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  1. Thanks for this very practical post. Do you have an opinion on clotting powder / quick clotting gauze? I’ve been carrying some in my bikepacking first aid kit for years (never used, knock wood…) and had the impression it could be helpful for an untrained person like me in situations that are somewhere between “boo boo” and “don’t die.” But maybe it’s just not very effective compared to the tourniquet you recommend?

    1. I don’t have a ton of experience or info on clotting powder/gauze, but I doubt they’d do more than just slow an ooze. Tourniquets are for worst-case scenarios – you only want to use one if someone is going to die from bleeding. They’ll almost always lose that limb, though 🙁

  2. Hi Doctor,
    Could you please recommend a good compact, MTB first aid kit?
I recently bought a Tourniquet and do have a compact firstaid kit,
but it’s still too big for my hydration pack storage compartment. I suppose I can take out the essentials. Please advise. Thanks!

    1. Hi Norbert – The MyMedic Solo or CycleMedic are great compact first aid kits. If you already have one, though, I recommend making it work for you. You could just take a few essentials on shorter, closer-to-home rides and then put together a more complete kit for longer, backcountry rides. I like to use a small dry bag for my med kit that I can add/subtract items from depending on the type of ride.

    2. Surgeon here. Good list and some interesting choices above. I carry a similar “boo kit,” rehydration salts, a SAM splint (can use for long bone fractures and as a c collar), and importantly – a cell and satellite phone if I’m off grid. I do wonder about the use cases of the other items. Tourniquets, decompression needles, and combat gauze are all essentials in scenarios where you would encounter penetrating trauma and arterial hemorrhage, not sure how much that happens in mtb. I guess anaphylaxis can happen anywhere but can’t think why it would occur to such a greater extent on rides that one would want to carry an epi pen. For a lot of the devastating spine and head injuries that do happen in mtb, there is not much you can do in the field, hence the importance of always having a means to contact the outside world to expedite hospital transfer.

      Great list and thanks for writing on this topic!

      1. Good call on the cell/sat phone – that’s a good tip. For the more advanced items, I guess it depends on what type of mountain biking you’re doing. Long cross-country rides aren’t going to require tourniquets and decompression needles. But more high-stakes riding with big features can definitely result in a collapsed lung or handlebar lever puncture to a major vein/artery.

        Anaphylaxis is rare and people with known allergies should carry their own epi pen. That being said, my dad had to use one on his friend who didn’t know he was allergic to bees. Saved his life.

        Thanks for your tips/input and stay safe!

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