Monday, May 21, 2012

Building an emergency Medical kit for range duty.... your thoughts?

Recently at the Appleseed clinic, one of the instructors hung a military style medic bag off the canopy pole ( you know... the tri-fold type with all the kewl pockets and fancy whojowasits). I looked the kit over, and compared it to my own piddly nod towards carrying a 'medical kit' ... a couple Israeli trauma bandages and...... um..... er.... well......... a bottle of water?

I've had the thought for some time that I needed to build an emergency medical kit to keep in my vehicle and carry with my range bag. Something a little more formal than the few items I shove in spare nooks now. Looking at the bag the Army trained medic brought with him to the Appleseed clinic, the urge solidified... and I've begun the job.

Honestly, my first thought was "Get a kewl medic bag full of kewl medic stuff like the kewl Army Medic guy had!" Sure... that's it.... buy an expensive kit full of really great gear..... that I have no idea how to use. The image came to mind of me sitting on the ground next to some poor doomed accident victim, the fancy tri-fold bag open in my lap, and me just staring at it wondering why it wasn't leaping up and fixing the guy on it's own.

My last formal first aid slash medical 'training' was in the Boy Scouts,
mumble mumble years ago. For all intents, I've had no training at all. On the other hand, I've had a lifetime in an industry where injuries are a daily occurrence, and all mechanics have first aid supplies in their tool box. I've patched up... cut, slashed, smashed, burned, stabbed, and smacked people... including myself. I've had ER docs unwrap my work, compliment me on the job, re-bandage it exactly as I had done, and send me off with a hefty bill. In other words, I'm better than nothing... but just barely.

With that in mind, I figured I'd build a medical kit that played towards what I can actually do, rather than one stuffed full of gear I don't know how to use.

You people is SCHMART.... and I'm asking for your thoughts on what should be in the bag. I'll list what I have so far (Amazon links so you can see what I mean), and things such as analgesics, sunscreen, and bug spray go without saying.... but feel free to chip them in anyway.

Military Cotton Canvas Ammo Shoulder Messenger Bag

BD Alcohol Swabs Thicker, Softer, 100 Individually Foil Wrapped

Braunamid Synthetic Suture / Needle Combinations - 45 cm - 2/0 - Medium

Kerlix Type Gauze Rolls 4"X4 yds, Sterile, 4/bag

Ammonia Inhalant 33 cc 10 per box

Betadine Swab Aid Antiseptic Pads, 10% Povidone, 100/bx

Betadine Solution, Antiseptic, 8 fl oz

Bandage Scissors EMT Paramedic Medical Tool Red 7.25"

Quikclot Sport Brand Advanced Clotting Sponge ,Stop Bleeding Fast, 50 Gram Package

New Israeli Battle Dressing, 6-inch Compression Bandage

Band-Aid Brand Adhesive Bandages, Assorted Sizes, Variety Pack, 280 Count

Universal Aluminium Splint

Unisol 4 Preservative Free Saline Solution, 12 Ounce


Obviously, this all leans towards wound treatment, which is foremost on my mind. But what about allergic reactions? Bee stings? Benadryl, but what form? What pain relievers would be best, besides the obvious Tylenol and Ibuprofen?

Piecing it together this way, Carteach has not even reached $150 in total outlay for the kit, and many of the supplies come in packs large enough to split between home and kit bag. The thing is.... I KNOW I'm forgetting important things!

Help me out here, all you smart people!

(Oh.... and I've already got a large double handful of forceps, clamps, surgical scissors, and disposable scalpels on hand. Don't ask how.... things just happen)




28 comments:

Anonymous said...

Tourniquets, something suitable for a sucking chest wound, snake bite kit? What about splinting material? Just the basics to keep blood in, air out, lungs uncollapsed....til the pros arrive, or you can get to them. JohninMd(help?)

Bob said...

"...snake bite kit?"

NO. Current snake bite therapy requires getting the patient to the hospital as quickly as possible so that treatment with anti-venom can be started. Tourniquets, cutting and sucking at the bite only result in increased tissue damage and delay start of anti-venom treatment. Emergency room doctors typically treat a snakebite with the "three A's:" Anti-venom, Antibiotics, and Anti-Tetanus.

Anonymous said...

Have you considered buying a ready to use kit? Here's two examples.

http://www.galls.com/style-TK096-general_catalog-dyna-med-medic-back-pack-first-responder-kit

http://www.galls.com/style-TK095-general_catalog-dyna-med-compact-medic-first-responder-kit

Anonymous said...

We have four levels of kit. One is some quick clot and 4x4 bandages in a baggie in the range bag. Just to apply pressure and slow down the bleeding until someone can get to:
#2 fairly complete first aid kit intended for coastal cruising from West Marine.
#3 is the bug out kit in a 19" Stanley tool box. It has pretty much everything except the ambu bag (won't fit). It is in:
#4 the overflow supplies plastic tote. We tend to stock up on some things and decided to keep them all in a central location hence the plastic tote.

Notes:
We do not keep the #3 bug out kit in the vehicle because of the heat and humidity. We check the #2 car kit frequently.
A couple of things you may want to add are butterfly bandages and crazy glue. Both can be used in place of sutures. Glue was recommended by an EMT we know.
Wife is a retired RN with ICU, CCU, surgery and recovery experience. Probably from when you were in cub scouts. :) So things are covered as long an she isn't the one in trouble. I catch heck for that a lot.
I have an identical Stanley tool box with the gun cleaning tools and supplies. It sports an NRA sticker the other is labeled with a placard. Both are designed for grab and go if we have to evacuate by car and are stored with the bug out bag.

Terry T
Florida

ps. the super glue is also good if you break a nail....

Nate P said...

I'll give you my opinion as an ER doctor.
The alcohol and betadines are similar enough that 1 of the 3 would be fine.
The ammonia inhalants work well, but don't really do anything that a knuckle rub to the sternum won't do.
4x4 dressings work well when the wound isn't severe enough for the battle dressing or quick clot.
Ace Bandages hold more pressure than the Kerlix.
Get a box of disposable rubber gloves.
Ibuprofen and Tylenol should be could enough for pain, but asprin is first line for chest pain.
25 mg tabs of Benadryl would be enough for allergy.
The sutures are nice, but most bleeding would be controlled with pressure and a good dressing and it may be worth being seen by someone if the wound is bad enough to be sown closed.

Nate P



Nate P

Willorith said...

got my kit in blaze orange bag from Major Surplus for $149

Sport Pilot said...

Your medical kit is a little ambitious for your purposes but will suffice nicely. I trained as an EMT-IV and even though I didn’t maintain my certification I carry less. I’ve learned that just about anything can be improvised to use as a splint so I’ve chosen not to include splints in my gear bag. You should probably include a CPR Mask and some chemical cold packs in your bag though as I didn’t see them mentioned.

Murphy's Law said...

Forget the sutures. Like Nate said, if it needs to be sewn shut, it probably needs to be looked at, and if definitely needs to be cleaned. Even if you know how to suture a wound, if you close one without cleaning it, you've made things worse. Hello, infection! Any open wound can be packed with gauze to control bleeding if it's that bad, and real medical care is going to be needed. I good rule of thumb is "don't pack anything that you don't know how--and when--to use".

Boatnoise said...

There are already some good comments above. Choosing items for your kit that that are versatile is a good idea, as well as including only things that you know how to use.

I captain a schooner during the summer as part of a sailing school for high school kids (you can imagine the types of injuries encountered). We are never more than a day or two from port, but the kids are aboard for two weeks at a time, so sometimes treatment goes beyond first aid. I've found that the most used items are sterile gauze pads, medical tape, antibiotic ointment (with cotton swabs for application in order to prevent contamination of the ointment tube), rubber gloves, ace bandage, a good antihistamine (benadryl), antidiarrheal (Immodium), and a good analgesic/anti-inflammitory/antifever such as ibuprofen. We also keep standardized information cards (index cards) for each drug on hand which include brand name, generic name, description (color, shape, etc.), safe dose, when to give, when not to give, side effects, and what not to mix with. This allows us save space in the med kit by repackaging the meds.

Thinking about other situations you might encounter, it would be good to have a small flashlight, pen and paper (taking notes can be helpful if help is a long way out, also for keeping track of meds dispensed), duct tape (think splints, wound management, etc), some women's sanitary napkins (also versatile and few things are more absorbent), and a resuscitation mask (breathing barrier) if you're trained in CPR.

Anonymous said...

Really good info from your readers. It just doesn't get any better than having an ER Doc and an EMT weigh in.

A couple of additions to my post:
The kit I call #2 from West Marine is kept in the car. I wasn't clear in my original post.
We do have a splint in the go box - it is a SAM splint, is not real expensive and is really small until used.

Nate mentioned the asprin for chest pain. We keep Bayer quick release crystals in the night stand next to the bed in addition to the first aid kits.

Terry T
Florida

Carteach said...

Excellent advice from all, and I am taking it into account.

Why not buy a fully stocked kit from the word go? Because.... it will be full of stuff in small quantities, the majority I have would no idea what to do with. As I use the things I DO know how to use, or commonly use, I'll end up buying larger quantities anyway.

No... I'll put together a kit of things I know how to use, or commonly use in daily life. I am surely used to improvising, no stranger to it.

Old NFO said...

I add one of these, http://www.galls.com/style-RB015-general_catalog-adult-bvm-with-mask-restraint And a set of small, medium and large masks. Additionally, something to seal a punctured lung.

Carteach said...

NFO, I wouldn't know how to use it....

Earl said...

Keep the patient warm and covered.

I remember most about those that need first aid, it is always something that we weren't prepared for totally, but having been prepared for unexpected, you treat, stabilize and evacuate to professional attention.

The airways are critical, the masks seem more to protect us from contaminating each other. I don't associate major burns with shooting ranges, nor drowning. Your bag is full, hope you never need it.

treefroggy said...

http://www.amazon.com/3M-Vetrap-Bandage-Tape-Yard/dp/B0002YFS3I/ref=sr_1_5?ie=UTF8&qid=1337654444&sr=8-5

VetRap. Best thing to hold a dressing in place on a limb. Doesn't loosed up when wet. Most medical tape loosens pretty quickly, and the good stuff is 4X more expensive.

Anonymous said...

US Navy Corpsman OIF x2, OEF.. other places... about 10 years with USMC Infantry units.

from your self reporting about your level of first aid knowledge, your about as smart as most of my Marines. Thats not too bad. The basic principle is that "Air Goes in and out, Blood goes round an round, and any deviation from this is a bad thing"

-Keep your high speed isreali bandages & practice with them. They can put a lot of pressure on a wound, can be applied one handed, and stopping major bleeding is the single most effective thing you can do to save a trauma patient.

-Supplement this with lots and lots of rolls of kerlix. in a bad spot, you can go through this stuff faster then you would ever believe packing a wound trying to stop a deep bleeder

-I agree with the ER Doc.. Ace Wraps are useful for adding pressure (but not necessary with the isreali bandages) and you need them for sprains, & holding splints

-Triangle bandages. Your boyscout neckerchief is for more than just the look. Learn how to make it into a sling, tourniquet, part of a splint, bandage or almost anything else. buy lots, they're cheap.

Tourniquets. Buy a half dozen of the CAT tourniquets. Practice with one, distribute the others. Best thing you can have for major bleeding in a limb.

This will get you through most of the "Oh Shit" moments. If you want to get into Airway management and learning how to stick IVs, do better splints and how to really treat bleeding, take an EMT class at your local community college. Basic Class is about a semester long. 4 months of a couple of nights a week and you'll actually something about what your doing when the defecation hits the rotary oscillator.

Otherwise all your doing is buying shit that some guy on the internet told you to get.

The small stuff...

Buy. a Damn. Bar. of Dial. Soap. the $.89 yellow bar of non moisturizing, kills everything, soap. I have treated and cleaned more minor wounds telling the patient to grab some water and a bar of soap and wash it out then i have ever bothered with betadine or iodine. Why? Because that bar of soap wont dry out like an alcohol pad will after a hot day, and a few people are allergic to betadine/iodine/shellfish and the last thing you want to do is dump an allergen into someones wound. Its no bueno.

Meds- If you dont know how to use it, dont buy it. Make sure everyone you know that has a major allergy has their own up to date epi pen.

DO buy: Tylenol, aspirin, benadryl, immodium, and your favorite decongestant. a couple of tubes of neosporin for covering those freshly soaped and rinsed wounds.

Bandaids. all shapes and sizes. Preferably with cartoon characters, to inspire manliness.

Gloves, as the good dr already said.

a copy of your major info.. name, ssn, phone number, next of kin, major medical history/allergies/meds, doctors or specialist you see and their contact info, health insurance policy numbers etc... AND A BLANK ONE for that idiot that you come across that didnt plan all this ahead of time.

But mostly, take the EMT-B class and figure out how smart you want to be, and you'll know what gear to buy from that.

-Doc

Justin Unbounded said...

Of all the things that you mentioned, I think the training is probably the most important. As you mentioned, you could have the most impressive kit ever assembled but if you don't know how to use it then it is worthless. Which training you want to take is largely based upon how much training you want and how much time and money you are willing to spend.

Your local Red Cross does regular first aid and CPR training for little or no cost. They sometimes will offer AED training which I would also recommend.

If you want more serious training than that, then the cost/time jumps. A lot of local colleges offer EMT/paramedic classes but these take a lot of time and cash.

Look around and contact people. You'd be surprised what you can find. Here are some basic links: http://www.redcross.org/takeaclass

http://www.heart.org/HEARTORG/CPRAndECC/CPR_UCM_001118_SubHomePage.jsp

http://www.firstaidweb.com/

irontomflint said...

I'm no medical wizard, but one area I didn't see covered was the eyes.
I think that you should get a couple eye wash cups and a bottle of eye wash solution.

Carteach said...

I knew I had the best and smartest readers...

Thank you for all the advice folks, and I am taking it all into consideration, especially from you folks who have Been there and Done that.

As the suggestions come in, I've been changing that Amazon 'wish list' of gear. Things go on, things go off, even the bag itself has changed.

Training.... probably the best suggestion of all. I'll start looking into that today. My career is about to get VERY busy, but I have a few days off now and then. With luck I'll be able to plug some affordable first aid training and CPR in there someplace.

dustydog said...

If you are going to be out in the boonies, something to splint a broken arm, leg, and finger with - the stick plus the duct tape.

Automated defibrillator, if you can afford it. Because most people die of heart attacks, even at the range.

A regular box of band-aids, in a box where everything else is wrapped in plastic. Because 90% of the time you go to the first aid box, you just need a band aid and you are going to bleed on everything you touch until you bandage your finger.

A thingy that has an endothermic reaction and gets cold. Because a cold compress is nice when hot brass burns you, or you get bruised.

Duct tape, because when people need tape, they look at your first aid bag as a source of tape. Might as well have the cheap stuff available, in addition to the expensive sutff.

Good tweezers and a flashlight, for pulling splinters.

If you are paranoid, a cheap mobile phone on a pre-paid plan for calling 911. Hopefully with some way to keep the battery from discharging until you need it.

Huey said...

Lots of good advice....in my book you need 3 kits actually....

1. a small "bbo boo" kit for cuts and scrapes at the range, buy one of those $1-$2 little box kits at Wally World or wherever and add some decent bandages and maybe a tube of neosporin...add some tylenol, asprin, bismuth tablets and maybe benadryl...this is always in your range bag or on you....

2. a BOK for those "oh crap" scenarios...assuming we are not talking SHTF and TEOTWAWKI type scenarios and medical treatment is available your main goal is to stop bleeding and keep air moving...nitile gloves, celox gauze (better for sticking in wounds if need be), mutliple Israeli bandages (many firearm wounds will have both an entry and exit wound, and sometimes not where you would expect), 4x4's, trauma shears (cheap), a "space blanket" to treat for shock, and a CAT or other tourniquet. Chest seals are nice to have if its a chest wound (Ashermans are not that expensive or hard to use http://www.youtube.com/watch?v=sfk6dqxMvNI) and if you want to get all SF medic you can get some training on using a needle for chest decompression...not recommended for beginners... Remember, you are trying to avoid immediate loss of life during the "golden hour" until proper medical help (EMT/Hospital) comes into play.

3. "Large Kit" this is the bag that keeps all the other stuff and additional meds on hand...splints, ACE wraps, bug bite cream, hand sanitiser and the like...I like the guy that mentioned soap..we tend to forget in the "modern world" but soap is a medicinal product in preventing disease and infection.

Important thing about all of this stuff..get training, if nothing else a basic 1st Aid and CPR class given by the Red Cross.

Good post and good responses here. Glad you had a good time at Appleseed, still need to go this year...

Huey said...

also should of added...small flashlight (Mini Maglite) to the BOK in case you need to be able to see what you are doing...

Michael W. said...

Two other additions I might suggest.

A GOOD pair of trauma shears. You may have to remove clothing to get to a wound, and those suckers will cut through ANYTHING. Belts, heavy clothing, under-wire bras, you name it. With their blunt tips they are much safer than other kinds of scissors. I would also recommend stashing a small bottle of the very best dark rum you can lay your hands on. If you are ever so unlucky enough to need to use these items, I will guarantee that you will need a good stiff drink when it's all said and done.

Anonymous said...

My car kit's in a red bag marked FIRST + AID, so if some idiot (e.g. me) puts a bullet in my leg at the range and somebody else has to go dig under my front seat for it, he'll know it when he sees it.

But I really should get a minimal IFAK for the range bag: Israeli dressing, celox, gloves, shears, tape, 4x4 pads. If I need anything other than that stuff, either I'll be dead, or it can wait while I walk to the car. Well, a few bandaids are handy, I've cut my fingers on staples sticking out of target backing.

Carteach said...

Friends, taking all this advice into account, I'll be ordering the beginnings of the med kit this weekend. When I have it mostly together, I'll write it up here and look for more help in fine tuning.

Also, I've located a Red Cross class not far away that will be running in July. If I can make the date, I'll sign up for that too.

Thank you all!

Anonymous said...

Dammit - the one thing that I need to know - the one piece of information that I was hoping to learn from this thread, is WHAT DO YOU DO WHEN SOMEBODY GETS SHOT???

Blood is leaking from a hole or two, people are carrying on like it is an emergency (because it is an unusual circumstance), and I am standing there with my first aid kit, wondering if I should patch the hole on the outside, or shove gauze or a tampon or something into the holes.

I know that it is complicated. I know that there is gobs of training to be had. But it's too late to take a class when you are looking at someone bleeding.

Extremities, I figure direct pressure, and a tourniquet if that doesn't work.

High extremities (groin, armpit) and torso hits I figure the tourniquet won't work, so some of that quick clot that I've been meaning to buy for my kit might be vital, or at least nice to have.

In the absence of years of training, or decades of experience on the streets, what should I do? My knowledge starts and stops at direct pressure, and my experience is limited to band-aids on cuts.

What do you do when seconds count? With a really serious bullet wound that somebody could live through if only I had known what to do.

Anonymous said...

Here's a thread from The Gun Counter from about a year ago on this topic.

http://theguncounter.com/forum/viewtopic.php?f=6&t=15841

Good friend Doc Russia (boarded in emergency medicine, tactical medicine fellowship) came up with this. Read the thread for his rationale.

(1) QuikClot Combat Gauze, Z-Folded

(1) Black SWAT-T Tourniquet

(1) HALO Seal (2/pk)

(1) 5 X 9" Trauma Pad

(1) Nasopharyngeal Airway, 28 French

(1) Surgilube, 3g Packet

(5) Sheer Strips 1 x 3 Band-Aid

(1) Aspirin 325 mg Tablet packet

(1) Ibuprofen 200 mg Tablet packet

(1) Diphenhydramine 50 mg tablet packet

(2) Safety Pins, 2"

(2) Nitrile Gloves, Large

(1) Splinter Picker/Tick Remover

(2) Triple Antibiotic Ointment packets

The whole business fits in a double AR mag pouch. Add an Olaes bandage if you're so inclined.

You should come in under $100 for the kit.

Carteach said...

Started assembly this evening. Amazing how many things I already had on hand at the house.

I've ordered a few more things (Shears, DEET, etc) and need to hit up the local discount drug store for a few OTC things.

When I get it to suit, I'll unpack and gut the whole thing and we'll go over this again...