First Aid Kits
Here’s a list of what can be found in my first aid kit. Most of it goes into a small sandwich box, which then goes in a drybag so that none of the contents get water damaged which would render most of them useless. Remember to check your First Aid Kit before going on a trip.
If any blood or body fluids are involved in your incident then a pair of thin nitrile gloves, or even gloves used on petrol forecourts can protect you from the risk of cross contamination If the gloves tear or you can’t get them on over your cold wet hands, minimise your risk by not touching the patient. Give them the dressing and ask them to apply it by themselves.
A wound that has visible dirt in it has a high risk of infection. Clean tap water from a bottle is satisfactory but I prefer carrying sterile pods. Clean a wound with gauze swabs and water before applying a dressing.
Micropore is an adhesive tape. It’s much kinder to the skin than gaffa tape. It lacks the versatility and strength of gaffa tape, but your patient will thank you for the extra care you have shown. It’s lightweight and doesn’t take up much space.
These may seem like an extravagant use of space and weight when a knife does the same sort of job. I carry scissors in my first aid kit in case I need to cut any clothing. If something can be cut with scissors, then this is a safer option than using a knife.
Plasters. I like the butterfly shape plaster. They are great for protecting that inside of the thumb area that is prone to blistering, and the wings of the plaster provide great adhesion.
Guaze swabs. These measure about 5cm by 5cm and are great for cleaning a wound.
Melolin dressings are pads of guaze with a non-adhesive lining. If I have a small wound that needs a dressing, I’ll dampen a melolin dressing with sterile water and cover the wound.
A roller bandage can be used to hold a dressing or SAM splint in position.
Warning: A roller bandage that is applied too tightly round a limb can cut off the blood supply below where it’s applied. The danger and consequences can’t be over-estimated, so if ever you apply a dressing or bandage that goes round a limb, check the circulation at regular 10 minute intervals. This is most easily done by examining the nailbed of the fingers or toes. They shouldn’t turn blue! If you squeeze the blood out of the nailbed by applying a constant pressure for 5 seconds. When you release the pressure, the colour should come back within 2 seconds. This is a great little test at room temperature, but when people have cold extremities or have hypothermia, it will take longer. Therefore use roller bandages with great care.
Think about the medication that you may require on your trip (home or abroad). Include the leaflet so that you can check all the instructions. If you are going on an extended trip, and you are thinking of including medications you don't usually take, such as anti-diarrhea medication, check with your pharmacy or GP as what would be suitable for you.
You are responsible for the medications that you take, so take your own medications with you. Do not rely on the trip leader to provide any medication.
Most injuries and illnesses will involve some level of pain, so I always take Paracetamol with me. For an adult 1g of Paracetamol is a good start. Ibuprofen is also an effective pain killer, and because it acts in a different way to paracetamol, the two can be taken together. There are several groups of people who should avoid Ibuprofen, so always read the label and be careful not to exceed the stated maximum dosage. Contrary to popular opinion, there is a body of evidence that suggest Ibuprofen delays the healing of soft tissue injury. It is now recommended ibuprofen is most effective for healing when taken 48hrs after a soft tissue injury.
On a multi-day trip think about anti-diarrhoea medication and rehydration fluids in case of diarrhoea and/or vomiting. If you’re that ill, you probably won’t consider paddling, but there’ll be people on multi-day expeditions who may not have a choice.
On sea kayaking trips consider sea-sickness medication.
SAM splints are light weight, relatively cheap, robust splints that can be shaped to give support and protection to an injured limb. Don’t use as they exert a pressure around the whole limb> the problem with anything that wraps all around a limb (e.g. a bandage or clingfilm for burns) is that if the limb swells, there is a risk of cutting off the blood supply to that area and below. The consequences can be awful.
I’ve seen people try to improvise a splint with a paddle, gaffa tape, and spray decks for paddling. I’ve only ever seen one satisfactory splint that has been improvised. So it is possible, but trust me, buying the specialist kit is the way to go.
Specialist Bits and Bobs
Tweezers don’t take up much space or weight but can be useful for removing ticks, urchin spines, and lifting of jellyfish stings. You can also buy specialist implements for removing ticks.
A thermometer is a bit of a luxury but it can be useful. If you’ve become unwell on a multi-day trip, being able to measure the body temperature can help you judge if it’s serious. If its below 36 degrees Celsius or above 38.3, then you may well have a medical problem (sepsis) that at the least means you need to see a health care professional the same day. Of course another use would be to check for hypothermia, or heat exhaustion/stroke but there should be enough signs and symptoms for you to be aware of and treat these conditions promptly to ensure the best outcome.
If you’re planning a multi-day trip you might want to consider packing an emergency dental kit. These are small lightweight, reasonably priced and can be purchased in supermarkets and pharmacies.
As well as this first aid kit, I’ll also pack a group shelter, a flask of hot drink or stove to make one, some food, and some spare warm clothing for cold environments or a baseball cap for hot sunny days. Think about your environment so that you can protect yourself as best you can before setting off.
My First Aid Kit resides in my day hatch. Some leaders like to carry a few essentials somewhere a bit more accessible such as the pod in front of the cockpit. It can contain whatever you think is most appropriate. I carry my own paracetamol, a few sweets for a burst of energy, a pod of saline water, and a couple of plasters that are good for protecting small wounds and/or blisters.
Steri-Strip stitches. If a wound is deep enough to require stitching, the best first aid treatment is to clean the wound and apply a dampened flat guaze dressing such a melolin. If a wound is closed with steri-strips, it can start to knit together and heal, but if it’s not been cleaned thoroughly, the steri-strips will be sealing in the infection…and that’s going to get messy, painful and potentially very dangerous. I simply clean the wound with water and guaze, and then ask the casualty if I can assess it’s depth by pulling the sides apart. If I do this and I can see bone or any underlying structure, then this will need treating at A+E. The doctors and nurses can do the professional cleaning and suturing.
Triangular bandage. I’ve never had to use a triangular bandage on any kayaking trip. I don’t teach how to create an armsling or elevation sling, there just isn’t enough time in the Aquatic First Aid course, and it’s quite an intricate process to memorise. Instead of trying to remember what goes where, a sling can be improvised from the spray deck and gaffa tape. If necessary, practice first on someone without an injury. In cases of a dislocation I’ve found that the casualty usually prefers to hold their own arm in the position they find most comfortable, and no sling is necessary or even welcome.