Examining A First Aid Kit

A long distance hiker is well aware they should not head off into their great unknown; scaling fells, fording rivers, battling storm battered cliff tops etc. without some first aid goodies on them. So we jump on the internet, find a nice, light, compact first aid kit that seems to promise us all the trimmings for a tenner, bung it in our pack…and then probably don’t open it until we need it.

I am absolutely guilty of this; thankfully ‘when I needed it’ was only for hot spots, but if it had been a broken leg, a gnarly gash, or a fellow hiker had a concussion, my unfamiliarity with the exact contents of that pack might not have lead to the best possible results. Whilst I am fortunate to have a reasonable degree of first aid training and practice, this is not the case for all. The day course someone did when they were twelve becomes limited in its a usefulness when the first time they’ve seen, let alone needed to work out, a triangular bandage after fifteen years is somewhere along Striding Edge in low visibility as the sun starts to disappear.

So lets unpack a standard first aid kit. I’ve gone for the Mini First Aid Kit from the General Medi Store on Amazon as it is by far and away the bestseller. It boasts ’92 useful and valuable hospital grade medical supplies’ in a neat 140g; but what are those supplies, what do they do, and how do you use them?

As well as written information, I have also included a few links to videos below. First Aid videos tend to be a bit, um, budget. It also seem a rule to have terrible background music…but the information is sound I promise!

  1. Conforming Bandage

Also known as a retention bandage, roller bandage, elastic bandage or compression bandage

What is it? A conforming bandage is a long, thin bandage designed to mould itself (or ‘conform’) to the area it is applied to providing extra security. They are generally made of an elastic knit material designed to be stretchy and adhere to itself. Sometimes they have an infection or odour resistant coating.

What is it for? Conforming bandages are used to keep dressings in place rather than directly on a wound or injury. Their use secures primary dressings, provides a breathable layer whilst also protecting against infection. They are designed to be absorbent to pick up and contain leaks that might occur.

How is it used? Simply, it is wrapped around the dressed injury; starting from outside the injured area, overlapping as it is bound and finishing outside the other side of the dressing In theory, its material means that there is no need for safety pins or tape to hold it in place as it should hold itself or have the end easily tucked in. In practice, if you can secure it with a pin or similar you probably should. It is especially useful for injuries that occur on joints (elbows, knees, wrists etc.) as it allows a degree of flexibility. It can also be used on sprains or strains without dressings as a compression bandage, either directly or over an ice pack to be held in place.

For a video reference on how to apply: AIF Education

2. Tourniquet

What is it? A tourniquet is a device that can be tightened to stop excessive bleeding. These can be fashioned from bandages, but many first aid kits now include a basic medical tourniquet. In these sorts of first aid kits they tend to be of a rubberised variety (like phlebotomists use).

What is it for? Tourniquets are only for use in catastrophic bleeds once all other options have failed; they are not simply there for if you can’t be bothered to apply pressure for ten to twenty minutes. A catastrophic bleed tends to be a pulsating bleeding wound that, most of the time, is arterial (but can also be venous). A very tight tourniquet on for a long time can result in tissue damage or even the loss of the limb so be damn sure you’re saving a life by using it.

They work by restricting blood flow to the injury, stopping the bleed.

How is it used? Leave any embedded objects in the wound (rocks etc.). If applying strong, direct pressure does not work to stem the bleeding, both manually and through pressure bandaging a wound, and there is real concern that the patient could bleed out, it is time to apply the tourniquet.

Place the tourniquet about three inches above the wound on bare skin and tighten it until the wound stops bleeding. Depending on the tourniquet type, this can be via fulcrum, windlass, clip or a slider. Once the tourniquet has been tightened and the bleeding stopped, do leave on for longer than two hours. Get the patient to a hospital as soon as possible.

For more information on tourniquets: VeryWell Health (an American site; information on emergency services differs in other countries)

3. Alcohol Swabs

What is it? These are moist pads, soaked with 70% bacteriacidal alcohol. They are usually made of 2ply cotton, are non stick, and are individually contained in sterile foil packets.

What is it for? It is not for a quick sucking shot of Dutch courage before attempting to jump the Strid (side note: please don’t attempt to jump the Strid). Alcohol swabs are for cleaning the area around a wound prior to dressing. The isopropyl alcohol kills 90% of bacteria. In the case of hiking, this may involve removing dirt or sweat.

How is it used? After removing from the foil packet, use the pad to clean the area around a wound. Do not swab the same pad back and forth; use multiple pads if required. Alcohol swabs are not for use on the wound itself and will sting.

4. Antisepetic Wipes

What is it? On a base of a crepe material (similar to the 2ply cotton used for the alcohol pads), antiseptic wipes are usually soaked with a mixture of cetrimide (a synthetic antiseptic) and deionised water. They are also often individually contained in sterile packets.

What is it for? Antiseptic wipes are for cleaning the wound itself.

How is it used? Don’t go digging around for anything embedded, simply do a surface clean. Wipe the wound and use another to wipe it again. Use in combination with the alcohol pads.

5. Gauze Pads

What is it? Gauze pads have a loose, open weave and are made of either cotton or synthetics. They are highly absorbent and usually covered with a thin layer of perforated plastic to prevent wound adhesion. They are individually packaged and sterile.

What is it for? Gauze pads are for containing, covering and protecting a wound as part of a dressing, and for absorbing any continuing leakage.

How is it used? After the wound is cleaned, a gauze pad should be used to cover it and either affixed on the sides with medical tape or held in place with a conforming bandage.

For a video demonstration: SM Canada

6. Moleskin Pads

What is it? Not actual moleskin. Moleskin is woven, carded, cotton yarn in a dense weave. It is napped to finish which gives it a suede like appearance. These will be adhesive.

What is it for? If you’re not familiar with them yet, you will be at some point. They’re plasters especially for blisters.

How is it used? Moleskin pads work by reducing friction and providing cushioning. Some pads will have a hole in the middle, allowing a blister space without pressure. Ideally the pad is then further covered with medical tape or another dressing. However, as the primary material in them is cotton, which is hydrophilic, they have a tendency to rub off quicker than one might like (seeing as they are placed on the foot where sweat and water gather during hiking). Many hikers prefer to just clean the blister and then use leukotape over the top (or just plain duct tape) for longevity.

For video information: Kevin Runs

7. Triangular Bandage

What is it? A triangular bandage is a large free weave cotton cloth. Whilst it it in the shape of a triangle, it can be folded into other shapes depending on its use.

What is it for? Generally this type of bandage is used as a sling for an injured arm. However, because of its size and adaptability, it is also used as a bandage for head injuries as well. In fact, it is pretty versatile and can also be used to stabilise a fracture or create a doughnut dressing for a significant wound.

How is it used? To use as a sling it should be free rolled and held behind the patients neck by a pin or a knot. The arm should be at a height for the forearm to sit horizontal, however there are other styles of slings for injuries that require total immobilisation or more elevation.

For a video demonstration: SM Canada

8. Cotton Swabs

What is it? Wads of cotton wound around both ends of a short rod, usually made from plastic or wood. You’ve probably been digging in your ears with them for years (which we all know is not their intended purpose but do it anyway). In a first aid kit, they will come in a sterile packet but won’t be individually wrapped.

What is it for? Wound cleaning and medical ointment application.

How is it used? Without touching the cotton end, wet it with saline to gently dab and clean the area around the wound. If you have an antiseptic cream or similar that you need to apply, use the cotton swab rather than your fingers.

9. Emergency Blanket

Also known as a first aid blanket, space blanket, Mylar, thermal, foil or weather blanket

What is it? Large, lightweight sheets usually of a shiny aluminium based mylar foil, but sometimes in a synthetic material (polyester or acrylic based) and in an obnoxiously loud colour like bright orange.

What is it for? These lightweight blankets are designed to prevent the further loss of body heat in victims of hypothermia or shock and work by reflecting body heat back to the victim. Can also be placed under a casualty that cannot be moved to prevent heat loss into the cold ground until medical assistance arrives – as long as the patient can move themselves to accommodate it.

How is it used? Wrap the affected person as thoroughly as possible in the blanket, including under them if they are on the ground.

In the case of a casualty that cannot be moved until medical assistance arrives, do not attempt to move them yourselves or further damage could be risked. Ask them to roll or move their own body so the blanket can be placed under them. This prevents their body temperature being lowered by contact with the cold ground.

For more backcountry uses for a foil blanket: Seattle Backpackers Magazine

10. Assorted Plasters

What is it? If I have to tell you what a plaster is then you’re either below the age of 2 or an American (it’s a band aid). Within a first aid kit you will find a variety of different plasters in all manner of shapes to accommodate a variety of different injured body parts.

The plasters in a prepackaged first aid kit might not be hypoallergenic, so if you have reactions to certain types of plasters, best to bring your own just in case.

What is it for? Covering small cuts and injuries to protect and cushion.

How is it used? After cleaning the wound you stick it on. I’m trying not to sound patronising here, but I’m failing. My fault for choosing this format.

11. CPR Barrier Mask

What is it? A barrier device that consists of a flat sheet with a one way valve in the middle.

What is it for? This is to protect both the patient and the first aider from an exchange of body fluids during CPR respirations. It is not essential to performing CPR, but since we’ve just gone through a pandemic we’re all a bit more aware about how infectious we all can be.

How is it used? If CPR is required, place the valve in the mouth of the patient, rolling the sheet out to cover the surrounding area of the face and neck. When the respirations are performed, breathe into the other side of the valve.

How to perform CPR (without a barrier mask): St Johns Ambulance

12. Medical Tape

What is it? A breathable, pressure sensitive adhesive tape. Can be made from porous cloth, foam or paper with a hypoallergenic adhesive.

What is it for? Securing dressings. Medical tape is also designed to be removed easily and not cause further irritation or break clotted wounds.

How is it used? Can be ripped as well as cut into the length required then secure the dressing.

13. Saline

What is it? A sealed vial of 0.9% sodium chloride.

What is it for? To clean or flush wounds. As the pH of saline matches that of the body, it does not sting or hurt. It can also be used as an eye wash if only untreated water is available.

How is it used? Douse a cotton tipped swab with saline to clean a wound before dressing it. To use as an eye wash, lean back and trickle into the inner corner of the open eye. It should then fall over the rest of the eye flushing out the irritant.

14. Medical Scissors

Also known as bandage shears

What is it? A small pair of scissors with a bent blade.

What is it for? To cut gauze, other dressings, bandages and tape to size. It is bent because the angle makes it easier to cut a line through the dressing parallel to the skin.

How is it used? …cut stuff. But only first aid stuff. Don’t use it to shear open your Idahoan potatoes, cut an annoying tag off your pants, trim your toenails, mess around with paracord…and then cut the gauze for an open wound.

15. Safety Pins

What is it? …safety pins? You know? There’s usually a pack of different sizes for different sized dressings and bandages.

What is it for? Securing dressings and slings.

How is it used? When you have finished bandaging the injury or fashioning a sling, the ends of the bandage can be secured with safety pins.

16. Tweezers

What is it? A small pincer-like instrument, usually made of metal or plastic.

What is it for? There are two main uses for tweezers; removing debris like glass from wounds or splinters, and tick removal.

How is it used? Unless the wound is a catastrophic bleed (see tourniquet), if significant pieces of debris can be easily removed without injuring further then do so. Simply use the tweezers to grasp the piece of debris (stone, wood splinter, glass etc.) and gently pull it out.

For tick removal, the tick should be grasped at the embedded head end and gently pulled upwards until the head pops out. The head should not be ripped off and left in.

A video on tick removal: Greenbelly

So that’s all for what’s in the best selling lightweight first aid kit on Amazon, but do you need anything else? Well, that’s really for you to decide – different trips might need different additions. A multiday Knoydart expedition has different potential risks to a paddleboarding weekend or a 24 hour Three Peaks challenge. You might want to bring a pair of sterile gloves rather than rely on washing your hands with camp soap in a first aid situation, you might think a foil blanket is insubstantial for Glencoe in October and go full emergency shelter and bivvy, you might decide that half of the kit is just stuff you already have on your multitool and you can lose 70g.

I would suggest bringing paracetemol and ibuprofen (which almost goes without saying) and make sure that if you are in a group that everyone knows each others medically relevant allergies.

To contact Mountain Rescue call 999, ask for the police, and then ask the police to put you through to the nearest MRT. All remote and backcountry medical services are provided by voluntary Mountain Rescue Teams, even if you’re far away from the mountains, even in the Norfolk Broads. If you have an InReach device, you can also contact them that way.

If you do need the help of a Mountain Rescue Team, it is only polite to make a donation. Having confidence in your first aid abilities and understanding how to use a first aid kit will make their life easier (and, hopefully, the life of a patient). If you lack that sort of confidence, consider a basic first aid course with St Johns Ambulance, who offer many refresher courses free and online. If you want to get specific with your first aid, consider a Wilderness First Aid course.

All in all, make sure you are well prepared and then go off, a little bit more smugly, and have your next fantastic adventure a little bit more secure that if someone gets a splinter, you’re the one that can leap in to action and save the day from that renegade wood shaving. Tweezers at the ready!

References

AIF Education (YouTube channel)

NHS

Physical Sports UK

Seattle Backpackers Magazine

SM Canada (YouTube channel)

St John’s Ambulance

St John’s Ambulance (YouTube channel)

VeryWell Health

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