View Full Version : GSW/blow-out kit components - best bang for the buck
Chatterbox
06-14-14, 01:52
I'm currently trying to put together a set of kits (about 20) for a number of people on a fixed budget (about $300). The budget is such that the "buy once, cry once / two is one" approach is not going to work - some people would end up with nothing. Increasing the budget is not an option. So I would dearly like recommendations for what are the cheapest things that will provide a workable modicum of care. As an illustration, right now I'm thinking a TK4 tourniquet/ Israeli Field Dressing / Kerlix Gauze, which gets me to around $15 or so, but I would dearly love to hear from some SME.
What's the level of training of the intended users?
Chatterbox
06-14-14, 03:21
None to begin with. I'm hoping to be able to arrange a presentation on how to use the components.
We have Oleas bandage's in our Active Shooter and and daily jump bags. They are modular and will eliminate the need for an additional occlusive which should be there and additional Kerlix while being I believe more effective then the Israeli. We get them from www.tacmedsolutions.com and at $6.95 each it really helps the city's budget crunchers. That site has good training videos too for helping your people get valuable information.
https://www.youtube.com/watch?v=DEwDZEVhjfs&feature=youtu.be
None to begin with. I'm hoping to be able to arrange a presentation on how to use the components.
Some bandaids and some kerlix oughta do it then. Untrained or casually-trained personnel mainly need to know how to apply pressure to something that's squirting blood, and how to use their cell phone to call trained personnel. They don't need a gunshot wound/"blow-out" kit.
Chatterbox
06-14-14, 14:52
Some bandaids and some kerlix oughta do it then. Untrained or casually-trained personnel mainly need to know how to apply pressure to something that's squirting blood, and how to use their cell phone to call trained personnel. They don't need a gunshot wound/"blow-out" kit.
In some situations one or both of those (cell coverage / trained personnel ) may not be available for significant period of time, on the order of hours. Does that change your recommendation in any way?
In some situations one or both of those (cell coverage / trained personnel ) may not be available for significant period of time, on the order of hours. Does that change your recommendation in any way?
Tourniquet. No sharp instruments.
Chatterbox
06-14-14, 16:40
Tourniquet. No sharp instruments.
No sharp instruments - meaning no suture kits and the like? Or are you concerned about the patient removing the tourniquet due to pain?
Sounds like the combination of Oleas bandage (which is both a pressure dressing and gauze, as far as I understand) and TK-4 would fit the bill.
Gloves?
CPR mask?
Sudafed/Epi-pen?
Tweezers?
Duct tape?
Far more likely to need stuff like this than pressure bandages.
No sharp instruments - meaning no suture kits and the like? Or are you concerned about the patient removing the tourniquet due to pain?
Sounds like the combination of Oleas bandage (which is both a pressure dressing and gauze, as far as I understand) and TK-4 would fit the bill.
The ability to apply a hands-free pressure bandage could be valuable if we're talking hours. Likewise, a tourniquet. Both are suitable for relatively safe use by minimally-trained people.
I can't envision a scenario where, even given a several hour delay, a suture kit would be important, nor scalpels, needles or any other cutting instrument beyond a pair of blunt scissors.
$300 for 20 people is $15 per kit which puts a serious handicap to a kit. A real TQ by itself will run you $30. Pretty much limits you to a boo-boo kit instead of a blow out kit.
With no formal training and continued practice I'll second the no invasive tools sentiment. No decompression needles, NPA kits, sutures, scalpels... Nothing than can easily make the situation worse if misused under stress.
Chatterbox
06-17-14, 10:59
Thank you, I very much appreciate the information. Hopefully the last question - are Israeli Field Bandage or Olaes Bandage qualitatively better than H-dressing, or is it more of an incremental improvement?
I'm currently trying to put together a set of kits (about 20) for a number of people on a fixed budget (about $300). The budget is such that the "buy once, cry once / two is one" approach is not going to work - some people would end up with nothing. Increasing the budget is not an option. So I would dearly like recommendations for what are the cheapest things that will provide a workable modicum of care. As an illustration, right now I'm thinking a TK4 tourniquet/ Israeli Field Dressing / Kerlix Gauze, which gets me to around $15 or so, but I would dearly love to hear from some SME.
What about a "got get a part time job to finance a kit" approach? I understand budgets are tight. But really look at what you are saying. There are 20 people that think the odds of them getting shot are high enough to carry a TQ, chest seal etc and get training to use it. But the threat isn't serious enough for them to find a way to pay for decent kit? Even if you find a local diner and wait tables for a week or two you could save up enough for a pretty nice kit and red cross training on how to use it.
Call me blunt but it sounds more like people want to pretend they are ready for sthf but have no real interest in what that means.
Chatterbox
06-17-14, 11:18
What about a "got get a part time job to finance a kit" approach? I understand budgets are tight. But really look at what you are saying. There are 20 people that think the odds of them getting shot are high enough to carry a TQ, chest seal etc and get training to use it. But the threat isn't serious enough for them to find a way to pay for decent kit? Even if you find a local diner and wait tables for a week or two you could save up enough for a pretty nice kit and red cross training on how to use it.
Call me blunt but it sounds more like people want to pretend they are ready for sthf but have no real interest in what that means.
I appreciate your point of view, however the constraints are what they are.
Call me blunt but it sounds more like people want to pretend they are ready for sthf but have no real interest in what that means.
In my experience, it's far more likely that someone will go out and spend $100 or more on an extensive IFAK so that they can pretend that they are ready for the S to HTF. That's IF you believe that the S will ever HTF. I think that every time I see a TQ and/or IFAK attached to the MOLLE vest/belt of the dentist or construction supervisor shooting next to me at any given carbine course. For the vast majority of people, especially untrained people, and the situations that they will face, an "IFAK" with anything more than about $25 worth of Johnson & Johnson doodads is a waste of time and provides only a false sense of medical competence.
Chatterbox, what is the focus of the people these are intended for? Is it LE based, or Citizen/Civilian and Emergency Preparedness based? Reason I ask, because unless you're LE or in an environment where you're more at risk, Hmac's recommendations have a lot of reasoning behind them. A fixed budget will go pretty far with absorbant gauze pads and then kerlix wrap. Hmac is pretty qualified to answer, and any disagreements we have for thoughts are based on differences in my environment in the time it takes to get to guys like him, or in my profession where I physically cannot get out of where I'm at to get to him. For everything else, he's got a lot of experience that's worth listening to.
I'm not a fan of the TK4, as elastic can degrade over time. The CAT or SOFT-T Wide, while more expensive, are better in the long run not only in terms of quality but how they're used as well. If you're looking to add a TQ, I would get the gauze items first. Extremity injuries from a gunshot wound requiring a TQ are not as common. They are an important part of the kit, but in our environment of the US it will more than likely be used for other accidents that occur. We had a Fire Chief in my region who's life was saved by a TQ after an accidental amputation, and it is these types of events that they are used at here, rather than an actual gunshot.
Chatterbox
06-17-14, 13:15
High risk, OCONUS.
Eurodriver
06-17-14, 15:21
Even in Iraq, unless we were CLS certified, we had the mentality of just applying quik clot and/or a TQ. So much safer for everyone involved.
High risk, OCONUS.
If OCONUS, I'm surprised you wouldn't have a bit more support from your employer. And if OCONUS, you should have a vested interest in ponying up the $ for a proper kit, even if it's out of your own salary. You're talking less than $100 to do it right. Are you talking $300 for 20 people, or $300 each?
http://www.austereprovisions.com/ProductDetails.asp?ProductCode=IC3K%2D1
This plus a proper TQ that isn't effected by elements like a TK4 is the cheapest I'd probably consider without building it yourself from individual components. Are you needing a case also, or just contents? Kits I currently carry on that type of gear is the Blue Force Gear Trauma Kit Now on the PC and the HSGI Bleeder Pouch on the belt.
If you're a gunfighter in a high threat OCONUS, you should probably already have the background as to what, where, and how to obtain the necessary items.
Even in Iraq, unless we were CLS certified, we had the mentality of just applying quik clot and/or a TQ. So much safer for everyone involved.
Not sure I agree with that mentality. Not the treatments, but the less than optimal casualty care plan.
The CLS-qualified individual, platoon medic etc. might not be able to get to the pt, or might be the casualty.
Everyone in the squad/team/etc. must have the training, first aid supplies and mental preparedness to administer first aid as required. Most often, life-saving interventions are done by the guys at the site of injury.
Stick to the algorithm you have been taught (ABCDE/MARCH-ON), and stick to the principles of TCCC.
OP, I think you approached the issue backwards.
You should first define the knowledge and interventions the guys should be avle to do, and then design the IFAK around those factors. As others have stated, no point in having fancy stuff if they don't know why, how and when to use it.
Chatterbox
06-17-14, 17:37
If OCONUS, I'm surprised you wouldn't have a bit more support from your employer. And if OCONUS, you should have a vested interest in ponying up the $ for a proper kit, even if it's out of your own salary. You're talking less than $100 to do it right. Are you talking $300 for 20 people, or $300 each?
http://www.austereprovisions.com/ProductDetails.asp?ProductCode=IC3K%2D1
This plus a proper TQ that isn't effected by elements like a TK4 is the cheapest I'd probably consider without building it yourself from individual components. Are you needing a case also, or just contents? Kits I currently carry on that type of gear is the Blue Force Gear Trauma Kit Now on the PC and the HSGI Bleeder Pouch on the belt.
If you're a gunfighter in a high threat OCONUS, you should probably already have the background as to what, where, and how to obtain the necessary items.
Thank you. I do want to clarify is that the closest I've been to being a gunfighter was when I walked past Travis Haley. :)
Thank you. I do want to clarify is that the closest I've been to being a gunfighter was when I walked past Travis Haley. :)
Not to pry but I'm trying to think of reasons for High risk OCONUS situations.
1. Gunfighter - spring for the kit yourself or from an employer
2. Oil/Gas/mining/construction - employer should spring for or be paying enough for good medical care
3. Standard of living/Medical/Theological mission work - get some donations. If you are doing good work in bad places lots of people would help take care of something like med kits.
Outside of food/shelter/water there isn't a much quicker way to die than poor medical care. Are you going to be with in an hour of a decent care center/hospital? If not have you planned for geart to take care of stuff for the X hours it will take after stabilization until you can get to long term care? I'm thinking pain meds, anti-biotics etc. Something like this might be a good read: http://www.amazon.com/Wilderness-Medicine-6th-Beyond-First/dp/0762780703
You should first define the knowledge and interventions the guys should be avle to do, and then design the IFAK around those factors.
It appears that's exactly what he's trying to do here....asking about basic first aid supplies for untrained personnel on a tight budget. Kerlix is great stuff. Light, cheap, great as gauze, can be used for splinting, even as a tourniquet. It will cover about 95% of what an untrained civilian needs out in the field in non-mil, non-leo use.
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For my EDC that I have in my cargo pockets;
1) Flat "Thin-Cinch" $5.60
2) Z-Pak Dressing $2.00
3) TK-4 $6.25
4) 6 ft Duct Tape $0.25
5) 2pr Nitrile Gloves $0.80
-------
Total $14.90
Pretty basic, and you can add a better TQ and/or Quik-Clot later as budget and instruction/class permits.
Heisenberg
07-22-14, 17:10
Is there any chance of cutting down the number of kits? Can you designate fewer people as acting medics rather than every person? If moving in teams of 4-5, you could conceivably cut your number of kits required by at least half, increasing the capability of each kit significantly. If everyone knows who has the beefed-up kits, then not necessarily everyone needs to have one on their person.
How large is the overall group that these 20 kits will be potentially treating?
Gauze pads: 4x4, 8x10, 10x30. Roller gauze/Kling. Ace wrap 6". Triangular bandage. Medical tape 1" (optional). Nitrile gloves. EMT shears. Get as much as you can afford and divvy it equally up between the kits. Later expand as money becomes available.
You can improvise an "Israeli dressing" with the Ace wrap & gauze pads. Tourniquet is made from the Triangular bandage. Roller gauze to Z fold into a wound to provide pressure from within the wound. Roller gauze or pads can be used to "fill" the void of a large wound to allow the Ace wrap to put pressure on the deeper tissue. Large pad covers large wound.
Take a good First Aid class. Learn to bandage & dress wounds on different body parts so you're not fumbling when/if the time comes. Learn to quickly create a tourniquet and pressure dressing from what you have.
In my experience, it's far more likely that someone will go out and spend $100 or more on an extensive IFAK so that they can pretend that they are ready for the S to HTF. That's IF you believe that the S will ever HTF. I think that every time I see a TQ and/or IFAK attached to the MOLLE vest/belt of the dentist or construction supervisor shooting next to me at any given carbine course. For the vast majority of people, especially untrained people, and the situations that they will face, an "IFAK" with anything more than about $25 worth of Johnson & Johnson doodads is a waste of time and provides only a false sense of medical competence.
Here's a thought. Maybe the dentist or construction worker that you are criticizing just wanted to make sure that a TQ and/or IFAK was available to someone with advanced medical training in the event something did happen to them.
I recall from another thread that you bring a pocket full of band aids to training classes despite being a trauma surgeon. Maybe the dentist or construction worker wanted to be prepared, since it sounds like some trauma surgeons are not.
There are many things about the current "advanced EMS for dummies" concepts that worry me. I find the beliefs that A) penetrating trauma is common and B) that anyone can do it, to be....uh..."interesting". Last carbine course I took, the guy shooting next to me, a dentist, had a very impressive IFAK on his chest rig. Man, I think I could have taken out someone's gallbladder with that kit. He didn't have a clue how to use the stuff. On the other side of that coin, I'm a trauma surgeon. I had a couple of band aids in my pocket.
Here's a thought. Maybe the dentist or construction worker that you are criticizing just wanted to make sure that a TQ and/or IFAK was available to someone with advanced medical training in the event something did happen to them.
I recall from another thread that you bring a pocket full of band aids to training classes despite being a trauma surgeon. Maybe the dentist or construction worker wanted to be prepared, since it sounds like some trauma surgeons are not.
Nah. Pretty sure these guys were just looking for something to add to make their second-line gear look cool. Both had blood-type patches velcro'ed on, for example :rolleyes: . What kind of stuff do you attach to your gear? And what kind of training and refreshers do you go through to use it? Or do you just bring it along for the trauma surgeons that happen to be in your training class?
Relative to the band aids in my pocket, they supplement the very complete first-aid kit that the course organizer brings with him, and sits right next to the cell phone and sign showing latitude/longitude of the range where we're shooting. No need for me to hang any of that unnecessary crap on my vest. I'm not worried about looking cool.
Nah. Pretty sure these guys were just looking for something to add to make their second-line gear look cool. Both had blood-type patches velcro'ed on, for example :rolleyes: . What kind of stuff do you attach to your gear? And what kind of training and refreshers do you go through to use it? Or do you just bring it along for the trauma surgeons that happen to be in your training class?
Relative to the band aids in my pocket, they supplement the very complete first-aid kit that the course organizer brings with him, and sits right next to the cell phone and sign showing latitude/longitude of the range where we're shooting. No need for me to hang any of that unnecessary crap on my vest. I'm not worried about looking cool.
Actually, a blood-type patch could come in handy if the patient is unable to speak and a transfusion becomes necessary. Believe it or not, there always seems to be at least one M.D. in every training class I've taken. Imagine that.....
Relying on someone else to bring along a very complete first aid kit is probably not the best plan, but to each his own.
For me, I'm an attorney that sues unprepared trauma surgeons. I have very little practical medical training other than the Wilderness First Aid course I went through due to the fact I do quite a bit of backpacking and hiking.
Actually, a blood-type patch could come in handy if the patient is unable to speak and a transfusion becomes necessary. Believe it or not, there always seems to be at least one M.D. in every training class I've taken. Imagine that.....
Relying on someone else to bring along a very complete first aid kit is probably not the best plan, but to each his own.
For me, I'm an attorney that sues unprepared trauma surgeons. I have very little practical medical training other than the Wilderness First Aid course I went through due to the fact I do quite a bit of backpacking and hiking.
You won't sue any trauma surgeons from events at a firearm training course. You'll be too busy suing the course organizer, or the firearm manufacturer, or the ammo manufacturer, or the weather man, or whomever else. As to blood-type patches, you'll also be wanting to be prepared to sue the hospital that gives a potentially lethal blood transfusion based solely on a cool-looking patch that the patient has velcroed on their clothing. If there was ever a hospital that was stupid enough to do that, they deserve your courtroom attention. I'd even volunteer to act as your expert witness. You'll need someone to give you advice since this is an area that you're apparently unfamiliar with.
As to blood-type patches, you'll also be wanting to be prepared to sue the hospital that gives a potentially lethal blood transfusion based solely on a cool-looking patch that the patient has velcroed on their clothing. If there was ever a hospital that was stupid enough to do that, they deserve your courtroom attention. I'd even volunteer to act as your expert witness. You'll need someone to give you advice since this is an area that you're apparently unfamiliar with.
LOL----well, you passed the test, I guess. The better answer would be if, in a state where it is permitted, a paramedic administered a transfusion in flight and used a type other than O-negative, courtroom attention would be called for.
I still suspect you are a recent graduate, but that's just my opinion and worth exactly what you paid for it.
I still suspect you are a recent graduate, but that's just my opinion and worth exactly what you paid for it.
I suspect that I was doing trauma surgery back when you were in grade school.
Can't we all get along?
:(
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Can't we all get along?
:(
Everybody's getting along just fine. This is all just normal doctor/lawyer banter.
.
LOL----well, you passed the test, I guess. The better answer would be if, in a state where it is permitted, a paramedic administered a transfusion in flight and used a type other than O-negative, courtroom attention would be called for.
I still suspect you are a recent graduate, but that's just my opinion and worth exactly what you paid for it.
Dad's home. Everyone play nice now.
Peruna- Check your PMs.
JAustin316
09-23-14, 21:53
Some bandaids and some kerlix oughta do it then. Untrained or casually-trained personnel mainly need to know how to apply pressure to something that's squirting blood, and how to use their cell phone to call trained personnel. They don't need a gunshot wound/"blow-out" kit.
Even casually trained people are better than no people when SHTF. Going over a TQ and an occlusive isn't brain surgery and I can only hope someone you feel safe shooting with is able to grasp those concepts easily. No needle Ts (DART Kits) and you'll be fine! Might want to throw in some general CPR into it as well.
TacMedic556
10-26-14, 21:26
Olaes bandage is a great piece of kit that can cover many bases. Try getting a quote from http://www.chinookmed.com/ on a multiple kit order, they have always worked with me on prices for custom orders.
Back to the Olaes, it provides you with multiple options and is highly effective for large wounds that are hemorrhaging.
Olaes Video
http://www.youtube.com/watch?v=YbKDNuLB54A
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