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PostPosted: Sun Oct 19, 2008 9:12 pm 
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STFU NOOB.

Welcome, post an introduction in the intro thread. Always can use more medics around.

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PostPosted: Sun Oct 19, 2008 9:57 pm 
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Doc Simon wrote:
STFU NOOB.

Welcome, post an introduction in the intro thread. Always can use more medics around.


Heh! Thank you for the welcome. :D


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PostPosted: Mon Oct 20, 2008 10:00 am 
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posie wrote:
There is a lot of stuff that seems deceptively easy to administer. For example, I am trained to administer dextrose 50%/D50 through an IV. A nurse here on ZS said that they were uncomfortable with administering D50 because there is such a high potential for necrotized tissue, and I certainly agree - as a II, I'd never give D50 unless we were en route to an ER, the vein was 100% patent, and my paramedic or medical control told me to do it.

Just because someone carries D50 in their FAK doesn't necessarily mean they would administer it in that form. Most advanced FAK's and trauma kits are space limited, so rather than carry a bunch of indivdual 250cc bags of D5W in addition to NS, it simply makes sense to carry more NS and a single 50mL vial of D50, then dillute it 9:1 with NS to make D5W as required.

posie wrote:
I was pretty surprised to see ET tubes and IV & IO sets in some of the kits (let alone morphine, atropine, naloxone, needle decom kits, and other stuff). In my state you have to have a physician's license to buy those kinds of items, and I thought that was the case all over the US, but apparently some smart folks have persuaded their personal physicians to give them prescriptions, which is great. As numerous people on this board have stated, in a Katrina-like situation, you will probably be able to scare up a paramedic, nurse, or doctor who DOES know how to use your painstakingly assembled badass FAK.

It is WAY too easy to innocently overstep your bounds in an emergency situation and not realize how much harm could potentially be done. In my opinion this temptation to ACT NOW could potentially be very high in someone who has access to equipment that is beyond their scope of practice.

I can only speak for myself, but having a FAK with most of the more advanced items that you mentioned presents no more temptation for me to "ACT NOW" and use them in a non-PAW situation than does having a couple thousand rounds of 5.56 NATO on-hand for my AR tempts me to take out the first obnoxious coworker that pisses me off.

Without a drug bag full of fast acting sedatives and paralytics available I doubt anyone here would attemp to perform RSI on a conscious PT even in a PAW scenario. If on the other hand a loved one in the PAW is unconscious due to an inability to maintain a patent airway or aspirating stomach contents into their trachea and medical asistance is definitively unavailable, then the risks associated with intubation and "do no harm" somewhat go out the window given the alternative of not taking any action.

Jim

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PostPosted: Tue Dec 02, 2008 11:01 pm 
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This is an amazing thread. Thanks much for posting it. I got a lot of useful info out of it.

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PostPosted: Mon Apr 13, 2009 1:43 pm 
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Hooligan wrote:
I think some people see certain things in others pack and think they need to get them when they really are not qualified to use them. NPA, OPA chest needles epi-pins and any IV treatment an untrained person should not have in their FAK. Certain skills unless in an extreme situation are not to be used even if you are trained if you are not on duty for a medical provider.


I respectfully disagree. I want every guy assembling his first FAK to shove an epi-pen and benadryl in there.

Epi pens, particularly Epi Jrs, are like cops. They're never there when you need one. All you gotta do is hop on the phone with 9-1-1 and they'll tell you how many times to stab El Barto.

-Nobody, MS-3, decomissioned LPN

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PostPosted: Mon Apr 13, 2009 2:14 pm 
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Nobody wrote:
Hooligan wrote:
I think some people see certain things in others pack and think they need to get them when they really are not qualified to use them. NPA, OPA chest needles epi-pins and any IV treatment an untrained person should not have in their FAK. Certain skills unless in an extreme situation are not to be used even if you are trained if you are not on duty for a medical provider.


I respectfully disagree. I want every guy assembling his first FAK to shove an epi-pen and benadryl in there.

Epi pens, particularly Epi Jrs, are like cops. They're never there when you need one. All you gotta do is hop on the phone with 9-1-1 and they'll tell you how many times to stab El Barto.

-Nobody, MS-3, decomissioned LPN


So what you're saying is, you have no street emergency medical experience. (Med school/LPN does not = EMT. I would happily invite any doctor or any nurse to try and do my job as good as I could. They would have to have vast ER experience, a level head, and would likely still need luck to do it. I dont pretend I am a doctor or nurse too bad for the most part both of those professions are too pretentious to realize the are not EMTs) You're also saying a 911 dispatcher is going to tell a layman how and when to use an Epi Pen. Also, a layman will be able to properly convey symptoms, vitals, and other things to the 911 dispatcher. I didnt know that the gubbmint could afford to pay doctors to be 911 dispatchers. :roll:

I am all for people carrying them, as long as they are responsible and dont use them without the right training, but not for your reasons.

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PostPosted: Thu Apr 16, 2009 12:10 pm 
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great advice


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PostPosted: Sat Jul 04, 2009 12:34 am 
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Citizen Simon wrote:
So what you're saying is, you have no street emergency medical experience. (Med school/LPN does not = EMT. I would happily invite any doctor or any nurse to try and do my job as good as I could. They would have to have vast ER experience, a level head, and would likely still need luck to do it. I dont pretend I am a doctor or nurse too bad for the most part both of those professions are too pretentious to realize the are not EMTs)


Wow. Now I know why I left this subforum in the first place. I should never have looked looked back.

Doc/CitizenSimon, I respect your opinions, but I don't remember you being too old, which means you don't have twenty years of experience under your belt. Even if you did, I still say there is no reason for statements like these.

Saying that no doctor could do your job is just a little ridiculous. There is also absolutely no reason to attack someone just because you think they are infringing on your territory. An MS-III is not some idiot off the street. Maybe his opinion is not completely sound, but there is no reason to just call someone out like that. You learn a lot in med school, and I really don't like hearing how ALL doctors are pretentious.

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PostPosted: Sat Jul 04, 2009 4:57 am 
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Veritas wrote:
Saying that no doctor could do your job is just a little ridiculous. There is also absolutely no reason to attack someone just because you think they are infringing on your territory. An MS-III is not some idiot off the street. Maybe his opinion is not completely sound, but there is no reason to just call someone out like that. You learn a lot in med school, and I really don't like hearing how ALL doctors are pretentious.


I didnt say all, I said they were for the most part. Yeah there are probably some kick ass trauma docs that could hang with a street EMT, but I am more than willing to go head to head with any doctor in a field test. Lets do a rapid trauma assessment and medical interventions in a street scenario. I'm no longer an EMT and I am willing to bed I'd still trounce any doctor you put in my path. Street emergency medicine is a completely different animal. As for the 'attack' it wasnt an attack sorry that it came across that way. As for that 'his opinion may not be sound, but there is no reason to call someone out like that" uh, are you serious? If someone's opinion and education are questionable it is totally appropriate to call them out especially if they are despising questionable medical advice. You ever seen a doctor try to stick an IV? I've had to retrain doctors on several occasions in my military career on sticking IVs because it's a skill they never use. I've taken a few doctors out with me in my ambulance so they could see how we lowly EMTs live. For the most part they didnt hang too well. An RN is what? 2 years of school. A paramedic is what? 2 years of school. EMTs are grossly under appreciated in the medical field its terrible. There are some other EMTs on here, such as gana, what would tell you the same thing.

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PostPosted: Mon Sep 28, 2009 2:32 pm 
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Right, only hyper-mega-super trained doctors, with time to post on ZS, are qualified to touch medical equipment. The odds of me ending up in PAW next to this uberdoktor seems iffy. As such, there's time and extent to prepare for the unexpected now. As I find things useful to my view of PAW, I hunt it down, add it to the FAK and learn what it is and when it would be useful. There's no way I'm going to use some of the things in my FAK on my own unless someone was talking me through it... but I like the idea of having things handy to uberdoc or mega-EMTman when they do show up.

Realistically, the EMT and care giver FAKs probably get depleted almost immediately through the prelude-to-crisis and immediate aftermath. In PAW, there's also tremendous value for bartering of medical supplies.

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PostPosted: Fri Nov 06, 2009 10:03 pm 
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I have to chime in.

Working a code or a mega code? Yeah. Paramedics get more practice.
I don't think we can use the term EMT to blanket talk about skills.
EMT-P, If I am having a heart attack yeah? You can work me so the doc can prounounce me dead, I'm ok with that.

I have seen more paramedics who are clueless than I have seen doctors who are sub-par..
I have seen superlatives in both fields.

EMT-B?
Shutup put the o2 on and drive.
There is a reason most aren't authorized IV's.

Doctor>EMT.
Yes even for trauma.

Army Medicine? That's different. My PA can beat up your PA.
But for civilian medicine, I'd rather have a doctor work pretty much anything.
The biggest part of the Patient Care is the Caring.
That's lacking in a large percentage of all aspects of medicine, but primarily with Nurses and EMS =)


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PostPosted: Thu Nov 19, 2009 10:47 pm 
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Thanks a lot for this very useful post. Have learned a lot thus far and will continue to use this as a basic reference. Hopefully I don't have to use any of the more serious items on the list.

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PostPosted: Fri Mar 05, 2010 6:13 pm 
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Hi, great post!

I don't think the original poster can possibly mean "5 decades" of prescription drugs...thats 50 years!

Assuming a ton of stuff (2 pills/day, the weight of a random bottle of unopened tylenol on my desk, etc) thats more than 50+ pounds of drugs. Not only that, even assuming that most drugs are good several years past their expiration date (most are), its kinda silly. Keeping them in anything but a cool dark place (which the trunk of the car certainly isn't) also significantly shortens the lifespan.

6 months is a more reasonable supply in total, with possibly a couple of weeks in your possession (split between GHB, EDC, etc) at any given time.


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PostPosted: Thu Apr 22, 2010 3:41 am 
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Hooligan wrote:
I have a suggestion maybe when people post their FAK they also should post their level of training. I feel it would help in advising people what they should and should not have in their first aid kit. I think some people see certain things in others pack and think they need to get them when they really are not qualified to use them. NPA, OPA chest needles epi-pins and any IV treatment an untrained person should not have in their FAK. Certain skills unless in an extreme situation are not to be used even if you are trained if you are not on duty for a medical provider.


Got to agree with Posie on this, and Hooligan raises a good point. If I tell you to shove a tampon into a bullet wound, and you read it in a book, too, you might assume that both the book's author and I had the requisite knowledge and training to give such sage advice. We'd ALL be wrong! I only know how to use an epi pen because the instructions are written right on the thing, and I took the time to read them (that means STUDY) BEFORE I needed to use one. And I only know WHEN to use one as it pertains to my own allergy to stings- I'd NEVER just randomly go jabbing someone, wounded or not, with an epi pen because they seem a little run down or something equally silly. My own medical training is so out of date as to practically useless, though I'm reasonably sure that CPR and basic first aid hasn't changed much since I last certified, and any hole nature didn't put there is usually a bad thing, esp when it leaks stuff. Still, getting re-certified is high on my list, so that once I get all the cool stuff, I'll know how to use, when to use it, and if I should use it- proper tool for the job, and all that.

And, for the record, I know a guy who SWEARS by the tampon thing, and carries one while hunting- he won't listen to me, so I told him that after he bleeds out with his tampon method, I'm taking his stuff. One of these days, I just might come into some really good gear! I'll miss him, tho.

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PostPosted: Tue May 11, 2010 3:41 pm 
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Oh thanks for this thread. I was just going to buy one of those prepackaged FAK from Walmart because well I didn't know where to start.

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PostPosted: Fri May 14, 2010 3:46 am 
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LyraJean wrote:
Oh thanks for this thread. I was just going to buy one of those prepackaged FAK from Walmart because well I didn't know where to start.


The prepackaged FAKS are alright to (use as/create from) a "boo-boo" kit, and to restock it from, but if you are going to be lugging it around with you all the time, most of the contents are simply not practical. You need to start somewhere, and at least you are starting.

Like any other individual piece of equipment, "individual" is the key word when selecting it- what are YOU most likely to come up against? Scorpion stings tend to be rather rare in Alaska, so that's an item you can skip, if you're in Alaska. Arizona, on the other hand, well- you might want to hang onto those. Someplace like Kansas, for example, isn't going to present the rock/cliff climbing challenges NY or Colorado might, so consider how likely you are to get hurt, and by what, in your AO, then design a kit around those injuries.

Consider multiple function items- a 4X4" gauze pad will do everything a 2X2 will, but the opposite can not be said. Duct tape in your gear can double as first aid tape. Try setting up simple solutions to several types of wound severity- scrapes/scratches/bruises, cuts/punctures (maybe with heavier bleeding), broken bones, amputation/gunshot wounds or similar OMG type wounds. This is the approach I am taking as I assemble my kits. I'm not trying to handle a lot of "multiple need usage", as much as multiple applications for any given item when possible. A tourniquet has only the one use, but when you need that use, you don't want to try and make do with a couple windings of duct tape, right?

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PostPosted: Fri May 14, 2010 4:02 am 
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KnightoftheRoc wrote:
My own medical training is so out of date as to practically useless, though I'm reasonably sure that CPR and basic first aid hasn't changed much since I last certified


Heh, me too... Last time I had a legit cert was in '95... but some things have changed since then.

I learned from my niece that the Red Cross specifies you should call EMS before you start life-saving measures, whereas back in my day the calling 911 thing was only after you had taken a pulse, checked for breathing, and begun compressions if applicable.

Also back in my heyday a sucking chest wound was best left untouched by a first responder until EMS arrived, now a plastic baggie and some scotch tape is the recommended treatment.

Just saying the specs have changed and probably based on solid evidence... if you have the ability to get caught up, you should do so.


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PostPosted: Fri May 14, 2010 11:01 pm 
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Bravo Doc Simon. I agree with your post about retraining Docs in traums situations. I ahve had to do the same thing myself. I especially like the disclaimer.

About overstocking your bag with stuff that you are not trained to use... You can do it but I would very much like to stress to everyone reading these threads DO NOT EXCEED YOUR SKILLSET! Work within the scdope of your training in a real world situation. Good Samaritan laws do not protect you if you exceed your scope of dities, training, and certifications. You will almost, most definitely, probably, find yourself on the bad end of a lawsuit stick.

The one thing to remember when reading all these post is that you shall do no harm! If you do because you thought you were doing the right thing and you harm someone, not kill him it will not hold up in court. If you do this in a PAW situation and you kill or hurt someone it is on your conscience(sp?).

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PostPosted: Wed May 26, 2010 1:28 am 
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First off I'm a new member and threads like this are what made me want to join the ZS forum.

For me a FAK is like insurance or an avalanche transceiver I have / carry one for me. That way if I'm injured the needed supplies are available. While it's nice to think that there will always be someone around that knows what to do I wouldn't bet on it. Therefore a first aid book is always in my FAK. The more comprehensive the kit the more comprehensive the book, but always written for the untrained.

Level of training: EMT-B (not current), wilderness medicine, 10+ years of SAR in Oregon.

Thanks for everyone's input I've already learned a bunch.

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PostPosted: Wed May 26, 2010 5:14 pm 
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And don't forget to pack a good light in your FAK! Pet peeve of mine: Epi pens, sutures, fricking scalpels but not lights. Not so much as a disposable penlight.

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PostPosted: Wed Dec 08, 2010 6:18 pm 
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Where is everyone getting their Epi-Pens without a prescription and how are you justifying the high cost for something that will be replaced every 1-2yrs when it expires? I would buy an Epi-Pen for my FAK if they didn't cost so much. But with no one in my family having allergies I just can't justify it.


Quote:
About overstocking your bag with stuff that you are not trained to use... You can do it but I would very much like to stress to everyone reading these threads DO NOT EXCEED YOUR SKILLSET! Work within the scdope of your training in a real world situation.


I cringe at some of the stuff people have in their FAK's! One, I wonder how in the world they obtained it, and two, I have been an EMS provider for over 15 years and I don't take giving meds or performing invasive procedures lightly at all. So I can't imagine someone with no to very minimal training and education performing advanced skills.

I think it's great that people want to have advanced capabilities but honestly you may very well end up causing a worse situation for the person you are trying to help. There is a reason Paramedic's go to school for two years to deliver the advanced life support level of care.

I don't want to sound like I'm preaching (least not too much :) ) but I want to throw out the caution. And definitely, unless the person is yourself or a family member, DO NOT even think about performing an advanced level procedure unless your in the middle of a major catastrophe.

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PostPosted: Thu Dec 16, 2010 1:59 pm 
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There is a reason Paramedic's go to school for two years to deliver the advanced life support level of care.


Hehe, try 8 years over here (RN-> ICU->Paramedic) :twisted:

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PostPosted: Thu Dec 16, 2010 10:28 pm 
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Thank you! I've been trying to figure out everything I need for my first aid supplies but there's so much to know and a lot of conflicting info out there. This should definitely be a sticky.

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PostPosted: Sat Jan 15, 2011 8:35 pm 
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Hooligan wrote:
I have a suggestion maybe when people post their FAK they also should post their level of training. I feel it would help in advising people what they should and should not have in their first aid kit. I think some people see certain things in others pack and think they need to get them when they really are not qualified to use them. NPA, OPA chest needles epi-pins and any IV treatment an untrained person should not have in their FAK. Certain skills unless in an extreme situation are not to be used even if you are trained if you are not on duty for a medical provider.


In this kind of situation, if they need airways asherman seals, and pressure dressings, let's be real, they are not going to survive. The kits should focus on daily issues and the small stuff. A little of the trauma stuff for coming up on an accident or something when civilization still exists, or if there is just a delay in transport. People forget that in triage there is an additional catagory in disaster. Expectant, too bad to fix with what is available, or will require more stuff than we can spare with little chance to survive. In most cases of disaster/ end of the world, if they need CPR, they are dead.

And I am a 29 year paramedic with Combat medic time as well as a Paramedic instructor in case you doubt my knowledge base


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