First aid kit

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  • dblas

    Past President, MSI
    MDS Supporter
    Apr 6, 2011
    13,087
    One of these days, I’m going to actually get around to posting my packing list for my Range IFAK, and full bag I have on hand for SHTfF. I’ve been an EMT for over 20 years, paramedic for 12, plus when I was deployed to Iraq I was a Combat Lifesaver. I work in Gorgeous Prince George’s, spent the first half of my career in Suitland/Oxon Hill, and the past 10 years in Langley Park (the Mecca for MS13). I could not even begin to count how many stabbing and shooting I have treated.

    Since this is a gun forum, I can’t recommend enough going out and taking a Stop The Bleed class. They are even offered online due to the corona. In person Is better though. TQs are the gold standard for limbs. When I first started they were a last ditch effort, now we know that they are paramount in saving lives. We used to substitute blood pressure cuffs before commercial TQs were available to us. Chest seals are easy now since you can buy valves ones and you don’t have to jury rig something anymore. For the money, IMO, hemostatic gauze isn’t worth it if you have to buy it yourself. Quik Clot or Celox cost $20-$30/pack. Compressed gauze costs $2-$5/pack. Studies have show plain gauze is just as effective as hemostatic gauze when packed PROPERLY. The chance Of anyone here having to use hemostatic gauze is low. Combine that with the fact that it is significantly more expensive and has an “expiration” date, and I don’t see the benefit of it.

    For a quick list to throw together in a ziplock bag, get a CAT TQ, Israeli bandage (or ETD bandage of your choice-I like the H and H thin fold), Hyfin chest seal two pack, and two packs of compressed gauze.

    34??
     

    mac1_131

    MSI Executive Member
    MDS Supporter
    Jan 31, 2009
    3,280
    Most of our military go through more advanced field medical training than their civilian counter parts including GSW and loss of limbs. Yes agree you only need some basics however, the majority of people do not have the training or knowledge to do anything more than putting blow out patches on people.



    If people are interested in advanced medical processes they should be properly trained and certified. Other wise depending on the injury they could do more harm than good. Also, you may not be covered under Maryland's Good Samaritan Law as it basically deals with drug overdoses. So I urge caution in providing any medical treatment that is beyond your knowledge.



    https://bha.health.maryland.gov/Documents/Good Samaritan Law Fact Sheet (feb2018).pdf
    I think this document is out of context and produced in context of opiod overdoses.

    I can't imagine maryland's long standing good samaritan law doesn't cover more general circumstances too.
     

    outrider58

    Eats Bacon Raw
    MDS Supporter
    Jul 29, 2014
    49,818
    Your first aid kit is for you! Don't use your first aid kit on your buddy when he gets shot, use his first aid kit on him. Words of wisdom from a DI from long, long ago.

    Yeah, in combat where everyone is carrying a blowout kit. That kit you carry is for you(unless you're the doc).
     

    Sam Salvati

    blacksmith
    Apr 22, 2013
    630
    Finksburg
    I’ve been a EMT/Paramedic for 9 years now. GSWs are relatively easy to treat (in the prehospital setting) and don’t require a whole lot of equipment. Most GSWs that I see (mostly handgun)are controlled easily with an Israeli bandage or Tourniquet. Last shooting I ran the guy took 4 9mms to the legs, Israeli bandage on each leg and the bleeding was controlled in well under a minute. In my range bag I carry trauma sheers, 2 Israeli bandages, 2 Tourniquets, 2 hemostatic dressings, 2 chest seals, and 2 decompression needles. It barely takes up more room than a magazine. “Tourniquet the limbs, pack the junctions, seal the box.” If anyone wants some basic trauma training I’d be happy to help.


    Would be a great in person class with a couple members?
     

    dblas

    Past President, MSI
    MDS Supporter
    Apr 6, 2011
    13,087
    Nice quiet Branchville. I’ll try and keep the locals up here by the Tick Tock so they won’t bother you.

    I used to hang out at Tik Tok....back in the 90's.

    They can come down here if they like, there is actually a nice little carniceria/bodega around the corner from me.
     

    outrider58

    Eats Bacon Raw
    MDS Supporter
    Jul 29, 2014
    49,818
    I used to hang out at Tik Tok....back in the 90's.

    They can come down here if they like, there is actually a nice little carniceria/bodega around the corner from me.
    I grew up across the street from Tik Tok.


    A denizen of the woods of Carole Highlands ES where we were in constant mischief back in the 60s-70s.


    Them were the day...:)
     

    Docster

    Ultimate Member
    Jul 19, 2010
    9,768
    I think you’re over analyzing a bit but, I would lean more towards the thicker material. Wound packing is painful, I’d prefer to just get it over with quick. Thicker material means you fill the wound faster. That being said, I do prefer the dressings that have a hemostatic agent in them, especially if it’s something you’ve never done before and probably have minimal training in. My thought process is, even if you don’t pack it 100% perfect, you still have the hemostatic agent in it to assist. As the other medic said though, if done properly standard gauze is just as effective.

    It is. Packing the wound and maintaining pressure is #1. Hemostatic agents are fine but make inexperienced people lazy and inattentive
     

    cap6888

    Ultimate Member
    Oct 2, 2011
    2,556
    Howard County
    Most people don’t understand how hemostatic agents work. I saw a cop trying to treat a gsw patient one time who had a gsw to the chest. He had is quik clot gauze out holding it on the wound like he was trying to just use it as a pressure dressing. People don’t understand that when you pack a wound it is DEEP into the tissue to try and actually stop the flow at the blood vessels inside. Then you have to hold it there with strong direct pressure for several minutes. People think it’s magic powder, when it really isn’t.
     

    shadow116

    2nd Class Citizen
    Feb 28, 2008
    1,542
    Emmitsburg
    Most people don’t understand how hemostatic agents work. I saw a cop trying to treat a gsw patient one time who had a gsw to the chest. He had is quik clot gauze out holding it on the wound like he was trying to just use it as a pressure dressing. People don’t understand that when you pack a wound it is DEEP into the tissue to try and actually stop the flow at the blood vessels inside. Then you have to hold it there with strong direct pressure for several minutes. People think it’s magic powder, when it really isn’t.

    Seems he did not know how wound packing worked at all. You can't pack a torso wound. Bleeding in the torso is not compressible and wound packing will not work. You are just wasting time and supplies.
     

    MJD438

    Ultimate Member
    MDS Supporter
    Feb 28, 2012
    5,849
    Somewhere in MD
    What the proper way to apply a tourniquet. Do loosen it every so many minutes or leave it clamped down.



    Thanks
    Once properly applied, leave tq in place and transport to definitive care (nearest emergency department or trauma center).

    ETA - note date and time of application

    Sent from my SM-G960U using Tapatalk
     

    JaeLess

    Member
    Nov 20, 2020
    42
    Z fold is legit. I have used it in Live Tissue Training on swine models with femoral cuts. Pack, pack and more packing with direct pressure will stop the bleeding. The powders work ok, but some generate heat while they cause coagulation. The theory is that when they get to the OR, they can just irrigate / “wash” the powder out of the would and then send them into surgery. The end of the day, Israeli bandages, CAT tourniquets, 5x7’s and Kerlex are all you really need when it comes to bleeding control.
     

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