The Basic Survival First Aid Kit
by Jane-Alexandra Krehbiel BS ES RN

There are a variety of commercially available first aid kits for those planning expeditions or sailing trips, but most people really require something basic yet substantial.   The first most important point is that although a good first aid kit has a core of certain articles, that mine may differ considerably from yours simply because I may have more family members and because my family may include younger children, or the elderly, and there may be those with some special needs which might dictate stocking additional items.  Also, the very best first aid kit is often the kit you assemble yourself.  A first aid kit may not be terribly expensive to assemble, but if it’s assembled quickly you are likely to spend more than if you gathered essential articles more slowly.  It is my belief that those interested in preparedness should first assemble a basic kit, and then add refinements and additional materials over time.   Many of the items I mention here, especially the medications, can be picked up inexpensively and as generics at Wal-Mart.  In addition, since Wal-Mart’s turnover is often great, they often have an expiration date that is farthest in the future.    CPR certification at your earliest convenience is an excellent idea, and anyone in your family 13 or over should also be certified.

Store your basic kit as you wish.  Some people with children amass all of this in a closet, in order to locate everything quickly. This works, but if you do this, then you are stuck throwing everything into a canvas styled gymn bag if you ever need to evacuate.  Some use rigid plastic tool kits, or even orange luggage with multiple compartments.  Your means, your desires, and your lifestyle all dictate what works best for you.  One friend of mine uses a camo print multiple compartment backpack he bought from E-bay.   You could also assemble a home kit, and an abbreviated evacuation medical kit if you wish.

Basic Supplies:   Wound

Sterile 4×4 gauze, one large package for each family member
Sterile 2×2 gauze, one package for each family member   (Can be used as eye pads too)
Clean 4×4 gauze, one package for each family member
Clean 2×2 gauze, one package for each family member.
A triangular bandage for each family member. (or make this yourself by ironing and cutting muslin and packaging in small freezer bags. These are not generally sterile)
Large safety pins also
Roller gauze. (6-8 in a variety of sizes to secure dressings)
Some chemical ice packs
A variety of band-aid styled dressings, I prefer the cloth variety
Butterfly bandages
Elastic bandages (both small and large)
Spray bottle of normal saline  (marketed as nasal saline) as gentle eye rinse.
Three types of wound tape, paper, micropore, plaster (for multiple uses)
Sterile cotton swabs (about 200)
Several packages of a variety of protective medical masks.

(Sterile gauze should be placed in contact with a wound whereas the clean can be used as padding over it.  Remember that although this may sound like a lot of gauze, that one serious wound will consume your supplies within just a few days.)

Neosporin cream, several tubes
Hydrogen peroxide 2 bottles
Isopropyl alcohol 2 bottles
Povidone iodine in bottles, 2 bottles
Diphendydramine (Benadryl or generic) topical liquid for insect bites etc.
needle nosed or fine splinter forceps (tweezers)
Hemostat
Dollar store reading glasses as magnifiers if you’re over 40, to remove splinters
Glass thermometer in protective casing, both rectal and oral varieties
Paramedic shears or blunt scissors.
Vinyl medical gloves (1-2 boxes)  I skip Latex entirely due to allergies to latex in so many patients.
Plain, inexpensive and deodorant free sanitary napkins. (Multiple uses, padding in splints etc.)
Wire splint
Rubber tourniquet     (last two items available from www.first-aid-product.com)

General Meds

For each item I mention here, you should have a source of this med for each family member.  What I mean by this is that if you have infants and children, then you must stock Tylenol (acetaminophen) for EACH AGE GROUP. Drops for infants, chewables for children, and tablets for adults.  The one exception is aspirin, which should not be given to children below 18 without a physician’s order, because in the presence of a viral syndrome, it is implicated in causing Reye’s Syndrome.

Acetaminophen  (tylenol)
Aspirin
Imodium AD
Pepto Bismol
Diphendydramine (Benadryl)
Iosat for all family members   (www.nukepills.com   ) Complete info on site
Omeprazole (decreases stomach acid in periods of stress. Mostly for adults)
Claritin dissolving tabs  (Loratadine)  allergies
Ibuprofen (Advil etc.)  Not for those with bleeding disorders, use
liquid in children in accordance with pediatrician’s directions.
10  Ipecac bottle  (to induce vomiting following certain poisonings)

Always keep 30 days worth of prescription meds you use on an ongoing basis, in your home.

REHYDRATION

I have mentioned stocking gatorade for adults and pedialyte for children. Assembling your own rehydration supplies, and gatorade kit will be covered in future.

Items you should add if you have those with these particular special needs:

Diabetes:
Prescription glucagon injection
Ketodiastix
Insulin syringes and your injectable insulin(s)
Source of sugar or juice to treat hypoglycemia
A spare glucometer with extra battery, strips, lancets and supplies.
Insulin pump supplies, and pump batteries and peripherals (if you use a pump)

Allergic Emergencies   (anaphylaxis):
Speak with your physician about the possibility that you or a family member should should carry an epipen.

Asthma:
Prescription inhaler
Nebulizer        (Get an inverter to operate or buy a battery operated model)
Meds (Rx) and normal saline for nebulizer treatments

Ostomy:
Spare supplies of everything you use including hand wipes
and small plastic bags for trash.  Pack these as small as you can in advance.

Children

Dehydration can kill young children in as little as a day.  Although adults can use gatorade or a homemade rehydration solution, ideally need a supply of pedialyte or similar product to avoid dehydration during vomiting or diarrheal illness.  I will discuss formulating an acceptable rehydration solution with supplies at home in an upcoming article.

Nice to have as you build your Kit

Sphygmomanometer  ( Manual Blood Pressure cuff with stethoscope)
Otoscope        (Small plastic for ear exams, inexpensive at Wahlgreens)
Exergen Temporal Thermometer   (Can determine temp without waking child)
Snake bite kit (With extractor….I prefer the Sawyer;s Extractor snake bite kit)
Finger and extremity splints      Keep this simple.

One suggestion is    www.first-aid-product.com

I have not included suture supplies in a basic first aid kit quite deliberately.  Unless you have specialized training, and access to antibiotics then most physicians and nurses would prefer that a wound be allowed to heal through second intention (from the bottom up) rather than by being sutured.

With medical training and in the future

AED  (The variety for office or home, available completely automated and for about  $1200.)
These are automated to the point that they will not fire and defibrillate unless they
detect a rhythm that they can correct. This is not the Lifepak version hospitals use for codes in Emergency Rooms, ICUs, and floors.

Precipitous delivery pack       
An inexpensive sterile package of supplies for unexpected infant delivery. About $30, and if you ever need one, priceless.

Skin stapler/remover       
With specific training only

Dermabond pens       
http://www.best-price.com/search/landing/query/dermabond/s/yahoo/
Again, with the same cautions that I provided earlier.  Many wounds, especially if unclean, should not be sutured or closed because they need to remain open in order to drain infectious material which may develop in the next few days. Closing such a wound could result in sepsis.  There are a few circumstances where a clean wound, or facial wound may be a candidate foir dermabond closure.

Frozen sponges.       
I keep a variety of new, clean sponges and handiwipes, wet and frozen in
freezer bags in the freezer. Cover them with a washcloth and you have an instant
ice pack which is not only well tolerated, but over time as it melts is form fitting.

Duct tape               
I keep this in my kit in order to remove cactus splinters and small splinters which
may be hard to see. Apply to area, allow to stick, and gently remove. Many times
the cactus needle will be out.

Large sterile syringes (without needles)    
Useful for wound irrigation under slight pressure.
Available at almost any medical supply house.

Ambu bags           
Adult and pediatric.   These can be purchased from some of the sources
I have listed in this article.  It can be useful when doing CPR to have a bag
in order to pump, rather than to be breathing into someone’s mouth.

About antibiotics:  
If you are a family with a child with cystic fibrosis, then you likely have emergency antibiotics on hand. Most of us do not, and probably should not.  There are a huge variety of antibiotics available and they have specific uses.  One prescribed for a lung infection may well be useless or even harmful for what is known as a “skin appendage infection”.    Again, develop a good working relationship with a physician who understands and respects the need for patient preparedness, and those of you who really do require some antibiotics in the house for emergencies, will have them prescribed.

Disclaimer:   This is not designed to be a substitute for medical care or consultation with your own health care provider. The best patient is an informed patient and one who has certain basic supplies available.  Readers are encouraged to ask their own physician what supplies they should add to their family kit for their own special needs.  This kit is intended to be a starter/novice kit and should evolve as the skills, interest, and knowledge of the owner do.