[MikeOReilly]

First Aid Kits - Survival & Prepardeness

Thanks for this Gary. I'd love to get your thoughts on pre-package kits like this one:

Marine 3000 - Marine - Medical Kits - Adventure® Medical Kits - First Aid Kits and Survival Gear

It seems really expensive, but for us non-medical types, is it at all worth it?

 

[travlin-easy]

Mike, kits such as these are often very overpriced, and the contents can be procured individually at a fraction of the cost. The biggest problem with any of these prepackaged kits is they have a lot of things that will never be used, especially if the user does not have a medical background and a high level of training. Not many folks will be placing a splint on a broken limb, especially if it's a compound fracture. And, you can make a reasonable splint from a couple battens and some ace bandage for a simple fracture.

One of the best kits I've come across is a WWII battlefield kit, which is housed in a 50-caliber ammo box. I picked it up at an army surplus store for $25.

Good Luck,

Gary

 

[MastUndSchotbruch]

Mike, kits such as these are often very overpriced, and the contents can be procured individually at a fraction of the cost. The biggest problem with any of these prepackaged kits is they have a lot of things that will never be used, especially if the user does not have a medical background and a high level of training. Not many folks will be placing a splint on a broken limb, especially if it's a compound fracture. And, you can make a reasonable splint from a couple battens and some ace bandage for a simple fracture.

One of the best kits I've come across is a WWII battlefield kit, which is housed in a 50-caliber ammo box. I picked it up at an army surplus store for $25.

Good Luck,

Gary

Did you notice the expiration date 1/1/1948 :laugher

 

[hellosailor]

Mike-
As Gary said, you can usually order up the items for a kit, for much less than a pre-packed one. That $800 kit is nicely organized, and for some reason trying to organize things in a DIY kit is always impossible. You need to get a slew of packing cubes or vinyl pouches and then keep fiddling around until you can get things organized, labeled, and stowed. But usually that will cut the price in half.
There's also a lot of stuff in there that you or I would never use, which would only be of use if you asked "Is there a doctor in the house?!" and someone stepped forward.
One of the things that is taught in every first aid training is that you should never exceed your training. Use what you know how to use, resist any temptation to go beyond that. So the stuff most of us are not trained for (needles, IVs, breathing tubes) might as well not be packed, unless you're planning to have it for that doctor who just happens to be passing by without his bag.

How much is it worth to have a pre-packed nicely organized bag, from a quality supplier? In some cases, easily worth what they charge. In others...look at it this way, the same money and some time & effort will buy you one for the boat, one for the house, and one for the car.

 

[travlin-easy]

Did you notice the expiration date 1/1/1948 :laugher

Most items in a first aid kit never expire - but the owners do. Keep in mind that an unused kit, one that has never been opened, is completely sealed from outside air by a tight fitting gasket around the rim. It would be quite difficult to contaminate the contents under these circumstances.

As for organizing the items, this depends upon your organizational skills. Some folks know where every item in their boat is located, and some even have a chart of item locations. First aid kits are pretty easy to organize, and if you set it up correctly, a great kit can be put together for under $500 and the includes the cost of the air tight Pelican case. Or you can pay some outfit to sell you a cheap, compartmentalized plastic box, one that is anything but weather proof, with a bunch of gauze bandages and Band-Aids of various sizes, a couple rolls of tape, a bunch of aspirin in tiny packets of two tablets each, some first aid creams, and a very generic first aid instruction pamphlet. My brother purchased a WM first aid kit like that for about $75 several years ago. It was a piece of junk.

Good luck,

Gary

 

[Zanshin]

My current emergency kit is housed in a large airtight and watertight Peli case. Almost all of items were also packaged sterile (including forceps and other steel tools). Despite that storage and keeping the pack underneath the waterline, the contents have deteriorated in tropical conditions and that is why I'm now replenishing with fresh stuff. The surgical gloves have congealed to a solid mass, the paper packaging that started to crumble; I put all of the medical supply paperwork for the medicines and the user manuals in a sealed baggie which has kept that stuff in good condition.

I have eyed the Marine 3000 pack several times, more for the organization that has gone into separating the components into compartmentalized sections than for the rest of the contents. It has a lot of items that one might need but for my tastes it has too much of many items.

Although many of the things in there are unlikely to be used (what are the odds of needing Güdel tubes?) one should keep in mind that with modern communications one can have a doctor on the phone or SSB after an incident and he/she can guide you in using what items are on hand. I signed up for a British medical service last time around and they get a complete list of tools and medicines so that, in an emergency, they know what resources are available to them. There are similar services in the USA and in the EU using the GMDSS system will also get you an emergency doctor on the blower.

I think if I hadn't already had a kit aboard I would have purchased the Marine 3000. I have gotten differently colored vinyl bags and am separating the first-aid components into the bags so that for a typical injury only one of them is needed.

What I learned on my last refresher course had me add a blood-sugar testing kit, a pulse/oximeter and urine strips to my kit; I'd not thought about those before and they are so dirt-cheap that it is a no-brainer to add them to the kit. The oximeter should be one with both visual and aural signals so that one doesn't need to look at it while it beeps out the pulse.

 

[MedSailor]

Most items in a first aid kit never expire - but the owners do.

:laugher Hehe. Good one Gary.

As for organizing the items, this depends upon your organizational skills. Some folks know where every item in their boat is located, and some even have a chart of item locations. First aid kits are pretty easy to organize, and if you set it up correctly, a great kit can be put together for under $500 and the includes the cost of the air tight Pelican case. ...

Good luck,

Gary

For organizing a home grown kit, I like soft sided tackle boxes. A small pelican case for the meds is a good option to add.

Bass Pro Shops® XPS® Stalker? Backpack Tackle Bag or System | Bass Pro Shops

 

[MedSailor]

My current emergency kit is housed in a large airtight and watertight Peli case. Almost all of items were also packaged sterile (including forceps and other steel tools). Despite that storage and keeping the pack underneath the waterline, the contents have deteriorated in tropical conditions and that is why I'm now replenishing with fresh stuff. The surgical gloves have congealed to a solid mass, the paper packaging that started to crumble; I put all of the medical supply paperwork for the medicines and the user manuals in a sealed baggie which has kept that stuff in good condition.

I have eyed the Marine 3000 pack several times, more for the organization that has gone into separating the components into compartmentalized sections than for the rest of the contents. It has a lot of items that one might need but for my tastes it has too much of many items.

Although many of the things in there are unlikely to be used (what are the odds of needing Güdel tubes?) one should keep in mind that with modern communications one can have a doctor on the phone or SSB after an incident and he/she can guide you in using what items are on hand. I signed up for a British medical service last time around and they get a complete list of tools and medicines so that, in an emergency, they know what resources are available to them. There are similar services in the USA and in the EU using the GMDSS system will also get you an emergency doctor on the blower.

I think if I hadn't already had a kit aboard I would have purchased the Marine 3000. I have gotten differently colored vinyl bags and am separating the first-aid components into the bags so that for a typical injury only one of them is needed.

What I learned on my last refresher course had me add a blood-sugar testing kit, a pulse/oximeter and urine strips to my kit; I'd not thought about those before and they are so dirt-cheap that it is a no-brainer to add them to the kit. The oximeter should be one with both visual and aural signals so that one doesn't need to look at it while it beeps out the pulse.

I took a look at the Marine 3000 kit contents. I have to admit it's really good. I'd endorse it. Even the guidel? tubes (nasal airways) are something that you aren't likely to need, but don't take up much space and in the unconscious concussion patient could come in handy.

A question though, if your kit deteriorated so quickly in a pelican case, won't this one, in a soft sided bag deteriorate even more quickly? I wonder what the solution is to the tropical problem? A pelican case with desiccant packs?

MedSailor

 

[Zanshin]

I opened up my peli case quite often - since I kept oft used bandages and other junk in there as well; so it must have been the moist air that I let in that triggered the problems. I also kept saline and hydrogen peroxide in the same container and that, too, might have made things worse. I'll now keep tools and dry supplies separated from medications and from liquids. Also, my Peli case is not full and perhaps friction from moving about also played a role. The commercially available packs are packed tight but I don't expect the consumables to last more than two or perhaps three years before they need replacing. The first-aid bag I got here is a commercial first-aid item made of thick solid Cordura and although it is water-resistant it is certainly not waterproof. In addition to the modules I have gotten a number of re-sealable plastic containers that are air- and watertight and am going to try to use them gainfully.

In stocking the meds last time I was surprised at the short shelf life of most of them, so I'm holding off as long as possible before purchasing them. While I've known that antibiotics have a short lifespan, I expected that other items would be labeled with a couple of years - i.e. Epipens are about 1 year, and even burn crèmes were only about 2 years. I can now understand why the Docs teaching the course made such a big deal about the commercial first aid kits and their resupply, and how they would need to keep careful track of expiry dates and ports where they could stock up on expired items.

Of course I fervently hope that none of these items will ever see use! Hope for the best and prepare for the worst...

Addendum: I remember taking a picture of the bag holding the surgical gloves which was in the Peli case, here it is:

 

[travlin-easy]

Zanshin, I have three-year-old surgical gloves in my kit that look and feel as good as the day they were packaged. Looking at that photo you posted, I believe that what you are observing is a typical reaction of latex and another forum of plastic have when they come in contact with each other. Surgical gloves are usually packaged in sterile paper containers so this does not happen. When latex turns to goo, it's quite similar to what happens when plastic fishing worms are placed in certain plastic tackle boxes, which anyone that has fished for a few years knows exactly what I'm describing.

I have a large Pelican case, one that originally housed three 33mm cameras, lenses and several rolls of film. That case has a vent in the bottom for when the case is placed on an airplane so it will not explode when transported at high altitudes. If that vent is open, then moisture can enter the case.

Also, I have a desiccant, moisture absorbing package in the case, one that does a great job of eliminating any form of moisture, humid, salt air, wide temperature swing induced condensation. That pack gets changed about every three months - just to be on the safe side. I also have desiccant packs in all my pill containers for the very same reason. You can purchase the desiccant crystals at numerous locations and they're not expensive.

One of the items that came with my WWII kit was an endo-tracheal tube, an item that I know how to use quite well, and invaluable in battlefield conditions. I've never seen one in any first aid kit other than military kits, but if someone has a severe allergic reaction to something, it is a go-to item that can often make the difference between live and death. I also have a trocar tracheotomy set in the kit, which I hope I never have to use, but I have the training to use it if necessary.

The biggest hurdle to overcome with medical treatment is if you are sailing single handed. It's very difficult to treat yourself when you have been severely injured. I fell through the hatch of my old 27 Catalina one afternoon and broke two ribs. The pain was excruciating, and despite the fact that my wife was with me, she had absolutely no sailing experience at that time whatsoever. I had to bring the boat back to the marina, tie it up, get off the boat, and she drove me to the nearest ER where the ER doc said "well, they didn't punch through your lungs, they're broken, but now you have to take a couple months off from work and allow them to hear. Oh, try not to cough." He game me some pain pills and my wife drove me home. Had I broken a leg or arm, the situation would have been far more difficult to handle by myself.

Sorry for the rant,

Gary

 

[rockDAWG]

I just ordered most of my stuff from the Pharmacy through the hospital. I always get the wholesale contract price (dirt cheap). If the drug is non formulary, I will order through the retail pharmacy. I have handful colleagues who own retail store.

The nice thing is that when the drug expired, I send them back to them and get the fresh supplies. ....hahaha.

 

[hellosailor]

Maybe some of you folks can clear something up for me. For a large skin tear or abrasion, traditionally you cleaned it and covered it, let it scab over and heal "dry".
More recently, sprinkling some quikclot or similar to scab it and seal it quickly.
But now I'm seeing that type of large skin wound treated by covering with a hydrophillic (vaseline-ish) dressing like Dermagran-B instead to heal 'moist'.
What's better for what criteria?

 

[travlin-easy]

Maybe some of you folks can clear something up for me. For a large skin tear or abrasion, traditionally you cleaned it and covered it, let it scab over and heal "dry".
More recently, sprinkling some quikclot or similar to scab it and seal it quickly.
But now I'm seeing that type of large skin wound treated by covering with a hydrophillic (vaseline-ish) dressing like Dermagran-B instead to heal 'moist'.
What's better for what criteria?

For abrasions, the best remedy, and the safest, is to thoroughly clean the wound, then cover it with an antibiotic salve such as Bacitracin Ointment, which is then covered with a gauze bandage. The bandage should be changed every day and the wound recoated until it heals properly. This not only helps prevent infection, but additionally will help prevent scaring.

For tears or deeper cuts in the skin, sutures may be required, but unless you have someone aboard that knows how to do this, and have some topical anesthetics, this is usually not an option. Under these circumstances, after cleaning the wound thoroughly and stopping the blooding, a series of butterfly bandages covered with a pressure dressing usually will do the job. Again, an antibiotic ointment should be applied to prevent infection and the bandage should be changed daily.

Hope this helps,

Gary

 

[hellosailor]

Thanks, Gary. The ointment dressings are something I had only heard of recently (year ago?) for this purpose. Like so many things (CPR with vs without breathing) there's always something new being suggested, or not.

I draw the line at stitches, unless I really have to do so. Apparently now they are also being "unsuggested" in favor of butterflies whenever possible, due to the butterflies needing much less work, less pain for patient, no problems with the buried part of stitch infecting, no extra trip for removal, etc. I've also compromised there and added medical crazy glue to the kits, again just in case, not for casual use. Apparently crazy glue works, and "real" surgical glue is now sold for veterinary use because it wasn't as flexible as the "new and improved" grade of surgical glue, which of course doubles the price again. I compromised on the veterinary stuff.(G)

 

[travlin-easy]

Many years ago, when I worked in Surgical Research, we experimented with Crazy Glue, which back then was called Eastman 910, made by Eastman Kodak.

Every year, people died from liver lacerations in car wrecks, mainly because there was no way to stop the bleeding. It is impossible to successfully suture a person's lacerated liver, and you cannot live without one.

The Eastman 910 (crazy glue) solved this problem. We placed a small vial of glue in a Crossman pellet pistol, one that was fired by a C02 cartridge, blotted the lacerated liver with a surgical gauze sponge, and fired the glue at the laceration. The glue came out in a fine vapor that totally covered the liver, bubbled for a few seconds, then completely sealed everything. No more bleeding. We then glued the laceration back together with the 910, and after several months, circulation had been restored in the laceration area, which was amazing.

Crazy glue is currently in use for small lacerations, particularly on the fingertips, where healing can be somewhat difficult because of constant use of the hands and difficulty in preventing pressure or contact with the would surfaces. I've also seen it used in place of sutures in skin lacerations, and it seemed to do a great job. Minimal scaring and no possibility of suture infections, which are quite common.

I have it onboard for other reasons, but in a pinch, it may be a good addition to a first aid kit as well. However, I would also have some crazy glue solvent onboard, too - just in case you happen to touch your fingers together while applying it to a wound.

Good Luck,

Gary

 

[hellosailor]

Crazy glue solvent? AKA Acetone, in case someone needs a fast nail job.(G)

The generic stuff will still do better than nothing, but the veterinary & surgical grades are supposed to cause less stinging, and form a more durable bond/seal. If you figure the bottle should last 3-5 years unopened, not so expensive to add one in. Some are packed with single-use tippets for the bottle as well, so you get a fine control then throw it out instead of worrying about the tip clogging. New tip for the next application.

Funny thing about plain crazy glue though. I put some on a shoelace where the aiglet had come off? Figured if I soaked it and let it harden, that would work. Nope, the plain cotton (I think) shoelace actually started smoking and would have caught on fire. "Glue" usually doesn't do that, does it?

 

[travlin-easy]

I know when we sprayed it on a lacerated liver, it got extremely hot for a few seconds before hardening. We were told by Kodak it was because we used it in a vapor form, which triggered an unusual reaction.

Gary