First Aid/Ski survival kit

[North]

I just finished my WFR, so my first aid kit is likely as big as it's ever going to get. Daily kit for backcountry skiing/sledding has:

Nitrile Gloves
CPR Mask
NPA
(4) 4x4 Gauze carried in plastic bag (for chest seal)
(2) 5x9 Gauze
CAT Tourniquet
Hemostatic Z-Fold Gauze
Wire Mesh Splint
Triangle Bandage
Compression Wrap
Athletic Tape
Benzoin
Syringe
15g Glucose, Tylenol, Advil, Benadryl, Aspirin

Before the mask showed up, that all fit in a 6.5 x 4 x 3 Dopp from Jagged Edge. I probably need to bump to the next size so I can fit the mask and trauma sheers. For overnight trips I'm planning to add

Steri Strips
Tweezers
Band-Aids
Immodium
Transperant Dressings

I carry a SAM splint on the snowmobile, and plan to add a rescue sled. Survival wise I could do better. I've only carried a lighter, basic repair kit, and emergency bivvy for yrs. This season I'm bringing an extra puffy most days. Could add a Tyvek tarp or similar for hypowrap.

[LHutz Esq]

I carry the hemostatic gauze.

Sure it is unlikely that I will deal with arterial bleeds that often. However, I carry the same kit coaching the racer kids and those edges are sharp!

I like the way the hemostatic gauze comes vacuum packed and I figure if I am going to carry something - that might as well be it. Haven't used it skiing but have used it with the fire department and it seems effective.

Other than that the only thing I added to my basic kit was better scissors and a tourniquet.

[fleaches]

I had put together the required 1st aid and repair kit for the grand traverse a couple of years ago and still just carry that, with a skeltool and some bits.

One thing i added is a "wire only" splint which is very compact and light compared to the big padded ones, but I've never had to use it. https://firstaidsuppliesonline.com/f...w1KgMf17te0W2e

[Yukonrider]

Good bump, I need to revise mine this year too.

For survival stuff are people carrying the thin or the thick bivvys? Has anyone spent a night in a space blanket type bivvy? They're much smaller, but I can't imagine a night sitting in the snow wearing that and your ski clothes.

Also for discussion: What are peoples thoughts on carrying strong drugs in your kit? I have some expired surgery meds I carry (They're labeled in the kit, I can't recall what they are now but I think its 5mg hydrocodone with aspirin). Sure could make a ride out more tolerable.

[LHutz Esq]

As for major bleeds - anyone watch Connor Ryan and Ryan McClure's vid and be very interested in the field medical aspects?

My understanding is that, though rare, a complicating factor in a compound femur fracture can be a ruptured artery? I get that 1) a compound fracture of the femur is probably somewhat rare and b) that it take an artery with it rarer still - but it did get me thinking.

Also, I understand that he or some of his friends post here - so if anyone doesn't think this is an appropriate place to discuss this I will happily delete this post. That vid did convince me to start taking the tourniquet in my BC gear though.

[adrenalated]

My understanding is that, though rare, a complicating factor in a compound femur fracture can be a ruptured artery? I get that 1) a compound fracture of the femur is probably somewhat rare and b) that it take an artery with it rarer still - but it did get me thinking.

Doing femurs isn't that uncommon in avalanche accidents.

Yes, a fractured femur has a high risk of an arterial bleed. Specifically, femur fracturs tend to displace due to the tension on them by large muscle groups (quads) and the displaced bone can easily sever the femoral artery. In Ryan's accident (yes he posts here) this happened and they used a Voile strap as a tourniquet, which worked. The actual manufactured TQs are supposedly more effective and less painful and aren't that much extra weight.

My kit looks pretty similar to North's. I carry everything he does, and added a couple additional hemostatic bandages and gauze, a HyFin chest seal, an additional triangle bandage, and trauma shears. I also always carry the SAM splint but don't carry a wire mesh splint. I think a lot of this depends on where you travel. Think about the response times in your area. Where I ski, unless I manage to get avalanched literally into the middle of the road or directly into a possible heli LZ, the minimum response time for SAR is probably 3-6hr.

I could also do better on survival - I go with firestarters, a medium weight bivy (bit more than a space blanket, less than a real bivy), and extra puffy. One idea I just saw was a lightweight titanum mug so you can melt snow over a fire if needed. I'd like to add a rescue sled to the kit and possibly a more beefy bivy and 3/4 Thermarest to live on the sled.

[sf]

Don’t know that much about trauma care etc, but this thread made me wonder;

I’ve learnt that clotting agents won’t really work on massive arterial bleedings? But perhaps this is depending on cause of said injury? Skiing injuries is not a big concern in my profession.

Regarding the last question / femoral fractures. In that perticular film it looks like the fracture is close to the hip (unless a shitload of displacement). If the artery snaps close to the hip you might have difficulty getting effect from a TQ

But I may be talking out of my ass here. Please feel free to tell me I’m wrong. Medic-shit is fascinating, I just don’t prioritize my time on it

[North]

For me, first choice for an arterial bleed is a tourniquet. Second choice is hemostatic gauze (and lots of it) packed into the wound. I carry the hemostatic gauze for the scenario you have identified - arterial bleed at a junction where a tourniquet cannot be placed effectively.

Good bump, I need to revise mine this year too.

For survival stuff are people carrying the thin or the thick bivvys? Has anyone spent a night in a space blanket type bivvy? They're much smaller, but I can't imagine a night sitting in the snow wearing that and your ski clothes.

Also for discussion: What are peoples thoughts on carrying strong drugs in your kit? I have some expired surgery meds I carry (They're labeled in the kit, I can't recall what they are now but I think its 5mg hydrocodone with aspirin). Sure could make a ride out more tolerable.

I think the emergency bivvy + insulation would be effective if you can keep it in one piece.

My instructors recommended a combo dose of Acetaminophin and Ibuprofen to get an effect similar or better than opiods w/o the side effects.

[doebedoe]

Bump. It's time for me to revise my bc ski 1st aid kit and I thought I'd see what other people are carrying.

My day to day -- fits in a crampon bag in the bottom of my pack

Bleed stuff: quick clot bandage, a couple 4x4 gauzes, tourniquet, coban wraps, In a zip-lock bag (which can act as occlusive dressing if needed)
Splint stuff: SAM. Extra voile straps. Small athletic tape.
Annoyance stuff: couple band aids, butterflys, moleskin
Drugs: Aspirin, diphenhydramine, Ibuprofen, acetaminophen, big naproxens, immodium
Other stuff bag: couple hose clamps, skeletool & bits, bit of bailing wire, lighter, various screws, space blanket, zip ties, duct tape, pole basket.

Big days where rescue would be tough/slow I add a bivy that can double as an OK rescue sled. https://www.ortovox.com/us-en/shop/e...-pro?size=none. Hut trip is just extras of the above.

Even in my limited time on patrol I have seen a need for quick clot dressing where retro with a doc said it was part of the life saving treatment. Ski edge to an artery too high up to be tourniquet-ed.

[sf]

For me, first choice for an arterial bleed is a tourniquet. Second choice is hemostatic gauze (and lots of it) packed into the wound. I carry the hemostatic gauze for the scenario you have identified - arterial bleed at a junction where a tourniquet cannot be placed effectively.



I think the emergency bivvy + insulation would be effective if you can keep it in one piece.

My instructors recommended a combo dose of Acetaminophin and Ibuprofen to get an effect similar or better than opiods w/o the side effects.

Thanks.
Yeah, packing gauze - hemostatic or not - is what I’ve learnt to use.

My comment was directed at what I mistakenly interpreted as a couple of posters bringing «stand alone» clotting agents. I know some people who think it’s magic powder [emoji1745]

But yeah, should probably put together a slightly better kit myself. Crampon bag was a good idea

[singlecross]

I pack my mechanical/tool kit in a couple of slip fit soup cans and include a candle and a couple peppermint tea bags. A cup of hot tea heated over a candle in a soup can provides a lot of hope if your spending the night out in the woods in Winter.

Hot tea is one of two things the British got right.

[rod9301]

My day to day -- fits in a crampon bag in the bottom of my pack

Bleed stuff: quick clot bandage, a couple 4x4 gauzes, tourniquet, coban wraps, In a zip-lock bag (which can act as occlusive dressing if needed)
Splint stuff: SAM. Extra voile straps. Small athletic tape.
Annoyance stuff: couple band aids, butterflys, moleskin
Drugs: Aspirin, diphenhydramine, Ibuprofen, acetaminophen, big naproxens, immodium
Other stuff bag: couple hose clamps, skeletool & bits, bit of bailing wire, lighter, various screws, space blanket, zip ties, duct tape, pole basket.

Big days where rescue would be tough/slow I add a bivy that can double as an OK rescue sled. https://www.ortovox.com/us-en/shop/e...-pro?size=none. Hut trip is just extras of the above.

Even in my limited time on patrol I have seen a need for quick clot dressing where retro with a doc said it was part of the life saving treatment. Ski edge to an artery too high up to be tourniquet-ed.

Have you tried to use the skeletool on binding screws? If not, you should

Sent from my moto g 5G using Tapatalk

[~mikey b]

I bought a skeletool for its weight but I also carry a Doc Allen versatool for actual screwing

[Ørion]

Gerber Armbar Drive takes real bits and at 2.5-3.1 oz (slim or reg), saves enough weight over the skeletool to have an independent set of mini-pliers if desired.

[MakersTeleMark]

For a very long time I carried 2 tabs of LSD in my 1st aid/repair kit. I figured if I was so fucking out of it, which I have been multiple times in the past, I'd rather just be tripping balls, especially if I had to get carried out for miles with a broken femur.

I've managed to avoid doing those things anymore, knock on wood, and one night, those two tabs came in magically and wonderfully handy for me and my lady friend at the time.

[eSock]

Also, I understand that he or some of his friends post here - so if anyone doesn't think this is an appropriate place to discuss this I will happily delete this post. That vid did convince me to start taking the tourniquet in my BC gear though.

They went on a Blister podcast and talked more about the incident and it sounds like the ski strap used was 'perfectly ineffective' as a tourniquet in reducing the bleeding but not cutting off blood flow, cuz his artery hadn't actually been severed and if he'd been tourniqueted properly, he probably would have lost the leg. Which is to say, unless you really know what you're doing and when to use an tourniquet, you should really consider if you should be carrying it.

[MakersTeleMark]

IMHO, IANAD, it's better to have a t and lose a leg then die.

[doebedoe]

Have you tried to use the skeletool on binding screws? If not, you should

Sent from my moto g 5G using Tapatalk

I carry a small bit extender and common 4mm bits (P3, Phillips 2, T20/T25). I've used it on bindings several times.

I used to carry a Brooks Range mini ratchet tool but it occassionally wasn't long enough, and I've needed pliers before and not had them.

[doebedoe]

They went on a Blister podcast and talked more about the incident and it sounds like the ski strap used was 'perfectly ineffective' as a tourniquet in reducing the bleeding but not cutting off blood flow, cuz his artery hadn't actually been severed and if he'd been tourniqueted properly, he probably would have lost the leg. Which is to say, unless you really know what you're doing and when to use an tourniquet, you should really consider if you should be carrying it.

IMO the learning here is not "don't carry or use a tourniquet". It's that everyone spending significant time in the backcountry ought to have at least have Stop the Bleed training so they know when a tourniquet is appropriate. And then to carry one.

[Jason4]

My first aid kit is stocked similar to most lists I’ve seen here with a few modifications.

I don’t carry any narcotics, just various NSAIDs, Benadryl, and Immodium AD.

I’ve split my kit up into a small “oh shit” kit that’s just a CAT tourniquet, gloves, hemostatic Z-folded guaze, a knife, and a felt tip pen in a small zippered pouch. It goes into the top pocket of whatever pack I’m carrying that day whether it’s an 18l pack on chair lifts or my 40l touring pack. It’s the only first aid I carry on lifts because I figure ski patrol can get there in a few minutes and I only need to deal with things that could go sideways in a few minutes.

When I’m touring or sledding I carry the rest of the comfort care kit which includes the things needed for longer term care. This kit is kind of bulky and weighs about 2lbs. I think the most used items are the blister care (moleskin) and the ibuprofen. I also carry more bulky gauze and something I can make a sling out of. I carry cloth tape and electrical tape. The E-tape is nice because it will stick to itself ok enough in most conditions even when it’s wet. I’ll probably add an i-gel airway to my kit soon but they are bulky and I’ve been dragging my feet on it.

The rest of my “survival kit” includes an MSR Pocket Rocket with the smallest can of fuel available, two lighters, some TP folded up small, an InReach Mini, two-way radio with some useful local frequencies, a small kit of slings, cord, and carabiners, and an Alpine Threadworks rescue sled/tarp.

I have more tools with me on the sled and I always have a shovel and probe in winter conditions. The tarp plus a shovel can be used for shelter pretty easily. In addition to the obvious transport the tarp is also really good to trapping heat which is important with any serious injury in the backcountry.

I have had to drag someone out of the backcountry in a sled/tarp and I have needed (but didn’t have) a CPR mask/airway. Fortunately I haven’t had to stop any serious bleeding. The more time you spend in the mountains the more real these problems are, especially if you add snowmobiles to the mix.

[bodywhomper]

IMO the learning here is not "don't carry or use a tourniquet". It's that everyone spending significant time in the backcountry ought to have at least have Stop the Bleed training so they know when a tourniquet is appropriate. And then to carry one.

This seems ideal.

The Red Cross training is that if you, the responders, determine that the bleeding is life threatening and cannot be stopped with direct pressure, then apply a tourniquet. https://www.redcross.org/take-a-clas...VihjRTtUZ94ZNa

[Diamond Joe]

While we're on he subject of tourniquets... I have a CAT in my truck kit, but CATs are kind of oddly shaped and don't pack very well, if you're trying to carry one on your person. These guys make an awesome solution to that problem, and make it easy to carry a TQ (or pack more than one). Their "ETQ" is about the size of a small multi-tool or a G19 mag (and IIRC actually designed to fit in a sidecar/mag carrier). Considerably smaller/easier to carry than a CAT, made in the USA, etc

https://www.snakestaffsystems.com/bu...gP3U8LLMXQcsYv