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Building a Target First Aid Kit: Part 2

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In part 1 of “Building a Target First Aid Kit,” we discussed what a First Aid kit was for, and looked at the type of conditions where one can be useful. In this part, we start to populate the kit.

Building a Target First Aid Kit (Part 2)

A first aid kit is a must for any survivalist — or anyone who wants to be prepared for an emergency. But a first aid kit is only as good as the supplies in it. You have to make sure your kit is well-stocked with everything you need to treat injury and illness.

Check out our tips below for stocking your first aid kit.

Bandaging Cuts and Scrapes [1]

When starting a first aid kit, the initial thing to address is cuts and scrapes. Why? Because these are usually the most common problems needing attention, the problems which tend to need the widest range of supplies, and because many other problems have this as a secondary (post-treatment) need. It is helpful that the sale concentrated on these supplies.

Coconut Uses For Survival When You Have Nothing Left

Any time the skin is penetrated there are always three or four steps to go through for optimal results: cleansing the wound, disinfecting the wound, closing the wound (in some cases) and protecting the wound. Cleansing a minor wound is best done with running, hot, clean and biologically safe water, but this will not always be available. Manually removing particulates and wiping with a sterile cloth may be all that is practical. As for disinfecting, wiping (which may aid in the cleansing) or dousing with an antiseptic may be adequate, particularly if the cleansed wound is filled with an antibiotic as well. Minor wounds are often “self closing” by the bandaging; if any help is needed, butterfly bandages or surgical strips will do the job. Some wounds are best left open to reduce the chances of infection and to encourage healing from the inside out. Finally, protecting the wound is what bandaging is primarily concerned with.

For a small kit, the best source of antiseptics is individually packaged towelettes (wipes), usually alcohol (which has a tendency to evaporate in storage, and stings when applied), Providone-Iodine (may stain) or Benzalkonium Chloride (sting-free, clear). As for an antibiotic, you generally can’t do better than Neosporin or equivalent triple antibiotic (Bacitracin, Neomycin and Polymyxin B) ointment. This is available in individual pouches or various sized tubes. The pouches are smaller; the tubes are more convenient and durable. Be aware that some people, particularly children, may have allergic reactions to Neomycin; there is a “dual antibiotic” without the Neomycin available for kids, but it may be hard to find in individual pouches. Avoid the versions of antibacterial ointment which include “pain relief”; it sounds like a good idea, but these tend to use a petroleum jelly base because it is cheap and helps the topical anesthetic relieve pain, but the petroleum can react with the Bacitracin, making it unstable. If you can’t find what you want in individual packets, and you don’t have room for a regular tube, you can make your own individual packets using a bit of plastic drinking straw. ( https://equippedcat.wordpress.com/2014/08/26/drinking-straws-for-survival/ )

For small minor wounds, the bandaging of choice is the Band-Aid. Most everyone knows about these pads with adhesive wings. They come in a wide variety of sizes, shapes, types and appearances. A larger bandage can usually be used for a smaller wound, but a small bandage should never be used for a larger wound (any wound bigger than the Band-aid’s pad). Thus, my preference is to not bother with Band-Aids less than 1″ in size (unless young children are to be covered by the kit). Band-aids can be divided into two classes, water-proof and regular. I prefer water-proof, but they are sealed on all sides of the pad with adhesive, which means the pad is smaller, and thus they are for smaller wounds than regular Band-aids of the same size. They can come dosed with an antibiotic; I prefer to administer my own antibiotic. There are several types which are marketed as “comfortable”, decorative and/or “invisible”; these may be fine or even preferable under normal circumstances, but they are not as durable and should be avoided in any serious first aid kit (again, unless children are to be covered). The minimum class of Band-aid to consider, in my opinion, are the “flexible fabric” ones. Even better are the “heavy duty” ones (J&J calls them “Tough Strips”) which come with an enhanced adhesive. Finally, there are “special case” Band-Aids, most commonly for fingertips and knuckles.

Then there is “Tegaderm”, which is a waterproof film to cover and protect wounds from liquid, dirt and germs, while still allowing moisture out and oxygen in. It does not prevent using a small amount of ointment in the center, and being fully transparent, allows monitoring the wound without removing the bandage. They are available in a wide variety of sizes, big and small, and have a fairly high price in normal quantities ($1 each for small ones, on up). They are thin, flexible and hardly noticeable; almost artificial skin. There is also a “+pad” version which includes a pad in the center to provide some absorption and padding for the wound, but I’m not sure this is enough better than a waterproof Band-Aid to be worth the higher cost.

If the wound is too big or otherwise unable to be handled with the appropriate Band-Aid, then the solution is usually a gauze pad of an appropriate size. And some way to hold the pad on. Roller gauze (roller bandage) or tape are the classical ways to do this, although lately there is the cling wrap option. Roller gauze is just a roll of cloth (gauze) you wrap around to hold the pad in place and fasten by taping or pinning. It is available in various widths to match the size of the body part to be wrapped. Tape is also an old standard, but there are dozens of types of tape these days, and most don’t seem to hold very well under extreme conditions. The more “comfort oriented” the tape, the less likely it is to hold for very long or under stress. Good old “cloth” tape may be the most reliable; 3M has Nexcare Flexible Clear which seems to be a bit less obnoxious than cloth but seems to hold nearly as well. Whichever tape you choose, a 1″ roll would seem to be the best size of tape for a smaller kit; 10 yards is a good length and commonly available. There is half inch tape available, but I’d avoid it (doesn’t hold as well as the equivalent 1″ tape) unless it is all that will fit in your kit.

As mentioned, a modern competitor to the roller gauze is “cling wrap”. It might be called self-adherent, Coban (by 3M), Co-Flex, cohesive bandage, VetRap or Vet Wrap. This is a roll of material which sticks to itself but does not have an adhesive. It is used like roller gauze, but does not have to be externally fastened in place. Like roller gauze, it is available in various widths. Of course, some modern roller gauze also claims to be “self fastening”. From the examples I have seen, the roller gauze does not stick nearly as securely as the cling wrap, so I would still use tape or pins, but at least it should stick well enough and long enough for you to securely apply the tape or pins even if you have only one hand for the task. Roller gauze is more compact than cling wrap at each size, and smoother and more absorbent, so could actually be used without a dressing. If you wanted to shrink the size of the cling wrap, you could re-wrap it around a smaller hub; a section of drinking straw or popsicle stick perhaps.

When choosing your gauze pads, be aware that there are both “pads” and “sponges” available; make sure you know which you need and which you are getting. The pads are often better for bandaging, as you can get ones which are “non-stick”, which means that when you go to remove it for a change or to inspect the wound, it does not hurt or cause any damage. The sponges are good for cleaning and soaking up, but can stick to a wound and cause pain or even reopen the wound when removed. In the sponges, the more “plys” (layers), the better. Another pad option is called “Xeroform”, which is a pad soaked in petrolatum with 3% Bismuth Tribromophenate. These are non-stick and great for wounds which should be kept moist, such as burns and surface wounds (scrapes, “road rash”), plus they provide some antiseptic and antibacterial benefits. They are quite thin, and do not have a “dry” side, so probably should be covered with a dry pad or some other covering.

This mostly covers bandaging. There are a few additional considerations. For one thing, it is important that the bandage stays in place. One way to enhance this is to paint the skin with Compound Tincture of Benzoin (CTB) which protects the skin from the adhesive, and, more importantly, makes the adhesive work better. The best choice here is individual ampoules, but these are hard to find in small lots and the big lots seem quite expensive. “SwabSticks” are somewhat bigger, but easier to find in reasonably priced lots, and a bit easier to use.

Next, wound dressings (particularly non-waterproof adhesives) and water do not get along at all well. And, after going to all the trouble of disinfecting a wound, it would be unfortunate if new infections were washed into the wound. One of the items included in the sale is the J&J “Shower Care”, an adhesive film which covers the bandage and protects it from “showers”. These allegedly don’t help if the wound is immersed in water, but any additional protection from external infection or loosening of adhesion is worth considering. In the same vein (so to speak), fingers are tough to bandage, both because they move a lot which encourages adhesive failure, and because they get wet a lot. Finger cots, sort of like just the fingers of exam gloves, can be helpful to keep the bandaging in place, and the water off.

Finally, there is a common inclusion in first aid kits called a “triangular bandage”. Despite the name, it is not primarily a “bandage” although it can be used as one. Being a large triangle of cloth, it has many other potential medical uses, including fastening on a dressing or splint, or making a tourniquet or sling. I prefer the “Dry Sterile Burn Dressing Super Combat Cravat” by H&H Medical. Why I like it is that it is 1) sterile, thus provides some large bandaging options, and 2) larger than many, 45″ on a side and 63″ on the diagonal. Standard triangular bandages would probably be adequate, and possibly be in a smaller package and/or cheaper.

Best Protective Items

You should have noted the importance of preventing bacterial contamination of wounds during the discussion of Bandaging. Plus, in this day and age, you will want to protect yourself from the blood and bodily fluids of those you are performing first aid on. So at a minimum, you want to have several pairs of gloves. There are a wide range of possibilities. I prefer sterile, since it is just one less source of contamination. Unfortunately, as with many things sterile, the packaging significantly increases the volume, so a combination of sterile and non-sterile may be necessary if space is limited. I prefer non-latex because some people are allergic to latex, and I prefer non-powdered because the powder can be messy. And I prefer surgical gloves, since they have a “right” and a “left” and are more comfortable than the “universal” exam gloves.

Surgical gloves are sized by number, up to 10.5 or so, as opposed to the S/M/L/XL/XXL of standard (“exam”) gloves. Unfortunately, each manufacturer uses their own forms, so a size 9 from one company may not be the same size as a size 9 from a different company. It is best to try out pairs of various sizes each time you get gloves from a new company. Too small and they will be difficult to put on and more subject to tearing; too big and you will lose dexterity and they can get in the way of what you are doing.

Similarly, in case mouth to mouth resuscitation or classic CPR will be done, some kind of barrier between your mouth and the patient’s would be appropriate. I like the mini full face shields like those by Ambu. They inexpensive and very compact, cover much of the face to prevent contamination either way, are clear so you can monitor the patient, hook over the ears for security, and have a “one way” valve for safe performance of artificial respiration.

Finally, you will want to be able to clean yourself up before doing first aid, and possibly after. A disinfectant towelette is the most practical method to include in the kit. Any non-staining disinfectant or antiseptic will do, but I prefer VioNex from Metrex as being gentle to use and not messy.

Quantity

Choosing the items to include is not too difficult. Choosing the NUMBER of each is rather more of a challenge. Obviously, the more of each item you have, the more things you can deal with. On the other hand, it should be obvious that the more stuff you have, the more space you will need (or you will have to leave other useful things out), and the more it will cost. I tend to use a “doubling” formula, where I have one of something big or less likely to be used, two of smaller or more likely things, four of even smaller or even more likely things and so on. In some cases, the product packaging may influence the decision. If the package contains four, putting five in the kit would require extensive justification since you would have to buy another package, and have three left over.

Summary of Medications, Bandaging and Basic Protection

My contents list to cover these:

(The number under “Uses” refers to the number(s) listed after the problem(s) to indicate which are addressed by the item)

Part of Sale? # Item Alternatives (Notes) Uses
         
0 Prescription medications (No current ongoing conditions)
0 OTC Medications (To be listed under the problem addressed)
0 Fresnel lens, 2″ x 3 1/4″ (credit card) (Will use splinter magnifier instead)
8 Benzalkonium Chloride Towelette/Wipe or providone-iodine or alcohol or a combo 1
yes 1 Neosporin 0.5 oz tube Triple Antibiotic or individual pouches or dual antibiotic 1
1 3M 1/4″ x 4″ Steri-Strip, pack of 10 or large butterfly bandages 1
2 3M 1/8″ x 3″ Steri-Strip, pack of 5 or medium butterfly bandages 1
yes 8 J&J 1″ Waterproof Tough Strip Band-aid 1
yes 8 J&J 1″ Tough Strip Band-aid 1
yes 4 J&J XL Waterproof Tough Strip Band-aid  (1 3/4″) 1
yes 4 J&J XL Flexible Fabric Band-aid (1 3/4″) (Tough Strip version has the smaller “waterproof” pad, so would be duplicate) 1
yes 4 J&J Large Waterproof Pad (2 7/8″ x 4″) (Hybrid between a pad and a Band-Aid) 1
yes 2 J&J Waterproof Knuckle Band-aid 1
yes 2 J&J Waterproof Fingertip Band-aid 1
4 Curad 2″ x 3″ gauze pad or 2″ x 2″ (They didn’t have J&J 2×3) 1
yes 2 J&J 3″ x 4″ gauze pad or 3″ x 3″ or 4″ x 4″ 1
2 McKesson 4″ x 4″ 12 ply sponge, 2 pack 1, 3
2 Integrity Xeroform 4″ x 4″ or 2″ x 2″ or 5″ x 9″ or other size or combo 1, 3
0 3M Tegaderm 2 3/8″ x 2 3/4″ or 1 3/4″ x 1 3/4″ or 4″ x 4 3/4″ or 6″ x 8″ or other size or combo (Will probably add some if I find them at an attractive price) 1, 3
yes 0 J&J 2″ x 2.5 yard Kling roller gauze or cling wrap or 3″ (Too big for my case) 1
yes 0 J&J 4″ x 2.5 yard Kling roller gauze or cling wrap (Too big for my case) 1
4 Safety pin size 3 (2″) 1
1 Nexcare 1″ x 10 yard Flexible Clear Tape or J&J cloth tape 1
2 PTI Compound Tincture of Benzoin (CTB) SwabStick or ampoules 1
yes 2 J&J Medium Shower Care Sheet (4″ x 5″) 1
6 Flents Finger Cot (2 each S, M, L) 1
1 H&H Sterile Super Combat Cravat or other triangular bandage 1, 7, others
2 Medline Sterile Surgical Latex Free Glove, pair
4 SemperShield exam glove (individual)
1 Galarneau Mini CPR Face Mask or Ambu (in 2″ x 2″ case) 11, 12, 14
4 Metrex VioNex towelette

In this list, the items are fairly comprehensive, but some of the numbers are a bit small since I spread the products purchased over 4 kits. In particular, the number of sponges is way low according to some experts. Adjust the numbers to your preferences and situation. The Target cases are not really sized to include roller gauze and probably can’t contain cling wrap wider than 1″ unless it is repackaged.

Want to know more? Check out these related articles:

First Aid Kit List

Must-Have First Aid Kit Contents

What to Include in a Home First Aid Kit

 

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