By definition, first aid is the provision of initial care given to an injured person, until more advanced medical care is available. For the unprepared backpacker, the onset of an unplanned injury can be a daunting- and even dangerous- experience. Injuries in the wilderness that are not treated with proper first aid techniques can quickly worsen and become more perilous if conditions deteriorate and with the passage of  time.

Time. A key principal of effective injury mitigation. Shawn Ritchey, EMT, Founder of Dynamic Perspectives in Safety and President of Shawn Ritchey Safety Training, teaches his clients to "buy time" with simple and effective first aid techniques.

"I wouldn't rely on a pre-packaged first aid kit. A good first aid kit should simply have the contents you need for type of trip you are planning," said Ritchey. He continued, "Our goal is to buy time for anyone that becomes ill or injured. I believe the best way to do that in wilderness settings is to address: Exposure, Hydration, Fear."

Given the need to control the factors, Ritchey has an unofficial "Top 5" must-have backpack essentials and 2 additional items you undoubtedly haven't considered.

The 5 Essentials

1. Emergency Blanket or Bivouac Sack: Under-rated and too often left behind, the emergency blanket is a life-saver. Today's blankets and bivvy's are light-weight and easy to pack. At 3.5 oz. the AMK Emergency Bivvy Sack is shaped differently than an emergency blanket, adding to its versatility. The bivvy can be used as a heat reflector to warm a shelter, as a sleeping bag cover, and to reduce heat loss in a person's body due to thermal radiation and convection. Most lightweight emergency blankets can also be used for emergency eyewear simply by cutting a strip off the bottom and covering the eyes. 

2. Hand warmers/heat packs: Very beneficial for addressing the onset of hypothermia or to assist in drawing out topical infections. HeatMax Hot Hands, at just 2 1/4" x 4", are suitable for use on the feet, hands, armpits, neck and groin. The company claims the packs stay heated up to 10 hours.

3. Medications: When you are hours or days from care, having the right medication could be life-saving and will certainly buy time. Always make sure to carry any prescription medication you are supposed to take. Tell someone in your party what dose you take, in case you become impaired and unable to fend for yourself. According to Ritchey, aspirin can be an anti-inflammatory, pain-reliever and can address cardiac concerns. Primatene Mist can be helpful for severe allergic reactions because it is a lower dose of epinephrine. (But this is NOT intended to take the place of an epi-pen)

4. Triangle Bandages: Very versatile and light-weight. Standard muslin can be used for tying off items, splinting, filtering as well as general dressings in place of packing gauze. Tyvek bandages can be used for tying off, splinting, filtering, as well covering for hypothermia and even as a non-sterile burn sheet. Coban, while not a triangle bandage, is a very versatile catch-all bandage. 3M makes a Coban bandage that is self-adherent and latex-free. It is ideal for compression, immobilization, and securing dressings, splints and other devices to patients. To keep it out of your pack, you can use the duct-tape trick; pre-wrap it around your walking stick and tear off what you need, when you need it.

5. Unprocessed honey: A great source of energy (i.e. for Diabetes, hypothermia, etc), but has also been shown to reduce wound infections as well as promote healing.

The Two Essentials You Haven't Considered

1. 30 cc syringe with O2 tubing: Expert sources declare that the only real way to prevent infection of a wound is to clean the wound. The 30 cc syringe is adequately sized to create enough pressure for doing just that. In the wilderness, you can also use it along with the tubing for siphoning water out of hard-to-reach crags when water is in short supply. Hydration is a real concern in warm or cold climates.

2. Mad Libs: Do not underestimate the importance of "comfort-care" and laughter, when trying to buy time. Cody Lundin in his book, 98.6 Degrees, states, "Your psychology creates your physiology." Laughter can be a great way to help address fear in someone. Simple games can help distract an injured person from the pain they are in for short periods of time. Addressing one's fear, attitude or outlook can positively influence an otherwise uncomfortable situation.

More Information
Shawn Ritchey Safety Training, click here
AMK Emergency Bivouac Sack, click here
HeatMax Hot Hands, click here

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