Medical kit for Angolan kayak expedition

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Medical kit for Angolan kayak expedition

Postby Ozymandias » Sat May 21, 2016 11:56 am

Hello All,

Two weeks to go until I'm in the middle of nowhere in Angola, kayaking down the Kwanza River. Any medical professionals / field medics on the board care to take a look at our expedition first aid kit list, and comment? We have a helicopter casevac plan in place, but it will still be a long wait for help on certain stretches of the river. Main risks are: water & mozzie-bourne disease, fungal infections, trauma from crashing kayak, heatstroke, drowning, landmines, animal bites (as in scorpions, snakes) plus (very unlikely) animal attack: crocs, hippos and there's even a confirmed man-eating lion along one stretch!

List is based on suggestions here as well as past experience in the bush: http://www.expeditionmedicine.co.uk/ind ... r-003.html. We are both first aid trained, and as you can see from the list, have access to some gear you definitely couldn't buy in the West without a doctor's license!

Anything missing or redundant? As always, weight is a big factor so no suggestions of defibrillators etc.!

Essentials

zinc oxide tape
Ibuprofen
Coartem antimalarial
Malaria testing kit
Praziquantel (Biltricide) for bilharzia (Schistosomiasis)
Imodium
Betadine
Gauze dressing- simple dressings
Compeed blister pads

Analgesia

Morphine
IM Voltarol
Rectal Voltarol
Co-codamol
Paracetamol

Fracture Management

zinc oxide tape
clingfilm
Sam Splints

Antibiotics

Co-Amoxiclav
Ciprofloxacin
Metronidazole
Flucloxacillin

Lotions and potions

antifungal (Clotrimazole)
antihistamine (Cetirazine and Anthisan) - Eurax cream for bites
steroid (1% Hydrocortisone)
antibiotic (Fucidin)
antiseptic spray
Daktarin (miconazole) for feet.

Dressings and Wound Closure

Simple dressings impregnated with betadine
Some dry dressings
Tegaderm +Pads
Crepe bandages (a large one to use as a sling)
Steristrips & Superglue
Ethicon Mersilk suture kit and an injectible anaesthetic
Celox RAPID Z-Folded Gauze – 1.5m, for serious bleeds
Celox or Quick Clot or any other hemostatic granules

Medical Emergencies

Treatment for anaphylaxis: adrenaline (Epinephrine), chlorpheniramine and hydrocortisone.
Oropharyngeal airway
Tourniquet capable of doing a leg

IV Access and fluids

IV Fluids (keeping this basic due to weight considerations)
giving sets
venflons
syringes
needles
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Re: Medical kit for Angolan kayak expedition

Postby nowonmai » Sat May 21, 2016 3:05 pm

Looks good. Only thing it's missing is 200 Marlboro Reds. If you're lying on an attap bed dying of wounds/sepsis/something that medical science hasn't even named yet in Angola then a couple of smokes would go down a treat.
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Re: Medical kit for Angolan kayak expedition

Postby AztecDave » Sat May 21, 2016 6:46 pm

a roll of good duct tape (Gorilla) and some 550 test para cord. I'm not kidding.
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Re: Medical kit for Angolan kayak expedition

Postby seektravelinfo » Sat May 21, 2016 10:02 pm

Super-glue
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Re: Medical kit for Angolan kayak expedition

Postby grawp » Sat May 21, 2016 11:53 pm

Are you cleared to add ketamine to your kit?
It can make bone-setting and other such situations where pain control and management are crucial, a whole lot easier.
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Re: Medical kit for Angolan kayak expedition

Postby MJK » Wed May 25, 2016 6:00 am

I didn't see anything for dental mishaps. Bottle of oil of clove would be worth its weight in gold if you needed it. Ambesol at the least.

That's quite a bag of goodies you're packing; you should christen the kayak all that shit gets stuffed into 'Big Pharma'.

Just curious as to whether you are putting in close to the source point and hauling out at the first dam. How are you getting to your starting point? Looks like an interesting trip.
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Re: Medical kit for Angolan kayak expedition

Postby Ozymandias » Wed May 25, 2016 6:25 am

Good point on the dental side. Was probably distracted as I'm off to the dentist this morning to get some last-minute drilling done before the journey! Will grab some oil of clove. Grawp, I'd be keen to get Ketamine, but not so sure on local availability!

We are flying down to Huambo and then driving to the source in 4x4, which is a few hours away in a place 25 km north-east of Mumbwé village. From there it's about an 80km trek along the river until it's big enough to actually kayak in. The kayak (a Klepper Aerius Classic II + 545) breaks down into a 55kg package that we can pull along behind us on a DIY trailer we made (see image below). When not in use, the trailer breaks down and fits inside the kayak.

Image

There are a couple of dams along the way we'll have to walk around, including the impressive Cambambe Dam (shown below). Can't wait to zoom the drone around that! In total, should be around 200km of hiking.

Image
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Re: Medical kit for Angolan kayak expedition

Postby Ozymandias » Wed May 25, 2016 6:27 am

AztecDave wrote:a roll of good duct tape (Gorilla) and some 550 test para cord. I'm not kidding.


Got 'em!
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Re: Medical kit for Angolan kayak expedition

Postby Ozymandias » Wed May 25, 2016 6:28 am

seektravelinfo wrote:Super-glue


Got it. Went for Gorilla brand. Interested to see how strong it is.

Image
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Re: Medical kit for Angolan kayak expedition

Postby MJK » Wed May 25, 2016 8:22 am

That's quite a jaunt you have planned. Are you going all the way to the Atlantic? How long do you figure it will take you?
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Re: Medical kit for Angolan kayak expedition

Postby Ozymandias » Wed May 25, 2016 8:43 am

Yes, all 1,100km to the Atlantic! Should take between 30 and 45 days, depending on how much hassle we get from local authorities / wildlife / weather / tropical diseases.
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Re: Medical kit for Angolan kayak expedition

Postby ReptilianKittenEater » Wed May 25, 2016 12:39 pm

Its a given but seeing that pic of walking through tall grass bring plenty of bug spray.
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Re: Medical kit for Angolan kayak expedition

Postby OneLungMcClung » Wed May 25, 2016 2:37 pm

You've got cling film under ortho, but I recommend Ace Wraps as well, they are great for holding splints and also double for compression vs. inevitable swelling. http://www.acebrand.com/wps/portal/3M/en_US/AceBrand/Home/Tips/How-To/

ABx - you need doxycycline, it's a great antibacterial against a variety of microbes. Be aware of it's issue with causing sunburn. Decent for getting on board before suspicious food. Get this book for when to use what: http://www.amazon.com/Sanford-Guide-Antimicrobial-Therapy-Guides/dp/193080878X This is the standard for all of my docs. Also, I see your anti-malarials but make sure you check CDC for resistance http://www.cdc.gov/malaria/map/

Bruh. You're going to Africa, you've GOT to have anti-diarrhea meds. When you are pissing rusty water out of your ass, you want to slow it down.

That "tourniquet capable of doing a leg", I hope its a CAT or some other similar device. With these, tighten until pulsatile bleeding stops. CAT: http://combattourniquet.com/ Get three, mine injuries, while survivable, often get the aid team injured too, last thing you want to be doing is deciding who gets the cat and who gets to die.

Do you have a satellite phone?

Get two filter straws per person for water as well: http://lifestraw.com/

Your suture kit needs multiple uses, you may use it more than you think. Make sure it has 0 silk (big stuff), as well as some finer thread (like 4 or 5) for facial injuries. Avoid absorbable while in the bush, it's not as durable. The plan is to suture then remove after 7-10 days.

Anaphylaxis, get diphenhydramine pills, and injectors if you have and IV kit. Anyone reacts to anything, get 50mg on board stat.

Your tegaderms, what size are they? The standard are those 3"/75mm ones, but get a few of the big 8"/200mm ones, you'll be surprised how many dings you get.

Glad you got crazy glue, we use it all the time for minor cuts, its awesome out in the field as a stop gap.

grawp wrote:Are you cleared to add ketamine to your kit?
It can make bone-setting and other such situations where pain control and management are crucial, a whole lot easier.


I second this. Ketamine is magic for setting bones. However, highly controlled substance, be aware obtaining and carrying and getting clearance can be a beast.

I work Emergency/Trauma, PM me any questions. And take pictures man!

Ozymandias wrote:Hello All,

Two weeks to go until I'm in the middle of nowhere in Angola, kayaking down the Kwanza River. Any medical professionals / field medics on the board care to take a look at our expedition first aid kit list, and comment? We have a helicopter casevac plan in place, but it will still be a long wait for help on certain stretches of the river. Main risks are: water & mozzie-bourne disease, fungal infections, trauma from crashing kayak, heatstroke, drowning, landmines, animal bites (as in scorpions, snakes) plus (very unlikely) animal attack: crocs, hippos and there's even a confirmed man-eating lion along one stretch!

List is based on suggestions here as well as past experience in the bush: http://www.expeditionmedicine.co.uk/ind ... r-003.html. We are both first aid trained, and as you can see from the list, have access to some gear you definitely couldn't buy in the West without a doctor's license!

Anything missing or redundant? As always, weight is a big factor so no suggestions of defibrillators etc.!

Essentials

zinc oxide tape
Ibuprofen
Coartem antimalarial
Malaria testing kit
Praziquantel (Biltricide) for bilharzia (Schistosomiasis)
Imodium
Betadine
Gauze dressing- simple dressings
Compeed blister pads

Analgesia

Morphine
IM Voltarol
Rectal Voltarol
Co-codamol
Paracetamol

Fracture Management

zinc oxide tape
clingfilm
Sam Splints

Antibiotics

Co-Amoxiclav
Ciprofloxacin
Metronidazole
Flucloxacillin

Lotions and potions

antifungal (Clotrimazole)
antihistamine (Cetirazine and Anthisan) - Eurax cream for bites
steroid (1% Hydrocortisone)
antibiotic (Fucidin)
antiseptic spray
Daktarin (miconazole) for feet.

Dressings and Wound Closure

Simple dressings impregnated with betadine
Some dry dressings
Tegaderm +Pads
Crepe bandages (a large one to use as a sling)
Steristrips & Superglue
Ethicon Mersilk suture kit and an injectible anaesthetic
Celox RAPID Z-Folded Gauze – 1.5m, for serious bleeds
Celox or Quick Clot or any other hemostatic granules

Medical Emergencies

Treatment for anaphylaxis: adrenaline (Epinephrine), chlorpheniramine and hydrocortisone.
Oropharyngeal airway
Tourniquet capable of doing a leg

IV Access and fluids

IV Fluids (keeping this basic due to weight considerations)
giving sets
venflons
syringes
needles
Money Talks...
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Re: Medical kit for Angolan kayak expedition

Postby Ozymandias » Wed May 25, 2016 3:15 pm

Cheers OneLungMcClung, load of good info there. Couple of responses:

We have something similar to Ace Wraps, which I didn't list, but I see they're quite cheap on Amazon.co.uk (I am in London now) so might grab some!
I am already on doxycycline as my anti-malarial, and will have plenty spare when I get there. Used it before and haven't had the sunburn side effects, so should be OK.
Imodium is the brand name for loperamide, should bung us up if required.
We have CAT devices. We do have a satellite phone and a support team with access to 4x4s and a helicopter if the shit really hits the fan.
I don't think one of our sponsors (Water-To-Go) would be too happy if we used LifeStraw's products, but it's the same idea for filtered water.
Our Tegaderms are a mix, but generally the big ones.

As for the ketamine, getting it's not the problem. It's getting it legally!

Will look into the diphenhydramine pills and suture kit as you advised. Thanks!
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Re: Medical kit for Angolan kayak expedition

Postby nowonmai » Wed May 25, 2016 9:00 pm

You're far too polite to do this so I'll do it for you.

https://www.justgiving.com/fundraising/kayakthekwanza

http://www.kayakthekwanza.com/

https://twitter.com/kayakthekwanza

Best of British luck to you both.
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