Sunday, August 13, 2006

A Traveler's Emergency Kit (or A MASH Unit?)

I ran across this article on eScuba and thought you might want to have this information available for your next diving expedition, particularly if you have a doctor along on the trip. Permmission to publish by the author - who is a personal friend.

A Traveler's Emergency Kit
by Dr. Bruce Miller

This section lists supplies and medications that you should consider taking along when you travel to areas where little or no medical care exists. If you're a physician, you'll find plenty of problems in the indigenous population that can use your help.

For those who want to avoid collecting the supplies and medications, I enthusiastically recommend DAN's DSS Guardian First Aid Kit. It contains most of the supplies I've listed in a handy, compact travel kit. You can easily customize it to your own specifications as well. For example, you can't take along too many one-inch Band-Aids®-I carry at least 100-and several rolls of 1-inch-wide cloth adhesive tape. You'll be the most popular diver on the trip! All of this fits inside a zipper bag the size of a loaf of bread.

5 disposable scalpels with #15 blade*
1 needle holder*
1 pair pickups (e.g., Adson™)*
2 small hemostats*
2 3.5cc syringes with 25-gauge needle or dental syringe with 30-gauge needles*
1 tissue scissors*
1 oto-ophthalmoscope*
1 disposable airway*
1 Swiss Army knife or Leatherman tool-really useful to have along!
1 stethoscope

2 packs each 4-0 Ethanol-Vicryl™ sutures on a PS-2 needle*
1 bottle 1 percent Xylocaine®* with epinephrine (or 2 percent dental capsules)
Ed. Note: The use of the epinephrine in the hand or foot...especially the fingers or toes is contraindicated. There is the possiblity of an ischemia serious enough to lose a digit.
12 packets alcohol swabs
2 sterile drapes with eyeholes
2 pair each sterile and disposable gloves
2 rolls 3-inch Ace™ elastic wrap
2 rolls 1" cloth tape
1 box Steri-strips™
1 box Telfa™ pads
1 box 1" Band-Aids® #100
2 rolls self-adherent roller gauze (wide)
1 roll Coban™
1 packet of Duoderm™ (thin)

1 tube fluorinated steroid (Temovate®, Diprolene® AF)*
1 tube 1 percent hydrocortisone cream
1 tube antibiotic ointment
1 tube topical antifungal cream (Naftin®, Lotrimin®, etc.)
1 tube Duolube™*
20 Tylox® caps
30 Ibuprofen® or Aleve®
30 enteric coated ASA or Tylenol® tablets*
30 prednisone tablets (20mgm)*
20 Cipro® or Cephalexin® tablets (500mgm)*
20 Famvir® or Valtrex® 500 mgm tabs or Zovirax® 800 mgm tabs*
20 oral antifungals (Sporanox®, Diflucan®, Lamisil®)
20 acid blockers (Pepcid®, Tagamet®) or Prilosec®*
20 nonsedating antihistamines with pseudoephedrine (Claritin®-D or Allegra®-D)
1 bottle Jungle Juice
1 box Pepto-Bismol® tablets
1 Ana-Kit®
#15 (or higher) broad-spectrum (UVA/UVB) waterproof sunscreen and Chapstick®
1 bottle Domeboro Otic®*
1 bottle Afrin® Nasal Spray
1 box Transderm-Scop® patches*
1 water filtration device
* Indicates either a prescription drug or equipment that requires specialized training to use, so tailor this list to your own skill level.

Oregon physician Dr. Bruce Miller's recommendations are based on 20-plus years' experience backpacking, climbing, ski patrolling (in the Pacific Northwest), travelling, scuba diving around the world, and, "most hazardous of all, spending water-ski weeks in a houseboat on Lake Shasta."
Reader/diver Jan Kempiak writes in response:
Ern, wouldn't a person need an RX to get a "mash" unit like that, containing steroids and antibiotics? It didn't mention any instant ice packs, jan
My response:
You're absolutely right! That's why I called his kit a 'MASH unit 'in jest; a lot of his items require a prescription or have to be bought by a physician. However, it is a well stocked kit for a physician. Note that I state that it would be good particularly if you have a doctor in the group. Also note that he provides an asterisk for those items requiring a prescription.

You're also correct in that instant ice packs and heatable packs would be a good idea.