Good First Aid Info With Gear Recommendations

[DayTrip]

After reading a lot of the recent posts about getting stuck overnight, falls, ice, etc I've decided to take the approach mentioned by someone else in another thread about looking at each hike as a collection of "possible scenarios I'll encounter" and then organizing gear for that scenario and only bringing gear for scenarios I'm likely to encounter as opposed to carrying everthing for everything all the time. Many of these scenarios involve First Aid for specific injuries. I've been going through my current "kit" and rethinking it's adequacy for things I'd actually encounter.

So my question is: can anyone recommend either a website, book, etc with reputable information that would cover injuries, treatment and required gear to treat? Not general info but specifics for specific problems.

I had looked into a certification course in North Conway that sounded awesome but it was pretty expensive, required a 2 day stay and focused a lot on groups because it was a certification course. Unfortunately I don't have the ability to commit to that nor the money. And I hike alone so a lot of the instruction would have to be geared toward what I could do to myself (and yes I realize I can't self-treat everything). For example, the most obvious "scenario" of all in the Whites is probably the sprained/broken ankle. If I had to treat that and walk out on my own (or try) what should I have? Last year I did exactly that and was able to walk out but if it had been worse I don't think the stuff I had was adequate other than duct-taping the crap out of my ankle. Should I carry an air cast? Splints? Etc, etc. Knee injuries I expect are another common issue (twists or hyperextending), blisters, etc.


And for that matter if anyone wants to throw out their "most likely scenarios" for discussion purposes I'm sure that would help get me thinking about the right stuff. I'm not asking anyone to rehash the topics (many have already been covered of late). I'm looking more for the highly experienced hikers of the VFTT to say "well what if you're out on a hike and BLANK happens" and I can research. In another thread (which I unfortunately can't find) someone had a link to 10 most common ways people are injured/killed hiking. I believe unroped falls was number one but I'm not a climber, just a hiker. Looking for the common occurrences that would happen in the Whites in all 4 seasons doing "conventional" hiking on the 48 4k's.

 

[jniehof]

The general rule is to never provide "suggested" first aid kit lists; selecting a kit is part of applying your training. Many wilderness texts will not provide a list just for that reason. A book is absolutely no substitute for a WFA class and if you're spending the time and money to go to the Whites, a course is a worthwhile complementary investment. I honestly didn't feel truly confident until completing a full WFR. Presumably you were looking at SOLO. Check their full list; there are several upcoming in CT. Other options are the Wilderness Medical Society and Wilderness Medical Associates (through whom I did my WFR.)

Disclaimers completed, the best books I've found are Tilton & Hubbell Medicine for the Backcountry: A Practical Guide to Wilderness First Aid (apparently out of print) and Isaac & Johnson Wilderness and Rescue Medicine: A Practical Guide for the Basic and Advanced Practitioner. The latter was my WFR text and also has a complementary scenario workbook, Clausing's Wilderness and Rescue Medicine Workbook, which may give you some ideas for your second question.

Honestly Dan Allen's Don't Die on the Mountain may be a better reference for the untrained.

Incidentally, unroped falls are probably more common among hikers than climbers.

 

[DayTrip]

I think it was the WFA I looked at. That sounds familiar (I couldn't find all the stuff I had printed for it). SOLO is the organization? Thanks. I'll check and see how close to my house they are located.

 

[mirabela]

SOLO and WMI are probably the top two organizations in the US providing Wilderness First Aid (WFA) and Wilderness First Responder (WFR) courses. I cannot recommend this type of training strenously enough. IMHO, it's worth postponing a number of gear purchases and a few extended trips to free up the weekend and the cheese to do a course.

WFR, if the day comes when you can swing it, is an even more serious commitment of time and money, but worth every penny and every minute. You really don't want a field emergency to be the first time you've done the things you'll need to do if it ever happens for real.

Both SOLO and WMI offer their courses at a variety of locations, so you don't necessarily have to travel to Conway. College campuses and other local outdoor organizations often host them. Here in Vermont, for instance, the GMC usually hosts a couple of SOLO courses each year. I'd be surprised if there weren't a few within an hour or so of you over the course of the year.

 

[John H Swanson]

The WFA course is probably the most used emergency training I've done. The course is great and the 16 hour "investment"is well worth the time. After treating 2 broken legs, 2 broken arms and a bunch of environmental issues I'm happy to have the training.

I took my first WFA course at SOLO in NH and it was great but frankly there was too much content to absorb it all. I've gone thru it 6 times as the full course is needed for recert. All the subsequent ones wee not at SOLO. I can say that after 3 or 4 times the info is pretty well in the brain and the course notes are quite annotated with highlights

The course is offered by the AMC locally (NYC area for me). They used to follow the SOLO content but switched to another org with essentially the same content. I know there is one at their Mohican Center soon and I think that one is SOLO

I once read that most hiking emergencies are trips or falls and most injuries are lower leg. I find the 3 mentioned to be the most common other than blisters or cuts.

That said the course focuses so much on improvising the gear you need that I have practiced using other gear in the pack so much that I have now paired down my first aid kit to 130g. My intention is to never consider leaving it out because it is too heavy and this one never fails to make that cut. . It is about the size of 4 decks of cards in a ziplock bag. I do have a larger one that is 2" x 4" x 6" The main addition being a triangular bandage and Spenco elastic bandage.

 

[MadRiver]

I certify my WFR/CPR credentials every two years. What I carry is a personal choice for me. I tend to carry a tad more than most, yet for me I feel confident that I can render aid in most back country situations. Though I no longer carry a potable helicopter or AED, I do believe I can at least keep you warm and comfortable until help arrives.

 

[nartreb]

Do take a WFA course. You can find them in various locations, and sometimes at a discount.

There's everyday "first aid" (blisters and bee stings), and then there's actual emergencies. Most "first aid kits" you find for sale are pretty useless in an emergency. A three-inch bandage? That's great if you encounter a vicious raspberry bush. Part of the WFA course is about improvising your gear. You can do a lot with duct tape, some extra clothing, maybe a stick or a hiking pole. (Carrying an ankle brace isn't crazy (especially if you have loose tendons), but shatter your tibia and you really need a full cast and crutches- neither of which will fit in your pack.) If you take the course in winter, you'll get to experience the importance of being kept warm. Since taking the course I'm much more likely to carry a sleeping bag, tarp, and sleeping pad on a day hike in winter.

So yeah, I'll throw out one common injury: hypothermia. Can be dectected by talking to the people you hike with / meet. To treat, give shelter, clothing, a warm drink, and something sugary to eat (perhaps dissolved in the drink). Gear implications: warm jacket, tarp, thermos of hot water and/or a small stove, packets of a sugary drink mix. Note that the real world is always complicated: got to ensure you don't get cold while tending to the victim; got to choose between getting the stove started and getting to a better shelter; etc. Probably the most valualble part of the course is a systematic approach to emergencies, e.g. step one: is your location safe? (Active avalanche zone = Move first, full exam later!)

 

[DougPaul]

Disclaimers completed, the best books I've found are Tilton & Hubbell Medicine for the Backcountry: A Practical Guide to Wilderness First Aid (apparently out of print) and Isaac & Johnson Wilderness and Rescue Medicine: A Practical Guide for the Basic and Advanced Practitioner. The latter was my WFR text and also has a complementary scenario workbook, Clausing's Wilderness and Rescue Medicine Workbook, which may give you some ideas for your second question.

I'd like to add Medicine for Mountainnering & Other Wilderness Activites edited by James A Wilkerson, now in its sixth edition. It covers both first and second aid. (I started with the first or second edition in the mid 1970's and have purchased every edition since. I used it at home yesterday...)

Doug

 

[mirabela]

Another thought -- there are a number of different pocket-sized wilderness first aid books like this one around. None will substitute for training, but even with training it is well worth including one of these five-ounce books in your kit. One of the things WFA or WFR will help you to understand is that pretty much the only situations that require you to do anything in a hurry are those that involve a compromised airway, problems breathing, a cardiac event or a patient losing a lot of blood, the manifest or suspected need to stabilize a head, spinal, pelvic, or femoral injury, or exposure to dangerous environmental conditions (ranging from the cold ground to an avalanche path). In basically all other cases, you've got the time to get out a snack, consult your book to make sure you understand what to do, and make a good plan with your group before doing anything. That's exactly what happened when I came on the scene where a hiker had dislocated a shoulder on the LT a few years ago.

Like Mad River, I recertify my WFR every third year, and I did the whole course over after three recert cycles. These courses are totally worthwhile experiences in their own right, one makes lots of good outdoor-friend connections by doing them, and they develop one's capacity to think dynamically and in situationally responsive ways about what's appropriate to carry on any given trip, about how to manage risk and prevent injuries and illnesses while in the field, and about how to manage any emergencies that do arise.

 

[DayTrip]

I certainly agree that the course sounds fantastic. Just don't have the ability to set aside two consecutive days right now and pay the money. It is definitely on my "gear" list for things I'd like to do this year. But in the interim I'd like to find a good workable solution to address what I can. The books mentioned sound like a good starting point and I have an Amazon gift card from the holidays so I'll probably start there. Thanks.

 

[mirabela]

Understood. Another decent resource for a starter generic first-aid kit contents list is the ADK Winter Mountaineering School's course handbook. See page 32. This doesn't explain what to do with any of the stuff, just a list of contents for a kit. Enjoy.

 

[DayTrip]

Thanks for that link mirabela. Looks like a lot of info.

 

[J.Dub]

One of the things WFA or WFR will help you to understand is that pretty much the only situations that require you to do anything in a hurry are those that involve a compromised airway, problems breathing, a cardiac event or a patient losing a lot of blood, the manifest or suspected need to stabilize a head, spinal, pelvic, or femoral injury, or exposure to dangerous environmental conditions (ranging from the cold ground to an avalanche path). In basically all other cases, you've got the time to get out a snack, consult your book to make sure you understand what to do, and make a good plan with your group before doing anything.

^^^This.


Sorry to be a little late to the party here, but I thought mirabela's comment above was worth highlighting. I concur with the other comments that it's less about what you carry in your FAK and more about knowing how to improvise (which a WFA/WFR class will help teach you; a wilderness medicine book, maybe not so much?).

Strongly encourage you to take a WFA or WFR course. I'm a fan of SOLO -- where I got my WEMT -- but I'm sure WMI and WMA also do a fine job. Based on where you are in CT, you could probably find a SOLO class in CT or MA without too much trouble. One additional suggestion would be to practice the wilderness first aid skills several times per year, to keep yourself fresh. If it's been two years since your WFA class, will you remember how to splint a forearm fracture with a trekking pole and a bandana? Every once and a while it's a good idea to get your hiking mates together and just do a short day-hike, with several practice emergency stops along the way.

 

[sardog1]

One of the reasons I hike solo is that not enough people have at least taken a WFA course. Watching someone fumble while I lay bleeding and/or concussed, trending toward shocky, would probably put me right over the edge. Rather go quietly alone than cursing …

I cannot emphasize too strongly the merits of at least doing WFA. The improvisation aspect is important, but even more important is having some close-to-real practice. You ain't never gonna get that from no book larnin'.

WFR is overkill for most people who aren't leading trips or otherwise need the certification, IMO. I'm not denigrating the merits of the course content; it's the time commitment and expense that I'm talking about.

 

[JCarter]

On the time factor - I have to give up 1 weekend of hiking every 2 years for SOLO WFA training. (That's 1 out of 104 weekends, less than 1%). I think that's well worth it. Ok, so really don't go out all of the other 103 weekends, but you get the point.

My last cycle I took the class through UMass Lowell (they certify their outing club trip leaders), so I didn't even have to travel. I'm sure there are similar things close to where you live, though you may have to poke around local colleges, AMC chapters, or Boy Scout Councils to find a class, since not all of them get listed through SOLO's website.

 

[erugs]

One of the biggest wastes of space and money and weight was when I bought and carried a SAM splint about a dozen years ago. Upon realizing that, I bought and carried a small wire mesh "splint" I found at REI. I don't carry that with me any more, either. Ace Bandage, Duct Tape, Pain Killers, Mole Skin. For day trips, I don't even worry that much about super-cleaning a wound. Enough clothing, lighting, food, and water are more important. Food isn't that important for survival but it does help the emotional side of the day hike.

I'm sure that there could be times when I might wish I hadn't kept things so simple, but as the old expression goes, "If wishes were horses." You can't bring everything, so bring enough to feel comfortable. The best way to feel comfortable? Take a SOLO WFA course. Or do book learning and practice.

A few well-studied knots go a long way everywhere.

 

[JCarter]

Funny you should mention a SAM splint. I nearly always have a 36" flatfold tucked into what's probably supposed to be a hydration reservoir slot in my pack. At only 4 oz, it's less than half the weight of my InReach satelite beacon, but you're right, it might be a wasted 4 oz. In my teenage years, my standard FAK had a wire mesh splint, but I haven't seen one in 30 years, but it would need padding to be used.

Realistically though, neither would be likely to convert a non-mobile patient to a self-mobile patient, except possibly with a very small subset of foot/ankle injuries. Let's face it, a broken finger/arm doesn't stop you from walking, but a broken leg will, regardless of splint. If something "really bad" happens, your goals are (1) stay alive and (2) evac (i.e. get to definitive care). So, things to keep warm (foam pad, bivy sack, food, etc) are more important than fancy splints and bandages.

And cleanliness is highly overrated, if your goal is to get to a hospital in 24 to 48 hours.

 

[Scubahhh]

Wilderness First Responder by Buck Tilton is another good source... Surprised nobody's mentioned it. $24 @Amazon/$15 Kindle (that way you can carry it with you everywhere).

 

[SherpaWill]

I took the WFA course through SOLO in '93 at the old Crawford Notch Hostel. It was a great weekend. Bill Kane and Bill Aughton were both excellent instructors.

 

[DayTrip]

Wilderness First Responder by Buck Tilton is another good source... Surprised nobody's mentioned it. $24 @Amazon/$15 Kindle (that way you can carry it with you everywhere).

I wound up getting a WFR book on Amazon. I believe it was this one. I really like the organization of the book and the content so far (I've read about 7 chapters). Probably has more info than I need but it seems like a pretty good starting point until I can attend an actual class.

And to the others who posted about not carrying all kinds of FAK stuff that is exactly why I asked the question. From what I can see most of the stuff in my current FAK would probably never get used and is just dead weight. I'm not looking to strap a medicine cabinet to my back with defibrillators and IV's and all kinds of crazy nonsense. I was just looking for those "must have" items in relation to me as a solo hiker that could make the difference between getting out of the woods and getting into serious trouble. The day I wrecked my ankle several people who were wondering why I was staggering along and mentioned they had "air casts" so I got to thinking maybe that was the kind of item I should be carrying if so many others had it (but then again I walked out of the woods with nothing so maybe I don't).

I think the WFR book I bought will help scale the FAK kit back to essentials and give me a good frame of reference for what I'm likely to encounter solo and what I'd be able to treat solo (breaks and sprains, bad cuts, etc).