Purpose
Introduction
This chapter will cover potential contents for 2 types of travel health kits:
- Basic personal travel health kit
- Extended kit for a group going to a remote area, including items which may be brought by a licensed medical professional
These contents are suggested items and should be personalized based on several factors, including:
- The availability of local medical care and evacuation
- Itinerary, planned activities, and duration of the trip
- The number of people who may be treated
- The medical expertise in the group
- Space and weight for medical supplies
- How the kit will be carried
Personal travel health kit
All travelers should bring a personal first aid kit with basic medical supplies that depend on the traveler's health history and the type of trip. The goal of this travel health kit is to allow management of common minor illnesses and injuries, treatment of recurring problems, and continuing treatment of chronic conditions (see Travelers with Chronic Illnesses chapter). It is common practice for travelers to carry some prescription medications for presumptive prophylaxis and treatment in certain regions; for example, travelers' diarrhea, malaria, or altitude illness (see Travelers' Diarrhea, Malaria, and High-Altitude Travel and Altitude Illness chapters). Narcotics and psychoactive medications for personal use should be carried in the original prescription container and are limited in many countries to a 30-day supply or less (see Traveling with Prohibited or Restricted Medications chapter). Store medications and first aid supplies in a durable, water-resistant container and keep it readily accessible during the journey. See Table 1.9.1 for suggested content.
Table 1.9.1: Personal travel health kit
| Bandages and Wound Care | |
|---|---|
| Items | Use, Indication, or Comments |
| Adhesive bandages in various sizes | Minor cuts and scrapes; include waterproof options |
| Adhesive felt or gel pads | Blister prevention and treatment |
| Elastic bandage for sprains | 4-inch and 2-inch are most useful; can also use to secure large dressings |
| Gauze pads and non-stick dressings: 2 × 2 and 4 × 4 inch gauze | To clean and cover larger wounds; regular gauze and ointment create a non-stick dressing |
| Medical adhesive tape | To secure dressings |
| Self-adhesive bandage wrap | May be preferable to gauze or elastic wrap |
| Small bandage scissors | To cut bandages or tape; if in carry-on luggage, TSA permits scissors with blades less than 4 inches from the pivot point |
| Wound closure strips (“butterfly”) | Requires some expertise; clean wound before attempting to close; can alternatively use pieces of tape |
| Topical Medicines | |
|---|---|
| Items | Use, Indication, or Comments |
| Aloe vera gel | Sunburn, thermal burns, generally soothing for skin |
| Anti-itch lotion | May contain cortisone, antihistamine, moisturizers, or other soothing ingredients |
| Antifungal cream or powder | Treatment for presumed fungal skin infection or vaginal yeast infection |
| Antimicrobial ointment | Keeps dressings from sticking to wet scrapes or burns; softens dry, cracking wounds and crusts |
| Antiseptic wipes or solution | Benzalkonium chloride or alcohol wipes |
| Hydrocortisone cream | For rashes |
| Medicines for Common Problems | |
|---|---|
| Items | Use, Indication, or Comments |
| Acid blockers or antacid
(e.g., omeprazole, famotidine) |
If prone to reflux or gastritis |
| Antihistamines | Allergies and allergic reactions; if using “sedating kinds,” such as diphenhydramine and hydroxyzine, may also be used for sleep or intestinal cramps (age >2 years) |
| Aspirin, acetaminophen, or ibuprofen | Pain relief, arthritis |
| Cough drops or throat lozenges
(with benzocaine) |
Cough, sore throat, irritation from dry, cold air at altitude |
| Decongestant tablets or spray
(pseudoephedrine, not phenylephrine) |
Nasal congestion, ear pressure when flying |
| Loperamide | Non-bloody diarrhea (see Travelers’ Diarrhea chapter) |
| Meclizine or scopolamine | Motion sickness (see Motion Sickness chapter) |
| Mild laxative such as
milk of magnesia tablets, stool softener, teas |
If prone to constipation |
| Oral electrolyte solution powder | For rehydration of moderate-severe diarrhea or vomiting (available in low-income countries) |
| Prescription Medications—Include All Regular Personal Prescription Medications | |
|---|---|
| Items | Use, Indication, or Comments |
| Acetazolamide and/or dexamethasone | Altitude illness prevention and treatment (see High Altitude Travel and Altitude Illness chapter) |
| Albuterol inhaler | If history of asthma or wheezing |
| Antibiotic for travelers’ diarrhea, if prescribed | Presumptive treatment for moderate to severe travelers’ diarrhea (see Travelers’ Diarrhea chapter) |
| Antibiotic—specific for likely problem | If personal history of recurrent urinary, sinus, skin infections |
| Epinephrine auto-injector | If history of severe allergic reactions (anaphylaxis; Severely Allergic Travelers chapter) |
| Malaria chemoprophylaxis | If traveling to an endemic area (see Malaria chapter) |
| Needles and syringes | If regularly self-administered injectable medication like insulin (carry copy of prescription) |
| Spare prescription glasses or contacts | |
| Instruments and Equipment | |
|---|---|
| Items | Use, Indication, or Comments |
| Digital thermometer | Bring plastic sheaths to use orally or rectally |
| Headlamp | Helpful for remote areas, power outages, or emergencies |
| Tweezers | Splinter or tick removal |
| Documentation (Hard Copy or Digital) | |
|---|---|
| A medical summary stating diagnoses, regular medications (generic, not trade names), and allergies, in case medical care is necessary while traveling | |
| Copy of advanced medical care directive, including DNR information | |
| Electrocardiogram if previously abnormal, history of heart or lung disease, or older than 50 years | |
| Emergency contact card | |
| International Certificate of Vaccination or Prophylaxis (ICVP or Yellow Card) | |
| Travel and healthcare insurance information | |
| Travel-sized first aid manual or guide (Box 1.9.1); need 1 for a group |
| Preventive Items, as Applicable | |
|---|---|
| Items | Use, Indication, or Comments |
| Condoms, other barrier precautions, or other contraceptives | See Sex and Travel chapter |
| Exam gloves | Infection control and personal protection |
| Face mask or N-95 respirator | Respiratory infection protection |
| Insect repellent | See Mosquitoes, Ticks, and Other Arthropods chapter |
| Lip balm with sun protection | For dry, cracked lips |
| Mosquito net | Malaria and insect bite prevention |
| Personal hygiene items | Hand sanitizer, disinfectant or wet wipes, facial tissues, menstrual pads or tampons |
| Sunscreen (SPF 30 or greater) | Zinc oxide cream provides the most complete sun protection for nose, lips, and face (see Sun Exposure in Travelers chapter) |
| Water purification tablets or device | If clean water will not be available or if using surface water (see Water Disinfection for Travelers chapter) |
| Travel With Children (see Traveling Safely With Infants and Children chapter) | |
|---|---|
| Age-appropriate doses and products for malaria prevention, travelers’ diarrhea, and insect repellents | |
| Medication for pain, fever, allergy, with syringe or medicine cup to measure | |
| Safety equipment, including car seat, flotation device, or helmet |
Notes
Abbreviations: TSA, U.S. Transportation Security Administration; DNR, do not resuscitate; SPF, sun protection factor.
Expanded travel health kits
This list includes items to consider for extended remote travel or expedition in addition to items in the personal kit (Table 1.9.2; see Adventure Travel chapter). No kit will include all these items, and this list is not comprehensive. The traveler assembling the kit should add, substitute, or omit items based on the criteria listed above.
Guides and group leaders with advanced first aid training should begin with contents listed for the personal first aid kit and add items from the expanded kit, according to their level of training and the specific risks of the trip. In addition, they should carry safety and rescue items. Guides and leaders will often need to rely on medical expertise and supplies among the other group members.
In most cases, injectable medications provide little advantage over oral or topical drugs, but they can be added without significant bulk and weight. On the other hand, intravenous fluids are very heavy and bulky.
For certain expeditions or remote group travel, a medical professional may be designated. More often, in the event of illness or injury to a group member, another member of the group volunteers to help under the liability protection of a Good Samaritan. Typical requirements in the United States for acting as a Good Samaritan include:
- There is an emergency
- The provider is not responsible for the injury
- No prearranged duty to treat
- No reward or compensation for services
- No gross negligence
The standard of care provided in a remote location considers resources available, accessibility to a higher level of care, and ultimately what a healthcare professional with similar training would do in a similar situation.
Table 1.9.2: Expanded travel health kit
| Bandages and Wound Care | |
|---|---|
| Items | Use, Indication, or Comments |
| Adhesive tape (cloth-type, athletic) 1–2 inch | Very versatile tape: secure dressings, tape over blisters, tape sprains and sports injuries |
| Bandage scissors or larger “trauma” scissors | Can use a sharp knife or a pocketknife with small scissors; sewing stores sell small folding scissors; if in carry-on luggage, TSA permits scissors with blades less than 4 inches from the pivot point |
| Eye pads | Can use folded gauze |
| Gauze roll (3–4 inch wide) | Hold dressings more securely and comfortably than tape where there is hair, movement, or moisture; for narrower wrap, fold while wrapping |
| H-shaped adhesive strips (knuckle bandages) or large size (2–3 inch wide) adhesive strips | Convenient but tape and gauze can be used |
| Hypoallergenic medical tape (½–1 inch) | Easy to remove, does not cause skin irritation |
| Occlusive dressing | Provides sealed coverage of wounds |
| Scalpel blade (#15) | Incision and drainage of abscess; minor debridement |
| Small syringes and needles | For local anesthetic or other injectable medications |
| Splint (padded, flexible aluminum) | Splint any small to medium-size joint |
| Splinter forceps | A hypodermic needle can also be used for probing in the superficial skin layer |
| Suture material, non-absorbable and absorbable | Wound stapler is an alternative but is bulky |
| Suture set | Needle holder or straight clamp and forceps |
| Trauma pad (ABD-abdominal pad) | Can use large menstrual pad |
| Wound closure strips or cyanoacrylate skin adhesives | Hold together edges of small cuts; medical skin adhesives are easy to use but expensive; ethyl-cyanoacrylate (e.g., “super glue”) contains the same substance and may be the only option available |
| Miscellaneous Equipment | |
|---|---|
| Items | Use, Indication, or Comments |
| Duct tape | Many uses; wrap some around a rod or tube |
| Emergency space blanket | An emergency thermal layer or ground tarp for injured or ill person |
| Exam gloves, non-sterile | Infection control and personal protection |
| Expandable foam nasal packing or silver nitrate sticks | Nosebleed requiring packing or cautery |
| First aid references | See Box 1.9.1 for options |
| Foley catheter (12–14 gauge) | Urinary retention (a true emergency) |
| Knife or multifunction tool | Standard guide equipment with many uses |
| Lubricant packets | For some examinations or for placement of foley catheter |
| Medication envelopes or plastic bags (small) | For providing medication to a group member |
| Nasal, oral, or supraglottic airway | Maintain airway in unconscious, breathing victim |
| Note paper and pencil | Recording medical and location information for communication or evacuation; could use phone note |
| Otoscope | |
| Oxygen saturation fingertip monitor | Small, portable, inexpensive, and provides important information for respiratory problems and altitude illness |
| Packets of oral rehydration solution (ORS) | Diarrhea, significant dehydration; heat illness |
| Pocket CPR masks | Masks remove the need to do mouth to mouth resuscitation |
| Small nasogastric feeding tube | For fluids if severe dehydration |
| Small syringes and needles | For local anesthetic or other injectable medications |
| Stethoscope | |
| Tactical or military-style tourniquet | For severe limb trauma with large vessel bleeding |
| Thermometer | Extended range thermometer to measure for fever or for hypothermia |
| Diagnostics | |
|---|---|
| Items | Use, Indication, or Comments |
| Blood pressure cuff | |
| COVID-19 rapid test kits | |
| Fluorescein strips | Aid in diagnosis of corneal abrasion, UV keratitis, corneal ulcer |
| Pregnancy test kit | |
| Urine dipsticks | |
| Documents | |
|---|---|
| Items | Use, Indication, or Comments |
| Medical certificates and licenses | For the healthcare professionals in the group |
| Pertinent medical information of group members | Allergies, medication lists, and active health problems (voluntarily provided) |
| Topical Medications | |
|---|---|
| Items | Use, Indication, or Comments |
| Antifungal cream (miconazole, tinidazole, clotrimazole) | Treatment of presumed fungal dermatitis: irritating, itchy, red skin rashes; some products combine with cortisone cream |
| Benzoin ampule/swabs | Helps tape or moleskin stick to skin; apply to skin, wait 30–60 seconds until sticky, then apply tape |
| Glucose or dextrose paste | Hypoglycemia; could use honey or sugar under buccal mucosa |
| Hemorrhoid suppositories or ointment (contain various ingredients: zinc oxide, topical anesthetic, cortisone, phenylephrine) | Pain and itching of hemorrhoids |
| Permethrin cream 5%, lotion 1% | Treatment of scabies and lice |
| Temporary dental filling
or zinc oxide eugenol cements |
Lost fillings, newly painful cavities, broken teeth |
| Tincture of iodine (2%) or betadine solution (10%) | Topical disinfectant for cleaning wounds; make a dilute (10:1) betadine solution to use directly on or in a wound but can use full strength on intact skin |
| Topical ophthalmic anesthetic | Corneal abrasion or removal of foreign body on cornea |
| Zinc oxide cream | Sun protection and generally soothing cream for irritated skin; the most complete sun protection for nose, lips, face |
| Prescription Drugs | |
|---|---|
| Items | Use, Indication, or Comments |
| Bronchodilator inhaler | Asthmatic wheezing brought on by exertion, cold, allergy, smoke, or infection |
| Diazepam 5 mg | Sedation; also consider an antipsychotic (e.g., haloperidol or olanzapine) |
| Epinephrine 1 mg/mL self-injecting, ampule, or multi-dose vial | Life-threatening allergic reactions; include even if no known history of severe allergy or asthma in the group, since an individual may have a new reaction to bee sting or food allergy (see Severely Allergic Travelers chapter) |
| Hydrocodone 5 mg or codeine 32 mg; both come combined with acetaminophen/paracetamol | Moderately severe pain; also effective for cough suppression, diarrhea, and abdominal cramps (see Traveling With Prohibited or Restricted Medications chapter) |
| Injectable diazepam or lorazepam | Intractable seizure; intramuscular as effective as intravenous |
| Lidocaine 1% injectable | Wound closure with sutures, or incision and drainage |
| Naloxone | Narcotic overdose, if carrying injectable narcotic or for a group with unfamiliar members (see Substance Use and Substance Use Disorders in Travelers chapter) |
| Ondansetron 4–8 mg dissolving tablets | Nausea and vomiting |
| Prednisone 20 mg | Asthma, allergic reactions |
| Antibiotics and Other Anti-Infection Medication | |
|---|---|
|
The antibiotics below are suggested options because they are inexpensive, widely available in many countries, and have multiple overlapping uses. If a parenteral (injectable) antibiotic is desired, consider selecting one that can be given intramuscularly and has broad coverage (e.g., ceftriaxone). One approach is to consider common infections by organ system. For more detailed infectious diseases and antimicrobial considerations, see The Sanford Guide to Antimicrobial Therapy (Box 1.9.1) or the specified Yellow Book chapter below. Travelers’ diarrhea (see Post-Travel Diarrhea chapter): 1st choice azithromycin; 2nd choice ciprofloxacin Urinary tract infections: 1st choice nitrofurantoin or ciprofloxacin; 2nd choice trimethoprim-sulfamethoxazole Respiratory infections (see Post-Travel Respiratory Infections chapter): 1st choice azithromycin, 2nd choice amoxicillin, tetracycline, or amoxicillin/clavulanate Skin infections (see Post-Travel Dermatologic Conditions chapter): 1st choice cephalexin, 2nd choice dicloxacillin or flucloxacillin, doxycycline, or trimethoprim-sulfamethoxazole Sexually transmitted infections (see Sex and Travel chapter): azithromycin, doxycycline, or ceftriaxone |
| Additional Anti-Infectives | |
|---|---|
| Items | Use, Indication, or Comments |
| Fluconazole | Vaginal yeast infection; can also use cream (e.g., clotrimazole, miconazole) |
| Ophthalmic antibiotic ointment or drops: ofloxacin 0.3% or genoptic | Bacterial conjunctivitis or corneal ulcer |
| Otic (ear) drops: neomycin, polymyxin b and hydrocortisone solution; ciprofloxacin with dexamethasone | Otitis externa; could use ophthalmic drops but will not contain steroid |
| Tinidazole, metronidazole | Giardia and other protozoa |
| Cardiac Medications (Especially if a Group of Older Adults); see Travelers With Chronic Illnesses chapter | |
|---|---|
| Items | Use, Indication, or Comments |
| Aspirin 325 mg | Angina, suspected acute cardiac syndrome |
| Diltiazem or metoprolol | Blood pressure, angina, rhythm control; may need oral and injectable |
| Furosemide or bumetanide tablets | Diuresis with congestive heart failure; avoid if sulfonamide allergy |
| Nitroglycerine tabs, spray, patch or paste | Chest pain of presumed cardiac origin |
| Specific Environment Additional Considerations: High-altitude (see High Altitude Travel and Altitude Illness chapter) |
|
|---|---|
| Items | Use, Indication, or Comments |
| Acetazolamide 125 or 250 mg tablets | Prevention and treatment of AMS |
| Dexamethasone 2 or 4 mg tablets | Prevention and treatment of AMS |
| Hyperbaric bag | Stabilize serious altitude illness; heavy and bulky, so for major expeditions or larger groups |
| Nifedipine, sildenafil, or tadalafil | High altitude pulmonary edema |
| Oxygen saturation monitor | Battery operated, fingertip monitor |
| Specific Environment Additional Considerations: Jungle and Forest | |
|---|---|
| Items | Use, Indication, or Comments |
| Artemether-lumefantrine or atovaquone-proguanil | Breakthrough malaria treatment when diagnostics or local care are not available; appropriate malaria chemoprophylaxis is first approach (see Malaria, Reliable Supply section) |
| Doxycycline 100 mg | Presumptive treatment of tick-borne rickettsial infections; may also be used for prophylaxis of leptospirosis in adults (200 mg orally, weekly) begun 1–2 days before and continuing through the period of exposure (see Leptospirosis chapter) |
| Insect repellent
DEET; IR3535; permethrin |
Topical repellents for skin; permethrin is to treat clothing or bed nets (see Mosquitoes, Ticks, and Other Arthropods chapter) |
| Malaria rapid antigen test kit | Helps determine need for treatment and evacuation (see Malaria, Diagnosis section chapter) |
Notes
Abbreviations: TSA, U.S. Transportation Security Administration; OR, oral rehydration solution; CPR, cardio-pulmonary resuscitation; UV, ultraviolet; AMS, acute mountain sickness; DEET, N,N-diethyl-meta-toluamide
Box 1.9.1
- Brandenburg, W. E., & Locke, B. W. (2017). Mountain medical kits: Epidemiology-based recommendations and analysis of medical supplies carried by mountain climbers in Colorado. Journal of Travel Medicine, 24(2), 1–9. https://www.doi.org/10.1093/jtm/taw088
- Dobiesz, V. A., & Sullivan, W. (2017). Medicolegal issues in expedition and wilderness medicine. Emergency Medicine Clinics of North America, 35(2), 485–494. https://www.doi.org/10.1016/j.emc.2017.01.004
- Iserson, K. V. (2013). Medical planning for extended remote expeditions. Wilderness & Environmental Medicine, 24(4), 366–377. https://www.doi.org/10.1016/j.wem.2013.05.005
- Keystone, J. S., Kozarsky, P. E., Connor, B. A., Northdurft, H. D., Mendelson, M., & Leder, K. (2019). Travel medicine (4th ed.). Elsevier