Summer is here and in the pediatric urgent care I have begun to see more soft tissue injuries, broken bones and lacerations. While kids are out of school they have markedly more freedom to explore and with this they find creative ways to injure themselves. It is important to have first aid supplies ready. I am going to share the top 10 items in my first aid kit and what I include for my family’s long trips away from civilization. Please know the ready made first aid kits they sell in stores are overpriced and often fail to contain important items.
Ace wrap *velcro type
DoTerra Lavender Essential Oil
Benadryl liquid (generic is fine) is top of my list especially if we are going back country. Blame my likely too early exposure to My Girl that awful movie where the little girl dies from an anaphylatic reaction to bee stings. Literally if someone could have immediately gotten a teaspoon of Benadryl into her she might have lived. Anaphylaxis happens more often today than it ever has in the past. The risks are real but the immediate treatment if you don’t already carry an EpiPen is oral diphenhydramine. If you can’t figure out the dose remember this: 1 tsp for a little kid and 2 tsp for a bigger kid is a great place to start. 2tsp is equal to one adult 25mg capsule if that helps you to do the emergency calculation. I got stung by a large black scorpion deep in the back country of the Grand Canyon and Benadryl made a nice difference in my ability to breathe easier. I still got sweats and nausea but at least I could breathe.
Good tweezers made the list from another fun story of my own life in which I had taken the four year old hiking at Enchanted Rock State Park. Despite my best efforts of telling him to stay on the trail he meandered off. I heard such a shriek that I thought for sure he had been bitten by a snake. Instead he turned back towards me and looked like a pin cushion. God bless the Texas Prickly Pears. I had my Swiss Army knife and if you have ever had to use the tweezers from it to pull thousands of microscopic cactus spines from a screaming kid you will understand why “good tweezers” made my top 10 list.
I am not crazy about Neosporin nor triple antibiotic ointment. My husband is sulfa allergic and triple contains a sulfa antibiotic and so we don’t carry it. Also kiddos can be sensitive to the Neomycin component of Neosporin. A safer bet is plain Bacitracin. This is a narrow spectrum OTC antibiotic ointment that does a great job on the typical skin flora invaders. This will not help MRSA. So if you have a known MRSA+ history best to carry Rx Mupirocin.
I carry a tiny little squirt bottle of 50/50 peroxide and rubbing alcohol to sterilize equipment like my tweezers and in the summer time to help ear canals. In my Swimmer’s ear blog I discussed that this condition is preventable but you have to clean the ear canals right after swimming. I have witnessed many a river camping trip ending in the urgent care with painful rotten ear canals.
Epsom salt. Yes I actually carry it in a zip lock bag. Foot puncture wounds do well to be soaked immediately.
In the old days Ace Wraps had these miserable toothy clips. Now days they are equipped with Velcro (ie hook and loop) closure systems. These are inexpensive and worthy item to have in your kit. Can also be used as a tourniquet/compression above an arterial bleed. Familiarize yourself with wrist and ankle wraps as they are most commonly injured extremities. Learn how to check for perfusion in the extremity you wrapped. https://www.youtube.com/watch?v=WwhFALn7DN4
Telfa or non-adherent pads are way better than band-aids for dressing open wounds. The last thing you want to do is accidentally peel off the healing that the body has already done. It is also incredibly painful to remove sticky band-aids from a flesh wound. But you may be thinking, how is this going to stay on an active kid? You hold it on with Coban.
Coban is amazing. This stuff is flexible (great over knees) and sticks to itself like Saran Wrap. Plus it comes in many fun colors. Best price is Walmart for this and most of these items. You wash the wound with your Hibiclens and flowing water, air dry then add a bit of bacitracin ointment to the Telfa pad/wound and then cover the area with Coban to hold it all in place. Works amazingly well and is super easy to change/remove.
Hibiclens does not sting yet it really works. That is why I love this soap. Studies have shown that wounds cleaned with fresh fast moving water and soap do better than any other form of torture a parent can come up with. I swear by this stuff. We use this as prep before suturing large open wounds. No child has ever complained to me about this soap. We also use it for soaking ingrown toenails prior to procedures. A small bottle is sufficient as a little bit goes a long ways.
I travel with lavender essential oil. In reality I travel with more EO’s but this one made my top ten for the first aid kit. This stuff has great anecdotal evidence for everything from bug bites/bee stings, allergies to abdominal cramping. It is also a great gentle cleanser. The 2007 data in the NEJM regarding Lavender causing precocious puberty should be approached with some careful consideration. Indiscriminate use of any EO can be harmful as they are powerful medicines in their own right. Especially one that has known estrogenic effects. However, small scrupulous use on a bee sting is very different than slathering a young boy’s body (ie entire surface area) daily with lavender lotion.