Hi
Following a mate having a fairly serious off at FoD a few months back, a couple of us decided we really need to be more prepared for accident swhen out in the wild (and/or closer to home). To that end we’ve just done a First Aid Course through Borderlands First Aid (from Monmouth). Very informative and useful it was, and I would recommend anyone to do that course or an equivalent.
I’m putting together a new, improved 1st Aid kit and I’m just interested to hear what people have in their kits, above and beyond the expected. I’m looking at having trauma dressings, haemostatic gauze, CA Tourniquet, SAM splint etc available, probably in a “general” kit at home/van and then a pared back kit (smalller dressings, fewer bandages etc) for riding. If going in to the back country then items from the general kit could be added.
So what have you used that you didn’t think you would and any suggestions for me to consider?
I have got the ITC First Outdoor First Aid Manual which gives a good starting point for basics, and our course leader made other activity based suggestions.

Emergency foil blanket. X2 or 3

I’ve only got a stripped back kit for on the bike, but there’s a few bits in there I was recommended by a guiding friend that’ve come in handy.

1 – scissors/tweezers for cutting bandages etc and for removing splinters or grit etc
2 – a pair of medical gloves in a ziplok bag for if treating wounds
3 – Ibuprofen tablets for reducing swelling after an injury/a bad headache, also antihistamine for stings
4 – The rest is just a range of plasters/dressings, antiseptic wipes and a sling

In my mind there are 2 uses for a first aid kit; one is to keep the patient stable until the ambulance gets there, or you get to A&E. The other is to enable you to carry on with the ride. If you break an important bone or gash your knee, ride over. If you slash your cheek or forearm you can patch yourself up and not waste the 4 hour drive to Wales.
Steri-strips, painkillers, eye wash, tweezers, plasters, bandage, scissors and gaffer tape. If you sprain your thumb it’s amazing how a wrap of gaffer tape can help.
Edit – and because so few of us carry an inner tube, take something else that will do as a sling.

Wipes.
Plasters.
Wound dressing.
Bandages.
Tape.
Scissors.
Whistle.

All for about a fiver from Millets.

Plus

Foil blanket.
Mobile phone.

In addition to the above surgical super glue in mine

I’m looking at having trauma dressings, haemostatic gauze, CA Tourniquet, SAM splint etc available, probably in a “general” kit at home/van

Most of those are time critical life savers that you need to hand immediately, not in the van or at home.

Tic removal device.

Know exactly where you are & access & egress.

As Big John Says, I’ve got bits and bobs from a standard kit to keep going, a space blanket and a trauma dressing for any big nasties and if I need to use that, I’m calling the cavalry.

I’ll also have ibuprofen, immodium and anti-histamine.

Sadly I spend more time in my van than I do on my bike, so they would be more useful to be there (perhaps in their own drybag) and then when riding that bag could quickly and easily be added to my cycling 1st aid kit. Celox dressings are sadly not cheap so I can’t really have loads and loads in different kits.
But yes, I take your point, you want to be able to get your hands on them instantly.,

Jimdubleyou

I always thought that a 999 call would be the easiest answer but experience taught me otherwise.
Our mate came off at the top of the final part of the blue descent in the Forest of Dean, maybe a mile from the trail centre. However: no phone signal for any of us in the group. Other riders went down to the centre to alert somebody but we had no idea if they were succesful. In the end I went down myself, and incredibly fortunately met a forestry guy who opened up one of the access gates and led me, in my van, to the casualty. While I was driving up I got hold of the ambulance service who were very helpful but said they couldn’t get a unit to us in less than an hour and a half. I know if I’d said he was having a cardiac arrest or a catastrophic bleed then that might have been quicker but it would have been on us to keep him alive until they arrived, in what 30 minutes time?
As it turned out, we could get him in to the van and I drove him, incredibly slowly, back to the car park where the ambulance turned up 30 minutes later.
He had multiple breaks in his shoulder (which has involved a plate and about 10 screws) and concussion.

For me there’s 3 categories of things that are worth carrying.

1) Little trivial things that are never going to do anything major but might save a ride. Painkillers, anti-diarrhea tablets, blister plasters (the big super sticky compeed blister plasters are amazing kit- you can butterfly a cut with them, you can fix a camelbak with them, or use them as a small tyre boot). A self amalgamating bandage (hold dressings on, patch up minor injuries so you can keep riding, very useful improvisational tool) These are obviously least important but maybe most useful, over their life.

2) Useful things for helping extract someone- splints and slings and whatnot. But I’ve removed all of those as it’s just never a “need to have”. And it’s improvisable to some extent, you can cobble together an arm support from bag straps, tape, etc.

3) Things that if you don’t have them you may desperately wish you had. Trauma bandage. ASPRIN. The stuff that might keep someone going til help arrives. A light (because you can’t rely on your phone). I’m super pleased with my little light, it’s got an SOS flasher and a USB charger so it can keep a phone going, love it. A proper emergency bag.

And then it’s all on the “how useful vs how big”, I built a big super useful first aid kit that I was really happy with and then I didn’t always carry it because of bulk. The version I have now is probably 2/3ds as likely to actually be useful, but also more likely to be in my bag.

And I really mean it about the asprin.

The other is to enable you to carry on with the ride.

And/or get off the hill which I view as a responsibility, since I’m voluntarily undertaking an inherently risky pastime.

The asprin thing was really hammered at my last first aid refresher I did. Obviously new research has filtered through.

Thanks for the reminder, I’d not put any in my first aid kit.

I carry very minimal if anything.

Hydrocolloid and film dressing
tick twister, steristrips
Powerful painkillers
Sterile needle
Ressusiaid

Stuff like major trauma dressings – just use a shirt and bind it with an inner tube splint – use a pump or bind it to the limb next to it

tourniquet – I believe advice has changed but again – an inner tube will do if you really need one
Duct tape from your spares kit ( i have some round my pump) is handy

the kit is useless unless its with you

Well done on taking the course. the single most important thing is knowledge

I started with a lomo first aid kit and dry bag and added and removed from there.

Aspirin
Tick remover
duct tape
steristrips & superglue.
trauma dressing
considering a Tourniquet but not got one yet, Recommended on my last course a couple of months ago.
incident card X2 and chinagraph. One card with the critical info to pass to emergency services that could be given to a third party who needs to go for help, the other with a simple grid for vital stats and commentary over time if there for a while.

Not first aid specifically and maybe into a different league of stuff and maybe more for my mutiday stuff when leading groups when in the hills or sea kayaking….

A Spot PLB
A set of mini flares (proper sized flares in the boat but the mini flares would be in me BA on rucsac in the hills).

The Spot is in my back pocket now whenever I ride/run/paddle/sail. The feeling of potential crisis I had after a big mtb off a few weeks ago whilst riding solo that broken ribs on my front, back and side a long way from help reminded me if I needed it that stuff happens.

I find a sling useful any time I mess my wrist up

And I really mean it about the asprin.

The asprin thing was really hammered at my last first aid refresher I did. Obviously new research has filtered through.

Why is it so important? Anything special about it vs. Ibuprofen (which I have in my kit already) ?

In the car I have a pretty full kit and I carry a smaller version with me on the bike. Basically what everyone else has said already ie plasters, dressings, steri strips, bandages, foil blanket etc

I also have a sharpie permanent marker. Essential when dealing with multiple casualties, or even one in a changing state.

Write time of accident, record pulse and conscious state by writing on their arm, forehead, leg etc. I was advised this is better than an incident card as the card can become detached from the casualty.

Can be invaluable to professional medics when they get to the casualty.

I’m sure no one would be ungrateful enough to mind being written on if it aids their recovery.

Aspirin in mine as was told on my course that it could be used if someone thought they may be having a heart attack.

bikesandboots
Full Member

Why is it so important? Anything special about it vs. Ibuprofen (which I have in my kit already) ?

Heart attacks. 300mg, chewed and swallowed, only real caveat is check if they’re allergic.

only real caveat is check if they’re allergic

And you don’t mess up and confuse stroke and heart attack. For some strokes it’s good still but for others (hemorrhagic) it’s bad news.

Stroke and heart attack are quite different symptoms though?

Stroke and heart attack are quite different symptoms though?

They are indeed. But panic is panic. Bloke running our course was very up for us to carry aspirin but also cautioned that there have been cases of first aiders getting flustered and making what would in normal circumstances be an obvious error and giving aspirin to someone having a stroke with ‘less than ideal’ consequences. Not necessarily thinking the stroke was a heart attack but forgetting which one you gave aspirin to.

An interesting thread with some good comments.

I think Northwind has the right idea – stuff for minor cuts/scratches/splinters/etc which you might use and then crack on with your ride, and stuff for bigger incidents where your priority is to stabilise the casualty until the Professionals arrive.

I also think the stuff you need in a UK trail centre is probably different to what you’d carry somewhere more remote.
Don’t get too hung up on having the right kit for every eventuality – knowledge is your most important tool – you can improvise many things with an inner tube, duct tape and a riding jersey.

A couple of other points worth mentioning – don’t get too hung up on hygiene – if you can wash the gravel out of a graze then great – but anything which is going to need a hospital visit will get a thorough wash when they’re seen.

Don’t go out of your way to close bigger wounds – as long as you stop/control the bleeding until you get to hospital you’ll have done the best you can. If you start gluing things it’ll only need cutting/scraping out at hospital so they can check the wound is clean.

I’ve been at the sharp end of a couple of incidents where we had to improvise – the first was someone falling quite a long way and getting stuck between two rocks in the Snowy mountains (Australia) 2 hours drive from a phone signal, and 6 hours drive from Melbourne. We winched this guy out with a Turfor (hand winch) and carried him to safety on a stretcher made from branches and tow ropes.

The second was my mate degloving his finger 5 hours drive from a hospital in morocco – i hacksawed his ring off and taped his finger together with duct tape –

Don’t go out of your way to close bigger wounds – as long as you stop/control the bleeding until you get to hospital you’ll have done the best you can. If you start gluing things it’ll only need cutting/scraping out at hospital so they can check the wound is clean.

That’s a very fair and valid point.

One point to clarify from my own post….

trauma dressing

After a quick google what I meant was a Haemostatic Bleed Control Dressing. Confusingly these seem to be called trauma dressings too but not all trauma dressings are Haemostatic dressings. A bit spendy but hopefully never opened until it’s out of date.

I’m sure you know this, but just to clarify, as the knowledge within the thread is quite varied:

Haemostatic Bleed Control Dressing.

The term dressing is misleading, these are wound packing items, not a covering, your gonna get warm & dirty fingers inserting them.

The best live clip of “keep it simple stupid” and of being cool, calm & collected and of reassessing what wasn’t working and changing what they were doing to save someone’s life is Cerdic Gracias crash in 2013, whilst “just riding along”, no fancy kit, just plain old common sense saved his life.

CONTAINS GRAPHIC CONTENT and crazy French humor:
https://www.vitalmtb.com/videos/member/WARNING-GRAPHIC-CONTENT-Cedric-Gracias-Reunion-Island-Crash,24315/iceman2058,94

We had the Cedric Gracia video played to us on the course! One of the key things for me in that video was he was just riding along, not going crazy or riding anything dangerous (it seems). If a life threatening injury can happen like that then having a slightly bigger kit than you want to carry is, for me, a worthwhile price to pay.

As a First Aid Trainer at work, I use that Cedric Gracia example in my courses!

I am far, far from an ‘expert’ first aider but I know the basics, The most important thing in the toolbag is knowledge, and we always teach people about properly asessing the situation, the risk, and their own limits.

And even though as Mountain Bikers we tend to think of First Aid as stopping bleeds and recognising broken collarbones when your mates chinned themselves on a drop off… The most important life saving skill to me is to recognise when someone needs CPR, and just bloody getting on with it. As we have seen demonstrated very visually at the Euros, its a true life saver.

The video shows how benign the accident was but not enough of what actually helped. What did they do and what did they change? I found the editing frustrating too

this thread has reminded me I need to get some tick tweezers (or 2) for the family first aid kit. Is there a STW consesus on which tick tweezers to buy?

I’ve used the o’tom tick remover a few times and seems to be fairly easy to use

Yep, the Tick Twister was recommended to us on the course this week.

@benp1

but not enough of what actually helped. What did they do and what did they change?

Obviously it’s not educational footage as it’s just someone’s GoPro which incidentally happened to film them on a ride save a buddies life. I’ve no idea what’s going on with the “stuntman” bits, lost in translation perhaps.

What they did was: immediately recognise a catastrophic haemorrhage, request medical assistance, apply direct pressure (to an open femoral artery bleed on top of a fractured pelvis, ouch!), recognise when their direct pressure didn’t work and reapplied the direct pressure in an alternative way, recognise when it was working and just keep the pressure in place without moving (I think Cedric may even has his fingers inside of the wound and they’re kneeling on his fingers too). Very simple in the “direct pressure” approach, applied to a difficult site with an open wound, without any pre warning of what they were about to face in a very calm manner, reassessing their actions in a highly stressful situation to someone they have personal attachment to. Chapeau.

Edit – and because so few of us carry an inner tube

can attest that innertubes are very good at stopping fairly serious bleads. I had to do it myself having come off, none the wiser i’d done anything, only to lift my arm up and sprayed blood veryowhere, riding buddy looked a little green. Stupidly, i had no first aid kit on me, despite for years and years carrying loads of stuff around. So out comes the inner tube, sliced it and wrapped it round my arm..

Have also used innertubes as slings and also to strap splints to peoples appendages.

There’s no point in keeping the CAT tourniquet in the van. You need them on you because when someone needs it they need it NOW!!, not in a bit. And practice using them so you can get it on quickly and properly.

@the_kenbourg.
Just to put your 999 wait into perspective South Western Ambulance Service (and I assume all the others) have been under unprecedented demand this year. Last week we experienced over 3,000 calls every day (the highest being Sunday where there was over 3,500). This combined with high numbers of staff currently isolating and off sick is meaning we’re struggling.
It also doesn’t help that we’ve lost hundreds of hours to ambulances stuck at the Emergency Departments waiting to offload our patients because there is no space for them to go.

The other problem is that FOD (and a lot of Gloucestershire, Wiltshire, Dorset, Somerset, Devon and Cornwall are pretty rural and miles away from said EDs where the ambulances typically are.

It sucks and is normally a problem at this time of year, but for some reason 2021 has been much much worse than normal.

But decent first aid kits and the basic knowledge of how to use them is gonna help us all out on the trails.
Even if you haven’t been on a course it’s worth carrying one as you’ll hopefully come across someone who has (especially at a trail centre). Also YouTube can teach you pretty much anything. Lol.

Zerocool , I meant no disrespect to the emergency services, but rather to emphasise that realistically there are a lot of situations where they are not going to be able to bail you out in 15 minutes.
Even if our situation had been an absolute priority (which it wasn’t), by the time we had got some phone signal, called in help and that help (air ambulance?) arrived it could easily have been 30 minutes plus. None of us had the knowledge (at that time) to handle a catastrophic bleed or cardiac arrest, and no phone signal meant no YouTube!
To that point (absence of phone signal) St John’s and also the Red Cross have useful apps that it might be worth installing.

I did a wildness 1st aid 2 day course with High Peak first aid training nr Hope last week (highly recommended). The only thing I’d add is a conforming bandage (semi-sticks to itself, good for sprains or holding dressings or splints in place).

Hadn’t thought of using an inner tube as tourniquets – obvious really.

During the training they kept on going on about the injuries mountain bikers get – salutary!

The thing I’ve needed most, whether for people with me or people I’ve come across on the road/trail after an injury, is a foil blanket. Thin cycle clothing is not great for your health when you suddenly go from hot and sweaty to stationary and possibly in shock

Hadn’t thought of using an inner tube as tourniquets – obvious really.

Wow lot of love for tourniquets in the mountain biking ambit.
We are taught at work, that tourniquets are for catastrophic bleeds, that is proper bleeding out and going to die soon territory. I think it’s fairly unlikely you’ll going to get one of those mtb’ing. To work properly they are very painful and obviously they can cause some issues in stopping blood flow, although not as much as used to be feared. They’re not for stopping a bit of a bleed.
The idea of using an innertube as a tourniquet in such circumstances is great but I suspect it may be defeated / compromised if you don’t actually know how to stop a catastrophic bleed with pressure in the first place. If someone is bleeding out you need to be able to stop that before messing around with inner tubes and whatever you are going to use as a windlass. Putting a proper tourniquet on someone is hard enough and they’re designed to do the job effectively, Chuck in cutting innertubes, blood all over the place etc and you’re in a whole new arena. Again it’s going to be very unlikely you’re going to be in such a situation, short of man-traps or ieds (or maybe disc brakes on road bikes) on the trail. The only place I have a tourniquet is by my chainsaw kit. All imho.

An inner tube will not act as a tourniquet; you simply cannot get it tight enough as they stretch loads. Good to use as an arm sling though- unroll out to full length, pass behind the neck so dangles both sides, down the chest. Pass injured hand through one side and then the other. Very effective.
Either carry a proper CAT and learn how to use it, or don’t think a tube will work to stop catastrophic bleeds. Learn about pressure points to limit bleeding and also how to properly dress a big wound to limit blood loss.
Two things a bit missing from above- environmentals, eg a simple piece of carry mat as a sit mat, to isolate a casualty from the cold ground. Carry a minimum of two foil blankets per person and a proper mountain shelter for the group. Duct tape to fit the foils closer to the body, perhaps using two to make a very effective cape and a kilt. Foils work as shelter from hot sun too.
Secondly, for big grazes and scrapes- a tiny tin of vaseline. Great for lost skin. Rinse the wound thoroughly with water first, cover with vaseline to keep more dirt out of the wound and oxygen away from the damaged nerve endings. This’ll make the remainder of the day a lot more pleasant and then when you get home wash thoroughly and dress as needed.