The Doctor's Black Bag (Jasher's Travel Medkit)

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Jul 22nd, 2006, 01:19 PM
  #1
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The Doctor's Black Bag (Jasher's Travel Medkit)

Hello,

I've received a couple of off-forum questions recently about the contents of my travel medical kit -- just as people often wonder where tour operators go on holiday, people seem curious about what a doctor packs in his travel medical kit, so I thought it might be useful to post them here.

I customise my medkit depending on trip length, planned activities, and the remoteness of my destination, but these are the basics -- note that this is in addition to any presription medication.

Hand sanitising gel
Alcohol or Betadine swabs for disinfecting cuts, scrapes, etc
Triple antibiotic ointment (Polysporin)
An assortment of plasters (bandages)
Sterile gauze pads and tape
Ibuprofen
Aspirin
Digital travel thermometer
Benadryl (antihistamine)
Insect bite cream
A few throat lozenges (cough drops)
A course of antibiotics (Cipro)
A course of cold medicine (Sudafed)
A course of Immodium
Salt and sugar packets to create oral rehydration solution -- you can also buy commercial rehydration solution
Tweezers (on my Swiss army knife)

You don't need huge amounts of any one item -- I usually do 4 of each for things like plasters, gauze pads, alcohol swabs, salt packets etc. I have a little zipper pouch I got from a drug company, but you can put everything in a Ziploc bag to keep the smaller items from getting scattered through your luggage.

In case you're curious, so far I've used everything except the Cipro, Benadryl, and Immodium (touch wood) on my trips. This trip was the first one where I used the Betadine, gauze, and tape though...more on that in my trip report.

Because I have a bad ankle due to an old sports injury which tends to give out at inconvenient times, I'll bring an ACE bandage if I plan to do a lot of walking/hiking.

If I'm going somewhere extremely remote, I'll also take a separate emergency sterile kit (syringes, a blood draw/transfusion kit, and sutures). There is a high incidence of HIV in Africa and equipment does get re-used without being properly sterilised -- I don't want to make anyone paranoid, but it's something to consider. I've made up my own from supplies I got at the hospital, but you can buy them commercially as well. If you go to the trouble of bringing one of these, keep it in your daypack -- it doesn't do you much good sitting in your tent if you really need it.

Cheers,
Julian
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Jul 22nd, 2006, 01:35 PM
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That's a really good list, Julian - oh and welcome back by the way!

I have printed this out and will put it in my travel closet (a nice luxury when you become empty-nesters). I have a basic zipper pouch which I stash everything in and throw in the suitcase.

You are so right on the game drives though - a lot of good that pouch will do back at the tent or lodge! What I did in May was take a a VERY small zipped pouch (found it at a backpacker's store - Mountain Equipment Co-op) that had 2 bandaids, 2 advil, a guaze pad, 2 pkgs of afterbite, and some alcohol wipes in it. I added a small tube of neosporin, two immodium, 2 antihistamine (non-drowsy) and 2 cold tablets. This served us well. Especially when Jim ran into the thorn tree on one of walks at Sweetwaters - I was able to slap a bandaid and some neosporin on it right away. Now if the air would have turned blue when he ran into it (it didn't) I could have taken the advil...
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Jul 22nd, 2006, 03:36 PM
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Great list, thanks. I have adapted mine to suit.
 
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Jul 23rd, 2006, 12:34 AM
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Dear Julian...Is it really true that you can use the same antibiotic ointment as many times as you like without developing resistance? And especially triple antibiotics?

(Sorry, I had to add the "dear; when I rad back it sounded so much like one of those "Dear ...." sort of questions)

Also, would a couple of particulalrly salty margaritas act as an effective oral rehydration agent? ;-)
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Jul 23rd, 2006, 12:36 AM
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ANd does anyone have a solution for dyslexic fingers on the keyboard?
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Jul 23rd, 2006, 12:46 AM
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kimburu,

Why haven't I thought of that before...margaritas on safari would be awesome! I definitely need to e-mail the lodges and tell them to be prepared to offer up margaritas as my drink of choice.

Have you had margaritas on safari before, and if so, where???
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Jul 23rd, 2006, 01:01 AM
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Rocco,

I think they would dehydrate you very very rapidly......especially, since at Kwando you can expect to go on all-day drives!!!

Hari
 
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Jul 23rd, 2006, 01:51 AM
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Rocco... I just thought of it when I saw Julian's post! I cannot recall if I had one on safari - not my regular drink but one I enjoy. Even if you are not staying somewhere that does that kind of cocktail, I am sure only the triple sec would present a problem ingedient-wise and you might need a hip flask for that - half ounce per glass so it doesn't need to be much. Then it's simply a question of getting the barman to make you up a half-litre in the kitchen belnder when he's off duty and keep it chilled for you....Only pre-planning needed is probably to check they have tequila in the bar.

Hari ... I was not suggesting it before game drives Apart from anything else the "stories" start to come during the second drink, with the "opinions" following soon after, and although a captive audience is very nice at times like that I don't want to be a "Local man left behind in African bush" newspaper headline - although with the way I tell them I might be able to save myself from the animals by boring them to death at fifty paces. ;-)
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Jul 23rd, 2006, 04:37 AM
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Thanks for the input. I am taking the OC medications for our family trip of 8 to Kenya in August. I did not have the tweezers and sugar and salt packets. I have been on tours where no one has brought even cold tablets and I have depleted my supply pretty fast. I always come prepared. Thanks again. Betty
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Jul 23rd, 2006, 07:44 AM
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Hello Kimburu,

Antibiotic resistance is much more of a problem with oral antibiotics than it is with topical antibiotics, so you should be fine. The reason for using the triple antibiotic ointment is because it covers the broadest spectrum of bugs, and you never know what you may be exposed to in the bush. I scraped my shin pretty badly on the woodpile at Savuti, and I don't even want to think about what sort of bugs might be resident there...

Cheers,
Julian
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Jul 23rd, 2006, 08:21 AM
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Re: Topical antibiotic creams/ointments
I usually only have my patients use these for 24hrs. max. Studies show that many people will develope a reaction/sensitivity/allergy to these types of topicals. Your own immune system 9unless compromised) will prevent further infections.

These skin reactions can occur even if this has never happened prior. It seems that as more people develope resistance to oral antibiotics these skin reactions become more prevalent.

Those who are allergic/sensitive to penicillan and other antibiotics should be extra careful using these topicals. One however, does not need to have problems with oral antibiotics to have these reactions to the topicals.

The first 24hrs. is usually (unless in contaminated areas) all that's needed for topical application. So use sparingly and for no longer than 24 hrs.
My 2 cents;
Sherry

p.s. Welcome back Julian - can't wait for your report and pics. - sounds like you may have seen the dogs!
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Jul 23rd, 2006, 08:41 AM
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Thanks Julian.
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Jul 23rd, 2006, 09:01 AM
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And thank you Sherry. That's certainly something to take into account. In that case I'd be safer taking something I'd used before when travelling, right?
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Jul 23rd, 2006, 09:39 AM
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Jasher,

What about Phenergan or something similar? My husband got very ill in Botswana and ended up getting several injections(our travel Dr. talked me out of taking syringes). We think he may have had a reaction to the anti-malarial since he was eating/drinking the same things as everyone else at the camp.
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Jul 23rd, 2006, 02:11 PM
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Great idea Julian!

Moremiles.....Phenergan is a sedating antihistamine. Julian has listed Benadryl which is acrivastine (in the U.K.). Acrivastine is a fast-acting non-sedating antihistamine and would be my first choice too.(Please be aware there are other formats of Benadryl that contain sedating antihistamines, particularly U.S. brands).

Travellers that have had recent dental work done, or those prone to dental infections should carry a combination of amoxicillin and metronidazole (or co-amoxiclav, also known as Augmentin).
If you are allergic to penicillin, then erythromycin can be used as an alternative to amoxicillin.

I would also add some moisturising eyedrops especially for contact lens wearers because of potential dust.

Pseudoephedrine (Sudafed) can be very useful for runny or congested sinuses. But if you are diabetic or have high blood pressure - it is safer to use a nasal spray instead of an oral medication.

Regards

Gaurang
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Jul 23rd, 2006, 02:44 PM
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Sorry, I listed the wrong drug. I read about some pres. drug that travelers always keep with them if they are having severe vomiting, etc. and have to get on a plane. What do you recommend?
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Jul 23rd, 2006, 05:09 PM
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Julian,

Sorry about your shins.........however, that makes us really curious about your trip and your game sightings.

Hari
 
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Jul 23rd, 2006, 11:22 PM
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Hi Moremiles

Phenergan can be used for nausea and vomiting and also to help you sleep. A drug called cyclizine (also an antihistamine) would be a better alternative to Phenergan, for nausea and vomiting.

Regards

Gaurang
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Jul 23rd, 2006, 11:37 PM
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Hi Julian

My medical kit is not disimilar - and I also include sterile syringes etc. if going somewhere really remote or where it may be time consuming to get back to a good hospital.

Actifed tablet. Night nurse type tablet
Alka Seltzer
Amoxicillin
Ankle support
Antihistamine eye drops (like Allecrome or Cromol or Otrivine-antistin)
Aspirin
Band aids
Bandages, Alco/Savlon wipes, Elastic bandage, Scissors, dressings
Betnovate cream
Bite and sting relief spray
Chapstick/ rich moisturiser
Chloramhenicol eye drops
Ciprofloxacin/Ciproxin
Domperidone (also known as Motilium or Domstal)
Hydrocortisone cream
Immodium (Lopermide)
Insecticides
Metronidazole
Paracetamol
Re-hydration sachets
Sun block
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Jul 23rd, 2006, 11:38 PM
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Have prob missed some stuff out there but I'll add as I think of it. And I've used most of the items once or more over the years...
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