FIRST AID KIT
By Dr. Clare O'Leary and Pat Falvey.

Our expedition kits have been graciously sponsored by Wyeth.

Prior to a major expedition, all climbers are recommended to undergo a full medical and dental check-up. The following is a list of suggested medications to include in a first aid kit. These should be discussed with your doctor before travelling, particularly if you have any pre-existing medical conditions. Always carry your medication in your hand baggage.

Paracetamol
Use as a painkiller, or for fever
Dose: 500mg-1g 6hrly

Gastrointestinal system

Gaviscon
Antacid; use for indigestion
Dose: 10-20mls after meals and at bedtime
Lansoprazole
Use for heartburn
Dose: 30mg once daily.

Domperidone (Motilium)
Use for nausea and vomiting
10-20mg every four to eight hours

Lomotil
Use for diarrhoea
Dose: 4 tablets initially then 2 tablets every 6hrs until symptoms resolve

Senokot
Use for constipation
Dose: 2 tablets at night, increased as necessary

Dioralyte (Oral rehydration salt)
Use to replace fluid and electrolyte loss in diarrhoea
Dose: 200-400mls after each loose stool.

Topical treatments

• Anti-inflammatory cream
• Insect repellent (containing DEET)
• Antihistamine cream
• Antiseptic cream
• Antibiotic ointment (fucidin)
• Anusol HC (for haemorrhoids)
• Flamazine (for serious sunburn)
• Blister dressings 'second skin' eg compeed

Malathion 0.5% preparation
Use for scabies, head lice and crab lice
Apply over whole body x 24 hrs for scabies
Apply over whole body x 12hrs or overnight for crab lice
Apply to dry hair and scalp x 12 hrs for head lice

Desloratadine (Neoclarityn)
Antihistamine; use for allergy, (reaction to bites/hives)
Dose: 5mg once daily

Eye drops

Tears naturale/lacrilube
Use for dry eyes
Apply as required

Chloamphenicol eye ointment
Use for superficial eye infections
Apply 3-4 times daily

Ear drops

Kenacomotic
Use for outer ear infections
Apply 4 times daily

Anti inflammatories

Use for any joint pain/injury. Avoid if allergic to aspirin.

Diclofenac (Difene)
Dose: 50mg three times daily after food

Ibuprofen (Brufen)
Dose: 400-600mg three times daily after food
**Effective for high altitude headache

Antibiotics

Ciprofloxacin (Ciproxin)
Used for treatment of bacterial infections including bacterial causes of diarrhoea, respiratory tract infections and urinary tract infections.
Dose: 250-500mg twice daily for 5-7 days

Co-Amoxyclav (Augmentin)
Use for treatment of respiratory tract infections, urinary tract infections, skin infections, animal bites, and severe dental infections.
Dose: 625mg twice daily for 7 days
Do not use if allergic to penicillin

Metronidazole (Flagyl)
Use for amoebic dysentery
Dose: 800mg three times daily for 5 days

Flucloxacillin (Floxapen)
Use for skin infections, ear infections
Dose 500mg four times daily

Strong Analgesics (Painkillers)

DF118
Use for moderate to severe pain only. May cause nausea/vomiting/drowsiness
Dose: 30mg every 4-6 hours
This type of medication should be used with great caution at altitude because of its potential to cause drowsiness. You should discuss its use with your team leader/doctor prior to use.

Sleeping tablets

Avoid at altitude.
Almost all sleeping tablets will depress breathing. This is likely to exacerbate insomnia due to periodic breathing. Acetazolamide is the safest agent for treatment of this.

Oral Contraceptive Pill

Avoid at altitude
There is an increased risk of clotting at altitude; this is associated with changes in the blood, dehydration and immobility. The risk of clotting may be compounded by the pill.

SPECIFIC HIGH ALTITUDE DRUGS

ACETAZOLAMIDE (Diamox)
Prevention of AMS - 125-250mg orally twice daily 24hrs before ascent and first two days at high altitude
Treatment of AMS - 250mg twice a day orally until symptoms resolve
Main side effects are numbness/tingling and urinary frequency.

DEXAMETHASONE
Prevention of AMS - 2mg every 6hrs or 4mg every 12hrs orally
Treatment of AMS - 4mg every 6hrs orally, intramuscularly or intravenously
HACE - 8mg initially, then 4mg every 6hrs orally, intramuscularly or intravenously

NIFEDIPINE
Prevention of HAPE - 20-3Omg of slow release preparation orally 12hrly
Treatment of HAPE - 10mg orally initially, then 20-3Omg of slow release preparation orally 12hrly

Miscellanous

• Throat lozenges
• Cough medicine
• Zovirax topical
• Salbutamol inhaler
• Bandages/Dressings/Steristrips/Non adherent dressings/Adaptic
--dressings
• A variety of sterile needles/syringes
• Scissors/blade/scalpel/tweezers
• Sterile water/local anaesthetic
• Suture pack
• Sun block and lip block both with SPF 30
• Stethescope
• Pulse oximeter
• Sphygmomanometer
• Portable hyperbaric chamber