|Wilderness first aid is one of those things that, if you have all the gear, knowledge and
training, you probably won't need to use. Maybe this is because groups that adequately
prepare themselves are also relatively safety-conscious and don't get into trouble in the
first place. The fact that you are isolated and far from help should inform everything you
do, whether that be handling hot pots over a fire or running a rapid. Prevention is a much
less painful and expensive option than a wilderness medevac.
Proper preparation is crucial for wilderness first aid. Take a first aid course before your trip - it is pointless to have a well stocked medical kit if you don't know how to use it. There are many excellent first aid courses available through St. John's Ambulance and other organisations. The dilemma is that most first aid courses assume that the ambulance is 10 minutes away and that the victim can swiftly be transported to a hospital. Try to find a wilderness or backcountry-oriented course if you can. Better courses use extensive simulations and role playing components to teach the participants how to deal with real- life situations. Unless one uses first aid skills frequently the retention time of this knowledge is surprisingly short and frequent recertification is essential (every 3 years).
A CPR course is highly recommended if you are going to be doing a lot of canoeing; artificial resuscitation is a hands-on skill and cannot be learned from a book. The ABC concept (Airway, Breathing, and Circulation) may well save the life of someone in your group. Remember that ALL near-drowning victims MUST be seen by a doctor AS SOON AS POSSIBLE. Even if the victim seems fine and is eager to go, complications associated with water inhalation are almost certain to arise
On a short trip you might only carry a basic first aid kit. The most frequently used items in your kit will probably be Band-Aids, so be sure to take an adequate supply. Your kit should include a checklist which you go over before every trip to ensure that all the components are there. On a longer trip, or with a larger group, you will want to carry one of several first aid books as well as a medical kit, which should be carried separately from the first aid kit.
If you want to send your first aid instructor ballistic, ask him about carrying antibiotics and other prescription drugs. Very few certifying bodies condone the self-administration of such medication, yet on a long, remote trip you may have no other choice. The best advice I can give is to visit your family doctor, wilderness medicine book in hand, and tell him or her about your planned expedition. Hopefully you will be able to get the prescriptions you need for a long or remote trip. The good news is that you may enjoy a lifetime of canoeing without a serious mishap: I have never had to use any of the prescription antibiotics, antinauseants, antihistamines, or painkillers in my expedition mini- pharmacy.
Serious injury or illness in remote areas will usually involve evacuation to medical facilities. In researching your trip you should find out if there are any inhabited areas along your route including cabins, cottages, fish camps or native settlements. Most people living in the bush have some form of radio communication and may be able to summon help. Fish camps often have float planes coming in on a semi-regular basis which you might be able to commandeer in a medical emergency. If you are trying to flag a plane down in an emergency, light three fires to attract attention: three of anything is a universal signal for help. A huge SOS in the sand and a signalling mirror might be useful additions to your fire. Any plane or helicopter-based rescue is expensive and not covered by most health insurance plans, so be careful out there!
Basic First Aid Kit
Medical KitQuantities depend on size of party and length of trip. For additional ideas on kit composition please see the referenced books.