional gauze roll takes.  I gave them a call and suggested they put together pre-filled kits for high adventure crews headed to Philmont, Sea Base and Northern Tier.  They are looking into it.