What college students really need in their first aid kits

By Dr. Jill Grimes, CNN

(CNN) — It’s 2 a.m. and your college student is miserable. (Parents, you’ll know this because they’ve texted you.) Their student health center is closed, the nearest 24-hour pharmacy is across town, and you don’t think this is serious enough to justify the expense of urgent care or an emergency room.

Maybe it’s a pounding headache, vomiting, a hacking cough or severe congestion. Your student wants relief now, and you’ll be happy they have a well-stocked first aid kit to provide it.

You don’t need to cram an entire pharmacy into it, but you do need helpful tools, common medications and emergency supplies, stored somewhere easily accessible. I’m a family physician who practiced urgent care in a university health center and a mom of college students, and here is what I recommend.

Your ticket through triage

Start with an accurate digital thermometer. Campus health centers are busy, and being able to tell a triage nurse that your temp was 102.7 degrees (as opposed to saying, “I felt feverish,”) will help the nurse determine how urgently you need to be seen. Similarly, a pulse oximeter provides helpful blood oxygen levels if you’re dealing with a cough or shortness of breath. The more specific details and data points you can provide, the easier it is for the healthcare team to help you.

Supersize your pain/fever medication

Students from across the country tell me that pain relievers are the most-used item in their kits, most commonly ibuprofen (brand names Advil or Motrin). Students tend to reach for their family’s pain reliever of choice, whether that is ibuprofen, acetaminophen (Tylenol) or aspirin (Bayer, Excedrin, etc.), and they should learn the differences.

Ibuprofen is anti-inflammatory; it reduces swelling, lowers fevers and relieves pain, including menstrual cramps. Acetaminophen works well for headaches, sore throats and fevers, is easier on the stomach than ibuprofen but can irritate the liver (a problem when alcohol binging coexists.) Aspirin is not recommended in teens, though doctors may individually recommend aspirin/caffeine combination products for migraines. For your first aid kit? I recommend a full-size bottle of ibuprofen and a smaller acetaminophen.

But hangover headaches need more. When your pounding headache is the result of alcohol (or a stomach virus), a pain reliever alone will not fix the problem. Your body needs rehydration. Adding an ample supply of single-serving electrolyte powder packets in your first aid kit is just what the doctor ordered.

How do you spell relief?

College life is filled with caffeine, stress, chocolate, pizza, alcohol and nicotine … all the elements that cause heartburn. Not surprisingly, an antacid is the second most popular first aid kit ingredient students told me they used. I recommend a simple antacid (think TUMS or its generic alternative) for occasional heartburn because it works immediately and comes in chewy bites or gummies that are much more appealing than the traditional chalky tablets. If students are having heartburn frequently enough that they feel the need to take long-acting acid blocking pills, it’s time to see a doctor and figure out why.

Seconds matter: Include naloxone

Drug overdose (accidental poisoning) is the leading cause of death in young adults in the United States, according to the US Centers for Disease Control and Prevention. College students are at risk of accidental fentanyl overdose when they unknowingly take counterfeit “study pills” such as amphetamine/dextroamphetamine (Adderall), anxiety pills such as alprazolam (Xanax), or a pain or “party” pills such as oxycodone (OxyContin or Percocet).

Fentanyl can cause you to stop breathing within minutes. Having naloxone spray (Narcan OTC, available from pharmacies without a prescription) immediately on hand to administer to an unconscious roommate is not simply a convenience but a lifesaver. Know that there is only one dose in the spray, so never “prep” with a test spray before administering. Always call 911 and stay with the person until help arrives.

Cold symptoms? Skip the combo pills

Although it’s tempting to grab one pill to fix all your cold symptoms, treating each symptom with one medication can help you avoid accidentally doubling up on ingredients, improve your response and prevent drug interactions. Most combination cold products include a fever and pain reliever (acetaminophen), a decongestant (phenylephrine) and a cough suppressant (dextromethorphan).

Students taking Tylenol (acetaminophen) may not realize they are double dosing. Phenylephrine is no longer believed to be effective as an oral decongestant, according to the US Food and Drug Administration, though it has yet to be removed from combination cold remedies. Pseudoephedrine (original Sudafed), which is kept behind the counter but does not require a prescription, is a better choice. Lastly, dextromethorphan can interact with ADHD and antidepressant medications, so cough drops are a safer alternative.

Itchy bites or seasonal allergies?

Nothing will keep you from sleeping or distract you from studying like itchy bug bites or the constant sneezing and drippy nose of seasonal allergies. Allergists recommend bypassing diphenhydramine (Benadryl) and instead, picking your favorite nonsedating antihistamine pill, like fexofenadine (Allegra), loratadine (Claritin) or cetirizine (Zyrtec), according to the World Allergy Organization.

These second-generation antihistamines have similar efficacy, fewer undesirable side effects, and far less potential for abuse, according to the FDA. Add in a hydrocortisone cream for extra itch relief. Over-the-counter nasal steroid sprays don’t provide immediate relief, but they are a great choice for seasonal allergies.

Nasal decongestant superpower: Stopping nosebleeds

This one could save you a trip to urgent care. Most doctors avoid recommending nasal decongestants because they can cause physical dependence and rebound congestion if used beyond three days. However, every college first aid kit deserves one bottle of oxymetazoline hydrochloride spray (like Afrin), because it’s the first intervention we try.

If your spontaneous nosebleed won’t stop after continuously pinching the lower soft part of your nose for 10 minutes, spraying a few squirts of Afrin into the bleeding nostril and reapplying the continuous pressure for another 10 minutes will often do the trick. This tip is for uncomplicated nosebleeds in otherwise healthy young adults; nosebleeds after trauma require medical evaluation.

Skip the triple antibiotic ointment

You might be surprised that doctors no longer recommend triple antibiotic ointment for scrapes and cuts, as discussed in this 2018 systematic review. Petroleum jelly prevents infection as well as antibiotic ointments on cleaned, standard cuts, with the added benefit of not contributing to antibiotic resistance. Additionally, about 3% to 6% of people have a skin allergy to neomycin, a key ingredient in most antibiotic ointments, according to the National Institutes of Health. Pack a tube of petroleum jelly (Vaseline) in your first aid kit instead of antibiotic ointment and remember to flush all scrapes and cuts with copious amounts of clean water before covering them with the jelly.

Your eyes will thank you

College students often fall asleep without removing their contacts, especially when exhausted from late-night studying or over-intoxicated from partying. Prying a dried-out contact off your eye the next morning can result in a painful corneal abrasion (a scrape in the clear covering over your eye) according to the American Academy of Ophthalmology.

Keep sterile saline eye drops in your first aid kit for this emergency. Flood your stuck lens with the solution, then “butterfly blink” (soft and fast) repeatedly. If this doesn’t easily dislodge the contact, or if you have pain or a change in vision, seek immediate medical help.

Remember the C in RICE

For sprains and strains, we recommend Rest, Ice, Compression and Elevation (and anti-inflammatory medications like ibuprofen, unless contraindicated). Most college first aid kits forget the compression wrap (aka ACE wrap). Be sure to start below the injury and wrap upward, overlapping each layer but never so tightly that fingers or toes become numb or painful.

Sexually active? Plan ahead

While not everyone is sexually active in college, consider adding condoms and emergency contraception such as Plan B to your kit, because again, when you or a friend need them, you want them immediately.

A first step in healthcare adulting

College students don’t need to diagnose and treat every disease — that’s their doctor’s job. But they should learn to handle common medical problems, recognize when they need to seek professional attention and keep basic supplies on hand. A well-stocked first aid kit is an important first step toward healthcare adulting.

Here’s that packing/shopping list

• Adhesive bandages (often sold as Band-Aids — include specialty bandages for knuckles, fingertips and blisters)
• Digital thermometer
• Full-size bottle of ibuprofen
• Smaller bottle of acetaminophen
• Electrolyte powder packets
• Calcium carbonate antacid chews (often sold as TUMS)
• Naloxone (sold as Narcan OTC)
• Pseudoephedrine (often sold as Sudafed)
• Cough drops
• Nonsedating antihistamine pill (often sold as Allegra, Claritin or Zyrtec) for allergies
• Hydrocortisone cream
• Oxymetazoline hydrochloride spray (often sold as Afrin)
• Tube of petroleum jelly
• Saline eye drops
• Compression wrap (such as ACE wrap)
• Condoms
• Emergency contraception (often sold as Plan B)

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