Chapter 6 – Medical Kits

What you stock up on should be related to what you know how to use and what you can obtain. There are potentially thousands of drugs and different pieces of medical equipment and you can’t stock everything.

Fortunately, it is possible to manage 90% of medical problems with only a moderate amount of basic equipment and drugs. Obviously, sometimes the treatment may not be as such high quality as that provided by a proper hospital, but it may be life saving and reduce long term problems. For example, a broken tibia is usually managed by a general anesthetic, an operation for an internal tibial nail, followed by pain relief and physio. But it can be managed by manipulation with analgesia and immobilization with an external splint for 6-8 weeks and as a result the patient may be in pain for a few weeks and have a limp for life, but still have a functioning leg.

Also, appendicitis has been treated with high dose antibiotics when surgery has been unavailable such as on a submarine or in the Antarctic. Although in both cases management is sub-optimal and may have some risk, in a survival situation it can be done and may be successful, with limited medication and equipment.

Obtaining medications can be difficult. The problem is two-fold. First is access and second is cost. Below are some suggestions for legally obtaining medicines for use in a survival medicine situation.

  • Talk to your doctor. Be honest explain exactly why and what you want, that you want to be prepared for any disaster and have some important basic meds available, for if medical care isn’t freely available. Demonstrate an understanding of what each drug is for and that you know how to safely use it. Most MD’s would probably be very supportive. Although, I would suggest that you don’t request narcotics the first time. Then return the meds when they have expired, this will confirm that you are not using them inappropriately.
  • Discuss with your MD your plans for a trekking holiday. Most MDs recognize the importance of an adequate medical kit if you are traveling in the 3rd world or doing isolated backpacking. Most would prescribe antibiotics, rehydration fluid, simple pain killers, anti-diarrhoea meds, antibiotic and fungal creams, and if climbing steroids and frusemide for AMS.
  • Buy a boat. Australia, New Zealand and the UK, require all boats sailing beyond coastal limits to carry a comprehensive medical kit. This includes antibiotics, strong narcotic analgesia and a variety of other meds. Although not a legal requirement in the US, I imagine most MD’s would happily equip an ocean going yacht with a comprehensive medical kit, especially if you can demonstrate a basic medical knowledge. The US Public Health service offers suggested medications and equipment, depending on numbers and expected isolation.
  • Prescription medicines are available over the counter in many third world countries. I am unsure of the legalities of purchasing these. I imagine a single course of antibiotics would be unlikely to be a problem, but that large amounts or narcotics would be illegal. (Editor’s Note: Many U.S. residents bring antibiotics and other drugs back from Mexico. While it may be legal to bring back drugs for your personal use, you should consult with your personal legal advisor before facing customs uninformed.)
  • Not for human use. Veterinary meds are widely available and relatively cheap. Several books discuss obtaining them (Benson’s books, see book list), so I won’t cover it in detail here. I personally don’t recommend this, but obviously for some it is the only viable option.Generally speaking, most veterinary drugs come from the same batches and factories as the human version, the only difference being in the labeling. This is the case for most common single-component drugs such as antibiotics. If you are going to purchase veterinary medications I strongly suggest only purchasing antibiotics or topical preparations and with the following cautions:
    1. Make sure you know exactly what drug you are buying
    2. Avoid preparations which contain combinations of drugs and also obscure drugs for which you can find no identical human preparation
    3. Avoid drug preparations for specific animal conditions for which there is no human equivalent.
    4. Buy drugs which are generically identical to their human counterparts, e.g. Amoxycillin 500mg (Vet) = Amoxycillin 500mg (Human), etc.
  • Obtaining general medical supplies is often easier. Basic bandages and stethoscopes, etc. can be bought from any medical supply house. I understand there is no federal law prohibiting the purchase of things like sutures, syringes, needles, IV’s etc., but some states can make it difficult.Try looking in the yellow pages for medical or emergency medical supply houses or veterinary supplies. A number of commercial survival outfitters offer first aid and medical supplies, however I would shop around before purchasing from these as their prices, in my experience, are higher than standard medical suppliers.

    The above approaches for obtaining medicines can also be used for obtaining medical equipment if you do have problems. The most important point is to be able to demonstrate an understanding of how to use what you are requesting.

I’ve included three kits. The first is designed for someone with some limited medical knowledge and a good book. A lot of common problems can be managed with it, minor trauma (cuts and minor fractures), simple infections and medical problems. The second is designed for someone with extensive medical training and should be able to cope with 90% of common medical problems, including some surgery, spinal and regional anesthesia, general anesthesia with ketamine, treating most common infections and medical problems, and moderate trauma. Obviously there is a vast middle ground between the two.

The kits are designed for long-term care rather than to cover short (48 hrs) delays in getting to formal medical care. The third is a reprint of the medical scales for British flagged commercial vessels, to give you an idea of what the “experts” believe is required for isolated intermediate term survival medicine.

NOTE:

  1. I’ve tried to use the international generic names for drugs. However, there are some differences between the British and the US pharmacopoeias and where possible I’ve tried to include both e.g. Lignocaine (UK & NZ) = Lidocaine (US)
  2. I have not included any quantities. This is dependent on what you are planning for and what you can afford. Unfortunately most medications require rotation, with 1-5 year shelf lives, making this a costly exercise, as they are not like food you can rotate into the kitchen
  3. Always store a supply of any medicines you take regularly. Blood pressure pills, allergy pills, contraceptive pills, asthma inhalers etc.