Luckily I haven't ever needed to use most of the items in my first aid kit, but it has definitely come in handy on multiple occasions. I have two kits, one stays in the truck and contains the items recommended during RedCross and NOLS wilderness first aid classes. The other is a small one that I carry on a daily basis. The most commonly used items are bandaids since we always seem to be out of them at work and people manage to cut themselves.
I've been involved in a couple first aid situations. None were very serious, but they all had the possibility of escalating if not attended to.
While hiking on a fairly remote beach in northern California (no cell service, ~1 mile from nearest road, no other people around) we ran across a woman who had recently had knee surgery and had just re-damaged her knee. She was in a lot of pain and couldn't walk, and the only route back to the road required you to climb up a collapsed bridge to get back up on the bluff. She and her companion were at the bottom of the bluff trying to figure out what to do. We ended up getting her back up onto the bluff, and then took turns doing a fireman carry to get her the 1mi back to their car. No first aid supplies were used, just some training.
Last year a friend of mine stepped on an in-ground hornets nest and several people in our group wound up with multiple stings. This was of course very painful, but the concern was that a couple of them had never been stung before and didn't know if they were allergic or not. I suggested they take benadryl and we kept an eye on them for signs of anaphylactic shock while we headed back out the trail. This was a low risk, but it's the kind of thing that can be a major problem in a remote area.
While skiing with my brother we came across a kid (~9 years old) who had fallen and broken his arm. He had removed his glove and jacket to nurse the injury, which was unfortunate since it was a very cold day. He was sitting in the middle of a trail under a blind crest, I had my brother go up and wave off any on coming skiers, and after checking for any risk of spinal injury I moved him to the side and tried to keep him warm. There was no way to get the glove back on without causing pain, so I stabilized his arm under his jacket. Again, no cell service. Eventually another skiier came by and we told them to go have a lift attendant call the ski patrol, who took 30 minutes to arrive. The big risk here was exposure due to the weather. No first aid supplies were used.
In the US the vast majority of "overland" trips are never really all that far from advanced help (say 12 hours or less). There are three basic classifications of injuries.
- An "ouchie" or discomfort situation such as a minor cut, burn, stomach upset, headache, etc. It's nice to have supplies to lessen these kinds of injuries, but no specialized equipment or medications are really needed. Flush wounds with clean water, cool burns, wait for stomach upset or headache to pass.
- An "ok, this injury makes the trip no fun" situation such as a sprained ankle, broken bone, concern of infection, more serious illness, etc. These aren't immediately life threatening, but you want to get the person back to civilization for treatment (slow evacuation). The key here is stabilizing the person and making them as comfortable as possible during transport.
- A SHTF situation where someone's life is in immediate danger (rapid evacuation). These are the scariest and the least predictable. You could be facing a massive injury, heart attack, hyperthermia/hypothermia, velocirapter attack, or who knows what. It's impossible to plan for all possibilities, and even an ER doctor wouldn't be able to help in all cases. This is part of the risk we assume by being away from advanced help. Personally, I carry a CPR mask, gloves, children's Tylenol, a tourniquet, lots of big bandages, and the realization that if something catastrophic happens your chances of success are fairly low.
In all of the situations I described above the thing that helped most was simply asking "do you need help" and then keeping the victim calm. It is also important to be able to determine which of the 3 classifications the injury falls under (stay, go slow, go fast). And the bottom line is that some training and a willingness to help are much more important than what is in a first aid kit.
- Matt
