General Medical Supplies

Bandaging is always a priority and it sometimes seems there will never be enough, so the more you have, the luckier you will feel, if you should ever need them. Many can be boiled and re-used in a pinch. Commercial or mil. spec. trauma bandages (BloodStopper, TrauMedic, etc.) are the most versatile. Other bandaging products to consider include large (3×3, 4×4, 5×9, etc.) gauze or trauma pads and dressings (J&J “NU-GAUZE” are the most absorbent gauze pads I’ve found and are not appreciably bulkier than regular ones when packed), 2 and 4 inch gauze compresses, gauze roll bandage (the best clings to itself and is “stretchy”), triangular bandages, burn dressings (Spenco “2nd-Skin,” “Aquaphor,” etc.) and transparent waterproof but breathable dressings (3M “Tagaderm”) and bandages (3M “Clean Seals” and Curad “Aqua-Protect) which now bring this same breathable waterproof protective technology to the adhesive bandage market.

A few tampons or standard size (not the thin style) feminine sanitary napkins can serve not only their intended purpose, if necessary, but they can also be used as highly absorbent compresses for dealing with bleeding or seeping wounds. Kotex “Discreet” brand are the smallest package, but some means of cleaning the fingers prior to insertion must be provided when used for their intended purpose. The disinfectant in the medical kit or packaged antiseptic towellettes would suffice.

Elastic bandages are valuable for many medical and survival uses and are versatile performers. The self adhering styles are the best, followed by those with built in clips which cannot be lost. Elastic bandages which have loose metal clips, which experience tells us will be promptly lost, are not the best choice. You can always use safety pins or tape to secure the bandage (sometimes you have no choice), but tape can be a PITA, particularly when the bandage must be removed and replaced regularly.

Splints

A “SAM Splint” or a wire mesh splint can prove very useful when dealing with broken bones or sprains or to hold things together. The SAM Splint, which stands for “Structural Aluminum Malleable,” is a light aluminum sheet sandwiched between thin foam. It is quicker and much easier to work with than other styles, including the wire splint. You don’t have to improvise padding for the SAM splint as required with a wire splint or one made from found materials. It is easy to cut a small piece off for use on smaller body parts like a finger. It can be stiffened, if needed, by putting a crease in it. Unlike the typical wire mesh splint, it has no sharp barbs where the wire mesh has been cut to size, so you won’t risk a cut or puncture wound.

The standard 36 inch SAM Splint is about 3/4 inch wider and six inches longer than typical wire splints. It is 4 1/4 inches (11 cm) wide and comes in four different lengths: 36 inch (91 cm), 18 inch (46 cm), 9 inch (23 cm), and a finer size: 4-1/4 x 2 inches (11 x 5 cm). The 36 inch is standard for most medical kits. Its weight, 4 oz., is about the same as old style steel wire splints, but almost double that of an aluminum mesh wire splint. Its biggest drawback is just that, it’s bigger. With the foam padding, it is quite a bit bulkier than the wire splints, taking up three to four times the space, depending upon how you pack it. It is available rolled and folded flat. The flat is usually easier to pack, but the round can be “squashed” into a more rectangular shape. Vacuum packing will reduce this bulk somewhat, but not a lot.

Wire ladder splints, which look exactly as you’d expect from the name, are not as versatile as these other styles since they do not mold to the body part as readily and don’t lend themselves to use on small body parts. Inflatable splints are too limited, too heavy, too bulky and too susceptible to damage for survival use. Cardboard splints just aren’t durable enough and if they get wet, well…

Adhesive Bandages

Pack lots of adhesive bandages, you almost can’t have too many. Aside from use on minor injuries resulting from a crash, survivors have a knack for getting small scrapes and cuts. Because of the high risk of infection, you must treat any injury in the wild, no matter how small, as life threatening. That means it needs to be protected and treated.

The old fashioned plastic or sheer plastic style bandages are poor performers. I suggest you simply trash any plastic strips in your first aid kit and replace them with better products wherever possible. The elastic knit cloth type bandages stick lots better, stay on longer, and are easier to live with, conforming to the body much better. “Coverlet” brand by Beiersdorf are the best, though difficult to find (try the Yellow Pages under “First Aid Supplies or Medical Equipment & Supplies”), closely followed by Curad “Flexible Fabric.” Johnson & Johnson “Band-Aid” brand “Flexible Fabric” bandages have pads which extend all the way to the edges of the bandage so that it cannot be sealed completely. This risks contamination of the wound and is not acceptable, in my opinion. The elastic knit style is available in a wide variety of sizes and configurations.

Bandages made with flexible foam plastic tape adhesive have recently become available. The jury is still out, but they seem to be an improvement in some areas. Curad’s “ActiFlex” seem to perform better than 3M’s “Active Strips” or Band-Aid’s “Sport Strips.” Like the rest of the line, the Sport Strips pad extends all the way to the edges, a significant failing. They also performed surprisingly poorly in wet adhesion tests. The ActiFlex are the only adhesive bandages which seem to hold particularly well on damp skin, making them an excellent choice for tropical or life raft use. If used on dry skin, either the ActiFlex or Active Strips perform adequately and the foam tape doesn’t absorb moisture the way the fabric bandages do. While the foam tape doesn’t stretch quite as much as the elastic knit, it does stretch in all directions, an advantage. Some people find these the most comfortable to wear, others still prefer the elastic knit.

Don’t forget to include specialty bandages for knuckles and fingertips. They aren’t an extravagance. The hands seem to be a magnet for injuries and are the most susceptible to contamination. These specially configured bandages protect wounds in these areas much better and stay on much, much longer.

As noted above, transparent waterproof but breathable bandages (3M “Clean Seals” and Curad “Aqua-Protect), which are an outgrowth of products designed initially for surgical and hospital use, are now readily available and offer some significant advantages for wilderness care. The thin clear protective material is flexible enough to work in most places without coming loose. It really seals the wound completely, which in the dirty wilderness environment is probably a good idea in many cases. In some cases you may want to then cover this bandage with something to protect the thin material for abuse.

Wound closure or suture strips are a modern replacement for butterfly bandages, used to close a wound and hold the edges together. Most kits include a package of these with about three to five strips per package. This is another example of a specialty bandage that you should have more of in the kit. These strips are much better than butterfly bandages, are easier to use and take up less space besides. Having tried out more than a few of these products over the years, the “Cover-Strip II” by Beiersdorf seems to be the winner here. The advantage is that they can be repositioned in case you goof in applying them, which occurs frequently. The others, such as J&J’s “Steri-Strips,” cannot, losing their tackiness if pulled up.

Another technique for closing wounds is to use “super glue” (also often called “crazy glue”) to join the edges of the skin together. This is a fairly common technique in many emergency and operating rooms. My emergency medical consultants seem to agree that there is no need to try to find and purchase the overpriced “sterile” super glue used in hospitals and now available over the counter from some limited sources, trademarked “Dermabond.” Any unopened tube of super glue will work satisfactorily. There remains some controversy with some doctors and those who sell and manufacture the Dermabond claiming that consumer grade super glue is dangerous, but many others have found, as we have in our own personal experience, that it works fine with no adverse effects.

One advantage of the Dermabond is that it looks “medical” which might be an advantage for use on someone who might otherwise be concerned when you try to use a consumer packaged super glue.

Dermabond comes in a crushable ampoule applicator, which does make it easy to “paint” the edges of a wound. Super glue is available in applicator packaging that makes it easier to position exactly one drop exactly where you want it without making a mess of the patient or yourself, but you still must use some means, NOT YOUR FINGER, to spread it out. These sturdy plastic applicators seem less susceptible to damage than the conventional small metal tubes of the glue that offer less control and are worth the small extra cost.

Use Google to search on Dermabond and you’ll find plenty of information on the proper use of this glue.

Preparations

Many kits now include small towelettes, pads or swabs of various antiseptics, adhesives, cleansers and the like packed in individual application packets. While very convenient, the shelf life of this packaging tends to be pretty short, much less than if the product was in liquid form in a bottle. While very convenient, all too often you tear open the package to discover the pad is dried out and useless because the packaging leaked or was punctured. If you rely on these sorts of packaged products, be sure to replace them with fresh ones every year or two. Another serious drawback is that they are of such limited quantity. Better to pack small containers of the preparation, either instead of, or perhaps better, in addition to the packets.

Small 1/2 or 1 oz. plastic bottles of things like Betadine (Povidone Iodine 10% solution), an antiseptic scrub, or Mastisol, an adhesive (much better adhesive than Tincture of Benzoin, often found in kits. It also doesn’t sting like Benzoin does if you inadvertently get it in the wound), can often be obtained from your physician, who receives them as samples, or at a good medical supply house. Alternatively, you can decant from a larger bottle into a small one. The one drawback, such as it is, is that you also need to pack small gauze pads or cotton balls to apply these preparations.

Similarly, single application foil packs of antibiotics, salves and the like, while convenient, aren’t necessarily the best choice for our uses. If you only need a little of the compound, the remainder is wasted and cannot be saved for possible future use. If you need more than a few applications of the compound, the number of packets on hand, you are also out of luck. In a survival situation, with the possibility of numerous dressing changes, you’ll run out too soon, unless you add lots. Small tubes of these preparations are a better bet for survival use. However, if you do open a tube for some other first aid requirement, you should probably replace it at your earliest convenience since it loses its sterility once opened.

Once again, the best bet may be to have some of each, single use packets and tubes.

While it’s hard to get docs to agree on anything, the generally accepted standard treatment for small wounds these days involves cleaning and disinfecting it thoroughly with Povidone Iodine 10% solution (or the surgical soap version of same). The strong stream from an irrigation syringe can be used to better clean out debris, if necessary and forceps can be used to pull out any imbedded debris.

Afterwards the choice is to either cover it with a dry bandage or apply antibiotic ointment (single, double or triple as it suits you), then apply the bandage. Put ten docs in a room to discuss this issue and you’ll find about evenly split, plus a few with their own favorite dressing, but you won’t go seriously wrong either way. In the wilderness, where infection is a far bigger potential problem, seems that application of antibiotic ointment is a better bet.

The standard treatment for minor burns is to cool it immediately under cool (not cold) water. Since this isn’t always possible in the wilderness, or even other places. some alternative must be considered. The two most highly recommended treatments are both based on natural remedies, aloe and tea tree oil. Both act to cool the heat of the burn and prevent drying out.

George Townsend & Co.’s “Martin’s BurnAway Plus,” which is a tea tree oil product that also includes aloe and some other ingredients. This has proven very effective in numerous instances, both on heat burns and sun burns. Nothing else I have tried even comes close, pain goes away almost immediately and doesn’t come back, healing is speeded up significantly. It must be used to be believed. (It has also proved incredibly effective when used on insect stings of all sorts.) For dressing, again, a aqueous gel product like 2nd Skin is the best way to go.

Specialty Medical Supplies

Concerns about blood borne pathogens have led to products designed to shield the aid giver. There are kits available which include disposable suits, gloves, face masks, etc. All well and good, if you have the space and no weight constraints. However, if the injuries are massive or bleeding severe, it’s virtually impossible, in a survival environment, to avoid contamination. The best you can usually do is to bring along a supply of surgical gloves, most first aid kits only include one pair, and a CPR mask. For gloves, the thicker style are more durable and puncture resistant and some experts recommend vinyl or nitrile gloves because they are tougher, though somewhat less tactile. Also, many people are allergic to natural latex. The best natural latex gloves I’ve found are “Diamond Grip” by Microflex Medical Corp. (800-876-6866). For CPR protection, the smallest and lightest solution is the “CPR Microshield” by Medical Devices Int’l which is available at most medical or safety supply houses and from Adventure Medical.

A dental repair kit would make a good addition to a comprehensive kit. A tooth can be damaged during the crash or a filling could come loose or be lost. These and other dental problems could manifest themselves just when you need the extra problems the least.

You want to select a dental kit or product that utilizes a single component compound for filling cavities and repairing teeth. “Cavit” is the best such product according to my dentist advisors. It is easy to use and hardens after contact with saliva. Those which require you to mix two compounds together, a powder and a liquid catalyst, are much more difficult to use. There are a number of different kits available and both Adventure Medical and Atwater Carey offer a good one that includes Cavit.

If you fly with young children or infants, you need to consider their special medical needs, aside from any personal medications required. These should include pediatric medications, chewable analgesic tablets or liquid analgesics for example. An oral medicine syringe can be a big help for infants. A few adhesive bandages with cartoon characters or bright colors might be worthwhile. Pediatric modules with such supplies are available from the kit suppliers. Discuss this issue with your pediatrician and include any additional items recommended.

Rx Meds

You should give serious consideration to including some strong prescription pain medications and antibiotics in your survival medical kit. Easing the pain of a serious injury can be vital when your options are limited. Pain can often be so debilitating that it can adversely affect survivability due to its detrimental effects on a survivor’s mental state, though, pain alone has never killed anyone directly. In some rare cases pain can even be a help, giving a survivor something to focus upon. More often, however, pain can prevent you from doing things that must be done, if you are to survive, no matter what. Not everyone has the capability to ignore severe pain, if that’s what is required. Under these circumstances, pain relief is the only practical alternative, despite the adverse effects some of these drugs may have.

The probability of infection is very high in wilderness injuries and is a leading cause of disability and death when comprehensive medical treatment is not available. Antibiotics can make the difference. Prophylactic use of antibiotics in any wilderness or survival environment is generally a good idea. You can’t possibly carry something for every bug you might contract in the wilderness, but a well chosen broad spectrum antibiotic or two will be a lot better than nothing. These are usually effective against the most common infections that occur in such environments. If you are traveling in areas other than North America, then additional antibiotics to deal with the bugs and problems endemic to those areas may be appropriate. Consult with your physician or a specialist about this.

Discuss with your physician the inclusion in your medical kit of some of the medications listed below. Some doctors may be very hesitant to provide the requisite prescriptions; some will refuse flat out. If your personal M.D. isn’t interested, you will have to find one who is. One source would be the emergency room at your local hospital or trauma center. These emergency room physicians and trauma specialists may be more understanding and accommodating. Your best bet is to ask around for a doctor who specializes in wilderness medicine or who is associated with a search and rescue organization and thereby has a keen appreciation for what you are trying to do. You can also contact the Wilderness Medical Society for a referral. Another alternative is Wilderness Medical Systems who’s medical director, Dr. Gil Preston, will provide prescription medications in their medical kits after a phone consultation.

For pain relief:

• Hydrocodone Bitartrate 5 mg and Acetaminophen 500 mg Tabs (GENERIC, Vicodin, Vapocet and others) #
  and/or
• Hydrocodone Bitartrate 7.5 mg and Acetaminophen 750 mg Tabs (Vicodin ES) #
  and/or
• Oxycodone Hydrochloride 5 mg and Acetaminophen 325 mg Tabs (GENERIC, Percocet and others) #
  and/or
• Ibuprofen 800 mg Tabs (GENERIC, Motrin and others)

Traditional Antibiotics:

(Note: you might be able to get these or an equivalent antibiotic from your doctor as samples in sealed packages)

• Cephalexin 500mg Tabs (GENERIC, Keflex) #
  and/or
• Erythromycin 500mg Tabs (for those allergic to Penicillin or Cephalexin) #

Non-traditional Antibiotics:

(Note:These both are smaller pills than the traditional antibiotics above and the number of pills required is much less, but they are more expensive. Use when space is at a premium.)

• Ciprofloxacin 500mg Tabs

(These are taken only twice a day, halving the number traditionally required)

• Zithromax 250mg Capsules

(A full course of treatment only requires six doses, but they are VERY expensive.)

Prescription Medications and Emergency Medical Preparedness in Survival Situations

Preparing a comprehensive medical kit for travel, aviation, wilderness expeditions, or emergency preparedness requires thoughtful planning and a clear understanding of the medications and supplies included. While over-the-counter products can address many common medical concerns, certain prescription medications and specialized tools may significantly improve the effectiveness of a well-equipped survival or first aid kit when used appropriately and responsibly.

Topical Corticosteroids for Skin Conditions

One category of prescription medication commonly considered for advanced first aid kits is topical corticosteroids, also known as adrenocortico-steroids. These medications are frequently used to treat inflammatory skin conditions such as:

• Contact dermatitis caused by poison ivy, poison oak, or poison sumac
• Minor burns and sunburn
• Allergic skin reactions
• General skin irritation and inflammation

Non-prescription hydrocortisone creams in strengths of 0.5% and 1% are often included in commercial first aid kits. Although widely available and relatively safe, these formulations are considered very low potency and may provide limited relief in more severe cases.

Stronger prescription alternatives, such as triamcinolone cream or ointment in 0.1% or 0.5% concentrations, may offer substantially greater effectiveness for treating significant skin inflammation. Medications in this class are commonly available in generic formulations, making them relatively affordable. Healthcare providers may also recommend other corticosteroid medications depending on individual needs and medical history.

The Importance of Medication Safety

No medication is entirely without risk. Even commonly used over-the-counter drugs such as aspirin or acetaminophen can cause side effects, allergic reactions, or dangerous interactions when misused. Prescription medications require even greater caution.

Any prescription medication included in a survival or medical kit should be accompanied by clear and complete usage instructions, including:

• Approved uses and indications
• Proper dosage information
• Contraindications and precautions
• Potential side effects
• Drug interactions
• Emergency warnings

One practical method is to include photocopies or printouts from reputable drug reference sources such as professional pharmaceutical guides or manufacturer information sheets. Many pharmacies now automatically provide medication information with prescriptions, and healthcare providers can often assist in obtaining additional documentation.

Proper Medication Packaging and Storage

Standard pharmacy pill bottles are not always ideal for survival kits or field use. Bulky containers consume valuable space and may not adequately protect medications from moisture, vibration, or environmental exposure.

Recommended Storage Options

More practical alternatives include:

• Small screw-top waterproof containers
• Heavy-duty zipper-lock plastic bags
• Compact field medical organizers
• Blister packaging for individual doses

When using small containers, it is important to minimize empty space inside the bottle. Excess movement during transportation can damage tablets over time. Packing cotton into remaining air space can help prevent vibration-related deterioration.

For plastic bags, thicker 4-mil bags are significantly more durable than thinner 1.5- or 2-mil varieties and are less likely to puncture or wear through during extended field use.

Moisture Protection

Moisture is one of the greatest threats to medication stability. Small desiccant packets—the same type included in many commercial medication bottles—can provide additional protection against humidity and condensation.

Blister Packaging Advantages

Blister packs offer excellent organization and environmental protection for many medications. However, care must be taken to avoid puncturing the thin foil backing during packing and transport. Storing blister packs inside a protective plastic bag can improve durability.

Determining Appropriate Medication Quantities

When planning medication supplies, it is wise to prepare for worst-case scenarios. A general preparedness guideline is to carry enough medication to support each person for at least one week under emergency conditions.

For antibiotics, a full standard treatment course is often recommended. Traditional antibiotic regimens commonly require approximately 10 days of medication, depending on the specific drug and medical condition.

Protecting Medications from Heat

Many medications lose potency when exposed to excessive temperatures. Survival kits stored inside vehicles or aircraft are particularly vulnerable because interior temperatures can rise dramatically due to solar heat gain.

To reduce heat exposure:

• Remove medications from parked aircraft or vehicles when practical
• Store medications deep inside insulated gear or survival kits
• Use separate removable medication pouches for easy transport
• Avoid prolonged exposure to direct sunlight

Proper temperature management can significantly extend the useful life and effectiveness of emergency medications.

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Bites and Stings in Survival Environments

Snake Bite Prevention and Treatment

The most effective treatment for snake bites is prevention. Exercising caution in wilderness environments greatly reduces the likelihood of dangerous encounters.

If a venomous snake bite does occur, it is important to remain calm and avoid outdated or harmful treatment methods.

Ineffective and Dangerous Snake Bite Kits

Traditional snake bite kits that include razor blades and suction cups have been widely discredited by modern medical experts. Cutting into the wound and attempting to suck out venom—either orally or mechanically—does not remove a meaningful amount of venom and may worsen tissue damage or introduce infection.

Older “cut-and-suction” kits should not be relied upon for emergency treatment.

Venom Extraction Devices

Some modern venom extraction devices have shown limited usefulness when applied immediately after a bite. Certain suction-based extractors may remove a small percentage of venom if used within minutes of envenomation.

However, even these devices should not be considered a substitute for professional medical care. Their primary value lies in potentially reducing venom load while evacuation and emergency treatment are arranged.

Recommended Immediate Actions After a Snake Bite

Current wilderness medical recommendations generally emphasize:

• Moving away from the snake safely
• Remaining calm to slow venom circulation
• Immobilizing the affected limb
• Seeking emergency medical care as quickly as possible
• Avoiding unnecessary movement or exertion

Most healthy adults survive venomous snake bites with appropriate medical treatment, although severe illness and complications may still occur.

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Insect Stings and Severe Allergic Reactions

For individuals with serious allergies, insect stings can trigger life-threatening anaphylactic reactions.

Epinephrine Auto-Injectors

Epinephrine auto-injectors are considered essential for people with known severe allergic reactions to insect stings or other allergens. These devices provide rapid emergency treatment for anaphylaxis and are designed for use by non-medical personnel.

Because auto-injectors typically contain only a single dose, carrying at least two is generally recommended.

Important Safety Considerations

Epinephrine is a powerful medication that can also produce serious side effects, particularly in individuals with certain cardiovascular conditions. Proper training and medical guidance are essential before carrying or using these devices.

Additionally:

• Auto-injectors have limited shelf lives
• They are sensitive to heat exposure
• They require regular inspection and replacement

Anyone carrying epinephrine should fully understand when and how to administer it safely.

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Field Surgery and Wound Management

The Reality of Wilderness Surgery

Field surgical kits are commonly marketed for survival use, but performing surgery outside a sterile medical environment carries substantial risk.

Even relatively simple procedures such as suturing wounds require training, experience, and sterile technique. Deep or contaminated wounds are especially vulnerable to infection in wilderness environments.

Priorities in Wound Care

In most survival situations, wound care priorities should focus on:

1. Controlling bleeding
2. Cleaning the wound thoroughly
3. Protecting the wound from contamination
4. Monitoring for signs of infection
5. Maintaining clean dressings

If rescue or evacuation is expected within several days, conservative wound management is generally safer than attempting surgical intervention.

Risks of Improvised Surgery

Untrained attempts at wound closure or surgery can:

• Trap bacteria inside wounds
• Increase infection risk
• Cause additional tissue damage
• Complicate later medical treatment

More advanced procedures, including amputations, involve extremely high risks of shock, sepsis, and death when performed outside professional medical facilities.

Training and Preparedness

Individuals who choose to include surgical tools in a survival kit should seek proper medical training and understand the limits of their abilities. Surgical equipment should never create a false sense of competence.

Surgical Staplers as an Alternative

For simple wound closure, surgical staplers may offer advantages over traditional suturing:

• Faster application
• Easier for inexperienced users
• Less technically demanding
• Potentially less painful
• Lightweight and compact

High-capacity models with standard staples are generally preferred for preparedness purposes. A compatible staple remover should also be included if prolonged field care may become necessary.

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Final Considerations

Building an effective medical or survival kit requires balancing practicality, safety, and realistic expectations. Medications and medical tools can be valuable assets, but they must be supported by proper knowledge, responsible storage, and appropriate training.

The most important principles of wilderness and emergency medicine remain consistent:

• Prevent injuries whenever possible
• Use evidence-based treatment methods
• Avoid harmful outdated practices
• Understand the limits of field medicine
• Seek professional medical care whenever available

A thoughtfully prepared medical kit, combined with training and sound judgment, can significantly improve safety and survival outcomes in emergency situations.