BushwalkBushwalk
Having a good practical working knowledge of first aid, its principles and rationale is really the most important part of any first aid kit.
First Aid KitWhat to Carry and How to Carry it
Matt McClelland
42 | BWA June 2020
First aid is all about prevention and assisting sick or injured people until they recover of until full medical management is available. As first aiders our role is primarily to prevent other people (including ourselves) from getting injured or sick. First aid is mostly about experience and knowledge, not gear.
The third unconscious person I came across was on his front, and the fourth was in a seat. In first aid training and books, the casualty was always lying on their back, and it was embarrassing how confusing that was for me at the time. People never injure themselves as the book or instructor says, so do not learn just what to do, understand the principles and why we do it. Understanding “why” means that we can improvise and deal with unusual situations and prioritise them. When I was studying to become a first aid instructor I read The rationale of first aid by St John Ambulance Australia it was a great leap forward for me.
If you have a good understanding of first aid principles, and you have a calm head then it is much easier to improvise and take care of the situation - even with no first aid kit. A first aid kit is simply a tool that helps us step up the level of care a few notches. This stepping up is often very worthwhile, for example, being able to reduce the risk of infection or use medication to help serious medical conditions, but the kit alone does nothing.
Mental health first aidIt is not just blood and broken bones. Before we get into the first aid kit, please allow me a small soapbox. First aid courses basically never cover mental health first aid. This is a real issue and I hope that this area of training will become more common in the future. There are two core streams here, firstly helping people following an emergency, Psychological First Aid (similar to crisis counselling), and Psychosis First Aid that helps people experiencing the onset or increase of mental health issues. This kind of first aid maybe less ‘sexy’ than dealing with blood or broken bones, but done well it can have an enormous positive impact on the person's life and the outcome of your bushwalk.
The best training I have done in this space is in Solution Focused Therapy. There is no scope here to go into detail, but worth looking into options if this is an area of interest.
Why do we even need a first aid kit?Now don’t get me wrong here, it is not all about knowledge and experience, and I encourage you to carry a first aid kit. There are some situations where some simple items can save people's lives, like an allergy or a heart attack. Other items buy you a lot more time for help to arrive, like bleeding or snake
Two first aid kits make it easy to pack and find what you need. One is for common minor issues, and one is for rare emergencies.
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bite. Some items just allow you continue your adventure, such as treating blisters, small cuts or light burns.
There are a bunch of factors such as terrain, length of walk, isolation, weather and group size that determine the number and type items you carry. Possibly the biggest impact will be how you perceive the duty of care you owe to people in your group (and yourself). Duty of care is simply a moral (and potential legal) obligation to ensure the safety and well-being of others. Yes it is possible to do the minimalist thing and manage (not very well) a wound with toilet paper and leaves, but when you think through your duty of care you can decide if that is actually what you want before you leave home.
Suggested listA good start is buying a first aid kit with most of the contents and a casing that suits you then add and remove from there.
This list is one I developed for club group leaders, so it has been designed to cope with various conditions for larger and diverse groups of people. But for longer walks you are likely to be exposed to a wider range of injuries and may need to manage the longer.
Personal protection
4 Rubber gloves
1 CPR Face shield
1 Alcohol gel hand wash
Injury and bleeding management
20 Adhesive bandage (eg Band Aids™) (various shapes and sizes)
1 Spare gauze pads
3 Sterile non-stick compresses 2 x (7.5 x 10 cm), 1 x (5 x 7.5 cm)
2 Triangular bandages
2 Elastic roller bandage
1 Moleskin
1 Steristrips
1 hypoallergenic tape
1 Zinc oxide tape: securing dressings, strapping and repairs
Wound cleaning
5 Burn-aid burn gel
5 Chlorhexidine wipes
10 Ear buds
2 Saline squeeze vials
Hardware
1 Trauma shears: removing clothing, packs and shoes
1 Tweezers: removing splinters, stings and other foreign bodies
3 Splinter probes: removing splinters
1 sewing kit: repairs to packs & clothing
1 Small torch: night emergency backup & neurological pupil assessments
5 Safety pins: General gear repairs
Information
First aid booklet
Pencil & paper
Group contacts and party member medical details
Medications
Panadol: pain relief
Ibuprofen: pain relief
Aspirin: pain relief, possible use for man-agement of suspect heart attack
Gastrolyte: to help with rehydration and replacement of electrolytes.
Emergency management
Whistle: for attracting attention and re-grouping
Bike tube pieces with frayed edge: emer-gency fire starters
Gas Lighter: emergency campfire lighter, sterilising metal.
Micropure: water treatment for ten litres.
Space blanket: keeping warm, preventing hypothermia, managing shock
PLB: Emergency communications when out of mobile coverage
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Personal medications
There are some first aid items that people in your group may carry themselves. Such as medications for allergies, asthma, heart conditions and much more. Hopefully along with the medication they will have an action plan that outlines the process of managing the condition if it fairs up. Speak with them about it and know where it is in their pack.
But what about …?Yes I can already hear people screaming out, “But what about …?” If you have someone in your group with a specific risk then there may well be more training and equipment for you to carry. If you see a reasonably foreseeable, reasonably likely and the outcome significant enough to warrant then, add it :)
How far do we take this is always going to be a question. Should we carry oxygen cylinders? A semi-automatic defibrillator? Splints? Stretchers? Maybe (not usually), consider vulnerability in your group, costs, weight etc. Think about what is expected of you and what most other people would do in a similar situation. Think about stuff going bad and how you would cope without having it.
At present it is not normal to carry a defibrillator on a bushwalk. When they become as small and cheap as your phones then I suspect they will be added to our backpacks. The first aid kit will always be changing as technology, medicine, communication and transport improves.
How to pack itIt seems that most walkers have a first aid pouch and pack it near the top of their pack. Usually the PLB is separate. While this works, I do things a little different. I have two first aid kits as well as a bandage and PLB separate. Let me explain.
PLBs need to be handy, but not the first things you grab, so it lives in the main section of my pack. I carry a roller bandage on an outside mesh pocket in my pack (in snap lock bag). The first aid kit item I need most is almost always a roller bandage, usually for a minor strain or sprain. I keep it handy for that reason. It also quick and easy to access in case of a snake bite or major bleeding.
Oh Crap! bag. This is a vacuum bag sealed emergency first aid kit, easy to rip open, but very waterproof so it can be carried in the top of your pack. This bag contains items used for significant events such as major bleeding, snake bite, broken bone etc.
“I have two first aid kits as well as a bandage and PLB separate. Let me explain.
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Oh Crap! Bag My major emergency first aid kit is for those moments when someone shouts out or is way too quiet. Maybe a “trauma kit” would be a better name, but I prefer mine. This is a clear vacuum sealed back (or just suck the air out of a snap lock bag) with triangular bandages, shears, gloves, shock blanket, etc. These items are to help when someone has likely in a lot of pain or at risk of bleeding out quickly. This bag rips open quickly and basically never gets used, but sits at the very top of my pack, not in any extra waterproofing.
Oh Yeah bagThis is all the other stuff in the main first aid kit list. It is the part of the first aid kit that gets the most use. It is for dealing with the minor or less urgent issues, before they become big and ugly. For blisters, small cuts etc.
Getting helpRemember that first aid is mostly about buying time before medical aid can be accessed, and avoiding things from getting worse. For most minor issues you can visit a doctor after you finish the walk, if you need to visit all. Occasionally, someone in your group or someone you find on the track may need medical aid urgently. In situations such as a heart attack, stick in the eye, significant bleeding, severe allergic reaction, and significant burn, the faster you get help, the more likely the person will survive as well as have a faster and better their recovery.
You do not want to be in this situation wishing you had a way of contacting help and not been able to. Mobile phones are the best tool, when they work. Download the Emergency+ app now, and you can use it to make the call and know your location. When you are out of mobile range then I always recommend carrying a PLB.
Potential improvisationsThere are many things in your pack, on your body and around you in the bush that can be used to help with first aid. It is worth considering what you already have in your pack that can be used.
For example, a sleeping mat can be used to keep a person warm and comfortable, it can also be used as a splint or maybe even a stretcher to help move someone a short distance if really needed. I have used a space blanket/tarp to splint a broken lower arm effectively. When my son broke his lower arm, he was holding his arm across his tummy. Instead of going through the trauma of opening the first aid kit we were able to make him comfortable just by lifting the lower part of his shirt over his arm and hold it for the drive to the hospital, probably more effective than a triangular bandage in this case.
First aid by remote controlA last little tip before we finish. Good first aiders take control of a situation, keeping everybody safe and making good stuff happen.
Great first aiders take control, keep things calm and clearly instruct people to help. If the injured person can safely help, then ask them to. They can clean their own wounds, and put on band aids. Asking people to do their own first aid, under good clear instruction, means you may not need to touch them at all, reducing your exposure and their risk of infection. It helps keep people calm, may even reduce their pain. It helps you be more situationally aware of what is going on around you, allowing you to deal with several injured people at the same time. It also helps improve the dignity of the overall experience and helps people learn new skills from you.
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