What's in Your "Oh Shit Kit"?

In preparation for another season instructing in the Colorado Rockies, I've been sorting through my gear closets and passing along the equipment that I no longer use or need. When I came across my emergency kits, it occurred to me I don't remember everything I put into these many months ago when I made them. With that in mind I figured this was the perfect opportunity to talk about emergency preparedness. 

It's nobody's favorite topic, but preparing for backcountry emergencies is a necessary aspect of the outdoor sports we choose to participate in. Before I start on my choices for emergency gear, there's a few things I think are worth getting out of the way.

To start with, equipment is useless without the knowledge of how to use it. The best of the best when it comes to training is a Wilderness First Responder (WFR) course. They are offered throughout the country by numerous organizations and is the current industry standard when it comes to backcountry emergency medicine. But, hopefully you know this already, and if you haven't taken the course, you've already figured out when you're going to do it. At a very minimum, a Wilderness First Aid (WFA), is a good starting point for any backcountry enthusiast. 

Ok, now let's get into emergency kits. You'll notice I'm not calling them first aid kits. While first aid is typically the largest component of any emergency kit, it shouldn't necessarily be the the only thing you have with you. Your "Oh Shit Kit" should have the ALL items you need in case of emergency. Lastly, it should also be separate from the items you should also be bringing in case of bad weather or a long day, like an extra down jacket, or headlamp. 

Disclaimer: This article in no way replaces medical training and experience. The equipment you carry should be a based on the activity, location and your own critical thinking based on your training and expierence. 

Basic Kit

Let's be honest. No one likes carrying more than you need to. A bulky emergency kit is a nuisance, especially since it takes up space and never gets used. We all know that whatever "first aid kit" you bought at REI has way to much crap you don't actually need. For routine trips into the backcountry, its often the first thing we glance over when we go to pack for a day at the local crag or backcountry ski hill. For areas close to roadways, or with good cell coverage, we often skip the first aid kit. The next time you skip out of work early for a quick session at the crag, ask your partner where their first aid kit is. Do you know the answer already? For their sake and your's I hope you do. 

I don't like carrying a big first aid kit either. As a EMT with experience working in ambulances, emergency rooms and search and rescue, I've slimmed down my "day to day" kit to exactly what I need to keep manage minor injuries and prevent loss of life. This is the kit I take with me for those "routine" adventures I mentioned earlier. In this case, I'm familiar with the area, know how long it takes to reach definitive care, and am certain I have the ability to activate emergency response in the event of an emergency. The items in this kit are things I either can't, or would really rather not improvise in the field.   

Small Kit Unpacked Numbers.jpg
  1. Plain old bandaids. Could be replaced with a straight role of tape, but they don't take up any real space, and are nice when you need them. 
  2. Butterfly closures. A solid step up from a band-aid, and again, they don't take up any space. Helpful for closing up awkwardly located lacerations. 
  3. Knuckle bandage. If you're a rock climber you know how useful these can be. 
  4. 4x4 Gauze pad for bleeding control. 
  5. 5x9 Gauze pad for bleeding control. 
  6. 4" Gauze Roll for bleeding control. 
  7. Medical tape. Often gets used for other things and is most useful for minor injuries. 
  8. 1 Triangular Bandage. Multiple uses including improvised tourniquet, bleeding control and slinging arms. 
  9. Aspirin. Dose 324mg for non-traumatic sudden onset chest pain or other signs and symptoms of heart attack. This little bag takes almost no space but can make a difference in a cardiac emergency. 
  10. A REI brand first aid kit bag, with the original contents removed and replaced with the above. I like using a clearly recognizable bag in the event someone else is searching. 
Small Kit Packed.jpg

As you can see, this little kit takes up very little space (a bit bigger than my fist), and ways around 7oz all together. It's enough to handle a minor emergency or begin to address a more serious issue. Keep in mind that this kit is designed for small local adventures. Separate from this I'm packing things like extra food, water, layers and a headlamp if there is any possibility of needing them. 

Advanced Kit

While the small basic kit is nice, it certainly doesn't cut it for extended trips into more remote areas. Whenever I'm venturing into new areas, get far from definitive care, or travel to an area without cellphone service, I choose to carry my larger, more comprehensive emergency kit to cover a wider range of emergencies. The easiest way I think about it, is if there is any possibility of getting stranded and being forced to spend a night out, this is the kit I choose to carry. 

Big Kit Unpacked Numbers.jpg
  1. SOAP Note Template, extra waterproof paper and pencil. The ability to pass along a record of care and vitals to secondary care is extremely useful. 
  2. 2 Triangular bandages. As mentioned above, multiple uses. 
  3. Various medications (see below for breakdown). 
  4. Wound care items (see below for breakdown) 
  5. Signal Mirror
  6. Spare batteries
  7. "Goo". Extra calories/energy/electrolyte replacement as well as sugar for diabetic emergency. 
  8. Hand warmer
  9. Backup headlamp. Highly recommend Petzl e-lite headlamp. Extremely light, durable, waterproof and bright. 
  10. Whistle. Costs $1 at most outdoor stores. Be heard. 
  11. Aquamira water purification. Has come in handy more than once running out of water. 
  12. Lighter.... for... fire. 

Wound Care Kit Expanded

BC Unpacked Numbers.jpg
  1. Gloves
  2. 2x2 Gauze Pads. Probably would be the first thing to ditch in this whole kit. Not a particularly useful size for wound care. 
  3. 2x 5x9 Gauze pads. 
  4. 3x3 Gauze Pads
  5. 2x 2" Gauze Rolls
  6. Medical tape
  7. Blister care
  8. Alcohol wipe. Good for big abrasions. 
  9. Speciality bandaids, for those weird cuts and scrapes. 

Medications 

I carry a number of single use packets of medication. I find the individual wrapping is easier than pulling from big pill bottles and trying to label a number of ziplocks. I've been using this pack from Amazon for medications. It includes the following, all of which I carry. 

  • Ibuprofen - (NSAID) Treats: Pain, fevers and swelling
  • Aspirin - (NSAID) Treats: Pain, heart attack
  • Acetaminophen - (Analgesic) Treats: Pain
  • Benadryl - (Anti-histamine) Treats: Symptoms of allergies 
  • "Diotame" - (Anti-nausea) Treats: Nasuea 
  • Calcium Carbonate - (Anti-acid) Treats: Heartburn 
  • "Diamode" - (Anti-diarrheal) Treats: Diarrhea 

Not Included

There are two things on my shopping list that I don't currently have but would like to add to my emergency kit. The first is a hemostatic soaked gauze pad, like QuikClot. I personally haven't had the opportunity to use this yet, but several of my co-workers can attest to it's effectiveness in bleeding control, especially on areas that cannot be "tournequeted". The second item is a Spot emergency beacon. Especially now that I find myself venturing into the mountains without a partner, the Spot is a way to contact help from where ever you are. Doesn't need much more explanation than that. If you've ever hiked out to make a 911 call, you know how stressful this situation can be. This light and reliable tool solves that issue. 

Conclusion 

Carrying an emergency kit can make a huge difference in a backcountry accident. Building your own emergency kit forces you to think ahead and prepare for worst case scenarios. Pre-making more than one kit allows you to pick and choose the right tool for the right adventure, and makes it more likely that you'll have what you need with you when the time comes.  

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