Medical Bag: Do you have one?

[Glocktogo]

Shy away from qwik clot granules, they need to be irritated out of the wound. Celox powder or celox A would be better, and some impregnated gauze would be better still. Combat sponges are good for large open wounds, but suck for packing in GSW/ penetrating trauma. For bandages I like the olaes much better than the Israeli/ emergency trauma dressing. I FAR prefer the SOFT-T tourniquet over the CAT. The SOFT is simpler and has a metal windlass opposed to the plastic on the CAT. You'll want an occlusive dressing for open chest/neck wounds. Lots of z pack gauze, kerlix/ cling, 6X6's/sponges, Ace bandages etc. Super glue works well, but I find it's better if you put steri strips over it.

I have a few different kits. It all depends on your need, as form follows function. For my fighting kits I have mostly blowout kits. 2ea flat rolls of duct tape wrapped around them. 1 ea 4 inch Olaes bandage (contains occlusive dressing and z-pack gauze), hemostatic agent and an additional z-pack gauze. Some kits have 3 1/2" 14 ga angiocath for needle decompressions and cricothiroidectomy's. Eta I forgot to list nasal airway and tourniquet.

My home kit has misc wound care items, the stuff I listed above, dermabond (medical glue) steri-strips, sutures nasal and oral airways, tourniquets, benadryl & pepsid for allergic reactions, epipens etc.

Might want to mention that unless you have a medical cert to stick someone, you'd be better off trashing the angiocath. I don't know of anyone I'd trust to stick me and I damn sure wouldn't stick anyone else. That's a good way to go to jail. If they're having brething problems, you can always burp the occlusive dressing to relieve tension pneumothorax. Unless you're more than 20-30 minutes from a Level 1 trauma center, the odds of needing to do a needle decompression are pretty low.

I'd add to your kit some tampons for plugging GSW, a hands free headlamp for working in low light (or a couple of chem sticks), a Sharpie for marking medical information and pair of EMT shears, or at least a seatbelt cutter like the one made by Benchmade. Otherwise your kit sounds pretty well thought out.

 

[Surveyor1653]

Might want to mention that unless you have a medical cert to stick someone, you'd be better off trashing the angiocath. I don't know of anyone I'd trust to stick me and I damn sure wouldn't stick anyone else. That's a good way to go to jail. If they're having brething problems, you can always burp the occlusive dressing to relieve tension pneumothorax. Unless you're more than 20-30 minutes from a Level 1 trauma center, the odds of needing to do a needle decompression are pretty low.

I'd add to your kit some tampons for plugging GSW, a hands free headlamp for working in low light (or a couple of chem sticks), a Sharpie for marking medical information and pair of EMT shears, or at least a seatbelt cutter like the one made by Benchmade. Otherwise your kit sounds pretty well thought out.

I don't know that I'd go that far, but you could sure be sued. I think that here you're dealing with an issue of: If you've received training in the proper applications of and use the modality in the proper way, most Good Samaritan laws protect you (I'm not an attorney and am not offering legal advice, BTW). I'm only saying that this sounds a hair over the top to me and I could be wrong.

The good thing about this is that the guys I train with know how to needle a chest and so do I. Most of them aren't cert'ed or licensed in any way and I doubt anyone will go to jail. Now I'm not talking about rolling up on a pileup on the freeway and just sticking people 'cause you can but in the context of being "grid down" you could certainly be many days away from a Level 1 trauma center. I'm not telling anyone what to do, either, I just bring it up since the gist of the thread is in that vein.

Given the choice in a "grid up" scenario though, burping an occlusive dressing still may not do what a needle decompression will for the patient. If your lung is crushing your heart, you're probably not going to mind that needle in your chest anyway. Even if the hospital's five blocks away, it may still be the better choice. The individual will have to make that decision for himself, in that moment. The ability to observe symptoms and determine if a needle is necesary is critical. I'm here to tell you that I'll needle my kids en route to the hospital if I think that they need it. I know that's not what Jerry was saying, I just wanted to illustrate another "what if". The "my kids" part changes the dynamic of the argument, too.

The golden key to the crapper: the training, not the gear. If you took the Combat Lifesaver course in the Army in 1993, good for you, but you still need to refresh those skills. First aid skills are like any other: They're perishable. Train, refresh, repeat. Of course, YMMV.

+1 on the headlamp. Definitely add chemlights to the equation, too. Forget the powders and spend your money on the z-guaze impregnated with clotting agent.

PM TacMedic on this forum for info on the classes he puts on for good training opportunities.

 

[Norman]

Might want to mention that unless you have a medical cert to stick someone, you'd be better off trashing the angiocath. I don't know of anyone I'd trust to stick me and I damn sure wouldn't stick anyone else. That's a good way to go to jail. If they're having brething problems, you can always burp the occlusive dressing to relieve tension pneumothorax. Unless you're more than 20-30 minutes from a Level 1 trauma center, the odds of needing to do a needle decompression are pretty low.

I'd add to your kit some tampons for plugging GSW, a hands free headlamp for working in low light (or a couple of chem sticks), a Sharpie for marking medical information and pair of EMT shears, or at least a seatbelt cutter like the one made by Benchmade. Otherwise your kit sounds pretty well thought out.

Thanks for the suggestions. I've been trained in needle d's and cric's on more than one occasion. I've also trained to start IV's and intubate, but those are outside my scope of practice too. Needle D's aren't nearly as complicated as one might think. Also burping the occlusive dressing isn't 100% reliable. With that said, I'd never decompress someone I didn't know. I know who I would and would not stick if it came down to it, and it is a pretty select group. The flip side is that the angiocaths can be used on me. I lucked out because a handful of my family members have a considerable amount of medical training, and normally when I wear my fighting kits there is a critical care paramedic out with me. You are right though about needle decompressions being a tricky matter. One must be trained, and also weigh the risks vs rewards.

Tampons are good for keeping the wound free of debris, and making sure you don't get blood everywhere. They do absorb blood like a wick, so if you have a heavy bleeder I'd say pack the wound with gauze then a tampon to keep pressure on the bleeder. I have also effectively used a maxi-pad and ace wrap as a pressure dressing on an uncontrolled bleed on a dog that got hit by a car.

Okie I take allergy shots, so they're prescribed

 

[doctorjj]

I'm surrounded by medical supplies. Literally.

 

[338Shooter]

And an RN that knows what all the chit in there is for.

 

[Glocktogo]

I don't know that I'd go that far, but you could sure be sued. I think that here you're dealing with an issue of: If you've received training in the proper applications of and use the modality in the proper way, most Good Samaritan laws protect you (I'm not an attorney and am not offering legal advice, BTW). I'm only saying that this sounds a hair over the top to me and I could be wrong.

The good thing about this is that the guys I train with know how to needle a chest and so do I. Most of them aren't cert'ed or licensed in any way and I doubt anyone will go to jail. Now I'm not talking about rolling up on a pileup on the freeway and just sticking people 'cause you can but in the context of being "grid down" you could certainly be many days away from a Level 1 trauma center. I'm not telling anyone what to do, either, I just bring it up since the gist of the thread is in that vein.

Given the choice in a "grid up" scenario though, burping an occlusive dressing still may not do what a needle decompression will for the patient. If your lung is crushing your heart, you're probably not going to mind that needle in your chest anyway. Even if the hospital's five blocks away, it may still be the better choice. The individual will have to make that decision for himself, in that moment. The ability to observe symptoms and determine if a needle is necesary is critical. I'm here to tell you that I'll needle my kids en route to the hospital if I think that they need it. I know that's not what Jerry was saying, I just wanted to illustrate another "what if". The "my kids" part changes the dynamic of the argument, too.

The golden key to the crapper: the training, not the gear. If you took the Combat Lifesaver course in the Army in 1993, good for you, but you still need to refresh those skills. First aid skills are like any other: They're perishable. Train, refresh, repeat. Of course, YMMV.

+1 on the headlamp. Definitely add chemlights to the equation, too. Forget the powders and spend your money on the z-guaze impregnated with clotting agent.

PM TacMedic on this forum for info on the classes he puts on for good training opportunities.

Understood. In the information age, the info is out there but the training might not be in place to back it up. I think some training groups these days are delving into areas best left for the pros. While having knowledge and skills is never a bad thing, knowing when it's a last resort and not a "I finally get to use this knowledge" item is critical.

 

[Surveyor1653]

Understood. In the information age, the info is out there but the training might not be in place to back it up. I think some training groups these days are delving into areas best left for the pros. While having knowledge and skills is never a bad thing, knowing when it's a last resort and not a "I finally get to use this knowledge" item is critical.

Man, you said it. I'm no medic and don't claim to be but there are a lot of surf board owners out there who are by no means surfers, know what I mean?

 

[Lurker66]

There was a time i was hip to emergency services. Today, its just hold the fort down till the pro's get there. Call for help, Ensure enviroment is safe, ABC's, try to control bleeding, prevent shock.

If its shtf time, ill do my best with whatevers at hand.

 

[Okie4570]

Thanks for the suggestions. I've been trained in needle d's and cric's on more than one occasion. I've also trained to start IV's and intubate, but those are outside my scope of practice too. Needle D's aren't nearly as complicated as one might think. Also burping the occlusive dressing isn't 100% reliable. With that said, I'd never decompress someone I didn't know. I know who I would and would not stick if it came down to it, and it is a pretty select group. The flip side is that the angiocaths can be used on me. I lucked out because a handful of my family members have a considerable amount of medical training, and normally when I wear my fighting kits there is a critical care paramedic out with me. You are right though about needle decompressions being a tricky matter. One must be trained, and also weigh the risks vs rewards.

Tampons are good for keeping the wound free of debris, and making sure you don't get blood everywhere. They do absorb blood like a wick, so if you have a heavy bleeder I'd say pack the wound with gauze then a tampon to keep pressure on the bleeder. I have also effectively used a maxi-pad and ace wrap as a pressure dressing on an uncontrolled bleed on a dog that got hit by a car.

Okie I take allergy shots, so they're prescribed

I guess that could be considered a bad thing a good thing at the same time.

 

[Norman]

Lol true. Im just allergic to grass and weeds such as timothy and ragweed. I just started them this spring, so I can function without them. Prior to my shots my nose would run and eyes water like a mofo. It's more of an annoyance than anything, but the shots controlls it. The upside is when I finish the antigen therapy, I'll be allergy free for 15ish years if not forever.