Be Prepared, Part 1: First Aid

by Mike Arakawa

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I was never a Boy Scout, but I'm a big believe in the Boy Scout motto "Be Prepared." In this series of articles, I'm going to explore a topic many of us probably don't spend a lot of time thinking about in the context of fishing: emergency preparedness. Now, I rarely fish more than about half a mile from either my truck or a roadway. That's a pretty easy walk for anyone in decent physical shape, right? But what if you're trying to make that walk over broken or brushy terrain, at high altitude, in the dark...with a broken leg? That changes things somewhat.

First, let's take a look at what these articles are not.

They are not a course in first aid. Any number of excellent classes and books exist which can teach you that. I encourage anyone who does not have basic first aid skills to enroll in some course of instruction and learn them. While you're at it, a CPR class isn't a bad idea either.

These articles are also not a primer on wilderness survival techniques. As with first aid, survival skills are best taught in a hands-on setting by a competent instructor, and there are many available, as well as a host of books on the subject. These skills are also highly specialized for different environments. I'm going to tell you what works for me, as well as a couple of things to keep in the back of your mind wherever you are.

Right now I'm going to focus on first aid. Whenever I'm fishing, I always carry a small first aid kit with me - just in case. My kit contains some very basic items that probably aren't a bad idea to have available no matter what you're doing or where you're doing it, and I carry them in a small neoprene pouch with a velcro flap closure. The whole thing is about three inches by seven inches, and fits neatly into one of the back pockets on my fishing vest. I chose to assemble my kit more or less from scratch, but if you choose not to do that there are any number of commercially available first aid kits that will work just fine.

My kit includes the following:

  • Bandaids - I like to keep several of these on hand. You can carry different sizes of them if you like, but I find that the standard size work just fine for most everything.
  • 4x4 gauze pads - I have taken a handful of these and placed them in a zip-top sandwich bag. This way, when I need them, I don't have to rip open the individual wrappers one at a time. Having them in the bag like that means they aren't sterile anymore, but that's a relatively minor concern when you're making a pressure dressing to try and control bleeding. If it makes you germophobes feel any better, once you rip open the wrapper to use it, the thing's no longer sterile anyway.
  • Kling or Kerlix gauze - This is rolled gauze that is typically used for bandaging. Combined with a handful of 4x4's, it works very well for pressure dressings when you're trying to get the bleeding stopped. I have also used it as a field-expedient sling for a broken arm when there was nothing better available, and in a pinch it could be used as dressing material if you're out of 4x4 gauze. Other uses for it will no doubt come to your mind. I carry one 3-inch roll of this.
  • Triangle bandage - Used to make a sling to support a broken or dislocated arm.
  • Trauma tape - This is the really sticky white tape that paramedics use. It's available in various widths, and I carry a fairly thin roll of it so that it doesn't take up a lot of space. And no, sports trainers' tape is not the same thing.

If you want to, you can also carry a couple of butterfly closures with you, but if someone is cut severely enough that you feel the need for them, your first priority under field conditions is probably going to be bleeding control using your 4x4's and Kerlix roll. The emergency room can worry about getting the skin stitched back together later. If space permits, consider carrying a packet of coagulant agent such as Celox or QuikClot to help control severe bleeding.

If you rely on emergency medications such as a rescue inhaler for asthma or an epinephrine injection kit for allergic reactions, then of course you should make these a part of your kit in addition to everything else.

Obviously, this is a very small, very basic first aid kit designed with a focus on primary care. If you like to fish in remote areas where you need to hike or backpack in, you would want to carry a much larger kit with a number of additional items in it and larger quantities of everything. You would probably also want to get some training beyond just first aid basics, since in that environment you may be hours or days from professional medical help.

You may have noticed the absence in my first aid kit of hydrogen peroxide and other antiseptics. This is because I anticipate using the kit in an environment where I will be concerned primarily with controlling bleeding rather than keeping everything neat and clean. If you're out by the creek and a medical emergency occurs, your priorities will be to handle the immediate emergency and then get somewhere where further care is available - either by you, another member of your group, or a medical professional. At most, you may want to dump water from a canteen over the wound site to wash the blood away and give you a better look at what you're up against. I also don't carry anything to use as a splint, since this can usually be improvised from whatever is at hand if you need to.

A number of different kits for removing fishing hooks from your anatomy are available out there, but the most effective method I have run across is probably this one here. Remember that depending on where you've got the hook stuck in you, it may not be practical to take it out in the field. You might have to leave it in place, secure it with bandaging material, and go to the nearest medical facility for assistance (assuming you're not somewhere out in the back of beyond where there is no doctor available).

For an excellent resource dealing specifically with backcountry first aid, I recommend the book Medicine for Mountaineering & Other Wilderness Activities by Dr. James Wilkerson.

So that's my take on personal first aid kits. In roughly 25 years of fishing mountain streams, I've only ever had use mine a couple of times for relatively minor injuries. Still, I'd rather be prepared than not.


Mike Arakawa is the managing editor of StreamFisherman.net, and a former emergency medical technician.

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