Range Safety and First Aid

[Dr.Zubrato]

Everyone has a range bag, and we usually don't forget to bring our hearing protection, or eye pro, but most people seldom consider having a form of first aid, or blowout kit on the range.

Which brand of FAK/IFAK (First Aid/Improved First Aid Kit) or blowout bag do you train/use or bring to the range, and what does it contain?

A vital component of a blowout bag is a tourniquet, and there are many types, such as CAT/H/Israeli/Tk4 etc and have different training protocol.
If you don't have one or two in your range bag or in your car, definitely buy them. They're cheap and are worth more than their weight in gold, when accidents happen.

You can save your life, a family members, or a stranger's.

I have CAT tourniquets, one in my car with a blowout kit, and one rubber banded to my rifle sling.
For my purposes, a chest rig isn't practical as HD or range use so it stays on my sling.

My blowout kit for the range contains : Nasopharyngeal Airway and a safety pin, decompression needle, vacuum packed gauze, quickclot, medical tape, sterile bandages, medic shears, and antibiotic ointment.
I would suggest keeping it in your car at all times if you can only afford ONE KIT, and taking it with you to the range. Obviously two is preferable, for your range bag, and for your car.

Btw: For you guys with CAT touriquets, they're intended as single use only so buy one for practice, and one for the real deal.

Just wondering, have you guys seen a CAT break through multiple uses? I've practiced with one on myself, and trained a few other people on the same one for brachial/femoral artery bleeds with no breaks or failures. At least 10 successful uses (eliminated distal pulse, and able to transport pt in the field.)

For those of you guys thinking "Man I don't know how to use any of that!":
For one, you can receive training, and it isn't too hard to pick up. And secondly, someone around you may be in the medical field like paramedic/doctor/nurse, and can use more advanced stuff in your safety kit on you or someone you love.

Thoughts, and experience?

 

[B!ngoFuelUSN]

I always carry the big kit from AR500. They make a number of nice kits that, though basic are tuned more to trauma than cuts and scratches. Add a CAT tourniquet, Israeli bandage, chest seal(s) and a few other items. All in my range bag/backpack with a red cross patch over the compartment that houses it all. I'm not an expert with it but trained in first aid and was part of the school ambulance squad when in college. Long time back by now. I would really like to get a refresher and a more advanced set of skills.
Seems like if there is any place to carry a kit, the range would be the place.
B

 

[splithoof]

My Kit:
Two tourniquets, set of oral airways, BVM, several occlusive dressings, various rolls of gauze and bandages, coaches tape rolls, rolls of Coban, normal saline for rinsing, OB kit for large blood loss, five sets exam gloves, gown, EMT shears, complete change of clothes w/shoes, large alcohol wipes, pressure dressings, 13 gallon plastic trash bags, penlight, BP cuff, stethoscope, burn sheet, space blanket, roll of duct tape.
Have used all this stuff many times in career. I don't travel with ALS gear, as that would be beyond scope of practice when I'm not on the clock.

 

[bangswitch]

I've got a small bag I put together. Several battle dressings, some 4x4's, a piece of aluminum foil about a foot square (rolled around a small dowel) and a piece of plastic wrap the same size, 6 feet of paracord and a few other odds and ends. Flashlight is in the shooting bag, and I always have a pocketknife. The tourniquet is around my waist, holding up my britches. I used to keep a complete survival kit when I flew, but just cut it to essentials until EMS arrives.

 

[jonnyc]

I have 2 combat dressings in my range bag, and a fairly well-stocked FA kit in my vehicle GHB. Not to mention a cell phone and 2 hospitals within 10 miles.

 

[moxie]

I just wish I could get some folks certified CPR/AED/First Aid. "I took that in Boy Scouts, or the Army, or wherever." Eons ago.

 

[herrwalther]

I still have plenty of IFAK (Improved First Aid Kit) components left over from my deployment that didn't get used. I have a range duffel bag that has targets, chronograph, spotting scope etc. Also 2 CATS and 2 Israeli bandages. I also keep a vehicle first aid kit with reflectors, lights, emergency blankets etc.

 

[denton]

Most of my shooting is at a range with a well stocked first aid kit. My range bag kit is far more modest than what some of you have listed. It fits in a plastic travel box for a bar of soap, and is designed to handle the minor inconvenience level jobs. It contains tweezers, a magnifier, a couple of Band-Aids, Neosporin, two Aleve, and a papaya tablet that can be crushed or scraped to neutralize insect stings.

We did have a life threatening injury accident at the range a couple of years ago, our first in over 25 years of operation. Fortunately, we had a surgeon and a medical lab tech with some training shooting that day. They saved the kid's life, and held things together until the ambulance got there.

 

[Candyman87]

My range bag has a basic first aid kit for hiking, plus an Israeli bandage.

I'm usually at a well-equipped indoor range that can cover things other than boo-boos.

I have a more elaborate first aid kit in the car if I'm at an outdoor range. In there I've got everything I could need and know how to use.

I am First Aid certified within two years. I'm still looking to move on to get trained in Wilderness First Aid.

 

[kayak-man]

My question for everyone carrying a decompression needle: why?

If you a tension pneumothorax, then you may very well need to vent it, but with the blow out kit, we are already making the assumption that this is a GSW and not a spontaneous tension pneumothorax. So, let's use the hole that our patient already has, and vent through that.

I AM NOT ADVOCATING THAT CHEST DARTS SHOULD BE EXCLUDED FROM YOUR KIT.
I'm just trying to point out that a lot of people tend to reach for the dart when they are building a kit, and then pass over an occlusive dressing. If you're patient needs a needle decompression, go for it, BUT don't forget why we are releaving pressure in the chest: because it's getting in from the lungs or the through the chest wall, because a round penetrated that. If a lung is tagged, then yea, we might need to dart the chest, but otherwise, we can prevent a tension pneumothorax in the first place by using an occlusive dressing.

Ok, I'm going to take a few deep breathes now....

All right. Tourniquets, good stuff. As far as the CAT, I've never heard of one malfunctioning, other than the "rumors" and I haven't had a chance to use it, but I think it's a good peice of kit. I've also got a couple of SWAT-Ts because they were cheap, and can double as a pressure dressing.

As far as training goes, I think it's really hard to beat the WMI Wilderness First Responder. It's about a week long, and I felt was not too far behind EMT-Basic.

Candy Man, if you can, skip right to wilderness first responder. It's definately worth it,

Bang switch, I'm curious, what do you plan on using the aluminum foil for?

 

[Candyman87]

Candy Man, if you can, skip right to wilderness first responder. It's definately worth it

If I can find one rather locally, I will. Wilderness First Aid is still rather hard to find around here, but I'll be on the lookout.

 

[herrwalther]

If you a tension pneumothorax, then you may very well need to vent it, but with the blow out kit, we are already making the assumption that this is a GSW and not a spontaneous tension pneumothorax. So, let's use the hole that our patient already has, and vent through that.

Might as well. A decompression needle is small in comparison to the rest of the kit. You can get a collapsed lung from a bad fall too. Decompressing a lung in the field is never fun and should never be done by someone not knowing what to do. But if you know how, you likely aren't going to forget basic dressings in your kit. The head medic I trained under said if worse came to it, you could decompress a lung with a sharp, large diameter hollow pen.

All right. Tourniquets, good stuff. As far as the CAT, I've never heard of one malfunctioning, other than the "rumors" and I haven't had a chance to use it, but I think it's a good peice of kit. I've also got a couple of SWAT-Ts because they were cheap, and can double as a pressure dressing.

First hand account of a CAT failure. When they first came out, the spindle was made out of very cheap plastic and would break under too much pressure. Poor idea considering in a tourniquet that is where the most pressure is. They fixed the problem in the newer ones. A quick way to tell between the flawed CAT and the newer ones, the new ones will have an indicator (usually red) at the end of the pull strap.

 

[kayak-man]

Herrwalther, I'm not saying don't needle decompress, just that if your only going to buy one thing to treat a pneumo, occlusive dressings are the way to go.

Good info on the CAT. I'll check mine tonight for the indicator, but Since I bought them a couple months ago, I'm hoping they are gtg. Thanks for the heads up!

 

[hso]

it isn't too hard to pick up

I agree that training is more important than a big bag of gear, but I think you've overstated.

The kit you have requires specialized training to use all the different parts so how is the average shooter going to get the training to use it?

Where would they get the training?

How much time would the training take to get the basic skills to respond to a gunshot on the range?

How much time would it take to refresh and at what frequency to keep those skills accessible?

 

[WestKentucky]

I keep a "custom" kit in the truck. It contains enough stuff to get me through a day or ten stuck out in nowheresville. Slingshot, yellow glass marbles, bandaids, butane lighter, small block of commercial fire log (think fun size snickers, lights in 10 seconds, burns for about 5 minutes) Gerber multitool, duct tape, electrical tape, 10 quart freezer bags, q-tips, sunscreen, burn cream, neosporin, 100' fishing line, 5 fishing hooks, a 100' piece of 550 cord.......it's all multipurpose and it's all cheap and random. And of course there is an item or two that are just for me like an inhaler and juicy fruit chewing gum.

 

[Dr.Zubrato]

I agree that training is more important than a big bag of gear, but I think you've overstated.

The kit you have requires specialized training to use all the different parts so how is the average shooter going to get the training to use it?

Where would they get the training?

How much time would the training take to get the basic skills to respond to a gunshot on the range?

How much time would it take to refreshe and at what frequency to keep those skills accessible?

Excellent posts by everyone!

Hso, These are all great questions, but I can't answer them for everyone. Individual kits will look different, based on level of expertise and needs; as in EMT/Doc/ER nurse vs. average joe, and going to an indoor range vs. hitting up the sticks.
Many tactical training schools now have medical courses, like Tactical Response which really makes these skills available to the public, not to mention live BLS/ALS courses offered by different companies.
Time to refresh skills depends on whether someone phoned in a course vs. someone who paid attention, took notes, and makes down payments on those skills in the form of practice and re-reading their notes.

I would like to mention again, just because you don't know how to use things in your kit RIGHT NOW, doesn't mean someone on the range isn't trained and can use them on YOU.

It's great having a huge amount of stuff on hand, especially if you've been trained to use it but a word of caution. More stuff you have, the more crap you have to dig through to get to your emergency trauma stuff, so organize well or pick and choose the essentials for your environment.

kayak: Occlusive dressings are definitely the way to go, however after using your chest seal you may notice difficulty breathing in the patient. Depending on level of trauma, you've still got air filling the pleural space through a defect in the lung and that needle is priceless.
I do get your point through, people will skip over useful things to buy romanticized cool stuff.
Can't tell you how many people I've heard talk about field cricothyrodotomy as a first resort.

 

[herrwalther]

Herrwalther, I'm not saying don't needle decompress, just that if your only going to buy one thing to treat a pneumo, occlusive dressings are the way to go.

I agree with you there. Training/mindset on how to deal with a pneumothorax is more important than the toolset. I for sure would not want some random person stabbing my abdominal cavity for a collapsed lung because they saw it on ER or some other hip medical show.

 

[Sam1911]

The tourniquet is around my waist, holding up my britches.

FWIW, the effectiveness of improvised tourniquets is pretty close to zero. A CAT or SOF-T or RAT is cheap...

 

[hso]

hard to beat the WMI Wilderness First Responder

I did SOLO's and my opinion is that Wilderness First Aid and Wilderness First Responder will teach you much more than FR in a concrete setting.

 

[RustyShackelford]

Cadre/first aid-trauma medicine....

A few cadre & training courses are now being run in different areas of the US.
SIG Sauer's Academy, www.SIGsaueracademy.com offers medic classes as does Tactical Response in TN.
There are DVDs and books(US Army field manuals/FMs) for trauma & gun shots.
Id keep a small pack with things like the CAT, Quik Clot, shears, gloves, Asherman seals(I don't recall the full name by the device was R&Ded by a former SEAL medic/medical corpsman for sucking chest wounds).

Some places like Galls, PoliceHQ.com & US Cav have first aid gear.

 

[kayak-man]

Dr Z: totaly agree that needle decompression is a good capability to have. Every one I've talked to about occlusive dressings has said that, if the lung is compromised and you start getting that increase of pressure, it's preferable to vent the dressing prior to putting another hole into your patient. Curious about your thoughts on this. Also, you bring up a really good point about others having the know how to use your gear on you,

HSO: I've taken both the Red Cross first responder and the NOLS Wilderness First Responder, and have to agree, it is a MUCH better level of training, and you get pretty rock solid on patient assessment.

Rusty Shackleford: the asherman chest seal that your thinking of is one type of occlusive dressing. I'm not a huge fan of the Asherman, but I haven't used one, just what I remember one of my mentors saying. Right now, I've got some of the Halo chest seals and they seam pretty awesome, but again, I haven't used one in the field yet.

 

[Sav .250]

Could be useful in a "backyard" range. Most sanctioned ranges have material on hand to take care of any immediate problem. Plus, if necessary, an emergency vehicle can be called for.

Bumps, bruises, abrasions, which do happen, can be taken care of by the "owner" or a by-stander. As you have suggested.

 

[denton]

This has been a useful discussion. I've ordered a tourniquet to add to my tiny first aid kit.