MEDICAL: Putting Together a First Aid kit

Authors FAK

I started thinking, as summer is coming up, just what I want in my first aid kit for the range and any firearms classes I will be attending. Then I tried to decide what would be a good kit for just about anything I would do outdoors that might cause a traumatic injury. I thought about what we had at work (local fire/EMS department) and what changes have come along since the wars in Iraq and Afghanistan.

With the wars in Iraq and Afghanistan we have revamped a number of things we do in treating traumatic injuries. Probably the most significant change in this care has been the reintroduction of tourniquets. What for well over 20 years had been a major No-No is now initial care. In the “old days”, care was done by ABC; Air way, Breathing, Circulation.

Now the standard is EABC. The E, standing for Exsanguination or better known as “bleeding out”, is the number one killer on the battlefield. So our first step is to stop the bleeding with direct pressure. If direct pressure will not stop the bleeding we then can go to a tourniquet. Just to clarify, we do not use tourniquets for bleeding on one’s neck, ok people.

Treating trauma is pretty simple when you get right down to it. It involves stopping the bleeding with direct pressure and protecting the airway. Past that there is not much else one can really do outside an operating room. Trauma is cured by surgeons, and the only place we find those these days is in hospitals. That being said, my favorite kit item is the Israeli Bandage, also called the Emergency Bandage. It is a pressure bandage, tourniquet, sling, and just about anything else you can figure to use it for.

Israeli emergency Bandage

Israeli emergency Bandage

In addition to my favorite and most important item, here is a quick list and explanation of what else I would carry.

- Gloves: Latex or if you have a Latex allergy, Nitrile. Who wants to get covered by somebody else’s fluids?
- Trauma Shears: Excellent for cutting away clothing and light gear to get to an injury. Hell, you could strip your favorite person naked with these things in less than 30 seconds.
- ACE Bandage: Standard, which can be used in many ways, the same as an Israeli bandage.
- Kling Bandage: As with the ACE bandage, can be wrapped tightly to create a tourniquet or hold a 4x4s over a wound.
- Cravat / Tri-Angular Bandage: Good for making a tourniquet, securing a limb to a splint, or making a sling.
- Tape: I prefer cloth medical tape because it is strong. The other great tape to use is 100mph or Duct Tape. As any real man knows, you can fix anything with Duct Tape.
- 4X4 Gauze Pads: Can be used to cover just about any injury and then secured with either tape or Kling bandage.
- Band-Aids: For the little boo-boos.
- Neosporin Ointment: Good for small cuts and scrapes. More importantly, it is excellent for burns.
- Bee Sting Swabs: Can be used for any painful bug bite.
- Benadryl: For allergic reactions, which can be caused by a bug bite or sting, plants or even foods.
- Aspirin: For all of us old farts that still have the strength to lift a weapon and fire it. Keep some chewable aspirin with you just in case the Big One should rear its ugly head. Aspirin is the first line of defense for heart attacks.
- Ice Pack: For the bumps, bruises, sprains, and fractures. Cold should be used as much as possible for 48 hours to keep swelling down. Don’t apply the Ice Pack directly to skin as this can cause frost bite which is an injury you really don’t want.
- Plastic Bags: Use baggies to organize and separate out the above contents. Baggies can also be used in conjunction with the aforementioned tape to help seal a wound to the chest, back or abdomen.

Basic First Aid Kit Contents

I have not listed clotting agents like Quick Clot. The reason for this is despite its supposed efficacy in the movie, what Mark Wahlberg does with it when he gets shot in the chest in Shooter is an improper and dangerous use of the product. When used incorrectly these agents can do more harm than good. Become proficient with the other items listed above and you will not need them.

Now come some extras I believe one should also carry which are not really part of a first aid kit usually, but in my opinion should be.

Water, sunscreen (I prefer Coppertone spray SPF 70+), cell phone with fresh batteries, a multi tool, flash light with extra batteries, a good knife, and a GPS that gives latitude and longitude (now found in many cell phones).

These are items that in an emergency can truly mean the difference between life and death. Not all of us live in the big city and out there in the woods or our favorite isolated from civilization shooting spot that GPS, phone and light can mean the difference between a MEDEVAC helicopter getting to you and having to search for you.

What do you all keep in your FAK?

—————————————————————————————

~Andrew R.
Contributing Medical Correspondent

Andrew R. has been involved in EMS for 24 years with 18 of those years as a paramedic for a fire department just outside the Washington DC.  During this time Andrew has also served for 10 years on a Federal WMD Decon Team, 5 years as a Forensic Investigator for the Office of the Chief Medical Examiner for the State of Maryland, done ride-alongs with MDA (Magen David Adom, the ambulance service of Israel), and has been involved in the training of Navy SEAL and Air Force PJ paramedics.

Be Sociable, Share!

36 thoughts on “MEDICAL: Putting Together a First Aid kit”

  1. One handy item might be the SAM Splint, or any other universal splint. One of the more bulky items, but well worth it in my opinion.

      (Quote This Comment)

  2. Good article, amazing how many folks buy off the shelf kits that are all but useless in real life. I always pair up my gloves into a ball and have 4-5 pairs.

    In addition to the items you mention I also carry..

    2 x oral airways
    2 x nasal airways
    C-A-T tourniquet
    Lock knife with window breaker and seat belt cutter
    12hr Cyalume stick (night time marker)
    4 x saline packets (people always get shit in their eyes)
    2 x tampons (plugging bleeding wounds.!!!, good kindle for fires)
    4 x dioralyte (electrolyte replacement)
    2 x face shield (if you need to do mouth to mouth)
    2 x 14g cannula (tension pneumothorax)
    2 x 18g cannula (fluid replacement)
    Couple of syringes (cleaning wounds or Valsalva during hyperventilation)
    1 x strip of paracetamol
    1 x strip Ibuprofen
    Handful of sterile surgical wipes.

    Stevie

    [img]http://www.deathvalleymag.com/wp-content/uploads/2010/03/FAK 22222.JPG[/img]

      (Quote This Comment)

  3. Good ‘quick and dirty’ list, it’s pretty close to what I keep in my trunk. I double up on some stuff.

    I worked as an EMT in several mid sized city’s (South Central PA, Eastern PA, Western PA) in the past, I’ve also learned a few other things that I keep with the kit. (some because I am proficient with them and is a nice to have item).

    A slim form red lipstick. This is used to mark names, bp’s, stats, allergies, areas of issue (that aren’t apparent). it’s easier to remove than a sharpie and has proved useful.

    Tampons. ??What?? you say? Yes, Tampons. They’re great in an emergency situation when you either run out of or don’t have something for large puncture or bullet wounds.

    Sanitary Napkins. See Tampons above, but just about as good as a trauma bandage.

    The last two items I listed are also great in case my wife or any other woman I’m with happens to not have their with them. And before y’all start thinking I’m some kind of fruit or freak, these were suggested by medics I used to work with, and I’ve actually used them both in the field.

    I also keep an all weather pen, all weather paper as well as matches/lighter and a sharpie. I’ve got a bp cuff and stethescope as well as a cpr mask, some small splints and at least a 1 liter bottle of sterilized water.

    And one of the more important pieces that I tend to keep in the bag in the car is at least one or two small stuffed animals. If you run into a situation where you happen to come across an accident on a back road, or a situation where children are involved, it goes a LONG way to helping calm them down or keep them calm. We used to keep a small box of about 5 or 6 stuffy’s (as we called them) on the ambulance, if a child got a ride in the ambulance, they got a stuffy. It made their experience less traumatizing and helped build their confidence that they could trust us a little more and weren’t afraid. It’s a little thing, but hey…everything helps.

    And yes, it’s more of a jump bag then a medical kit, but I would rather have it and not need it then not have it and need it.

      (Quote This Comment)

  4. Great set-up. I concur with what Stewie and Norm added. Norm; for marking on pt’s these days the “standard” is blue sharpie. The blue doesn’t get lost in blood and other bodily fluids and looks pretty cool under NVGs.

    Sharpies are really handy; one can mark the outline of wounds/infections with it, use it for a windless when improvising a tourniquet, etc. Who would have thunk that the lowly Sharpie would become so important!

    Keep up the great work!

      (Quote This Comment)

  5. If you run out of trauma toys (stuffed animals) or like me don’t normally work in an environment were it’s needed. Make a baloon of a glove. It works!

      (Quote This Comment)

  6. Everyone is going to find what suits them for medical supplies based on mission, resources on hand, and CASEVAC time lines. But here is another acronym to throw at you its what I teach all my guys, MARCH.

    Massive hemorrhage
    Airway
    respirations (how fast or slow, deep or shallow, any at all)
    Circulation
    Hypothermia

      (Quote This Comment)

  7. Could you go into more detail on the Israeli bandage in a future piece? I’ve seen them for sale, but I didn’t know that they were that versatile. What kind of problems do you see being caused by Quikclot sponges and combat gauze?

      (Quote This Comment)

    1. Because many people treat QuickClot like it is just another bandage or something that you can just use whenever – it is a serous form of medication that requires training to use

      If you know how and when to use it then carry some, if not then ether get some training or use the stuff listed in the article

      I took a class on using it a wile back when I first went to Iraq, it can be a lifesaver if used properly. I had QuickClot, QuickClot sponge and an Israeli Bandage in my FAK

      I have actually been hearing that Celox is better – maybe the medics here can chime in on that one

      I’ll see if one of the medical Correspondents here can write something up on the Israeli Bandage

      ~James G

        (Quote This Comment)

  8. Good article, but it’s hard to imagine Combat Gauze doing more harm than good, since it’s just gauze impregnated with an inert kaolin substance that produces no heat. Old-school powdered Quik-Clot is pretty behind the times. Today even the QC products that do use a zeolite formulation (like the QC sponge) produce less heat that the first generation QC.

      (Quote This Comment)

  9. I’ll see if one of the medical Correspondents here can write something up on the Israeli Bandage
    ~James G  

    Thanks.

      (Quote This Comment)

  10. My little satchel that goes into my school bag or into work as of right now has:
    Israeli Bandage x2
    H Bandage
    H & H Compressed Gauze x2
    NPA x2 (with lube)
    4×4 Gauze (a few)
    Coban Wrap
    Gloves
    Shears
    Sharpie
    Chemlight
    C.A.T x2

    After this I’ll be adding some Benadryl, aspirin, and few assorted band-aids.

      (Quote This Comment)

  11. If you know how and when to use it then carry some, if not then ether get some training or use the stuff listed in the articleI took a class on using it a wile back when I first went to Iraq, it can be a lifesaver if used properly. I had QuickClot, QuickClot sponge and an Israeli Bandage in my FAKI have actually been hearing that Celox is better – maybe the medics here can chime in on that oneI’ll see if one of the medical Correspondents here can write something up on the Israeli Bandage
    ~James G  

    When I was in Iraq we were issued the Hemcon Bandages

    In Iraq in

      (Quote This Comment)

  12. The HemCon bandages look cool – thanks for the tip dude

    ~James G

      (Quote This Comment)

  13. I switched from Quik-clot to Celox a couple of years ago due to people who know WAY more about this stuff than I ever will gave me a class on the different ones. I was told that more people are doing harm than good with the Quik-clot, due to all the burning. You can pour some quik-clot in a bowl, pour some water on it and darn near cook over it. (I exaggerate but it WILL be too hot to touch.)

    Is Hemcon the one made from shrimp shells or something? I was told that it is not the same type of protein or not enough to trigger shellfish allergies. But then I spoke to a medic friend who had personally seen shellfish allergies from it.

    Good stuff. Not the sexiest topic so it gets avoided but it’s one of the most important.

      (Quote This Comment)

  14. I heard the same stuff lately about Quick Clot

    A buddy of mine that is a PSD/Medic in Iraq (he is also an ex-SEAL) told me that you can put Celox directly in your eyes if you have a bleeding wound there – not sure if that is true but it came from a pretty skilled guy

    ~James G

      (Quote This Comment)

  15. And one of the more important pieces that I tend to keep in the bag in the car is at least one or two small stuffed animals. If you run into a situation where you happen to come across an accident on a back road, or a situation where children are involved, it goes a LONG way to helping calm them down or keep them calm.   (Quote This Comment)

    In addition to a couple things from Andrew’s list in the article, this one on having a couple little stuffed toys is great. Seems like there is often (unfortunately) little kids around when some nasty injury happens.

      (Quote This Comment)

  16. I have a few different trauma kits – one on my vest, one in my backpack, and a more substantial one in my car. My definition of a trauma kit is apparently a but different from yours, though. I don’t put band-aids, ibuprofen, neosporin, etc in my trauma kit – I consider those to be more of a “boo-boo kit,” as they wouldn’t be used for life-threatening injuries, and I don’t want to dig through that stuff while desperately searching for a TQ. Moreover, I don’t want to pull out my IFAK unless I’m seriously injured.

    In my trauma kit:
    – SOFT-T tourniquet
    – NPA w/lube
    – Bolin chest seal
    – EMT shears
    – Nitrile gloves
    – Israeli bandage
    – Primed gauze (x2)

    In my boo-boo kit:
    – Band-aids (assorted sizes)
    – Surgical tape
    – Hand sanitizer
    – Waterjel
    – Neosporin
    – Motrin
    – Alcohol prep pads

    So, in review, trauma kit contains ONLY immediate, life-saving supplies and is readily accessible, while the boo-boo kit holds the extra stuff that’s nice to have for minor injuries and is kept in a different location (admin pouch or backpack).

      (Quote This Comment)

  17. Honestly a band-aid it the most common item I have ever used in my FAK, I must have cut and scratched myself a dozen times in Iraq

    But like you said I kept the bo-bo stuff in my admin pouch

    Great lists of your FAK items guys, keep it up

    ~James G

      (Quote This Comment)

  18. Honestly a band-aid it the most common item I have ever used in my FAK, I must have cut and scratched myself a dozen times in IraqBut like you said I kept the bo-bo stuff in my admin pouch
    Great lists of your FAK items guys, keep it up~James G  

    Oh, absolutely – funny how it’s usually the cheap, non-tactical stuff that gets used the most while the $30 high-speed tourniquet just gathers dust.

      (Quote This Comment)

  19. Yep – you always use the small stuff – but you always carry the serous shit just incase

    Too bad they don’t have Tactical Crystal Ball so you can lighten up your load before missions – lol

    ~James G

      (Quote This Comment)

  20. Mission will dictate what you carry from stuffed animals, airway equipment to tampons, etc. All ideas are good ones & again it depends on what your skill level is & what you will need this stuff for.

    I originally came up with this kit because a number of non EMS types asked me for the average “joe” what would I recommend with out carrying an ambulance with me?

    What do I carry for a jump kit? IV fluids, chest decompression kits, airway equipment, and more of what I already listed. I just don’t want to haul all that stuff every time I go for a hike at my favorite mountain.

    How much do you want to lug around & what can you make work for you in an emergency from that deep laceration to the boo boo on the range or in the woods becomes the question.

    Again all ideas are good & help everyone to make up a kit that will suit their needs.

      (Quote This Comment)

  21. http://www.youtube.com/watch?v=cUm3tEfYd44&feature=related

    Above is good youtube video by the guy that originally came up with the Israeli bandage.

      (Quote This Comment)

  22. A couple of other things I keep in my IFAK: an NPA kit (Lube and an NPA), and an IV Starter kit (tourniquet, alcohol wipe, a few gauze pads, needle and catheter. I’ve also got an Asherman chest seal (even though everyone tells me they suck), and a DA 1156 wwith the Admin info filled out.

      (Quote This Comment)

  23. The nice thing about the Asherman chest seals is that they will stick to just about anything & are really good for sealing large lacerations & abdominal wounds as well as chest wounds.
    I don’t know who “everyone” is but I have a number of medic friends in Israel that use them & like them.

      (Quote This Comment)

  24. I didn’t read all the comments but did anyone consider super glue? I’ve used it for years to immediately close cuts and stop bleeding. I even used it a time or 2 to glue a tooth crown back on till I could get to the dentist a week or 2 later. Really does work in pinch! Also heals cuts faster.

      (Quote This Comment)

  25. No one mentioned it, but you are right as to all the uses of Crazy Glue.

    Like I said there will always be something new that one can use.

    Great posts people.

      (Quote This Comment)

  26. A buddy of mine that is a PSD/Medic in Iraq (he is also an ex-SEAL) told me that you can put Celox directly in your eyes if you have a bleeding wound there – not sure if that is true but it came from a pretty skilled guy
    ~James G

    Please, please, please, dear god do not do this. Eyes, neck and chest are the biggest no-nos in regards to hemostatic agents, any of them. Unless there is no eye left and you have bright red blood squirting out…..never use it on the face.

      (Quote This Comment)

  27. Word on that – I thought that advice was a little odd, but he is sort of crazy

    Thanks for the info

    ~James G

      (Quote This Comment)

  28. Please, please, please, dear god do not do this. Eyes, neck and chest are the biggest no-nos in regards to hemostatic agents, any of them. Unless there is no eye left and you have bright red blood squirting out…..never use it on the face.  (Quote This Comment)

    Also, don’t replace the saline solution in your buddy’s eye wash bottle with liquid drano. It took him forever to get over that.

      (Quote This Comment)

  29. Please, please, please, dear god do not do this. Eyes, neck and chest are the biggest no-nos in regards to hemostatic agents, any of them. Unless there is no eye left and you have bright red blood squirting out…..never use it on the face.  

    This is the issue with these that I didn’t go into detail on, thanks Shai.

    They are made for extremity / limbs bleeding only. They are not & have been used too many times with ill effect on the torso & open wounds to someone’s head.

    This comes back to my belief that pressure bandages & tourniquets will do what needs to be done with out clotting agents. A tourniquet can be kept on a limb for many hours with out damaging the limb. The old thought that you will lose the limb has been disproved.

    As for the Drano in the eye, you got to be shitting me!! :>0

      (Quote This Comment)

  30. The only person I know that would use haemostatic’s in an eye would be the same person that would use a tourniquet around the neck for a head wound..!

    I actually heard that a jundhi wanted to do that when being taught basic TCCC….Go figure.

      (Quote This Comment)

  31. Not from me but great advice from a forum mate on which I based my two kits… a small hiking kit which follows this setup and my a personal webbing trauma kit which includes a CAT, Israeli dressing and chest seal. The team medic carries the rest.

    [quote]…but a webbing first aid kit doesn’t need to be absolutely huge. Often those store-bought kits are full of kit you’ll never use again once you’ve tried them in the field. They’re the type of thing that drivers buy to chuck in their car boot to make them feel better, or that recruits rush down to the garrison town to get when they realise the army doesn’t issue them with a personal aid kit.

    My personal first aid kit is in a small green box (actually the issue ‘personal FAK’ box) about the size of my palm.
    In it I keep various tablets:

    -Loperamide, to stop me having the runs

    -Painkillers:
    -Paracetamol (good for general aches and pains, esp headache)
    -Ibuprofen (good for musculo skeletal pain as is an anti inflammatory)
    -Codeine Phosphate (stronger pain killer, can be used with paracetamol to improve analgesic effect)

    -Loratidine, (anti histamine) non drowsy anti allergy, good for bites and stings that would otherwise irritate.

    I also have a few plasters for small cuts etc, a couple larger dressings (5x5cm) for deeper cuts and some elastoplast tape to secure them. No point carrying a belt pouch full of 50 plasters and ‘non adherent dressings’, it’s a personal aid kit and you’ve got to be pretty stupid to cut yourself 50 times in one outing! I carry a pair of tweezers to remove splinters and thorns picked up when crawling about and a safety pin (many uses such as lancing blisters etc and boring through bruised nails to release the blood). Most importantly though I carry dioralyte rehydration sachets.

    I also carry a trauma kit that is most likely too involved for a cadet to carry, but there’s no reason for you not to carry an FFD if they’re issued to you. Try to ask your medic for the crepe bandage too though, other wise the FFD is a little pants.[/quote]

      (Quote This Comment)

    1. Great info, Thanks

      ~James G

        (Quote This Comment)

  32. As James has mentioned too, band aids – together with small gauzes and tape – are the thing I use the most too. Lots of sharp edges on our equipment and wounds don\’t like mixing with cordite.. All the sexy stuff I\’ve never had to use yet being in brigade recce

      (Quote This Comment)

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

Upload Files

You can include images or files in your comment by selecting them below. Once you select a file, it will be uploaded and a link to it added to your comment. You can upload as many images or files as you like and they will all be added to your comment.