Kit Buildup - GSW Kit

[rob_s]

BTW, the reason I asked this is that I sometimes get a "why do you need that, just call 911" reaction from some folks to this topic.

[Submariner]

For a Range Kit I would go with two tourniquets, four pairs of large or extra-large non-latex gloves, two 6" Izzy's with sliders, one pair of trauma shears, (you can substitute a roll of kerlix, and a handfull of 4x4's for one of the Izzy's to save some coin) Throw it all in a ziplock baggie and call it good. Oh and keep a SAM splint and a couple of triangle bandages in the truck. Just a matter of time before someone trips during a drill and dislocates their shoulder, breaks an arm/wrist/collar bone etc. and that stuff can make the ride to the ER much more tolerable. I will argue that is ALL you should need, ever, as an untrained person, in any situation. Anything else will get you in trouble eventually.

...

Just my two cents.

OK. This makes sense. Which tourniquet do you suggest and why.

[RESQDOC]

Kits as above are very adequate. Even if you don't know how to use something, someone else might come along that does. Or, go cave man simple and stock a bag with ACE type elastic wraps and maxi pads. Very basic supplies are needed in the first few minutes of a trauma. Training is more important than the specific gear.

Hemostatic agents are certainly appropriate if you have been trained in their use. They are not Magic Dust and need to be employed correctly. We authorize Quick Clot Gauze & Quick Clot ACS as well as some other agents.

Our preferred tourniquet is the TK-4L (Cinchtight/H&H Associates), however we also authorize and appreciate the RMT, SWAT-T, SOF-T, and CAT units.

Get a SLICK litter from ARUC Systems while you are at it. They make the RMT also.

The 'to use advanced skills in the US or not, as a bystander' question is difficult. In general, if you do something that is beyond your scope of training without being licensed and/or not operating under someone else's license is an no-no and can (and has) resulted in charges from battery to homicide, plus civil lawsuits. Remote medical personnel such as SAR team medics often operate under expanded scope of practice rules with a physician backing that up. Unfortunately, even Katrina like settings have produced legal consequences even when the patients would have died without the interventions. We want justice, we get lawyers...

[rob_s]

FWIW, I'm more interested in self-treating, or loved-one-treating than worrying about some other guy. Unless maybe it's me that shot him.

[VTLO910]

I've done Search and Rescue since I was 14, ARMY Medic for 4+ years, and Career EMS for 10 years... being such, I always tried to find things that had multiple purposes. Here is a few things that either had multiple purposes, or was simply cost effective compared to buying the actual thing.

Duct Tape... Cheap, and great for keeping dressings/pressure dressings in place. Of course they make WHITE colored tape now so it appears less barbaric...lol Also great for securing Pt's to something or splints if needed.

Tampons/Pads... Both great for GSW's (Gun Shot Wound's). They are made to absorb blood, not much else to say. Although having females in my Units, I always seems to be that godsend on those NOT SO FRESH days...lol

Expired Quick Combo/AED Pads... Don't throw them away, instead clip off the wires and put them in your trauma kit, appropriately marked as NOT to be used to defib. These are great to use as Occlusive dressings. They STICK a hell of a lot better then the ones you can buy, and they are bigger as well.

Razor... I can recall too many times that HAIR got in the way. Use your shears to cut the massive teen wolf patch down to manageable size and razor that chest (if appropriate). I have found that if I have the time to make a better sealing surface it keeps more blood in, and makes less of a mess. This is not always possible, but if it does not impede Pt care, I recommend it. OH, and you can always use it on those days your boss is telling you that you look shaggy... (Yeah Baby Yeah)

I'm sure there's more, but that's all I have time for right now...

[FMF_Doc]

Rob- for self care and/o treating family then I recommend the VOK from Tactical Response Gear, and the training to use it.

The class teaches self care as part of it's core.

[Gutshot John]

There is a big difference between what the lay person should carry for his own use and what a trained medic is going to have on hand.

As TacMedic mentioned needle decompression is not a likely scenario even for a medic dealing with a GSW as the bullet itself has already made a hole. I'd argue that an airway of some form is probably a bigger priority. If you're carrying a more significant bag (probably as a medic with extended transport times) than a 14 gauge needle might be worthwhile.

People are also getting a bit wrapped up in the tourniquet choice. I recommend the SOF-T. It is the current standard and is pretty easy to learn how to use. That said any tourniquet is better than none. Learn how to use what you own. I don't really see the virtue in using a (SWAT) tourniquet to simply hold on gauze...you probably won't ever see it again. Keep some tape handy.

The lower your training level, the more simplicity (KISSOFF principle) is a virtue. Any kit you get from TacMed Solutions is perfectly adequate to anyone here. If you want to build your own:

1. Trauma Shears
2. 2x Hemostat (Combat Gauze is what I'd recommend)
3. 4 4x4s and 4 rolls kerlix (OLAES Bandage alternatively)
4. Surgical (or Duct as someone pointed out works) Tape
5. Airway (nasopharengeal and maybe a pocket mask)
6. Gloves
7. Petroleum Gauze (so small it won't take up any space/add weight, so you might as well have it, just in case you run into a pneumo)
8. Tourniquet

WITH PROPER TRAINING...You should be able to treat 99% of GSWs with the above.

[NinjaMedic]

At work I do carry hemostatics, however I suppose that I am biased against them since I have yet to need them on a patient. I certainly dont deny that they have there place which is why I have them available it is just something that I have yet to encounter the need for. (since I said that I will probably have to use them tommorow)

Also as long as the tourniquet works (in my opinion based on the NAVSEA type studies) then it is all personal preference.

[K.L. Davis]

This is part of this post.

Within the scope of what the orginal idea, feel free to make some suggestions for this kit -- please copy the list before your post and add, subtract or make changes to the existing list. Please give your reason for the changes.

If anyone wants to recap the thread into a kit list?

[ToddG]

Could we work backwards on this ... Starting with a basic pre-made kit, what would you add?

e.g., Tac Med IFAK contains:

1 - SOF® Tactical Tourniquet
1 - 4 inch Olaes® Bandage
1 - Petrolatum Gauze
1 - Nasopharyangeal airway 28F
1 - Pair of Gloves, nitrile, Size: Extra large
1 - 2 inch Tape, surgical
1 - Laderal Face shield
1 - Trauma shears
1 - STAT Triage Card