The bone protruding from the young man’s moist red jeans pulled the student’s blood to her feet. Her face became as pale as that of the victim lying on the ground. Unknown to the student, the “victim” was an artistic creation for the purpose of showing wilderness survival students how to react to medical emergencies in the wilderness.
When the exercise was over, two lessons would be apparent:
1) It is very difficult to treat and transport a seriously injured person in remote, rough terrain, and
2) A well equipped first aid kit is second in value only to the knowledge of how to use it in remote medical emergencies.
A mountain medical kit should be designed to meet one’s individual medical needs, medical knowledge, and anticipated medical problems of the environment in which you live.
Building a mountain medical kit
This suggested first aid kit was compiled over a 10-year period of wilderness survival training programs throughout the western states and Mexico. First aid knowledge of the staff using the kit was at the Emergency Medical Technician level, some with extended clinical experience in Emergency Room and/or ambulance equipment treatment. Quantities are for a group size of 15 for 30 days.
If injuries occurred, they usually required evacuation over rugged terrain to reach an area where a helicopter could take the person out. The contents are based on those circumstances and the need to treat injuries and diseases encountered during a Stone Age living experience that involved hiking 200 to 300 miles in 30 days.
Medications listed are those found to be the most commonly needed. Caution should be exercised when giving or taking any medication. Question the patient as to allergies and past medication history. If there is any question of whether they can safely take the medication, DO NOT GIVE IT.
Remember, an adverse reaction may occur in spite of the individual’s past history. Only give the proper dosage. More is not better. In all likelihood, your family doctor will be happy to work with you in developing your own kit. If you explain why the prescription medications are needed and keep the quantities requested as listed, the doctor will probably issue the needed prescriptions.
Read next: Wilderness First Aid Basics
Check with your pharmacist regarding shelf life, storage conditions, and signs of decomposition.
First and foremost, one must achieve proficiency in basic first aid if the mountain medical kit is to have any real value in an emergency. Using any tool without adequate training is often fruitless and occasionally dangerous.
If you lack the training to recognize common disease processes and indications for the use of some of the medications, do not use them.
Supplies for your mountain medical kit
1—medium size. The first aider should have the training to apply. A collar is a necessity to stabilize and transport a victim with suspected neck injuries.
1—size #4, 1—size #2. Training is required to insert an airway. They are seldom used but are essential when transporting an unconscious victim.
Gauze pad, sterile
12—4-inch x 4-inch individually wrapped pads. These are sterile dressings for large wounds or burns.
Gauze pad, sterile
12—2-inch x 2-inch individually wrapped pads. Sterile dressings for small wounds etc.
2—four-inch roll used to anchor sterile dressing. It may be reused and does not have to be sterile.
2—two-inch rolls used as above.
1—two-inch roll non-allergenic paper tape for attaching anchor bandages and dressings. It can be split into one inch if needed.
1—one-inch roll cloth tape. Used to transport ankles or wrists. It also works well for butterfly stitching.
100—one inch. Minor wounds and friction blisters caused by hiking. Some staff members prefer bandaids over Moleskin. Tough Skin or Second Skin for blister treatment. Bandaids will cushion the blister, and unlike moleskin will not pull the blistered skin off when removed. Bandaids are a great cure-all for young children’s “wounds.”
1—Triangle bandages can be used for arm slings and for a number of anchor bandages on different parts of the body, plus they are also folded into a cravat bandage.
1— “Slip n Snip” or any small pair of scissors.
Needle & Thread
3— medium needles and one small spool of strong thread. Needles are a much-used item for the removal of splinters, stickers, and draining of friction blisters. Thread is for butterfly stitching and mending of clothes.
3—18 gauge. Removing splinters and opening minor infections.
8—medium and large. They are used to fasten anchor bandages, slings, and torn clothing.
One pair pointed to remove splinters and thorns. Most commercial tweezers must have a point filed to reach maximum effectiveness. (Some medical offices use disposable instruments—check with your doctor.)
2—6-inch x 6-inch pieces. Moleskin is used to cushion “hot spots” on feet to prevent blisters when hiking. Some staff members prefer “Spenco Skin Guard Padding” in place of Moleskin.
Recommended article: How To Field Treat An Injury
1—3-inch x 13-inch piece. Second-skin is used to cover burns, abrasion areas, and friction blisters. This product dries up in storage, so don’t buy more than needed.
6—packages 1/8-inch x 3-inch. Used for closing lacerations without suturing.
6— packages 1/4-inch x 3-inch. Same as above for larger lacerations.
Cotton Q Tips
24—Sterile, individually wrapped. Swabs are used to put Benzoin on the skin to increase the adhesive-ness of the steri strips. They are also for cleansing wounds and eyes.
2—4-inch. A support bandage on the wrist, ankle, or knee. It also makes a great pressure bandage to stop bleeding. (Just enough pressure to stop bleeding, don’t cut off circulation!)
2—4-inch. A support bandage on the wrist, ankle, or knee. It also makes a great pressure bandage to stop bleeding. (Just enough pressure to stop bleeding. don’t cut off circulation!)
“Spenco” Velcro Ankle Wraps
Two. Excellent for ankle or wrist support. This product allows the victim of a sprained ankle to hike if necessary.
Two. A strip of foam-padded aluminum 1-inch x 10-inch works well as it can be shaped over the finger and yet used to splint a fracture in the hand. The finger splint is used quite often to aid the healing of lacerated fingers. It prevents bumping or bending, which tears open wounds.
One. While limbs or sticks can be used from the environment to splint arms, some breaks require a splint that can be formed. (Angulated or displaced fractures in the wrist, elbow, and shoulder.) Plaster casting material makes excellent formed splints, but required water. Have your doctor show you how and suggest size and quantity.
Two. Used as a dressing for pressure bandage on severe bleeding.
6—10. Stress seems to bring on the unexpected, even if preventive medication has been taken.
2—one rectal fever and one rectal hypothermia. Most fever thermometers will not read low enough for hypothermia readings, and hypothermia thermometers often do not read high enough for fever. Heatstroke or heating water to thaw frostbite. There should be a range of 70 to 110 degrees. The temperature must be taken rectally to be accurate. Carry thermometer in a protective, padded cover. The finger splint can be used if nothing else is available.
One #11—Scalpel blades are used in lancing blisters and removing large splinters. The #11 can be used to drill a finger or toenail to remove pressure and pain due to blood under the nail. (The sharp edge of the 18 gauge hypo needle will often do the same thing.)
Instant Ice Pack
One small and one medium—Used for treatment of burns, sprains, fractures, contusions, Scorpion, and insect bites. Carry the ice pack in a protected case such as its cardboard box to prevent pre-mature activation.
Snake Bite Kit
One suction kit for poisonous snake bite. Recommended snake bite treatment methodology is continuously changing and should be reviewed yearly.
One small compact for emergency fillings, toothaches, and broken teeth. EDK puts out a small compact dental kit that will handle a short term problem. Dent Aid and EDK both market a larger kit that will handle temporary repairs of any kind. But both of these are too large and bulky to carry on the trail.
One. Any small light, compact, flashlight will work. A unit with a clip and a flex tube head or a headlight attachment is handy when working on a victim with both hands. The plastic model flex tubes are the lightest but tend to fall apart. The brass model flex tube is heavier but holds up well. Store the two AA alkaline batteries outside the flashlight until needed to maintain battery life. Carry a spare set of batteries in your shin pocket when you enter the field to prevent the cold from taking their life.
Medications for your mountain medical kit
Thirty tablets, 50 mg.—Carried for control of nausea, although this medicine has other actions that may be taken advantage of.
NAUSEA: children 1/2 tablet every four to six hours. Adults 1/2 tablet every four to six hours or one tablet every eight hours.
ALLERGY: Hayfever, minor insect bite reactions 1/2 tablet every six hours or before bedtime. May take 1/4 tablet at meal times instead.
SEDATION: Children 1/4 to 1/2 tablet at bed-time. Adults 1/2 to one tablet at bedtime.
PAIN MEDICATION: May be augmented allowing less narcotic to be used by taking 1/2 to one tablet every six hours with one or two Tylenol #3 tablets every four hours.
WARNING: Should not be taken with other central nervous system depressants, including alcohol.
Dryness of mouth, blurring of vision, dizziness, drowsiness.
Tylenol with Codeine
12 tablets—for control of minor to moderate pain. Dose: one to two tablets every four hours with food. Dosage may need to be adjusted to the severity of the pain and the response of the patient.
CONTRAINDICATIONS: If allergic to Tylenol or codeine do not take.
WARNING: May be habit-forming. Should not be taken with other central nervous system depressants, including alcohol. Do not give to children under twelve years of age. Children should have Tylenol with Codeine elixir. If such are in the group this should be carried and dosed: 3 to 6 years, one teaspoon 3 to 4 times per day. Seven to 12 years, 2 teaspoons 3 to 4 times per day. Robitussin AC is an acceptable substitute for Tylenol with Codeine elixir and dosed the same.
NOTE: DO NOT USE Robitussin PE, CF, DM, or DAC.
PRECAUTIONS: Individuals with head injury or acute abdominal pain should not be given this medication if they are to be diagnosed within the next two hours. Caution should be used in giving this drug to the elderly, debilitated, and dehydrated.
ADVERSE REACTIONS: Nausea, vomiting, and constipation.
30 tablets. Used for abdominal cramps and ulcer pain. Dose: the dosage should be adjusted to treat the individual with the least adverse effects. Adults, one or two tablets three or four times per day according to condition.
CONTRAINDICATIONS: Prostate problems, ulcerative colitis, hiatal hernia, Glaucoma. Do not take if allergic to Phenobarbital.
WARNING: May be habit-forming. Use with caution if in a high-temperature environment. May cause heat stroke or fever. Use with caution with heart problems, liver problems, or someone taking anticoagulants. Should not be given to pregnant or nursing women.
ADVERSE REACTIONS: Blurred vision, drowsiness, urinary retention, constipation. The elderly may react with excitement, agitation, or drowsiness with a small dose.
100 extra-strength tablets 500mg each for mild pain and fever. Don: two tablets 3 or 4 times daily. DO NOT EXCEED eight tablets in a 24 hour period.
CONTRAINDICATIONS: If allergic to Tylenol do not take.
100 tablets for mild pain and fever. Dose: adult 10 grains every 6 hours as needed. Aspirin is one of the mainstay drugs of modern medicine. (Bufferin may be a bit more gentle on the stomach.) It is one of the best anti-inflammatory drugs available and, as such, is very effective for a wide variety of pain syndromes, headaches, fever, etc. It should not be used in children under 15 with flu illness but is otherwise safe and effective. Always take aspirin with food in the stomach.
CONTRAINDICATIONS: If allergic to aspirin, do not take. Avoid using in patients taking anti-coagulants and in persons with active ulcer disease.
20 tablets for the management of diarrhea. Dose: two tablets four times per day. Do not take once diarrhea has stopped. Often one dose is sufficient. Lomotil is an extremely effective drug. It is fast at paralyzing the bowel. In many diarrhea illnesses, its use treats the symptoms but not the disease and may, in fact, lead to prolonged illness. It should be used infrequently and then sparingly. Most diarrhea is best treated with diet —Gatorade for 6-8 hours, then light low protein low-fat foods: bananas, rice, toast, tea applesauce for 12-24 hours.
CONTRAINDICATIONS: Should not be given to children under 12 years of age in tablet form. If allergic to diphenoxylate hydrochloride or atropine sulfate, do not take.
WARNING: If dehydrated, do not use Lomotil until the problem is cleared up. Lomotil may aggravate the problem. Individuals with ulcerative colitis should not be given Lomotil unless qualified medical personal are available to monitor the patient. Individuals with liver disease should not take Lomotil. Do not use alcohol, barbiturates, or tranquilizers with this medication. Pregnant or lactating women should not take this drug.
ADVERSE REACTIONS: Dry mouth, rapid heartbeat, urinary retention, nausea, vomiting, headache.
We use Keflex and Tetracycline—check with your doctor as to their recommendations. Keflex is used for minor wound soft tissue infections.
20, 25 capsules for the treatment of itching related to Poison ivy and insect bites. Dose: one to two capsules three or four times per day, depending on the response of the patient.
CONTRAINDICATIONS: Nursing mothers and newborn infants should not use this drug. Individuals with lower tract respiratory symptoms, including asthma, should not use Benadryl.
WARNING: Not recommended for pregnant women. Benadryl has additive effects to central nervous system depressants, including alcohol, and should not be used with them. It may decrease the patient’s alertness and motor skills.
ADVERSE REACTIONS: Sedation, sleepiness, dizziness, disturbed coordination. Nausea, vomiting, diarrhea, or constipation. Dry mouth and urinary dysfunction are not uncommon.
“Ana-Kit” by Hollister-Stier for severe acute allergic reaction. (Bee stings, etc.) Dose: follow directions with the kit. General: Epinephrine must be protected from light. It is impossible to keep it in a cool environment as called for while carrying in a mountain medical ki. If Epinephrine becomes brown in color or contains a precipitate, it should not be used.
WARNING: Use caution, giving an injection to elderly people or those with heart disease, high blood pressure, diabetes, hyperthyroidism, and pregnancy. However, in a life or death situation, you must often choose between the lesser of two evils.
ADVERSE REACTIONS: Anxiety, headache, fear, and palpitations.
30 tablets for relief of “hay fever” symptoms or extreme congestion due to a cold. Dose: Twelve years and older, one tablet every four to six hours. Six to twelve years, 1/2 tablet every four to six hours. DO NOT EXCEED four doses in a 24 hour period.
CONTRAINDICATIONS: Persons with lower respiratory disease, including asthma, should take Actifed with caution.
WARNING: Do not give to children under six years of age. Use caution in patients with glaucoma, high blood pressure, heart disease, diabetes, thyroid disease, or difficulty with urination. Do not take if pregnant or nursing. This medication should be taken with caution when using antihypertensive or antidepressant drugs.
ADVERSE REACTIONS: Dryness of mucus membranes, sedation, and dizziness. These reactions are more common in individuals over 60 years of age.
One SPF 50 or 100 for prevention of sun-burn and protection of sensitive areas. Dose: Use as directed on the container.
One tube of Vaseline for lubrication of rectal thermometer and chapped skin.
One tube for treatment of minor open wound injuries to prevent infection. The tube should be placed in a plastic sandwich lock bag to prevent leakage and damage to kit contents.
One tube 1 percent to relieve minor itching from insect bites, skin irritations, and rashes. Doses use as directed on the container. Should be placed in a plastic bag as above.
WARNING: If pregnant, do not use it for a prolonged time or on a large area.
One ounce for increasing the sticking ability of steri strips. Dose: Apply with Q-tip on both sides of the laceration but do not place in the wound. Allow to dry and place the steri strips over the Benzoin.
One 1/2-ounce—to treat eye irritations due to allergy or dust from strong winds.
Neosporin Ophthalmic Ointment
One 1/8.ounce tube—short-term treatment of eye infections. Dose: Apply the ointment every three to four hours, depending on the severity of the infection.
WARNING: Avoid prolonged use. Stop treatment as won as infection appears gone. If the infection does not clear up, medical aid must be sought.
ADVERSE REACTIONS: Allergic reactions to neomycin are common.
1/2 cup—treatment of local infections of the hands and feet. Dose: one tablespoon of salt per quart of warm water. Soak the affected area as often as needed to remove the infection.
50 tablets—to prevent heat disorders. Each tablet should contain Sodium chloride, Potassium chloride. Calcium carbonate and Dextrose. Dose: one tablet with at least eight ounces of water as needed for conditions. Not over ten tables per day. Gatorade or ERG should be carried if individuals are unable to take tablets (children) are in the group. It comes in individual 8 oz., I quart, 2 quart, and 8-quart mix quantities. Use as directed on the container.
WARNING: do not take if pregnant, nursing, under two years of age or without adequate water.
30 tablets. (Rolaids, Tums. Gaviscon, Alka Selzer—your preference)—heartburn, upset stomach. Tums work well as an antacid and are also a good source of calcium for leg cramps, etc. Dose: follow directions on the container.
WARNING: follow warnings on the container.
Adapt the contents of this kit to the needs of the group or your family. The kit is more usable if compartmentalized with more commonly used items (bandaids, tweezers, Tylenol, etc.) together.
Items of a similar nature (pain meds, Benzoin and steri strips, dressings and bandages, etc.) can be placed together in zip lock bags, so they are easily found. Carry it in a comfortable container that will always be with you on your outings.
A Mountain Medical Kit is second only to the knowledge of how to use it in a medical emergency far from medical assistance. With the help of this article, you should be able to build your own and stay safe while exploring the great outdoors. Also, don’t forget to add specific medicine you might need when planning to extend your stay in the wilderness.
This article has been written by James H. Redford MD for Prepper’s Will.