First Aid for the Trail

By Dr. Tom Long

So you are planning a 50 miler. Trek leader, SPL, quartermaster, permits, maps - everything is coming together. An "old and trusted" ASM has signed on again as the "medic" for the trek. He is a paramedic in real life. Plans are in great shape. Any need to worry about first aid? You bet! Accidents and mishaps are unpredictable, unexpected and the outcome is uncertain. Maybe the paramedic is the victim.

First aid literally means first help or first assistance. Sometimes the needs are obvious and very little assistance is necessary. Sometimes we need a first aid kit. Every Scout knows that first aid supplies are among the ten essentials. Before a Scout achieves the rank of First Class he has mastered many first aid skills enabling him to feel self-sufficient in the wilderness. A Second Class Scout has made a personal first aid kit that should be functional. In the event of an injury, a Scout should use his own first aid kit rather than the patrol supply. Now that's a fine reason to make a good first aid kit.

First aid kits are commercially available. Take a hike to your favorite backpacker store. Kits are available in every size, shape and weight you can imagine. There are personal first aid kits and kits for the entire crew. Prices range between $10 and $240. What do you really need? First aid kits should be waterproof, accessible, well stocked and clean. Weight is an important consideration - a doctor's bag is too bulky for your backpack. Personal medications should be properly labeled and are intended for the identified person only. Let's focus on the patrol first aid kit.

Waterproof packaging is easily assured using heavy-duty, Ziploc bags. Mark your backpack to indicate the location of the kit for prompt availability and ready access. Standard supplies include rolled gauze, gauze pads, band-aids, probably some elastic bandages, tape and any non-prescription antibiotic ointment. And there are many items readily available to every first-aider nearby or in your pack: water, the scissors on your pocketknife, sling material from your scarf to name a few. I like to add some one-of-a-kind items for a crew kit, especially when the backcountry is the destination. There's no 911 resource out on the trail. Remember accidents are unpredictable. One such item is a Sam Splint, a lightweight, reliable splint that is adaptable for many skeletal injuries. Safety pins are always handy. A thermal blanket may be life saving. Someone in the crew should carry an oral airway or Microshield for initiating CPR. Lightning strikes are uncommon, but this equipment may be lifesaving. Every good first aid kit needs an outdoor emergency medical guide. The Scout Handbook or First Aid merit badge book is a good starting point. A favorite book is Mosby's Outdoor Emergency Medical Guide. Think comprehensive and lightweight in making your selection. Personally I like to stash a few more small items in my kit, just to be on the safe side: waterproof matches, extra moleskin, some iodine tablets just for good measure and even some Gatorade powder as an electrolyte replacement solution. Now anyone might want to add further to this list, usually some item that is unique for him. These special items belong in a personal first aid kit and may include, for example, sunscreen, eye drops, a special allergy medication etc.

An important part of the first aid plan is injury prevention. I like to say Scouts should have one foot on the ground at all times. Remember the buddy system - two heads are better than one, especially if Scouts need to make a critical decision. Stow your fuel safely, treat your water, bag and hang your food. If you plan to fish, use barbless hooks. These are required in most Sierra streams and they are easier to extract from hooked backcountry fishermen. Don't fill your pack with too many gadgets - all those ounces add up to pounds. Be prepared! The best trip is one where the first aid kit never needs to be restocked.