Medical kit vs personal care kit

Recently I have mostly done day hikes instead of multiday trips.  This has gotten me thinking about my medical kit being overkill for such short trips, and not having enough "personal care" items.  In a previous post I talked about my loudouts for various medical kits.  One that I am now starting to think about is a personal care kit, which to me is an extension of a foot care kit.

While a group will probably have a single medical kit, which has supplies appropriate for dealing with a medical emergency, each member of a group should carry a kit of supplies to help mitigate issues and deal with minor problems.  One major problem that this kit needs to be able to address is hotspots and blisters.  Being such a common problem it is best if everyone has enough supplies for the length trip for their normal foot problems, and hopefully something like trail toes or body glide to prevent these problems.  Additionally each person should have sufficient doses of their preferred analgesic for minor aggravations.

Another critical item, especially in rougher terrain, is a roll of 1" or 1.5" athletic tape.  This can be used to deal with minor hotspots prior to them becoming a bigger problem, as well as being useful for an ankle supporting taping.  This is a critical skill to learn, and I recommend everyone take at least a WFA class so that they learn this along with other skills.

Some other items make this kit more useful, depending on conditions and how much weight each person wants to carry.  Tincture of benzoin is useful when trying to get tape or moleskin to stick, especially in warmer weather when a lot of sweating is happening.  I would also consider adding lip balm to this kit along with some sun screen to deal with wind and sun exposure in all seasons.  Sun burns are unpleasant, and in the long term increase risk for skin cancer.  During warmer months adding a backup of insect repellent can help reduce the chances of mosquito and tick borne diseases.

For day trips the sunscreen and insect repellent are mostly backups for previously applications.  It makes sense to have single use packets of these items to reduce weight, and since they may not be used every trip.  Likewise a small bottle of each is useful for multi day trips, since reapplication will be necessary, and the reduced waste is preferable.

It is important that each person in a group have the minimum items to deal with their likely or known medical problems without dipping into the groups medical kit.  In most cases a few preventative items can go a long way, allowing fewer treatment items to be carried by the group.

manmade tinder practice

Today I decided to finish off the second exercise in the Bushcraft forums Bushclass.  For this 5 manmade tinders need to be lit by ferro rod.  I selected the following materials, Tinderquick tab, FAT tinder, Esbit tablet, IGKNIGHT fire starter brick, steel wool, and Livefire.  Here are my experiences and observations.

Tinderquick:

This was the easiest of all to light.  It took only a single small spark, however it does burn out fairly quickly.  The ease of lighting makes them great for a real situation where you need a fire.  However I think really good prep will be needed in wet conditions due to reduced burn time.

FAT tinder:
These little tinders are what I have with my paracord bracelet.  Like the tinderquicks they are easy to light, but have a reduced burn time.  This can be extended by placing the rubber ranger band holding them on the bracelet into the mix.  They are nice because you can carry many in a small space and always have some available.  They are also sealed so they won't get wet.

Esbit tablet:
The Nesbit tablet is a real pain to light.  It took many attempts with a small ferro rod.  Obviously it is very long burning, since it is primarily for cooking, not fire lighting.  It also burned cooler than most of the other tinders.  This would not be my first choice to start a fire, but it would work in necessary.

IGKNIGHT bricks:
These are my second favorite tinders.  They are easy to light, though not as easy as a tinder quick.  They burn very hot and for a reasonably long time.  Generally half a tablet works well, and a full one in wet conditions will get stuff going.

Livefire:
This is always in my kit.  It lights fairly easily, has a very long burn time, and can be turned off easily by shutting the lid.  Thus it is good for starting many fires, as well as providing light or even cooking using my Emberlit Fireant if wood isn't available.  It is so useful, and really light.

Small Ferro Rod Strikers

Lately my primary means of starting fires has been the ferrocerrium rod.  This is one of those situations that bigger really is better however I always have seemed to have gotten small rods.  Primarily I do lighter weight backpacking and hiking, so carrying a 1/2 inch bar doesn't seem to fit that.  Additionally when I am out backpacking there is usually some backup, either a mini bic or some stormproof matches.  I use the ferro rod most often because it takes more skill and practice, and it takes time to get good with.

Recently at navigator I tried making a fire in the rain with the kit I brought.  I had good tinder material, chunks of fatwood, jute cord, and waxed wood shavings.  I also brought the Sparrows Lockpick flint butcher set.  This consists of three ferro rods, one large diameter that is stubby with a hole and lanyard, another longer moderate diameter, and a smaller one drilled with 2 holes.  It also comes with a dedicated striker, which has an aesthetically interesting design, looking much like a butcher knife.

At navigator I found using this striker to be very difficult when my hands were cold and wet.  I have seen some people on the internet connecting lanyards to it, which gives more usability, however I still not convinced it will work well in cold weather situations.  Eventually one of the other participants used his gobspark to get our tinder lit.  So I set out last night to try a bench top experiment with different rods and strikers all of small size.

The gear:
flint butcher set
LMF style rod with handle and striker from livefire
ceramic striker from wazoo survival
rod equivalent in diameter to those in some buckles
cheap and crappy ferro rod and magnesium block

For each of the ferro rods I tried each of the three dedicated strikers and subjectively compared the consistency to generate sparks and especially huge ones.  I found that the hardest to use was the flint butcher striker.  I only ever got weaker sparks, and never the big gobby ones that stayed lit for a while.  This could still be a technique issue, but as of right now it isn't working well for me.

The middle of the road was the scraper on the livefire striker.  This worked well on all of the ferro rods, however one issue with it is that only one of the sides has a good 90 degree grind.  It does also have some grooves at the end, which can also be used.  This is also the piece of kit that I have the most experience with.  I have had trouble before in wet weather with consistency.

The last and my favorite of the bunch was the little ceramic striker from Wazoo.  It was the easiest to get lots of consistent pressure and big sparks from all of the ferro rods, regardless of size.  It is also the smallest and lightest of all 3 strikers.  That is an advantage in my view in warmer months where you won't have gloves, but it would be the hardest of them to use with gloves.

So what I learned was that for the smaller sized ferro rods the best performing dedicated striker I tested was the small ceramic one.  As such I will likely switch to carrying that instead of stashing it deep inside my survival kit.  Additionally for colder weather conditions a different setup is probably a good idea, specifically one that works well with gloves on.  One of my big concerns is still weight, so I likely will never carry a giant ferro rod all year round.  From what I saw at navigator the gobspark is probably a good bet for winter.

Navigator Core AAR

Over the weekend I attended the Goruck navigator core event in Lost Nation VT.  I didn't know what to expect, other than learning a bunch of navigation skills which was my goal.  I am a hiker and trail runner here in New England, and have always relied on trail systems and easy egress.  We have good trail networks here, and most land is surrounded by roads.  So while I carry a compass, it is generally so I can go in a straight line until hitting a road if necessary.  I really wanted to change that and get some real skills.

The packing list I looked at had some stuff that was never used, and is not listed below in my load out, such as a cordellet and webbing.  Since then they have updated the list, which is very much inline with what was actually used.  So my full load out was not very optimized.  I am use to running lighter weight gear, so packing like this is a bit out of my element.  However, I felt ready for whatever cadre threw at us.

I arrived the night before after the 4 hours in traffic heading out from Boston.  I was greeted by the folks from the navigator legacy event, who where all around the campfire.  Soon after a couple of other folks from my class showed up.  We had a good amount of time that evening to talk with the cadre and the legacy participants.  This was insightful in regards to what to expect, as well as good outdoor knowledge.

We started out at 0800 with a  bunch of classroom information on map reading.  I have never dealt with maps in this way before, so it was very informative.  Cadre Doug was really good at teaching us how to read the map, and gave us a bunch of exercises to help us understand how to use the UTM grid.  Following this we had our first movement.

Unlike a regular Goruck event which is team based, our movements were solo, and skills focused instead of PT focused.  That isn't to say that the movements were easy easy, the terrain was difficult, steep, and at some times with thick foliage.  For the first movement we had a single location to get to,  however it still required some route planning to get from the easy low ground up to our individual points at the top of the hill.

After we returned we had more classroom time, and learned new skills necessary for locating our position if lost.  Then we started our big movement.  This one involved hitting 4 different checkpoints.  During this movement I mistakenly attached my Spot tracker to the shoulder strap of my ruck, which may have disrupted my compass some.  However the bigger problem was traveling through such rough terrain, where I probably got off course some.  This prevented me from solidly hitting my next point.

This big movement was my first time really spending time out at night.  It was intimidating at first, but it the became fairly comfortable.  It might not have been as easy if following a trail, but moving with map and compass it was very reasonable.  I am glad for this experience, and learned a great deal.

The next morning we had a chance to try finding our position using known points.  Unlike most of the places I hike, the peak of our hill was heavily wooded.  In addition the weather was less optimal, with reduced visibility to other hilltops.  This made resectioning more difficult, but between that and using a bit of logic with the terrain it was possible to figure out which peaks I was actually looking at.  

At the end of the course I felt confident to truly start the next part of learning about navigating.  While I had trouble actually executing the navigation during the event, I feel confident to go out and try this some more.  Luckily I remembered there is a fixed orienteering course in my home town, which I plan to use my compass skills and pace count to try to hit all the fixed points.

Loadout:
Base: Patagonia RPS pants, Patagonia Caplene midweight, wool injini socks, 
Mid: Patagonia nano air and Patagonia nano puff
Shell: Patagonia super alpine and EMS hiking pants
shoes: 5.10 aesent for day 1, altra superior 2.0 for day 2
socks: 2x Darn Tough, injini toe socks
Hydration: 3l source bladder, nalgene with pace lid
pack: GR1 with waist belt
Sleep system: Tarp tent notch, black diamond alpine z poles as support, zlite pad, sea to summit comfort light pad, EMS velocity 35 degree bag, enlightenment gear 20 degree quilt
nav tools: seat2summit map case, map tools super GTA scale, Suunto mcl compass, pencils, waterproof field notes notebook

Vacuum sealing med gear

Tonight I did a small experiment in reducing bulk in my group medical kit by vacuum sealing some of the components.  I had gotten a food saver to package backpacking meals, but figured that some of the bulkier components of my medical kit could be a bit more compact if vac sealed.  This took a fair bit of trial and error since I haven't used the food saver much.

What I discovered is that the best vac is pulled when the bag is significantly oversized compared to the item when it is a soft item such as a 3x3 or elastic bandage.  This obviously adds some mass to the kit, however this particular kit is optimized towards small group adventures instead of fast backcountry trips.

I also found that the vacuum pulled by a food saver is by no means near what is used by commercial manufacturers.  I have a few vac sealed roller gauzes, which show less volume than the supplies that I prepared, however the cost is much higher than normal supplies.  Thus is my small experiment in gear prep.

Pros:

• waterproof
• smaller size for gear
• supplies will not get contaminated/outer packaging can be cleaned
• can turn round gear into flat gear
• can prepackage procedure kits

cons:

• extra mass
• slower access

Tully Trail - central MA

Gear list:  (*new)

Primary clothing:

 Patagonia capilene t-shirt

 Patagonia RPS rock pants

 Uv buff *

 Injinji wool socks

 Altra superior 2 shoes

Pack

 Gossamer gear gorilla 40L

 2x medium stuff sacks

 Cuben fiber zipper pouch

Extra clothing

 Patagonia super alpine shell

 EMS hiker rain pants

 Patagonia R3 fleece

 Darn tough wool socks

Shelter/sleep

 Tarptent notch + footprint *

 Ems velocity 35 degree bag

 Bag liner

 Gossamer gear inflatable pillow

 Sea to summit comfort light pad *

Water

 2l hydration pack

 Sawyer mini filter

 16oz sawyer bag

 Straw for filter

 Syringe for filter

General gear

 GSI soloist cook set

 GSI spice missile

 Pot coozy

 Emberlit fireant

 Firesteel with striker

 Petroleum cotton balls

 Gear repair tape

 Trowel

 Tp

Goal zero guide 10 adventure set

Sawyer bug repellent *

Ambit3 vertical

Small fixed blade knife

Suunto clipper compass

Sea to summit map case *

Trash bag

Medical kit-backpacking loadout

Book

BD spot headlamp with extra batteries

BD Alpine carbon Z trekking poles

Pencil and logbook

Food:

 1.5 cups trail mix

 2x munk pack apple oatmeal

 1 instant coffee

 1 mre instant cappuccino

 Homemade unstuffed peppers

 2x maple waffles

 Mountain house breakfast

 Mesh sack and cordage for bear bag

   

Weight without water: ~18 lb

I decided that I needed to get away for a while on a backpacking trip over the weekend.  It was first solo trip, and actually just my second backpacking trip ever.  I just got some new gear, like a tent for solo backpacking and some new trekking poles (mostly for winter use).  So I was eager to get out and try them, and also take a weekend off from my training routine for my upcoming ultra.

This was a good time testing out some gear and trying new things. I loaded a bit heavier than if I were doing a longer trip since I knew it was a fairly short loop. This gave me the chance to try things and see what worked and what didn't. For the most part I am happy with what I brought, even though there is much room for optimizing such as lighter rain gear. The thing that I didn't like however what how I loaded the pack.

Day one was a late start, getting on trail a bit before noon. I checked in at the ranger station at the Tully Lake Campground and then was off. I took time early in the trip to make the side trip over to the ledge lookout, about 1.5 miles into the trip. The view was nice and is worth checking out. After about 2 miles in I had the trail to myself. Even in the first couple miles I only saw a few other people, which was nice. For the majority of the day I was alone. The only section a significant number of people is around the Royalston falls shelter. There is a parking lot nearby, and a significant number of people made the short trip while I was cooking dinner.

As to cooking dinner, I used the fireant as a biomass stove. The last time I used it didn't go all that great, however this time the available deadfall worked well. It was easy to get going and stayed lit throughout cooking dinner. For dinner I brought a home made dehydrated meal. This is my first time making one, and it mostly turned out well. I added a touch too much tomato sauce and also brought too much. I think the 'regular' size version would be fine, with some sort of side or desert added.

I got to try setting up camp with the new tent. It was a bit tempting to stay in the shelter since I have never done that, but that will be a different trip, with a bug net. The new tent is my first non free standing tent, and uses two trekking poles as support. It wasn't hard to setup, though it did take some fiddling with to get right. I probably should read through the instructions yet again before the next time I go go out. Even so it was setup fairly quickly.

After dinner and setting up camp I had plenty of time to read. This was weight that was very much worth it. This leg of the trip was really short, and even after setting up camp and eating there was plenty of daylight to kill. I got plenty of reading in, and it helped me settle into bed. I think light books might need to become a regular on my trips.

That night I got to try out the new sleeping pad. It was really comfy as I was laying down reading. However, it did slide a good deal in the tent, so I will have to put a few lines of sealgrip on the floor of the tent to prevent this in the future. It was still a major upgrade over my z-fold pad, though also heavier.

After a long nights sleep I woke up a bit late Monday morning. I had figured that I would naturally get up when I do to go to work, which is around 5, however I slept in until after 730. There went the idea of an early start. Breaking down camp was quick, and took maybe 10 minutes to get everything down and repacked. I then had an MRE cappuccino with cold water. This tasted surprisingly great. I think I prefer it to the normal instant coffee that I bring in winter.

After packing up and having my morning caffeine I hit the trail. I decided that instead of making the dehydrated breakfast that I brought that instead I would eat the snacks from the day before that I hadn't finished. This saved a good amount of time in the morning, though a full meal would have been better if I had woken up on time.

The second day of hiking was nice and I had the trail to myself. The trail is generally well marked, except for a few sections of road. I always hate those areas since I am a bit paranoid about missing the turn off, and wanting to be off the road ASAP. At the end of the trip I missed the turn where the Tully Trail does into the parking lot for the park before following the lake back to the campground. There is another trail, the Tully Lake Loop, which is also yellow blazed and follows the other way around the lake back to the campground. I ended up taking that, crossing the bridge and entering the woods by the disk golf course. This side trip had some nice views, and is worth doing but I wasn't expecting to tack on another ~5 miles to the day. Between that and a late start to the day I got out about 2 hours later than I had planned on.

This trip was a good bit of experience trying new things and seeing what works and doesn’t work for me.  For the most part my gear is lighter weight, although I don’t strive for crazy light weight like some people.  Personally I won’t sacrifice some things like a reasonable medical kit or a real knife just to hit some pack weight.  That being said my pack was heavier than ideal for this trip, though I tolerated it given the short distance and last minute planning.  This lead to a number of things that worked well and a number that didn’t

The first big annoyance for me was the choice to take the 16oz soft bottle that came with my Sawyer mini water filter.  On the trail I use a 2L bladder with the filter inline, however this isn’t ideal in camp.  The last trip I did, as well as when camping at Baxter I had a 1L soft bottle that the filter can screw onto.  This is much better around camp while cooking and hydrating.  I think it makes sense to be a standard setup since the 1L platy weighs just 35g. Not very heavy for much more convenience.  It also gives me the option for more water in situations where that makes sense.  

I took my solar charging kit on this trip, which I don’t normally while hiking.  It usually comes on car camping trips where I am setting up camp to go climbing or hiking in a specific area.  It is a reasonably heavy bit of kit at about 1 lb.  The reason I brought it was that it was my first time using my gps watch for a long hike, and I wasn’t sure if it would need a charge or not.  It turned out that it did, however I think if I had just charged up the battery pack I have that would have been sufficient for this trip.  In the future I will probably just bring a battery pack by itself pre charged instead of also bringing the solar cells.  For longer trips (>3 days?) I might consider bringing the panel.  I think that one of their new battery packs like the flip 20 and changing some settings on my watch will be sufficient.  Also turning off my phone at night and putting it into airplane mode during the day will be useful.  I tend to use my phone as my camera, so it would be a pain to leave it off all the time.  

One thing that worked very well this trip was my stove and cook kit.  I used the emberlit fireant for the second time, and it worked out great.  I fueled it with small deadfall that I found around the shelter.  This was all that was needed to bring my dinner to a rolling boil reasonably quickly.  I then used my insulating coozy to finish cooking.  I have used the pot and coozy combo a few times now, and it is really a great way to make dehydrated meals, or anything that has to simmer.  

Overall this was a wonderful trip, and I learned a lot.  I will be making some tweaks to my setup for the next trip.  I am happy though that for the most part my gear selection seems to work well, even if it will slowly evolve over time towards more efficiency.  

Medical Kits

Last weekend I took the Wilderness First Aid class from WMI/NOLS.  This is the first medical class I have taken since finishing paramedic school in 2009 and deciding to move back into research.  The class was great, and I picked up a few tricks even with the thousands of hours of training and years of experience in emergency medicine.

This class was good motivation to restructure my wilderness medical kit into three.  I had one kit that was used for a wide variety of activities, ranging from backpacking to rock climbing.  This lead to a kit that was overbuilt for some activities like lightweight backpacking, and not enough for cragging with a bunch of friends.  I have been thinking for a while of restructuring into two kits but it hasn't been a real priority until recently.

So I want to talk about kits, and why I think it is a really important item, and my thoughts on being prepared in the woods.  First off, if you don't have any training, or it lacked hands on time, or it has been a while, get some training.  While I have a high level of training I haven't practiced in a long time, and I felt rusty at the class.  Take a class, and make sure it has a hands on component.

Through work I had to take an AHA first aid class which lacked hands on.  This was not helpful in my opinion.  For anyone to actually do something useful, especially where EMS is not readily available, you have to have some hands on time with skills.  This is how EMT classes work, you spend hours doing patient assessments, splinting, back boarding, and setting up oxygen in addition to learning the medicine.  I liked how the NOLS WFA class followed idea this with a heavy focus on assessment and scenarios.

Through this training you will better appreciate what to put in a kit.  However, I feel like a medical kit for wilderness adventure will always change.  You will learn new things, especially if you take more classes, or through experience you will figure out some things work better for you than others.  Even so I would recommend making a gear list, and keeping it up to date with how you want a kit setup.  I use github as a way of tracking versions so I can easily go back and see previous setups if I want.  However you do it though, this list is important.  It allows you to periodically restock your kit, because hopefully you aren't using the big items in it often.

As to the contents themselves you need to evaluate the activities you do, what types of groups you travel with, your level of skill, and also what you feel comfortable providing to a stranger in distress. These are all personal questions so there is no one size fits all kit.  Though many of the kits available through NOLS or adventure medical can be a good starting place.

I know some people skip carrying medical supplies, or carry just a few bandaids and pain killers.  To me this seems irresponsible in the wilderness.  While major things are uncommon, when they do happen having the right items can make a difference in outcomes.  Everything is a tradeoff however.  More medical supplies that may never get used means more weight.  On a long backpacking trip that is an issue.  So optimizing for light weight matters a lot.  But day hiking you can think of it as training weight, especially if it isn't a major objective.  The way I broke it down is into 3 kits, one for trail running and fast packing, another for general backpacking, and a third as my general use kit.  The general backpacking is a fairly comprehensive kit, though it is still reasonably light, whereas my general kit is suitable in situations where I might have a number of people in my group.  This gives me three options based on the activity. You might find that more than 3 kits suits you, or maybe 2.

My kit lists are available for viewing at https://github.com/spowers42/gear-lists  I hope they prove useful as an idea on how to put together a kit.