Beyond Band-Aids: The Essential Family Medical Kit

You're off tomorrow to a remote exotic location, and your wife asks about a medical kit. Panic sets in. A quick online search turns up dozens of options. Now what?

It's a common question, but a problematic one. I'm not a fan of pre-made, store-bought medical kits. I get it - overnight delivery is convenient, but an unfamiliar and over-stocked (often over-priced) kit is intimidating and potentially even dangerous to the untrained hand. A medical kit isn't a checklist to cross-off but a set of supplies you should be comfortable with using. 

So sure - start with a basic kit, but familiarize yourself with it, adding what you need and eliminating what you don’t. Experimenting with unfamiliar supplies when the vacation turns sideways can be dangerous. Fill your bag with items you have seen and used before, supplies that you are comfortable with - not the newest and shiniest. It’s my bias, but packing sutures and scalpels is just asking for trouble if you haven’t seen them since your 8th-grade frog dissection. If you don't know what's in your kit, or how to use it, it won't help you when the wheels come off.

There's no cookbook formula for building a medical kit. The item you will need is the item you will forget. So a calm mind and sound judgment are still the most important things you carry.

The Comprehensive Kit

Where to start? Easy. It’s not Amazon. Start 2 months (at least) ahead of travel by plugging your destination into the CDC website. Every paradise has its nether regions - don’t be so naive to think you can avoid vaccines or essential prophylactic medications. They will save you. 

What's next? Just the single most important thing in your kit - a phone (preferably a satellite phone). Too expensive?  Not anymore. The Garmin InReach Messenger is around $300. The Iridium Go is a bit more but will set up a WiFi Hotspot for you from anywhere in the world.  Evacuation insurance is useless unless you have someone to call.

Now the medical kit - the medications that belong in your kit depend on your destination, the season, and the family traveling. With that in mind, the most important medications are the ones your family takes every day. I know it sounds Darwinian, but patients forget their prescribed medications every year. 

5 Supplies That Will Save A Life

Very few supplies (short of an AED) can genuinely save a life (and when AED’s become more affordable, they will make my list). These 5 items save lives every day. If you do not have these in your medical bag, call your Crescendo MD provider to get them prescribed for you.

• Epinephrine auto-injector (anaphylaxis)

• Naloxone (opioid overdose)

• Sugar (hypoglycemia)

• QuikClot (severe bleeding)

• Tourniquet (extremity  bleeding)

Everything else in your kit exists to make your trip more comfortable. These 5 supplies exist to keep someone alive. Learn how to use them - saving a life is fun.

What I Carry - Common Meds for Common Problems 

Pain & fever: Acetaminophen (fever) and/or ibuprofen (pain, swelling) with chewable formulations for kids.

Gut trouble: Loperamide to slow things down, Miralax to speed things up and glycerin suppositories to grease the wheels. Don’t think you can avoid constipation (or diarrhea) while traveling. Ondansetron (Zofran) is a must for nausea & vomiting. Scopolamine patches (or Dramamine pills) for motion sickness (car, boat, or plane) will engender gratitude from everyone in your family (Ginger chews are an alternative remedy for nausea).

Travelers' diarrhea (TD): TD deserves its own line item. Single-dose antibiotic therapy is gold, so include azithromycin (or ciprofloxacin, depending on your travel location) and include children's doses. Water purification tablets are also a no-brainer.  

Allergies: Antihistamines are essential (cetirizine or diphenhydramine) for seasonal allergies, allergic reactions, hives, anaphylaxis, and as a sleep aid. 

Ears, nose & throat: A decongestant nasal spray for sinus and ear pressure when flying is a real lifesaver - especially on descent.  Add cough drops or throat lozenges (the kind that taste good so you will actually use them). Lozenges increase saliva production, reduce pain, and minimize cough.

Skin: Sun protection should be appropriate to the environment - mountains, sea, or desert - with SPF 30+ reapplied every 2-4 hours. For children under 6 months (or anyone with sensitive skin), zinc oxide–based sunscreen, protective clothing, and sun avoidance are the primary strategies. Insect repellent should contain at least 30% DEET or 20% picaridin. Round it out with aloe gel for sunburns; 1% hydrocortisone for bites; moleskin for blisters; and Vaseline for hot spots.

First aid basics: You can never have too many gloves, bandages or gauze. Add athletic (or duct) tape; a self-adherent wrap (Coban); a 3-inch elastic ‘Ace’ bandage (wrists & ankles); a 4-inch Ace (knees & thighs); tweezers (splinters, ticks); scissors (everything); and an LED flashlight because you can’t treat what you can’t see. 

Hygiene: Alcohol-based hand sanitizer and antiseptic wipes (countless applications).

Pro Tips: Think Swiss Army Knife

Multipurpose & versatility - if you have a choice, build your medical kit around medications that will solve more than one problem.

OTC

• Acetaminophen - pain or fever

• Ibuprofen - swelling, pain, or fever

• Diphenhydramine — allergies, itching, sleep, or motion sickness

• Cetirizine — allergies, bites, stings, or itching

• Bismuth subsalicylate — upset stomach, diarrhea, or nausea

• 1% hydrocortisone — bites, stings, allergies, or itchy & irritated skin

• Antibiotic ointment — minor infections or abrasions with a petroleum base for hotspots

RX

• Codeine - yes, there are potential side effects, but for versatility nothing is superior - pain, cough, diarrhea, anxiety, or sleep (drowsiness)

• Prednisone - anaphylaxis, hives, poison oak, bronchospasm, sinusitis, gout

• Azithromycin - travelers' diarrhea, skin or respiratory infections 

• Doxycycline - tick (Lyme) exposure, malaria prevention, or respiratory infections

• Ondansetron (ODT) - nausea, vomiting or migraines

The Bottom Line

Know your kit. Understand your kit. Know what's in it, and how to use it. Build your kit around your family, but remember that preparation and sound judgment are always the most valuable tools when your plans go south. 

About the Author

Alan Gianotti, MS MD, is a primary care physician at Crescendo MD. He has extensive experience in the fields of wilderness & expedition medicine and is a regular contributor to Auerbach's Wilderness Medicine and Bledsoe’s Expedition & Wilderness Medicine. He lectures widely in the field. 

At Crescendo MD, every patient receives a comprehensive travel medical kit built around personalized medications to support their health while away from home. Crescendo MD also provides international travel insurance to every patient, covering the cost of medical transport home in the event of a true emergency.