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What's in your first-aid kit for multi-day alpine missions?
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Let's say it's summertime in a relatively friendly range like the High Sierra. You're going out for a 3 day trip doing some alpine climbing in remote alpine basins. What's in your first-aid kit? |
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Normal backpacking stuff should be good. Bandaids, gauze, tape, chap stick, sunscreen, insect repellent (if needed), moleskin, Tylenol, Imodium because diarrhea is a trip killer, maybe a tourniquet or two. A little thing of petroleum jelly actually has a million uses, good for skin protection and wind burn, I’d probably bring an ace bandage if you think sprains or strains will be an issue. Really depends on what you think will cause the most damage. For reference, I’m a medic in the army so feel free to ask if you need / want more or less. I always have an emergency blanket they weigh nothing. |
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A roll of sports tape and an extra head lamp is probably the most useful things to have. |
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I always carry a personal locator beacon. I am usually operating under the assumption that I can call for a helicopter evacuation and it will arrive within 24 hours, when needed. In the event of serious injury, I plan to be able to treat a patient over night while waiting for a rescue. My default first aid kit is leukotape and insulation. Leukotape sticks to skin much better than athletic tape and breathes well (unlike duct tape). Works well for blisters, bandages, and any other application you might use tape for. "Insulation" is whatever I need to survive an unplanned bivy, without severe hypothermia or frost bite. That usually entails a belay parka and puffy pants for me, but it could be a blanket, bivy bag, sleeping bag, bothy bag, tent, etc. I will typically carry non-steroidal anti-inflammatory drugs (NSAIDs). These drugs can make it easier to evacuate an injured patient and do not add significant weight or bulk to my kit. If travelling on soft snow, I think it is important to have the equipment needed to make an improvised sled. Leg injuries are common and it is hard to move a patient with an leg injury, if you do not have a sled. *** I used to carry a much bigger first aid kit, when working as a guide, but I rarely used any of it. I found having extra kit to clean wounds was nice to have, but I do not carry that equipment for recreational climbing. Sam splints and slings are nice to have, but I do not carry that kit for recreational climbing.
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Kai Larson wrote: Very nice kit, no emergency blanket? |
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Mine rarely changes. I have a space blanket, 3M Nexcare surgical tape (it sticks to everything and can be used to fix clothing very easily), a few bandages, a bit of gauze padding, steri strips (and this weird black goo that you can use to bind a fairly a substantial cut), extras of my daily medications, and a pill bottle with an assortment of Oxys, hydromorph, nerve pain meds, ibuprofen, T3s, dexamphetamine, and allergy pills. In my experience, once the shock wears off, pain management is the most important thing. The dex is used in the event that I have to stay awake to make a long hike out or ensure my patient stays breathing over night. It works well. With my headlamp, batteries, lighter, and Inreach, the whole package fits into a small pouch. |
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Damn there are some prepared people here. My kit includes athletic tape and some Ibuprofen. If I need more than that I’m in over my head. Maybe I should take a wilderness first responder class or something. |
Michael Abend wrote: Look for a wilderness first aid course. Often 16 hours instead of 40 for a WFR one. |
John Allard wrote: I used to carry an emergency blanket. Then, I had an unplanned bivi and actually tried to use the blanket. I decided that an emergency blanket is worse than useless. It is so light that it does not drape over your body. The slightest breeze blows it off of you. It doesn't keep precipitation off. In high winds and heavy precipitation, (the exact circumstances where you need it most) an emergency blanket doesn't work. An emergency bag is useful. An emergency blanket is a waste of space and weight. These days, if I need to carry an emergency shelter, I take a DCF bothy bag that the good folks at Wild Things made for me a long time ago. Light weight, and can shelter two people if needed. I have used it on climbs for planned and unplanned bivis. I use it on ski tours for sheltered lunch breaks. I took a Wilderness First Responder course back in the 80s. A very good investment of my time. |
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Ted makes a good point, I almost always have caffeine pills in my pack in case you’ve got to pull a long day out. But I always pack coffee so they never get used. It really depends on what you think is most likely to happen and how quickly you can be rescued. Also agreed a wilderness first aid class might be worth your time, especially if you plan on doing more remote stuff. Having someone who knows how to do even modest emergency medical treatment is huge. |
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If you take my advice your gonna die. I have zero qualifications to comment on this. but I have Quik-Clot and a wire mesh splint (like Sam splint but cheaper and smaller and lighter) in every kit. I have family on blood thinners and the quikclot works amazingly well. |
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My usual emergency kit is usually extremely small, just a few grams. I mostly rely on the Leukotape to patch me/others up for cuts, blisters, and sprains. It's super bomber, and generally doesn't come off for days until I get into a hot shower. While the list below seems long, not everything usually comes, and it is barely noticeable in the pack. I've had to use 100% of these things either a few times or plenty of times (except for the inReach, aside from the periodic text message). Warning: YGD if you take what I take:
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Glad to see the comments for Leukotape - great stuff. Didn't see mentions of Tegaderm (transparent, semi-breathable bandages). These changed my world for wound care and combined with Leukotape create a waterproof bandage with ability to inspect the wound. For blisters or cuts, clean wound, place Tegarderm over wound. Tape perimeter with Leukotape but leave a window over the wound. Put gauze or any available material over window and tape that down (keeps tape from sticking to window). When it is time to inspect the wound, pull the center tape and look through the window. Assuming all is good, re-tape over window and get back after it. For blisters, I often forgo the window and just tape over the Tegarderm. You can leave it in place for days and shower every day (or wade creeks/rivers etc). I repaired blisters at the backcountry ski lodge and people left them in place the remainder of the trip (5 days) while showering every day. They loved me because the prior blister repairs done by the guides and/or their boyfriends all sucked. Agree with above comments that space blanket is less useful than space blanket bivy sack. However, my recent experience was that one tore easily on all the folds when it was finally deployed. They are brittle and there is no way to test them - once unfolded they are done. |
Michael Abend wrote: I held WFR certification for more than 14 years, and this is still mostly all I carry. Tape, a few gauze pads, ibuprofen and marijuana for headaches and nausea, and some extra candy or gels (fast, easy calories for bonkers). I would ABSOLUTELY take a WFR class if you have the time and money. It helps understand how to improvise solutions with the gear you already have (like sleds and splints), and how to recognize when a situation is heading into emergency territory, often long before it becomes a problem. The best way to solve a medical emergency is not to let it happen in the first place. (For example, sunscreen and alpine sunglasses are not "emergency" gear, only proper planning. Getting sunburned and snow blinded is not an emergency, and totally avoidable with any foresight whatsoever.) I also pack some Hot Hands. For "extra insulation," there's nothing lighter and more compressible than 6-8 packs of hot hands. You can put them in your bra, underwear, gloves, or pockets and make it several more hours through any terrible alpine belays. I put them in my hat, or the bottom of my sleeping bag, so I can sleep through the night - then there's less chance of making dumb-ass moves because I'm tired or lethargic. A clear head is one of the best pieces of safety equipment you can possibly have on hand at any given time. Make sure you use it! |
Free Spirit wrote: Agreed; needless to say, heading into glaciated terrain without glacier glasses and sunscreen is guaranteeing a bad outcome. If you were referring to my comment, what I meant was literally having an extra of those items between my partner and I. So 3 glacier glasses and 2 sunscreens for 2ppl. |
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Tape, Narcotics, and an inReach |
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I've deployed those foil "emergency blankets" twice in the field in real life. (Both times they were packed in by my "why-tf-are-they-moving-so-slow?!?" partners. Oh, they are slow because they are carrying so much shit.) The first time was somewhere in Solar Slab Gulley in January. The day was hot, bright, and dry, but night came fast and was bitterly cold. I guess I thought we'd be faster. Pine needles put holes in it almost immediately, and when someone jumped at the sound of a mouse investigating our food, the whole thing tore into pieces. We tucked the foil pieces into our clothing and climbing shoes. That seemed to help, but left silvery stuff all over our skin. The second time was on the Scenic Cruise on Halloween night. My 5.13 sport goddess partner got stuck forever getting into a chimney with a backpack on. It got darker and darker as we made our way up the wall, the top still nowhere in sight. An infinity of shadows and choss loomed above, and eventually we chose a wide ledge to wait until it was light enough to see the holds again. My partner proceeded to pull out of the pack a plethora of bars, tape, extra water, sunscreen - you name it, she hauled it up the wall - and an emergency blanket. It must have been a brand new one, because it didn't rip. We wrapped it around ourselves to block the wind, and it definitely helped, although to this day I am convinced that the heavy pack is what slowed us down so much to begin with. The only way we knew one of us dozed off, is because the wind would rip the foil out of your hand, and the whole blanket would be flapping around into the void of the Black Canyon, still held by the person who was awake. I'm amazed that it didn't become blowing trash in the canyon. Ultimately it was good we waited until morning. For some reason, the two bolt hangars that were supposed to be on the traverse pitch had NO hangars! Just studs poking out of the wall! I hitched them with a sling and hoped for the best as I climbed past in the cold light of morning - but I would have probably lost my freaking mind looking for (and finding) those in the dark. The universe was actually looking out for me that time! Spooky Halloween night in the Black. |
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Lots of great information and discussion in this thread: https://www.mountainproject.com/forum/topic/121111335/you-should-probably-carry-a-first-aid-kit |
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Bleeding control is extremely important. If you lose too much blood, you're screwed. If you enter hypovolemic shock (excess blood loss) and/or go unconscious, you greatly inhibit your partner's ability to get help, extricate, etc. I second Jack Walter's recommendation of a tourniquet as I don't see it mentioned further. Get a legit CAT tourniquet and learn how to use it. Hemostatic gauze is great but expensive. Kerlix/rolled gauze is great for wound packing and stabilizing impaled objects. Coban (cohesive bandage) is the best for going over the top of it all. Get your WFR. Such training is invaluable when you or someone else needs it. I'm an ocean lifeguard/EMT for a living. EDIT: The most critical things are my top priority. |
