Carrying a First Aid Kit while commuting
 

I posted in the "How was todays commute?" thread yesterday about how I came across a young man who was unconcious laying on the sidewalk on my ride into work yesterday morning. He was severly beaten up,bloody, and had several brutal wounds. I won't go into details, but the visual is still haunting me. I was with my buddy who has been commuting with me the last few weeks and luckily he had a plastic bag in his trunkbag and we were able to use that to check the boys pulse (this was to act as a barrier against blood borne pathagens). It wasn't strong but it was there. I called 911 and we used our bicycle headlights on flash mode to help guide the EMT's to the scene. After stablizing him, they were able to get a few words out of him like his first name and age, and come to find out he was only 16 years old. I can't believe anybody would do that to a kid, or anyone for that matter. I am just so glad that we came across him and got him help otherwise who knows how that could have ended. The EMT's were even shocked at how bad of shape he was in. I'm not looking for a pat on the back or anything from sharing my story, but it got me to thinking how my meager pack of bandaids and cleansing wipes was really of no help in this situation. I could have really used some exam gloves for my protection during checking his pulse, possibly some gauze pads to help contain the bleeding, etc. Also, a CPR mouth barrier could come in handy. I know the current method doesn't even require mouth to mouth and just compressions but it might not hurt. Since the incident I have started compiling a small first aid kit that will allow me to really assist better as a first responder if I should happen across another person in need. I'm sure a lot of you are already carrying great first aid kits, and if so what have you decided on as far as contents?

Wow, quite a day for you. Good job for being prepared to help. My first aid kit basically contains: gauze and non-stick pads, gloves, vet-wrap, band-aids, medical and duct tape, and gloves. But even more important is knowledge of 1st aid, which it is clear you have. Good job man.

First off, many, many kudos for your selfless actions and clear thinking it what must've been a horrific scenario. My prayers go out to the young man, whoever he is. You very well may have saved his life.

My first aid kit contains all of the above w/some hydrogen peroxide. Living very rural a snake-bite kit is part of my first-aid kit as well. While it may seem like a bit silly, I saw a 6 ft rattler on my street last year. It was at night and he was 'warming' himself on the pavement. Needless to say I came to a slamming halt until he slithered away into the bushes. Got a SB kit the next day.

Still, I'm really saddened about this kid. Hope he fully recovers.

Good on you for helping out. :thumb:

Sounds like you have a good enough kit. My own is along these lines:

Good kit - A couple pairs of nitrile gloves, sterile non-stick gauze pads (4"x4" would be the largest I'd carry), some hypafix (one of my favourite if not my very favourite small wound dressing product), an assortment of band-aids, tensor bandage, sling (great for so many different applications), a couple individual single-use mini-saline bottles, face mask w/valve, penlight, scissors.
Off the top of my head that's about the absolute most I'd carry in a biking/commute-to-work first-aid kit.

Could get a little more advanced with a few more items that would make it a...
Better kit: All of the above plus: Sam splint, blood glucose monitor + test strips.

Then there's overkill:
Completely-over-the-top-and-ridiculously-unnecessary-for-commuting kit - All of the above plus some goodies from my personal home kit including hard collar, bag-valve mask, pulse-ox, OPAs...

And to all the kids out there, remember, do not attempt advanced procedures or use equipment that you haven't been trained for, certified/licensed for. You don't want to hurt someone and it can be a mighty a litigious world out there. Some countries more than others.

Wow great job in helping! Great use of the bag and the headlight blinky to make it easier for the EMTs to guide them.

I have not put together a first aid kit at all and would either like to or buy a it made already.

Once you get your kit together, can you post what you got?

Things to consider adding:
Liquid benedryl in case of reaction to a yellow jacket/bee sting
Asprin (has many uses)

I don't think any first-aid that a commuter cyclist could carry is adequate for this kind of severe injury. Our local cycle paramedics carry full side and top panniers packed with gear.
I just carry a basic road rash kit: antiseptic wipes, gauze pad and some plasters.

Something is better then nothing.

I am a paramedic - the only things that will really do anything are gloves and mask for you (to protect against exposure) and some bandages so you can apply pressure to bleeding if you need it. Maybe a space blanket. Anything else will be pointless if you can't get the patient to definitive care, which is why the first step in any emergency algorithm is to call 911. An American Heart Association CPR/First aid course would do a layperson much more than any amount of equipment.

All I carry in my car are nitrile gloves, an equine first aid kit (better/bigger bandages than human stuff) and a fire extinguisher. The most important one is the fire extinguisher.

Because it is simply impractical to carry a comprehensive first aid kit you will almost surely have to improvise for anything worse than a minor boo boo.
A cell phone to call emergency services is probably the best thing most of us can do for a more serious injury/accident. For very rural commuters or Mt. bikers you may be on your own for awhile or have to limp out to somewhere you can be found. In that case a bit more first and/or second aid may be in order.

I carry about a dozen paper towels in a ziplock sandwich bag in my tool pouch. These can be used to wipe greasy hands or cover a wound. The baggie can also be used in a pinch to valve a sucking chest wound.
I also carry a spare tube in another baggy wrapped in a large bandanna with a rubber band(to protect the tube from damage) that can be used for a pressure bandage/ constriction band ect for larger wounds or unexpected amputations. (NEVER apply a constriction band or tourniquet unless you have been trained to do so) The large bandanna can be used to make a sling or battle type dressing, pack a very large wound ect.
Water bottle for emergency eye wash/ wound flushing.
Splinting is probably best left to EMS but a Mt. biker may find the need to splint. A tire pump can easily be extended to just the right length to splint an arm or lower leg.
Learn CPR and take a first aid class. There is not much worse than watching someones life slip away before your very eyes and not being able to do a darn thing about it. ( you will have nightmares for the rest of your life ) Knowing first/second aid can make the difference in a lot of situations but you have to also accept your limitations.

I carry cloth tape, nitrile gloves, an elastic bandage, several gauze pads, a barrier, and a pack of quick clot, which is a chemical clotting agent, along with benadryl and a couple wipes/antiseptics and smaller bandages. I focus on carrying things for life threatening injuries, as anything else can generally wait. It all fits in a small saddlebag. Duct tape and knives are elsewhere in my commute bag. I carry a larger pack when off on my own in the middle of nowhere.

Very worth it when you get smacked by a car and bust your chin open on the pavement. I started carrying large gauze pads after that. O_O

Kookaburra, I strongly approve of your love of Pinkie. :thumb:

A first aid kit while biking is a good Idea.

I have been through 3 first aid courses in the last 6 years because I work for the government and it is required so I am fairly up to date on first aid treatments and CPR.

Oh, something for everyone who has gauze - putting down a non-adherent pad onto an open wound (especially if it has some bacitracin on it) before putting the gauze on will save your patient much agony in the future. In the ER I work in we use Telfa. http://www.amazon.com/s/ref=nb_sb_no...keywords=telfa

1) Good job on stopping to help.
2) The cellphone is the best tool you can carry, it can summon the people with more tools and training.
3) A pretty extensive discussion on the subject can be found here: http://www.bikeforums.net/showthread...First-Aid-Kits

^^^ great link No Motor.

Awesome video: http://www.youtube.com/watch?v=0dboVSTCkuw

I don't tend to carry any 1st aid gear (but 2 of my coworkers tote a lot of it), but I do always have latex gloves, more for roadside mechanic work but would serve for medical use if needed.

edit-> looking at that link reminds me a of a friend who got hit by a car while commuting and got a compound fracture of his femur, and he was worried about the bone pieces cutting his femoral artery. I don't know what to pack for that; he just clamped his hand on his upper thigh until EMTs came. I guess if you had tourniquets you could ask someone to help apply it.

Would you use a tourniquet if you didn't know an artery was cut?

Looking through the other thread, some useful, OTC medications to have on hand:
diphenhydramine (Benadryl)
caffeine pills
4 baby aspirin (especially if you are a male over 40 with a history of heart disease in your family)

These could also be nice to have:
an antacid
immodium

I am allergic to bees, so I always carry Benadryl, caffiene pills, my rescue inhaler, and an epipen in my saddle bag. The last two items on the list are Rx only in the US.

If you really want to Boy Scout it up and be prepared for massive bleeding, take along some feminine sanitary napkins, super size. They make great trauma dressings, and don't stick to hair. That's what we used on horses in pony club, but they're not sterile.

Forgot to mention. On several occasions I have stopped to render aid at car accidents and urgently needed a temporary wound dressing. Usually cars will stop to gawk and offer help and about 50% of the people are women. If you ask,"does anyone have a kotex pad" you will probably have more sterile dressings handed to you than you could ever need.

You don't say?!

I do say, but you may want to double check before asking them for a kotex. :D :p

Non-stick telfa + hypafix :thumb:

I figure that I can't really carry enough to be ready for anything anyway. I've banged myself up pretty badly in the past and have never really wanted to use bandages, I just want to clean the wounds and get back on my way. I generally just flush everything with water, get the gravel out, and whatever's bleeding, just let it bleed. I've ridden home (4 or 5 miles) before with wounds that eventually required stitches when I finally got home, got a car and drove into the hospital. I wouldn't have wanted to bandage them, because they weren't bleeding significantly after the first few minutes, and any bandage you put on has to come back off again, and that's no fun.

Besides, I find you get faster service at the ER if you walk in with obvious, open wounds and tell the receptionist "Yeah, I just need someone to throw some stitches into this." :)

If it's bleeding badly enough that it's not going to stop on its own in a few minutes, I probably want to call for help anyway.

For treating other people, I think the most I'd want to carry would be a breathing barrier and a pair of gloves, and maybe a clean cloth for applying pressure. If someone is really bad enough that I need to use that stuff, I'll have called 911 anyway and I just need to stay with them until the people who DO have all the stuff show up.

Current training is that you never, ever use tourniquets, unless it's clear that someone is absolutely going to bleed out without it, especially if it's on a limb that is clearly mangled beyond saving or totally missing. They won't even talk about tourniquets in first aid training anymore except to say "do not do it."

So if there is clearly massive arterial bleeding, I'd do it if pressure wasn't working, otherwise no.

EDIT: Actually, having done some reading, I'll amend that. Throw out the tourniquets, pack a 50 gram Quickclot pad. The 50 gram size is said to be able to stop a femoral artery bleed. I'm buying some.

That is very true. An exception would be if you were alone and bleeding out with the fear of passing out and being unable to tend to/manage a pressure band/dressing.
If you do apply a true tourniquet to a limb, you are most likely going to lose that limb from the tourniquet downward.

First aid kit - cell phone and the T shirt I'm wearing.

Wow where to start... I'm not an expert, I am however currently deployed and I would like to think that my training is "current" (admittedly it is NOT extensive and my CLS cert is NOT current). First and foremost I am a helicopter crew chief/mechanic, my next assignment will be with a Forward Support Medevac Team and my wife is an ER nurse. AGAIN, please do your own research and don't take my word as gospel for any of this. If you need an aircraft fixed in the middle of nowhere I can probably be a great help but I feel sorry for anyone that would have to rely on my trauma skills to save them. In either event I'll do what I've been trained to.

Regarding tourniquets, if you even think they might be useful, use them. We are CURRENTLY trained to do so and a CAT (tourniquet) is by far the most easily accessed first aid tool on my flight vest, it is required as such. Everything else is tucked away in an otherwise inconvenient internal pocket. Current training is that a tourniquet can be left on for up to 8 hours before concern of losing a limb. I know this is highly contrary to what has been posted, that is why I am stating otherwise.

How important is it to stop bleeding? Even on a battlefield, with weapons designed to kill as effciently as possible, hemorrhaging still accounts for 80% of the deaths. You stop the bleeding you save lives.

Practically speaking, the types of tools you are going to have available as a cyclist are very limited assuming you brought any. When it comes to saving a life a cell phone is your best bet. Next, the ability to stop any serious bleeding is huge. Tourniquets do this. If you can keep a person from bleeding out long enough for the professionals to get there you have probably covered the majority of what could have killed the person, if the person dies it is unlikely that you have helped them with any of the other tools you would likely be carrying. For example, a space blanket might help prevent shock but blood loss will bring about shock that the blanket cannot stop.

Regarding Quickclot... it is an excellent tool. DO NOT USE IT AS A SUB FOR A TOURNIQUET and please DO NOT "THROW YOUR TOURNIQUETS OUT". Quickclot is an excellent alternative for wounds that cannot be addressed with a CAT... torso, neck, head. Quickclot would be an excellent addition to a CAT but different jobs require different tools. If you plan to carry Quickclot please read up on it and the precautions you should take with it. It is a fine powder that will render you useless if you get it in your eyes (it reacts with moisture, not specifically blood, and the crap can go airborne everywhere if you aren't conscious of the risk). QC must be applied to the point of bleeding. Not all bleeding is external and not all blood exits the body from the point in which it is leaving the vascular system (a tourniquet will will work if either of these probems is present in a limb). Medical staff will literally spend hours cleaning QC out of a serious wound as opposed to the seconds in which a tourniquet can be removed and further treatment can begin. You will not find QC in an ER. There are other precautions as well so don't consider this info as your education.

If this really is important to you please seek professional education and try to maintain it with some sense of on going training.

Helo mechanic out.

Thanks for posting.
My training is with the US Coast Guard and about 10 years out of date.
I am sure you would agree that a tourniquet is last in line after direct pressure, arterial pressure point elevating the wound ect.

I'm having a difficult time thinking of an item that could be more ponderable regarding its wisdom in a first aid kit. I assume you're talking about a little cut & suck kit. There's a good amount of legend behind their effectiveness but tons of analysis that indicates they are no good.

Any informed opinions on snake bite treatment?

I agree with Kookaburra1701 that the most important tool in an emergency is between your ears. Take a First Aid and CPR or First Responder course from a certified educational organization. I also agree that a few pair of nitrile or vinyl gloves and some basic wound care supplies are all that is needed for citizen first response. I too am a paramedic and the kit I carry contains gloves, a 10-pack of 4x4 gauze dressings, a roll of gauze bandage, a roll of Coban (stretch gauze that has been coated with a substance to make it stick to itself but still be removable/repositionable), a small roll of 1" athletic tape, a CPR micro shield, a small mylar space blanket, and a pair of bandage scissors. The entire kit fits in a small triangle bag.

- If you are going wilderness trekking where help could be hours away, you should consider a more comprehensive trauma kit, but this should be adequate for initial response to the majority of emergencies likely to be encountered by a cyclist. If you take a good citizen first aid, first response, or wilderness first response course you will be taught how to improvise what you can't carry in a reasonably sized kit. You can never carry everything you could possibly need so learn to prioritize.

- Direct pressure is the first line of bleeding control. Use some kind of reasonably clean dressing (a shirt or bandana will do in a pinch) or even just your gloved hand to put pressure over the bleeding wound. A first responder or wilderness medicine course will teach you about arterial pressure points, which are also useful for controlling bleeding on the arms or legs. Many bleeds can be controlled with a properly applied dressing and bandage. A tourniquet should not be used if bleeding control can be accomplished by one of the other means, but is viable when a patient has a severe bleed that cannot be controlled by other means, when there is severe bleeding from multiple sites, or when you need your hands for other priorities like keeping their airway open. You do need to learn to properly apply a tourniquet so again, a first aid course is a good idea.

- Snake bite kits are of dubious value. Take one of the courses mentioned previously to learn the currently accepted method of treating snake bites. Whatever you do, don't pull out your pen knife, cut Xs over the bite marks and try to suck out the poison. This is folklore that is best left to black and white Western movies. Honestly, your chances of being bitten by a snake while cycling, even offroad in the desert, are right up there with being struck by lightning or winning the lottery. Just watch where you put your feet and hands and if you see a snake, leave it alone, North American venomous species aren't aggressive but will strike if they feel threatened. Outside of the US there are some species that are actively aggressive, so know the snakes native to your area.

- Don't move a seriously injured person unless absolutely necessary to protect their safety or provide treatment. Again, a proper course will teach you the lowest risk methods of moving or positioning a person. Assure that the person can breathe adequately, immobilize any injured area including the neck or back (have them lie still and gently hold them in position), and control any serious bleeding. Contact 911 with your location and details of the incident and the victim's condition. Stay on the line unless the dispatcher tells you to hang up.

I'm guessing you've been out for 10 years then. Unfortunately the military has had a lot of "learning opportunities" since then. What you've stated is not incorrect and it will work assuming you know what you are doing (no different than anything else). It's my opinion that a lot of the changes are the result of people who didn't apply the older methods properly. For the average soldier it's been dumbed down, and I can appreciate that. However, the major parts of what you stated aren't what I have been taught in at least 4 years.

Same: elevating wounds is still a good idea.

Major differences: application of direct pressure and pressure points... I couldn't even tell you the details of pressure points. Obviously if it is a relatively minor wound you might escape w/o a tourniquet. The old method required an evaluation of the bleeding after 2 (I believe) steps were taken before applying a tourniquet and even then people were apprehensive about tourniquets due to the false belief that it would likely mean an amputation ...and people died as a result. Also under the old method, lets assume a tourniquet is required, during the first two steps the patient is still bleeding/dying. So if tourniquets do not automatically require amputations (you literally have hours) why even mess with the first to steps? Therefore we typically don't. You get jacked up around me and you are getting a tourniquet until someone that knows more can give you competent care. Part of the application process involves writing a "T" on the patients forehead and the time it was applied next to it. CAT's can be applied one handed to yourself if need be too. Also, since we aren't worried about amputation we don't sweat placing the tourniquet 2" above the wound. Now it goes as high as practical, one less detail I guess.

You might also be interested in knowing that IV fluids are no longer part of a CLS kit. I guess there effectiveness was questionable in the early stages of treatment and they were found to detract lesser trained people from performing higher priority care. Did I mention they dumbed everything down, lol?

I'd also like to add something that has already been mentioned... Protecting yourself, please have gloves too. A mask would be nice but not likely on a bicycle. We don't have them in military field kits but we also go through a crap load of regular health screenings so I feel relatively safe against anything serious.