do you even med kit bro?

I work in and around heavy trucks, heavy equipment and mechanic garages all the time. A lot of of things there that can cause significant injury in an instant. Also cover around 40K miles a year for work on the highways & byways, not including any personal driving, lots of chance to be either involved or be at the scene of an accident with injuries. Also like to shoot, and am frequently by myself doing it as my best shooting buddies live out of town. For all these reasons and more I've taken to carrying a trauma kit in my (almost) always with me EDC bag. It's never further away then my vehicle is.

It was a premade kit that I added some extra's to: mainly knuckle bandages and antiseptic ointment as hand/finger injuries are quite common in my line of work. I've been certified a number of times over the years in basic first aid and CPR, and was an instructor for several years. I'm by no means a medical pro, but I've got a few things in a compact kit and a little knowledge that may very well end up being the difference for myself or someone else at some important time. For the $50 or so I have invested in it, I consider it a cheap and VERY worthwhile investment. YMMV

The American College of Surgeons Committee on Trauma have been working on a Program called "Stop the Bleed" based on the fact that many of the deaths that have occurred after mass shooting incidents are due to exsanguinating hemorrhage from extremity wounds. Realistically major GSW to the torso is not going to end well and the focus needs to be on salvaging as many patients as possible with prompt application of tourniquet or very secure pressure dressings. The link is https://www.dhs.gov/stopthebleed. Many sporting activities take place in the boonies and cell phone communication is not reliable in these places. Also a good idea for police officers, game wardens, etc. for self- aid, when help may be a long way off if it can be summoned at all.

The phrase used in the medical community is "the golden hour." A proper medical center can do some serious medical miracles in that hour.
My old Appleseed location was Cawthon, Texas, which was 15-20 minutes out of Navasota, or about 30 minutes out from the larger trauma center in Bryan. Cawthon was not incorporated, so any 9-1-1 response would have been from the VFD. Which would have taken 15 minutes to arrive, and another 15 minutes to transport. Concensus opinion that self-transport to navasota was probably the best option, and if they needed more they could get LifeFlight to Bryan in under 15 minutes *LifeFlight has a training facility in Bryan, conveniently enough). Houston was about 30-40 minutes away by LifeFlight, as well).

A couple of the ranges I would go to were decidedly a long way away from serious medical care. As were the river bottom lands where I huunted--most of those were a thirty minute hike from the road. Yet, none of those locations were far, as the crow flies, from respectable medical care. Yet they were often an hour away. And further complicated by being solo most of the time.

In my case Unc' Sugar kept me in a bit more than my share of medical training. But, architecturally, I (by accident, not design) wound up helping renovate the ER in Navasota.

So, I probably pack more gear, redundantly, than most.

If your an out door guy ...........for sure. They don`t take up any/much space. Certainly give you comfort
and protection in time of need . I`ve got one under my back seat. Used it more than once.

I am fortunate to have gotten quite a bit of medical training in the Army (multiple "Combat Lifesaver" courses. Similar to the American Collage of Surgeons article, the 3 most likely causes of preventable death on the battlefield are bleeding (by far), followed by tension pneumothorax and obstructed airway. Current training focuses on the tourniquet primarily and also how to insert a nasal tube and handle a chest decompression.

So as mentioned before, the tourniquet is the single biggest bang for buck item. I also like "Israeli" bandages as they are a great pressure dressing that can be really cranked down tight like a tourniquet. I also have a nasal tube, needle for chest decompressions, gauze, tape, scissors, gloves, Asherman seal in my BOB.

I don't EDC anything, probably should. I could get a lot of mileage out of a pressure dressing and tape. The plastic wrapper for the dressing and tape can be used to seal a chest wound.

zorro45 said:

The American College of Surgeons Committee on Trauma have been working on a Program called "Stop the Bleed" based on the fact that many of the deaths that have occurred after mass shooting incidents are due to exsanguinating hemorrhage from extremity wounds. Realistically major GSW to the torso is not going to end well and the focus needs to be on salvaging as many patients as possible with prompt application of tourniquet or very secure pressure dressings. The link is https://www.dhs.gov/stopthebleed. Many sporting activities take place in the boonies and cell phone communication is not reliable in these places. Also a good idea for police officers, game wardens, etc. for self- aid, when help may be a long way off if it can be summoned at all.

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Not exactly a new thought. For battlefield medicine they mostly stopped teaching what you learn in most CPR classes. Example the check for a pulse, check for breathing etc. Combat medicine focuses almost solely on stop the bleeding.

strambo said:

I am fortunate to have gotten quite a bit of medical training in the Army (multiple "Combat Lifesaver" courses. Similar to the American Collage of Surgeons article, the 3 most likely causes of preventable death on the battlefield are bleeding (by far), followed by tension pneumothorax and obstructed airway. Current training focuses on the tourniquet primarily and also how to insert a nasal tube and handle a chest decompression.

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Same. I stayed on top of my CLS certification and maintained one through 8 years in. On one of my recerts I got to work with a vertible legend in the military medical community. He took the recertification handbook, ripped out half, and showed us some far more useful information not part of the course. Less than a year later I was using the skills for real.

strambo said:

So as mentioned before, the tourniquet is the single biggest bang for buck item. I also like "Israeli" bandages as they are a great pressure dressing that can be really cranked down tight like a tourniquet. I also have a nasal tube, needle for chest decompressions, gauze, tape, scissors, gloves, Asherman seal in my BOB.

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Buried somewhere I still have 2 Israeli bandages and an extra CAT I was issued. Pretty amazing how adding one little clip and better elastic made a bandage 100x better than the old OD green field dressing that was issued for close to 30 years. The CAT definitely does not expire and, as far as I know, neither do the bandages. When I get around to it I'll dig those out and build a med kit around those.

Speaking of expiration, I asked a PA about expired quick clot, he said you might as well keep it and use it if it is all you have, it won't hurt, just probably won't be as effective.

To the OP. I was a combat medic for a long time, and been to a lot of cool schools, and held a EMT-B, I i think thats A now, and P for awhile. (obviously not all at the same time, but through out 10 years)
Maybe I am jaded or desensitized or maybe just an unlikeable A**hole, but I can tell you right now, if I don't know you and we are on the range, and you get shot in any which way...I'm not doing anything besides calling 911 regardless of my med bag in my trunk or CLS kit in my pack. I don't hold any certifications now, and it makes me happy. I don't trust people, you would be surprised how fast people go to try to sue you. Unlike the military...who can't sue you, most of combat casualties will thank you for being their doc and doing doc stuff.....civilians...anything to make a buck...I'm not running the risk of people denying, counter accusing, and stringing me up in any court battle. For a ccw thing, take care of you and yours, if you are involved in a justified homicide then don't worry about the other guy, take care of you and yours. For a mass casualty, code white, mass shooting. Secure the immediate area, Martin Baker the hell out of there, and let the popo's do their thing as they let EMS get in within reason to handle the casualties. Rule #17....don't be a hero. I say this because unless you spent years in gun fights and dealing with combat trauma casualties, you'll probably just get in the way without the proper training. Last thing I want after getting shot is some inexperienced hero trying to stuff me with a chest tube after watching a youtube video.

Klint Beastwood said:

To the OP. I was a combat medic for a long time, and been to a lot of cool schools, and held a EMT-B, I i think thats A now, and P for awhile. (obviously not all at the same time, but through out 10 years)
Maybe I am jaded or desensitized or maybe just an unlikeable A**hole, but I can tell you right now, if I don't know you and we are on the range, and you get shot in any which way...I'm not doing anything besides calling 911 regardless of my med bag in my trunk or CLS kit in my pack. I don't hold any certifications now, and it makes me happy. I don't trust people, you would be surprised how fast people go to try to sue you. Unlike the military...who can't sue you, most of combat casualties will thank you for being their doc and doing doc stuff.....civilians...anything to make a buck...I'm not running the risk of people denying, counter accusing, and stringing me up in any court battle. For a ccw thing, take care of you and yours, if you are involved in a justified homicide then don't worry about the other guy, take care of you and yours. For a mass casualty, code white, mass shooting. Secure the immediate area, Martin Baker the hell out of there, and let the popo's do their thing as they let EMS get in within reason to handle the casualties. Rule #17....don't be a hero. I say this because unless you spent years in gun fights and dealing with combat trauma casualties, you'll probably just get in the way without the proper training. Last thing I want after getting shot is some inexperienced hero trying to stuff me with a chest tube after watching a youtube video.

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Some states have a 'duty to render aid' clause in their CCW laws, and in their hunting laws. Failure to do so is a Felony, at least in WI, might be a misdemeanor in others. They usually have a release from suit written in there also, with the words "In good faith" included.

entropy,
Ill render aid with a proper follow up shots. Unless this applies to bystanders then that is whatever.
Either way, I don't know of Cali having laws as such, other than good Samaritan law. If they have another duty to rescue law then they probably don't enforce them here for sure.
Define rendering aid by your state laws....I mean 80% of the state isn't a walking paramedic so rendering aid could be just calling 911 and putting on a tourniquet. Or maybe just CPR which is useless if say your hunting and your buddy shoots at a bush thats moving and hits say a kid with his .300 win mag. Hydrostatic shock will take its tole.

Two things: First, don't use tampons to stop bleeding. They give a false "positive" of stoppage while the internal bleeding goes on unchecked. Take a class on wound packing. Second, most states have "good samaritan" laws that prohibit suing someone for rendering aid in good faith. This does NOT, however, apply to professional healthcare workers in most cases. They are expected to render aid to the professional standard. This may not apply to your state, I haven't lived in all fifty. And have no plans to.

I carry a USMC IFAK attached to my range bag. Individual First Aid Kit. From my days in the glorious corps.

I've another I'll put in the car now that I think about it.

As for training, meh. I've spent some time with a corpsman, but regretfully I never got to go through Combat Lifesaver.

I can do more than the average Joe, but less than I should be able.

I too have an IFAK on my range bag and one in each vehicle, as well as one attached to my heavy plate carrier for work.

For those saying that gun shot wounds are unlikely, keep in mind that things like tourniquets are also useful for things like serious automobile accidents. I respond to crashes every day at work, but 99% of the time there is a non-first responder on scene before we are; some of these crashes involve things like missing limbs . . . putting a tourniquet high up on a missing arm can save a life, and for me is cheap insurance.

Blkhrt13 said:

Do you add medical training to your prepping and firearms training? This is part of why I'm trying save up and not buying more guns. Because I need more training both in tactics for shooting and to help learn more of what to do if an accident happens or in any other worst case scenario.


http://darkangelmedical.com/

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I took a Combat Lifesaver Class in the Marines and had to stay current on my CPR and basic trauma with the Forest Service as well. I have an IFAK on my "purse," which is the backpack I carry around with me everywhere. I feel like I am definitely not a surgeon but probably better than nothing. I should be able to take care of the basics but I applaud any effort someone wants to make to be less useless than me.

Like said before, giving first aid as a non-professional is generally not a huge concern regarding being sued thanks to Good Samaritan laws. Thank God.

Second, and I don't think it has been mentioned here before, you should really make a distinction between a comfort-oriented first aid kit, and a lifesaving-oriented first aid kit. For a regular person minding their own business, honestly I believe any decent first aid kit will have a bit of both. You won't ever carry your first aid kit if it only has tourniquets and chest seals (because you'll never need or use it), but it does you little good to try to fix a gunshot wound with band-aids and aspirin. Every good first aid kit has a bit of both, and you should choose what components work best for you depending on what you like, what you're most likely going to need, and what you know how to use.

Next point, there isn't any first aid kit on the market that is perfect for you. You'll have to expand, reduce and compliment as necessary. Personally, I have a fully stocked Ever Ready First Aid Fully Stocked First Responder Kit, Orange (Disclaimer, links are Amazon affiliate links. I tend to use them as a habit) at home, which I use as a "main" first aid kit, and use to stock my other secondary first aid kits as needed. My favorite secondary first aid kit is ADVENTURE MEDICAL KITS Ultralight 0.5 Solo First. I never carry one on my person, but if I'm carrying a range bag or backpack you can pretty much bet I have one inside. It's a tiny waterproof bag that weights about an ounce that you can stash in any backpack side pocket along with a CAT. So basically I have one on me 90% of the time. The trick is to buy boxes of individual "doses" of everything (Like these Wonder Seal Packets of clotting powder or Alcohol Antiseptic Wipes), keep those in the main bag, and simply put 2 or 3 mini doses in the smaller kits. That way you can have dozens of "fixes" in a tiny bag. I use my first aid kits (as a normal civilian) pretty often, although ironically never on myself.

Regarding IFAK's, honestly I've bought a "commercial" one once and decided to never do it again. The AR500 Armor® Tactical EPIK (IFAK) is just a loaded Condor Tactical Sidekick Pouch. Just buy a Condor First Aid Pouch in the size you want and fill it yourself for cheaper with what you want to carry and what you know how to use. I use the Condor Rip-Away EMT Pouch on my SHTF plate carrier, the Condor Tactical T&T Pouch as my serious range bag first aid kit. Then I just fill em up myself. But honestly my IFAK's are more as a hobby or a "just in case". If I had to choose only one, I'd take my Ultralight kits in a heartbeat.

Training is paramount of course. I personally did a 40 hours hands-on training, 40 hours theory training which is the best course I've ever done (certified lifeguard training). After that I've done more CPR courses, First Aid Courses, or or short preparedness courses than I care to remember, besides articles or Youtube videos to keep it fresh. I definitely appreciate knowing that I have first aid skills for most frequent injuries and issues. The downside about it is having friends come over whenever they want free first aid after minor but ugly incidents. Last time I used my first aid kit it was on the ugliest case of slide bite I had seen, on a friend, who was bleeding quite a bit making a mess in an indoor range. Wound Seal + Bandages + 3M Steristrips saved the day (it was almost funny to see the Range Officer standing by cluelessly while I gave first aid). I certainly recommend multiple packets of the smaller haemostatic agent (the Wound Seal above) rather than simply keeping Celox, which you will rarely if ever have an excuse to use. Wound Seal is useful to me at least 2 or 3 times a year.

Below you'll find a file I wrote for myself as a checklist for the components I like keeping in stock. Yes it will seem pretty exhaustive and overly complete, but it all fits in the first responder bag linked above that I just keep stashed in a closet. I keep that document in my first aid kit since it also provides me with some basic tips, advice and use suggestions. It explains what almost every serious component in the kit is, and how to use it. In the document you'll also find what I stock in my mini first aid kits, all of which surprisingly fits in my ADVENTURE MEDICAL KITS Ultralight 0.5 Solo First.

By the way, having some fun learning to use a Nasopharyngeal Airway on yourself is a must-do for anyone learning serious first aid. My eyes still tear up remembering it...

Of course, typical disclaimer that all of this is my opinion and any information is for informational or entertainment purposes only. Sigh.

Blkhrt13 said:

hanks for the post. This is what I was hoping for some serious tips and links!!

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Did you end up doing anything? I remembered this post while organizing my mini first aid bag today.

I don't carry any kind of first aid kit, but I should. I just never got around to it.
I personally don't think you need to buy anything exotic or expensive. First of all you need to get trained in CPR: this is where you can make the difference between saving a life and giving EMS something viable to work with. Second I think you should have a box of Kotex pads and some tape and some roller bandages (Kling or athletic wrap) to secure the dressing with. Finally I think you need a tourniquet and understand how/when/where to use it. Oh, and you need some latex gloves for yourself. You could also use one to seal a penetrating wound to the chest.
I agree that the chances of you using this stuff on a gunshot victim are remote (but it's possible); you are much more likely to use this on something else already mentioned like a lawn equipment accident. CPR, you may need at any time.
The biggest thing you need to bring to the table is the willingness to step up and get involved.

FWIW: I made my living for over 30 years as a paramedic and a firefighter/paramedic in an extremely busy urban EMS environment. I retired from the FD and still work something like 30 hours a week for a small, semi-rural EMS agency as a retirement/gun money job. I have been on many hundreds and probably thousands of critical trauma calls and the stuff I mentioned above would handle most of it. But I can't express in strong enough terms how critical having someone doing something before we get there would improve patient outcome. And at the risk of beating a dead horse here, the biggest thing is CPR. You can look up the statistics; if everybody just stands around waiting on EMS to get there, the chances of the patient surviving fall like a rock. Seconds count.

Just to beat the horse a little more: I spent almost my entire career in one of the biggest resort cities in the US (for that matter, the world). For the first decade or so, "saving" a victim of cardiac arrest was extremely rare. A group of people instituted a program to train hotel security, airport employees, people working in gyms as well as the police in CPR and the use of the AED. The department I worked for standardized our cardiac monitors defib pads with the same brand as the AEDs being used by all the trained laypersons. And these people took it seriously and started using the training. We started getting security video of someone collapsing in a hotel and security jumping into action with quick effective CPR and quick and effective use of the AEDs. As the video rolled our crews arrived and quickly disconnected the cables from their AED to our cardiac monitor and begin ACLS along with securities' BLS. By the time I retired, it was actually unusual to NOT arrive at the hospital with a viable patient. Again, this was made possible not by us having better equipment or better training but by the public getting involved.

I know this isn't as dramatic to discuss as gun shot wounds, but this is where the bystander can do the most good in a situation that is FAR more likely to be encountered than a critical trauma. A catch phrase used often in EMS is: "Trauma is a surgical disease". In other words, we can't fix the problem, and the ER can't fix the problem. The trauma patient needs a surgeon. That isn't to say there is nothing you can do. Stopping the external bleeding is something you can do but it isn't going to fix the problem and there is nothing you are going to carry in a kit that is going to fix the problem. Rapid transport will fix the problem by getting them to an OR.

FWIW: the gun club I belong to has an AED in the club house and phones on each range that direct dial the 911 center. When you pick up the receiver on the range, the phone at the 911 center starts ringing.

444 said:

FWIW: I made my living for over 30 years as a paramedic and a firefighter/paramedic in an extremely busy urban EMS environment.

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I appreciate the insight, it was interesting.

Question though. The eternal debate that seems so popular lately, Hands only CPR good enough? I can't really believe that ventilation is not worth it, just in case. You might break a few ribs doing the hand pumps, so ventilating isn't necessarily the risky part of the equation anyway. The most convincing reason I've heard so far is simply that that you might get some people to do hands only cpr whereas they wouldn't have done anything at all should they consider mouth to mouth necessary. Even if you are alone, at least it gives you a moment to stop and take a deep breath. I think most people underestimate how physically intense giving proper CPR is. 30:2 @ 100min is. It sounds trivial until someone pulls out a stopwatch.

Just to clarify, I do realize that it's a statistics game. A defibrillator doesn't save everyone, nor does CPR. It's just that I don't think the small downsides of ventilating are worse than it's small potential benefits.

444 said:

A catch phrase used often in EMS is: "Trauma is a surgical disease".

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Nice quote, I've never heard that.

MillennialGunslinger; to be honest, I don't know what the studies show in regard to CPR with ventilations. I do know that when someone goes down in cardiac arrest, the people standing right there, where and when it happened, are probably the only chance that person has to survive.

I worked at a department where we would receive an alarm and we had two minutes to be driving out the barn doors. It didn't matter if you were on the toilet, in the shower, eating dinner, or asleep; you had two minutes to be enroute to the call. If you made that time limit 9999 times in a row and on the 10,000th time you took three minutes, dispatch would notify the Battalion Chief any time of the day or night and he would be on the phone when you got back to the station wanting to know why it took you three minutes to respond. Over 90% of the time we arrived on-scene within 8 minutes of the time of alarm. Again, you could be asleep and eight minutes later you were walking up to the door of the house. This is an excellent response time. You won't get that most places. But as good as that is, if you look at the statistics, 8 minutes is too long. That victim of cardiac arrest needs help immediately. Even with an 8 minute response time, if nobody did anything prior to our arrival, we can start all the IVs, give all the drugs....................and the patient has a VERY slim chance of survival. The bystanders are the key link in the chain. They MUST step up and act if this guy is going to make it.

In EMS, the phrase "Trauma is a surgical disease" means: you have to load and go. You can't stay and play. We can apply dressings, do needle chest decompressions, start IVs and all that stuff, but if you delay transport to do any of that; you are not increasing the patient's chance of survival; you are decreasing their chance of survival by delaying the time it takes to get them to an OR. You still do the IVs, you still stop the bleeding, you still do all that stuff, but you do it on the way to the hospital. Again, where I spent the majority of my career your on-scene time was also closely monitored by several different agencies. If you were on-scene longer than two or three minutes, there had better be a good reason why stated in your report. And these patient's need to go to a Level 1 Trauma Center: just getting them to any old ER isn't good enough. The receiving hospital has to have a full surgical team available 24/7/365. I have seen critical trauma patients where they were being wheeled into an OR within 15 minutes of the time of alarm. That includes the EMS response time, on scene time, driving to the hospital and a brief exam in the ER.