Someone recently asked about recommendations for a pocket first aid kit that they could carry around all the time. I think that they were probably just asking for specific product recommendations, but it got me thinking. What should you keep in a pocket first aid kit?

I’m going to go for the classic medical training answer: it depends. It depends on what exactly this kit is for. I think that there are two things you might want to do with a pocket kit:

  • treat common minor problems quickly and easily, or
  • treat the most common (but still rare) life-threatening emergencies.

This article was last edited on September 7th 2017. A list of changes is at the end. Looking for first aid training? Check out this guide instead.

Pre-ramble

I picked a pretty generous definition for “pocket”: a large cargo-pants pocket or a small half-quart sandwich bag. I think that you can achieve one of these two treatment goals (common minor problems or life-threatening emergencies) in such a small space. If your kit it going in a backpack rather than a pocket, you might have the space to combine both little kits into a larger one, and you probably should.

In laying out these kits, I’m assuming that you can call a local emergency response number on your cellphone, get an ambulance within the best part of an hour, and get to a hospital comfortably within two. I hope you can keep a larger kit in your home, office, car, or so on with more and larger supplies as well as refills. If that’s not the case because you are in the wilderness, or can’t contact EMS, or don’t have hospitals for miles, these suggestions are not for you. You probably don’t need this sort of kit. Instead, you need to make a more in-depth assessment of your emergency response needs.

Training

Kits are no substitute for training. Taking some over-the-counter medication or putting a band-aid on yourself or your kid doesn’t require any training. Successfully assessing and treating a moderate medical emergency benefits from training. There is no life-saving procedure that you can perform with up-to a quart-bag of equipment but not training. The best life-saving training you can get is a CPR+AED class from the American Heart Association. After that, the most in-depth training you can get without becoming a medical professional is a Wilderness First Responder class from the Wilderness Medicine Institute of NOLS. Each of these should be refreshed at least every other year. If you take the refresher class every year instead, your skills will be even better. I’ve also written a more detailed guide to basic medical training.

Prevention

Medical treatment is what happens when you fail at prevention. The best sort of finger-bandage is proper knife-handling. The best burn treatment is being careful with boiling water. The safest way to treat a victim of a car crash is to know not to get behind the wheel when you’re tired or have had anything to drink. If you get good medical training, your instructors should emphasize this. When you pull out your first aid kit, something has gone wrong. Once you’ve treated the immediate problem and planned for anticipated problems with this injury, your next job is to change your environment, habits, processes, and precautions to make sure that this problem never happens again. Ideally, make sure that it’ll never get within five steps of happening again.

The Everyday Kit

This isn’t a kit intended to save a life. It’s a collection of the medical items you are most likely to need every day, to save you from having to scrounge up mediocre supplies when you have a minor medical event. Stocking this sort of kit involves a whole bunch of personal decisions. What are the things that you and yours need most often?

Cuts and grazes

If you get into bumps and scrapes regularly or have kids, you’re going to need everyday bandages. I can’t recommend 3m Nexcare Tegaderm dressings enough — they’re really actually genuinely waterproof and stay on better than anything else I’ve used. Your boo-boo kit should include:

  • variously sized Tegaderm bandages
  • small moist burn dressings
  • alcohol antiseptic wipes, and
  • nitrile gloves.

I’m not including larger bulky dressings, ice packs, trauma shears, or the like. Most of those items are too big for a pocket kit. If you have a large wound, you’re never going to have enough of the right cleaning and dressing supplies in a pocket kit. You need to go to a better-stocked cabinet for the right supplies. Instant ice packs are either too small to work well or too large to carry. Besides, you’re almost always better off with ten minutes of cold running water (burns) or a big long-lasting ice-packs from your freezer (sprains & strains).

Medication

Over-the-counter medication is another everyday supply. Look for the smallest available bottles for your kit, and get larger bottles of the same dose to refill (common brand names in brackets).

Personal spares

Your pocket kit is also a good place to keep spares: backups of other items that you use regularly. These are just examples; the specifics will be unique to you.

  • birth control
  • your preferred period supplies
  • individual prescription medication
  • anti-blister bandages or shoe inserts
  • wakefullness or sleep aids
  • compact sunblock
  • latex condoms
  • lip balm
  • toothpicks

Tools

Trauma shears are fun but not critical. There is one tool to put in your kit though: sharp-tipped tweezers for splinters and the like. If you’re prone to splinters, you might also want a fresnel lens to get a closer look.

That’s it. That’s all you need in your kit. If you’re the sort of person who’s thinking of carrying a first aid kit around with you, you probably already have the other items that you might want to use in a medical emergency.

  • watch with a second hand
  • sharp pocket knife
  • flashlight
  • notebook and pen
  • permanent marker
  • multi-tool
  • paracord

If you don’t carry all those items, put a compact substitute in your kit if you still have space. If you don’t carry a pocket knife, look for a ceramic “survival” razor-blade or sterile scalpels (and replace them after use).

The Never-Used Life-Saver

The exact opposite approach gives you a kit that you hope never to use: the tools that can make the difference in extremely-rare but truly life-threatening medical emergencies.

Many of the most common acute life-threats are best treated by someone with appropriate training. In some cases, appropriate medical equipment can make all the difference, but only if you already know exactly how to use it. The items that best treat certain relatively-common life threats require training beyond a basic class — you need to seek out training on these items individually, and many require prescriptions or have other legal limitations on their use.

It is unquestionably better to have regular first-responder and CPR+AED training than to put any single “life-saving” item in your first aid kit.

Personal threats

It’s possible that there are unique immediate life threats associated with your lifestyle or line of work. If so, you might want to get medical supplies to address that particular emergency. But here’s a much better suggestion: change the way that you live your life to eliminate that one thing that is unusually likely to kill you. See above about prevention. If that’s not possible for some reason, then stock the antidote to the highly-venomous snakes you like to juggle.

Cardiac arrest

The most common cause of death in the US is heart disease. The best way to treat acute cardiac arrest is immediate effective CPR and early access to an AED. If you want to carry exactly one item that is most likely to save a life in an acute medical emergency, buy yourself the smallest AED you can carry and maintain it properly. If that’s too much for you, get a CPR face-shield, keep aspirin in your kit, and install the American Heart Association’s CPR app on your phone to help you maintain 100+ compressions per minute at an appropriate depth. Don’t forget to set a calendar reminder to refresh your CPR training.

Diabetic emergencies

For life-threatening diabetic emergencies, carry single-serving honey packets. Never attempt to administer insulin.

Allergic reaction

Life-threatening allergic reactions can be treated with an epinephrine auto-injector. There’s only really one on the market right now: the EpiPen. There’s a new competitor from CVS, but since usability is important in auto-injector, I won’t specifically recommend that until I’ve handled it myself. You’ll need special training in its use and a doctor’s prescription. State law varies: it may not be legal to carry and use an EpiPen to save another’s life where you life. They’re expensive, but you should carry two, as well as some diphenhydramine.

Breathing trouble

Severe asthma attacks and other respiratory problems can cause life-threatening acute difficulty breathing. The only convenient tool that can help for this category of situation is an albuterol inhaler — you’ll just have to hope that the person with difficulty breathing is carrying theirs. This is another tool that requires special training outside of an ordinary first-responder class. Use the spacer; it really improves effectiveness.

Trauma

Trauma and bleeding are relatively less-common and less-often fatal. This kit is already getting pretty bulky, so I’m going to emphasize the few small items which are hardest to improvise and have the best life-saving potential.

Hæmostatic agent is (again) a specialist tool which requires additional training to use safely and effectively. It has a high impact in very specific cases of bleeding, and it can’t be improvised at all. Only buy sponge-type hæmostatic products, not loose granules or powder.

A tourniquet is a potentially life-saving tool to stop catastrophic bleeding. Tourniquet usage is covered in many First Responder level classes. A tourniquet is hard to improvise and particularly difficult to improvise quickly while someone is bleeding rapidly. There are two major types of commercial tourniquet: stretch-wrap-tuck and stick-and-twist. Both work.

A needle chest decompression is only indicated in very rare circumstances, requires additional specialist training, and exceeds the scope of practice of most medical certifications below the professional level. If you know how to use it, you might want to carry a kit for these extremely unlikely situations.

If you have space after all that, the only other item that might be useful is an Israeli-style pressure bandage. These items aren’t fundamentally different from other soft dressings designed to stop bleeding with pressure. But they are substantially easier to apply effectively under stressful circumstances. Not as cool as ripping up your shirt and tying it together with your belt and shoe-laces, but probably better for the person bleeding.

Changes

July 21, 2017

  • Added links to training providers and specific items (these aren’t affiliate links).
  • Changed tourniquet advice to reflect new information.

September 4th, 2017

  • Added links to my training guide.

September 7th, 2017

  • Added common names for over-the-counter drugs.

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Mostly abridged.

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