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Backcountry Skiing First Aid Kit Series: Starting in the Middle

By

Gavin Hess

The full kit for first-aid.

The full spread: most of this fits in the Gore-Tex bag, then a few bulkier/multi-use items live elsewhere in my pack.

  First aid kit contents are one of the more varied/contested items among ski touring partners and communities. From the legendary French guide’s first aid kit: two cigarettes and a cell phone, to a seasoned guide/search and rescue member who has seen too much and prepares as such, there is a huge variety of kits…

Responses

  1. Matt Zia

    My winter FA kit for work looks really similar. The one major thing I add to Gavin’s selection is a Hyfin vent (pre-made occlusive dressing). This lives in my FA kit when there’s a chance of penetrating injury. The MOIs for that in my mind are either an accidental gunshot wound during hunting season, or penetrating trauma during a high velocity impact (ice tool, tree branch, etc). For that reason, I carry the Hyfin vent during hunting season, during the winter while skiing and ice climbing, and during the summer while mountain biking.

    1. Patrick Fink

      I also have occlusive chest seal dressings in my hip pack that I keep in both of our cars to address trauma on the road, but I don’t carry one skiing. It’s far too specific, kinda finnicky, and can cause problems. They were developed for time-critical situations with gunshot wounds in mind, but aren’t well-suited to prolonged use and I’d caution against them.

      The occlusive chest dressing is meant to address a sucking chest wound; a rare scenario in which the lung itself is not punctured, the chest wall is, and the wound itself makes an only-in ball valve that causes progressive tension pneumothorax with each inward breath. The problem is that a muuuuch more common issue is the chest-wall-wounded, lung-also-wounded scenario. In this setting, applying an occlusive dressing can CAUSE a tension pneumo as air escaping from the lung is trapped within the thorax by the dressing.

      The rare scenario that is addressed by the chest vent dressing can be instantly fixed by enlarging the wound (takes some experience or understanding to have the confidence to do that). In the rare case that someone is struggling to breathe with the one unaffected lung, a hand over the hole (or duct tape) will do.

      You can hang on to the Hyfin Vent and use it if needed, but the crucial thing to know is that if you have it on a chest wound, and there is progressive difficulty breathing or loss of consciousness, it’s time to immediately remove it and stick your finger in the hole. Pssssssssssssssss……

  2. Slim

    Anyone know where you can buy a NuMask? I have never been able to find any for sale.

    1. Gavin Hess

      Hey Slim, That is an excellent question. I’ve heard rumor that the gentleman behind NuMask closed up shop some time ago. I went hunting last fall and came up empty handed – I’ll do a little more digging. You certainly aren’t the only one looking; the NuMask is an excellent tool and much more effective than a standard pocket mask

  3. bluepandaboy11@yahoo

    thoughtful collection of supplies. thanks for sharing. I opt for an inflatable mat considering the likelihood of staying put and waiting for help rather than packaging a patient and sledding them out. the triangle bandage is a curious [and what I perceive as redundant] addition. would like to hear your thoughts on that inclusion. although perceived by some as excessive in the first aid kit realm, Id be interested to hear about your blister care kit & routine (if any in particular beyond tape and a grimace). all in all thanks for the informative post

    1. Patrick Fink

      I feel like the discussion of blister care has to be separate from first aid, particularly trauma care. Some people are blister machines, others never have them. My answer to this issue is to carry a small roll of Leukotape, which is a superior non-stretching orthopedic tape, in my kit. I view this a potentially repair material as well, and it can patch up most blisters enough to get back to the truck.

      I think Gavin did a great job here of being prepared to manage the most common, serious backcountry issues that we are capable of intervening upon with minimal kit. To my mind, this is CPR after avalanche/lightning, life threatening bleeding, splinting of long bone injuries, basic airway management after trauma, and hypothermia. For those with medical licensure, an 11-blade scalpel and 6-0 endotracheal tube could round this out, and some wound consider adding an epi-pen depending on the group. The problem with expanding scope beyond this kind of care is that you can prepper yourself to death and end up with a kit nobody would ever carry.

      Personally: CPR mask, SWAT-T tourniquet, space blanket, israeli trauma dressing, NPA/OPA, 6-0 ETT, 11-blade, leukotape, safety pins, knife. But that’s my kit where I can reach a road within 1 hr of normal travel and have reasonable cell service. My hut kit and meds are quite different.

    2. Gavin Hess

      I dont often suffer from blisters, so I don’t tend to carry much blister care stuff day to day. The best blister care kit ive seen involves leukotape, compeed blister patches, and tincture of benzoine to get it all to stick.

  4. Dylan Johns

    That is a great setup! Having been a SAR team member in Colorado for almost 6 years, I would suggest the addition of a SAM splint (with roll of Coban) and a space blanket or other high efficiency/lightweight emergency bivy to compliment heating pads and other insulation. Field medicine can make all the difference, but no matter what, getting the subject evacuated to higher level of care is going to be the most important objective to work towards. SAM splints are going to be much more effective than most field fabricated splints for stabilizing extremity injuries. And aside from managing ABC’s, E (environment) may be one of the most important factors to manage and D (disability) can help reduce the time component and other secondary injuries/issues from manifesting.

    Knowing how to use NPA/OPA’s is important, and they can be great tools, but one must also know when not to use them is also critical.

    Want to emphasize the role of a satellite communicator as being an integral part of the medical kit, regardless of its form factor. I have seen some discussion on other forums about the number of communicators that are necessary to have in a group, with some feeling like one per group is acceptable to be more efficient with gear distribution. Relying on one device assumes that the person carrying that device is not the one who falls, splits off and gets lost from the rest of the group, is buried, or the device is inoperable to due damage or a dead battery.

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