First aid kit

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  • DitchDoctor

    Member
    Oct 30, 2020
    15
    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.
     

    fidelity

    piled higher and deeper
    MDS Supporter
    Aug 15, 2012
    22,400
    Frederick County
    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.
    Thanks for the list and professional insight.
     

    outrider58

    Eats Bacon Raw
    MDS Supporter
    Jul 29, 2014
    49,810
    I carry an IFAK to the range every trip. I need to carry one hunting as well. Especially after being missed by inches a couple gun seasons ago.
    I have chest seals in my kit. Which are preferred, valved or not valved? I'm carrying non-valved seals now...
     

    DitchDoctor

    Member
    Oct 30, 2020
    15
    I carry an IFAK to the range every trip. I need to carry one hunting as well. Especially after being missed by inches a couple gun seasons ago.
    I have chest seals in my kit. Which are preferred, valved or not valved? I'm carrying non-valved seals now...

    Most jurisdictions have went towards valved chest seals. If you use non valved seals you may occasionally need to “burp” the patient. Basically air gets trapped in the chest cavity, pressure builds up, and needs to be released in order for the lung to fully inflate. This is why the new seals have one way valves built in. To burp the patient, remove one corner of the chest seal, have the patient exhale deeply, then re-seal.
     

    Grampa G

    Ultimate Member
    Jan 11, 2010
    2,449
    Washington Co.
    Walmart has a product called Bleedstop for under $5 for 2 20g packages of a powder that has Amylopectin. Is it a product worthwhile adding to a kit?
     

    DitchDoctor

    Member
    Oct 30, 2020
    15
    I would be hesitant to use a product so cheap. We don’t use powdered agents in Maryland. I don’t have specific experience with that product but in Maryland prehospital medicine, and as far as I know the national registry of paramedics, we are not pouring any powder on GSWs. We do use gauze that has hemostatic agents in it, but this is for packing the wound. You would be far better off purchasing a well known and well tested product such as celox. If you ever get yourself in the situation that you need to use it you will be happy you spent $30 vs $5 on a packet of powder that an arterial bleed is just going to push off the GSW anyway. Especially if it’s you or your friends that need the help. My recommendation would be to spend the extra few dollars and get a reputable product. PS, don’t buy off brand tourniquets, they brake.

    Walmart has a product called Bleedstop for under $5 for 2 20g packages of a powder that has Amylopectin. Is it a product worthwhile adding to a kit?
     

    paperwork351

    no error code for stupid
    Mar 7, 2008
    867
    Gaithersburg
    I have a question on non hemostatic gauze for wound packing. Most kits have compressed, z-fold, s-rolled etc for linear and wrap but they are 6-ply. NAR has a specific wound packer that is 1-ply https://www.narescue.com/nar-wound-packing-gauze.html What is the advantage(s) of the 1-ply over the 6? The six version seems to be more versatile in an ifak. I don't know if it's woven or not or bordered. Lint and fibers of a kerlix type concern me. I lean to the narescue stuff.
     

    Grampa G

    Ultimate Member
    Jan 11, 2010
    2,449
    Washington Co.
    The Bleedstop was not in the first aid section but back in camping. I've never heard of it and assumed it may be for a superficial bleeding.

    During a first aid class I asked the instructor who was an ER nurse about quick clot vs celox for range bag. His response basically was it doesn't matter what you use if it keeps someone from bleeding out,
     

    outrider58

    Eats Bacon Raw
    MDS Supporter
    Jul 29, 2014
    49,810
    Most jurisdictions have went towards valved chest seals. If you use non valved seals you may occasionally need to “burp” the patient. Basically air gets trapped in the chest cavity, pressure builds up, and needs to be released in order for the lung to fully inflate. This is why the new seals have one way valves built in. To burp the patient, remove one corner of the chest seal, have the patient exhale deeply, then re-seal.

    Thanks! I will upgrade to the one way valved in the near future. :thumbsup:
     

    cap6888

    Ultimate Member
    Oct 2, 2011
    2,556
    Howard County
    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.
     

    DitchDoctor

    Member
    Oct 30, 2020
    15
    I have a question on non hemostatic gauze for wound packing. Most kits have compressed, z-fold, s-rolled etc for linear and wrap but they are 6-ply. NAR has a specific wound packer that is 1-ply https://www.narescue.com/nar-wound-packing-gauze.html What is the advantage(s) of the 1-ply over the 6? The six version seems to be more versatile in an ifak. I don't know if it's woven or not or bordered. Lint and fibers of a kerlix type concern me. I lean to the narescue stuff.

    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.
     

    Sealion

    Ultimate Member
    MDS Supporter
    May 19, 2016
    2,710
    Balto Co
    My bold prediction of 2020 is that DitchDoctor is going to be the go to emergency medicine expert on this forum. Good stuff.
     

    shadow116

    2nd Class Citizen
    Feb 28, 2008
    1,542
    Emmitsburg
    I have a question on non hemostatic gauze for wound packing. Most kits have compressed, z-fold, s-rolled etc for linear and wrap but they are 6-ply. NAR has a specific wound packer that is 1-ply https://www.narescue.com/nar-wound-packing-gauze.html What is the advantage(s) of the 1-ply over the 6? The six version seems to be more versatile in an ifak. I don't know if it's woven or not or bordered. Lint and fibers of a kerlix type concern me. I lean to the narescue stuff.

    So in referring to "6 Ply", I assume you are talking about Kerlix, crinkle gauze, or something similar?

    If you look at the loose weave of Kerlix, and compare it to the tight weave of NAR 1 Ply gauze, you are getting about the same amount of material per square inch.

    And for lint, Kerlix has been used in wounds for sometime, do not worry about it.
     

    Blaster229

    God loves you, I don't.
    MDS Supporter
    Sep 14, 2010
    46,407
    Glen Burnie
    I think what a lot of people fail to realize also, is that if treating while in a city center with good ems response, wound treatment doesn't have to be too complicated, i.e.... clotting agents and vented chest seals.
    I think the complexity of treatment usually goes up the further away you are from "civilization".
     

    outrider58

    Eats Bacon Raw
    MDS Supporter
    Jul 29, 2014
    49,810
    I think what a lot of people fail to realize also, is that if treating while in a city center with good ems response, wound treatment doesn't have to be too complicated, i.e.... clotting agents and vented chest seals.
    I think the complexity of treatment usually goes up the further away you are from "civilization".

    Definitely. Direct pressure on wounds is a good starting point. Maybe a belt around a limb with an artery bleed.
    My fear is getting shot while hunting alone(which is 99% of my hunting) or if there is a range accident and EMS is a ways away.
     

    Blaster229

    God loves you, I don't.
    MDS Supporter
    Sep 14, 2010
    46,407
    Glen Burnie
    Definitely. Direct pressure on wounds is a good starting point. Maybe a belt around a limb with an artery bleed.

    My fear is getting shot while hunting alone(which is 99% of my hunting) or if there is a range accident and EMS is a ways away.
    I'm pretty sure I'm using regular gauze and no coagulant if I'm downtown Glen Burnie.
    Where I live or western BFE, I'll use every trick in the book. Certainly a chest seal won't need to be burped within the time ems arrives in a city.
     

    Harrys

    Short Round
    Jul 12, 2014
    3,362
    SOMD
    I would be hesitant to use a product so cheap. We don’t use powdered agents in Maryland. I don’t have specific experience with that product but in Maryland prehospital medicine, and as far as I know the national registry of paramedics, we are not pouring any powder on GSWs. We do use gauze that has hemostatic agents in it, but this is for packing the wound. You would be far better off purchasing a well known and well tested product such as celox. If you ever get yourself in the situation that you need to use it you will be happy you spent $30 vs $5 on a packet of powder that an arterial bleed is just going to push off the GSW anyway. Especially if it’s you or your friends that need the help. My recommendation would be to spend the extra few dollars and get a reputable product. PS, don’t buy off brand tourniquets, they brake.


    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
     

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