First Aid Kit with MD/Nurse at Hand

[nova3930]

I'm trying to get my emergency supplies up to snuff now that we're in a permanent location. Ammo and food stocks are decent and getting better but my medical supplies are lacking.

My question is, if you had an MD and/or Nurse at hand what would you include in your emergency first aid kit? My wife is a family practice MD so I have in house professional care if the need arises. My neighbor next door, who I trust implicitly, is also a FP MD and his wife was a PICU nurse before becoming his office manager, so they're generally pretty close at hand as well.

And yes, I've asked the wife but she hasn't been much help.

[SOW_0331]

You could buy anything and everything and it mY be absolutely useless if it's not what you need when you need it. Since you didn't include some vital information (no problem in that, trying to protect your identity a bit) like budget, AO of primary location, and your ability to sustain your group without breaking into a finite amount of food stores...here's what I would recommend. Keep it basic and assess your readiness in order of;

SELF - Can you treat yourself with a basic med kit? Do you have one and have you selected it's contents to YOUR needs. Were all different. My area has me more worried about hypothermia than rattle snakes, yours may be the opposite. I'm carrying what I know I need to address an immediate threat to my life (trauma) as well as prevent simple injuries (sprains, dislocations and joint injuries, etc) from completely taking me out of the fight. Make sure you have a medicine bag too, Imodium can literally be life and death. Account for preexisting conditions. Essentially, if you were hurt right now, could you save your own life from a traumatic interruption in your bodies cycle of operations.

BUDDY - If one of your crew was to go down, how ready are you to provide any and all of the basic LifeSaving Steps? If you're even a little uncomfortable have your medical staff at home help you consume knowledge. Learn the anatomy and what makes us all tick. You might have a whole bunch of smarts and experience at your disposal, but if you can't give them alive if they're bleeding and unconscious/unresponsive, they're not a lot of good. As far as supplies, someone there or everyone has done clinicals in an ER. What did they use most or wish they had? Are they willing/able to give you some of that 5.56 medicine, or are you pretty much the only barrel chested warfighter in the group. That could be a problem.

MEDIC AID - Are you patrolling with these folks or are you setting up a firm CCP? What's your entry plan and with them being known medical staff, what are the chances they won't be at their workplaces giving care to the masses until the last possible moment? Cover any EVAC plans with them to get them back to your selected location? What common gear are you all carrying in your IFAK or med kits and what would you want all your teammates to know about you, should they need to carry specific gear to treat you (and all team members). Basically, are these doctors and medics your highest echelon of care, and if so, how are you going to get to them if you're a casualty a few kilometers away. Think long term logistics, the better and more equipped your med station is, the less shit you'll be lugging around. Says the guy rappelling with my 20# battle belt and med gear...

Really man you left out a lot. What's the size of the area you plan to stage as your medical station, is it protected and discreet, or are you looking to work out of a backpack. How comfortable are your friends with working on someone they know, rather than a stranger (you'd be surprised) and can they do anything else? Static position members like medics assigned to an aid station are good for ROs too. Again. Less shit to hump around for you. I recommend you gobble up some anatomy books, some reports on most common injuries that lead to fatalities in your area, and if you're interested I *may* be able to email you the PDF of the latest TCCC literature, as combat injuries are very different than what the most experienced ER staff may know. I can also get some feedback from a few older SOF Medical oriented guys, and find out what they needed or used most and what they chucked and never used. Good luck to you sir, you have to know your specifics and build your resources from the basics in up.

[SOW_0331]

Abbreviated version of that mess^, nobody can tell you or sell you a bunch of gear that will work for everyone. Your vague post was missing the details needed to recommend much of anything.

Learn the basics, become proficient in them. Build from the bottom up and cater each next step to your particular needs and environment. You'll probably end up with a dozen different med kits/bags/pouches. Good. Just mark them clearly...

[chuckman]

I have been trying to figure out how to answer this. My issue is not necessarily what you have but instead a) how you dole it out, and b) how do you store/protect it? Clearly the OP's wife is qualified to render advanced, very advanced, care. But to what end? A couple antibiotics are one thing, but what if you need follow-on care? What's the secondary and tertiary care plan? What if they are expired? Some items need refrigeration (i.e., some meds, etc.), and virtually all medical stuff have an expiration.

Figure out what are the injuries and illnesses with the highest probabilities and go from there. Penetrating trauma? Not very likely, but maybe, so have a tourney and a chest seal (or a couple, whatever). Ebola? Well, not very likely. How many of the widgets? How are you going to inspect them for turnover as you need?

[Hmac]

Most primary care doctors aren't trained in definitively dealing with trauma, so that's going to affect the equipment you choose to store on their behalf. You should ask your wife and neighbor what their recommendations would be. The equipment you need to have sitting around is going to depend on the capabilities of the individual doctors.

[nova3930]

OK, let me try to clarify. I appreciate the depth of response but I think people are probably over thinking what I'm asking, which is my fault for not asking the question very well.

You could buy anything and everything and it mY be absolutely useless if it's not what you need when you need it. Since you didn't include some vital information (no problem in that, trying to protect your identity a bit) like budget, AO of primary location, and your ability to sustain your group without breaking into a finite amount of food stores...here's what I would recommend. Keep it basic and assess your readiness in order of;

Budget isn't a consideration. My process is to first generate a list of possible useful items, then I prioritize with one of the criteria being cost. I don't need everything tomorrow, so this is a long term project, if there's something I don't have the $ for right this minute, then I save my nickels and dimes and get it when I can. (The previous applies to anything reasonable, I don't intend to buy an MRI machine to stash in the garage or anything like that )

AO is North AL. Should be specific enough I think.

SELF - Can you treat yourself with a basic med kit? Do you have one and have you selected it's contents to YOUR needs. Were all different. My area has me more worried about hypothermia than rattle snakes, yours may be the opposite. I'm carrying what I know I need to address an immediate threat to my life (trauma) as well as prevent simple injuries (sprains, dislocations and joint injuries, etc) from completely taking me out of the fight. Make sure you have a medicine bag too, Imodium can literally be life and death. Account for preexisting conditions. Essentially, if you were hurt right now, could you save your own life from a traumatic interruption in your bodies cycle of operations.

I've had some basic first aid classes at various points over the years, starting at the Boy Scout level and going up. Basic wound bandaging, splints, mouth to mouth, CPR, etc etc. I plan to increase my own skills as time goes on, but at this particular moment, I want to leverage the trained medical pesonell I have at hand.

My concern is not necessarily getting shot at, but more so what if someone is hurt (needs more than a bandaid but less than a trauma surgeon) and police/fire/paramedics are otherwise occupied. In the last few years we've had several tornado outbreaks around here where the authorities were pretty well occupied, roads blocked, etc. What could be kept around to keep someone trucking till we can get to the ER?

BUDDY - If one of your crew was to go down, how ready are you to provide any and all of the basic LifeSaving Steps? If you're even a little uncomfortable have your medical staff at home help you consume knowledge. Learn the anatomy and what makes us all tick. You might have a whole bunch of smarts and experience at your disposal, but if you can't give them alive if they're bleeding and unconscious/unresponsive, they're not a lot of good. As far as supplies, someone there or everyone has done clinicals in an ER. What did they use most or wish they had? Are they willing/able to give you some of that 5.56 medicine, or are you pretty much the only barrel chested warfighter in the group. That could be a problem.

Think I answered this above. Not looking for "end of the world" or to set up a field hospital or anything. Just whatever is the next step beyond the basic of bandaids and triple antibiotic.

I've also got to LOL at the idea of me as a "barrel chested warfighter." I provide support to some real hard charging soldiers, but me personally, I'm an engineer that rides a desk for a living. If I can go to my grave without ever having to get shot at or shoot at someone, I'll be a happy man, but I'll do what it takes to protect my family.

A family practice residency includes several ER rotations where they take care of what I described above ie more than a bandaid but less than a trauma surgeon. Like I say I asked the wife and her answer amounted to "uhhh suture kits and saline for irrigation" which I know there has to be more than that an MD could use.

MEDIC AID - Are you patrolling with these folks or are you setting up a firm CCP? What's your entry plan and with them being known medical staff, what are the chances they won't be at their workplaces giving care to the masses until the last possible moment? Cover any EVAC plans with them to get them back to your selected location? What common gear are you all carrying in your IFAK or med kits and what would you want all your teammates to know about you, should they need to carry specific gear to treat you (and all team members). Basically, are these doctors and medics your highest echelon of care, and if so, how are you going to get to them if you're a casualty a few kilometers away. Think long term logistics, the better and more equipped your med station is, the less shit you'll be lugging around. Says the guy rappelling with my 20# battle belt and med gear...

Patrolling? Not a chance. Assume a standard American brick home on about 30 acres. Assume that more comprehensive care will be available at some point if required. My wife is paranoid enough that if I told her "don't argue, stay home or come home" she would but again, not looking to go kicking in doors, killing people and breaking things, or any sort of "end of the world", just preparing for a situation where the ER might not be an option at the moment.

Really man you left out a lot. What's the size of the area you plan to stage as your medical station, is it protected and discreet, or are you looking to work out of a backpack. How comfortable are your friends with working on someone they know, rather than a stranger (you'd be surprised) and can they do anything else? Static position members like medics assigned to an aid station are good for ROs too. Again. Less shit to hump around for you. I recommend you gobble up some anatomy books, some reports on most common injuries that lead to fatalities in your area, and if you're interested I *may* be able to email you the PDF of the latest TCCC literature, as combat injuries are very different than what the most experienced ER staff may know. I can also get some feedback from a few older SOF Medical oriented guys, and find out what they needed or used most and what they chucked and never used. Good luck to you sir, you have to know your specifics and build your resources from the basics in up.

I think I covered this above. Maybe not. Kinda like drinking from a fire hose at the moment.

I have been trying to figure out how to answer this. My issue is not necessarily what you have but instead a) how you dole it out, and b) how do you store/protect it? Clearly the OP's wife is qualified to render advanced, very advanced, care. But to what end? A couple antibiotics are one thing, but what if you need follow-on care? What's the secondary and tertiary care plan? What if they are expired? Some items need refrigeration (i.e., some meds, etc.), and virtually all medical stuff have an expiration.

Again, assume more comprehensive care will be available at some point in the not distant future. A day or two at the most. Nix anything that requires refrigeration.

One thing I have been able to ascertain from talking to Drs at hand, is that outside of antibiotics and birth control, most expiration dates on medical supplies are CYA for the manufacturer. If kept cool and dry the actual shelf life is virtually unlimited. Dumpster diving after they cleaned out my wife's clinic is how I got some of current stash, because really, is a knee or ankle brace going to stop working because it's past it's expiration date?

Figure out what are the injuries and illnesses with the highest probabilities and go from there. Penetrating trauma? Not very likely, but maybe, so have a tourney and a chest seal (or a couple, whatever). Ebola? Well, not very likely. How many of the widgets? How are you going to inspect them for turnover as you need?

Most primary care doctors aren't trained in definitively dealing with trauma, so that's going to affect the equipment you choose to store on their behalf. You should ask your wife and neighbor what their recommendations would be. The equipment you need to have sitting around is going to depend on the capabilities of the individual doctors.

Think I covered both of these above. Think "more than a bandaid but less than a trauma surgeon." During residency they have to go through ER rotations where they take care of that level of injury. Wife was not much help as previously stated. For turnover, I'll probably do like everything else with logs that I inspect regularly and use/dispose/replace as necessary.

My list at the moment is:

suture kits (variety)
sterile saline
gauze
tape
butterflys
sterile pads
sterile sponges
OTC antihistamines
OTC pain killers
OTC drugs for stomach issues
splints
braces
ace bandages

ETA

I just pinged my neighbor, we'll see what he has to say...

[chuckman]

If you are in an area where water quality could be an issue, add immodium and meds for nausea/vomiting. I think your needle is pointing in the right direction and you are tracking.

[nova3930]

If you are in an area where water quality could be an issue, add immodium and meds for nausea/vomiting. I think your needle is pointing in the right direction and you are tracking.

Had immodium on the list, so adding nausea/vomiting meds (pepto and dramamine I guess).

Since I have a small child who can handle much less dehydration than an adult can, safe potable water was first on my list of emergency supplies. I've got a katydyn combi on the shelf with a good supply of chlorine dioxide tablets on top of about 10 cases of bottled water. I've also got a kataydn ceradyne drip filter on the "to get" list but it's somewhat lower in priority than some other things. The MD neighbor has a pond and there's a flowing creek of about 50ft in width about a half mile from the house so water supply shouldn't be an issue.

[Caduceus]

As always, depends on what you're planning for? Holding over until the ambulance arrives, or SHTF and a long term lack of access?

I'd say look at an ambulance and an urgent care and go from there.

A jump bag with trauma supplies, then a base station with other goodies. Plan on things you can fix relatively easily. You won't be intubating (unless you plan on bagging someone by hand for a few days), running liters of specialized IV meds, running codes, or doing surgeries. You could easily expect to do 'procedures' (such as sutures, simple excisions or debridements) or some wound-care type procedures. IV fluids for rehydration wouldn't be unreasonable. Lidocaine for anesthesia, maybe some opiates or stronger pain meds than just tylenol/motrin. Antibiotics of various flavors, arguably some muscle relaxers, meds for bladder infections, diarrhea, rehydration salt solutions, maybe some sleep meds. I hate to say go/no-go pills, but that might be a good idea in a real SHTF if you have enough people for mutual support and watch-standing.

[fyrediver]

Whatever you get it has to be something your "staff" is trained with and for, otherwise you're opening up a big can of legal worms. Fine if the world ends and government goes away, but probably not likely. If you go out and buy chest tubes, endotracheal tubes, or a bone gun and none of your "staff" can use them then it's a waste. You have to stick with what they can actually use.

On the other hand, standard medical care items should be fine. Caduceus is right: BP cuff, stethoscope, light, IV supplies, wound care items like she mentioned, basic meds, and trauma first aid supplies like roller gauze, gauze pads, triangular bandages, etc are universal. LOTs of basic trauma stuff. If you need it you'll likely need a lot of it.

Also think Personal Protective Equipment like masks, eyeglasses/shield, gloves, and gown/cover and some way to clean/decon the care providers. You're contemplating a somewhat mass casualty or longer term event so add that to the mix.

What's available to your wife in her practice? What kind of supplies does she go through there? That may give you some insight into what she's comfortable doing.