WHAT MEDICINES SHOULD BE IN YOUR FIRST AID KIT DURING TRAVEL

You should always have verbal orders or written protocols from your Medical Director to administer prescription medications in the field. You should have verbal orders or written protocols from your Medical Director to administer over-the-counter medications to minors.  Without these protocols, you are potentially practicing medicine without a license, which is illegal.  In addition to having medication administration protocols, you should obtain informed consent for medication administration, even non-prescription medication.  Inform the recipient of the indications, contraindications and possible side effects of the medication and obtain consent to administer.

Before administering any medication read the protocols, confirm the dosage, read the label and confirm the medication, ask the patient about previous history with this medication and any known allergies, ask the patient if they are currently on any medication and if so, review the protocols for contraindications.Please note that the following medication information is for medication available in the United States.  Outside of the Unites States medication may carry different trade names.  Some medication available only by prescription in the United States may be available without a prescription in other countries and may be prepared in different dosing.  If you purchase medication outside of the United States you should confirm classification, dose, indication, contraindication and possible side effects before administering it. 

All dosing is indicated for adults. Pediatric dosing should be dictated by your Medical Director.ATC medical advisor represents that the information provided was developed utilizing current resources and standards.  Medication administration is a complex decision that requires consultation with a Physician.  The information below is not a substitute for a Medical Director, nor should it be used without authorization and approval by a Physician.  Italiaoutdoors does not endorse or recommend specific medications.

Abbreviations

:PO:  Oral
SQ:  Subcutaneous injection
IM:  Intramuscular injection

Drug Information Provided OnAnalgesic (Painkillers)-Over-The-Counter
    Acetaminophen (e.g. Tylenol)
    Aspirin (e.g. Bayer, Ecotrin)
    Ibuprofen (e.g. Advil, Motrin)
    Ketoprofen (e.g. Orudis KT)
    Naproxen (e.g. Aleve)
    Phenazopyridine hydrochloride (e.g. Pyridium, Uristat)
Analgesics (Painkillers)-Prescription
    Hydrocodone bitartrate/acetominophen (e.g. Vicodin)
    Oxycodone/acetominophen (e.g. Percocet, Roxicet)
Anti-Allergy-Over-The-Counter
    Phenylephrine (e.g. Neo-Synephrine)
    Hydrocortisone acetate (e.g. Cortaid)
    Diphenhydramine hydrochloride (e.g. Benadryl)
    Pseudoephedrine hydrochloride (e.g. Sudafed)
Anti-Allergy-Prescription
    Albuterol
    Epinephrine (e.g. Adrenalin or EpiPen)
Antibiotic-Over-The-Counter
    Polymyxin B sulfate/bacitracin (e.g. Polysporin)
Antibiotic-Prescription
    Erythromycin
    Trimethoprim Sulfamethoxazole (e.g. Septra or Bactrim)
    Cephalexin (e.g. Keflex)
    Ciprofloxacin hydrochloride (e.g. Cipro)
Anti-Fungal-Over-The-Counter
    Tolnaftate (e.g. Tinactin)
    Miconazole nitrate (e.g. Monistat 3)
Anti-Fungal-Prescription
    Fluconazole (e.g. Diflucan)
Anti-Emetics (Anti-Vomiting) and Anti-Acids-Over-The-Counter
    Calcium carbonate (e.g. Tums, Maalox)
    Bismuth subsalicylate (e.g. Pepto-Bismol)
Anti-Emetics (Anti-Vomiting) and Anti-Acids-Prescription
    Prochlorperazine (e.g. Compazine)
    Promethazine (e.g. Phenergan)
Anti-Vertigo (Anti-Motion Sickness)-Over-The-Counter
    Meclizine (e.g. Antivert, Bonine)
Anti-Vertigo (Anti-Motion Sickness)-Prescription
    Scopolamine (e.g. Trans-Derm Scop)
Anti-Diarrheal-Over-The-Counter
    Loperamide hydrochloride (e.g. Imodium)
Anti-Diarrheal-Prescription
    Diphenoxylate hydrochloride with atropine sulfate (e.g. Lomotil)
Anti-Altitude-Prescription
    Acetazolamide (e.g. Diamox)
    Dexamethasone (e.g. Decadron)
    Nifedipine (e.g. Procardia)Analgesics (Painkillers)-Over-The-CounterAcetaminophen (e.g. Tylenol)

Classification: Non-narcotic analgesic, antipyretic
Dose: 650mg/4-6 hours PO (Regular strength), 1000mg/6 hours PO (Extra strength).  Maximum dose 4g/24 hours PO.
Indications: For relief of pain due to headache, cold and flu discomfort, minor muscle and joint discomfort and menstrual cramps. For reduction of fever. Especially useful for those allergic to aspirin or aspirin-containing products. Does not control inflammation.
Contraindications: Hypersensitivity, active alcoholism, liver disease, hepatitis.  Acetaminophen is a common ingredient in over-the-counter pain, cold and flu medicine.  Be careful of accidental overdose in combination with other products.
Side Effects: Hypersensitivity is rare.Aspirin (e.g. Bayer, Ecotrin)

Classification: Analgesic, Non-Steroidal Anti-Inflammatory Drug (NSAID), antipyretic, anticoagulant.
Dose: 325-650 mg/4 hours PO (Regular strength), 500-1000mg/4-6 hours PO (Extra strength), 162-325mg/24 hours PO for cardiac chest pain.  Maximum dose 4g/24 hours PO.
Indications: For relief of pain due to headache, cold and flu discomfort, minor muscle and joint discomfort and menstrual cramps. For reduction of fever. Controls inflammation. Can be used to “cauterize” exposed tooth pulp. For use
with cardiac chest pain.
Contraindications: Allergic sensitivity.  Gastrointestinal bleeding, bleeding disorders, impaired liver function.  Do not give to children under 12.
Side Effects:  Gastrointestinal distress, allergic reaction.Ibuprofen (e.g. Advil, Motrin)

Classification: Analgesic, Non-Steroidal Anti-Inflammatory Drug (NSAID), antipyretic.
Dose: 400-800mg/4-8 hours PO
Indications: For symptomatic relief of pain associated with headache, colds, flu, frostbite, toothache, arthritis, burns and menstrual cramps. May be used to reduce fever. For pain of inflammation and reduction of inflammation associated with muscle, joint and over-use injuries.
Contraindications: Active peptic or gastrointestinal ulcer, gastrointestinal bleeding disorder, history of hypersensitivity to aspirin or other NSAIDs.
Side Effects:  Nausea, epigastric pain, dizziness and rash.  Ketoprofen (e.g. Orudis KT)

Classification: Analgesic, Non-Steroidal Anti-Inflammatory Drug (NSAID).
Dose: 75mg/8 hrs PO
Indications: For symptomatic relief of pain associated with headache, colds, flu, frostbite, toothache, arthritis, burns and menstrual cramps. May be used to reduce fever. For pain of inflammation and reduction of inflammation associated with muscle, joint and over-use injuries.  
Contraindications: Active peptic or gastrointestinal ulcer, gastrointestinal bleeding disorder, history of hypersensitivity to aspirin or other NSAIDs.
Side Effects: Nausea, diarrhea and epigastric pain.Naproxen (e.g. Aleve)

Classification: Analgesic, Non-Steroidal Anti-Inflammatory Drug (NSAID).
Dose: 550mg/12 hrs PO
Indications: For symptomatic relief of pain associated with headache, colds, flu, frostbite, toothache, arthritis, burns and menstrual cramps. May be used to reduce fever. For pain of inflammation and reduction of inflammation associated with muscle, joint and over-use injuries. .
Contraindications: Hypersensitivity to aspirin or other NSAIDs.
Side Effects: Nausea, constipation, abdominal pain, headache, dizziness and drowsiness.Phenazopyridine hydrochloride (e.g. Pyridium, Uristat)

Classification: Urinary tract analgesic
Dose: 100-200mg/6-8 hrs PO
Indications: For symptomatic relief of burning, pain, urgency and frequency associated with urinary tract/bladder infections. Should be used concurrently with an antibiotic.
Contraindications: Hypersensitivity. Renal/liver insufficiency.
Side Effects:  Headache, gastrointestinal disturbance and rash.  Dye stains clothing.Analgesics (Painkillers)-PrescriptionHydrocodone bitartrate/acetominophen (e.g. Vicodin)

Classification: Narcotic analgesic, antitussive.
Dose: 5-10mg/4-6 hours PO
Indications: For moderate to severe pain. Narcotic. Good for musculoskeletal
and dental pain. Good for people allergic to codeine.  Suppresses cough reflex.
Contraindications: Hypersensitivity.
Side Effects: Sedation, decrease in blood pressure, sweating and flushed face, drowsiness and dizziness.Oxycodone/acetominophen (e.g. Percocet, Roxicet)

Classification: Narcotic analgesic.
Dose: 5-10mg/ 4 hours PO
Indications: For severe pain.
Contraindications: Hypersensitivity.  Caution with CNS depression, respiratory depression, seizures and shock.
Side Effects:  Drowsiness, dizziness, hypotension, anorexia, nausea,vomiting and constipation.Anti-Allergy-Over-The-CounterPhenylephrine (e.g. Neo-Synephrine)

Classification: Nasal decongestant
Dose: Blow nose before medication is administered, tilt head back, apply 2-3 drops or 1-2 sprays in each nostril.  Wait 5 minutes between nostrils.
Indications: For relief of nasal congestion that accompanies colds and allergies. May be useful to help stop nosebleed. May be useful to relieve sinus “squeeze” associated with diving.
Contraindications: Severe hypertension, ventricular tachycardia, pancreatitis, hepatitis, thrombosis, heart disease, narrow angle glaucoma.
Side Effects:  Rebound nasal congestion due to overuse (>3 days), stinging, burning, drying of nasal mucosa.Hydrocortisone acetate (e.g. Cortaid)

Classification: Glucocorticoid
Dose: Topical 1% cream, 2-4 times/day
Indications: For relief of pain and itching of nematocyst stings, poison ivy, oak and sumac, insect bites and other allergic skin reactions. May help dry up oozing rash of allergic skin reactions.
Contraindications: Serious infections, viral, fungal or tubercular skin lesions.
Side Effects: Itching, redness and irritation.Diphenhydramine hydrochloride (e.g. Benadryl)

Classification: Antihistamine
Dose: 25-50mg per 4-6 hours
Indications: For temporary relief of respiratory allergy symptoms and cold symptoms. Helps relieve the itching of allergic skin reactions. Useful in treatment of moderate allergic and anaphylactic reactions. May be used as a mild sedative and for insomnia. May help alleviate seasickness.  Can be used to treat distonic reations.
Contraindications: Hypersensitivity, acute asthma attack, glaucoma, peptic ulcer, hypertension and COPD.
Side Effects: Drowsiness, dizziness, weakness, hypotension, dry mouth, thickening bronchial secretions and urinary retention.Pseudoephedrine hydrochloride (e.g. Sudafed)

Classification: Nasal decongestant
Dose: 60mg per 4-6 hours
Indications: Decongestant useful in treating upper airway sinuses and nasal passages. Use of more that 5 days may cause reverse effects.
Contraindications:  Severe hypertension, coronary artery disease, lactating women, MAO inhibitor therapy.
Side Effects: Nervousness restlessness, insomnia, trembling and headache.Anti-Allergy-PrescriptionAlbuterol

Classification: Bronchodilator
Dose: Two puffs of metered dose inhaler (MDI) with use of a spacer every 4 hours and as needed.
Indications: Shortness of breath or respiratory difficulty thought to be secondary to reactive airway dysfunction (asthma) or HAPE.
Contrainidications: Tachycardia secondary to underlying heart condition.
Side Effects: Palpitations, tachycardia and tremor.Epinephrine (e.g. Adrenalin or EpiPen)

Classification: Bronchodilator, antiallergenic, cardiac stimulant.
Dose: .3ml 1:1000 SQ or IM. Repeat as necessary.
Indications: For severe allergic reactions including anaphylaxis and status asthmaticus.
Contraindications: No true contraindications with anaphylaxis.  Hypertension, cardiac disease, glaucoma and shock.
Side Effects: Increased heart rate, nervousness, dizziness, lightheadedness, nausea and headache.Antibiotic-Over-The-CounterPolymyxin B sulfate/bacitracin (e.g. Polysporin)

Classification: Antibiotic
Dose: Topical
Indications: Contains ingredients for prevention of infection in minor wounds. Works as a lubricant, offers some relief from itching.
Contraindications:   Hypersensitivity.
Side Effects: Hypersensitivity reactions-burning, itching, inflammation, contact dermatitis.Antibiotic-PrescriptionErythromycin

Classification: Antibiotic
Dose: 250mg/6 hrs for 5 days.  Take with food.
Indications: For sinus, pulmonary, ear, eye, respiratory and soft tissue infections.
Contraindications: Hypersensitivity, liver disease, hepatitis.
Side Effects: Abdominal discomfort and cramping, nausea, vomiting, diarrhea and rash.Trimethoprim Sulfamethoxazole (e.g. Septra or Bactrim)

Classification: Antibiotic
Dose: Single strength tablet contains 80mg trimethoprim and 400mg sulfamethoxazole.  Double strength tablet contains 160mg trimethoprim and 800mg sulfamethoxazole.  Dose is 2 single strength tablets or 1 double strength tablet/12 hours PO.  Recommended length, 5 days for UTI and infectious diarrhea, 10-14 days for  kidney infection.
Indications: For marine wounds, kidney, ear, sinus and some respiratory infections. Best for urinary tract infections. Works with infectious diarrhea if ciprofloxacin unavailable.
Contraindications:  Hypersensitivity, anemia.
Side Effects: Nausea, vomiting, diarrhea, decreased appetite, stomach cramps, headache.Cephalexin (e.g. Keflex)

Classification: Antibiotic
Dose: 250-500mg per 6 hours for at least 5 days.
Indications: For skin, bone, pnuemonia and urinary tract infections.
Contraindications: Hypersensitivity. Sensitivity to penicillins.
Side Effects:  Oral and vaginal fungal infections, diarrhea and abdominal cramping.Ciprofloxacin hydrochloride (e.g. Cipro)

Classification: Antibiotic
Dose: 250mg/12 hours PO for UTI.  500mg/12 hours PO for kidney infection, infectious diarrhea, bone and joint infection.  See Physician for length of course.
Indications: Best for infectious diarrhea. Okay for bone and urinary
tract infections.
Contraindications: Hypersensitivity.
Side Effects:  Nausea, diarrhea, vomiting and constipation.Anti-Fungal-Over-The-CounterTolnaftate (e.g. Tinactin)

Classification: Antifungal
Dose: Topical, 2 applications/day
Indications: For treatment of superficial skin fungi such as ringworm, jock itch and athlete’s foot.
Contraindications: Hypersensitivity.
Side Effects:  Mild irritation.Miconazole nitrate (e.g. Monistat 3)

Classification: Antifungal
Dose: 200mg vaginal suppositories nightly for three nights or topical cream as needed.
Indications: Vaginal candidiasis.
Contraindications: Hypersensitivity, first trimester of pregnancy.
Side Effects:  Itching, burning and stinging.Anti-Fungal-PrescriptionFluconazole (e.g. Diflucan)

Classification: Antifungal
 Dose: 150mg once.
Indications: Vaginal candidiasis.
Contraindications: Hypersensitivity.
Side Effects: Fever, chills, dizziness, drowsiness, headache, constipation, diarrhea, nausea, vomiting, abdominal pain.Anti-Emetics (Anti-Vomiting) and Anti-Acids-Over-The-CounterCalcium carbonate (e.g. Tums, Maalox)

Classification:  Antacid
Dose: 500mg tablet as needed
Indications: For symptomatic relief of heartburn, acid indigestion, sour stomach and other conditions related to an upset stomach, including intestinal gas problems.
Contraindications: Hypersensitivity.
Side Effects: Swelling of legs and feet, fecal impaction, metabolic alkalosis.Bismuth subsalicylate (e.g. Pepto-Bismol)

Classification:  Antidiarrheal, antinauseant.
Dose:
Indications: For use in the control of diarrhea, nausea and upset
stomach. May help prevent “traveler’s diarrhea.”
Contraindications: Bleeding ulcers, hemophilia, kidney impairment.  Should not be taken by the aspirin allergic.
Side Effects: May turn tongue and stool black.Anti-Emetics (Anti-Vomiting) and Anti-Acids-PrescriptionProchlorperazine (e.g. Compazine)

Classification: Antiemetic
Dose: 5-10mg/6-8 hours PO or 10mg/12 hours PO (Extended release) or 25mg/12 hours rectal suppository.
Indications: Nausea and vomiting.
Contraindications: Hypersensitivity.  Glaucoma, bone marrow suppression, liver or cardiac impairment, blood pressure problems, CNS depression.
Side Effects: Muscle spasms of the neck are a common side effect, but are treatable with diphenhydramine.Promethazine (e.g. Phenergan)

Classification: Antihistamine, antiemetic.
Dose: 12.5-25mg/4-6 hours rectal suppository
Indications: Nausea and vomiting, motion sickness.
Contraindications: Glaucoma, CNS depression, intestinal or urinary tract obstruction.
Side Effects: Drowsiness, disorientation, hypotension and syncope.  Muscle spasms of the neck are a common side effect, but are treatable with diphenhydramine.Anti-Vertigo (Anti-Motion Sickness)-Over-The-CounterMeclizine (e.g. Antivert, Bonine)

Classification: Antiemetic, antivertigo
Dose: 25-50mg PO per day, I hour before exposure to motion.
Indications: Prevention and treatment of motion sickness, vertigo.
Contraindications: Hypersensitivity.
Side Effects: Drowsiness.Anti-Vertigo (Anti-Motion Sickness)-Prescription Scopolamine (e.g. Trans-Derm Scop)

Classification: Antinausea, antiemetic
Dose: 1.5 mg transdermal patch. Keep out of eyes. Put one patch behind ear 4-5 hours before needed.  Remove after 72 hours.
Indications: Prevention of motion sickness.
Contraindications: Glaucoma, urinary or intestinal obstruction, tachycardia.
Side Effects: Dry mouth, drowsiness, blurred vision, hallucinations, confusion.
Anti-Diarrheal-Over-The-CounterLoperamide hydrochloride (e.g. Imodium)

Classification: Antidiarrheal
Dose: 4mg PO initially followed by 2mg PO after each loose stool
Indications: For use in the control of diarrhea. Thought to limit peristalsis. Helpful in evacuating someone with severe diarrhea.
Contraindications:  Hypersensitivity.  Diarrhea secondary to certain bacteria (e.g., E.Coli)
Side Effects:  Dry mouth, dizziness, abdominal discomfort.Anti-Diarrheal-PrescriptionDiphenoxylate hydrochloride with atropine sulfate (e.g. Lomotil)

Classification: Antidiarrheal
Dose: 5mg/6 hours PO
Indications: For severe diarrhea.  Evacuate after 24 hours with no improvement.
Contraindications:  Liver disease, dehydration, glaucoma.
Side Effects:  Drowsiness, lightheadedness, dizziness, nausea.Anti-Altitude-PrescriptionAcetazolamide (e.g. Diamox)

Classification: Diuretic.
Dose: 250mg/6 to 12 hours PO (prevention dose = 125mg/12 hours PO)
Indications: For prevention and treatment of mild to moderate acute mountain sickness.
Contraindications: Sulfa-allergies, pregnancy, dehydration or renal disease.
Side Effects: Dehydration, tiredness, altered taste, nausea, numbness in extremities and lips. Dexamethasone (e.g. Decadron)

Classification: Corticosteroid.
Dose: 8mg PO or 10mg IM initially then 4mg/6 hours PO or IM during evacuation.
Indications: For treatment of High Altitude Cerebral Edema and increasing ICP from head trauma.
Contraindications: No absolute contraindications for short-term emergency use except hypersensitivity.
Side Effects: Cough, dry mouth, throat irritation, blurred vision, indigestion, personality and behavioral changes, muscle weakness.Nifedipine (e.g. Procardia)

Classification:  Antihypertensive
Dose:  10mg/8 hours PO or 30-60mg/24 hours PO (Extended release).
Indications: High Altitude Pulmonary Edema (HAPE).
Contraindications:  Hypersensitivity. Hypotension.
Side Effects:  Peripheral edema, headache flushed skin, dizziness.

Referenes: Mosby’s 2005 Drug Consult for Nurses.  Elsevier Mosby, St. Louis, MO.  2005.  ISBN 0-323-02847-0.Ogden MD, Herb and Tod Schimelpfenig.  Edited by Drew Leemon.  NOLS Field Medical Protocols and Drug Orders 2004.  Unpublished document.Saunders Nursing Drug Handbook 2004.  Saunders, St. Louis, MO.  2004.  ISBN 0-7216-0300-9.

Emergency Care And First Aid For Travel And The Outdoors

PREPARING FOR AN EMERGENCY BEFORE YOU GO Many of the same steps taken in everyday life can be applied to your travel and outdoor activities.  Below are listed both the general planning for emergency tips and also how the same information applies to travel. Weather you are Bike Touring in the Dolomites or Rock Climbing in Sicily you need to ensure you have considered the following. MEDICAL CHART One of the first things you should do is fill in, for each family member, the medical chart provided. The chart provides medical information you and doctors or paramedics need in an emergency, such as allergies and immunization dates. There is also a place for important emergency telephone numbers in the front of the book. Fill these out now, before you forget.You can make a copy of the chart and data to be carried with you on an excursion or travel destination.  Research the local area you are traveling to in order to find the emergency numbers for that specific area. KNOW THE ROUTE TO THE HOSPITAL Know the best route to the nearest hospital emergency room. If an ambulance or paramedic team is not available, you may have to drive yourself or a victim to the hospital. It is a good idea to make a practice run so that the roads will be familiar to you at the time of an emergency. Wrong turns can take precious minutes and could mean the difference between life and death.  This is something your tour provider does for you while on vacation, in fact a great way to help you decide on a service provider is to ask about their emergency plan, good company's will have the data handy.  If you are traveling on your own make sure you know the general EMS (emergency medical system) for the area you are traveling.   EMERGENCY MEDICAL IDENTIFICATION Wearing an emergency ID bracelet or necklace or carrying an emergency information card could save the life of someone who is unable to speak after a serious accident. This medical identification is particularly important for one who suffers from a serious condition such as diabetes, epilepsy, glaucoma, or hemophilia, or who may have a serious allergic reaction to certain medications (such as penicillin) or to insect stings. These bracelets, necklaces, and cards include such information as the individual's name, address, blood type, and any serious conditions or allergies. They should be worn or carried at all times. A bracelet or necklace is generally better than a card since it is more easily noticed on the victim. These items are available through several manufacturers. Ask your doctor, hospital emergency room, or local medical association where you might order them. In the meantime, you can make your own card. Include your name, address, telephone number, name and telephone number of a relative to contact, your doctor's name and number, your immunization dates, any serious medical conditions, medication taken regularly, allergies, and any other important information. Be sure the card is prominently displayed in your purse or wallet.

First Aid Kit Checklist

Basic care: Prepackaged first-aid kits typically contain many of the following items:

• Antiseptic wipes (BZK-based wipes preferred; alcohol-based OK)
• Antibacterial ointment (e.g., bacitracin)
• Tincture of benzoin (bandage adhesive)
• Assorted adhesive bandages (fabric preferred)
• Butterfly bandages/adhesive wound-closure strips
• Gauze pads (various sizes)
• Nonstick sterile pads
• Medical adhesive tape (10-yd. roll, min. 1" width)
• Blister treatment (e.g., Moleskin, 2nd Skin, Glacier Gel
• Ibuprofen/other pain-relief medication
• Insect-sting relief treatment (e.g., AfterBite)
• Antihistamine to treat allergic reactionsSplinter (fine-point) tweezers
• Safety pins
• Comprehensive first-aid manual or information cards

Comprehensive care: Carry all of the basic items listed above; add items below based on anticipated needs.

Note: The list below is intentionally extensive; rarely will a single kit include every item shown here.

• Wound coverings
• Rolled gauze
• Rolled, stretch-to-conform bandages
• Elastic wrap
• Hydrogel-based pads
• First-aid cleansing pads with topical anesthetic
• Hemostatic (blood-stopping) gauze
• Liquid bandages
• Oval eye pads
• Medications/treatments
• Hand sanitizer (BKZ- or alcohol-based)
• Aloe vera gel (sun exposure relief)
• Aspirin (primarily for response to a heart attack)
• Antacid tablets
• Throat lozenges
• Lubricating eye drops
• Loperamide tablets (for diarrhea symptoms)
• Poison ivy/poison oak preventative
• Poison ivy/poison oak treatment
• Glucose or other sugar to treat hypoglycemia
• Oral rehydration salts (e.g., CeraLyte)
• Antifungal foot powder
• Prescription medications (e.g., antibiotics)
• Injectable epinephrine to treat allergic reactions (e.g., EpiPen, Twinject)

First-aid Tools

• Knife (or multi-tool with knife)
• Paramedic shears (blunt-tip scissors)
• Safety razor blade (or scalpel w/#15 or #12 blade)
• Finger splint(s)
• SAM splint(s)
• Cotton-tipped swabs
• Standard oral thermometer
• Low-reading (hypothermia) thermometer
• Irrigation syringe with 18 gauge catheter
• Magnifying glass
• Small mirror
• Medical/surgical gloves (nitrile preferred; avoid latex)
• Triangular cravat bandage
• Steel sewing needle with heavy-duty thread
• Needle-nose pliers with wire cutter
• Headlamp (preferred) or flashlight
• Whistle (pealess preferred)
• Duct tape (small roll)
• Small notepad with waterproof pencil or pen
• Medical waste bag (plus box for sharp items)
• Waterproof container to hold supplies and meds
• Emergency heat-reflecting blanket

Personal care, other items

• Sunscreen
• Lip balm
• Insect repellent (plus headnet, if needed)
• Biodegradable soap
• Water-disinfection system
• Collapsible water sink or basin

Remember that First Aid supplies expire and make sure you know how to use everything in your kit.  If you take something out REPLACE as soon as possible

Emergency Care And First Aid For The Outdoors and Travel

THE ABCD’S OF EMERGENCY CARE You should learn how to apply the ABCD’S to a patient’s lifeline. The acronym ABCD's will help you remember the steps to follow as you help an individual and provide care.  Once you reach the end of the Lifeline you return to “A” and continue to monitor a patient’s lifeline. The ABCD’S of primary care are: A =     Assess scene, Alert EMS and Airway Open.  You assess the scene for safety, call the Emergency Medical Service and open the patient’s airway.    B =    Breathing.  Check the patient’s Breathing and if necessary, begin rescue Breathing.    C =      Circulation.  Check the patient for signs of circulation and if necessary, begin Chest Compressions.    D =     Defibrillation.    S =    Serious bleeding management: Shock management: Spinal injury management. Emergency First Response Primary Care (CPR) teaches you the steps and techniques for handling life threatening emergencies. In the Event of an Accident The first thing to do is assess the scene: Is the situation safe? Are there any hazards that will cause my partner or myself more harm? These include physical dangers such as rock fall and avalanches but can also include weather (lightning, wind) and environmental dangers (extreme cold, high altitude). Once you have addressed these and feel that you are safe from them, you can now begin a rapid primary assessment of life-threatening injuries by following the acronym ABCDE. The ABCDE of Assessment A – Airway with Cervical Spine Stabilization Q: Is there air moving in and out? Think: Look, listen, and feel. If the climber has sustained a fall that could have damaged his spine, stabilize his neck and protect his spine.A: YES – Move on to B.A: NO – Look for cause of obstruction. If you see something, remove it. Attempt to open the airway with jaw thrust or head tilt-chin lift and begin CPR. Call for help immediately. B – Breathing Q: Is the patient breathing, and if so, how? Fast rate, uneven chest rise, or laboring to catch their breath?A: YES – Breathing without difficulty, move on to C.A: NO – No breathing = begin CPR and call for help.A: NO – Labored breathing = Position for comfort, reassure, give oxygen (if available), and call for help. C – Circulation: Q: Does the climber have a pulse? Check multiple locations (radial/wrist, carotid/neck, femoral/groin).A: YES – Move on to next question for circulation.A: NO – Begin CPR, call for help. Q: Is the climber bleeding profusely? If so, where?A: YES – Find source (Look on the ground, the chest, abdomen, pelvis, and thighs. Remember bleeding can be internal) and stop bleeding with direct pressure, elevation, or tourniquet.A: NO – Move on to D. D – Disability: Q: Is the patient fully alert?A: YES – Move on to E.A: NO – Assess by AVPU scale. How do they respond? Call for help.A – AwakeV – VerbalP – PainU – Unresponsive E – Environment: Q: Does your current environment offer danger to patient’s condition?A: YES – Protect your patient and limit exposure. Get them dry, warm, insulated from cold ground, and out of the wind. If at altitude, move lower if possible.A: NO – Think about evacuation or continuing to climb if no injuries. Remember to reassess your partner as often as needed based upon injuries; identify resources and dangers of your current situation, and all potential methods of evacuation. To learn more about assessment and caring for injured climbers, read about wilderness medicine and consider taking a Wilderness First Aid (WFA) or Wilderness First Responder (WFR) course.