INTRODUCTION
The contents of your medical kit can range from Minimalist, which will have only the most basic first aid items, to Advanced Life Support, with all the drug and equipment “bells and whistles.” Most people will pack something in between these extremes, depending on the answers to the following questions:
Who: The skill of the practitioner(s) and the number, ages, and chronic illnesses of potential patients.
What: The type of activity and the space/weight limitations for the kit.
When: The time of year and the trip length.
Where: Is the activity in the mountains, tropics, or ocean?
Why: Is the purpose work or play?
How far and how long to reach definitive medical care?
To assess the need for each item, ask the following questions: What is the chance you will need an item? Can you improvise without it? Will someone die/be disabled without it? Do you have space/energy to carry it? Do you know how to use it?
An appropriate medical kit should be durable, padded, weatherproof, a bright color, and easy to carry.1 Even an automobile kit will need straps to tote it to where it is needed. Ideally, it will open completely to be able to identify and access everything in an emergency. Use plastic bags (e.g., Ziploc) to keep similar items together.
If you carry medications, include a weatherproof/laminated drug-treatment card for each, because a wide variety of practitioners may end up using the same kit. These cards should include (a) correct pediatric and adult doses for specific conditions, (b) information on how to reconstitute (if powder) and administer the medication, and (c) contraindications and adverse effects.
FIELD MEDICINE KIT
A “one-man mobile forward clinic” consists of a clinician carrying a backpack with a complete basic life support kit and simple surgical instruments. “In skilled hands and with support from the local population, the one-man mobile forward clinic may handle close to 80% of all casualties.”2
Dr. Matthew Lewin, who equips scientific teams for remote expeditions, suggests that some of the basics for any kit are ear plugs, nail clippers, superglue (small wounds), suture stapler (larger wounds), thermometer (to determine if there really is a fever), duct tape (lots of uses), condoms (no need for pregnancy or STDs in the field), pregnancy tests (to know if care must be modified), zip ties (to prevent tampering with the kit, but allows it to be opened if the clinician is the patient), adrenaline (envenomations and allergic reactions), and antibiotics. For any other medications, use pills rather than capsules, which may crack in an arid environment; even better are vacuum-sealed medications. What Dr. Lewin does not include are venom suction extractors (worthless), rehydration salts (use salt and sugar), or unnecessary narcotics (abuse potential is great).3
