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oldeclimber


Sep 25, 2003, 9:35 PM
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What's in your med bag?
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What kind of meds do you carry to the crag?
What kind of tragedy are you really prepared to handle?
Do you have any favorite med brands for packaging reasons, convenience or whatever?
Do you always carry your meds up the wall on multipitch?
Do you discuss things to do in the event of a medical emergency with other climbers in your group?
Any special rules or procedures that you use or think are important?


Partner coldclimb


Sep 25, 2003, 9:41 PM
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Tape. Tape fixes everything. :D I also have a first aid kit, but I don't know what'd in it, and I've never used it. Used lots of tape though. I have three rolls in my bag, now that my dad's soccer coaching season is over and he had some extra. :wink:


crackaddict


Sep 25, 2003, 10:02 PM
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This is a cool thread.

I carry a backpackers type first aid kit filled with most everything over the counter in it. Antiseptic, bandages, painkillers etc. Plus some extras.

Some things that have come in handy in it are.
Benadryl- I always see bees and wasp out climbing. Ever seen some one get a bee sting that is allergic. I have. Watch out they swell up quick. Scary that someone could die from a sting. Up on a climb is not a good place to have this occur. This can be taken care of with one simple pill.

I went to the army surplus and bought some things that would help my kit.

Water ration- small bag of water that can be used to hydrate or clean wounds when clean water is not existent.

Widerness flare- Small and lite for your kit.

Signal mirror- handy to have lite metal mirror.

Duct tape- goes w/out saying

Cold Compress- Great for swelling or heat exhaustion.

I carry this kit when ever I am outdoors.
It is just smart to be prepared.


jookyhead


Sep 25, 2003, 10:24 PM
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Ibuprofen and Duct-Tape :lol:


andypro


Sep 25, 2003, 11:07 PM
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among the other useful stuff people have mentioned, I always carry two eppi pens. For that random case of anaphylactic (sp?) shock. Tha'ts bad juju and can kill in a matter of less than a minute, and you never know when or why it might happen. Why carry two when one should do? Murpheys law.

I also carry a bottle of that hurt free antiseptic wash stuff. I dont remember who makes it..johnson and johnson or bandaid I think. It's got lydocain in it. Great stuff, but some people are allergic. VERY allergic. See first paragraph.

The best thing to have in your bag that I've found is a little pad of paper with medical histories, health issues, allergies, prescription needs etc. of all your partners.

One thing I see people carrying that I really frown upon are narcotic pain killers and/or injectable pain killers (dilaudid, morphine, demerol, etc). They can easily kill someone that would have lived, just suffered a bit. I've seen it happen. They go into shock, but are still screaming about the pain. easy morphine injection later they're happy as can be, but it takes twice as long tog et them down ebcause you have to constantly stop to administer CPR and tha'ts usually fruitless. Not a good way to end a good day.

That said, OTC tylenol with codiene is good stuff. Just tough to get legally here in the states. I climb mostly in canada, so I jsut buy a small bottle of 30 or so for a few dollars, then ditch it before crossing back over the border. If you need mroe pain meds than that, you better either be a paramedic or field doctor, or good at putting up with bitching and complaining. Cant stress enough that pain killers are downright dangerous in most accident cases that youd get into climbing.


rcaret


Sep 25, 2003, 11:18 PM
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I always carry a large Med Kit that has

Supplies for treating anything from blisters to major trauma, plus equipment for dealing with infectious materials
Essential equipment: CPR kit, scalpel, digital thermometer, EMT shears, splinter forceps, duct tape
For wounds: 20cc irrigation syringe, surgical scrub brush, povidone iodine, Tincture of Benzoin, wound closure strips
Antibacterial towlettes, antiseptic cream, gauze pads, non-adherent sterile dressings, trauma pads
Stockinette and gauze bandages, strip/knuckle bandages, and adhesive tape
For sprains and fractures: moldable SAM splint, elastic bandage, 2 triangular bandages and safety pins
For burns and blisters: Spenco 2nd Skin, moleskin, adhesive knit bandage and antibiotic ointment and aloe vera gel
Medications: Extra Strength Tylenol, Motrin, antihistamine and 4 pill vials for medication others may need , codeine ect
For handling infectious materials: 6-pair nitrile examination gloves, antimicrobial hand wipes, disposal bag
Includes comprehensive wilderness medicine and life-threatening emergency reference guides, accident report and pencil .


And for all the times I've had to use it . It has ben for Motorcycle , Auto ,Bicycle or Home accidents ,But never a climbing accident ?


mkjwngoat


Sep 26, 2003, 2:46 AM
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The only things you really NEED in your med bag is
tape-obvious
gauze-you need something fairly sterile to stop severe bleeding, otherwise infection can be lethal in an otherwise minor wound.
Triangle bandage- I can begin to explain all the wonderful uses.
non-aspirin- Legal an less of a stomach irritation
benidryl- allergic reactions

As for things like epi pens, if you can find a doctor who belives in you enough to give you an open script, then go for it. Narcotic pain killers and other meds (such as dopamine and lidocaine for cardiovascular emergencies) really have no place unless you know immediate hopsitalization is available.
As an EMT myself, i rarely go out of my way to carry meds or gear that are intended to be used in a controlled pre-hospital setting. Most of the emergencies are likely to be trauma anyways, and all the Techs who pick the guy up are going to do is put them on high flow oxygen and take them to the ER.
The last point I feel that needs to be made is that if you go beyond what you are trained for your likely to cause complications. So yeah, splint a broken bone or stop bleeding, even give CPR, but I won't give a cricothyrotomoy because I don't know what will happen. The patient will live longer if you do everything you can and are able to do, but nothing more.


flypn


Sep 26, 2003, 6:55 AM
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I carry an Outdoor Reaserch Mountaineer med kit that I've stripped down. The only things you really need are ibuprofen (10-20ish), antihistamines (same#, but I might take more), epinephrine (if you can get your hands on it), gauze/bandages (10mx.), one form or another of antiseptic (iodine is the classic), a good water filter (I have aquamira drops) this is to irrigate a wound (flushing out and maintaining a clean wound is key, thats the reason we use bandages, iodine, bacitracin, etc, so all you really need in a pinch is water. this is also presuming much about your location and the condition of the patient). The last and formost is several pairs of rubber gloves. if you are interested in how to come up with your own system, I'd highly reccomend taking a Wilderness First Responder class, or at least a Wilderness First Aid class. Just look up Wilderness Medical Associates, Wilderness Medical Institute, or Stonehearth Open Learning Opportunities online.

cheers!


oldeclimber


Sep 26, 2003, 7:21 AM
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I really like where this thread is going. Some helpful items already.
Please don't forget to cover the other aspects of my original post ......

Do you discuss things to do in the event of a medical emergency with other climbers in your group?

For example: I carry a GPS when my son and I go way out there. If I crash, he knows to hit the MOB (Man overboard) key on the GPS to mark my exact position, render whatever first aid he can, head back to the truck, drive until he can hit a cell site, call 911 and give them the GPS coordinates. So that even if he is scared and confused, I may still be able to get help from anyone with a GPS.


vertical_reality


Sep 26, 2003, 7:29 AM
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The last time this was discussed, everyone was prepared to stick a Bic pen in your throat.


da5id


Sep 26, 2003, 7:34 AM
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go for medical micropore tape. it bonds to skin and nothing else. if you put a little gauze of something over a wound, then cover it in one layer of micropore tape, it wont come off, not even in an extended swim. not good for non-medical taping thouhg because you cant wrap it around several times, as it literally wont stick to itself


epic_ed


Sep 26, 2003, 9:09 AM
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A guy with medical experience recently shared his experience as the first responder to a fatality on Nutcracker in Yosemite. There's nothing that could have been done for the guy who fell, regardless of the medical kit, but Yves stressed the importance of having several pair of non-latex plastic gloves. And a CRP kit. I can imagine in even the best case a serious fall can create a huge mess.

I carry vitiman-I, Benedryl, water purification tablets, a small SAM splint, gauze, athletic tape, and duct tape. Considering adding a pint of Bacardi 151, various narcotic pills, and a one-shot Derringer for worst case scenarios.

Ed


galt


Sep 26, 2003, 10:12 AM
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Depends on who I'm climbing with. If it's just a friend, I carry tape and chalk. (Ever use chalk on a scrape that's bleeding? Not the greatest idea in the world, but it soaks up the blood. NOTE: YOU MUST CLEAN THE SITE AFTER YOU GET HOME!)
If I'm with a group (7+ people for over 3 days of climbing) I'm usually the designated Med guy (I'm WFR and have yet to be in a group climb with more anyone more qualified) and I always have an extensive medical kit on hand including:


- MY MIND
- A sealed envelope with everyone's medical history. (If anything happens open the envelope and you have their info. If nothing happens you don't have to infringe on their privacy)
- Iodine soaked Gauze Pads
- Non-Latex Gloves
- Epi
- CPR Mask (I ALWAYS have that on my keychain)
- Benadryl
- Sam Splint
- More tape then the entire 96' Olympics used
- Butterfly Closures
- Bandana
- Gauze pads in every shape and size
- Water Proof Band-Aids
- Band-Aids in every shape and size
- Maxi-Pad (I used my only Surgical Sponges)
- Ibuprofen
- WFR/WEMT/WFA Field Book
- Pen
- LED Flashlight
- Needle
- Thread
- Safety Pins
- Trauma Sheers
- Hand Sanatizer
- Plastic Zip lock Bag
- 2 packets of salt and sugar
- New Skin
- Second Skin
- Duct Tape
(No doubt there are things Iíve forgotten, but Iím not going to go look in my kit)

Iíve further broken down my kit into triage and general comfort and Iím the only guy who touches my kit. (Someone goes in for a band-aid and your epi gets movedÖ bad news bears.) Hope this helps.


wc


Sep 26, 2003, 10:42 AM
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Mine is more like a rec bag than a med bag. We got your standard tape, tincture, gauze, bandaids, clippers, file board, benedryl, advil, etc

Then we have the fun stuff: lortab, xanax, codine, and of course the necessary safety materials. :shock: cough cough.


Partner phaedrus


Sep 26, 2003, 12:02 PM
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One thing I'll add to this, particularly for long trips, is a package of sweetened gelatin (i.e., Jello). Got this idea when I took a WFA course from SOLO a few years back. It's great for treating mild hypothermia: serve it warm- it's got sugars, proteins... all the stuff someone with hypothermia needs.


rizzuh


Sep 26, 2003, 1:09 PM
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1/5 of JD :)


biff


Sep 26, 2003, 1:18 PM
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I carry pain killers / water / tape / knife / sometimes vodka.

If it bleeds, put tape on it (use a shirt as gauze if required)

If it hurts, use painkillers / vodka.

If it really hurts get medical attention as soon as possible.

My feeling is that anything more than that would only be needed if the injury is really bad, and most of the places I climb a rescue can be made within 2 hours. Carrying anything more than that up a climb would be excssive, and trying to do anymore first aid than that would usually just lengthen the time to get proper medical attention.


micahmcguire


Sep 26, 2003, 1:29 PM
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meds? basically none. you have to ask yourself, why take any meds at all when you are simply trying to ensure the survival of a victim from the moment of first response until proper EMS arrives to take over? Its not like giving someone morphine for the pain is going to help them not bleed out before the chopper gets there. That is why, instead of wasting space in your emergency kits with pills and drugs, I suggest you pack in more gauze and tape. Its not like most of you are trained, qualified, or allowed under law to administer medication.

That point driven home (I hope), I bring Ibuprofen out on long hikes because it helps reduce the swelling in my hips, knees, and feet. In an emergency it wouldn't do squat.

I would suggest, however, that you know what emergencies to expect of any member of your party. If one of them is asthmatic, it is imperative that you make sure they will have access to their inhaler. One of my closest friends is asthmatic, so I always bring an extra albuterol inhaler for him when we go hiking or climbing. If one of your friends is allergic to beestings or something else, I would make sure that your party has at least one epinepherine pin with you just in case.

But as far as real meds go, its not like many or the chemical interventions you could do to a patient in that first responder setting are going to be helpful. Better than any meds, bring a cell-phone to call proper EMS with if something should happen. Trust me, they'll have all the meds that the victim is going to need (and proper training to boot).


meataxe


Sep 26, 2003, 3:02 PM
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How about: The machine that goes 'Bing!'...

I should probably start carrying a basic first aid kit. For short approaches, I guess the main thing would be to stop bleeding in event of a serious injury, because a rescue can take a lot of time if hauling stretcher over talus, etc.

If more remote, (1+ days for rescue) then I could see more of the pain reliever / antibiotic. If it's just a quick hike out, you can get cleaned up at the hospital.


jansuw


Sep 26, 2003, 3:04 PM
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What micahmcguire said! I have a little ziplock bag with this thing you get in Finland for beestings and snakebites (a pill), gauze and bandages. I can't imagine needing anything else? I have tape in my climbing bag always of course, and I always bring plenty of water. And, I always carry my cellphone! I mean, in Finland, who doesnt carry their cellphones, hehe. I'm trained in first aid and CPR, and the only thing that this thread has made me think of is one of those CPR mask things. Of course, I take more things if I'm off for a longer trip, but if you're cragging, do you need a disinfectant? Someone starts bleeding badly, you cover up the wound and call 911 or drive them to the nearest hospital. If you try to clean the wound, you're just gonna be wasting your time... Oh and plastic gloves, I'm gonna go buy some tomorrow! :)


phyreman


Sep 26, 2003, 3:40 PM
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I have to agree with some of the above posts... The only reason I see for carrying meds with you is if they are for YOU. For instance, the epi pen and others. Unless you are on some expedition where EMS is hours and hours away don't carry stuff you aren't qualified to use. As a paramedic I can assure you: Anything beyond basic stabalization usually does more harm than good.

Anyway, I carry:
Duct Tape
Medical tape
a couple 4x3 dressings
a few bandaids
a couple foil packets of polysporin
a nailclipper
a sterile scalpel (for cutting off those stupid flappers that ruin your day, nothing more advanced than that ;))
some rubbing alcohol pads.

All this weighs about 1.5 ounces.


mtnrsq


Sep 26, 2003, 4:52 PM
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Personal use = keep it simple.

Duct tape
small assortment of bandaids (water "proof")
swiss-army type knife (simple model - not too many doodads)
some 4x4s
ibuprofen or similar
antiseptic wipes
Coban
small fire starter set-up (waterproof matches, firestarter stuff) (a small fire is often the best therapy while you wait for rescue)
OTC antihistamines (take your pick)
non-latex exam gloves - the blue thick (6mil(?)) ones
small pencil/notepad
ziploc-type bag (2)
plastic trashbag
small packet of electrolyte mix
SAM splint

Other than the SAM splint it all fits in a surprisingly small bag. Not sure about the weight but it is a bit porky with the SAM splint (they are just so damn versatile....).

I do have a CPR micro-shield (key chain type) but lets face it - if you have a traumatic arrest/MI in the backcountry and ACLS-level care is hours away - CPR is not going to do much for you.

'bout it. As some said - using narcotic pain meds is dangerous business if you don't know what you're doing (and are keeping them current) - although they can ease you into the afterlife floating on a cloud.....If you have prescription meds - they should be for your use only.

Actual rescue calls bring a whole different med bag including airway equip, spinal stabilization stuff, O2, meds, assessment stuff, splinting stuff, dressings, etc., etc. AND more importantly - the training to know when/how to use it


xblacklungx


Sep 26, 2003, 5:29 PM
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tape at the moment, i saw a head-ache table advertised today that will aid muscle pains as well.. so i might have to check that one out!


oldeclimber


Sep 26, 2003, 7:57 PM
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mtnsq wrote:
In reply to:
using narcotic pain meds is dangerous business if you don't know what you're doing (and are keeping them current) -

Would you mind expanding on that comment a bit. Are you talking about tylenol 3 w/codine or something else? And what affect is altered by the age of the med. When is it proper to use a pain killer and what type would you use? And in addition, when is it definately not advised?

AndyPro Wrote:
In reply to:
That said, OTC tylenol with codiene is good stuff. Just tough to get legally here in the states. I climb mostly in canada, so I jsut buy a small bottle of 30 or so for a few dollars, then ditch it before crossing back over the border. If you need mroe pain meds than that, you better either be a paramedic or field doctor, or good at putting up with bitching and complaining. Cant stress enough that pain killers are downright dangerous in most accident cases that youd get into climbing.

There also seems to be a split opinion on whether or not to carry an Epi Pen. What is its purpose, and what are the pros and cons of its use? Is the Epi Pen available otc or is this something best left to medical professionals?

I was thinking more along the lines of using Benedryl (and a sting stick) for insect bites. Which is the better way to go and is there any problem with benedryl. Or should I just completely wrap the victim in tape, put a stamp on his forehead and mail him to the nearest hospital?


drkodos


Sep 26, 2003, 8:02 PM
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In reply to:
... The only reason I see for carrying meds with you is if they are for YOU.

Exactly.

Vicodin
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