I’ve been reluctant to address this question because what you carry in your first aid kit needs to be specific to your personal medical history (Hx), medical knowledge and skills, as well as route and mode of travel. The first step in developing your own medical kit is talking to your personal physician because he/she knows your medical Hx best and which medications may be contraindicated for you. Your physician may also have some small, easily packed samples for your kit and can update your vaccination status so you don’t have to worry about going to the ER for a booster shot if you cut or scratch yourself in the woods. Death from tetanus infection is highest in those over 60 so you early retirees working on your “bucket list” make sure your tetanus status is up to date.
Your doctor can also give you a prescription for medications like oral antibiotics which can be especially helpful to have on a long trip to a remote area. But you will need to convince him you know when and how to use them appropriately.
The medical kit. The ibuprofen and acetaminophen are in the Advil bottle. The antibiotic ointment and steroid cream are in the contact lens case. The Vaseline and Saline solution are not shown.
Your skin will be the most abused organ on a long hike or bike trip. (One exception however may be AT thru hikers in their early twenties, for them the liver seems to receive the most abuse.) If you ignore your skin problems they can make you feel miserable and in the worse case scenario they can land you in the hospital on IV therapy.
Start with prevention by applying sun screen and lip balm 15 minutes before you start your hike or ride and reapply as needed. To prevent chaffing and skin breakdown Vaseline is cheap and effective and often needed only in the early phases of a trip or on those high mileage days. For superficial cuts or abrasions a little antibiotic ointment, i.e. triple antibiotic, carried in one side of a contact lens case is good to have on hand. In the other side of the contact lens case I carry 1% hydrocortisone cream (a mild steroid) for inflammatory skin problems like bug bites or itchy rashes like poison ivy. Be aware that some itchy fungal rashes like ring worm or jock itch can worsen with steroid use so make sure you know what you are treating and if its getting worse not better see a doctor.
The most commonly used medications I carry are NSAIDs, i.e. Ibuprofen or Naproxen, for pain associated with inflammation. For non-inflammatory based pain, i.e. headaches, abrasions … I carry Acetaminophen. For ominous chest pain/angina I carry 2 aspirins and a cell phone.
Oral antihistamines like Benadryl are handy for allergy flares, itching associated with contact dermatitis and since sedation is a side effect of Benadryl it can double as a sleep aid which is helpful if your sunburn or itchy rash is keeping you awake. For nausea, diarrhea, heartburn, or prevention of Travelers Diarrhea I carry Pepto Bismol. Tums are also useful for heartburn as well as for calcium supplementation. Calcium deficiency is one of the most common dietary deficiencies in AT thru hikers.
I also carry prescription oral antibiotics and steroids for more serious infections or inflammations, i.e. skin infections, respiratory infections, urinary tract infections, poison ivy, etc. If we’re hiking or camping in an area with a high incidence of Lyme disease I also carry a round of antibiotics specific for treating that condition. I’m sorry to say that over the last two years between hiking the AT and bicycle touring in the US I have had to use most of these prescription medications. But because I was able to start treatment quickly we never had to abandon any of our trips. With that in mind you may want to speak with your doctor about possibly carrying some of these prescription medications.
Other items I find handy are duct tape, bandaids, a gauze pad, a needle and a bandana. I wear contact lenses so I always have a small bottle of saline available for irrigating a wound or foreign body out of an eye. Also an ultra light space blanket has come in handy to prevent hypothermia on a cold mountain top more than once.
As you can see I actually don’t carry much in my medical kit because I know if I need more than this simple kit I should get off the trail or road and get to a clinic or hospital. The most important things to carry with you on any trip are knowledge and experience. Those two things will keep you from panicking which will improve your chances of having a good outcome no matter what problems you encounter. Taking an EMT course is a good way to gain some basic medical knowledge and experience. Sue and I both began our medical careers as EMTs and recommend the experience.
Thanks for reading my post but I hope in your own travels you find none of the medications I mentioned necessary.