Let's talk bare-bones BOK

[occamsrazor]

Hi, first off thanks to everyone for this very interesting thread.

I've attended some very basic tactical medicine training (3-day course) but in reality my abilities are not much. I'm trying to make a personal blow-out kit for use against gunshot wounds (and possibly blast injuries) in places away from rapid medical care and with items that I realistically would be able to use myself, and with the intention of keeping it as small as possible. It has to fit on a belt-pouch, and should contain only those items that I am realistically able to use without causing more harm. So far I'm thinking:

Quikclot Combat gauze
1 or 2 OLAES bandages or similar
CAT TQ
Shears

My thinking was there was little point me carrying an NPA or decompression needle as realistically I'm not going to be able to use it.

Regarding a chest seal - is this something that a person with very basic training could use and benefit from? I've read many people recommend HALO seals, but also that tension pneumo is a leading problem. Would a seal with no valve such as the HALO used by a person NOT able to do a chest decompression be problematic? Would it be better for such a person to use a seal with a valve (Hyfin, Bolin, Asherman???) that would avoid a tension pneumo developing? Or does the use of chest seals require a level of training/diagnosis such that it is not worth me carrying?

Regarding pressure bandages, I see the OLAES gets recommended a lot but also I saw it discussed here that the package size is quite large. If packed size is an issue, what would you recommend?

Before someone points out that there is value in carrying items you can't use but better-trained others can use on you... I do accept that point, but the people I am with are unlikely to have any real medical training either, so the first medically-trained person encountered post-injury would likely be on arrival by car at hospital that may not be close-by. I may well put such items in a more extensive vehicle-kit, but for now i'm just thinking about a belt/vest pouch with items I can actually use on myself and or others injured next to me.

I realise these are very basic questions, but appreciate any help you can give.

Thanks...

[GTF425]

I'm not a Paramedic, but I am an EMT. I carry a vacuum sealed BOK in my admin pouch with:

1 x Combat Gauze
1 x SOFT-T
1 x Saline Lock Kit
1 x NPA, Adult Medium
1 x Israeli dressing

It's my understanding that the purpose of a BOK is to give you the ability to stop major life threatening injuries until you can provide the patient with more advanced life saving care. My priority is to stop massive external bleeding. Before I hand a casualty off, I always establish a patent airway and administer a saline lock. In the EMS world, I'm sure this is a no-no (especially for someone only EMT qual'd like myself), but for combat lifesaving, it's expected of everyone to be able to perform these simple tasks. Sterilization isn't a big deal to me and I've treated wounds bare handed. Obviously not preferred, but you do what you can with what you have. If you think it'll be a problem, toss in some gloves.

If all you want is a BOK, it's my opinion that all you need is to treat the ABC's. I have a medium medical pouch in my assault pack specifically for more advanced medical care.

[MessedUpMike]

Regarding a chest seal - is this something that a person with very basic training could use and benefit from? I've read many people recommend HALO seals, but also that tension pneumo is a leading problem. Would a seal with no valve such as the HALO used by a person NOT able to do a chest decompression be problematic?
Thanks...

I'm just an EMT myself, but I'll try to help you out a little. If my interpretation is wrong we'll both know soon enough.
If you're not planning on penetrating the chest cavity (and I personally wouldn't be), then a valve is not really going to do you much good. The point of the valve is to let air back out of the chest cavity, but not back in. 20 years ago when I started doing this valves weren't even taught in Maryland, you just sealed the whole thing and ran like hell. In a penetrating trauma, like a GSW, you can get the same effect with a piece of plastic and some tape. Leaving a small corner open would allow some of the air out, but not back in. Personally of I were shot I'd rather have the whole thing sealed of than nothing at all. In my mind the ONLY thing I'm trying to do in the field with my limited training and resources is by the Patient time until we get the an ER.

As a small side note I might be disinclined to making a BOK to fancy. It may seem like goofy logic, but I would be concerned that if my kit were to high speed low drag then Joe Plumber would be either be hesitant to use it if I were the one who went down, or try to needle decompress my throat.

[numberFN1]

This is a great thread wow thanks for all the helpful info! I'm thinking maybe I need something bigger than the HSGI bleeder/blowout pouch now though...

[dyegator]

This is a great thread wow thanks for all the helpful info! I'm thinking maybe I need something bigger than the HSGI bleeder/blowout pouch now though...

I know quite a few guys using this size or smaller ifak. I'm a believer in small Ifaks and recommend the following: Israeli or Olaes, chest seal of choice, either z-packed gauze or combat gauze, npa and NCD needle vacuum packed together, all with rip tape starters and contents list on exterior, TQs (either CAT or SOFTT on exterior kit). Reason being that anything this can't stop is going to need advanced care that will be provided by my aid bag or medevac of some sort.
My $.02

[Wicked]

This is a great thread wow thanks for all the helpful info! I'm thinking maybe I need something bigger than the HSGI bleeder/blowout pouch now though...

Don't know your AO or level of training, but my guess is probably not. That's exactly why I carry the lil' HSGI bleeder pouch - it keeps me from trying to convince myself I might need 3 CATs, 200yds of combat gauze and a kitchen sink in my IFAK. If it won't fit in there, likely I won't need it for the intended purpose of a BOK.

[JohnnyC]

I've got a z-pack gauze, quick clot, olaes, TQ, NPA, and angiocath, gloves and a packet of surgilube for the NPA. It's in an OSOE compact tear-off. It's small enough to be convenient, but enough stuff to be useful. I can rubber band an izzy or olaes or another TQ to the outside too if I want, although that increases the size.