The Travel First Aid Kit

1. A Checklist for the Perfect Travel First Aid Kit

The composition of a personal travel first aid kit is inevitably a personal decision – and ultimately a risk assessment. After all, the density and quality of healthcare can vary significantly depending on the country [1].

Even if a nearby clinic can be found abroad, this – depending on the country – does not automatically guarantee the availability of all relevant medications. Additionally, medication quality abroad may adhere to different standards or even be subject to counterfeiting [1].

Nevertheless, no travel first aid kit will be prepared for every eventuality. Therefore, all recommendations made here should only be considered as "options" and, in case of doubt, should definitely be discussed with the treating physicians before the trip [1].

Of course, the suggested medications should only be used if the indication (the reason for taking them) is clear. Again, an individual consultation with a physician may be necessary [2].

1.1. Travel First Aid Kit for Adults

A practical travel first aid kit for adults might include the following [1-4]:

• Personal maintenance medication: This should be self-explanatory. Additionally, every pre-existing condition, such as respiratory diseases or diabetes, presents specific risks. These should be clarified individually with the respective healthcare providers.
• A personal certificate when carrying narcotics: People who rely on narcotics in daily life should carry a specific medical certificate when traveling abroad. This ensures the necessary personal use can be documented.
• A first aid kit including disinfectant: Essential for treating wounds. A small pair of tweezers for removing splinters and a tick remover are also useful.
• A thermometer: Without one, it is impossible to accurately assess your body temperature.
• Mosquito protection in malaria areas: This should include a mosquito net, a skin repellent, and an impregnation agent for clothing and the mosquito net. Many mosquito repellents also help against tick bites.
• Electrolyte powder such as "Elotrans": Useful for counteracting significant electrolyte loss due to diarrhea.
• Ibuprofen: A "classic" over-the-counter pain reliever that helps with all kinds of pain and also reduces fever. It should only be taken for a limited time and in recommended doses, as it can affect the kidneys and stomach lining if overused.
• Paracetamol: Also reduces fever and relieves pain. A good alternative to ibuprofen. Here, the liver is the "limiting factor," so it should only be taken temporarily and in recommended doses.
• Loperamide: Can be used short-term for diarrhea (without fever and without cramping abdominal pain). Always follow the package insert.
• Dimenhydrinate (also known as "Vomex"): Effective against nausea and vomiting. It is also available in chewing gum form. Be sure to follow the package insert and avoid overuse.

At this point, it should be noted again that this list does not claim to be complete, nor can it replace consultation with treating physicians. Rather, the list should serve as a basis for discussion and then be tailored individually [1, 3].

1.2. Travel First Aid Kit for Children and Babies

For young children, a practical travel first aid kit might include the following [1-9]:

• Personal maintenance medication, if any: While pre-existing conditions are rarer in children than in adults, it is even more important to treat them adequately on vacation if they do exist. This also applies to potential complications of the respective condition.
• A first aid kit including disinfectant: Just as important for treating wounds in children as in adults. A small pair of tweezers for removing splinters and a tick remover are particularly useful for children. Highly recommended.
• A thermometer: Children are prone to febrile infections. To assess the situation correctly and to respond promptly with fever-reducing medication, a thermometer is indispensable.
• Mosquito protection in malaria areas: Also applies to children. This should include a mosquito net, a skin repellent, and an impregnation agent for clothing and the mosquito net.
• Electrolyte powder such as "Elotrans": Useful for counteracting significant electrolyte loss due to diarrhea, just as in adults.
• Ibuprofen and Paracetamol: Both medications can be used in childhood and are effective against fever and pain. However, it is crucial to follow the package insert for age-appropriate dosages and limitations. Long-term use is not recommended. Both drugs are available as tablets, powder for dissolving, or suppositories, which can be relevant depending on the child's age.
• Diarrhea medication: Great caution should be exercised with children. Certain "probiotics" and the substance "racecadotril" may be suitable for children. However, you should consult your pediatrician beforehand.
• Dimenhydrinate (also known as "Vomex"): Effective against nausea and vomiting. It can also be used in children. If vomiting prevents taking tablets, the active ingredient is also available in suppository form. It should only be used when general measures such as careful food intake and giving small amounts to drink are not sufficient. The medication only alleviates symptoms and does not address the cause.
• Moisturizing eye drops: These should be without active ingredients and preservatives. Useful for non-infectious conjunctivitis, which can also affect children.
• Betaisodona solution: A "must-have" for wound disinfection and simple skin infections. Should be part of every travel first aid kit – also for children.
• Noscapine (e.g., Capval®) for dry cough: The medication works against dry, irritating cough and can be used in children. This can be particularly useful at night to ensure adequate sleep. However, you should discuss this with your pediatrician before the trip.
• Daktar: The cream works against skin fungus and should be part of every travel first aid kit – also for children.
• Fenistil gel: Relieves symptoms of allergic rashes and insect bites. Also suitable for children and harmless.
• Adequate sun protection: Sun protection is indispensable for almost every trip and should be included in every travel first aid kit. Children are particularly sensitive and therefore especially dependent on sun protection.
• Decongestant nasal drops: Useful for mild colds and essential for middle ear infections, which children are particularly prone to. Therefore, indispensable for the travel first aid kit.

When it comes to children and babies, the use of medications requires even greater care. Therefore, it is highly recommended to discuss with your pediatrician before the trip which medications make sense and how to use them.

1.3. Travel First Aid Kit for Pregnant Women

Pregnant individuals can generally follow the above checklist for adults. Medications purchased in German pharmacies typically include a package insert that informs about any risks and dosage adjustments – for example, in the case of pregnancy.

As with other individuals, pregnant women should use the above checklists only as a guide and discuss the list in detail with their treating physicians. It is also important to ensure that all vaccinations necessary for pregnancy have been administered.

Generally, during pregnancy, it is advisable to avoid the following travel-related medications [10, 11]:

• Ibuprofen in the 2nd and 3rd trimester: This also applies to related substances such as diclofenac and (with exceptions) aspirin. Instead, pregnant women should use paracetamol for pain relief and fever reduction.
• Dimenhydrinate ("Vomex") in the 3rd trimester: The substance effective against nausea should no longer be used by pregnant women in the 3rd trimester, as it can otherwise increase the risk of preterm birth. There are numerous alternatives that your obstetrician can explain to you.
• Certain antibiotics: The substances to be avoided during pregnancy include cotrimoxazole, fluoroquinolones, rifampicin, linezolid, aminoglycosides, tetracyclines (e.g., doxycycline), and tigecycline. Here, too, your obstetrician can advise you on suitable alternatives.

2. Travel First Aid Kit for Popular Vacation Destinations

2.1. Egypt

For Egypt, there is no need for significant deviations from the above-listed travel first aid kit [12, 13].

Additionally, there is no malaria season in Egypt throughout the year, so malaria prophylaxis is not necessary before the trip [12, 13].

2.2. Mexico

For Mexico, the above travel first aid kit serves as a useful guide. However, it is important to note the risk of malaria [12, 13]:

There is a low risk in the southern province of Chihuahua and the northern province of Chiapas, as well as a minimal risk in the provinces of Campeche, Cancún, other parts of Chiapas, Durango, Jalisco, Nayarit, Quintana Roo, San Luis Potosí, Sinaloa, Sonora, and Tabasco [12, 13].

The rest of the country is considered malaria-free. Depending on your travel destination, it may be advisable to consult a tropical medicine institute before your trip [12, 13].

2.3. Thailand

Those traveling to Thailand will find the above travel first aid kit generally suitable. Similar to Mexico, special attention should be given to malaria prophylaxis [12, 13]:

The risk of malaria is present in some parts of Thailand throughout the year. There is a high risk in the regions directly bordering Myanmar in the west. A low risk exists in the region around Tak and on the island of Little Koh Chang [12, 13].

In the rest of the country, the risk is considered minimal. This includes popular travel destinations such as Phuket, Koh Samui, Koh Phangan, Koh Samet, and the islands of the Krabi province [12, 13].

Major cities such as Bangkok, Chiang Mai, Chiang Rai, and Pattaya are considered malaria-free [12, 13].

Therefore, a consultation with a tropical medicine specialist is advisable before a trip to Thailand [12, 13].

3. Travel First Aid Kit for Backpacking, Camping, and More

Besides general health and destination, the type of travel is also relevant for choosing a personal travel first aid kit [2].

The further away from civilization the travel destination is, the harder it is to get medical help in case of illness. At the same time, there may be a need for as light travel luggage as possible, especially on trekking tours [2].

The decision between "potential over-preparation" or "minimal version" in choosing the travel first aid kit cannot be taken away from anyone here. We point out, however, that the above-listed medications are available in small pack sizes [2].

As a rule of thumb: the more remote and longer the outdoor experience is planned to be, the more sensible a well-equipped travel first aid kit is. We strongly recommend an individually advised consultation with a physician [2].

4. Assembling or Purchasing a Pre-made Travel First Aid Kit

Although there may be providers selling "pre-made" travel first aid kits in sets, this is not advisable. The selection of a travel first aid kit should always be done individually and in consultation with the treating physicians [2].

However, individual elements of the travel first aid kit – such as a first aid kit or all materials for mosquito protection – can certainly be purchased in sets and then supplemented with personally important medications [2].

Conclusion

The contents of this article reflect the current scientific state of knowledge at the time of publication and were written to the best of our knowledge and belief. However, the article cannot replace medical advice and diagnosis. For any questions, please consult your general practitioner.