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SAR/Wilderness Medical Kits
Will Smith, MD, EMT-PTeton County Search and Rescue
Jackson, WYwww.wildernessdoc.comJuly 25, 2009
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Disclaimer
I have no financial relationships with any companies or items presented.
I’m just sharing my experiences of what works for me!!
Research and make your own judgments!
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Objectives
Discuss medical kits for Wilderness and SAR
Role of medical care in SAR, and other wilderness settings
What’s in my kit?
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What to bring? What is the trip / mission?
Urban vs. Wilderness vs. Technical
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What to bring? Known vs. Unknown Location
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What to bring? What are the local medical threats?
MEDICAL vs. TRAUMA
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What to bring? What is the known number of
patients and their conditions?
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What to bring?
Evacuation options? Helicopter vs. Ground vs. other Hours, Days, Weeks
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What to bring?
Local Medical Resources? EMS Clinics / Hospitals
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What to bring?
Level of Providers WFR, EMT-B/I/P, RN, NP/PA, MD
BLS ALS
What ALS skills will help in SAR or Wilderness settings?Airway Pain Management
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What to Carry All the Time?
Keep in your pack all the time. For you or friends.
Splinting (SAM) Basic Bandaging/Tape Ace Wrap/Coban Ibuprofen/Personal Meds Knife/Scissors
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What to Carry All the Time?
Blister Care Sunscreen Microshield - CPR Mask Anaphylaxis kit? Area/Trip specific items
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My SAR Medical Kit
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My SAR Medical Kit
A work in progress…
Compartmentalization is the key
Be ready to improvise
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SAR Medical Kit
Spare backpack Key pieces of medical equipment
Airway Bag (Oxygen) IV BagMed Bag
Personal SAR gearRadio, GPS, Survival Gear Food, Water
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Helicopter Rescue
Bring the kitchen sink
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‘Ground Pound’ Rescue
Bring just what you need.
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Compartmentalization
Ferno Professional ALS Kit - $300 www.allmed.net
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AirwayBag
NG
7.5
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24
Gum Elastic Bougie
$9.49 www2.mooremedical.com
24 242424
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IV BagEZ-IO
NS
IV Tubing
NS Flush
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Misc. Bag
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Med Bag
(fridge pack)
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Vecuronium Narcan
Ancef Dex Benadryl Versed Etomidate
Succinylcholine Rocuronium $19.50 $2.90 x 2 = $5.80
Vecuronium Vecuronium $3.75 x 2= $7.50
Narcan Narcan $19.25
$3.00$2.63 x 2 = $5.25$12 x 2 = $24 $18.75 $3.43
Pharmacy cost – June 2008(fridge pack)
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Epinephrine MDV - 30mg
Ampule -1mg
Albuterol/Atrovent Neb
$1.25
$2.30 x 2 = $4.60
$1.15
Pharmacy cost – June 2008
Reglan Zofran
Ampule -1mg $0.50 x 2 =$1
$9.00
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Morphine
$0.75 x 2 = $1.50$8.79 x 2 = $15.78
Toradol
Fentanyl
? Changing Morphine to Dilaudid
Pharmacy cost – June 2008
$0.50 x 2 = $1
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Prednisone 20 mg tab
NTG
Pepcid 10mg tab
Benadryl 25 mg tab
Ibuprofen 200mg tab
Pharmacy cost – June 2008
$0.75 x 2 = $1.50
$2.50
$0.17 x 3 = $0.52$4
$2.50
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Total Medication Cost�$154�
Considering new additions Ketamine ASA Hextend/Hypertonic Saline Extended spectrum ABX
(Moxifloxacin, Rocephin) Hemostatic agent (Combat Gauze) Dilaudid
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Intranasal Med Administration www2.mooremedical.com $2.85
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Main Compartment
Foley & Bag EZ-IO
$500
BVM
NS Combitube
Depends Texas Cath
Chest Seal
Vomit Bag 15 mils
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Other Bag Compartments
Pressure Bags
Head Lamp
Paper Pen
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Oxygen/BLS Bag Carbon fiber (3,000psi) tank $590 (w/regulator)www.spiracle.com
$710 backpack w/ tank and regulator
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Oxymizer
Saves oxygen by 2:1 to 4:1 by storing oxygen until early inspiration, so oxygen isn’t continuously flowing into the surrounding environment •To reach 2 lpm flow rate of 0.5 lpm (24 hours) 6 lpm flow rate of 3.5 lpm (3.4 hours)
www.pulmolab.com
$19.49
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Pocket Blue BVM $34
www.cybertechmedical.com
TPOD $ 98 Pelvic Binder
N/C
NRFM
Neb $ 94 Ext tubing
www.wildmed.com
Tubing and Valve $39
www.conterra-inc.com
Kerlex
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King LTS-D www.kingsystems.com $45
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AED�(Manual�
Mode)
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Other Things I’m Considering
Impedance Threshold Device ResQPOD $105 www.chinookmed.com
RAD 57 (O2 and CO detector) www.masimo.com $1,200 New Hb measuring capability?
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3 Bears Principle
Not too much! Not too little! Just right!!!
Per: David Johnson, MD Wilderness Medical Associates
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Summay
Bring what you have to in order to save yourself first!
Just do what matters for the patient, not what you can!
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Questions??? Lecture Notes: www.wildernessdoc.com