Started my own med kit and it got out of hand

[Pontif]

Well, as the title suggests, I began my own and I have too much of the same items, items that will probably never be used, items out of date, items from my uncle the dentist (we will not discuss those - but they are not drugs), and all this occured because I started researching what MIGHT be needed.

All this happened because I found a standard military pack (for civi use like the one in Cheaper than Dirt) LACKING. What happens if you need an IV to stabilize a patient for emergency evac. Got the IV and I know how and why to use it. Is it worth the space over a blood clotter? This is just one of a thousand examples.

Any suggestions on the mammoth task I have created for my self. Kinda got obsessed with covering all bases with the kit.

[Ceddie]

What training do you have? when did you last get certified?

the answers to those will go a long way to what you should have in your jump.

[NinjaMedic]

Additionally, what is your locale? That will have a lot to do with your needs.

[Rmplstlskn]

You need TWO or THREE kits...

One is large and home based, holding all the "have it if I need it" stuff, the second is the one you will grab and take with you with the basics to "attempt" to preserve life from whatever may come your way...

I keep a THIRD in my truck at all times with stuff I may need if I or others are in a serious vehicle accident...

When it comes to FA supplies, NOTHING is useless and nothing expires less some items (drugs/IV solutions, etc...), and even those can go far fast the printed expirations.

Rmpl

[NinjaMedic]

Rmplstlskn - If you want to keep expired items around for your own peace of mind in a post-apocalyptic situation thats fine but you should be extremely cautious keeping expired items in any kit which you genuinely expect to use on someone. I havent seen a post in the introduction thread from you or the OP to give me any frame of reference on your level of medical knowledge but I will give yall the benefit of the doubt and assume or at least hope that you are a paramedic or an RN or a well trained ER tech at the very least. Now while you in particular are not directly advocating invasive procudeures, the OP asked about IV's and thus I am going to get on my rant.

I think we should reiterate that it is illegal in almost all states to provide advanced medical care including any invasive medical procedure such as starting an IV except at the explicit direction of a physician. This means that unless you are in a situation where you are either at work in your personnal vehicle or have an alternative arrangement with a physician to provide you with medical direction at all times even off duty (unlikely), then when you speak about building a personal first aid kit with invasive supplies and non-OTC medications you are advocating commision of a crime. This should be treated no different on this site than if someone advocated preparing a full auto conversion kit "just in case the zombies attack" and "my life would have to be in danger for me to use it". And the invasive medical supplies such as medications, IV catheters, IV fluids, etc you must have bought on Chinook Med right? I highly doubt it. Did you go down to walgreens and hand the pharmacist your perscription from your physician for 2 20g IV caths, 2 18g IV caths, 2 16g IV caths, and 4 1L bags of NS to be used PRN for severe MVC's? I dont think so.

Personnel who have been trained and approved to procure and use these items likely either have an issued kit with somewhat limited authority to deviate from a standardized equipment/medication list, or if the are given the autonomy to make their own decisions on what to carry they likely have other resources and personnel with which to consult when making their decisions.

I am tired of hearing the "I took CLS in the army when I was an 18B and thus I know how to start an IV on a young, fit adult male with 15% body fat and rope like veins so I am going to carry IV supplies in my pickup in case I come a cross a bad wreck or if an off duty trauma surgeon happens to come across me as i am dying he can bring me back with an IV". We should be policing ourselves on this forum and have just as little tolerance for this type of inappropriate information dissemination as we do any other. This isnt the zombie squad.

We should be able to discuss specific procedures from the aspect of new research, education, etc. If someone has questions about a specific medication or piece of equipment that they would like to get approved for thier agency thats fine. That being said if we get down to speaking about specific recomendations for medical supplies we should in good conscience limit the discussion and our advice to BLS equipment and procedures.

The debate in this thread needs to be does his locale warant the addition of a blanket to his first aid kit due to the space implications or can he do without it, is one sam splint enough, how many tourniquets, should he keep OTC meds in it, what types of bandaids are most effective for the everyday cuts and scrapes, commercial chest seal or alterative, etc etc etc. This IV supplies vs hemostatic agents question shouldnt even be on the horizon. If anything the most advanced thing we should be debating is whether he really should have a hemostatic agent or not.

What liability does this forum take on if we support Pontif's thought process that he needs to start an IV to "stabilize a patient for emergency evac" and ends up killing the person when permissive hypotension might have saved their life? Unless you are a PMC deployed in OIF/OEF and forced to scrounge items with very limited medical support these discussions have no place on this site. Sorry if anyone is offended but I am tired of seeing this thought process supported.

[Pontif]

My background medical training includes EMT training (not certification, youth work as a counselor in a hospital prevented completion), work with emergency room staff as a tech for 4 years and a great deal of study.

I did not mean to get the subject onto the specifics of the liability by mentioning the IV scenario. Need to be careful with my wording.

My intent was to consolidate the most necessary items in a portable pack that might aid in emergency situations involving various situations. Scrapes to a blow out kit to establishment of a viable air way (which I do have training in) and various other situations.

I began with the basics and found several situations on a vacation that I was not prepared for. I live in the south- MS.

I will post more in a min. Have a mom needing my attention.

William

[Hmac]

What NinjaMedic said is true. Stopping at an accident and providing first aid is great. Please do, if you're qualified. But if you start an IV or provide any other medical care, you'd better be fully credentialed to do so, including having an MD who has formally signed off on your licensure that he is willing to accept responsibility for your actions. If you are an EMT-Paramedic and do have a supervising physician who has formally signed you off, great...have at it. If you don't, the ER doc where that patient goes is likely to have your EMT certification pulled if you have one, or have you arrested for practicing medicine without a license if you don't.

Good samaritans, I'm all in favor. Medical "hobbyists" whose credentials consist of having an uncle who's a dentist...no thank you.

[danpass]

.....

[afff_667]

As a former EMT-P for over 15 years with an active urban fire department in north Texas, I remain comfortable with my IV skills, ability to do needle decompression on a chest, etc, but I never carried all that equipment in my personal bags/kits for the reasons cited above by Ninjamedic and Hmac. The medical directors under whom I worked were pretty specific about free-lancing when off duty no matter how bad the situation might be. They were realistic and realized that there wasn't a single one of us that would stand by and simply watch someone die, but they strongly and very vocally encouraged us to pick our battles very, very carefully when on our own.

I retired from that world, and no matter how competent I may have been (or may still be, I hope), I no longer have the required credentials and the support of a MD/medical director to perform any advanced treatment, so I don't carry a 14-ga, Quickclot, etc. I really wanted to, too...just in case. However, the most invasive treatment I plan and equip myself for is inserting an NPA to manage an airway. Sure, I carry gloves, a TK-4 or two, compressed gauze, Kerlix, an Ace, and Izzy bandages, etc, but that's it.

I've heard the old argument about someone arriving on scene who could use all that stuff, but in all my years I never once encountered a medical doctor as a witness/bystander at a scene actually doing much of anything for fear of a malpractice suit. In fact, few docs I knew would actually stop for an accident, etc knowing that EMS and someone with adequate insurance coverage was on his/her way.

A properly outfitted VOK should buy a victim enough time for EMS to arrive and take over in most situations the vast majority of us may find ourselves in while on the range, in training, or on vacation. There are exceptions, of course, but take a look at the reality of where you think you'll be, the resources that are normally available, and I think most people will find that they really don't need all that much.

[Hmac]

I've heard the old argument about someone arriving on scene who could use all that stuff, but in all my years I never once encountered a medical doctor as a witness/bystander at a scene actually doing much of anything for fear of a malpractice suit. In fact, few docs I knew would actually stop for an accident, etc knowing that EMS and someone with adequate insurance coverage was on his/her way.

Good Samaritan laws cover doctors stopping at accidents quite thoroughly in virtually every state. I've NEVER known a doctor to be afraid of a malpractice suit from work at an ambulance scene. And I know a lot of doctors.

But it is true that when doctors arrive on the scene, if they're smart, they'll just stand around and let the professional pre-hospital guys do their job. I'm a Medical Director of an ALS ambulance service and I have two EMT-P friends that I have signed off on. I have told all of them that at ANY accident or medical scene in our PSA, they have complete discretion to ignore ANYONE that shows up and says they're a doctor. Including me.

I'm a whiz in the ER and in the OR. In the field...I'm clueless (well, almost clueless). We all have to do what we're good at and what we're trained to do. I can usually (not always) start an IV on a hospitalized patient who has good veins. Out on a Minnesota back road, in the winter, at night...? I'd trust my greenest Paramedic first. It's not a trivial skill, it's a perishable skill. Most importantly, it's not just knowing how to do it, it's knowing when to do it and why.