Trip Name:________________________
Trip Equipment Process:
1. Request Equipment & turn it in to the
Coordinators/ Expy Staff by Wednesday
2. Expy Staff pulls equipment
3. Leaders check all equipment off trip sheet
4. POST TRIP: Mark broken equipment first
aid used on back of this sheet & w/repair
tags
5. Expy Staff dry, clean, put away and repair
returned gear
Leader
Req.
Expy
Out
Out
Trip Leaders:
.
Date of Trip: ___________________
..
Number of Participants:
Expy Staff Sign Out (Circle):
Corey
Corey
Leader
Req.
MSR Whisper Light
Stove
Bennet
Expy
Out
Anna
Out
Haley
Bennet
In
w/ Tyvek ground tarp
Coleman Stove
Sleeping Tarp, four person
w/ green ground tarp
w/ one or pair of trekking poles
Pyramid, three person
w/ 1 gal fuel tank & hose
Cooking
Haley
Tent, four person
Shelter
Pump Bottle
Storage Bottle
Anna
.
Expy Staff Sign In (Circle):
In
w/ 1 MSR Pump Bottle
Extra Fuel Bottles (total)
w/ black ground tarp
w/pair of trekking & connector
poles or pyramid pole
Pots (total)
3 Quart
4 Quart
First Aid Kit
Frying Pan
Square/Clothing Happy Sacks
Cooking Kit
Rectangle/ Sleeping Bag
Happy Sacks
w/ Foot Care Kit, Resource
bag, Wound Care Kit, Epi
Kit, Miscellaneous bag,
Trauma Kit, Medications bag
w/ sump screen, sponge,
soap, dip cup, pot grips, 2
spoons
Other
(1 per person)
Animal Resistant Food
Canisters
- w/ trowel, TP, hand
sanitizer, bio bags (12)
Water Filter Kit
Vehicle (circle):
12 Person Mini Van
w/ Dromedary
Other Misc.
Winter
Chains
Ice Scraper
Kitty Litter
Gazetteer
Van Brush
Van Safety Equipment
- w/ cone & vest
(1 per person)
Poop Kit
(9-10 recommended for
a 11 person trip)
Van
.
Any Equipment issues: (please describe)
Please mark quantity of First Aid Equipment used
Leader First Aid Kit Contents
Quick Reach kit:
Wound Care and Prevention:
__ Trauma Shears (1 large)
__ Mole Skin (8x3) (2)
__ 1” Roll of Athletic Tape (1)
__ Band-Aids (10)
__ Tampons (3)
___ Latex-Free Gloves (1 Lg & 1 Med)
___ Roll of Sterile Gauze (1)
___ 4 x 3 pads (2)
___ 4 x 4 pads (2)
___ 3” Coban Self-Adherent Wrap (1)
___ Povidone Iodine Bottle (1)
___ Irrigation Syringe (1)
___ Mole Skin (8x3)
___ 1” Roll of Athletic Tape (1)
___ 2” Roll of Athletic Tape (1)
Packaged Trauma Materials:
__ 4 x 3 pads. (2)
__ 4 x 4 pads. (2)
__ Stretch gauze rolls (2)
__ Gloves (2 pair: 1 Lg, 1 Med)
__ Maxi Pads (1)
Medications (see reverse for info):
__ Acetaminophen (4 packets)
__ Anti-Inflammatory (10 packets)
__ Antacid (3 packets)
__ Anti-Diarrheal (8 pills)
__ Decongestant (10 packets)
__ Triple-antibiotic (6 Packets)
__ Hydrocortisone (5 Packets)
Splinting:
___ Ace bandage (2) *Contains Latex
___ SAM Splint (1)
Epinephrine Kit
__ Epinephrine bottle (1)
__ Sterile Syringes (4)
__ Antihistamine (10 packets)
Miscellaneous:
___ Maxi Pads (3)
___ Tampons (3)
___ H20 treatment – AquaMira parts A&B
___ Extra Aqua Mira Caps (6)
___ Lighter (1)
___ Tempa-Dots (3) or Dig. Them. (1)
___ Tweezers (1)
___ Safety Pin (1 large)
___ Bio-hazard bag
___ CPR Face Shield (1)
Resources:
___The Wilderness Medicine Handbook
___SOAP notes (3) & Incident forms (5)
___Pencil
___ Repair supplies –tent pole sleeve & backpack hip buckle
August 2015