First aid kit w/ bullet trauma in mind


PDA






sevenpoint62mm
July 9, 2004, 08:06 PM
Looking for ideas on making a first aid kit for my truck with gunshot wound trauma in mind. I have a small range bag but its not always with me and this is more for a first responder situation, holding things together til the medics come.
The average kit of 4 inch band-aids isn't going to make for a pressure dressing so I think I need to make my own (unless someones made a kit with this in mind already). While I have the past EMT experience you can't fit a whole ambulance into a neat 8x10x6 (or so) nylon bag. Considering the small space what all would you good folks recommend. So far I got:

3 - 3 in x 75 inch gauze rolls
6 - 4x4" gauze pads
3 - 5x9 surgical dressings
1 - roll medical cloth tape
1 - roll duct tape
1 - 4 oz of antiseptic
1- 1 cpr mask
1 - pair of gloves
1 - sharpie, black
1 - surgical scissors
1 - 24 inch nylon rope (1/4" thick)

What else? Any ideas?

If you enjoyed reading about "First aid kit w/ bullet trauma in mind" here in TheHighRoad.org archive, you'll LOVE our community. Come join TheHighRoad.org today for the full version!
jwmoore
July 9, 2004, 08:12 PM
Something for an occlusive dressing - saran wrap or the like.

~W

(Edit: Asherman Chest Seal (http://www.remotemedinc.com/index.asp?PageAction=VIEWPROD&ProdID=224) is a ready made occlusive with a one-way valve. Pricey, but worth it if it's needed.)

sumpnz
July 9, 2004, 08:13 PM
If you want to deal with trauma you need trauma packs. IIRC they are around 8-12" square, pretty thick, and can absorb a lot of blood. I had one on my forhead when I was 16 (backseat in a T-bone). I think they doubled it over to fit better and then wrapped the gauze rolls around to keep it in place and put pressure on the ground flesh.

I seem to remember someone here recommending tampons for gunshot wounds. Not to sure if they're the best idea though.

sevenpoint62mm
July 9, 2004, 09:02 PM
Some good ideas. I only listed 4x4s because we used them my the fistfuls for gun wounds but with limited supplies and space a more direct approach to filling the wound (as suggested) might be in order.

I heard theres a soft rubber insert you can put into bullet hole paths for blocking blood loss, anyone seen these and how much?

JohnKSa
July 9, 2004, 09:02 PM
If you keep your eyes open, sometimes you can find surplus medic kits for sale pretty cheap. Places like Cheaper than Dirt, and Sportsmans Guide often carry them.

The only problem I've seen is trying to repack them after you open them to see what's inside!

Hope ya never need it.

Tierhog
July 9, 2004, 09:23 PM
Get a hold of a public safety magazine like galls and get some stuff called QuickClot, it is saving lives in the middle east right now. I have a complete kit, and it only cost $50.00. Money well spent if I never need it.

crewchief
July 9, 2004, 09:59 PM
You might want to see if you can add one of those sticky flapper valves for open chest wounds with lung damage. They allow air to escape the cavity and when the wonded breaths in it seals to allow better airflow to the lungs and help the lung from collapsing.

Josey
July 9, 2004, 11:08 PM
Duct tape, a zip-loc baggie and feminine pads. A tampon has been used before to slow bleeding from a non-exit wound. I carry adult diapers also. They work for occlusive dressings along with the duct tape. They work well for traumatic amputations also.

GunnySkox
July 9, 2004, 11:41 PM
The thing to remember is that you don't, AFAIK, stuff the tampon into the wound, putting anything into an open wound is a major no-no. Tampons and feminine-pads are used because they're highly absorbent. Tampons are for places where the pad might not work as well, like joints, where the cylindrical shape might work better. There's a good article on MadOgre.com about first-aid-kits.


~Slam_Fire

MarkDido
July 9, 2004, 11:42 PM
When I was young and foolish and still running the streets as an EMT, we used feminine pads for major trauma. Much cheaper than the stuff they sell for that purpose. Just don't get the "scented" kind

abdrdude
July 10, 2004, 02:55 AM
I believe that I would include one of the pocket-sized emergency Space Blankets, used to treat the victim for shock. A small book on First Aid might be usefull even if you are trained in basic first aid.

Double Maduro
July 10, 2004, 03:31 AM
Not tampons, pads.

They work just like field dressings and some come with adhesive.

Disposable betadine ****** for antiseptic, it is cheap and you get a lot in a sterile container.

Buy some sling material, you can use it to secure dressings.

A ladder splint or two.

Tape.

scissors.

Pain killer.

Super glue, you can use it to close small wounds.

Suture set, needles and thread, DO NOT CLOSE UP A PUNCTURE WOUND, bandage it and let a doctor clean it.

Gloves.

Lots of gauze.

Ace bandage.

Tweezers.

Magnifying glass.

Matches. An alcohol lamp will work for sterilizing instruments also.

Alcohol.

Antibiotic cream.

Burn ointment.

Space blanket. You will want to keep the patient warm, helps prevent shock.

Water. Don't give anything by mouth if it is an abdominal wound.

Do not give any pain killer to a patient with a head wound.

The steps to follow.

1. Clear the airway. It doesn't help to stop the bleeding if the patient suffocates. Perform CPR if necessary.

2. Stop the bleeding, direct oressure, if that doesn't work use a restricting band (like a tourniquet but you loosen it every 10 minutes.

3. Imobilize the fracture, if any.

4. Keep patient warm, calm and as comfortable as possible while you wait for help or transport them to help.

There is so much more. Go to a first aid class from the Red Cross and you will learn a lot. You can probably get your employer to pay for it.

DM

RevDisk
July 10, 2004, 07:36 AM
http://www.revdisk.net/medkit.html

This is a small write up of my medi-pak I used to keep in a vehicle when going around. I used a beat up spacious backpack instead of a custom jobbie that'd cost an arm and a leg.

I add things here and there. Especially when I pick up a tip from a nurse, doc or medic.

Over time, I plan on adding more items. Maybe working on the catagorizing and add links to where one can purchase said items cheaply.

sevenpoint62mm
July 10, 2004, 11:02 AM
Wow great info guys. I'll splurge for a Asherman (never hurts to buy quality bullets, condoms, or medical supplies).

Short of a defrib unit I should be able to deal with the situation until help arrives. I hope I never have to face using it but better to be ready.

Anyone have experience with QuikClot or compariable product?

Blackhawk 6
July 10, 2004, 11:32 AM
While I have no direct expereince with Quik-Clot (thankfully), several close friends do. All are fans. I have two packets in my blow-out kit.

DragonRider
July 10, 2004, 07:37 PM
There have been some issues with Quick Clot. I am only reposting what I have read, make your own decision and look for further information

http://www.tacticalforums.com/cgi-bin/tacticalubb/ultimatebb.cgi?ubb=get_topic;f=22;t=000265#000000

http://www.tacticalforums.com/cgi-bin/tacticalubb/ultimatebb.cgi?ubb=get_topic;f=22;t=000269#000000

http://www.tacticalforums.com/cgi-bin/tacticalubb/ultimatebb.cgi?ubb=get_topic;f=22;t=000295#000000

HTH

John

sevenpoint62mm
July 13, 2004, 06:48 PM
How does traumadex stack against Quik-clot?

MJRW
July 13, 2004, 06:54 PM
I need to ask this:

Why if you are preparing a first aid kit, would you not focus on other more likely types wounds, injuries, ailments, etc.?

sevenpoint62mm
July 13, 2004, 08:42 PM
More likely ailments aren't going to be as life-threatening. Also going to have a face mask for airflow/CPR but other then that I can wait to get home to treat minor issues. Anything requiring more professional threatment I can either get to medical help or wait long enough for help to get to me. Car wrecks and weapon wounds are about the only treatable trauma you will die from before you can get to medical attention.

Med 10
July 13, 2004, 10:21 PM
While it is certainly better to have some medical supplies on hand rather than none, the best advice is to get some experience in treating injuries. To do this I would strongly recommend if youre time and budget allows it to take an EMT class. Most community and tech schools offer one. Sure it takes time but in a year or less you go from having a glorified firstaid kit to having a fully, properly stocked jumpbag and most importantly the skills to use it effectivley.

Like double Maduro said, there is so much more. GSW's in the real world almost always never do what you would expect. Such as accurate count of entry/exit wounds, why only 2 in front but more in back? sometimes no exit wounds. { these are bad!} is the person obese? what kind of clothes are they wearing? heavy jackets? I once had a patient develope a tension neumo from a GSW to chest. She was an innocent bystander who was heavyset with a large bosum, entry under left breast, no bleeding, lowlight conditions, Look at victims hands, sometimes they raise their hands to fend off attack and sustain wounds to hands. Bystanders will always give you conflicting stories while you try to get a primary assessment done. Some folks can walk away from the scene and drop dead on the frontporch when they get home, remember, once you start to treat someone you CANNOT stop untill someone with equal or higher training takes over that is abandonment and will get you in lots of trouble. Know youre state laws!

Do have a basic understanding of human anatomy? where are the major vessels? pressure points? do you know the signs and symptoms of shock? compensated? they may look fine then uncompensated shock kicks in. UH-OU. Why does the victim have muffled lung sounds on the affected side? I put an occlusive dressing on the chest wound? try burping it! ah much better. Can you take a basic set of vitals? Blood pressure is the main thing to watch. Blood loss leads to low B.P. Remember to raise there feet. What about fluids? I.V. fluids can keep the victim hemodynamicaly stable long enough to get to an E.R...........maybe.

As you can see there is SO much to know and learn about trauma and field medicine. I strongly encourage you to get some training. EMT intermediate is a good goal to shoot for. Most programs take a year or less and you could volunteer or work partime somewhere to get the experience. The life you save may be a loved one or good friend!

BTW, Good advice Double Maduro. you a medic?

Also If 444 is floating around out there somewhere I'm sure he could give you more advice.

Lone_Gunman
July 13, 2004, 11:46 PM
I'm a surgeon, and my advice is to spend as little time as possible screwing around in the field with first aid kits, and get whoever is shot to a hospital ASAP. Most gunshot wound victims can be saved if you will just get them to a hospital.

Unless you have a lot of training, having a bunch of medical gear isn't going to be helpful. You will not be able to stop bleeding in the abdomen or chest no matter what you have. Putting a 4x4 on a belly wound is useless.

Hold direct pressure on anything squirting blood, and give CPR as necessary, but most importantly get to a hospital.

Also, remember if you are treating strangers to be aware that HIV and Hepatitis are pretty prevalent these days. I don't recommend getting a stranger's blood on you if you can help it.

deej
July 14, 2004, 01:37 AM
QuikClot is rapidly falling out of favor because of the exothermic reactions mentioned in the above links.

This file (http://phtls.org/datafiles/DrJeffreySalomone%20Hemos%20Drsg%202004Mar03.pdf) talks about some of the currently available topical hemostatic agents currently available; however, the last line of the presentation is noteworthy: "No evidence these agents are superior to direct pressure!!"

As has been stated above, direct pressure (combined, I would say, with a bulky dressing) is the way to go.

Double Maduro
July 14, 2004, 03:27 AM
med 10

66-68. One of the jobs my favorite uncle gave me.

I have forgotten so much. Time for a refresher course.

DM

Billy Sparks
July 14, 2004, 07:40 AM
I have lurked on this thread for a while. I agree with Lone_Gunman the only true cure to trauma is a trauma center (not neccessarily the closest hospital but that is a whole nother kettle of fish). Thinking back through the gunshot wounds I have treated over the years, except for shotguns they really don't bleed a whole lot. I feel comfortable with a couple of 5x9's and some gloves in my range bag.

MagKnightX
July 14, 2004, 07:54 AM
One question: What's with the sharpie?

jwmoore
July 14, 2004, 09:02 AM
What's with the sharpie?

It's important to document.... Write vitals on your glove, 'T 0905' on a patient's forehead :D... You (at least I) can't give or write a thorough report from memory....

~W

sevenpoint62mm
July 14, 2004, 09:23 PM
my advice is to spend as little time as possible screwing around in the field with first aid kits, and get whoever is shot to a hospital ASAP. Most gunshot wound victims can be saved if you will just get them to a hospital.

I think we can all agree on that. I'm just concerned about making sure the "golden hour" is an hour and not 3 minutes.

Jwmoore pegged it on the sharpie.

R.H. Lee
July 14, 2004, 10:45 PM
In case you shove a shotgun down your pants, you might want to have a pair of Neuticles (http://abcnews.go.com/sections/us/WolfFiles/wolffiles105.html) on hand.:D

Pilgrim
July 14, 2004, 11:23 PM
No bone saws?

No cauterizing irons?

No pitch to melt down and pour into gaping wounds?

Billy Sparks
July 15, 2004, 07:53 AM
I think we can all agree on that. I'm just concerned about making sure the "golden hour" is an hour and not 3 minutes.

Just something to think about do you know the address of where you shoot? If it is a remote location can you give directions? Do you have a cell phone? Does it work there? Where are the 1st responders coming from? If you cell phone works will it hit the appropriate 911 center?

I ask all of this because if there is a accident or illness (we worry about GSW, but what about a heart attack or a bee sting?) you want to put in
the call early.

444
July 15, 2004, 10:17 AM
" do you know the address of where you shoot?"

This is critical. If you are calling 911, know the EXACT address of where you are if possible. If it takes a second to find out, find out.
This is one of my pet peeves. This causes me high blood pressure. This pisses me off so bad I can't see straight. If you give your location as a cross street, you had better be standing in the middle of that intersection. Otherwise we can't find you. We aren't psyhic. If you don't give us your EXACT loaction, we can't find you: period. Close isn't good enough.
Imagine if I invited you to my house and simply gave you the name of the closest cross street. Imagine if I lived in an apartment complex and I just gave you the name of the complex and no apartment number. Or said I didn't know the building number. :banghead: How successful do you think a business would be if they gave out their location in advertising as: I don't know exactly, but it is close to 1st and Main. :cuss:

bogie
July 15, 2004, 11:14 AM
Keep in mind that a range accident likely WON'T involve a gunshot. More likely something like a beesting or snakebite, cuts/puncture wounds from shrapnel bouncing back from targets, sprains and minor cuts, etc... I'd guess that the most traumatic type of injury would occur with catastrophic chamber failure, due to a bore obstruction or overloading.

I'd recommend having a CB or cell phone in your vehicle, along with GPS coordinates for your range.

Billy Sparks
July 16, 2004, 08:10 AM
I always hate wreck calls that get dispatched I-40 South of Hwy 52 or where ever. This is the intersection of two major mulit lane roads that run from county line to county line. There is nothing more fun than driving on a multilane highway in rush hour trying to run fast enough to not be run over but slow enough to look for a wreck. Oh did I mention communications wants to know if you looked in the other lanes. :banghead:

along with GPS coordinates for your range
I really don't know how helpful that will be. I don't know if a lot of the 911 centers around me are capable of using GPS coordinates. Most E911 systems are built around a street address, with the fudge factor of GPS I don't know if it would return a valid address. Better to have a steet address even if a approxmation (500 block of Whatever St.) and a GPS then just a GPS coordinate.

If you enjoyed reading about "First aid kit w/ bullet trauma in mind" here in TheHighRoad.org archive, you'll LOVE our community. Come join TheHighRoad.org today for the full version!