Galen’s Annotated Chirurgeon Kit
One of the FAQs that comes up among Chirurgeon’s both old and new is what to put into a Chirurgeon’s Kit. I was first certified as an EMT in 1979, and have maintained a first aid kit in various forms ever since. I finally got around to doing an inventory on what I carry, and will try to go through my kit in this missive as I might go through it with an apprentice Chirurgeon. There is nothing magical about what I carry, and many of the items are strictly personal preference. Since this is also my mundane kit, I have a few doc items which I would not use while working as a Chirurgeon.

Belt Pouch

This is my "quick response" kit, always with me. I can do almost everything with the materials that fit in this 7x8x3" pouch
  • Bandage Scissors
  • Medic shears – the heavy duty kind that can cut a penny in half
  • Gloves
  • Pad paper
  • Pen
  • CPR shield or mask
  • Bandaids – assorted sizes in a zip-lock bag
  • 1" Tape
  • 4X4s
  • Kleenex
  • Anaphylaxis kit - NOTE: For advanced providers only under their mundane certs!
  • Cell Phone – I consider this the most important part of a kit. If it takes more than a bandaid, it probably needs to go to the local ER. If you have a phone, you have access to emergency response.
  • Flashlight
  • Tackle Box (Plano model 7620)
  • Baldric
  • Stethoscope
  • Trauma dressing
  • 4X4s
  • 2X3" Bandaids
  • Scalpel Blades (#11 and #15) – no, I’m not doing surgery outside the hospital. I have many uses for these sharp items, but again, not recommended for general use. Here's the scalpel blade I prefer to use!
  • Bandaids (assorted sizes)
  • Oropharyngeal airways (infant through large adult sizes)
  • Gloves
  • Hard candies – good for hypoglycemia as well as to make your own breath a bit more presentable when you are called out in the middle of the night.
  • Pen light
  • Pens and pencils
  • Chapstick – this is an item you would give away. Don’t let someone use it then put it back in the kit!
  • Nail clippers
  • Fine forceps
  • Tongue blades
  • Various hypodermic needles mostly for removing splinters
  • Eye drops
  • Tincture of Benzoin this helps tape stick to sweaty people. I have small ampules that you squeeze between your fingers and then dab directly on the skin
  • Pre-moistened towelettes
  • Alcohol prep pads –  for cleaning any of my equipment that is not disposable. Since I’m not doing any invasive procedures, I shouldn’t have to use any skin disinfectants.
  • 2" Kling
  • 3" Kling
  • 4" Kling
  • 4" Kerlex
  • Q-tips
  • Eye pads
  • Triangular bandages
  • Dental Floss
  • Syrup of Ipecac
  • 1" Tape
  • 2" Tape
  • Contact lens case
  • Surgical mask with eye shield
  • Roller Bandages
  • CPR Pocket Mask
  • Surgical Gloves
  • Tourniquet (blood-drawing type) – This would not work as tourniquet for stopping bleeding. I would use this as a constricting band, e.g., in case of snake bite.
  • Waterless antibacterial hand cleanser
  • 2" Elastic bandage
  • 3" Elastic bandage
  • 4" Elastic Bandage
  • Safety pins
  • Bite stick
  • ABD pads
  • Adolph’s Meat Tenderizer – I use this for stings. The poison in a sting is a protein, and the meat tenderizer is a proteolytic enzyme – it breaks down proteins. I haven’t seen any scientific trials on this, but it makes sense.
  • OTC Meds box
  • Acetaminophen 325 mg tablets
  • Ibuprofen 200 mg tablets
  • Aspirin 325 mg
  • Chlorpheniramine maleate tablets, 2 mg
  • Hydrocortisone 1% cream
  • Antibiotic ointment
  • Pseudoephedrine tablets 30 mg
  • Cough and cold tablets
  • Diphenhydramine tablets
  • Diphenhydramine ointment
  • Chewable antacid tablets
  • Immodium tablets
  • Here’s my philosophy on OTC meds. I have stopped carrying any to events. I had very few requests and I was throwing away more expired meds than I was using. If you wish to keep meds around, cover the most common things that would require drugs: headache, upset stomach, cold symptoms, allergies, and skin rashes. Refer to the Chirurgeon’s Handbook for the Society policy on OTC meds. Get generic drugs (such as Wal-Mart brand). They are much cheaper and contain the same ingredients as the brand-name product. You should also avoid liquid medicines (harder to dispense in a sanitary fashion). The ideal would be unit dose packages like they use in hospitals which are available from health and safety supply houses.

    Misc box
  • Clipboard with forms
  • Zip-lock baggies (various sizes) – I use these rather than the quick-cold packs. I always have a cooler with ice at events, or ice can be obtained from the kitchen staff. I have always found them willing to help, if asked politely.
  • Mosquito repellant - DEET is the best. There is a new form out which is a cream. It has a lower percentage of DEET and is encapsulated so very little of it is absorbed through the skin. This makes it much safer for young children. It is also available combined with sun screen. Just as an added note, if you apply standard sun screen, then put DEET over the top, the DEET will dissolve the sun screen, leaving you with a splotchy sun burn pattern!)
  • Duct tape
  • Toilet paper
  • Bandaids
  • BP cuff
  • Sun screen
  • Tampons
  • Sanitary napkins
  • Surgical masks
  • Spare paper
  • Drug Reference
  • Armor Repair Supplies
  • The following items are used for reference in working with apprentices, or if there are general Chirurgeon questions that need to be researched on-site:
  • Other items to consider: Saline for contact lenses
    Dental kit
    SAM Splints
    Thermometers (regular and hypothermic)
    Syringe and angiocaths for cleaning wounds
    Liter saline bags for eye wash and wound cleansing
    This is a fairly advanced kit, and has been built up over a good number of years. A good starting point is the American Red Cross Community First Aid book. It recommends the following materials:
     
    ARC First Aid Kit recommendations
  • Gauze Pads (4X4)
  • Roller Gauze
  • Tape
  • Cold Pack
  • Plastic Bags
  • Disposable Gloves
  • Bandaids
  • Hand cleaner
  • Small Flashlight and extra batteries
  • Bandage scissors
  • Forceps
  • Blanket
  • Triangular bandage
  • Syrup of Ipecac
  • Antiseptic Ointment
  • Activated Charcoal
  • First aid kits are available in most department stores starting at about $10 for a decent kit. Medic supply stores carry extensive kits costing hundreds of dollars. Imagination and innovation can put a kit together much cheaper. My roller bandages are made from an old sheet. Ask health care providers if they would be willing to donate some supplies to a volunteer for a non-profit organization (but please don't ask employees to steal materials to stock your kit!). If you have access to pharmaceutical company representatives that manufacture OTC meds, they might be able to give you samples (I've gotten a box of packets of 2 Advil each via this route).

    I welcome a discussion of kit contents on the chirurgeon mailing list (http://groups.yahoo.com/group/SCA-Chirurgeon). I would especially be interested in hearing about what non-standard first aid supplies you carry to take care of SCA-specific problems.

    In service to Physick and Chirurgy,

    Friar Galen

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