A first aid kit for mountain bikers is a tricky thing. On the one hand, we often ride in remote areas, out of cellular coverage and maybe hours from the nearest road, so having a first aid kit is a good idea. On the other hand, have you tried stuffing one of those St John's Ambulance first aid boxes into a Camelbak? Mountain bikers are weight weenies, and don't like lugging around unnecessary weight.

So, what do you put into your first aid kit?

Here's what I stuff into mine:

• the bag: an Ortlieb waterproof first aid bag, with a roll-top closure (bought it on the 'Net at www.ortlieb.com).
• Micropore tape
• Some dressing material. Melolin is good for field-dressing grazes, as it has a perforated plastic surface that prevents the dressing from sticking to the wound. Available at Guardian.
• gauze
• compression bandage. Good for bandaging over the dressing to prevent ingress of contaminants and to protect the wound from further falls
• antiseptic. I use Betadine, because it comes in a small plastic bottle (lighter than glass bottles eg Acriflavin)
• alcohol swabs.
• antihistamine (for allergy to bee stings etc)
• anti-inflammatory, to reduce swelling. Voltaren is powerful, but mustn't be taken on an empty stomach. Requires prescription.
• rock-climber's sticky tape. good for sticking dressing on sweaty skin when Micropore won't cut it.
• Panadol, or other mild pain-killer.

What I don't have is those cool sticky sutures like the ones Ice Cube has to close up deep gashes. Any idea where to get some in KL?

-- Joe (joeadnan@yahoo.com), August 20, 2001

Answers

Joe, you really bring those items in your Camelback? How heavy does your bag weigh? No wonder you need all those fancy titanium tubings to keep the total weight down!!

-- matt (mmarzuki@hotmail.com), August 21, 2001.

It fits into a small bag, about 6" wide, 4" tall and 3" deep. So not really that big. I only carry the first aid kit when the ride is remote or where it is a ride where I'm responsible for the safety of other riders.

-- Joe (joeadnan@yahoo.com), August 21, 2001.

I think Joe's 1st aid kit is pretty comprehensive and adequate. Mayby should throw in a few plasters.

I would like to refine Joe's kit though... micropore is good only for dry skin. Once mixed with sweat, rain or mud it will rendered useless. I suggest Durapore instead. Yes those rock-climber's tape (Zic Oxide tape) are ok too. Both Durapore and zinc oxide tape can double well as rim tape too!

As for the disinfectant, iodine based antiseptics (e.g. betadine) are very good but... ouch... very painful on open wounds. May wanna consider something less painful like chlorhexidine 0.05% w/v, or less preferred EUSOL solutions. I am sure these can easily be found in the local pharmacy stores. However, one good advantage of the iodine- based antiseptics is that they can double in as a water purification agent. Best to use tincture of iodine instead of betadine or povidone iodine though. How much to add... 4 drops of tincture of iodine to 1 litre of water... let it stand for at least 30 mins. Now you can drink that water from those lovely waterfalls and rivers without fear of diarrhea!

Another item I would also recommend is Op-site. That's a waterproof breathable second-skin-like-material that hospitals use to stick intravenous cannulas onto your hand. It's great to cover wounds with Melolin, and then put the Op-Site over the Melolin. This effectively makes your dressing waterproof/mudproof etc.

Additional items that may help but of-course adds weight to your who kit... safety pins (for splinters, broken tights, etc), tweezers (for those splinters or ticks), small scissors.

As for the cool sticky sutures... you can fashion the durapore with a pair of scissors into those cool sticky sutures :). Cooler eh? However I've got something even better... tissue glue. Show it to you the next time we meet.

-- Eric Tan (orang_gunung@hotmail.com), August 22, 2001.

On every outing, I tailor my medical kit depending on the group size, length & type of ride. My basic medical kit includes the flwg:

A.Wound management 1. Wound closure strips - for closing cuts. This is the one Joe was refering to. 2. Topical antiseptic oitment - Betadine povidone iodine 3. 20cc. irrigation syringe w/ plastic tip - for cleansing & irrigating wounds.

B. Bandage materials 1. 3"x4" non-adherent dressings (2) - doesnt stick to wounds. 2. 3"x3" sterile dressings (4) - protect wounds. 3. 2" or 3" conforming gauge bandage (1) - to hold dressing in place. 4. medical adhesive tape (1) - 0.5"/1" x 10 meters. 5. elastic compression bandage (1) - for sprains, strains or snakebites. 6. strip adhesive bandages (5) - for small cuts, blisters. 7. cotton tips (2) - may be use to remove foreign materials from the eye.

C. Medications 1. ibuprofen 200mg (4) - painkiller, reduce inflammation. 2. antihistamine 25mg (2) -for treatment of allergic symptoms. 3. oral rehydation salt tablets (2) - Servidrat. 4. insect sting relief pad (1) - relief pain from insect bites & bee stings. 5. analgesic balm (1) - Counterpain, relieves muscular aches & pain. 6. Aloe Vera (1)- topical anti-inflammatory for treating abrasions, sunburns 7. Ultra carbon (2)- for relief of diarrhea

D. Infectious control 1. examination gloves (2) - protect youself from infectious disease e.g. aids. 2. ziplock bag (1)

E.Essential equipment 1. splinter picker (1) - for removing embedded objects. 2. safety pins (3) 3. small bag to carry the above items

The above items can be purchased from the local pharmacy stores. Apart from the above, I also carry the flwg in my camelbak to complement my medical kit: 1. multitool - leatherman wave w/ scissors 2. duct tape - multi purpose tape. 2" wide. 3. sam splint - a versatile & lightweight foam padded aluminium splint.

IMHO, the most valuable thing is your knowledge on managing medical emergencies in remote environments when professional medical care or rescue is not readily available. Learn to improvise. In the wilderness, one must utilize whatever supplies or materials are on hand and depend heavily on common sense (e.g. seatpost & handlebar to make splint, etc.). Learn and practice on how to use the items in the medical kit. No point having a medical kit if you dont know how to use them. And never attempt to perform any procedure that you are not comfortable with, or trained to render, unless the victim will die without that intervention.

-- IceCube (adadli@pc.jaring.my), August 22, 2001.

I m not so sure on the number of iodine drops to disinfect water. From what I hv learnt, if u disinfect water w/ 10% povidone iodine solution (betadine), u would need 8 drops per liter if the water is clear and cold. Contact time is 60 minutes. 30 minutes if water is warm. U rarely find warm water in the jungle.

-- IceCube (adadli@pc.jaring.my), August 22, 2001.

IceCube, you're right about the amount (no of drops) and standing time for Betadine (Povidone Iodine Based)... 8 drops to 1 L of water.

However, cold water is defined as water of 15 degress C or less. In our tropical lowland setting (not the highlands), the water can be safely classified as warm. Hence standing time is 30 mins. If up in the highlands of temp < 15 C, or if the water is slightly turbid (not clear), then doubling the standing time to 1 hr is correct too.

For those who choose to use Povidone Iodine, please make sure that it does not contain "alcohol". This is because industrial/medical alcohol sometimes contain Methylated Spirit (Methanol), and that is poison!

As for myself, I also include a DEET insect repellent (e.g. OFF) with me. It is obviously good for preventing mossies (mosquitoes) and midgies (sandflies) bites. It can also be used for removing leeches, but often the bite-wound bleeding wound not stop and it leaves a scar!

-- Eric Tan (orang_gunung@hotmail.com), August 22, 2001.

One more item I forgot to mention.... triangular bandage. This may be a rather useful item to carry, since collar-bone fractures seem to be one of the more "common" injuries that I have noted; especially for Kiara.

-- Eric Tan (orang_gunung@hotmail.com), August 22, 2001.

Wahh. I am always so impressed with the level of knowledge and preparation evidenced in these discussions. Obviously the long ride kit has been covered in detail. May I throw in what I suggest for a mandatory short ride kit? 2 x Elastic (tensor) bandages, small unbreakable bottle of antiseptic ointment. If nothing else, take these. Almost no weight, and they'll get you out to where you can do a better job with the full kit. Over the years the two items that have been called upon more than anything else.

-- Pigpen (Pat Brunsdon) (patbrunsdon@optusnet.com.au), August 23, 2001.

And if u dont hv triangular bandage, u can still improvise. U can stabilize collarbone fracture, shoulder dislocation by using safety pins. Pull the bottom of the shirt up and pin to the top portion to support the lower arm just like when u would support the arm using the tiangular bandage. Then if u need additional support u can use the duct tape to tape the the arm to the abdomen.

-- IceCube (adadli@pc.jaring.my), August 23, 2001.

A bandana is a useful alternative if you don't happen to have a triangular bandage in the middle of nowhere. That was what a buddy used to support my clavicle mishap at Kiara not too long ago until somebody came up with a proper bandage. So even if you dislike wearing a bandana, it can be useful to carry one in your camelbak and it's not too heavy.

-- Pete Choong (yellowmanta@hotmail.com), September 27, 2001.

well i would like to tell u guys to add 1 more item to your medical kit which is the "ehylchloride clouro de etilo chloure d`ethyle" ita a skin anaesthesia for prompt relief of pain and its mighty usefull. a few sprays to the open wound will like numb it and u won't feel the pain anymore.

-- marcus (marcus@manson.to), September 30, 2001.

I don't think this item has been mentioned: a rather thick bandage, complete with a long piece of gauze for securing it onto the injury site. I have used what I call "army field dressing" (which may be purchased from Army Suplus stores in Pertama Komplek), as well as a No.13 Bandage (available at Guardian, by special order). They have worked well on a torn knee and a punctured thigh, both rather nasty and bloody wounds.

The "army field dressing" is rather bulky (roughly 3"x2"x1"), and comes wrapped in green plastic. I suspect it's intended for really nasty combat wounds. The plastic helps to keep it clean, but it's not waterproof (and it's jolly hard to find the dressing if you drop it off-trail!).

The No.13 Bandage is a lot smaller (approx. 1.5"x1"x0.5"), but since it's wrapped in paper, you'll need a plastic bag to keep it clean and dry.

Of course, if one is already carrying a triangular bandage, that could double-up as dressing. The only problem is that you'd probably want to wash the bandage pretty well before you use it again. The other two bandages on the other hand, are disposable.

-- Shaharudin "Dr. Nosedive" Damis (dshaharudin@yahoo.com), March 14, 2002.

Be prepared seems to be the theme here. Good job Joe, in this world of hi-tech electronics, cells phones, GPS etc, there's times that these may not work.

You may want to pack a whistle (the ones the PE coaches use), and close to your body. No batteries required, no hills to worry about. You blow that thing, and others can hear you from quite a distance.

double A

-- Andrew Annuar (aannuar@shaw.ca), September 28, 2002.

My personal First Aid kit,

Throw in a few band-aids, 5 packs of gauze-pad(3x3-12 ply) 1 combine ABD pad )5"x9" 1 mini first-aid manual 1 needle 1 surgeon rubber glove 1 triangular bandage 4 antiseptic towes, the mini-wipes 4 iodine minipads i roll of bandage tape 1 pair of small sized scissors

all the above fits into a small fanny pack (purchased from mountain equipment coop www.mec.ca)

double A

-- Andrew Annuar (aannuar@shaw.ca), September 28, 2002.