Why I Don't Carry A First Aid Kit

Why I Don't Carry A First Aid Kit
&
What I Carry Instead

                                                              

by Ras Vaughan

     I'll be the first to admit that I tend to be a bit of an iconoclast. I've spent much of my life questioning the conventional wisdom, and frequently finding it wanting. And this pattern of rejecting the accepted norms has been a key part of my approach to adventuring. Three years ago I published a what-I-would-consider-playful-but-others-might-consider-snarky piece about the 10 Essentials and how few of them I generally carry, which, while it accurately describes my mindset, would be wildly irresponsible to promote as an approach for the masses.  

     In light of Kathy's recent incident it may seem surprising that I haven't reevaluated my minimalist approach. Admittedly, it put me in the position of having to carry her a short distance to a paved road, run more than a mile through the woods in the dark with no headlamp, drive the car around to the gate nearest her, and then run another mile + in the dark with no headlamp and an armful of extra layers for Kathy, and finally hike back out the aforementioned mile + with my beloved wife as she gingerly hobbled along on a freshly injured ankle. 

What One Carries In One's Head

     However, none of this came as a surprise to me. I run through possible scenarios such as we faced at that moment all the time in my head. I don't mean to make it sound like I'm some sort of survivalist savant who perceives every possible outcome in a split second and can choose the right course of action in an instant. It's simply that I consider the possibilities ahead of time, so when I am faced with them in real life they are not new and intimidating ideas. They are, instead, situations I have faced before on a theoretical level, which leaves me better prepared to face them in actuality, should they occur.

     Mental preparedness of this sort is the most valuable asset in an emergency/injury/survival situation. An old adage born of Prussian military strategy informs us thusly: "No battle plan survives contact with the enemy." While I don't consider the natural world to be my enemy, these sage words can be directly applied to adventuring, and even to life in general, and can be paraphrased variously as, "No plan survives initial contact with reality," or, "No plan survives implementation." Regardless of how you phrase it, it comes down to the fact that our hopes and expectations for how the future may play out are invariably inaccurate. Therefore, the need for an alphabet of contingencies, plans B through Z and beyond, is foreseeable. 

     I use Murphy's Law ("Anything that can go wrong, will go wrong") as a predictive principle when running through scenarios in my mind, whether it be before, during, or after an adventure. But I temper the wide open possibilities it implies with Occam's Razor, in that the most common injuries are the most likely to occur. Numerous other aphorisms from everyday life resonate in the adventure realm, such as "Hope for the best, prepare for the worst." Yet it's vital that attempts to be prepared for an emergency don't form the groundwork of the emergency itself. A first aid kit is heavy, whereas ideas weigh nothing.

The Burden Of The Unnecessary

     The Minimalist/Ultralight/Alpinist approach is predicated on the idea that faster and lighter is also safer. Any and all weight carried increases wear and tear on the body and mind, increasing the chances of suffering an injury. A first aid kit is foremost among those pieces of gear that are anathema to ultralight travel: something you hope never to use. I assert that a first aid kit is less a piece of gear and more a self-fulfilling prophecy. It's a fine thing to stick in the trunk of your car just in case, but not in your backpack.

Ready Made Kits and the Illusion of Preparedness

     What injuries are you really going to need to treat on the trail? What first aid are you realistically going to perform in the wilds? Stitches? Sterilizing? Splints? Is there an ointment that will make the difference between escape and tragedy? Sure, we all like to think that we are going to grit our teeth and sew shut a gash on our arm Rambo style, but in reality superglue and duct tape are far more viable options for treating a laceration.

     Staunching bloodflow is an immediate need. Staving off infection, less so. In an emergency/survival situation the number one goal is to remove yourself from the situation; to either get rescued or get yourself to help. Wounds can be flushed and sanitized after the fact. And in a genuine emergency/survival situation, urine can be used straight from the source. When it leaves the body urine is sterile, and it comes out in a lightly pressurized and focused stream, perfect for flushing out wounds. In fact, it makes for a useful litmus test: if the situation in which you find yourself is serious enough to warrant peeing into an open wound, you know you are in a genuine survival scenario.

     In addition to the risks involved in carrying unnecessary weight comprised of items of questionable usefulness, there is a false sense of security that comes free with every pre-fab first aid kit purchased. Placing a red plastic clamshell or a nylon pouch emblazoned with a white cross into a backpack provides a sense of preparedness which is an illusion if you don't know what to do with the materials inside. And if you have the knowledge and skill to use the items in a first aid kit, odds are you would be able to perform the same ministrations without the kit or any of its' contents. To put it bluntly, the most important emergency/survival/first aid supply is your brain, and the most fundamental skill in such situations is the ability to improvise. 

     It goes without saying, yet bears pointing out, that Human Beings are bipeds. Our upright bipedal movement is the very thing that makes us distinct from other mammals and imbues us with our distinctive ability to cover long distances sustainably. However, this unique balancing act that enables our extraordinary mobility is also the source of our greatest vulnerability: falling. Our very bipedalism puts the "fall" in fallibility.  Injuries to the drive train (the ankle, foot, and knee) and injuries sustained from the resulting fall are the most likely to present an emergency situation on the trail. Gruesome injuries such as that suffered by Dave Mackey are the stuff of nightmares for runners, hikers, and climbers. Cell phones, satellite transponders, and emergency position indicating radio beacons can be invaluable in such situations, but are far beyond the scope of any first aid kit.

First Aid Kits Versus First Aid Supplies

     Commercially produced first aid kits invariably contain an assortment of bandages, gauze pads and ointments that are virtually useless in a genuine trail emergency, or, at best, unnecessarily specific. Band-aides, butterfly closures, and medical tape can be improvised from duct tape and toilet paper, both of which have numerous other uses. Gauze pads (4x4's, etc.), ACE bandages, and hemostatic dressings can be improvised from bandanas and clothing, and can be tied in place or held in place with duct tape. 

     To my mind, the majority of supplies in a first aid kit are designed to address minor nuisance damage, not to treat the sort of serious injuries that bring an adventure to an end and put one in an emergency/survival situation. If I have to choose between carrying 1/2 pound of supplies that I hope never to use versus having a minor owie go untreated and saving the weight, I'll suffer the untreated owie. The owie may or may not occur, but that extra 1/2 pound is going to be loading on my muscles and impacting my joints approximately 66,000 times over a twenty-five mile day. I'll gladly risk the hypothetical owie over the guaranteed 33,000 cumulative pounds of daily wear and tear.

What I Carry Instead of a First Aide Kit

     I see no need to carry specific single use items that can be improvised from existing materials. It's far better to carry items with multiple applications that can be made use of for first aid in an emergency, but don't add useless weight, and the added risk of injury or misadventure that comes with it. Everything from the clothes on your back to the straps on your pack to a stick laying by the side of the trail can be useful in an emergency. 

     First and foremost, anytime I am traveling on anything other than non-technical terrain and for more than a few hours, I use trekking poles, around each of which I wrap six feet of duct tape. This puts a total of twelve feet of duct tape at my disposal, which is to say twelve feet of one of the most versatile materials known to humankind. 

Ras loading duct tape onto his trekking poles in preparation for the AZT Yo-yo with Kathy.

     While working as a carpenter I have indeed used duct tape to, brace yourself, tape ducts. On the trail I have used it to repair shoes, mend tights, patch puffy down jackets and pants, repair trekking poles, bandage cuts (with a folded square of toilet paper), prevent blisters, protect cracked skin, mend packs, improvise grass-seed proof ankle gaiters, patch plastic baggies, and make a nose guard for my glacier glasses. And that's just a sample of the ways I've made use of duct tape on the trail; it's far from being an exhaustive list. And, of course, combined with the trekking poles on which I stow it, duct tape can be a key component of an improvised splint for a leg, arm, or neck.

Ras protecting his socks from grass seed heads on the Arizona National Scenic Trail.

     On long self-supported or unsupported adventures, from a multiday fastpacking trip up to a 1000+ mile thru-hike, I carry what I call my MacGyver Kit. As I'm sure is obvious, I named it after the mid-1980's television character with a knack for creative problem solving making use of random materials found at hand. However, my MacGyver Kit is not an arbitrary assortment of random odds and ends that I toss into a ziplok before heading out into the wilds (although, admittedly, that might make an interesting premise for a reality teevee survival show). My MacGyver Kit contains a carefully thought out, yet minimal, agglomeration of tools and materials that not only have multiple individual uses, but that can also be used in conjunction with one another to expand their potential exponentially.

Ras repairing a broken trekking pole wrist strap with fly fishing leader on the AZT.

     

My MacGyver kit contains: 

• approximately five feet of fly fishing leader line 
• one spool of upholstery thread
• leather needles (3)
• one tube of Tenacious Tape
• toenail clippers
• super glue
• two doses of antihistamine (one of the only single application items I carry)

Useful First Aid/Survival/Multi-use Items Also Carried:

• six feet of duct tape wrapped around each trekking pole = twelve feet
• two trekking poles
• disposable lighter (another thing around which duct tape may be wrapped)
• two large safety pins
• bandana (probably the single most useful and versatile part of my kit)

My Lethal Weapon's My Mind

      In a real life first aid situation, it's not the quality, quantity, or type of supplies that make the difference; it's the brain that's putting them to use. I have received first aid and CPR training and certification numerous times. I have undergone Coast Guard first responder and open water survival training as a merchant marine. I've studied how-to manuals such as the Boy Scout's Handbook, Foxfire books, Back To Basics, and SAS Survival Handbook, among others. I've spend my entire life reading survival and adventure books. I'm constantly running scenarios in my mind and scoping out my surroundings for materials and opportunities. I lived off the grid with no power, phone, or running water for seven years. And I have worked a ridiculously random assortment of jobs from which I have gleaned a flawed but widely varied amalgamation of skills. 

     The specifics of my life story may make it seem like I am uniquely suited to minimalist adventuring, but that is a reflection of decisions and choices I've made. I grew up a nerdy suburban kid and a social misfit, and I barely have a high school education. But the ability to improvise and the drive to survive are universal Human traits. They can be nurtured and developed in even the most shy, soft, and introverted of individuals. Human beings have incredible reserves of hidden strength and ingenuity, and the ability to access those reserves is a skill that can be learned and developed. Assembling your own mental MacGyver kit of abilities, skills, drives, and experiences is the key to coming through to the other side of an emergency/survival situation, regardless of the materials one may or may not have on hand.