Tactical First Aid Kit Contents Suggestions

[The Hank]

Your input is requested. I have tasked with putting together the basis for a tactical first aid kit for individual wear by members of a group. After much thought I have determined the following thusly:

(1) J75 carryall belt pouch, 6" high x 6" wide x about 1" deep (see: http://www.actiongear.com and do a search for Item # ALC175 which is the J75 CARRYALL BELT POUCH) with Alice type belt clips and snap closure to be modified to include Velcro so it seals up much like a SAW pouch and this will hold...

(2) Standard OD 4x6 Military issues field dressings NSN 6510-00-159-4883 from http://www.sierra-supply.com/

(1) Pouch blood clotting agent (see http://www.z-medica.com/ for details. Supposed to be kick ass stuff!)

(1) 4" Elastic Bandage (either Hunter Green or Black) Vetrap brand (See http://www.americanlivestock.com/product_0_1382.mhtml for more information on Vetrap. I understand some guys use it for weapons cammo and other stuff as well!)

(1) Standard EMT shears

(1) Straight hemostat

(1) Curved hemostat

(2) Pair Nitril anti-puncture gloves

(2) anti-bacterial wipes

(4) PVD (Povidine-Iodine) crush ampule swabs

(1) Asherman chest seal (ACS) NSN: 6510-01-408-1920 from Reasons Medical at http://www.cpo.to/special.html. The cheapest price I’ve found thus far at $9.95 each.

(4) Large safety pins

So what am I missing, perhaps some sort of disposable airway (see http://store5.yimg.com/I/medigear_1709_1320596 for a photo of the type I'm talking about), I also found these (http://www.life-assist.com/guedel.html) and they might pack a little better. But then they might also crush in long term storage too.

How about more field dressings than just two, a tourniquet?

Your input is most appreciated!

[Huey One Four]

Galls have things like that, you may like to check out their site.

Would save you having to make one up, just decide which one suits yours needs and waoila!

[RsovRanger]

Personally, I think that this aughta be in a gear forum...

That being said, what's the skill level of the person carrying it?
It does NO good to toss in johnny high speed shit if johnny isn't high speed enough to know how to use it.

I'm just an EMT-B with a couple add-on classes, but I'll tell you what I personally carry in addition to whatever else the mission dictates. This is *my* standard packing list.

FYI I honestly don't know the nomenclature of a couple things, and my spelling sucks. If you know what I'm talking about, pipe up and correct me please... if you can spell better, feck off!

1 Tornequiet, Ratchet type like a tiedown for a truck. Army issue suck.
4 curlex
3 "isralie" dressings, more or less a bandage w/ ace wrap built in for pressure dressing. Army issue first aid dressings suck.
2 nasopharenygeal airways W/lube, for her pleasure
2 oralpharenygeal airways, for her gag reflex.
2 aschuman chest seals
2 IV starter kits w/ saline locks and saline flush
1 needle decompression/crike airway kit

I carry it all inside a first aid pouch from tactical tailors, it's about 8"H x 6"W x 5" D. Comes with attachments for Rack, molle, alice.

Packed all according to order of use upon a casualty... airways outside in velcro pouch, tornequit on top, kerlex, isralies, needles protected at the bottom.

If you have access to IV equipment, you've got the parts to make your own starter kits for both the needle decompression/airway and IV starter kits.

That's just what I like to carry so I can either do self/buddy aid at close to my level of proficency, while minimizing size and weight on my always worn equipment.

[TerribleTed]

I like Rsov's packing list. You might also consider throwing in a couple cravats and maybe some tape.

The Hank:

I don't know what you're going to be doing with the hemostats, that you can't do with a well placed wound dressing.

The anti-bacterial wipes and betadine, is that for cleaning minor wound's? If so, take some bandaids.

I didn't see anything that indicated IV access.

Truthfully, you're best off just following RSOV's packing list. It has already been researched and is well-thought out.

[PSYWAR 1-0]

1 500cc saline
1 Velcro tourniquet
1 IVset
2 18ga Catheter
1 16ga Catheter
2 Alcohol pads
2 Betidine pads
1 Set rubber gloves
2 Rolls Kerlix
2 Vaseline gauze pad
1 AB field dressing
1 Cravat
1 Bandage scissors
1 Roll tape, 2 or 3 inch
1 Nasal airway
1 Oral airway


This is the individual kit that members of one SFG supposedly carry in a Tactical Tailor med pouch. This list has been making its way around the internet. Take it for what its worth or YMMV

[The Hank]

Huey One Four,
The sources I listed will actually end up making you a cheaper kit than anything you can get from Galls. The most expensive component, the Quick Clot, is around $23.00 a pouch in qnty's of 12 pouches (1 case), but I've never seen a kit yet that contains it. That said, the companies that sell TraqumaDex and Quick Clot sell small kits built around their products but the kits are slightly more money than the one I am building up.
Thanks for your input!
The Hank

To the rest of you, Thanks as well!

The kit is to be used by a team with base level skills and NO invasive capabilities at all so IV's, airways (other than oral j-hook types) and other type gear must be struck from the list. While I agree this limits the kit this is what I was stuck dealing with and I haven't the power or authority to modify it.

In answer to a few questions the hemostats were "suggested" for wide open type wounds. The betadine is used in the crush ampules to provide some peripheral wound antispectic properties.

The anti-bac wipes were more for the user and not so much for the usee. One must always clean up after the party, right?

Where do you guys get these "Isrealie" bandages? Do they have a NSN as well as a commercial source?

RsovRanger, you are right, this should have been in a gear forum but I wanted answers and not snoring sounds. See, I laid out a booby trap and you wandered right in... and answered the call!

Thank you very much for your input everyone!!
The Hank

[themadmedic]

Agree with Ted...not sure of a good use for hemostats in this setting other than "looking cool"...would loose them and gain more kerlex...you can never carry too much kerlex....

I think a part of the equation you will have to look at is what will these people be doing, and what kind of injuries might you expect to sustain?

It sounds like you are equipping personnel trained to about the EMT-FR or EMT-B level? Then I would suggest RSOV's or lucasf's kit minus the sharps---once again gaining more kerlex.

My personal outlook on these things is that you can't really put together a good medical packing list without looking at mission profile and training level of those working out of it...

[armybrat04]

I have a question. What are the prereqs. to becoming EMT certified? Can people uder 18 attend a EMT class??

[Matau]

The Hank,

You can find the Israeli bandages at www.tacticalgearcommand.com.

Cheers

Matau

[Huey One Four]

The Hank,

I didnt realise that, but now I know :) Learn something everyday dontcha? :D

[themadmedic]

Armybrat---depends on certain circumstances. Some places will allow people to attend EMT training programs prior to their 18th birthday---however you need to be 18 to become certified.

Some links that you may find useful:

http://www.ohd.hr.state.or.us/ems/certific/testing.htm

http://www.nremt.org/EMTServices/reg_basic_history.asp (1/2way down)


:cool:

[The Hank]

Matau,
Went to Tac Gear Command and ordered the Israeli badages. Never having used 'em before any tips or tricks? I assume instructions are included with them.
The Hank
P.S. They don't work and I going to do what my girlfiend does to me...I'm simply going to blame the whole thing on you!:D

[Matau]

The Hank,
The Israeli Bandage incorporates a non-stick trauma pad affixed to an elastic dressing.Glued to the bandage, over the centre of the trauma pad is a plastic "Pressure Bar", that is used to apply direct pressure to the wound to stop bleeding.
At the end of the bandage is another plastic bar that is used to clip onto the wrap to secure the dressing.
Have a look at this.....www.equipped.com/pp/pic911.htm

Cheers

Matau

[albodakine]

Pouch blood clotting agent .. Supposed to be kick ass stuff!

There are several chemical blood clotting agents available and more coming. Do your research though. One of them causes a "thermogenic" reaction. Basically a chemical reaction that raises the wound temparature to about 200 degrees fahrenheit, that's ba'ad. I believe this is the one that the Army bought, though. Figures.

$0.02
Al

[themadmedic]

Originally posted by albodakine


There are several chemical blood clotting agents available and more coming. Do your research though. One of them causes a "thermogenic" reaction. Basically a chemical reaction that raises the wound temparature to about 200 degrees fahrenheit, that's ba'ad. I believe this is the one that the Army bought, though. Figures.

$0.02
Al


That's why I am still a fan of direct pressure, packing the wound, and ligating the problem if identified...

[RsovRanger]

Alrighty... let's see what kinda shit I can stir with all this I'm thinkin about...

Quickclot: Seems like a great idea..... but it ain't. It causes big localized tissue damage due to its absorbtion. generally the same necrotic effect as lidocane with epi on extremities, but amplified. I personally don't want any doctor having to debride any more than he has to.

Team: What kind of a team are you making this little med-sop for? Experience tells me that planning requires knowing what you're up against.

Quote out of a little handbook I have:

How people die in combat:
31% penetrating head trauma
25% surgically uncorrectable torso trauma
10% potentially surgically correctable trauma
9% Exsanguination from extremity wounds
7% mutilating blast trauma
5% Tension Pneumothorax
1% Airway problems

12% of these that you work on die from infection and complications from shock

Preventable causes of death:
60% exsanguination
33% Tension Pneumothorax
6% Airway obstruction <maxillofacial trauma>


What does this all tell you?
You've got 3 different classes of casualties.
Those that are good, and don't need much if any help.
Those that are fucked, irregardless of what you do
Those that if you do the right thing, right now, will live.

Focus on your care for that last group. you NEED to be able to stop bleeding. you NEED to be able to keep an airway. you NEED to be able to treat a tension pneumothorax. you NEED to be able to push fluids to keep someone out of shock and with you long enough to get them to a hospital, the medics, whoever is higher care for you at that moment. If you can't do that now, then you need both the training and the equipment to be able to do so. I would seriously recommend EMT-B and PHTLS <prehospital trauma life support> as a good base for anyone that has to do care. Knowing what to look for for different things means it'll raise a red flag in your head if say..... this happens..

Area is secured by a platoon. You're called up to take care of a casualty. Team leader says he got shot going into a room multiple times. You right off have bright red spurting blood on the left leg, and you can see a hole going thru his body armor and uniform on the lower left side of the rib cage area. He is speaking to you, but in spurts.

What else could be wrong other than the obvious?

Obviously you need to control that bleeding on the leg right off and strip his shit. He's talking so he's got an airway for now. Tornequit that leg, and start a rapid assessment. C-spine injury in our line of work is rare, and it's pretty easy to just consider the MOI <method of injury> and rule out spinal injury. He's got a cariotid pulse, but not radial.... so that screams blood loss right there.. he'll be needing fluids later. You notice unilateral rise and fall of the chest, the wounded side just staying there while the good side rises and falls... What's that tell you? Probably needs a needle decompression for a tension pneumothorax, right? bam... stick a needle in that 2nd intercostal space and you hear a woosh... and now amazingly he's talking a little bit more normally and doesn't seem so spazzed as he was... clean off the hole and put a aschuman on the entry, and on the exit too, since it really doesn't matter as much... if shit can only get out its alright.. you don't want it going in. go on down, bury some curlex in that leg then bandage it with the isralie... you have all that covered, but you know it was an arterial bleed so you keep the tornequit on.... now since he still doesn't have a radial pulse although it is back to about normal on the cariotid, you know he's probably going to be in class 2 hypovolemic shock here soon so you pop in a saline lock and start a bag of hespan... now he's got a radial pulse since you upped his blood volume... gee... you just saved your buddy... load and go time, helo's are 10 min out... where's the skedco?

Of course it probably won't be quite as cut and dried, but if you can sustain your brother until you can get to a real doc, the CCP, whatever you have going... that means that someone that knows more than you can look at him and do even more invasive procedures... Imagine if every policeman/fireman/EMS dude was as agressive in care for trauma victims as we are...

Training, training, training. Medical knowledge is PERISHABLE. You don't talk it, do it, practice it, live it, you WILL forget it.

[themadmedic]

:cool:


Training, training, training. Medical knowledge is PERISHABLE. You don't talk it, do it, practice it, live it, you WILL forget it.

truer words were never spoken...