Mountaineering Medical Kit

I spent months, if not years, mulling over what to carry in my medical kit for mountaineering. I interviewed first responders, experienced military combatants, and even a career expedition guide. This is what I’ve arrived at for my kit and some of the thought behind it. If you too mull over planning for a medical emergency in the mountains then you are sure to appreciate this post.

DISCLAIMER: I’m not a professional EMT, Paramedic, doctor, nurse, etc. I’m simply a guy who likes to spend time in the mountains and has thought about medical emergencies. This article is a place where I can save my notes for future reference and you’re welcome to read them.

Most of my life I’ve been exploring outdoors. I’ve also experienced any number of medical emergencies in that time. I think we all have in some degree. For nearly a decade now I’ve been in remote areas where chances of an expedient rescue would be slim to none so emergency planning goes without saying.

Communications are first line of planning

People can be quick to dial 911 for anything, even a simple sprained ankle. On the other hand, I know people left crippled because they didn’t want to call in for help. Here’s a few modes of communication you may consider:

Cell Phone: most everybody has a cell phone these days. Make sure yours is charged. If a multiday trek then manage your battery appropriately. Keep in mind, your cell phone will not get a signal in many remote locations.

Satellite Beacon: these can be purchased from any number of companies. They transmit your coordinates to emergency dispatch when you activate the beacon. These communicate through satellites so they have better coverage than cell phones. Most have the ability to send SMS text messages as well.

Whistle: this is one of my favorite and I encourage everybody in my party to have one. A metal sports / coach whistle, can be heard for miles, and very helpful if your party gets split up! Three whistle blasts signals distress.

Glow Sticks and flashlight: a friend was flying at night over the wilderness helicopter. They saw a light flickering below them and landed to find a guy in desperate shape. Had he not had a source of light they’d never have seen him and he would have died. After hearing this story, I always carry a source of light such as; headlamp, and or flashlight. And not just a cell phone, that guy was waving his phone which has a nearly dead battery!

Signal Mirror: these are great if you have sunlight. You can signal vehicles and even aircraft in the distance. Again three flashes signals distress.

Despite having communication equipment, chances are good we’d be hours at best from assistance so you can not just plan for rescue and call it good.

What to take and what to leave in the vehicle

I tried to prioritize controlling bleeding, with some ancillary what I’d call comfort items. The most simple medical kit I’ve seen is “medical tape” which many climbers carry. You can do a lot with just that including bleeding control. However, my mountaineering kit is a bit more elaborate with the medical kit in my car being the most extensive where weight isn’t as big a concern.

Some items like bleeding control, are necessary in any kit. For those I copied the Individual First Aid Kit they supply to Border Patrol Agents. Military has similar kits you can use for inspiration in making yours. The others you will figure out with time and experience. For instance, I live in the desert where there’s LOTS of cactus so I carry a tweezers to pull needles out with.

You can even purchase kits online. However, I found those didn’t carry any items specific to my environment so I custom tailored my own.

Items in my mountaineering medical kit

It’s worth noting I have found Molle bags useful. This is a modular bag system where you can pull your equipment apart. My medical bag is Molle fastened to side of my main bag. On multiple occasions I’ve had to pull the medical bag off so I could better move and assist the person in distress.

Communications:

• Cell phone (pocket)
• Satellite Beacon (backpack)
• Signal Mirror MIL-M-18371E (medical bag)
• Metal Whistle (medical bag)
• Vibrant orange cloth (medical bag)
• Chemical light (backpack)
• Headlamp (medical bag)

Comfort:

• Carmex Tube (medical bag)
  
  This is great for chafing! It’s a small tube of petroleum jelly. I may however, forgo it and carry only triple antibiotic ointment which works as well.
  
• Band-Aids (boo boo bag inside medical bag)
  
  I keep what I call booboo items inside a small zip lock in the medical bag. It consists of alcohol wipes and miscellaneous sizes of Band-Aids. Small cuts are not a medical emergency. Most of the time I don’t bother to do anything with them. I find myself using the boo boo kit for little kids and women if they are along.
  
• Tweezers & small length of duct tape (medical bag)
  
  These are great to remove needles. My tweezers are integrated in my trauma sheers.
  
• Moleskin (medical bag)
  
  They sell these precut for blisters. I buy the sheets which cost much less and cut my own pieces using my trauma shears
  
• Chewable acetylsalicylic acid aka Aspirin (medical bag)
  
  This can be helpful in event of injury or pain. It maybe also prove helpful in the event of heart attack, which I think but don’t quote me it could slow that process down by thinning the blood a bit. I carry it for both but be warned, too much can exacerbate bleeding.
  
• Diphenhydramine tablets aka Benadryl (medical bag)
  
  These serve many purposes. They can calm a person during an emergency, reduce allergic effects even sever reaction to say bee stings, and I’ve heard help slow heart rate in event of rattle snake bite / slow effects. Research further, it’s made it’s way into my medical bag as a result. I mainly use them to sleep if unable to otherwise.

Bleeding control:

• Combat Application Tourniquet (CAT) & Carrier (backpack strap)
  
  The chances of needing this are slim, however, if you do and don’t have it you die so I try to always carry one. The CAT system is quick and easy. It Velcro’s on and a winze spins it tight and then locks it on. I have a carrier simply because of my environment. Here it’s very sunny which could in theory degrade the strength of the tourniquet. This system is on my shoulder where I can get to it with one hand if necessary and in theory apply it to myself should I need to.
  
• Packing Gauze (medical bag)
  
  You can purchase these at the pharmacy. It’s lengths of cotton gauze to pack wounds. I’ve used it multiple times to improvise bandages as well. I use it to fill the voids in my medical bag till it’s completely full as this is probably one of the most useful items you can have. I’ve heard of people also carrying tampons for packing.
  
• Combat Bandage (medical bag)
  
  This stuff is expensive but versatile. It’s a bandage with packing gauze, compression wrap, and clotting compound all in one. It can be used in many situations and could potentially replace the packing gauze if you’re rich enough to use these all the time.
  
• Medical and or duct tape (medical bag)
  
  You can always wrap other items in the bag such as the lighter with duct tape which I do. However, for compression and holding wounds together a roll of medical tape is best should it fit.

Desert / Environment Driven Items:

• Heat sources; lighter, chemical warmer, space blanket (medical bag)
  
  People don’t think much about the desert getting cold. However, it can get extremely cold at night. Especially in the mountains. If immobilized for a minor emergency during the day, it could turn into a life threatening problem at night especially at high altitude. These items won’t keep you comfortable but they maybe enough to keep you alive.
  
• Iodine (medical bag)
  
  This is great! It can be used to treat water, and or disinfect wounds. Both are vital, especially water treatment in desert. Water is in scarcity so ability to top off can prevent what could become an unforeseen emergency otherwise. Managing your water is a topic unto itself and vital for mitigating risk in desert.
  
• Electrolyte & sugar pouches (medical bag)
  
  This is one of the most used items in my kit. It’s electrolytes. I MAKE SURE they also have sugar. Most people don’t realize but sugar aka carbohydrate is critical to absorption of water. You can also experience hypoglycemia, low blood sugar, when exerting yourself heavily over many hours in rugged terrain so I find the sugar to also be a vital part of the kit.
  
• Minimum 32 oz reserve water (bag)
  
  I carry in addition to my primary water supply a reserve bottle. Planning water consumption is critical to a safe experience, especially in the desert environment. I typically gauge when I’m 1/2 way through my primary supply and should be returning at that point let alone touching the reserve. My vehicle as an additional 6 gallon container of water in it.

Miscellaneous items:

• Trauma Sheers (medical bag)
  
  These are moved to remove clothing that is otherwise in way of treating victim. For instance cutting a boot off to splint a broken foot. Mine are a foldable multitool set that includes other tools such as tweezers.
  
• Latex Gloves (medical bag)
  
  These are to put over your hands to prevent contaminating another person if you’re aiding them and or you getting a bloodborne disease.
  
• Alcohol Wipes (medical bag)
  
  They sell these at the pharmacy for cleaning cuts. I put a dozen or more pouches in my bag to clean cuts / wounds. Iodine and or antibiotic ointment is more versatile though.
  
• Antibiotic Ointment (medical bag)
  
  I use this stuff all the time. Mainly to treat cuts / wounds. This in combination with iodine work great. I feel the ointment also works somewhat protect the wound from contamination as it creates an greasy coating over the wound.
  
• Surgical marker (medical bag)
  
  I carry a sharpie mini as I couldn’t find a surgical marker. This is to write notes on the injured. For instance if bit by a rattle snake could circle the site and write the time. Then monitor and circle inflammation response with time marked circles. This could potentially help diagnose a dry bite (no venom). Could also write notes on person’s clothing as apposed to skin for instance injury to right knee, head trauma, male, 65 years old, approx. 160lbs, etc. etc. etc.
  
• Notepad & pen (backpack / shirt pocket)
  
  This is a secondary means to take notes.

Items removed from kit:

• Super glue pen (medical bag)
  
  This can be used to close wounds. However, that’s not really a good idea as wounds need to breath, and you can provoke an infection if a cut is sealed up.

Additional Items in my vehicle

• SAM splints (not yet)
  
  These are used to stabilize broken bones. I haven’t purchased any yet. Some people carry them on larger expeditions but I understand they’re not foolproof and somewhat expensive. However, it’s an effective tool with some training to immobilize a broken bone.
  
• Occlusive dressings aka check puncture seals
  
  A victims lungs can collapse if you puncture your chest. This will eventually suffocate them to death. Occlusive dressings are a bandage that covers the chest puncture effectively sealing gasses from entering your chest. They additionally, have a valve to alleviate / burb what has entered the chest cavity releasing pressure from lungs so the victim can breath.
  
• Super Combat Cravat aka Burn Dressing
  
  This is a versatile sterile cloth dressing. It’s primary function is to dress burns. Note burn trauma is something much different than bleeding. I don’t know much of anything about burn trauma other than you need to keep extra care from contaminating the burns.
  
• Nasopharyngeal Airway
  
  This is used if the victim has an obstructed airway. It’s a small tube inserted through the nose and down into the throat help facilitate breathing.
  
• Jerrycan of water
  
  I carry 6 gallons of emergency water in my truck.
  
• Steri-Strips
  
  These are 3M product which are used in lieu of stitches. I have never found them locally for sale. Instead I’ve been carrying duct tape, which in theory could be configured to close up lesions. I hope I never have to find out but YouTube showed a few videos on taping shut lesions with duct tape while allowing for the wound to breath.