By Mike Tayloe

After more than 20 years as a wilderness paramedic and fly-fishing guide, I can assure you that most anglers overlook the importance of carrying a good first-aid kit. I have dealt with many emergencies at remote fishing locations and responded to calls on the very rivers I guide on in Colorado, and I can safely say that–had any of the anglers involved had a little first aid training and an appropriate first-aid kit– quite a few of these situations would have had a better outcome.

First-aid kits are sort of like nail-knot tools: Most of the time, they are buried in the bottom of your pack or hidden in a side pocket, out of sight and out of-mind. But when you need to tie a nail knot, the tool makes everything easier. That said, nobody is going to die if you don’t have a nail knot tool, but not having a first-aid kit (and a little training) could make the difference between life and death.

I am often asked what supplies should be in a first-aid kit. Although this is a great question, there is a little more to it than just a list of supplies. It is no different than a person new to fly fishing going into a fly shop and asking for a list of “necessary” equipment for fly fishing. There are a lot of variables that the fly shop needs to know to outfit an angler correctly, and obviously, the angler needs to know how to use the swag on the list. It is no different for a first aid kit.

In another post, I will touch on some recommendations for what should be in a good kit, and why, but first I want to throw out a few considerations to keep in mind when you are purchasing or building your first aid kit. I think that these are just as important as what is inside the kit.

I want to get this out of the way early in this post: if you do not know what is in your kit or how to use it, you might as well leave it at home. Just carry a Ziploc bag with Band-Aids and some tape. I know that is a little harsh, but why tote around stuff that you do not know how to use?

You may be thinking to yourself, “Maybe someone will know how to use what I have in my kit, so I will just carry it just in case.” Then let them bring their own first-aid kit.

To Build or Not to Build a First-Aid Kit?

This is another question I get a lot. Should you build a kit yourself or buy one ready to go. Let’s look at things to think about before building one yourself. First, do you really know what you need and where to get it? If so, then sure, go ahead and put one together yourself. A couple of things to consider, though: Is the time and cost of buying all the supplies kit reasonable as compared to purchasing a full kit? Some of the items you need in a your kit cannot all be purchased at Walgreens or Wal-Mart. You will need to search for these specialty items, and the price may be a bit higher when you’re purchasing them individually. The things you can get from Wally-World may be packaged in bulk (bandages, dressings, etc.), and you may end up with way more than you need. One good thing about this is you will have refills forever! When building your own kit, just make sure the cost makes sense. Companies that make first aid kits purchase their supplies in bulk and get better pricing, so it may just be cheaper to buy a good kit rather than build one.

Buying a kit that is ready to go is not a bad idea; just keep a few things in mind. Look at the contents and make sure it has what you need. I often find that box-store kits have a few worthy items and then are stuffed with a bunch of fluff. Do you really need 25 bee sting wipes but just 4 Band-Aids? Are the supplies cheap? How can you tell? If you pay twelve dollars for a kit, you are going to get a twelve-dollar kit, period! Make sure the kit covers the things I outline below in considerations for a first aid kit.

Now, lets take a look at a few things that I think are just as important as what is inside a first aid kit.

Construction: Again, you generally get what you pay for. The material needs to be bomb-proof. This kit is going to get shoved in the bottom of pack, side compartment of your drift boat, or hatch of your skiff, and will travel through hell and high water with you. If the seams rip or the zipper blows (the most common failure in any kit), you will duct tape it together or stuff it all in a random bag, right? Then, when things go sideways, you end up digging through a bag or ripping off duct tape looking for supplies, or you may not even bother to treat a simple injury because it is a pain in the ass to get into your kit. And, yup, some injuries get worse over time.

Organization: I think its safe to say that the majority of folks in our industry are not professional medical providers—which is why I have a job!–so when things go bad in the field, stress levels go way up. This is not the time to be digging around in a disorganized kit looking for something to stop bleeding or to help your buddy breath. Kits should have pockets or “windows” to organize supplies, so they are easy to identify and access. Everyday items such as bandages and tape should be separate from the “real bad stuff” supplies. Regardless of the size of your kit, I always suggest it be modular. It is way easier to pull out a little bag of Band-Aids and antibiotic ointment for a small injury than to dig around a bottomless pit looking for the stuff, plus you can just hand the little bag of Band-Aids to your buddy and tell them to deal with it themselves. Another advantage of the modular system is you can pull out the section you need and carry it to the injured person rather than have the whole kit lying around on the ground. The same goes for serious issues: just grab the “serious” section, chill, and work on fixing the problem. Bottom line: organization reduces stress.

Quality Supplies: The quality of the supplies in your kits is important. Bandages and tape that come off 10 minutes after you put them on are pointless. It goes without saying that a CPR barrier or a tourniquet that rips when you really need it is, well, a bad thing. If you are building your kit, spend a little more on the brand-name items. Also, if you are buying a kit, make sure the outside does not hide a junk show on the inside.

The Right Stuff: When it comes to first-aid kits, one size does not fit all! Think about it: the kit you have for the Montana float trip may not be set up for that Belize saltwater trip. I am not saying you need to buy or build a kit for every environment you fish in, but you may need to tailor your kit for each trip to a different location or situation. You can easily add to or take out items specific to where you are going.

Size: Size constraints, the number of people you may need to treat, and trip duration are other factors that may require you to have two kits.

Scenario 1: A day trip with one to three people may only require a small kit to handle simple day-to-day issues and life threats. It needs to be storable in the pack you are using for fishing and stay out of the way until needed.

Scenario 2: A week-long trip with friends or family in remote Alaska means you need more stuff. You need to consider that you have more people who could potentially use more day-to-day items for longer periods of time. You may also take additional items (medications, etc.) due to the remote location and duration of trip.

I recommend that you have one small day-trip kit that always stays with you on the water and one slightly larger “basecamp” or “skiff” kit that remains at camp, in the lodge, in your skiff, or under the seat of your truck. Stock this kit appropriately for where you are going and for how long.

Just like you need to check your flies, leaders, and reels, you need to periodically check your first aid kit(s). Make sure the supplies have not expired or at a minimum still work. Make sure to replace any items you use and keep a mental note of things you need to add (usually noticed while in the field).

OK, to sum it all up:

• Appropriate first aid training is imperative.

• Make sure the construction of your first aid kit is bomb-proof.

• Remember, you get what you pay for.

• If you buy a kit off the shelf, make sure it meets your needs, has quality supplies and meets the considerations above.

• Your kit needs to be organized for easy access to supplies.

• If you decide to build your own, follow the advice above.

Used by someone with appropriate training, a first-aid kit can save a day on the water and, dare I say, possibly save a life.

Mike Tayloe, of Finns West, has been a paramedic for more than 20 years, focusing on remote and wilderness medicine, and he has provided remote medical services from Mount Everest to Antarctica. He’s also a fly-fishing guide in Colorado and Chile.