The Easiest Way to Make a Useful First-Aid Kit

Pre-packed medical kits are expensive and heavy and full of crap. For $100, that bulky two-pound nylon bag never has everything you need. You can put together a cheap, waterproof personal med kit that covers everything—hiking, camping, climbing, biking, trail running, kayaking, off-roading, hunting, and fishing—that's lighter, more compact, and better-equipped than anything for sale by the Red Cross or REI. It's simple. In a large one-gallon Zip-Loc, so you can see through it and quickly find what you need, pack these things:

A Meds Bag
Put ibuprofen, aspirin, acetaminophen, Imodium, and either Claritin or Benadryl in a pill container that has separate sections for each medication, and wrap a thick rubber band around it to keep it from popping open. Write each med's expiration date on little adhesive-backed labels and stick them to their sections, and before every trip make sure they're current or replace them. Ibuprofen, aspirin, and acetaminophen all relieve pain, but they have specific uses, according to the National Outdoor Leadership School’s Wilderness Medicine handbook.

Aspirin can prevent or mitigate an oncoming heart attack if you give it quickly enough. Aspirin and ibuprofen are NSAIDs that reduce inflammation throughout the body, according to the Cleveland Clinic, good for anything from a sprained ankle to a pinched nerve in your back. Ibuprofen is the usual non-heart-attack choice, according to NOLS, because it's less irritating to the stomach. NSAIDs reduce your blood’s ability to clot quickly and shouldn't be given if a patient is bleeding profusely or has a possible brain bleed, so acetaminophen is given in those cases, teaches NOLS.

For treating allergic reactions, Benadryl is a common choice but has serious side effects, so you could bring Claritin instead. Hydrocortisone or After Bite treats bug bites and stings, and a non-aspirin antacid such as Alka-Seltzer Gold or Tums relieves heartburn. Bring anti-fungal cream, even if you don't think you'll need it: “People also need to think about any personal medications they take on a regular basis,” says Tod Schimelpfenig, curriculum director of NOLS’ Wilderness Medicine program. “If these are essential, such as diabetic supplies, divide them between two people or two boats.” Put everything, pill container included, into a sandwich-sized Zip-Loc.

A Blister Bag
Moleskin, duct tape, and Leukotape-P are good for preventing blisters and covering ones that have formed, and Leukotape can double as a wrap for immobilizing an injured wrist or ankle, as NOLS teaches several ways to wrap joints. Rather than taking a heavy roll, stick some on a sheet of waxy sticker paper and bring that instead. Skip the weak white medical tape and go for Transpore, a clear waterproof tape, to reinforce blister dressings. Throw all that and an assortment of waterproof Band-Aids into a sandwich-sized Zip-Loc.

A Trauma Bag
You're going to need a quart-sized Zip-Loc for the trauma bag. Take two Ace compression bandages, a two-inch and a three-inch, with Velcro enclosures. Also bring a roll of two-inch Coban , which is like a lighter and stretchier Ace bandage that sticks to itself and can be torn to size by hand. Toss in an assortment of individually wrapped, sterile gauze pads and three cravats—strips of non-stretchy fabric—that are good for many uses, from stopping bleeding to constructing an arm sling.

Add a pair of nitrile gloves, too. You don't want to touch blood, and some people are allergic to latex. Blunt-tipped safety shears are recommended in NOLS' handbook, because you don't want to whip out your knife and add another poke-wound to someone who's already splayed out with an injury. But you hardly ever want to cut away clothing in an outdoors situation because clothes are protection from harsh weather, so many don't bother to bring shears.

Current medical procedure is to keep anything but small burns dry, because wet burns can lead to hypothermia in even mild conditions, but include two medium-sized 2nd Skin Moist Burn Pads in your kit for very small burns, as the moisture lessens pain. One large Tegaderm transparent plastic bandage is good for when a wound has to stay bone-dry (such as a larger burn), and a sheet of Steri-Strip adhesive wound closure strips hold closed gaping wounds. Benzoin, an extremely sticky tree resin mixed with alcohol, helps certain wrappings like Tegaderm and Steri-Strips say stuck-on for days in harsh, wet weather, so buy a few tinctures. They're small and weigh little.

Get an irrigation syringe so that you can fill it with potable drinking water and wash dirt, pine needles, and pebbles out of fresh wounds. It should be 10cc or 12cc, not the kind of pencil-thin syringe that doctors poke you with, according to NOLS’ handbook. Isopropyl alcohol wipes and Betadine antiseptic solution are good for lightly cleaning minor wounds, and for washing your hands or tweezers before treating someone. Add a few triple-antibiotic ointment packets to apply to wounds before bandaging them up, so that you can stave off infection.

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A Miscellaneous Bag
In another sandwich-sized Zip-Loc, pack a tweezer and a safety pin for digging out splinters. You'd be surprised how often one works where the other doesn't. A couple of Popsicle sticks work fine as finger splints and cost practically nothing, and a Pro-Tick Remedy key removes ticks without breaking off their heads or making you sicker. Exposing the tick to fire or drowning it in alcohol could make it regurgitate into your body, according to the Michigan State University College of Human Medicine, so stick to a tick removal tool.

Bring sunscreen and lipscreen, but replace them if they’re nearing their expiration dates, since they lose effectiveness with age, according to The Skin Cancer Foundation. For bug repellent, DEET is effective, but it can melt plastic gear and clothes, as demonstrated here. Picaridin is a repellent that comes as a lotion you rub into your skin, and permethrin is kinder to use on plastics than DEET, but it doesn't repel insects and bugs; rather, it kills them upon contact. If you're medically trained, bring SOAP templates and a pencil to keep track of a patient's physical and mental state. If you're not, a small notebook works fine for details you can pass on to rescuers.

A Special Needs Bag
Rather than getting its own bag, special needs supplies ride loose in the large gallon Zip-Loc. Even if you're not diabetic, you could come across someone who is, so bring a tube of Insta-Glucose. Squeezed onto the inside of a person's bottom lip, a serving of glucose can rouse a person out of unconsciousness caused by hypoglycemia, NOLS’ handbook says. It weighs practically nothing and is cheap. Dental wax is for securing a loose tooth and covers exposed nerves, which can be incredibly painful when open to the air. If you can stick a knocked-out tooth back in its socket within a half-hour and hold it there securely, the roots will regrow and you'll save the tooth. Orajel, a rub-on oral pain reliever, alleviates less serious tooth injuries. The SAM Splint, a foam-covered aluminum sheet, was invented by an American trauma surgeon during the Vietnam War. It can be cut by a knife or shears and be repeatedly molded into shape as a splint for any part of the body.

Quick-Grab
Not in a bag at all, but in a pocket of clothing that's always on your body so that you don't waste time digging through your pack when someone gets hurt. Bring an extra pair of nitrile gloves, and an extra gauze pad or cravat you can toss to someone. He or she can apply it and pressure to the wound to slow down bleeding, and it'll buy you time to get your med kit out of your backpack. If you have an allergy serious enough that you own an epinephrine injection pen (EpiPen), then keep it in a pocket and make sure everyone in your party knows where it is. Symptoms of anaphylaxis could begin within seconds of exposure to your allergen.

Special Situations
If you're climbing or hiking above 10,000 feet and don't normally live that high up, bring Diamox tablets. Your body isn't used to breathing such thin air, as Schimelpfenig explains, so you're more prone to altitude sicknesses until your body adjusts. Diamox, a non-antibiotic sulfa drug, speeds up your breathing rate so that you acclimatize more quickly, according to the American Alpine Institute. But it typically blurs your vision, causes your arms to tingle, and makes you peeconstantly, so use it less like a crutch and more like a backup if you find you're acclimatizing too slowly. In extreme cold, or constantly wet environments of moderate cold, a few hand warmers can save you from frostbite. Toe warmers are similar, but are designed to work in areas with less air, like shoes. Don't ever wait until your hands and feet are cold to warm them.

For hunting, Schimelpfenig recommends a hemostatic agent—a granulated powder designed to quickly clot blood, such as Celox or QuikClot. “There are certain wound types where it may be helpful, such as junctional amputations and deep narrow-tract wounds where direct pressure is not easy to do,” he says, referring to bullet and arrow wounds more likely among hunters. You can buy hemostatic powder loose in packets or built into a gauze pad, but for potential gunshot wounds buy what looks like a big plastic syringe filled with Celox granules. It's best for sticking into penetration wounds.

Conclusion
We know: It's a lot to take in, but now that you know what you buy it's just a matter of a few Amazon purchases. Nothing is so exotic that you can't find it at pharmacies, Amazon, Walmart, REI, Dick's Sporting Goods, or most outdoors stores. If you keep on top of your supplies' condition, most of your med kit will last for years. Before every trip, look through your supplies and medications to make sure it’s all in good condition and not yet expired. Sterile packaging, if kept dry, lasts for a long time, but adhesives will lose effectiveness over time, Schimelpfenig says. “There really isn't anything in a first aid kit that, if used improperly, could harm."

But obviously, although a better med kit benefits even the untrained person, get some training so that you know how and when to use all these supplies. The Red Cross, REI, NOLS, and SOLO host local first aid courses all across the US and Canada that cost as little as a dinner for two. You've just built the most comprehensive, kick-ass med kit on the planet. Showing up for an afternoon to learn best how to use it will be a relative breeze.

Matt Jancer is a certified wilderness first responder.

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