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Old 12-20-2012, 03:02 PM
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Question New First Aid Kit, Looking for Thoughts and Critiques



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So I finally got around to rebuilding my first aid kit, and am looking for input. It's meant to be an IFAK style kit for myself and possible others within a group. The carrier is a "rip away" style pouch (the mounting kit for my patrol belt is shown but the kit can be mounted on a regular belt, a backup and other pertinent locations). This lets me keep the thing out of the way, but still be able to easily access it should it be needed. As far as remounting the kit, its doable with all my gear on but not fast. In an real world situation I'd probably just shove the whole thing in my drop pouch rather an remount it on the belt.



1.) The carrier shown on the belt, it's a condor first aid pouch (yeah, all the geardos can hate but so far it has worked as well as anything I was issued in the USMC)

2.) The belt, shown for reference only, base on the kit I used in the USMC

3.) the mounting system shown with the IFAK carrier removed.



This just shows how I packed my kit. Bleeding control is on top with airway control also readily available. The minor injury stuff is kept in a zipper pouch so all of the stuff doesn't fly everywhere when I pull the kit out.



4.) the whole kit shown in "broken open" format

8.) the Contents of the whole kit, to be discussed in more detail below, not shown are trauma shears (which are usually stored on the outside of the kit), and imodium / asprin / pepto bismol pills, which are kept in my shoulder pocket.

9.) Hemorrhage Control Kit: This is primarily a trauma kit so bleeding control takes precedence over other parts of the IFAK. The kit includes:
1) METT Tourniquet
1) SOFTT Tourniquet (kept in pocket or strapped to SPC)
2) CAT Tourniquets (strapped to outside of IFAK carrier)
3) vacumm sealed Combat Gauze
1) regular Combat Gauze
1) Israeli Bandage
1) compression Bandage (poor man's Israeli bandage)
2) rolls of Gauze

the kit is based around getting the wound under control and getting the victim to "home base" where they can get actual care in a somewhat sterile environment. Tourniquets are the best way to stabilize an extremity wound, and contrary to popular belief do not compromise the limb (at least not initially). It's a habit from my military experience, where we all carried several tourniquets on our person on patrol. Combat Gauze is used in conjunction with the compression bandages and rolled gauze to deal with core/head wounds and sure up extremity wounds. The dressings will also be used in concert with the beta-dine and alcohol to attempt to prevent infection and keep foreign matter out of the wound cavity.

10.) Minor injury, stability group. this group is for minor injuries that are sure to occur in a field setting, useful for long range stuff so you don't have to come home every time someone needs a blister treated. It also contains the materials necessary to stabilize a non spinal bone break for travel. This kit includes:

2) waterproofed bags of band-aids, small bandages, and beta-dine swabs
1) waterproofed packet of moleskin for blisters
2) packets bio-freeze pain reliever
1) elastic tourniquet, I don't know why it's there, I'll use it to make a slingshot for something
1) SAM finger splint for immobilizing a minor injury, not a permanent solution but it will keep someone in the fight without tearing up an already broken digit.
1) triangular Bandage for immobilizing a break, not a permanent solution but it will keep the break immobilized until we can get the victim to a home base.
2) burn dressings, more for pain than anything else, but it will help to keep the burn sterile while the victim is evacuated

11.) Airway group: I only know the basics of airway related first aid, so this kit is limited to what I can safely carry out in the field. This kit includes:

2) Halo seals: basically an occlusive dressing (for sucking chest wounds) with adhesive already applied, I could make the same thing with some plastic and tape, but this usually easier to apply under stress.
3) chest needles, for treating a tension neumo-thorax, one is in the packaging still but they are all waterproof and sterile
3) naso-farangels, for clearing an airway, one is still in the package in case the other ones get wet or dirty.

12.) Personal protection and sterilization group. basically for protecting myself from infection and preventing infection in others. this kit includes

3) sets of non latex field gloves, basically cheap nitrile gloves to keep foreign blood out of my system
1) set of field gloves. stonger version of the nitrile gloves, in case they get torn up or soaking wet
1) vial of beta-dine for sterilizing a wound cavity
2) beta-dine wipes for sterilizing a wound
2) alcohol wipes for sterilizing a minor wound
1) CPR mask for mouth to mouth rescue breathing
1) roll of duct tape, this shouldn't really be in this group, its basically used like butterfly strips, which are worthless and fall apart in field conditions.

Things I am going to add:

right now the kit is set up to my skill level. as I get more training ill add the tools necessary to do a tracheotomy, which is next on the "to learn" list. I also want to add a space blanket for hypothermia and some more alcohol pads and neosporen for minor wounds. Super glue gel might also be a nice addition for wound closure when higher echelon care is not feasible.
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Old 12-20-2012, 11:07 PM
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Seems like a pretty advanced kit with the needle chest decompression. The nasopharyngeal isn't really used for clearing an airway but for maintaining a BLS airway. Since you have those in there I would be using a BVM and also put in OPA's as well. Also for advanced airways a product is made called a quick trach which takes the place of a surgical field trach. Also since you are making an advanced trauma kit are you able to do IV's and saline/ringers?
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Old 12-21-2012, 10:59 AM
jfirebalrog jfirebalrog is offline
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Seems to have the bases covered for initial trauma care, only things I can suggest is to standardize the Tk's and dressings,maybe replace the H or cinch tight(cant tell in the pics) with a blast bandage ,one of the ace's with a primed or similar ,and one of the decompression needles with a 10cc syringe(carrying betadine but no irrigation device,need the syringe for planned cric ability),and if those NPA's are all the same size replace 2with next 2 smaller sizes.

As you add to your skills I'd also throw in a saline lock kit like the NARP one which would take the place of the 10cc syringe as well.
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Old 12-21-2012, 11:06 AM
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It looks good to me, I will have to really study your kit to see if there are any recommendations I would have.
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Old 12-21-2012, 10:48 PM
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Thinks for the input, the primary limiting factor I have is space. I know how to do an IV, but I would have no room for the material or bag ("primitive" IVs are currently beyond my knowledge level). I've thought about putting in a BVM, but it takes up way too much space (When I get around to making a back-pack kit and vehicle kit I’ll probably add it to those). I’ll look into replacing one of the NPA with an OPA. The NPAs are currently 28 and 30, I’ll replace the 2nd 30 with a midsize OPA. I've never seen betadine in a syringe form. In any case wound irrigation was never something I was taught (not surprising because we never covered any form or wound cleaning and were taught the mentality “just shove the intestines back in they’ll flush him out with antibiotics when he gets medevac’d”). Are there any good resources you could point me to regarding field sterilization and wound cleaning.
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Old 12-22-2012, 02:54 AM
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Here are my thoughts on the BVM, if you are in a remote or tactical situation then if they require ventilation support they are dead. The underlying cause most likely is not treatable in the field.
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Old 12-22-2012, 12:12 PM
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The nasal airways are a very undervalued tool. I have an entire anesthesia cart of supplies at my disposal at work but if I could only have 1 thing out of it it, it would be a lubricated #28 nasal airway. It's simplicity and utility will compensate for a near complete lack of skill and save a life. Most people attempting to learn airway management grossly underestimate the difficulty of maintaining a patent airway in an unconscious person and that's where adjuncts like a nasal airway find their niche.
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Old 12-22-2012, 03:17 PM
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Quote:
Originally Posted by cajun777 View Post
Thinks for the input, the primary limiting factor I have is space. I know how to do an IV, but I would have no room for the material or bag ("primitive" IVs are currently beyond my knowledge level). I've never seen betadine in a syringe form. In any case wound irrigation was never something I was taught (not surprising because we never covered any form or wound cleaning and were taught the mentality “just shove the intestines back in they’ll flush him out with antibiotics when he gets medevac’d”). Are there any good resources you could point me to regarding field sterilization and wound cleaning.
The betadine would be diluted in clean water then used in the syringe for irrigation of dirty wounds. Since you have the capability to start IV's I'd look at the saline lock kits(12 bucks at NArescue.com) it has the 10cc syringe in it and early access is much more important than the fluids. They are pretty tiny so space shouldn't be much of an issue.

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Old 12-23-2012, 10:18 PM
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also if you are looking for advanced airways King LT or combi tube
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Old 12-24-2012, 01:23 PM
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Quote:
Originally Posted by Doc_Shane View Post
Here are my thoughts on the BVM, if you are in a remote or tactical situation then if they require ventilation support they are dead. The underlying cause most likely is not treatable in the field.
Including a 'fast trac'........haha I agree completely Shane. If advanced airways are being thought of in a SHTF scenario that persons chance of survival is < 1%. Even NPA's and OPA's I can see a little bit again, if you are providing artificial ventilations in a scenario where hospital care is unlikely....the chance of a positive outcome is probably poor.
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