Guadeloupe via The Civilized Explorer

The Civilized Explorer

Adventure Kits

While we never expect adventures to go wrong, all too often they do. If you are adventuring in wilderness areas or other locales where medical transportation will be delayed or prolonged, you need to consider an adventure kit, containing not just bandages and aspirin, but your own training for first aid and stabilization, and a resource for medical evacuation. This page provides Web resources for medical kits, medical evacuation, travel warnings for civilized explorers in sometimes less than civilized locations, and courses in first aid.

Please keep this in mind: If you buy a kit, you can open it up and admire the special scissors, look at all the adhesive bandages, sniff the antiseptic swabs, and still not have a clue what to do with it all. Having a first aid kit is just one step in having an adventure kit. If you do not know what to do, having a kit is of no use.

First aid kits, gear, and supplies

Okay, so you bought a first aid kit from a catalog. It has a snake bite kit, 4 x 4 gauze pads, a roll of adhesive tape, and a first aid manual, all in a convenient ripstop nylon carrying case with a belt loop so you have easy access. Meanwhile, your ankle is swelling visibly, turning red, and it hurts so bad you cannot stand it. There is no way you will get your ski boot back on that foot. Does your kit have the right stuff?

Adventure Medical Kits: This is an all-in-one site selling kits adjusted for your destination, the Lonely Travel Guide for that region, and the Healthy Travel Guide so you can read up on immunizations and diseases.
Outdoor Research: This is an annoyingly framed site, so look for the link to "Medical" and select that. You get a small window with not a lot of information; check the "All-Purpose Backcountry Medical Kits" and the "Family Medical Kits." Within those frames, select the Kit Comparison links for an overview. The highly rated kits are disserved by this poor Web site.
B&A Products: This site offers first aid kits for professionals; this page is oriented toward consumers, but it has excellent gear at good prices. Browse the site for additional ideas, starting with the catalog page. B&A sells AtwaterCarey and Sawyer first aid kits, which get high ratings from Those Who Know.
Fieldtex Products: Fieldtex offers first aid gear from industrial strength kits that fit out an ambulance to small fabric cases with minimal supplies. They will also create a custom case and kit for you. There are camping, hiking, and outdoor first aid kits available.
Chief Supply EMS, EMT Gear & Equipment: Chief Supply provides gear for professionals, and their equipment and supplies are generally sold individually. We did find two first aid kits, and the site also offers refills for exhausted supplies in your kit.
HeaterMeals: Some of the first aid kits for long term situations contain "ration bars." An alternative is a real meal from HeaterMeals. These boxed meals require no refrigeration and are heated to piping warm by adding water (supplied in the box) to magnesium filings (also supplied in the box). We have used these as backup meals for a couple of years, and we much prefer them to high-calory bars that do not stand up to high temperatures and packing in carry- bags.
Equipped to Survive: This site is supported by ads, but provides independent reviews of all sorts of gear and literature. It is a little too survivalist and the 'headlines' a little too over the top for our tastes, but it offers enough useful information to keep us coming back. Essays by people who helped in hurricanes, know how to do tarp shelters, use personal locator beacons, and recommend the latest Leatherman tools, flares, adventure medical kits, books, and more.
PLB Rentals: If it is not cost effective for you to own a personal locator beacon, you may want to consider renting one. If you need to be rescued, PLBs can get you saved in rugged territory; you do not even need to know where you are. See how PLBs work. The problem from the user's point of view is that there is no feedback that the signal has been received and that help is on the way.
MZ Communications: If you want to make a phone call outside cell phone areas, satellite phones may be your only option. MZ rents satellite phones with and without pre-paid minutes. With a sat phone, you can call for directions, weather reports, or just call home. To make a call for help, you need a clear view of the sky for the phone to work, you need a number to call, and you need to know where you are. Calling 911 on a sat phone is not going to get a response from a call center local to you. If you have a number you can call, you need to be able to tell your would- be rescuers precisely where you are, which is not an issue with PLBs. However, if you can talk to your responders, you can tell them what help you need and know that help is on the way.
Wilderness Medical Systems: This company overlaps into the following category. WMS sells kits, but they also provide medical evacuations, medical consultations by phone, and more. Kits are available for individuals and groups for just about any length of stay and any hope of real medical care. They will also refill your kit if you have used some of your supplies.

Medical insurance, trip insurance, evacuation

Okay, so you were standing on the roof of your rental truck surveying the playa at Black Rock City with all your best buddies, and Chris stepped back to take your picture -- right off the roof. She fell flat onto her back with a big WHOOMP! You all scrambled down, and she was laying there twitching, out cold, with this stuff running out of her ears. Both eyes were open, but one had a lot more pupil showing than the other. Now what? Do you pack up the truck and drive her two and a half hours back to Reno or do you call in REMSA?

We list medevac sites below, but note: If they have jets, they are not coming in to the playa at Burning Man. Most air evacuation services presume a transfer from hospital to airport for evacuation -- paved runways, refueling services. An airport. Even if the service will send in a chopper to airlift your buddy out of some God forsaken patch of nowhere, you have to call for them and tell them where you are.

We also list sites for travel insurance, but be sure to review their coverage carefully. Some policies will cover delays or cancellations due to acts of terrorism in a country on your itinerary; if an act of terrorism gives you the jitters but did not happen in a country on your trip, you may not be covered if you cancel. Note also that none of the policies we have seen cover cancellation due to war, declared or undeclared. Be sure to review the sites we list for war, health, and disease reports.

TravelSafe: TravelSafe offers 'cancel for any reason' insurance. Packages include cancellation for hurricane warnings, travel delay, baggage delay, financial insolvency of the tour operator, and terrorist acts, along with coverage for accident, sickness, and accidental death. There are restrictions and exclusions, so read the information carefully.
TripInsurance.com: TripInsurance offers several packages, some of which include reimbursement for losses you suffer from mechanical problems, strikes, and inclement weather; illness; financial insolvency of your carrier/ tour operator; pre-existing medical conditions under specified circumstances; emergency medical evacuation; accidental death.
Travel Insurance Services: I was going to mention this company, but the Web page took over my browser and covered my whole monitor. Jerks.
CSA Travel Protection: Along with the usual cancellation coverage, medical evacuation, financial default, and pre-existing medical conditions, CSA offers what they call 150% trip interruption insurance, on the theory that having your trip interrupted is more costly than the actual trip - rental car, tickets back to home, unexpected nights in a hotel, and so on. They also promise a live operator without having to go through a menu system.
Travel Guard: Travel Guard started out as travel insurance, but it has added programs for travelers as the needs of their customers grew. In addition to trip cancellation insurance (very comprehensive, even covering you for cancellation because you've been fired or laid off), Travel Guard offers insurance for lost or stolen baggage, lost or stolen travel documents, medical expenses, and medical evacuation. This is insurance, not medevac, so you are required to make your own arrangements and then seek reimbursement from the company. Travel Guard also offers emergency assistance, a 24-hour hotline for emergency travel changes, and relay of email or phone messages to family or others. Because this is insurance rather than a service, the rates are much less expensive than the evacuation services. However, you are left pretty much to your own devices to make the arrangements; depending on what disaster befalls you, you may not be able to make your arrangements.
InsureMyTrip.com: This site provides comparisons of travel insurance policies offered by various companies. Note that you can buy directly through InsureMyTrip, and they make a commission from the sale. You may buy package policies for single trips via air, cruise, rail, or other method, and have trip cancellation, medical and dental coverage, along with lost or stolen baggage, collision damage on rental cars, and more. You may also buy medical policies and medical evacuation policies, among other offerings. Be sure to read the FAQ concerning coverage for cancellations due to terrorism and war or threats of war.
Trip and Travel insurance: This site sells insurance covering trip cancellation, interruption or delay, medical and medical evacuation, missing luggage, missed connections, and the inevitable more. Read the "Review Coverage" page for what the policy will not cover as well as for what it does.
Access America: Access America is an insurance company that provides cancellation insurance which covers the bankruptcy of your travel supplier, a consideration in the recent economy. It also offers coverage for lost baggage, missed connections, trip cancellation/ interruption, emergency medical expenses and transportation, and coverage for rental cars. Access America offers a 24-hour hotline with multilingual operators to assist you in getting emergency treatment, refer you to legal assistance, provide cash, and get your lost baggage to you. As this is insurance, not service, you are on your own to arrange for evacuation and seek reimbursement later.
Medex Assist: For individuals, Medex provides programs for emergency evacuation, repatriation, and medical assistance while abroad. Medex has programs for long term residents abroad, short-term travelers to countries other than the United States, and medical insurance and assistance for foreign nationals visiting the United States. In addition to medical evacuation, Medex has services for replacement of lost documents, emergency translation services, referrals to local lawyers, and even emergency pet housing and return. Medex is US-based with an office in England and telephone numbers worldwide.
MEDJET ASSISTANCE: If you become ill or injured in the United States or abroad, MedJet will fly you to the hospital of your choice in a medically- equipped jet with a trained staff. MedJet is a subscription service -- pay an annual fee, and if you need the service, it is provided at no additional charge. Among the advantages of MedJet are that "medical necessity" is not a requirement for transport to another hospital and that MedJet will transfer the patient even if the trip is entirely within the United States. US-based.
Air Response, Inc.: Air Response will do medical transports in medically- equipped jets with trained personnel. Costs depend on the job and may be covered by insurance if they are medically necessary. US-based.
Air Evac Services: Air Evac provides fixed and rotary winged aircraft for medical evacuations, but they operate in Arizona. Long distance transport is available in the fixed wing aircraft, and Air Evac can provide trained medical escorts anywhere in the world. US-based.
AirMD: Medical transportation in medically- equipped jets with medically- trained staff, international transport available with medically- trained escorts. Cost depends on the circumstances; your insurance may cover the trip. US-based.
International SOS: This is an insurance company. It provides trip cancellation or interruption insurance, but it also can cover medical expenses for short- term travelers. The company has offices around the world, and it can provide or arrange for emergency medical evacuation, guarantee of medical expenses, doctor and hospital referrals, bail bonds, legal assistance and referrals, and considerably more. This company may have a local office at your destination, making it a serious consideration. US-based.
Travel Care: This company provides emergency and non-emergency air ambulance service world- wide. The company can provide pre-flight medical evaluation, ground ambulance clearance, medical flight staff, and translators. According to circumstances, the company may use its own fixed wing aircraft or a commercial flight. Costs depend. US-based.
Austrian Air Ambulance: World wide air ambulance service based in Europe. AAA will provide assurance of payment for services already provided, and evacuation in a medically- equipped jet with professional staff. The call center is staffed with multi- lingual personnel. Vienna, Austria-based.
Euro-Flite Jet Ambulance: This company provides Western style medical service and air ambulance evacuation from the former Soviet Union. It operates a Falcon dedicated air ambulance jet. Helsinki, Finland-based.
Kazair West: Provides charters and will arrange domestic and international medical evacuations in standard commercial fixed wing and rotary aircraft (all products of the former Soviet Union). Kazakhstan-based.
Baja Safari Mexico Club: Members are entitled to medical evacuation repatriation on emergency and non- emergency bases, along with other benefits. Mexico-based.
Arab Wings Air Ambulance: Staff members are in the Royal Jordanian Airforce Rescue Team. Amman, Jordan-based.
Care Flight: When you see the chopper come in to Burning Man, it comes from Care Flight. Care Flight will bring you in from a 150- mile radius of Reno. Not only medical service, but rescue. Medically trained crew of two on an equipped helicopter. Reno, Nevada-based.
Magic Valley Regional Medical Center: MVRMC operates helicopter and fixed wing aircraft for transport and care of people in southern Idaho and northern Nevada. The air ambulance craft are described as mini-critical care units staffed by medically trained personnel. Twin Falls, Idaho-based.
Asia Rescue & Medical Services: ARMS provides medical repatriation from Bangladesh, Pakistan, Nepal, Sri Lanka, Bhutan, Thailand, and the Maldives. Staff members speak a variety of local languages and English and French. In addition to treatment, ARMS provides repatriation of mortal remains, escort doctors, air ambulances, cash advances, and airline ticketing and transfers. Unfortunately, no telephone number is given. Enquiries are invited through the Web site. South Asia-based.
AMEV: Real men will want their own Armored Medical Evacuation Vehicle, a converted M113 or M2A0 armored personnel carrier. Fantasy-based.

War, health and disease reports

Okay, so you finally got your visit to Alice Springs, and it was nothing like you had imagined from the book. You figure you had a bad night's sleep because your neck is stiff, you have a horrible headache, and you think you may throw up. Maybe it's the flu. You have mosquito bites, so maybe it's malaria -- or is that from tsetse flies? Can you get malaria in Australia? You sing "You can get anything you want in ... " Alice Springs? That doesn't make any sense. You're really really confused.

Worldwide Emergency Telephone Numbers: Not all of us will be up a mountain when we need a doctor. Check this list to see if it has medical, fire, and police numbers for your destination, then confirm the number upon your arrival.
CDC Travelers' Health: The United States's Centers for Disease Control has a Web site for health information on destinations. It is organized so that you can browse by destination, outbreaks, reference materials, and by special needs (pregnancy, HIV, and so forth). The site is current for outbreaks, and the material the CDC provides is not biased toward selling you stuff.
International Travel & Health: The World Health Organization's page on health risks at specific destinations.
US State Department Travel Warnings: The US State Department issues travel warnings for areas where there is danger from military strife, communicable disease, or crime. Additionally, the site alerts travellers to draconian drug penalties, currency restrictions, and unusual entry requirements. It also notes areas where Americans are targets.
UK Foreign & Commonwealth Office - Travel Advice by Country: The UK has a Web page with advice for travellers on conditions in many countries, including dangerous areas within the United States and health issues within the UK.
Australian Department of Foreign Affairs & Trade: Although set up to promote business in happier times, this site now offers travel advice and travel bulletins to its citizens, frequent travelers in Oceana and Southeast Asia. If that is your destination, this is a must-read site.
Canadian Consular Affairs: In English; en française. This site provides information and assistance for Canadians abroad. If you are in a location with a Canadian consul but not American, for instance, feel free to drop in if need be. In addition to dealing with problems abroad, the site offers Canada's reports on security, safety, and health in over 225 destinations, including the United States.
Consular FAQ for UK nationals: Designed for British subjects, this site provides general information on avoiding trouble while abroad. Although assistance even to British subjects is not required, serious consideration is given to humanitarian requests even from Americans.
iJET Travel Intelligence: iJet claims to manage travel risk through real-time travel alerts, breaking situations, and changing travel conditions. The fee-based service offers itinerary-specific information, breaking travel alerts, and a personalized Web site, with medical and travel assistance.
GlobalOptions, Inc.: GlobalOptions, Inc. provides international risk management and business information to travelers and their companies. Unlike many of the companies we list here, GlobalOptions will provide executive protection in addition to crisis management, integrating their security services with medical consequence management.
Shoreland: Shoreland is an outfit providing information for travel health professionals. In addition to tips on setting up a travel health clinic, the site provides brochures on planning for travel taking health issues into account and a take-along reference guide.
Travel Medicine: Travmed.com is a commercial site offering a newsletter for travelers and a catalog of products they claim are designed to keep you healthy. They offer a great many products for general travel, so you have to look for the emergency first aid kits, which include splints, protective clothing, rehydration salts, suture kits, water purifiers, and the like.
Medical Info 4 Life: This site sells a kit for you to carry with you when you travel. You fill out the forms in the kit and make it available to EMS personnel in an emergency. The filled in kit will give your medical history, current medications, and an alert for special medical issues which emergency personnel should know. More information than a MedicAlert bracelet; available in French and English.
MDtravelhealth.com: MDtravelhealth offers information on various countries and what health issues may have arisen there. For many countries, the site offers locations of health facilities, analysis of the quality of the care available, and special needs advice.

Training

Okay, so you have started off on a rocky trail on the side of a mountain early in the morning with Pat. Pat is leading the way, and you suddenly hear crunching and sliding and a "whoop!" from Pat. You run to the place you last saw him and look over the side of the mountain. Ten or fifteen feet down, you see him in a pile of rocks. Scrambling down, you assess the situation. Pat is conscious, there is a gash on his shin which is bleeding but not pumping blood, and something white and pointy is sticking out of the wound. Pat is laying on his side on a rock, and he complains in a whisper that it hurts really really bad to breathe. You just bought a first aid kit, so you climb back up to your pack and get it out. It even has a manual. You find the page on cuts, and you ask Pat to hold the book, but no response. He is sweating profusely, pale, gasping for breath, with a blotchy face. Sheesh! Now who is going to read you the instructions while you do first aid on the cut?

First Aid and Emergency Medicine: This is About.com's Web site. It contains links to information on first aid training, first aid basics and supplies, care for children and the aged, and first aid for travelers and wilderness adventurers. The site provides links to other sites, with ratings for the quality of information provided. An excellent starting point. Recommended.
Emergency Cardiovascular Care Programs: Training for CPR; sponsored by the American Heart Association.
First Aid, CPR, and AED Courses: The American Red Cross offers courses for professionals and private individuals.
Medic First Aid: Medic First Aid offers training programs from basic first aid through sports medicine.
First Aid for Soldiers: The American army's Field Manual 21-11. This is a very thorough guide to all that can go wrong with the human body and how to provide first aid treatment. Individual chapters of relevance to your trip may be downloaded as .pdf files, and the entire manual is available in a .zip compressed file.
NOTE: Reading a book does not train you; you need to take training courses to learn how to provide first aid.
Adventure Network First Aid: This is an attractive site with information on first aid, stings and bites, how to choose a kit, using fitness to prevent injury, and survival. Lots of brief articles on survival issues, including fixing a broken tent pole, treating scorpion stings, and choosing winter eyewear.
Wilderness Medical Associates: Take courses in first responder, first aid, and EMT, specially geared to what is referred to as the wilderness context: no ambulance is available, no one can call 911, help is not on the way. In addition to the courses, WildMed offers tips on preparing a wilderness first aid kit for your specific destination and other helpful information. Recommended.
NAEMSP Position Papers: This is the table of contents for position papers prepared by the National Association of EMS Physicians. The papers discuss a wide range of emergency treatment strategies, some of which are pertinent for those in adventure situations: Clinical guidelines for delayed or prolonged transport: wounds (including a discussion of when to remove impaling objects); prehospital air medical transport; indications for prehospital spinal immobilization. Serious issues discussed on a professional level.
Desert Expeditions (.pdf download of 1.3MB): A guide to dealing with desert conditions on a vehicle-based expedition, including maintaining heat balance, diet, navigation, and first aid.

Taking a break

Duct Tape

Homeland security on a roll -- how to save yourself from attacks with duct tape. Illustrated for the reading- impaired.

Frank's Compulsive Guide to Postal Addresses

How to address a letter to new-found friends in all those foreign countries you visited.

Making International Phone Calls

How to make an international call from anywhere. Instructions on dialing access codes from any country to any country, international phone directories, embassy phone listings, and more.

As always, if you have any objections, corrections, suggestions, or questions, drop me a line via Cyber Poste: