Playing Doctor

"Dr. Hackenbush, I presume?"

A few days ago I went rummaging through our closet looking for a specific type of bandage to cover a boo-boo. Nothing major, no blood on the floor, no protruding bones, just a minor injury in an unusual spot that needed a specific type of bandage. I was sure we had what I needed, because I remember putting them in the first aid supply box a few years ago. But they were not to be found. OK, no problem, I went out to our camper (parked in our driveway), rummaged through the camper's first aid kit, found what I needed, poached a few other items from the box, checked the expiration dates on some of the meds and then headed back to the house. It dawned on me that I'm in the 'rob Peter to pay Paul' stage of medical readiness, and it was time for a refresh on all of our first aid supplies.

We have three separate first aid supply stashes - one in the house, one in the camper and one in my truck. The house kit is really a pile of supplies that sits on a shelf in our linen closet, and it's the supply that gets used most. Lots of band aids, gauze, wraps, tape, antibiotic ointment, etc. We probably completely turn over that supply every 18 months, particularly band-aids and antibiotic ointment (Neosporin).

The first aid kit in the camper has a slightly different focus. That kit is specifically stocked to support my wife and I with a higher level of care while on the road and camping. The idea is to be as self sufficient as possible for a week or more with no access to regular non-prescription supplies like you'd find at Wal-Mart. So, more gauze, more tape, more bandages, but also things like OTC pain killers (Tylenol, Motrin, Imodium, aspirin, etc.), betadine wipes, burn gel, electrolyte powder, cold packs, splint rolls, oral tooth pain killer, oral thermometer, even water purification packs. We don't want minor bumps, bruises and scrapes to grow into something that impacts our camping adventures.

The first aid kit in my truck is a subset of the camper kit. It travels in a smaller box and leaves out a lot of  the more esoteric components of the larger kit, like the dental care items and the electrolyte powder. Plus it's easy to transfer to my wife's car if we decide to use that for traveling.

So... hi-ho, hi-ho, off to Amazon I go, and I'll say this - thank the Lord for generics! While this re-stock wasn't cheap, the price could have almost doubled if I bought name brands vs. generics. Just price Neosporin ointment against a generic of the same compound. The generic is roughly 20 - 30% cheaper. And antibiotic ointments like Neosporin get used a lot in my house.

Many would say, "Hey, things don't really expire, you can keep them around longer and they'll be just fine". I'm on board with that thinking when it comes to things like gauze, tape, etc. But medication I have in my truck kit are subject to some wild temperature swings - below freezing in the winter, well over 100 degrees in the summer. Medications in the truck kit get tossed on schedule. I check the non-medications (again, gauze, tape, band-aids, exam gloves etc.) to make sure they are still securely packaged and haven't degraded due to heat and cold, and I'll toss those too if they look a little suspect.

These mobile first aid kits get stored in clearly marked waterproof containers. For years I'd just buy the pre-stocked kits like those offered by Johnson & Johnson and the Red Cross. They are a good way to get basic supplies in a single purchase, but I've always found the box or container they come in to be less than ideal. Down through the years I've tried other options like tackle boxes (first got the idea watching the great Jack Webb series 'Emergency' when I was a kid), ammo cans, backpacks, tool boxes and more. 

"Dammit Roy,  you grabbed the wrong box.
 It's full of spinner baits, not bandages!"

But what I've settled on are clearly marked hard cases made by a Canadian firm called Nanuk. Nanuk is a competitor to Pelican, but in my opinion the Nanuks are better designed and built, and cost about the same. The cases are just simple empty waterproof boxes, so all the supplies get put into Ziplock bags and labeled by content type (roll gauze, tape, medications, adhesive bandages, etc.). 

Nanuk makes excellent cases that beat Pelican in design and quality

There's one key supply item that I can't get for myself, and that is oral antibiotics. In my serious prepper days I explored getting a supply of oral antibiotics as part of my apocalypse preparedness, but never perused it. It would have required going to my family doctor, explaining I was preparing for the end of the world, and gee, wouldn't it be a good idea to have a supply of antibiotics on-hand just in case? 

Last summer my wife and I went on an extended camping vacation up through Kentucky, Ohio and Michigan, with a lot of stops along the way. The goal was to get to western Michigan for a family wedding, and we were scheduled to camp there for about a week. The campground was crowded, the heat was awful (it was during the 2025 summer heat dome that impacted much of the eastern US). We had our three dogs with us, and they were on edge because of the heat, the campground noises, the lack of a yard to play in. One of our dogs, while he's great with humans, can be aggressive towards other dogs, particularly other males who also think they rule the world. One day while out walking him, he got into an argument with another aggressive male. The lady holding the leash was incapable of controlling her large dog, and the two tried to lunge at each other. I pulled my dog back, and stepped between them to try to break things up, but in the mele my dog managed to nip me good on the calf. It was an accident - he was going for the other dog, not me. My calf just got in the way. Accident or not, I had two puncture wounds. So, we're in a state far from Georgia, and one that might not look too kindly on an 'aggressive' animal from out-of-state with no verification of vaccination other than a collar tag. And, we had a wedding to attend the next day. No way was I going to head to an ER or urgent care center unless absolutely necessary. I knew my dog was vaccinated, so there was no threat of rabies. I had plenty of Neosporin, bandages, gauze and tape to handle the two puncture wounds, but there was a serious threat of infection. Dog's teeth, and all that. I flushed out the two bites, applied pressure bandages, and remembered that I had brought along some 'left over' amoxicillin that had been prescribed to me for dental surgery a few months prior. There was enough for a 5 day round of treatment. 

The decision to not go to an ER was a carefully calculated one. The wounds were clean and well bandaged, the pain was under control, and my mobility was fine, I knew the dog didn't have rabies.  On the other hand, if I did go to the ER an unnecessary chain of events could have kicked off that would place my dog in quarantine, causing us to have to extend our stay in Michigan by weeks, add additional cost to the trip, and ruin the back half of our vacation. The single factor that tipped the calculation in favor of continuing without an ER visit was the availability of antibiotics. If I hadn't brought those along I think my wife would have forced me to the hospital.

There are lots of other ways to get hurt while camping - burns, puncture wounds, cuts and scrapes, falls, walking into tree branches, twisted ankles, etc. Pretty much the kinds of things that can happen around home. But when camping you are not around home (that's the whole idea of camping, right?), and you are not around the medical system that you depend on for support. This means non-critical self-care is more important than at home. So, a robust first aid kit stocked with supplies and medications specifically chosen to treat camping-related injury and health issues is important. 

I now consider prescription antibiotics a key component of this first aid kit. But how to get them (legally)? There's a few ways. One is to ask your family doctor. Another is to turn to one of the on-line pharmacies. These have been operating in the US for years (they are the same kinds of outfits that will sell you the 'little blue pills' after asking a few 'discreet' questions). Prices are a higher than if you get them through your family doctor, but nobody's going to ask you why you need them, or require an office visit. Some companies like Jase Medical will sell pre-packaged kits of a broad range of medications for survival or emergency use, but geeze, those are expensive. I'm a believer in buying generic and in bulk, and being aggressive in tossing out expired medications. A few days ago I bought a supply of amoxicillin from an on-line provider called TelyRx, and the cost came out to about $1.80 per capsule after the medical review fee and shipping were calculated in. This will ensure my wife and I have enough medication for each of us to have a regular 7-day course of treatment.

But what else goes in the kit? On this, I rely on the advice of a few close friends and relatives who work in emergency medicine. Two in particular have long term ER and trauma center experience, one serving as a SF combat medic in Afghanistan. The secret is... nothing exotic or fancy. Lots of gauze, tape, Ace bandages, hand sanitizer, antiseptic wipes, antibiotic ointment (Neosporin), lots of Band-Aids for the small but very common ouchies, anti-itch cream, some Quick Clot for small cuts, cold packs, burn gel, exam gloves and face masks, and a selection of common OTC medications like acetaminophen (Tylenol), ibuprofen (Motrin), low dose aspirin and Imodium. I leave out all the prepper and apocalyptic silliness like decompression needles, combat tourniquets, suture kits, IV starter kits, iodine tablets for treating radiation poisoning, etc. 

Also important is an inventory sheet, one that stays in the kit so you know what and how much to re-stock. I maintain a list in spreadsheet format and print it out and tape it to the inside of the case lid. As you see below, I also segregate most of the kit components into ziplock bags. This makes sure the individual contents are easy to find and identify, and the bags keep the individual contents dry and clean. 

The kit I keep in my truck, under the passenger seat. Note the two hand sanitizer
packets taped to the inside lid. A neat trick I picked up that allows the user to easily clean
his/her hands before rummaging around in the kit contents

As mentioned above, medical supplies are subject to heat and humidity damage, especially if the kit is stored in a car or truck where temps can range from sub-freezing to well over 100 degrees. This is why my vehicle kit holds only the minimum amount of medications. Some antibiotic ointment, hydrocortisone cream (for bug bites), antiseptic wipes, burn gel, hand sanitizer and quick cool packs. Everything else is gauze, tape and bandages, which are less susceptible to heat and cold. The larger camper first aid kit gets stored in the house when we're not camping, since the camper can get quite hot and humid when in storage over the summer months. 

By now I know many of you are yelling at your screen, "What about training?!" Excellent question, and I'll admit it's been a while since I've taken a first aid course. But I've taken basic and advanced first aid all through my military career (it was an annual requirement in most of my jobs), and kept up with it in a fashion after retirement from the Army. While I could use a refresher, I think it's fair to say that the basics really haven't changed in the last quarter century (check for a pulse, clear the airway, stop the bleeding, etc.), and the goal of these kits isn't to be able to perform emergency surgery, but treat minor wounds and if necessary stabilize for treatment at a hospital or clinic. No picnic table appendectomies or treating 50 caliber gunshot wounds. But I promise, I'll get more training before the end of the year.

W8BYH out