Paul Willet is not only a very experienced and talented kayak fisherman, but an adventurous world traveler, and he makes his living as a full-time paramedic in the San Francisco Bay Area. It pays to have someone as talented and dedicated as Willet on remote kayak-fishing trips, but if you can't- then at least pay attention to his well-thought tips on first aid.

Most experienced kayak fishermen here in Northern California take safety seriously, and we do a good job of being prepared and looking out for one another. In our chilly waters, we learn pretty quickly to dress for immersion. We know the dangers of hypothermia, and the perils of tricky beach launches. We carry vhf marine radios, and should all be familiar with what resources are available to us should a rescue become necessary.

On a recent expedition style trip to Panama, it became apparent this kind of journey presents some different hazards. Thinking about these things in advance is even more important when you find yourself half a day or more away from the nearest hospital. Whether you are fishing in remote areas such as Baja or on the Panama coast, you should know just how self-reliant you have to be. That Coast Guard cutter or rescue chopper may be a given in your home waters, but we can make no such assumptions while abroad. If one of your crew has a serious medical problem like a broken bone or a heart attack, you may be the only hope for initial treatment and transportation. Here are a few essential safety and first response aspects to consider:

Even if you are on a guided trip in the hands of local pros, you should know what the contingency plan is for emergency evacuation. You need to know just how easy or difficult it might be to access advanced medical care. This kind of knowledge allows you to be rational about what level of risk you are comfortable with, i.e. just how close to those boiler rocks do you want to get? You’ll also be a step ahead if someone does get injured. The time to learn this is before you get on the water.

You also need to know just a bit about the medical history of your crew. Is anyone diabetic? Highly allergic to bee stings or subject to serious food allergies? Taking heart medication? Taking blood thinners? Does anyone have serious cardiac history? Who in your crew has first aid training? If you’re not reassured by the answer, perhaps that person should be you.

A first aid kit is key, but someone with training is even more important. Your local Red Cross or AHA affiliate can help you with that. Speaking of first aid kits, you’re going to have to make do with the kind of equipment you are able to travel with. Think about something no larger than a shaving kit.

At a minimum, an expedition first aid kit should include the following:

1) Assorted bandages, from finger sized to larger types as large as your forehead. You should have several rolls of gauze bandages like Kerlix for wrapping, as well as first aid tape. An Ace bandage can be useful for sprained wrists or ankles. Butterfly bandages are great for closing deep cuts that will require sutures.

2) Iodine solution like Betadyne for wound cleansing. You can find packaged swabs that travel well and take up less space than a bottle. Add some antibiotic ointment like Neosporin.

3) Traveling with serious painkillers can be problematic, but include some aspirin (useful with chest pain), and some Ibuprofen for headaches or inflammation.

4) Imodium or Lomotil are available over the counter for travelers diarrhea. In a tropical environment you want to think about carrying a solution for rehydration. Pedialyte is widely available for electrolyte replacement. If you don’t want to carry these on the plane, they should be available in most drug stores once you arrive.

5) For longer trips, you may want to talk with your doctor about carrying a broad spectrum antibiotic like Cipro with you.

6) If anyone is taking serious medication daily, make sure that an adequate supply, say enough for three days, is kept separately. If Murphy’s Law strikes and that piece of luggage finds its way to the bottom of the ocean, you can still salvage your trip.

Okay, so now you have a bit of training, and a basic kit. What’s next? It pays to think a bit about the climate where you’re going. On our recent Panama trip, the weather was hot and extremely humid, all the time. Paying attention to hydration is key, as is being vigilant for signs of heat exhaustion or heat stroke. Heat exhaustion is serious, but can be readily treated in the field with early recognition. Classic symptoms are weakness, nausea, and often a headache. A patient with heat exhaustion will still be lucid, and his body will continue to sweat in an attempt to cool off. Think of it like this: the air conditioning is still working, it’s just too hot for it to help much. On the other hand, heat stroke is far more serious, and you may see a patient whose body stops sweating, who may be confused or even unconscious. His skin will be hot and dry. The AC has shut down.

This is a true medical emergency, and you need to act quickly. He may be unable to take fluids orally, or to keep them down. This patient needs to be treated with active cooling and IV therapy, by a doctor, as soon as possible. En route you can cool him off with moist towels, or ice packs placed close to major vessels in the arm pits, inner thigh, or along the neck to help cool him down. If you can’t transport him right away, consider a cool bath, but stay by his side at all times to monitor him.

In Panama, we found ourselves settling into a routine of rising early, getting on the water at daybreak and returning to camp for a few hours in the middle of the day. It just makes sense in the tropics. If you’re having trouble handling the conditions, you can skip the afternoon session and rest and hydrate. Live to fight another day!

Being on the salt for long hours, I found those little cuts from braided line and fish handling don’t close up and heal normally. You might shrug off such little annoyances at home, but I would advise you to be a bit more meticulous, cleaning any cuts or scrapes daily and applying Neosporin.

In the super-humid environment, a couple of us began to suffer from heat rash on our lower backs, also known as “prickly heat” This occurs when sweat can’t evaporate from the surface of your skin, and your sweat glands and pores become clogged and irritated. It’s a minor irritation that can make you miserable if you don’t manage it. Every chance you get, rinse your skin well with fresh water, and take advantage of every opportunity to be cool and dry. Treat your feet with the same care, because fungal infections can get bad in a hurry. You have to handle the little stuff early on…or it becomes big stuff.

On this most recent trip we had two minor incidents. One client, Eric, began to feel weak and complained of a headache while on the water. Our guide, Henny Marais, has spent years in Panama and recognized the heat related problem quickly. Caught early, the solution was to find some shade, take a swim to cool off, hydrate with water and electrolytes, and rest. Left untreated, the situation can get much worse, to a point where field treatment is not enough. The point is not to be stubborn when you start to feel poorly, and to keep a good eye on one another. Sometimes it takes a friend to tell you that you look like hell. Listen to them. Eric spoke up quickly when he began feeling poorly, and after a short rest and cool-down, was back to fishing that afternoon fully recovered.

The second incident was both more comical, and a bit more painful. Somehow a six inch floating Rapala (in a yellow perch pattern) equipped with two treble hooks, found its way into the seat of Bushy’s kayak, and from there it was child’s play to sink a barb into his nalgas, as they say south of the border. When several of us returned to the beach at last light, it seemed that Allen, who had been paddling and fishing in the little bay just a quarter mile from camp, was especially happy to see us.

Well, sometimes travel will show you who your true friends are. Bushy was quickly placed belly down under the light of a kerosene lamp, where his shorts were cut off to reveal a hook sunk deeply into lily-white flesh. Truly caring friends would have provided him with a shot of whiskey and a branch from a mango tree to bite down on. As it happened, we were able to remove the hook pretty easily with a loop of 80-pound monofilament, a good angle and a swift tug. It may have hurt a little, but Allen seemed so happy to have his pants back on that all was forgiven.

So, perhaps one more item to consider as essential for your expedition kit would be a heavy-duty pair of cutters, capable of snipping right through a stout hook. In the picture above, the pliers with the titanium sidecutters broke while working on the hooks.  Luckily we had another pair of cutters that were more industrial strength. Oh, and don’t forget the whiskey. Safe travels!