First Aid Kits: Playing Doctor (On the River)


Having at least one medical kit per group is a requirement for most permitted multi-day river trips. But there is seldom oversight regarding the quality of the kit. Most often, holding up an ammo box with a red cross painted on it satisfies the ranger who is checking gear.


Before I took a Wilderness First Responder Course this spring, I had frequently committed the dual offenses of having an inadequate first aid kit coupled with having inadequate knowledge of how to use what I did have. The WFR course opened my eyes and made me repent of my careless ways.


In planning for a multi-day river trip, I always work from what could possibly kill me to what merely might make me uncomfortable. Drowning might kill me, so the first things on my checklist are my raft and my life jacket, not being able to steer the boat could possibly kill me, so I always remember the oars. My sleeping pad comes somewhere in the middle of the list and my suction-cup beer coozy comes at the end. You get the idea. Until now a first aid kit has not made the top tier of essential equipment.

And so I decided that this year I’m giving it (and myself) an upgrade.

My previous kit was pieced together, but the instructors in my WFR course I attended recommended buying a comprehensive kit, both to make sure that the kit has everything and to keep down the cost.

NRS has four great options for river runners and a guide to figure out what might be the best one for your needs.

The Ultralight Paddler is a great kit for the car or those day hikes out camp. The Paddler is a solid kayaking kit designed for one-six people for up to seven days on the water. The Pro Paddler is even more extensive, meeting the first aid requirements of most permitted rivers. And for longer trips, and a kit that is able to meet the National Park Service requirements of a Grand Canyon float trip, NRS offers the Comprehensive kit, which is…well…comprehensive.

Multi-day river trips involve different activities in different settings. Most of us who raft or kayak know that water isn’t usually the major hazard on a river trip. And while my evidence is purely anecdotal, my guess is that there are far more accidents that happen in camp, on hikes, or scouting rapids than actually happen on or in the water.

For those non-water accidents, the NRS Comprehensive kit comes with essential items such as splints and shears; wound management items; blister items; infectious control items; bandage material; medications; and survival and repair items. It’s got something for that sunburn, that errant fishhook, that blister, and that twisted ankle. It also has something for that faulty memory.

The kit comes with a comprehensive first-aid guide and an illustrated guide to life-threatening emergencies. These guides can help act as a refresher for training you have forgotten but don’t let them stand in for first-aid or first responder training.

The real value of medical training isn’t any “one” treatment or trick that you learn. The real value is the system of patient assessment and care that allows you to make good decisions when bad things happen.

During my nine-day class, we only had one river scenario. We found our patient beside a set of rapids (really a gym track) his skin was cold and clammy; his heart rate was elevated; his fingers tingled; his chest was tight; his breathing was rapid. He stared straight ahead. I thought ‘heart attack.’ My partner thought, ‘normal response to scouting a scary set of rapids.’

My partner was right. By asking a series of questions and understanding the context, we found that the patient was just having an anxiety attack.

So we called off the helicopter evacuation.

In the wilderness, you are working with limited knowledge and limited supplies.

For many of our scenarios, our instructors gave us incomplete medical kits and almost never gave us adequate information on the patient, so we had to improvise and investigate. The number one thing we learned was that the best piece of medical equipment is in your head.

But even so…a decent first aid kit won’t hurt.