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Interviewer: So what kind of first aid kit do you really need? I mean there are so many options at sporting good stores but do you really need the biggest and most expensive one? We'll examine that next on The Scope.

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Interviewer: So you know how when you go into a sporting goods store to buy a first aid kit because you've got some longer hikes planned or you want to go camping or something else outdoors. And then you get to the aisle and you're paralyzed by all the options, the prices, the sizes and then you just leave without one because you're so overwhelmed.

Well we're going to try to help maybe make your trip to the store a little bit more fruitful next time. Dr. A.J. Wheeler is from St. Johns Medical Center in Jackson, he's also the medical director and a member of the Teton County Search and Rescue Wyoming and he's going to help us out.

Actually let's step back for a second and ultimately what is the point of the first aid kit? What is its job, in your opinion?
Dr. Wheeler: Well my opinion and my experience with search and rescue, most first aid kits need to be able to treat the most common injuries which happen in the back country which is by far soft tissue injuries. Bumps, cuts, scrapes, bruises, strains and sprains.

Interviewer: Okay.

Dr. Wheeler: The majority of people will encounter one of those if they have a medical problem on their trip. So that's what I generally lead people towards stocking their first aid kits for.

Interviewer: So I'm standing in an aisle, which one should I get?

Dr. Wheeler: When I look at the first aid kits that are prepackaged, often the most valuable thing you get out of the prepackaged kit is the case itself. So I'm definitely looking for something that is a hearty case, some kind of bag and I would prefer it to be waterproof. Your supplies won't be much good if they get waterlogged and then aren't useful at all.

Once I get past that, I want to be able to actually open the kit up in the store and look at its contents. Many of these kits have questionable quality as far as the components that are in the kits are concerned. And so I like to go through and see that the dressings are substantial dressings, that the band-aids and the medications and stuff that they may include in there look like they will actually hold up to back country rigors that they're likely to encounter.

Interviewer: Yeah, so in that instance the cheapest one might not be the best one because they've used substandard materials.

Dr. Wheeler: Certainly. The other pitfall that I see that people buying over the counter first aid kits is that they buy the kit and they don't ever open it up. They think great I have this kit, I'm all set, they throw it in their pack and off they go. Which leads to several problems. First, they don't know what's actually included in the kit.

And then the second problem is, you really should check your kit at least once a year. Go through the contents of the kit to make sure you're familiar with what's in there, but then also to go through and make sure that over time the dressings haven't degraded. You definitely can find some pretty grody things inside a first aid kit that's been stuffed in the bottom of a backpack for two or three years and not opened.

And you're going to need to regularly change things out in those kits. And that gives you then the opportunity to say, "Last season when I was out I wanted..." whatever, "and it wasn't there so I'm going to add that to my kit this year."

Interviewer: Yeah, like maybe some sort of blister kit or something like that in case you get blisters. That's a good idea. So when I'm in the store and I'm looking at the small one versus the big one, is the big one pretty much... is there a base kit and then the bigger they get they just add more bells and whistles and things. Is that how they usually build those out?

Dr. Wheeler: That's what it seems like to me. Certainly, some companies do a better job than others. And really reading what they are describing that kit for is really useful. The companies will definitely market ultra light ones and those are perfect for the mountain biker. It's got some band-aids in it, some ibuprofen, nothing else.

The two to three day kit is going to have more bandages and that kind of thing in it, it's going to maybe have a bit more medications and some more wound care. When you go over the week type kits, those are going to tend to be a bit more inclusive and may actually include some survival gear in those kits that you might need if you get into some trouble on a week long trip.

Interviewer: What are the must have items in there? Could you just name a few of those?

Dr. Wheeler: There are some things that are just hard to improvise when you're in the back country and those are generally the things that I try to identify as the must haves. One of those is definitely tape. It is very hard to improvise tape when you need it. Tape is very, very versatile and you can use it for gear repair as well as for medical dressings if you need to. And so having a good durable tape in your kit, I think is very important.

Some of the other must haves, I definitely think some kind of self adhesive bandage. The co-band is a self adhesive bandage that is compressive, which can be quite useful or perhaps an ace wrap. These are things that you can use to help make a splint or bandage larger wounds.

The other things that I also consider to be pretty important would be PPE or personal protective equipment. Definitely if you're going to be bandaging somebody else's wound, it's nice to have a pair of nitrile or latex gloves so that you don't have to stick your fingers directly into their bloody secretions. Pain medications. Just simple ibuprofen for most cases is perfect. But if you are going on a longer trip asking your physician perhaps for a prescription for something a little bit stronger to carry.

And then my personal favorite is the cellphone. I think cell phones are amazingly useful and you can put information on the cellphone, you can call for help from your cell phone and with the GPS capabilities most cellphones have you can even locate yourself.

Interviewer: I've heard that having some sort of something in case you get diarrhea while your out in the back country might be good. What's your opinion on that?

Dr. Wheeler: You know what, I do think that that is a good consideration. That's going to be I think more for those longer trips. Obviously, if you're out on a two hour bike ride, you probably don't need to carry the over the counter diarrheal aid with you for that. But if you're planning on being out for three or four days, copious diarrhea certainly could slow you down or perhaps even prevent you from continuing that trip.

Interviewer: What are some other things for those longer trips that you definitely want to take along? I like your thinking that there are just some things that you can't improvise.

Dr. Wheeler: For longer trips we definitely like to have something along for allergic reactions and so carrying some Benadryl, over the counter Benadryl is a great medication to take with you and that can also be used as a sleep aid if you have a noisy tent partner. And we also like to think about medications that people may already be on, you definitely want to continue your regular medications when you are on a trip like that and so carrying your normal medications. And probably planning a day or two extra, just in case with those medications.

Interviewer: Is there a resource that you would like to recommend for somebody that's maybe doing a little research?

Dr. Wheeler: There are definitely a lot of resources out there. The Wilderness Medical Society, WMS.org has some guidelines on first aid kits and that's where I learned a lot of what I recommend. And then a blog by a physician named Chris Van Tilburg who also taught me a lot of the stuff that I've passed on is also quite useful.

Interviewer: All right, any final thoughts on this topic? Anything you feel compelled to say or anything I forgot to ask?

Dr. Wheeler: Carry a first aid kit. I think the most common mistake I see, especially in those people who are planning shorter trips that maybe go a ways back is that they don't carry anything. The trail runner who plans to only be out two hours but then sprains his ankle six miles back without any supplies. Really those are the cases where I find people aren't prepared at all.

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