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As a retired surgeon/ER Doc I have been given the task of putting together a major emergency kit for an upcoming private Grand Canyon Trip.. I have access to all emergency meds.
 

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Discussion Starter #3
Sorry I didn't complete the thought (thread). Any suggestions as to what to include in this major emergency kit. Meds, casting materials, spare body parts?
 

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Hi,

Here's a starting point, from the GCPBA web site.

http://gcpba.org/2010/08/27/first-aid-kit/

As a physician, you'll likely add things in line with your personal concerns/experience/specialty, (I once chatted with a doctor on Westwater who was bringing suture kits and a full IV rehydration setup).

Hope this helps as a starting point.

Rich Phillips
 

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In the past we've brought

IV set ups

Epi/Benadryl

Zofran

Opthaine

Various oral narcotics

BLS/ALS airways with a BVM

Assorted dressing bandaging material
 

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The Old Troll
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large Ibuprofen

Large Imodium ---- Norovirus has struck whole expeditions on the Grand!

Desitin -- Rash is common on a long trip.

Sand between foot ware and feet will eat through skin. Mole Skin, Duck Tape and other remedies to keep folks on their feet are a must.

Eye wash --- Sand in the eye is a given.
 

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Hi again Doc. Hope you didn't mind my previous joke. I broke things down into two groups. Emergency first aid and treatment of common ailments. And then into the most common ailments in each.

EMS: falls, cuts, fracture, drowning, heat stroke, allergic reactions, ...
+1 on the suture kit, airways, sam splints. epi-pen....

Ailments: diarrhea, infection, rashes/abrasions, sprains, tendonitis
lomotil, walnut tincture, good general antibiotic, metronidazole, antibiotic cream, ...

My kit was the size of two loaves of bread and stored in a drybag where Everybody knew where it was. Never know who is going to get hurt. Have fun!
 

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Thanks to all for your valuable info re emergency kit. I asked my mechanic once before taking off on a camping trip into the wilds of Baja, what spare parts I should bring. His advice: forget it, just bering a credit card! Indeed, the only problem we had was a flat on the rocky road to Agua Verde and although I had 3 jacks, I had forgotten a tire iron!

Peter
 

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As a retired surgeon/ER Doc I have been given the task of putting together a major emergency kit for an upcoming private Grand Canyon Trip.. I have access to all emergency meds.
Another key element to our kit is finger/toe cots. With sand, sunscreen etc all over stuff, the real problem is keeping wounds & cracks clean so they heal DURING the trip. Without this, things just get worse and they most often develop early on in the trip.
 

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Another key element to our kit is finger/toe cots. With sand, sunscreen etc all over stuff, the real problem is keeping wounds & cracks clean so they heal DURING the trip. Without this, things just get worse and they most often develop early on in the trip.
An ounce of prevention... Not really in line with what to put in a major FA kit (NPS has a good list in the Regs too), I find it always helpful to wear gloves. Good gloves, like Atlas Fit gloves. All the time. On the water, on side hikes, etc. These can help with the hand drying and cracking. Making sure folks bring lotion and/or bag balm and USE it daily on their feet and hands is important, and can help keep items in the First Aid kits.

Just putting it out there. Have a great time!

-Josh
 

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Old Guy in a PFD
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I wouldn't dare presume to tell a doctor what he should bring on a canyon trip. I mean, he's the Doc, right?

I will presume to tell him he can expect dirty conditions; think camping without water for a week. The Colorado river often looks and acts more like chocolate milk, what with all the sediment in it. And, it's cold; even 150 miles downriver it will cause hypothermia in just a few minutes for someone who isn't protected. The air temp can be 110, the river can be 55, so the shock factor is a consideration.
You can expect critters that bite; from rattlesnakes and scorpions to the little purple wasp thingys and fuzzy spiders that I understand hurt like the dickens if they get you.
If something happens you can expect to be on your own for anything from several hours to days; that's how long it can take to get word out and get a chopper into you.
The other posters hit it right; a cut or scratch that gets infected is the devil to get and keep clean, and a major pain to deal with.
And expect the irritation factor to be high; there are plenty of ways to get a rash, or itch or something that doesn't require evacuation, but will make people a major pain to live with. Lots of potions, and lotions and salves and balms will help.

And expect to be paid for your services in beer.
 

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and something else to consider;
The river rules state that if a thing absolutely positively must be kept dry and clean, it will not.

Pack your stuff as if you were expecting it to be dropped, kicked, stepped on, dunked, and super heated, cause it will. The doctor who went on most of our trips used a big ammo can lined with plastic, the contents water proofed, and packed carefully. There's probably something better now, but keep in mind whatever you use will be fully tested as to it's ability to keep stuff dry and not squashed.
 

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Doc,
In addition to the usual meds like Epi and Benadryl, Zofran, and a broad spectrum antibiotic I have seen and done suturing and splinting or casting fractures on the GC. All the BLS stuff the NPS recommends as well.
We brought IV solution last year for an August trip for rehydration as well. Hopefully the only thing you treat is sunburn and blisters.
 

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What are you going to do with a BVM? I don't know the statistics, but I would presume that any respiratory arrest even in the canyon has a very high likelihood of a fatal outcome. I once thought bringing airway equipment into the wilderness would be a good idea, but I've since changed my mind. I carry a basic mask with a 1 way valve if it comes to it, but I won't be running a code long enough in the wilderness to need a BVM, king tube, LMA, etc.

Basic stuff like sunscreen, epi pen x several, benadryl, imodium, zofran odt, cipro, ibuprofen, LMX for suturing, dermabond for blister repairs, and PO opiates are about all that one needs to do a decent job out there. Steri strips, 4x4's, and cobain for dressings.

Invest in a satellite phone to call a friend if needed.

I'm an EM resident.
 

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I'm ready to get beat up.

Manuka honey.

While the definitive long tern treatment for serious burns is still excision etc there is some evidence that in the short term, prior to transport to advanced care, Manuka may be better than Silvadene.

One study claimed some, repeat some, effectiveness of a Manuka related MediHoney against MRSA.

Side effects of honey is that it is sweet.
Oral is recommended along with topical. Of course, more individual study is needed.

=========
Manuka Honey Effective Against Antibiotic Resistant MRSA
Researchers at the University of Technology Sydney have shown that medical-grade manuka honey, also known as Medihoney, improves the effectiveness of antibiotics. It can prevent bacteria from becoming resistant to the medications. Medihoney is a highly-absorbent seaweed soaked in special, sterilized manuka honey.
- - - -

PLOS ONE: Synergism between Medihoney and Rifampicin against Methicillin-Resistant Staphylococcus aureus (MRSA)
 

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With regards to the BVM, myself and my pals are all 20+ year medics. We'd rather be able to ventilate someone with room air vs no air at least as a shot. Statistically sure, your probably right, the chances of a successful resuscitation is slim, although we will give whomever the best shot possible. If that means an opa and bag and or dropping a tube then so be it. A least we can say we tried.
 

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I expect every member of the party to bring their own sunscreen, lotion, lip balm, soap, hand sanitizer, antiseptic ointment, and bandaids. I expect them all to be able to treat their own blisters, sunburn, minor burns/cuts/scrapes, splinters, and bug bites. I am a big fan of Superglue for cuts/cracks, and the flexible kind is even better. It is sold as adhesive for fake fingernails, in the cosmetics aisle. I think everyone should have their own bottle of it. On trips with kids, sometimes I hand everyone in the party a small bottle of hand sanitizer. Party favor.

As a boat captain, my enhanced kit includes all of the above plus a snake bite kit, more extensive bandages, screw top ice bag, a few rolls of cloth athletic tape, a couple of curved steel finger splints, toenail clippers, scissors, extra tweezers, an X-acto blade (not for surgery but in case something has to be lanced or dug out beyond what a needle will do), latex gloves, Quick Clot, antiseptic wipes, Cetaphil or baby shampoo for wound care, and a glucagon injector pen (my sibling is a type I diabetic and could go unconscious due to insulin shock).

When I am lucky enough to have a doctor along on a trip, I would hope that he/she would be able to bring along things the layman cannot get: a local anesthetic such as Lidocaine, sutures, oral antibiotics, high grade topical antibiotic ointment, and some better-than-OTC painkillers. That plus medical knowledge/training, of course. Come to think of it, I should probably just carry sutures anyway.
 

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Discussion Starter #20
thanks Ridecat,

My thinking exactly. As an ER Doc with wilderness experience, I expect everyone to have the basics to deal with minor problems. I conceive of my role as serious, hopefully not life-threatening situations requiring my intervention and my kit will reflect that. I plan on relaying the same mention to my fellow river rats.
 
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