The first aid kit in your house is probably useless

Open the first aid kit in your kitchen drawer. There's a very good chance it contains forty plasters of one size, a triangular bandage nobody in the house can tie, a pair of scissors that won't cut, and nothing at all for the two injuries that actually happen.

Shop-bought kits are assembled to hit a price and to look full when the lid opens. The contents are chosen for count, not for use.

What actually happens in a house

Over a decade of family life, on an acreage with tools and a workshop, the incidents are overwhelmingly these:

• Shallow cuts and grazes
• Burns — cooking, exhausts, a soldering iron, hot water
• Splinters
• Sprains
• Bumped heads
• Something in an eye
• Insect stings

That's the list to build for.

Strip out, put in

Out: the triangular bandage (unless someone has actually been shown how to use it), the tiny tweezers that don't grip, the blunt scissors, and thirty of the forty plasters.

In:

• Proper scissors, tuff-cut shears that will go through clothing.
• Real tweezers — splinter forceps with fine points, not cosmetic ones.
• Sterile saline pods. For flushing wounds and, critically, eyes. This is the single most-missed item.
• Non-adherent dressings in two sizes. Ordinary gauze sticks to a burn and taking it off re-opens the wound.
• A burn gel dressing or two. Burns are the injury people are least prepared for and the one where the first ten minutes matter most.
• An antiseptic you'll actually reach for. Iodine stains and stings; a lot of households own some and never use it. Whatever you choose, the test is whether you use it, because an antiseptic in a drawer does nothing.
• A crepe bandage and a cohesive wrap for sprains and for holding dressings.
• Plasters in three sizes, including fabric ones and a couple of large pads.
• Nitrile gloves. Two pairs.
• A foil blanket. Weighs nothing.
• A torch. The kit is often needed at night or in a garage.

Then write the emergency numbers and your own address on the inside of the lid. Somebody panicking can't always produce their own postcode, and a visitor certainly can't.

Burns: the ten minutes that matter

Cool running water for twenty minutes. Not ice, not butter, not a cold pack — cool running water, and for far longer than feels necessary. Most people stop after two minutes and that isn't enough to stop the burn progressing through the tissue.

Remove rings and watches before swelling starts. Cover loosely with cling film or a non-adherent dressing once cooled.

Get medical attention for anything that's deep, larger than the casualty's palm, on the face, hands, feet or genitals, or in a child or older person. Chemical and electrical burns always get seen.

Cuts

Pressure first, with a clean dressing, for a proper ten minutes without lifting it to check. Lifting to check restarts the clock.

Once it stops, clean around the wound and irrigate it with saline. Cover it.

A&E for: bleeding that won't stop under pressure, a wound that gapes when relaxed, anything deep in a hand, anything with something still in it, animal bites, and any wound where the tetanus history is unclear.

Two kits, not one

A house kit in a box in the kitchen, and a smaller grab kit in the car with gloves, shears, dressings, saline and a foil blanket.

The car one is the one that gets used at a football pitch, at a campsite, and at somebody else's house.

Check it twice a year

Things expire and things get used and not replaced. Put it on the same day you do the smoke alarms.

GermProof.com, a sister site, makes the chelated-silver antiseptic several of us keep in our own kits. That's a commercial relationship and you should weigh it accordingly — the list above is what belongs in a kit regardless of whose products fill it.