Creating a survival first aid kit, step by step
Creating a Survival First Aid Kit, Step By Step
B. Getting Started
- Getting Started
- Things to keep in mind
- Figuring out what you need
- Major Injuries
- Minor Injuries
- Continuing Operations
- My First Aid Kit
- Major Injury (trauma) Kit
- Minor Injury Kit
- Continuing Operations Kit
- Where to Find What You Need
- Traditional Stores
- Local Medical Facility
- Medic / Corpsman
- Putting Your Kit Together
- Buying a Premade First Aid Kit
- Military vs Civilian Kits
- Size of Your First Aid Kit
- Continuing Operations
A good first aid kit can quite literally mean the difference between life and death in a survival situation. A good first aid kit will give you all you need to mend yourself in the wild. A bad one can not only give you inadequate resources, but can be inherently dangerous to use, especially by someone who is not particularly knowledgeable on medical care. So, the first thing that you need to do to create your Individual First Aid Kit (IFAK) is to figure out what exactly you need it to do. Here are some things to keep in mind.
C. Finding out what you need
1. First, and most importantly, there is no higher echelon of care in a survival situation. That means there is no such thing as a band aid to keep the patient, or yourself, alive long enough to get to the hospital. The concept of ďfield stabilizationĒ is increasingly popular, and is particularly effective given modern transportation and the close proximity of high quality medical facilities. This effects you because most commercially available first aid kits are meant as short term band-aids, not long term solutions. You need to modify your kit to make sure you can deal with the long term effects of injuries and the fact that there may be no hospital to get the patient to.
2. Minor injuries are going to occur much more often than major ones. However, both can get infected, which can cripple you in the field. Trauma kits seem to be increasingly popular among survivalists, however, ignoring mundane items like band-aids, peroxide, or anti-biotic ointments can be fatal errors. Donít get sucked into the ďgear queerĒ philosophy and stuff your FAK with fancy trauma gear while neglecting to give yourself the ability to deal effectively with minor injuries.
3. Avoid ďtemporaryĒ solutions, these kinds of items are very popular, but next to useless if you canít get the patient to a hospital. The most popular of these stop gap measures is quik-clot. Quik-clot SHOULD NEVER be included in a FAK. This is because the granules within the kit that are used to stop the blood flow operate by burning the tissue shut, and must later be removed by a physician. Other items are only meant to provide temporary reprieve while you to implement a more permanent solution. One such item is the tourniquet, the tourniquet is a great tool, but is only meant to give you the time you need to apply a proper dressing. Leaving a tourniquet on too long will kill the limb, leading to the need for amputation.
4. Just as important as having the gear is knowing how to use it. The quik-clot is a perfect example of this, and the fact that ignorance of your gear can be inherently dangerous. However, you also need to know how to use your other specialized medical kit, such as the proper way to sterilize, pack a wound, find a vein, suture a wound, etc.
5. Infection has the capability to be much more dangerous than the original wound. With that in mind knowledge of how to sterilize a wound, as well as proper follow up hygiene, is paramount to success in the wild.
6. Quantity: make sure you have enough of a single item to last you for a good while. Youíre going to use items like band-aids on a regular basis, pack them in the necessary numbers. This is one of the problems with commercial first aid kits, they pack a wide variety of supplies, but never in sufficient qualities to sustain operations for an extended period of time.
7. Expiration dates: more than any other category (except maybe food), medical supplies will expire and become next to useless. Make sure you keep your supplies clean and up to date, because when SHTF an out of date hemostat is going to do you not a damn bit of good.
8. Another thing to keep in mind is that you will often be alone and as such will be forced to administer aid on yourself. This means that it is especially important to learn how to work on hard to reach areas, and even one handed and off handed (working with your ďwrong hand), especially with complicated procedures like suturing or the removal of foreign matter from wound cavities.
To figure out what supplies you need, it will be necessary for you to need to apply some basic first aid knowledge, and common sense, to come up with a good assortment of gear which will encompass the vast majority of your first aid needs. The types of gear in your kit can be divided into three groups: Major injuries (your stereotypical trauma gear), minor injuries (band aids and cough drops), and continuing actions (basically keeping your wounds sterile and immobilized until it heals naturally). For your major injuries a good acronym to use is MARCH-B. Itís used by the Navy and USMC to give the order in which you treat combat injuries, but is also good for making sure you hit all the bases as far as having a properly supplied kit available for all major injuries. Minor injuries are more of a common sense deal; think the things your mom keeps in the first aid kit in the bathroom closet. Continuing actions will consist of the things you need to keep the wound stabilized while it heals. These include things like antiseptics, splints, and slings, among other things. Each of these groups will also have tools attached to them which you will need to work on the corresponding cases.
- Major Injuries Ė MARCH B
Major Bleeds: This is probably the best known of the major injuries, and with good reason. The femoral artery can bleed out in 30 seconds. The methods to treat a bleeding wound are also numerous, with everything from combat gauze to Israeli dressings available. The kit you choose will depend mostly on personal preference, however, a few things to make sure to have will be at least two tourniquets, at least one H bandage or similar equivalent, gauze (copious amounts of this), and proper sterilization equipment. Again, this is the minimum, other things to have include sterile wrap, hemostatic gauze, compression bandages, sutures, liquid skin, alcohol pads, and multiples of all of the above.
Airways: This one is more skill than anything else, but with that being said making sure the airway is open, especially with an unresponsive patient, is of critical importance. The best method is to finger sweep the mouth and then use the jaw thrust to open the wind pipe. The head tilt chin lift is another method, but is becoming less used because it moves the head and neck around, not something you want in a possible spinal injury. With that said, the equipment you need for this category includes gloves, preferably non latex, and a way to keep the mouth open. This can be as simple as a stick. I personally use the veterinarian method of ďsqueezingĒ the jaw open, but make use of whatever way makes you feel comfortable.
Respiration: The thing most commonly associated with this category is CPR, so a face shield would be a good thing to include, not to mention learning the most up to date ratio of breaths vs compressions.
Circulation: This one encompasses whether or not blood is flowing properly to all parts of the body. This is more of a long term situation, like making sure you take the tourniquet off or you orient the patient in a position that allows the patientís blood to circulate. However, it also has to do with shock. Shock has the capability to be a major problem if not properly treated. Treating this condition predominantly involves skill, but a space blanket to control core temperature couldnít hurt your chances.
Head trauma: Well, I hate to say it, but thereís not much you can do for a spinal injury in a SHTF situation except immobilization and time (however, Iím not particularly knowledgeable on spinal cases, so youíll need to do your own research on the subject), in survival kits a SAM splint can be money for quick stabilization, but in larger kits, a full cervical spine collar is definitely preferable.
Burns: While not a part of the MARCH acronym, Burns are another major injury that I feel deserves it own category. Even so, most of the dressings used to control bleeding can be applied to burns. The primary difference is that a burn dressing will be loosely fastened and wetted down (note: dressing a burn is only for preventing infection and keeping foreign matter out, not stopping any type of blood flow, which shouldnít happen anyway since the wound should already be cauterized). You can also pack some cooling gel for minor burns (do not apply it to third degree burns or greater)
Fractures, Breaks, and sprains: I wasnít really sure which category I was going to put this injury in. Unless itís a compound fracture (at which point the associated bleeding becomes your primary concern, along with properly reseating the bone so it can properly heal), a broken bone is really not all that serious, just painful (and temporarily crippling, but thatís a survival thing rather than a medical thing). Treatment for a broken bone is simple, but requires the slightest amount of finesse. Provided you can properly seat the bone, hence the finesse, all you need to do is keep the wound immobilized and wait. For this a SAM splint is a great base for a broken limb, once the splint is in place simply wrap it in paracord and make sure it stays put. For a more long term solution simply find a strong stick and strait lash the stick to the limb on both sides of the break. An even better solution is to use two sticks (one on both sides of the limb), do the same lashing (a Chinese strait lashing will work too if you donít like the Boy Scout version). After the sticks are set wrap the whole thing in ace wrap, and presto, field cast. Note that whatever method you choose you will have to check the limb regularly to make sure it is healing properly. This should be done at least daily for the first week after the break and at least weekly after that. Fractures and sprains are even easier; you simply immobilize the limb and make sure it doesnít get any worse. Finally, for breaks in areas like the collar bone you will have to make use of a sling. I just fashion a hasty sling out of some clothing, but triangular bandages or cravats will work as well.
Tools: Some of the tools that come in handy for trauma kits include first and foremost the necessary ďPPEĒ, which include gloves and possibly a face mask. Another indispensable tool is a good pair of Trauma shears, which will allow you to cut though clothing to get to the wound. Some basic surgical tools, such as tongs, forceps, scissors, and tweezers, might also come in handy in special circumstances. Also bear in mind most of these tools can be used to treat less serious minor injuries, so duplication for other groups is unnecessary.
- Minor Injuries
Cuts and Lacerations: Small cuts and scrapes can be easy to ignore in the field. However, if you get an infection from said cut youíll regret the decision. Band-aids and antiseptic will make up the bulk of you minor injury kit. Since the wound isnít life threatening in and of itself, sterilization is your primary goal. Make sure you include band-aids of several different sizes and in generous quantities. You also need to make sure you include something to clean the cut, such as baby wipes or alcohol pads, so you donít seal the bacteria in when you cover the wound.
Blisters: Blisters may seem like more of a nuisance than a legitimate problem, but trying walking on one and youíll quickly find its worth treating. Moleskin is generally accepted as the best choice for treating blisters (and when I say treat, I mean cover and immobilize, blisters will have to actually heal on their own). Foot powder, if you donít already have some, is also a good edition, especially when you have to operate in wet environments.
Sun burn: Preventative measures are the best solution for this problem, but if youíre an idiot and let yourself get sun burned, aloe vera is the best treatment.
Puncture wounds: These are similar to cuts and lacerations except they contain a small but deep incision, think what would happen if you got stabbed by an ice pick. Unless they hit a major blood vessel puncture wounds are not immediately threatening. However, a myriad of interesting and deadly pathogens can live in puncture wounds because of the unique wound cavity. The most well known of these infections is tetanus, but others exist as well. While you should always make sure your tetanus vaccination is up to date, keeping the wound clean is of paramount concern (as in you should flush out the wound with betadine or a similar liquid antibiotic daily). This is where liquid antiseptic comes into its own, because it can hit the entire wound while gel will simply sit on top.
Scrapes: These are also similar to cut and lacerations, and the opposite of punctures, in that they create a very shallow wound cavity over a large area. This means that germs that require an oxygen-deficent environment wonít be a problem, but everything else will have a large area to work with. Scrapes have the propensity to bleed a lot initially, but can be easily stopped because the bleeding is usually exclusively capillary in nature. So, with that said, the most important thing to keep in mind is to keep the wound clean and disinfected until it scabs over.
Bites: Bites will not present much of a problem in and of themselves. However, the venom that may or may be injected with the wound can be a serious problem. With this in mind a good anti-venom kit is essential, especially in areas known to be inhabited by venomous snakes and spiders. A good bite kit will include a top notch suction device to get the venom out of the wound, as well as some alcohol pads to clean the wound area. Note there are still kits out there that adhere to antiquated techniques, so make sure you do your research before purchasing a kit. Bites from non venomous animals can range from annoying from serious depending on their source and location. Generally, it is safe to treat large bites as puncture wounds. Also keep in mind some animal soil their teeth with raw meat to stimulate infection in bite victims, so assume that the wound is saturated with bacteria and initiate the proper countermeasures. Another thing to worry about with mammal bites is rabies. If you contract rabies from a bite in a survival situation youíre a corpse waiting to happen, so donít get in the situation (I.E. kill the animal at a distance). Insect and rodent bites are a problem more because of the diseases they carry. With these, preventative measures and hygiene are of paramount importance. Another thing to watch out for are insects such as ticks and leeches that will latch on to you, and will need to be carefully removed. Chiggers, which actually burrow into your skin, are an even more annoying problem.
- Continuing Operations
Slings and Splints: If you break a limb, prepare to have it immobilized for upwards of a month to have it heal properly. When I was in Afghanistan we encountered several cripples who broke limbs and didnít allow them to heal correctly, and believe me, itís not a place you want to be. In a pinch you can use a SAM splint to keep the bones together, but this is far from a satisfactory permanent solution. With that being said, more permanent slings can usually be improvised from clothing items. Likewise splints and casts can be fashioned from a stout sticks and a pole lashing with 500 paracord, just make sure it immobilizes the limb.
Medication: Medication in your FAK should include some pain medication, cough drops, diarrhea medication, cortisone creams, and allergy pills if applicable. Eye drops might also come in handy from time to time. Diagnostic tools can also be helpful to have, while not completely necessary if weight is a premium. The minimum to carry is a thermometer, but stethoscopes and other tool will the useful if you have the room and the knowledge.
Cleaning equipment: You will need to occasionally change the dressing on a wound and continue to insure that the wound remains clean and sterile. Hydrogen Peroxide, along with a few cotton balls, is a great way to kill bacteria if you can carry the extra weight. Gel antibiotics can also be helpful in keeping the wound sterile. Medical tape is also going to be necessary to rewrap the wound as well as lots of simple dressings or bandages to keep it covered.
these are the contents of my personal FAK (note: items not shown include: trauma shears, quick release tourniquet, my surgical tools, and benadryl)
For my carrier I used the Snugpak universal cargo pouch, this pouch gives me the space I need for all my epiupment, while providing the durability necesary for extended operations.
This is my FAK connected to my "get home" belt, note that when in use the belt will also have a drop pouch, a cargo pouch, a SAW drum (magazine) pouch, and a nalgene bottle pouch. The second photo is my FAK with my surgical tools exposed, note the upper pocket in the green pouch is where I keep a few quick to get items: these include a small number of betadine pads, blades for my scapel, and a small number of suture kits.
This is my major injury kit, items not shown include my trauma shears, which are currently in my military IFAK, and my surgical tools, which are attached to my carrier.
This is my minor injury kit
This is my continuing operations kit, items not shown include my quick release tourniquet, which is currently in my military IFAK, and benadryl, which I've been using and haven't replaced.
A. Where to find What You Need
Putting your kit together
There is a wealth of supplies available for purchase online. Some of the major sites to look at include:
Amazon.com: A good general purpose site, but it has a lot of pretty specialized stuff if you know where to look. Just be advised, the quality of the products may vary vastly, so make sure you do your research before making a purchase.
Chinook Medical: This is one of the best sights Iíve found which deals exclusively in medical supplies. The site is particularly good for wilderness kits because a large portion of its inventory is produced for the tactical market, meaning itís good for use in the field rather than a hospital room.
Rescue Essentials: Rescue essentials is similar to Chinook Medical, however the inventory is expanded to include Civilian paramedics as well as equipment for tactical situations.
Tac Med Solutions: Yet another tactical medical site. I have discovered that you can find better inventories at the other sites, but it has a few unique products to work with. One of the things I like about this site is that most of its kits and larger products will have video tutorials available on the site, which makes it a great place to pick up some knowledge, even if you donít buy the equipment.
Medex Supply: This is a good general purpose medical online store, however, a lot of its equipment is meant for a clean, stationary environment. So it might prove more useful for those who want to stay put or have a kit made for a vehicle. Mobile light weight aficionados might want to look elsewhere.
EBAY: You can find anything on EBAY, literally. With that being said the quality and reliability of the items can vary from new to practically useless, so make sure you do your homework before you spend your money on a shady seller.
- Your Local Drug Store
The local drug store can be a great place to get basic first aid on the cheap. However, some of the more specialized equipment will need to be attained from specialized stores. Some of the major general purpose drug stores include
Other local or regional outlets
- The Hospital
Your local hospital is going to have a wealth of medical equipment, and when such equipment gets old or expires they have to get rid of it. This usually entails a dumpster, so if you know someone who works there (or even go up there and explain the situation) you might be able to acquire some high quality equipment on the cheap. Just remember, if the hospital is going to throw it away, thereís a reason, so make sure the equipment is still viable and safe before you commit it to your kit.
- Your Medic / Corpsman
This is pretty much exclusive to active duty military who are put in harmís way (admin clerks might have a hard time justifying the need to bolster their IFAKs with additional equipment). However, for infantryman or other combat arms MOSs it can be a great way to get gear for next to nothing. Most platoon level medics worth their salt will be happy to get you extra gear, and who knows, it just might come in handy downrange. Another thing to keep in mind is that when you turn in your IFAK to CIF they throw it away, so donít feel like your stealing if you take all the useful gear out before you give it back when you check out.
C. Continuing Operations
- Buying a pre made first aid kit
I would generally advise against purchasing a premade kit because it rarely has everything you need, and it often gives the bare minimum in terms of quantity (5 band-aids is not sufficient for any extended amount of time in the field). However, one of the ways to take advantage of a pre-made kit is to use it as a base and build off of it. This gives you a carrier as well as a few items, making the process of building the rest of the kit slightly easier.
- Military Versus Civilian Kits
In this day and age, almost all military equipment is simply civilian gear painted brown and given a serial number, so most of the medical equipment you find will be identical whether or not it is tactical. With that being said, there are some unique items in each category. An example of this is the fact that you wonít find CAT tourniquets in an EMT bag while at the same time you wonít find sutures in a military IFAK. Your best bet is to mix and match the equipment to best fulfill your needs. Just make sure you know how to use the kit you purchase. However, one of the attributes where military kits have a distinct advantage over their civilian counterparts is in the carriers. Tactical medical pouches have the advantage of being significantly tougher than their civilian counterparts, and as such can be strapped to the outside of a pack with little fear of ripping and strewing your kit all over the ground. Civilian carriers are also generally bright colors, while tactical pouches are more subdued. I prefer the earth tone kits, but whatever suits you, just make sure you know what you want before you make your purchase.
- Size of the kit
The size and completeness of your first aid kit will depend on a number of factors. The first and foremost of these is how you are going to carry it. If your kit is completely stationary (as in it is in a survival retreat or your home) the sky is the limit. For vehicle and foot mobile kits there are some space consideration that will need to be accounted for. To make life a little easier, Iíve divided the different size kits into a couple of general categories.
IFAK (individual first aid kit): This is the smallest first aid kit you should keep with you in a survival situation. It has enough gear to provide for a single person for a short while, or a few major injuries. These are the kinds of kits that United States soldiers carry in the Middle East. Thereís nothing particularly wrong with this type of kit, but donít expect it to last very long in the field.
Good Samaritan Bag: A Good Samaritan bag is one step up from an IFAK. It has the capability to cover a single person for an extended period of time, with enough extra gear to help the random needy individual from time to time. This is a good kit for a survival situation because it allows you to take care of yourself for an extended period of time. It will give you the ability to help others, which can help you make friends when SHTF, or at least have some pretty important items to barter with should it become necessary. The kit in this article (my personal kit) is a Good Samaritan bag.
Family Medical Bag: A family bag is the largest medical kit that can be introduced practically into a foot mobile set up. As its name suggests, this kit is meant to be able to take care of normal sized family for an extended period of time. These kits will have the same items as an IFAK and Good Samaritan bag, but in larger qualities. Family bags will also have to make special considerations for the children present in the group. A good Family bag will usually range in size from a small backpack up to a three day pack depending on the needs of the family.
Vehicle Kit: The main difference between the foot mobile kits and the vehicle kits are that you will not have to deal with the weight. Space, however, is still a limiting factor. Vehicle kits allow you to pack more specialized gear and in greater numbers, so take advantage of the opportunity. A good vehicle pack will be about the same size as a large family pack, but will contain more specialized and fragile gear.
Medicine Drawer: This is the smaller of the two stationary kits. It is about the same size as a large vehicle kit, but can hold even more specialized gear because of the fact that it wonít need to be moved around. The fact that it is set up in a stationary location means that you will be able to work in relatively sanitary and stable conditions. This greatly increases the number of different operations that you can perform. This mean you can include more exotic pieces of gear such as a dental kit, and even a child birth kit if applicable.
Medicine Cabinet: This is the largest of the home first aid kits, and pretty much the best you can do in a survival situation short of a full blown emergency room. The test of a good medicine cabinet is that if a real doctor was present, he could do pretty such everything he could do in a standard medical setting (short of some surgical or specialized procedures). This set up also requires the largest investment, and can cost several thousand dollars, meaning that it far outside most peopleís budget. Even so, itís something to work toward, and if you build slowly you can get there with a minimal financial imprint. Also, if you planning on building up this kind of substantial supply base, you might also want to look into purchasing an dedicated operating table of some sort so you donít risk cross infecting areas that have others uses within your home / retreat.
The organization of your gear will depend a lot on the carrier you buy and your individual organizational style. My personal carrier has a clam shell design, so I have access to most of my kit as soon as I open the pouch. However, for those with more traditional kits you need to put the more time critical components, such as tourniquets and hemostats, near the top and lower priority items, such as minor injury treatment item or diagnostic equipment, near the bottom. One of the things I do is strap the tourniquets to the outside for instant access, followed by the hemostats and dressings at the top of the pouch. Next comes the ace wrap and medical tape, and below that I place the antiseptics and alcohol pads. Below that will be all of the other items that I donít need instant access to.
Contrary to popular belief, your kit is not done once you finish putting it together. Several items in your kit will expire, meaning they will need to be replaced regularly. You also need to inspect your kit before and after taking your gear out to make sure all of the sterile seals on your applicable equipment are intact and none of your liquid kit is leaking.
Just having a kit is not going to do anyone any good if you donít commit time to proper education and practice. This, along with other continuing operations, will ensure that if and when you have to make use of your kit it will be second nature; lives could very well hang in the balance.
Knowledge is power, and in this case the power to save lives. There are several outlets for the amateur medic to learn the necessary skills; a few of the main ones are listed below.
The Red Cross: the American Red Cross is one of the primary outlets for the average civilian to receive basis medical training. Courses range from basic CPR courses to more advanced first responder certifications.
Community Colleges: Community colleges can offer a number of courses for a price. Available courses and prices vary depending on which facility your use, so make sure you do your research before enrollment.
Your Local Hospital: Depending on the facility, your hospital might offer basic first aid courses for a minor fee. Thereís also the fact that the doctors and nurses that work at these hospitals might very well agree to teach you some basic skills. Another way to get info is through the pamphlets and documentation that is usually placed liberally throughout the facility.
Disaster Preparedness Organizations: Disaster preparedness and survivalist organizations will usually have a least a cursory focus on primitive first aid, and their courses are usually cheaper than official classes.
Combat Lifesaver: This one is pretty much for military only. Itís a course usually taught by a medic or corpsman that gives you basic trauma education. Itís a great base for the aspiring first responder, especially when dealing with major bleeds and airway injuries.
Boy Scouts of America: The Boy Scouts of America is about 100 years old and has always been known for helping boys and teenagers learn survival skills. However, donít overlook the opportunity to learn a little yourself. However, more important than the skills you learn are the possible networking possibilities. In my old troop we had a parent who was a paramedic who gave us CPR and First Responder certification for free.
Online: Iím somewhat hesitant to put this on here because some people have the propensity to believe everything that they see and hear. With that being said the internet is a gold mine of videos and information, provided of course you are willing to sift through a massive amount of junk in order to find it.
Itís easy to be able to recite a bunch of memorized facts, but something else to be able to apply that knowledge to a field setting. Make sure you get at least a little hands-on time with your gear so that when the time comes that itís needed you wonít second guess yourself. You can conduct practice sessions with your expired equipment, or even actual gear if it is necessary. In any case, going though simulations is paramount to your success in real life situations.
If you go to the trouble of preparing your first aid kit and learning the skills, would it not make sense to keep the kit on hand for quick use? This may seem like common sense, but often times once a kit is completed it is stored in some closet, and is often a chore to get too, something you will not have the time to do in a medical emergency.