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Ask the Doc: What should be in my emergency kit?

Emegency

Q: What should I have in my emergency kit?

A: Planning and packing for a road trip is great fun, and part of that planning should address both minor and major emergencies, should mishap befall you or anyone else in your riding group — or the stranger on the side of the road.

The Federal Emergency Management Agency (FEMA) and the Centers for Disease Control (CDC) have embarked upon a project to create a culture of competence, so that bystanders can be trained to effectively and safely respond to disasters of any kind (disclosure: yes, I have been involved in that project). There are a host of examples of riders helping stray animals, cleaning up parks, and supporting worthy causes, from Rolling Thunder to Toys for Tots. Perhaps being prepared to assist in an emergency is the next thread in that weave.

Today’s emergency kit is not your father’s, by any stretch of the imagination. That kit bore a striking resemblance to what you might find in the school nurse’s stores, or the fishing tackle box so prevalent in the back of a police cruiser. Injury profiles of injured riders have shifted, as have the number and kinds of crises with which riders will be faced, whether riding or not. Preparedness means education — you don't have to invest a lot of time — as well as the right equipment — which need not take up much space.

Minor injuries like abrasions — even road rash — can be readily handled with soap and water to get rid of potentially harmful bacteria that live in dirt, like Clostridia. Clostridium causes tetanus as well as gas gangrene — both potentially lethal conditions. Since soap and water are not always readily available, premoistened antibacterial wipes or the seemingly everywhere (except where you are) alcohol-based gels, like Purell, work quite well for most bacteria. Anything alcohol-based will sting a lot, but it beats getting infected, any day.

A nonstick dressing to cover it will save you a lot of pain when you change it (daily). If you intend to be able to help others, a pair of liquid-impervious gloves is essential for your protection. Nitrile gloves are ideal and will protect you from blood-borne infections such as Hepatitis B or C, and HIV, to name a few. A Band-Aid or two takes up little space and has a myriad of uses, from blisters to small cuts.

Major injuries should always be accompanied by Emergency Medical Services care. Tools should help you to provide self-aid or buddy-care after a major mishap that may or may not involve a crash (think the kind of off-road camping adventure Spurgeon seems to love). What can you do that is life-saving by providing time for EMS to get to you or your buddy or for you to get to EMS? Stop the bleeding! Two tools are key: a tourniquet (stops arterial blood flow), and a procoagulant dressing (helps create a clot). Now you may be thinking, “He must be nuts! Tourniquets are the tools of the devil! If you put on a tourniquet, that limb has to come off — everyone knows that.” If that's your reaction, please read on.

Previously, placing and then periodically releasing a tourniquet was believed to help keep the limb alive. This is wrong. When placed, tourniquets should be left in place until definitive care may be provided. These devices are credited with saving combatant lives in Iraq and Afghanistan as well as civilian lives after major disasters, such as the Boston Marathon attack. Increasingly, tourniquets are included in the medical kits of SWAT and patrol officers and are recommended by the Hartford Consensus Conference that followed the Sandy Hook massacre.

SWAT tourniquetTourniquets come in two general types and both are effective. One is the windlass type exemplified by the CAT (Combat Application Tourniquet), that tightens with each windlass turn. The other is an elastic wrap that progressively tightens with each successive wrap and is exemplified by the SWAT-T (Stretch, Wrap, And Tuck).  Each may be applied with only one hand; I have taught and used both. Both are commercially available, but instruction in proper use is required. Multiple courses to teach different techniques are available, such as the Bleeding Control course and PreHospital Trauma Life Support.

procoagulant dressingThe other highly recommended tool is a procoagulant dressing, typified by Combat Gauze (Z-Medica; Wallingford, CT) that is impregnated with kaolin (found in clay) that accelerates your natural clotting process.  These dressings may be wrapped around a large bleeding surface like really deep road rash, or packed into large punctures.  They should only be removed by trained professionals, so once placed they are very much “fire and forget.”

These tools are so useful that multiple professional organizations recommend them, including the American Red Cross, the Wilderness Medical Society, and a host of police and EMS groups.  Remember, they need to be accessible, so if everything is locked in your saddlebag, that may be fine for you to aid someone else, but not to help yourself if you cannot get to it.  I recommend packing a tourniquet in your jacket. No jacket? There are belt, boot and ankle holsters available, as well!

Even if you are prepared for bleeding control, remember that older riders have a progressively rising likelihood of having a cardiac event that will outstrip our need for bleeding control, so please take a CPR course, as well, and learn how to save a life. Both the American Heart Association and the American Red Cross offer CPR courses. Bystander CPR increases the likelihood of surviving with an intact brain.

Maybe RevZilla should start selling rescue goodies such as these... along with a stylish leather carrying case, of course.

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