Me, too. Do have Red Cross Advanced First Aid and CPR certification.Quote:
Originally Posted by Sticks;2059193[B
Me, too. Do have Red Cross Advanced First Aid and CPR certification.Quote:
Originally Posted by Sticks;2059193[B
The thing that no one has mentioned in their kit is an extra pair of gloves and/or eye protection. When these wounds get bloody, they can get bloody all over the place. I carry a RESQ pak with everything up to a nasopharyngeal airway (resq-pak.com) in my range bag.
Having the material is important but knowing what to do with it is even more important. Have a plan of action and be sure it is firmly ingrained in your mind. having used your situational awareness skills, delegate someone to call 911 for immediate assistance; verify that the scene is safe; put on our gloves and eye protection; and THEN survey the victim and start treatment according to priorities. It sure helps to have the right equipment but it is equally important to have a plan...
I started my kit with the Galls Mini-medic 2 kit. And then added other things that I am familiar with the use of. Things like CAT tourniquets, quik-clot gauze (not the loose grains, that stuff has a myriad of issues, and is not longer recommended in military trauma medicine, at least it wasn't earlier this year when I got out), some occlusive dressings, a CPR mouth shield, and some other random things I thought important, like some h-bandages.
As far as experience, I had dozens of hours of training from our Navy Corpsmen. And a fair bit of experience from my two tours.
I did forget to mention that I carry a 28 fr. nasal airway with lube in all my GSW kits as well as a pair of Nitrile gloves.
As far as eye protection goes, I do wear glasses which helps, but in 32 years of EMS the only time I've worn eye protection is when I worked in an ER. I do have a pair of prescription Wiley X model XL-1 which are a full goggle, however I usually keep them in my BOB or they go in my range bag when I go shooting.
But because of size constraints in my GSW blow out kits, I forgo the goggles and opt for Nitrile gloves since they don't take up much space.
I did just have another thought. Maybe the good doctor, or Bark'n will have something else to say about this.
But we were always trained that bandages were a couple rungs up the ladder for stopping bleeding from gunshot type wounds.
Direct pressure, and pressure on a pressure point came first when possible, to save supplies.
And since we are probably dealing with a safe scene (I'm not grabbing my med kit as a civilian until the shooting stops, in a hostile enrivoment) and at a shooting range accident probably a single GSW (I am going off the assumption most people only shoot themselves once). It would probably actually be more beneficial to get that direct pressure going immediately. Someone else can go grab the bag.
My eyes are pretty sensitive to light, so I almost always have glasses on during the day, and my med bag got an addition of several pairs of extra gloves too.
About a month ago, my employer sent me to a Tactical Medicine class. I am a probation officer and work in the field and in the court rooms. I was provided with a tactical traume kit to handle blowout wounds like a GSW. I have one in my vehicle for field work, and one in each courtroom.
Really not a lot of kit to get someone stabilized and ready for EMS when they get there.
Tourniquets until recently was always considered a tool of last resort. That's because once a tourniquet is used, it often resulted in the limb needing to be amputated due to the tissue/nerve/blood vessel damage from the compression of the tourniquet.
I've been in EMS for 32 years and the protocol for hemorrhage control has always been apply direct pressure, elevate the limb above the level of the heart, and if that didn't stop bleeding, apply pressure to a pressure point proximal to the injury. If that didn't work, you could use a tourniquet but again, it was assumed to likely result in amputation.
I have never not been able to control bleeding by using direct pressure to the wound, and use of pressure points in all my years of EMS.
The problem is, people still continued to bleed to death, and my theory is that people simply do not apply enough direct pressure for a long enough time, and do not apply pressure to a pressure point correctly.
Tourniquets are now part of the hemorrhage control protocol because of all the recent successful studies done on the battlefield in Iraq and A-Stan. No longer is it assumed amputation will be necessary once a tourniquet is used. Results on the battlefield have shown that if you use a properly designed tourniquet, you have on average about six hours from the time the tourniquet is applied until the person reaches a trauma surgeon before there is risk of having to amputate the limb because of damage caused by the tourniquet.
Because people apply direct pressure ineffectively and because of the six hour window with use of a tourniquet it is now the standard bleeding control protocol for the National Registry of EMT's that you first apply direct pressure. If that doesn't immediately control hemorrhage, you then go straight to application of a tourniquet. You no longer mess around with elevating the limb and try applying pressure to a pressure point.
I hope that helps explains what is being done today for bleeding control.
But 4-6 hours to take one off is also what I have heard, which is well within the means of most places in CONUS. I keep one handy at the range (on my person) and have one close to the driver seat in my car. In a bad wreck, I wouldn't hesitate to use on on myself if I was coherent enough too. And we trained to put them on with one hand.
The advantage to a purpose made tourniquet (like a CAT or NATO), is that it is easy to put on and manipulate, even with one hand. Using a belt of bandanna and a stick, not so much.
Everything I need to know about first aid, I learned from Rambo. As long as I have rounds on me I can break them down and cauterize the wound with the gunpowder.
I just carry some whiskey & black powder - Take a good swig of that whiskey - dig the bullet out with a Bowie Knife - dump that gunpowder into the gunshot wound - light it - POOF! Fire & Smoke & the wound is instantly cauterized - tie a sweaty bandana around the wound and I'm right back in the fight again just as soon as I stop biting the bullet that I have in my mouth. No matter HOW BAD you're injured...be sure to say "It's Only A Flesh Wound!" :biggrin2:
That's the way the Real Men do it. :blink:
NO! Don't DO that! :nono:
OK, now onto being serious. I have a very basic trauma GSW kit though I need to replace 2 of my QuickClot because it's now beyond the Expiration date.
Don't let QuickClot go very far beyond the Expiration Date like I just noticed that I did :slap:due to reading this thread.
EMS is lightning fast in my area & the hospital Emergency room is two minutes away so if I am at home it's likely that I'll punch 911 ~ elevate ~ apply direct pressure & leave the actual life saving to the Professional Paramedics.
I have a very complete general FIRST AIDE bag & for GSW I have 2 additional paks by Adventure Medical which contain QuickClot, gauze, compression bandage etc.
I carry a Quik-clot dressing in my cargo pocket or my briefcase (when at work). I also have a knife, which I can use to make any other bandages I might need. And I do have a pair of latex gloves.
Might get some of those tourniquets, as it would be easier to use than an improvised one. Maybe a large zip-tie (only half joking).
Duct tape in each vehicle - used that many times for boo-boos.
I've had extensive first aid training in the military, and as a volunteer LEO.
While my days with SWAT are over, I still carry a full kit contained in a Blackhawk M7 medical pack in my trunk. PPE, splints, bandages, trauma bandages, scissors, tape, quikclot, OPA's NPA's, burn blanket, stomadhesive (for broken teeth)....etc etc.
I have tactical training and EMT-Tactical training. One of the most recognized training programs that I have attended is the Counter Narcotics Terrorism Operational Medical Support or CONTOMS training which used to be run by the department of defense but has recently resurfaced as an arm of the U.S. Park Police.
Zip Ties as tourniquets are a big NO. As well as lamp cord, paracord and other similarly small diameter cordage. That is the main reason amputations were such a common result from using tourniquets. Small diameter cords are what causes such extreme tissue/nerve/blood vessel damage when used to stop bleeding.
I will say, if that's all you got, then that's all you got. Life over limb, right? But it's a poor choice to use and a trouser belt would be a better choice over zip ties or paracord.
Purpose built tourniquets such as the CAT (combat application tourniquet); MAT (mechanical advantage tourniquet; and SOFFT or SOFTT (special operations force tactical tourniquet) run between $30-$40 each.
For something more reasonably priced, you can get the SWAT-T tourniquet for about $10 each. Instead of a nylon strap with a windlass device like modern versions of a traditional tourniquet mentioned above, the SWAT-T tourniquet is like a large ACE wrap made from a latex free rubber like material. They are a dual use type device in that, it can be partially stretched and wrapped around a dressing to make a real quick pressure dressing, or if you stretch it out to it's maximum stretch it is pretty effective in completely providing a tourniquet effect to stop arterial bleeding.
The other rather expensive items in kits are the hemostatic (blood clotting) agents like Quick-Clot and Celox. Those cost anywhere from $35 - $50 each depending on the size and type you purchase. Both also come in a gauze wrap similar to a roll of Kerlex or Cling roller gauze. They also have about a 4 - 5 year shelf life and really do need to be replaced once they have expired. So, you might want to consider whether you really want or need them in your kit. Their best use is for uncontrolled bleeding where a tourniquet can not be used, such as gunshot or knife wounds to the torso or abdomen. Obviously tourniquets can only be used on arm and leg injuries.
limatunes has brought up two very distinct concepts with treatment of emergency trauma - what is kept around the house or in a vehicle, and what is most practical and efficient as basic necessities.
I won't go into gory detail about improvised methods I've used to plug holes and tie-off missing limbs during an exciting and scenic mission in the paradise of the Nam jungles many years ago, and it would take three pages to itemize the hundreds of items carried around in a vitrual suitcase as a fire department paramedic a few years later. Naturally, I keep a very substantial first-aid kit in the house, truck, and boat (less the morphine and anti-nerve gas injections once contained in the Army issue pack); but, if anyone is interested in the very basics to light-carry in a small pack or motorcycle compartment, here's my recommendations for what they're worth:
Adheasive bandaids - just a few for minor boo-boos
(2) tampons - will easily plug puncture wounds (and bullet entry holes) because they insert easily and will expand to fill the wound.
(1) sanitary napkin - will cover large wounds.
(1) pair of 36" leather boot laces - tightly wrapped and tied for a tourniquet anywhere, securing a splint or padded for use as a sling.
(1) plastic sandwich bag - will cover large wounds and/or seal-off a sucking chest wound when taped down or manually held in place.
10' length of duct tape or waterproof 3" adheasive tape wrapped around a small core - will secure plastic bag or sanitary napkin over large or sucking wounds, can be used as a giant bandaid/stint to pull together and seal large cuts or avulsions, and can also be used to secure a splint, as a tourniquet, or for a sling.
(1) silver Mylar "space blanket" - to cover victim from elements and/or help conserve loss of body heat from trauma-induced shock.
(1) cell phone - to summon professional help with more stuff ASAP.