The PERFECT First Aid Kit!
Making sure you're prepared for anything can intimidate even the strongest and brightest of us. The universe holds too many random possibilities in our future for us to plan ahead for EVERYTHING. But --- what we CAN do is to maintain a fundamental preparedness stock of basic essentials, and to learn how to survive without modern conveniences such as running tap water, grocery stores, and immediate medical care.
Browsing through many, many social media posts about preparedness and off-grid living, the same question keeps coming up: "What should I stock in my emergency first aid kit?" If this is you, CONGRATULATIONS: you have come to the right place! (Also, CONGRATULATIONS for trying to stay informed and prepared!)
Let's start simple: basic pre-assembled first aid kits (marketed and bought cheap on the internet everywhere) include overpriced band-aids, a small tube of Neosporin, a single-use packet of aspirin, maybe a roll of sterile gauze or an elastic bandage, and a "fashionable" red case... pretty much to equip you just enough to handle a small papercut. This is NOT what we're looking for as serious people wanting to acquire real emergency supplies. Give your cute little first aid kit to your kids and let them practice putting bandages on their toys.
True, band-aids should be stocked in everyone's house. They're good for covering small cuts, and for the fingertips of novice guitar players. But these will do nothing to address an emergency situation. What we need is a comprehensive list of real supplies that everyone should own, and a good explanation on how, when, and why to use them.
THE CASE: First, let's talk about the cute little red first aid case with the cross on it. This might hold enough supplies to store in your bathroom closet, but it's not large enough nor designed to hold anything substantial. Sure, it has neat little pockets and hooks to hold a pair of scissors, but nobody - NOBODY stranded in the woods with a gunshot wound bleeding out has EVER stopped and said "Oh! Cute kit! Does that loop hold a pair of scissors?"
Additionally, if you have to "bug-out" and are travelling in a SHTF scenario, that cute little red case will attract A LOT of attention from A LOT of the wrong people. The bright red case screams "LOOKIE LOOKIE! WE HAVE MEDICINE! COME STEAL OUR SUPPLIES!" Best thing to do with that red case is use it to store non-essential items, toys, games, or paper and pens in the waterproof ones. Instead, carry your real emergency essentials in something that doesn't look valuable; a child's old school backpack, for instance. You can always organize the enclosed items into smaller waterproof cases, but keep them all in the most boring-looking travel bag that you can.
THE BANDAGES: Yes, of course, throw some band-aids in there. Butterfly clasps are good, too. But a good emergency kit will have sterile gauze of several different sized squares AND a roll of sterile gauze. Sizes should range from small squares up to large rectangles that can cover the thigh or half of the chest. Not only is sterile gauze good for dressing wounds, it is also used to soak up blood and clean the wound, and even more importantly used to apply pressure on an open wound. Since the gauze is sterile until you open the package, you minimize the risk of infection by applying it to the wound before applying pressure. There are also options to buy gauze bandages that contain quick-clot ingredients, so when applying it to a wound that is bleeding out, this will help the blood form a "seal" at the wound site and help prevent blood loss. Be advised that this is NOT an alternative to applying pressure if you have a gaping wound - especially when a vein or artery is compromised, you still need to press down on it HARD. Either way, when you use gauze, you're also going to need a big roll of gauze tape.
In addition to sterile gauze, you should also have a couple of rolls of elastic bandages. While sterile gauze is used directly on the wound, elastic bandages can be wrapped around the arm, leg, etc. over the gauze covering the wound. This can be a handy way to compress the wound and keep on the sterile gauze dressing. Elastic bandages are also
used to immobilize the wounded area, such as making a sling for someone's arm in the case of an injury to the shoulder, elbow, wrist, etc. They can also be used to secure a splint. Keep it rolled up and place it beneath a tourniquet at the site of the nearest, largest artery. Either way, when you use an elastic bandage, you're also going to need clasps (see picture) or safety pins to tie it off.
SPLINT AND TOURNIQUET: A tourniquet by itself isn't absolutely necessary because you can improvise one on the spot with a belt, fabric, etc. (anything lying around that is strong enough to be wrapped so tightly that it cuts off the circulation). Don't just pull it tight with your own strength; insert a stick between the fabric and twist it several times, thereby tightening it considerably more. Once tightened, leave the stick in the contraption and secure the whole thing.
Be warned - only use a tourniquet as a last resort, and DON'T remove it until the patient has been transported to a safe place with proper medical care. After cutting off circulation to a limb, to abruptly remove the tourniquet will cause severe damage and could result in bleeding out even worse than before, necessitate amputation from tissue damage, or even cause a heart attack or stroke from the sudden inflow of blood. Also - this should go without saying, but - as a friendly reminder, you can only use a tourniquet on a limb (arm or leg). You can't tourniquet the chest or torso, and DON'T EVEN THINK about putting a tourniquet around someone's neck!
A splint, on the other hand, is probably a good thing to have in an emergency kit. Yes, you can "make" a splint out of random items (remember the old Scouts' manual which showed how to tie two thick sticks on either side of a broken leg? yeah, right. like that will work well enough to be useful *sarcasm*), but if you need to move from point a to point b, chances are that a makeshift splint on a leg won't last long or be effective enough to serve its purpose. The good news is that modern emergency splints are lightweight, compact, and travel easily. They are made similar to a metal tape measure, pliable enough to roll up into a neat little ball, but very sturdy once straightened out. Secure the splint with an elastic bandage.
SCISSORS, STERILE SCALPEL, AND FORCEPS/TWEEZERS: You'll need scissors to cut off gauze from a roll, cut off pieces of gauze tape, cut off clothes from the patient to get to the wound, or to expose the chest when performing CPR. You'll need a scalpel to cut skin (for many reasons, but in the field, mostly to retrieve a foreign object like a bullet). Don't be a tough guy and rely on your pocket knife for all of this; you won't cut the gauze evenly, and it will take three times as long in a time-sensitive situation.
BLANKET: You'd be surprised at how often a blanket is needed in emergency situations. In the case of trauma, shock, and/or blood loss, the patient can get very cold, very fast. Even when the weather is hot. It can also be wadded up and propped underneath the patient's head or wounded area of the body. Additionally, if the situation requires the patient to be carried, you can fasten the blanket between two logs and improvise a stretcher. If you have a mylar blanket, use the shiny side to reflect light and flag down help or heat water.
CPR MASK/BARRIER: You really don't want to perform CPR on someone with a naked mouth. Mouth-to-mouth resuscitation makes you vulnerable to contracting all sorts of illnesses, from a common cold to SARS to Tuberculosis. Also, if the patient was choking or drowning, you really don't want them throwing up into your mouth as a result of successful resuscitation. CPR masks protect both the patient and the performer of CPR. You can also get a bag attachment so you don't need to breathe into the patient at all; just squeeze the bag and it blows air into the person's lungs. They even make CPR masks that fit onto keychains.
ALCOHOL SWABS: Lots of 'em! Make sure they aren't dried out, either.
BLOOD CLOTTER: Usually under the brand name "Quikclot", this can come in a spray, powder, or already included in the fabric of some sterile gauze dressings.
CLING WRAP: Can be used on sucking chest wounds and punctures to the lungs.
ACTIVATED CHARCOAL: Not only can you purify water by filtering it through activated charcoal, small quantities are safe to consume in the case of digestive poisoning.
AED (AUTOMATED EXTERNAL DEFIBRILLATOR): These are pretty expensive, but if you live off-grid, have a heart condition, or are prepping for TEOTWAWKI, you should really, really, really consider investing in one and the necessary CPR course that covers its use.
A reminder about medication: THEY DON'T LAST FOREVER! You'll need to periodically swap them out with new supplies before they expire. Sure, you might have an old bottle of Ibuprofen at your house that you still use, and it won't hurt you, but in an emergency you'll want to be assured that the active ingredients are still, well... active.
BABY ASPIRIN: Besides the obvious pain relief properties, chewing on a crushed baby aspirin can help limit the effects of a heart attack. Don't give to someone with an active open wound; aspirin is a blood-thinner and will prevent clotting.
DIPHENHYDRAMINE: More commonly known as Benadryl, a low dose can prevent allergies, a medium dose can relieve an allergic reaction, and a high dose will put someone to sleep. If you do happen to have an EpiPen for severe allergies and anaphylactic shock, you should still follow up with diphenhydramine about 15 minutes later to prevent the allergic reaction from returning. In a pinch, a medium dose can also be used as an anti-anxiety remedy.
GLUCOSE TABS: A very important solution to low blood sugar. If a diabetic takes too much insulin, they could go into a hypoglycemic coma. Even if you don't have diabetes, walking long distances without food will plummet your body's supply of blood sugar.
EPHEDRA/EPHEDRINE/PSEUDOEPHEDRINE: A bronchodilator that can relieve an asthma attack or respiratory distress if you don't have an inhaler. In many states, real ephedra is an illegal stimulant, but you can get the legal substitute in Primatene Mist.
LIDOCAINE: A topical numbing agent.
These next few items are by prescription only, however they are indeed worth mentioning:
OXYGEN: Unfortunately, in the United States, you need a prescription or medical practitioner's license to get medical-grade oxygen. The smartest device to get would be an oxygen concentrator, but don't fall for devices that are sold online or over-the-counter without a prescription. The flow rate and oxygen concentration aren't high enough to really do anything. Oxygen sold in pressurized cans, aka "recreational oxygen", is NOT pure oxygen and has no medical value. If you don't need a prescription, don't waste your money.
EPI-PEN: Again, in the United States, you usually need a prescription to get your hands on one of these. And they're expensive.
RESCUE INHALER: Prescription only. If you have a choice, avoid the ones with steroids. Try Albuterol.
NITROGLYCERIN: If you're lucky enough to live long enough to develop heart problems, you can get a prescription. A spray or tablet is placed under the tongue and dissolves rapidly into the bloodstream, possibly preventing cardiac arrest or at least minimizing the damage caused by one.
NALOXONE: Usually sold under the name Narcan, this injection or nasal spray will immediately reverse an opioid overdose.
***This is NOT a replacement for adequate emergency medical training. A CPR course is strongly recommended.***