On a recent ski vacation with another family, my wife and I thought we had made a great trade. We would watch Sophie (our friends' 8-year-old daughter), giving them some time alone. The next night they would reciprocate, and watch our boys, Matthew, 8, and Eli, 5.
I was watching the kids outside our hotel. Our plan was to go sledding before it got dark, and then take the kids for dinner. Sophie, Matthew, and Eli frolicked in the snow, Florida kids enjoying the novelty of winter.
A moment later, the childhood play turned into a mouthful of blood and a tearful little girl after a snowball made a direct hit. I quickly pulled a gauze pack out of my first aid kit and applied it to Sophie's cut lip as she sobbed. Her parents arrived a moment later as they were leaving the hotel to go on their “date.” I watched the kids for five minutes, and this is what happens, I thought. I felt guilty that a preventable injury happened on my shift, and that the snowball was thrown by my son, Matthew, who was feeling guilty as well.
“I guess I'll take her to the ER,” her father said as we examined the 1 cm cut into the vermilion border of her upper lip. A quick examination of the oral cavity (with the flashlight I always have with me) revealed a loose incisor tooth as well, a “pre-existing condition,” I would find out later.
“Two or three sutures, and she'll be good to go. We can do it upstairs,” I volunteered.
“Will I still be able to go sledding?” Sophie asked through her sobs.
“Sure, Sophie,” I replied.
A medical travel kit is convenient, avoids the need to seek medical care away from home, and may prove life-saving
Fifteen minutes later, we were on our way to the sledding hill, Sophie had gained a 6:0 suture mustache, and our friends were off to dinner. I was amazed that they still released her to my care after the first mishap. My wife, Melanie, also has promised not to complain about the medical bag I always bring with us.
A medical travel kit may be a source of convenience, as this story illustrates, avoiding the need to seek medical care away from home and the time it takes as well. It also may prove life-saving. The circumstances of your travel will greatly influence what you may choose to bring. Consider, for example, who is traveling in the group. Do your traveling partners include children? Do they have health limitations or underlying disease? Are they compliant with their current medical regimen? What amount of space do you have? You may be limited to a small kit within a body pack, as used for a short day hike, or you may need to carry an extensive kit for a transatlantic crossing.
Also consider how far away you will be from definitive medical care. It might be minutes, hours, or days. Will you be in a cold or hot environment, a wet or dry one? Depending on your space limitations and budget, you could build this kit into an impressive setup, adding an oxygen tank, airway management, and even a defibrillator, but the costs can really start to soar. This is a basic list of what I would recommend, and it can all be squeezed into a medium to large fanny pack. Costs can be kept under $200, well worth the piece of mind and cheap compared with other aspects of your travel.
Here are some ideas about what to pack in a basic kit.
- ▪ Paper and pen: There's always something to chart, including perhaps important field observations for those providing definitive care.
- ▪ Mini-sharps container.
- ▪ Trauma scissors and a multi-tool (Leatherman, Gerber).
- ▪ Flashlight, but not any flashlight, get a good one. I use a Surefire E2.
- ▪ First Care pressure dressings that can be turned easily into a tourniquet.
- ▪ SAM splint. These aluminum and foam splints can be made into any immobilization device.
- ▪ ACE wrap, Kling, or Kurlex to be used alone or with the Sam Splint. If you are short of space, you can use a First Care dressing.
- ▪ Moleskin, mandatory for those blisters from breaking in new hiking boots.
- ▪ Tape, duct tape.
- ▪ Adhesive bandages.
- ▪ Dermabond, disposable skin stapler, sutures 4:0, 5:0, 6:0.
- ▪ Needle driver, iris scissors, forceps, scalpel.
- ▪ Lidocaine, lidocaine with epinephrine.
- ▪ Insulin syringes, 3 ml syringes.
- ▪ Oxymetolazone (Afrin) nasal spray (for epistaxis, stuffy noses, colds).
- ▪ Sudafed (colds, eustacean tube problems).
- ▪ Zofran: I like the disintegrating tablets, which can be used in kids as well.
- ▪ Pepto-Bismol tablets and ciprofloxin, if traveler's diarrhea is likely to be in your future.
- ▪ Ibuprofen.
- ▪ Chewable aspirin, sublingual nitroglycerin. (Nitroglycerin has a very short shelf life and is heat sensitive.)
- ▪ Dexamethasone, diphenhydramine (Benadryl), epinephrine 1:1,000, morphine/Dilaudid, diazepam, Ativan, and Valium. (These are for allergic reactions, and the dexamethasone plus lidocaine injected into my knee one year allowed me to ski pain-free all week.) If you carry morphine or diazepam, put a copy of your DEA certificate in the kit.
The piece of mind of knowing you have the tools to get out of a jam or even to keep from interrupting your holiday to seek medical care are well worth the time it takes to put this kit together.