Many commercial first aid kits are seriously deficient. Most include little more than a few band-aids and bandages to cope with minor cuts or scrapes, some aspirin and salve, maybe a compress and triangular bandage, if you’re lucky. Many low budget commercial survival kits include even less in the way of medical supplies. These hardly come close to the sort of supplies that might be needed. Authorities on wilderness and survival medicine stress the importance of carrying a comprehensive medical kit with plenty of extra compresses and large capacity bandages and dressings to cope with the traumatic injuries often associated with an aircraft or automobile crash.
The most important thing to keep in mind is that it is unlikely that an ambulance is going to pull up and take you to a hospital around the corner. This is where wilderness and survival emergency medical treatment differs from traditional first aid or EMT training. In fact, the terms “first aid” and “first aid kit” become something of a misnomer when used in the context of survival. Certainly, there will be a period of “first aid,” but “survival (or wilderness) medical treatment” and “medical kit” are a more correct description. It goes far beyond initial first aid.
Traditional first aid treatment for serious injury or disease involves stabilization of the patient so they can be safely moved to a hospital for treatment. Out in the wilderness you are on your own and whatever you do must suffice for the duration of the survival predicament. Typical first aid training is helpful and much better than nothing, but often inadequate and inappropriate for the circumstances.
Even most wilderness medical training makes assumptions that the injured party can be evacuated, though it will take time and may be difficult, and that help can be summoned within a reasonable time frame. This assumption may not be valid for survivors. A survivor or group of survivors must be, worst case, completely and totally self-contained. If you avail yourself of wilderness medical training, be sure to explain this to the instructors so they can address specific issues where this survival perspective might affect medical treatment and decisions. Survival medicine is NOT the same as wilderness medicine. Help may not only not arrive in a timely manner, it may not arrive at all in the foreseeable future. Our goal is to provide our visitors with sound advice that covers all potential survival situations. Many of our readers are going to carry field surgical equipment, regardless of wether or not you or I may consider that appropriate. As such, we’d be neglecting our responsibility to them if we stuck our head in the sand and ignored that reality. With luck, we dissuade the majority and perhaps make others think twice.
Remember, the most important piece of medical equipment isn’t in the medical kit, it’s in your skull. All the supplies and equipment in the world will do you little good if you haven’t the training to make the best use of it. In an emergency you may not have time to read the first aid or wilderness medical treatment manual. Even then, at best, these manuals are a mediocre substitute for good training and hands on experience. The nice thing is, this sort of knowledge can be just as useful at home or work as it will be in a survival situation. It couldn’t hurt to have the skill to save someone’s life.
Medical Kits
Adventure Medical, Atwater Carey Ltd., Outdoor Research (OR) and Wilderness Medical Systems all make good wilderness oriented first aid kits. Choose their medium or larger size kits, depending on the size of the survival kit itself, and go from there, using the suggestions provided here. Generally, the very largest expedition size kits are not the best choice, if space is at a premium, since they are quite bulky. I’ve listed the smaller kits within their product line that I feel are best suited for survival kit use. If space is not a problem, by all means, get the largest kits. In most cases, everything you need can be stuffed into the next to largest size kit. The soft packs for these kits are available for purchase separately, if assembling your own kit appeals to you, or if you want to upgrade to a larger kit using the supplies you already have.
A note about where you put these kits. If there are injuries, you don’t want to have to go searching through the survival kit for the medical supplies. They should all be on top, readily accessible. It’s also important to be sure the medical kit, alone, can be removed from the survival kit without disturbing the rest of the kit, or at least without making too much of a mess of it. Since the medical kit will generally also serve as your general purpose first aid kit, you may need to remove and replace it just to deal with a small injury or some other mishap or discomfort not necessarily related to a survival situation. There’s also always the possibility you will be the first to arrive at the scene of an accident.
If you do make use of the medical supplies, don’t forget to replace them at the earliest opportunity. Otherwise, over time, you can deplete the kit of the essential supplies you may need some day. The manufacturers can supply replacement items and modules or you might find them at a local safety or medical supply store.
My kits were originally based on the OR kits, the first to market with these comprehensive wilderness first aid kits in organized zippered pouches. Since OR made the market for this style kit, the others have followed. Each has its strengths and weaknesses, but none of them is seriously deficient. The most important and salient differences are noted below.
Outdoor Research’s pouches seem to pack the most into the least space, while making it easy to find what you need quickly. One downside of these packs is that the open pockets don’t protect the contents from the environment as well as Adventure Medical and stuff can be lost behind the fabric pockets. The solution to the latter problem is just to indicate on each pocket, with an indelible ink pen, what’s in it, if it isn’t readily apparent. Another minor drawback is that while you can stuff a lot into these pockets when you assemble the kit, it isn’t always so easy to get it all back into the pockets in the field, if need be. OR provides more bulk supplies and less individual use packets, an advantage for our purposes. OR doesn’t include some of the more sophisticated supplies, as found in the Adventure Medical kits, but they can be added without having to replace too much of the OR kit contents. For survival kit use the OR kits are still an excellent choice. They will accommodate an amazing amount of supplies without getting disorganized or too bulky, a consideration for many.
Adventure Medical produce what you might call “leading edge” kits, at a slight price premium. These kits have a good selection of equipment and supplies and a well designed soft pack with some excellent and unique features, though the packs are not quite as compact as others. That could be a consideration for some. Everything is protected behind clear flexible vinyl, a superb feature. Adventure Medical uses few individual pockets, mostly for equipment, with most supplies in bulk pouches. Since you can see into these pouches easily, it isn’t as bad as it sounds, though you must still rummage around at times for the supplies you need. On the other hand, it’s a lot easier to get stuff back into these pouches than into the overstuffed pockets of the OR kits. Adventure Medical uses some better quality, more sophisticated products in some cases, where OR uses old standbys. Virtually all preparations in the Adventure Medical kits are in individual use packets, a disadvantage for survival use, but an advantage otherwise. The “Fundamentals” and “Backcountry” are the best choices from Adventure Medical for inclusion in a survival kit.
Atwater Carey provides a good value, but the packaging of the kit is not as accommodating as Adventure Medical’s or OR’s. Atwater Carey relies strictly on individual use packets of medications. These kits will probably require a bit more supplementing than the others. The “Family” and “Expedition” kits are most appropriate for a survival kit.
Both Adventure Medical and Atwater Carey also make some of their kits, equivalent to these recommendations, available in waterproof Pelican dry boxes. These are targeted at the water sports and marine markets, but the contents are virtually the same as their regular kits. This style packaging will appeal to some, but the down side is that there is relatively little extra room for additional supplies and equipment, whereas the soft packs can easily expand and accommodate a lot more. Other disadvantages are that they are much more bulky and heavier than the pouch style kits and cost a great deal more because you are paying for the Pelican case.
Wilderness Medical Systems includes high quality items, but the packs themselves are not very organized, being little more than bulk pouches. One significant advantage is that they will custom pack your kit with pretty much anything you desire. Don’t like individual packets, they will provide bulk supplies, Want more of something and less of something else, no problem. Want to add items not included, they’ll be happy to provide. The listed components are just a starting point.
As noted in passing above, even the best of these first aid kits really ought to be supplemented with more or different supplies and equipment, if you’re serious about survival. They need to be shifted from the realm of first aid to the somewhat more demanding requirements of survival. While designed explicitly for wilderness use, the needs of, for example, aviation crash survivors with regards to trauma supplies and medications can be both greater at the onset and last longer, as well, than that of a group of backpackers or mountain climbers. Not all the extra bandages or supplies will necessarily fit inside the first aid kit itself, but don’t let that stop you. They can be packed separately in the survival kit.