WFA and now First Aid kit changes for me

[Blissful]

Well I spent the last two days getting down and dirty with earning my Wilderness First Aid certification. And after that, I decided to forget being the total gram weanie when it comes to the first aid kit. I will blog about it later, but now I am adding the following to my first aid kit that I didn't have before - and really, it doesn't add that much more weight at all -

The guy gave us each a small plastic syringe to irrigate a wound - weight prob less than an ounce. After seeing hikers with infections that went systemic from cuts, it makes sense to use this to irrigate wounds
Various gauze pads to clean wounds with, bandaids of course
Pieces of moleskin, not just duct tape
safety pin
I carry a small ace wrap
small film canister of hibiclens - soap of choice (can get at a drug store) for cleaning wound; they are not big on antibiotic cream which was new for me. Says it attracts dirt, but I carry a small tube anyway
Carry a watch (I do anyway. Good for checking heart rates and for noting time of injuries, etc for rescue and others)
two triangular bandages - good for lots of first aid, weight negligible
a small tick removal device
Other Medicines - have in the kit -
some salt - for sun issues and rehydrate - look for the restaurant packs
some sugary jello (maybe have in food bag, just be sure you hang it) - good to rehydrate, hypothermia and diabetic issue, liquidfied
some aspirin - 325 mg, for heart issues
benadryl for allergy reaction (it can happen to anyone at any time) - and consider getting a prescrip for epipen from dr
Tylenol (sometimes Vit I but Tylenol is the drug of choice)
some small ziplocs to put on water and / or ice packs for injuries
some doxycycline for tick bites

[10-K]

My guess is you'll take some of that stuff back out in a while. I took a WFA course and did something similar afterwards.. :)

At any rate, make sure you rotate the doxy before it expires - it's pretty toxic when it's old. From drugs.com:

Using expired doxycycline can cause damage to your kidneys.

[canoehead]

Good stuff. I think if your hobbies include inherent risk. IE; Climbing, Hiking, kayaking etc. Then you should be responsible for learning the basic safety procedures for that activity.
Lots of folks will buy the first aid kit and NOT have the skills to use it. I've been certified or teaching WFA -WFR classes for 25 years and didn't really need to use those skills. I have tended to a few accident victims on the trail, rivers etc... But in 07. I had the opportunity to do CPR and help blow life back into older gent, laying on the ground beside his pick up truck while his wife stand there crying and looking for help. That's when I drove up and then 2 other folks stopped to help me. Today that man is still with us. Everyone should learn at least the basics of first aid. It might be some close who needs you.

[swjohnsey]

If you are gonna carry doxycycline maybe Tinadazol for giardiasis.

[Sailing_Faith]

My guess is you'll take some of that stuff back out in a while. I took a WFA course and did something similar afterwards.. :)

At any rate, make sure you rotate the doxy before it expires - it's pretty toxic when it's old. From drugs.com:

Using expired doxycycline can cause damage to your kidneys.

Never knew this,

Thanks.

[Blissful]

Good stuff. I think if your hobbies include inherent risk. IE; Climbing, Hiking, kayaking etc. Then you should be responsible for learning the basic safety procedures for that activity.
Lots of folks will buy the first aid kit and NOT have the skills to use it. I've been certified or teaching WFA -WFR classes for 25 years and didn't really need to use those skills. I have tended to a few accident victims on the trail, rivers etc... But in 07. I had the opportunity to do CPR and help blow life back into older gent, laying on the ground beside his pick up truck while his wife stand there crying and looking for help. That's when I drove up and then 2 other folks stopped to help me. Today that man is still with us. Everyone should learn at least the basics of first aid. It might be some close who needs you.

Wow. This is where it's all at. I'd like to quote you if I may in an upcoming blog I plan to do on taking WFA. I mean I was one of those that blew it off. Now I am glad I took it so I can help others out there if the need every arises (and you hope, of course it doesn't)

[Blissful]

My guess is you'll take some of that stuff back out in a while. I took a WFA course and did something similar afterwards.. :)

At any rate, make sure you rotate the doxy before it expires - it's pretty toxic when it's old. From drugs.com:

Using expired doxycycline can cause damage to your kidneys.


Yes good thing to note about meds that can expire, etc. Same with the Epipen.
The stuff I plan to carry really doesn't weigh that much more. I mean our instructor was showing fancy scissors, burn ointment,other stuff etc that I don't ever plan to to carry. But the stuff I did mention is weight negligible all things considered. I'd like to think those couple of hikers that died of heart attacks last year AT-wise might have been helped if someone had carried a few aspirin in their first aid (and what is the weight of that?).

[BrianLe]

When I took my last "wilderness oriented first aid" course, I was struck by how these folks seemed to just assume the "weight vs. safety" trade-off should always tilt towards "safety" for anyone they considered to be responsible. They didn't quite come out and say it that way, but I had a sense that each of the instructors carried a relatively huge amount of medical supplies whenever they went in to the woods.

I'm certainly not saying that's "wrong", just that it isn't necessarily for everyone.

From the specific list at the start of this thread:

To irrigate woulds I'd take the bite valve off of my platypus hose.
Triangular bandages: if in need I'll make the conscious choice to cut up some existing piece of clothing or outerwear to make one.
Tick removal: my tiny knife includes small scissors and a small tweezer, which in fact I used to take a tick out of my leg with on the AT.
Salt: generally I have lots of salty foods with me.

Many of the things on that list I do agree with and carry anyway, though not all primarily for "first aid" --- aspirin and tylenol for example, ziplock bags, safety pin, moleskin, a watch.

I guess I just agree with whoever said earlier that it's a natural progression to take stuff out when on an "ultralight" kick, then add a lot back in right after a first aid course, and then to back off and take some of that back out for a more long term, steady state first aid kit.

[Blissful]

Not sure how long it will be posted, but you can see our WFA course via the news broadcast - I'm the one hollering in the opening scene and they show the man bandaging my "wounded arm"

http://www.nbc29.com/category/175568/video-landing-page?autoStart=true&topVideoCatNo=default&clipId=6735742

[moof53]

Very good post. It is one thing to hike, camp and be outdoors and to do it as light and as comfortable as possible. But, there is ALWAYS the possibility of being seriously injured. How many have have not been injured in the safe confines of our every day lives? You might get by just carrying a bandaid but maybe not. Having the items mentioned, or at least a plan on how to use other readily available items you carry in their place, is a good idea. You may have only a few minutes to help yourself or someone else.

[SawnieRobertson]

Hey, Blissful. You are a great screamer. That can be an important asset in case of any sort of wilderness/rural/urban disaster. Motivation for taking and passing a WFA course should also be to be able to tell others how to treat your wound if you cannot do it yourself. Those with the utmost in good intentions who have not gone to the trouble/expense of taking a certification-level course are potentially as dangerous as an ice-covered slope. It is a great thread that you began.--Kinnickinic

[dzierzak]

The instructor in the WFA course I took kept emphasizing that the best resource is between your ears. That said, a small amout of preparation and insight can take many of the items you normally carry into usable first aid kit items.

[Grits]

Great thread and here is something from the Mountain Rescue Association worth reading and passing along.
http://www.mra.org/images/stories/training/backcountrysafety.pdf

[Don H]

If you are gonna carry doxycycline maybe Tinadazol for giardiasis.

I carried Doxy from day one and ended up needing it in MA when I came down with Lyme.

[Blissful]

The instructor in the WFA course I took kept emphasizing that the best resource is between your ears. That said, a small amout of preparation and insight can take many of the items you normally carry into usable first aid kit items.


This is SO true.
On the scenerios I used my tent fly to make a hypowrap for hypothermia issue, benadryl from my first aid kit for bee sting with developing hives, tent poles for splints, sleeping bag numerous times, ensolite pad, clothes and socks for padding and bandaging, hat for a chin strap to keep the neck still for a possible spinal issue, cocoon pillow for comfort, etc. Not to mention your cookwear to heat water for wound care and drinks, crocs to add cushioning in a leg splint, etc

[Blissful]

I carried Doxy from day one and ended up needing it in MA when I came down with Lyme.

I used my one time dose in NY on my SOBO when I found an embedded deer tick.
If you happen to see the tick, don't wait, take the loading dose if you have the med. If you get symptoms of it, like you feel like the flu, take it also.

[Blissful]

Great thread and here is something from the Mountain Rescue Association worth reading and passing along.
http://www.mra.org/images/stories/training/backcountrysafety.pdf

Excellent, I need to put that link in my bog when I write it up.

[Blissful]

Hey, Blissful. You are a great screamer. That can be an important asset in case of any sort of wilderness/rural/urban disaster. Motivation for taking and passing a WFA course should also be to be able to tell others how to treat your wound if you cannot do it yourself. Those with the utmost in good intentions who have not gone to the trouble/expense of taking a certification-level course are potentially as dangerous as an ice-covered slope. It is a great thread that you began.--Kinnickinic


It was a good learning experience. Our instructor said we are MUCH better in the backcountry to deal with events there than even the trained rescuers from the "front country" because they lack the experience of dealing with the situation in rustic settings.

On the video, the man handling both my screaming and the news reporter's camera in his face was a BSA scoutmaster who likes to take his scouts backpacking (they just did their 50 miler last year). Kudos for that.

[Blissful]

When I took my last "wilderness oriented first aid" course, I was struck by how these folks seemed to just assume the "weight vs. safety" trade-off should always tilt towards "safety" for anyone they considered to be responsible. They didn't quite come out and say it that way, but I had a sense that each of the instructors carried a relatively huge amount of medical supplies whenever they went in to the woods.

I'm certainly not saying that's "wrong", just that it isn't necessarily for everyone.

From the specific list at the start of this thread:

To irrigate woulds I'd take the bite valve off of my platypus hose.
Triangular bandages: if in need I'll make the conscious choice to cut up some existing piece of clothing or outerwear to make one.
Tick removal: my tiny knife includes small scissors and a small tweezer, which in fact I used to take a tick out of my leg with on the AT.
Salt: generally I have lots of salty foods with me.

Many of the things on that list I do agree with and carry anyway, though not all primarily for "first aid" --- aspirin and tylenol for example, ziplock bags, safety pin, moleskin, a watch.

I guess I just agree with whoever said earlier that it's a natural progression to take stuff out when on an "ultralight" kick, then add a lot back in right after a first aid course, and then to back off and take some of that back out for a more long term, steady state first aid kit.


Unfortunately the water to irrigate a wound is dirty from your saliva in the tube and not sanitary enough. Better off getting a fresh bag and using aqua mira or filtered water. Needs to be as clean as possible. The syringe again weighs little and effectively cleans. And hikers have gotten off because of wound infections.

A triangular bandage weighs zip and is much easier to make a sling or other bandage, believe me. I tried to make some stuff from clothes. Not secure enough to do what you need it to do. And you'd rather cut up clothes when you can carry an ounce of a bandage? This was an eye opener for me. Same as I take a small ace wrap.

Tick removal too - this is for the deer ticks. Dog ticks, sure can use the tweezers you have. Deer ticks much harder to remove d/t size with head intact so as not to excrete more bad stuff into you.

Salt - you can't give someone with heat issues salty foods, they need the liquid and salt easily dissolves. It also makes an oral hydration solution.

That's why I mentioned weight in the beginning of the post. All the things you mentioned add negligible weight to one's kit.

[canoehead]

Wow. This is where it's all at. I'd like to quote you if I may in an upcoming blog I plan to do on taking WFA. I mean I was one of those that blew it off. Now I am glad I took it so I can help others out there if the need every arises (and you hope, of course it doesn't)

Feel free to quote me. I believe everyone should know at least the basics of first aid, and anyone hired to lead individuals, groups or are responsible for others while in the outdoors should be certified with a WFA. That's the minimum qualification you will need to work for me, the WFA would allow you to do day hikes, school day programs, weekend with an overnight. The WFR is needed to run an overnight - multi week programs, and WFR/EMT for our WOLF Program Expeditions. At least that's how it's structured in my business.

[S'mores]

Hey Blissful!! (Kathleen here) Thanks for posting the link! I hadn't found it anywhere else. I agree with you on sacrificing a bit of weight now. I know I am going to be adding baby aspirin. I already always carry benedryl but I'm still wavering on that syringe.. I did take one though.. its just so bulky! The pack I had with me in class is exactly what I would have so you can see I am already on the heavy side. This summers section for me will bring me right back to Charlottesville, I wish I could time in to get down there for the WFR course. Either way, I would love to look you up when I get down there!

[Mango]

I took a WFA course lst spring; the thing that struck me most was the time spent on assessment v. actual treatment. My head was spinning from all the acronyms, procedures, etc. I needed to remember. It has since occurred to me that a great tool in the wilderness would be a First Aid app for a smartphone, which many thru- and section hikers carry. Mine is a Blackberry, but I haven't been able to find a suitable app for it.

I asked NOLS, but they said they didn't "publish" one and didn't know of one available. Since you're already carrying the weight of the phone, an app seems to make so much more sense than the little WFA book. You wouldn't need a signal to access it - just enough battery power to activate the checklists, advice, etc.

Anyone got any leads on a FA app?

Thanks,

Mango

[Don H]

Unfortunately the water to irrigate a wound is dirty from your saliva in the tube and not sanitary enough. Better off getting a fresh bag and using aqua mira or filtered water. Needs to be as clean as possible. The syringe again weighs little and effectively cleans. And hikers have gotten off because of wound infections.

I don't think irrigating wounds is something you will need to do on the trail. I worked for years as a Paramedic and I never irrigated wounds in the field. On the AT you are rarely more than a few hours from medical treatment. Major wound care should consist of controlling bleeding and bandaging. Irrigating major wounds (I'm talking about something like a 6" gash in the head from a fall that's bleeding like a stuck pig!) just results in more bleeding and introducing more bacteria into the wound no matter how sterile you think your procedure is.

Minor wounds should be allowed to bleed a bit, treated with a topical antibiotic and covered. This is where I saw several people get into trouble. Small wounds that got infected and became major problems. It's just something you need to keep on top of buy keeping an eye out for infection, changing bandages and keeping the area as clean as possible. Not something that is easy in our hiking environment.

[double d]

I think everyone should take a WFA class at some point, as I did during the spring of 2011 at the Green Mt. Club. A little pricey, but for a two day, 16 hour class, it was a great learning experience and I also got to meet a lot of interesting people during the class as well. But again, I think everyone should take a WFA, you will learn alot, even if you already know alot.

[JAK]

Congrats Blissful. I finally put together a decent kit on my last hike but it still needs work. I need to take a course again as its been awhile. Something I always mean to do but haven't is put together my own aide-memoire of how to respond to different scenarios. There are alot of great resources out there but if you go through the process of writing your own notes in a little notebook and carry it in your first aid, along with your own checklist of materials, I think you would be that much more prepared and less likely to panic, even if you never had to read the notes you wrote. I hike alone, but as others have more or less said, if you come across someone else that needs help it would feel like crap if you weren't even prepared with the basics. Kudos all.

[Don H]

I think everyone should at least take a first aid course, maybe not necessarily a wilderness first aid course.

[Blissful]

Hey Blissful!! (Kathleen here) Thanks for posting the link! I hadn't found it anywhere else. I agree with you on sacrificing a bit of weight now. I know I am going to be adding baby aspirin. I already always carry benedryl but I'm still wavering on that syringe.. I did take one though.. its just so bulky! The pack I had with me in class is exactly what I would have so you can see I am already on the heavy side. This summers section for me will bring me right back to Charlottesville, I wish I could time in to get down there for the WFR course. Either way, I would love to look you up when I get down there!

Love to see you!!! I'm on facebook too. I plan to take WFR when my WFA expires in 2 years.

[Blissful]

occurred to me that a great tool in the wilderness would be a First Aid app for a smartphone, which many thru- and section hikers carry. Mine is a Blackberry, but I haven't been able to find a suitable app for it.


Mango

This is a great idea. I saw that SOLO has an app for the SOAP note but one like this would be great.

[Blissful]

I don't think irrigating wounds is something you will need to do on the trail. I worked for years as a Paramedic and I never irrigated wounds in the field. On the AT you are rarely more than a few hours from medical treatment. Major wound care should consist of controlling bleeding and bandaging. Irrigating major wounds (I'm talking about something like a 6" gash in the head from a fall that's bleeding like a stuck pig!) just results in more bleeding and introducing more bacteria into the wound no matter how sterile you think your procedure is.

Minor wounds should be allowed to bleed a bit, treated with a topical antibiotic and covered. This is where I saw several people get into trouble. Small wounds that got infected and became major problems. It's just something you need to keep on top of buy keeping an eye out for infection, changing bandages and keeping the area as clean as possible. Not something that is easy in our hiking environment.


I wouldn't think so as a paramedic in the "front country" as they call urban areas. Help is nearby. I guess the syringe idea comes into play of trying to keep a major wound as clean as possible in the back country, hence irrigation for dirty wounds. I mean I won't debate how much bacteria is added by a syringe vs leaving a dirty wound with its bacteria present alone. But with the scenarios presented, even three miles up a trail from the road (in the case presented by the instructor it was the rocks of Old Rag) and with a major injury and blood loss where the patient cannot hike, it could still take upwards of 10 hours to get a person down with rescue personnel from time of discovery. And that is if you can get a phone signal. 10 hours with a dirty wound is plenty of time for bacteria to multiply in a big wound and raise havoc in the system.
Of course the more treacherous parts of teh AT are well away from medical help. There are many, many places on the AT that roads are a good distance away, not to mention medical help farther away than that. So this time factor could be multiplied.
I think your last two sentences sums it up well.

[Blissful]

I think everyone should at least take a first aid course, maybe not necessarily a wilderness first aid course.

Yes totally agree.

CPR isn't a bad idea either. Not saying it would have helped - but at least three hikers died this year on the AT last season from cardiovascular accidents.

[Don H]

I wouldn't think so as a paramedic in the "front country" as they call urban areas. Help is nearby. I guess the syringe idea comes into play of trying to keep a major wound as clean as possible in the back country, hence irrigation for dirty wounds. I mean I won't debate how much bacteria is added by a syringe vs leaving a dirty wound with its bacteria present alone. But with the scenarios presented, even three miles up a trail from the road (in the case presented by the instructor it was the rocks of Old Rag) and with a major injury and blood loss where the patient cannot hike, it could still take upwards of 10 hours to get a person down with rescue personnel from time of discovery. And that is if you can get a phone signal. 10 hours with a dirty wound is plenty of time for bacteria to multiply in a big wound and raise havoc in the system.
Of course the more treacherous parts of teh AT are well away from medical help. There are many, many places on the AT that roads are a good distance away, not to mention medical help farther away than that. So this time factor could be multiplied.
I think your last two sentences sums it up well.

"Front country" paramedics also deal with extended delays in extricating patients to a medical facility. An example would be someone trapped in a collapse, cave in, etc. In my state of Maryland we have (as most states have) a Wilderness Protocol for EMT and EMT-Paramedic levels. At this level of training irrigation of wounds is allowed.

If you want a recent first hand account of a major injury on the trail and how long it took to evacuate someone ask Rusty Bumper who posts here occasionally. He was medivaced off Chairback after breaking his leg. If I recall it was 4 or 5 hours and that was in the 100 Mile Wilderness. Now if they would have had to carry him down, who knows how long that would have taken.

[BrianLe]

"Since you're already carrying the weight of the phone, an app seems to make so much more sense than the little WFA book. You wouldn't need a signal to access it - just enough battery power to activate the checklists, advice, etc.
Anyone got any leads on a FA app?"

Rather than an app, perhaps think in terms of an eBook, first aid. There are free ones out there, for example, I think I have one by the U.S. Army. Very possibly whatever eBook software you have loaded has a store that sells such a book --- I carry a couple that way.

Then I augment that with a somewhat reduced font sized version of a "Thru-hikers medical guide", which you can find various places including here: http://www.whiteblaze.net/forum/content.php?58
That way I have a one-sheet-of-paper backup for cases where for whatever reason a smartphone eBook isn't cutting it.