This summer, I was asked to recommend medical supplies to a mountain bike team riding the Trans-Cascadia backcountry mountain bike race. First responders, like mountain bike racers, must balance having the appropriate medical equipment commensurate with skills, while keeping one’s kit as light and compact as possible. The minimum requirements for first responders in most states is Basic Life Support (BLS) include American Heart Association/American Red Cross Basic Life Support (CPR), First Aid, and Blood Borne Pathogen training. Here is a shortlist of the bare essential for BLS personnel which may be useful for backcountry skiers and snowboarders.

Minimum BLS Gear for every responder

1. Personal Protective Equipment: CPR Mask, 2 pairs of medical gloves, eye protection, and a medical face mask.
2. Cloth Medical Tape (athletic or waterproof) can be used to make a splint, secure a cervical collar, bandage an open wound, create an upper extremity sling and swath, cover blisters, and repair gear.
3. Hand Sanitizer, alcohol or benzalkonium, is to disinfect rescuers’ skin.

Optional Supplies for individuals or team, depending on length of outing

1. Malleable splint (SAM), to fashion an extremity splint.
2. Adhesive compression wrap (Coban, Coflex), gauze roll and/or ACE bandage, for bandaging and splinting.
3. Paper tape for blisters or commercial blister bandages (duct tape is a reasonable substitute).
4. Glucose paste, electrolyte powder, or sports gel for hypoglycemia
5. Epinephrine (autoinjector or ampoule including syringe/needle) and non-sedating antihistamine (loratadine or cetirizine) where laws/protocols allow.*
6. Headlamp, while not really medical, is essential for after-dark patient care
7. Small tarp or space blanket, for exposure.
8. Paper and pencil to document care
9. Small first aid kit, for basic wound care and over the counter medications, is optional:
   1. Acetaminophen
   2. Antihistamine, preferably non-sedating
   3. Antiseptic wipes
   4. Antibiotic ointment
   5. Syringe, 20 cc
   6. Adhesive bandages
   7. Butterfly bandages
   8. Gauze, 4×4
   9. Non-adherent dressing, 4×4
   10. Forceps, small
   11. Safety pins

*Epinephrine autoinjectors are more expensive and have shorter shelf-life compared with ampoules. Most states restrict this to personal use, not for third party administration, for BLS responders. MRA members should check with their medical control.