Well, I managed to pack my Pelican 1550EMS to the gills!

I welcome feedback on anything I may have missed.

good list, mike. i saw several items i'm missing. i've copied your list for closer inspection the next time i get my kit out.

as far as your kit goes, you might consider...

a couple chem-lights taped to the lid.

a pair of 2x reading glasses in case someone needs to read the fine print with older eyes.

a couple zip lock bags and a heavy duty plastic yard/leaf bag can be handy as a ground cloth, temporary pack cover, or for tenting someone in place.

not for the kit, per se, but i carry a foam sleeping pad in the truck to keep a patient (or, me) off the cold ground. they are great as a makeshift splint, too - with a bit of good padding, full immobilization. SAM splints are great, but there's no end to the uses of a foam pad for creative types.

a couple zip ties cause they take up little space and i always forget to replace the ones in my repair kit.

i keep 50' of paracord in the kit so i can stitch up the above splint. straps, belts, work, too, but take up more room. lots of other uses for paracord, too.

i keep some dental filling material in my kit as well as clove oil. ya just never know who might crack a crown or something.

you might re-think the sawyer extractor. or, at least re-confirm your committment to using it.  i still carry one in my kit, but may stop.  many wilderness experts are going away from them in recent years citing they can do more harm than good.  NOLS/WMI, for example, is definately off the extractor kick.  if memory serves me (not likely), the issue as it relates to vipers is 1) 30% are dry bites so no issue at all; 2) few adults experience long term issues from viper bites - i.e. mostly just get real sick for a day or so; 3) by the time the kit is out and deployed, the venom is already starting to circulate and you just can't get enough out to do any good; and 4) what you do get out, can apparently do damage as it pools just below the surface of the skin increasing the chance of long term localized tissue damage.  I'm no doctor, but it does seem to be an area worth thinking about before you use the equipment.  i suppose, the closer i was to med help, the less likely i'd be in using one. 1-3 hours away from a hospital, probably not.  12hrs or a day away, i might give it a try.  definately an area worth thinking about ahead of time.


all for now. thanks for posting this and i hope other sadd in their 2cents as well.  d

Great lists and ideas guys. I will definately print it out and compare it against my med kit.

I do disagree on the extractor though Davis. I believe there is no finer tool available for sucking the pimento out of a Martini olive. And we all know how important a martini is in a med kit. Some of the finest doctors wouldn't dream of doing a complex procedure blowing less than a .08.

Pimento's have no place in a martini. Words to live by!

Respectfully yours,

Dean Martin

Thanks for the feedback Davis!

The goal of the kit is to be able to support injury if evacuation is not possible for several days.

I do have chemlights in the truck's tool kit, as well as garbage bags and rain panchos.  I also have paracord and tiedown straps that could be used as well for any miscellaneous uses. 

I do need to add a magnifier to the kit to aid in splinter and tick removal.  I was strongly thinking about what to do for dental usage, at the least I need to have a candle to melt to replace a filling with.  I also forgot to put the SAM OnScene Patient Assessment Guide on my list.

With regards to the Sawyer Extractor, it is the only method of venim removal that I support.  I have done a lot of research on this topic, as venomous snakes are close to my heart (I actually used to work in the reptile house at the L.A. Zoo).  The benefits of the Extractor (and only the extractor, no lame razor blades and suction cups) outweigh the risks.  This is especially true with children, or those bitten by immature vipers. Yes, about 30% of viper bites contain venom, however, multiple bites can also occur.  Its a biot of roulette, and applying the vaccuum to a non-venomous bite will do little harm.  You do need to jump on it though, as the venom will circulate fairly rapidly, again dependant upon where envenomation (venous vs. tissue) occurs.  You would not want to use it on someone who limps in an hour after being bitten.

The problem with the study that was done on venom removal is multifaceted.  They had 8 subjects (all male, none under 28 yrs old), did not use real venom, injected in non-random locations, and extracted for 15 minutes.  The only downside of the devices use is the contusions and other tissue damage that the suction causes.  For me, having seen the best and worst of snake bites, I'll take my chances with the Sawyer, and of course follow the other guidelines for care. Of course, the good news in WA is that there are few vipers.  SoCal was a whole different story!

For bee stings I have switched to the Mitigator products which takes a different approach.  It uses an abrasive to open up the area and a paste containing papain and other good stuff.  This is good for bees, jellyfish, fireants, etc.

chem lights, plastic bags, paracord, etc. are dups in my med kit. works great when the accident scene isn't next to the truck. it's nice to be able to say to a helper "go to truck, get orange box under back seat, bring back here".  had that sit back in june with my nephew's friend. saved a bunch of time.

as far as snake bits go, i'll yield to your expertise on the matter. i definately wasn't trying to argue for or against them and definately didn't want to debate something i don't understand. i just thought it would be good to point out that a growing number of doctors and teachers in the wilderness first aid community have moved away from the devices and some actually recommend against them.  NOLS is definately against them and that is where i have most of my wilderness first aid training.  i'll be the first to admit that i bought the sawyer kit with no more research than reading the package at rei - not exactly an informed decision.

here are some things the medical community agrees on with regard to snakebite treatment:

No ice or any other type of cooling on the bite. Research has shown this to be potentially harmful.
No tourniquets. This cuts blood flow completely and may result in loss of the affected limb.
No electric shock. This method is under study and has yet to be proven effective. It could harm the victim.
No incisions in the wound. Such measures have not been proven useful and may cause further injury.

guess this means my buddy's cut, suck, and spit days are over. d