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PostPosted: Mon Jun 16, 2014 11:03 am 
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So I'm branching out from the firearms forum with my first post to FA. Not surprisingly, this post is still about guns :awesome: what can I say I'm addicted to firearms.

Anyway..

I'm building my first trauma kit. It's mostly for GSW/knife wounds but could be used also for wilderness first aid. I am a total noob about FA but learn quickly so bear with me please.

This kit is residing on my chest rig and is already packed pretty full but could be repacked to free up space. I am looking for constructive criticism and suggestions on what to add or remove.

Current contents:
Israeli bandage 4" x 2
Celox 35g granules x 1
Quikclot sponge 25g x1
1 pair Nitrile gloves
Antiseptic wipes x 5
5"x 9" Trauma pad (abdominal pad) x 4
Duct tape 2"x 26"
Triangular bandage x 1
4"x 4" gauze x 2
2"x 2" gauze x 2
3" conforming gauze x 1
Chapstick x 1
Sunscreen packet x 2
Hand sanitizer packet x 2
Poison oak cleanser towlette x 2
Acetaminophen 300mg x 20

Things I'd like to add:
Trauma shears
Chest seal
SWAT tourniquet (Izzy bandage may double as TQ?)
Smelling salts
Extra gloves

Thoughts?


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PostPosted: Mon Jun 16, 2014 2:25 pm 
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Tell us what kind of training you have, that makes a difference in what 'stuff' you should carry.

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PostPosted: Mon Jun 16, 2014 3:46 pm 
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Little to none only what I've read about in books, or seen in how to videos. Was certified in CPR years ago but I have zero formal training, hence the 'noob' part of my initial post.

Some training would be nice when finances allow.


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PostPosted: Mon Jun 16, 2014 3:59 pm 
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AS556 wrote:
Little to none only what I've read about in books, or seen in how to videos. Was certified in CPR years ago but I have zero formal training, hence the 'noob' part of my initial post.

Some training would be nice when finances allow.


I would suggest to you to get some training. It is entirely possible to make something bad, much worse, due to the lack of training.

See of the Red Cross offers anything in your AO.

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PostPosted: Mon Jun 16, 2014 7:13 pm 
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Man, it's really hard to give advice on this stuff without knowing a little more about the intended use.

Is this intended to provide self-aid/buddy-aid, or aid for multiple people? Makes a big difference in how MUCH gear you are going to carry.

Under what situations will this be used? Makes a big difference in how MUCH gear you are going to carry and the TYPE of gear. Is it primarly going to be a range/work FAK or a Ima Going To WAR(!) FAK? Is the time to difinitive care going to be long or short? Are you likely to be alone or with somebody?

What is the ratio of nice to have to need to have that you're willing to put up with? If you are seriously just focused on bleeding trauma, you'll just muck things up by stuffing additional items like chapstick, sunscreen, etc. into the FAK. Consider making a seperate 'comfort kit' for those items.

Example: I have a standard FAK that I throw into my range bag when I go shooting OR when I go with my buddy to cut firewood, work on home projects, or otherwise do other labor tasks that have the opportunity for bleeding trauma. It is intended to treat one bad bleed on one person. I carry zero dedicated boo-boo items (like bandaids or sting-eze) because I'll just go home or to the buddy's medicine cabinet if I get a mnior injury. During nearly all of these activities, I will be with at least one other person, and I will rarely be more than 15 minutes away from a Level II trauma hospital. Accordingly, my gear requirement will be radically different than a situation where you plan on going off into the hinterlands for a week to go hunting all by your lonesome.

As far as training, it DOES make a difference. Most bleeds, even bad ones, can be successfully addressed by grabbing a towel (or even just taking your bare hand) and pressing down on the injury really hard, and having the person sit down and try to chill out. That takes essentially no equipment. If you have more gear, you can do a nicer, neater job wrapping things up.

Anyway, that's a long-winded answer to say 'it depends'. I'll tell you what I carry in MY range/work FAK based on my circumstances and percieved uses.

1 - CAT TQ
1 - 5 X 9 pad
1 - Small roll duct tape
1 - Medic shears
1 - Izzy bandage
2 - Rolls 4" kerlix
1 - nitrile gloves
2 - 4 x 4 pads
1 - space blanket

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Last edited by DannusMaximus on Tue Jun 17, 2014 8:03 pm, edited 1 time in total.

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PostPosted: Mon Jun 16, 2014 7:42 pm 
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I'll second the "separate your GSW from your bandaids" comment.

One you can rifle through and grab stuff, or use up and run out, or stuff crap in there, or whatever. The other you need ready to go, with a firm knowledge what is in there, where it is, and that it is in excellent condition.

I ran into that situation with my FAK in the last 12(ish) months. I suddenly needed emergency gear, and found out my FAK is crammed with crap and I had a hard time finding what I needed. I still have not fixed my problem, but at least now I'm aware of it.

On that note, I'd make sure your GSW FAK is neat and organized, and has lots of little pockets and dividers and stuff. The other can be a big jumble because it does not get used for anything important.

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PostPosted: Mon Jun 16, 2014 8:36 pm 
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woodsghost wrote:
I still have not fixed my problem, but at least now I'm aware of it.

Fix the damn problem, woodsghost!! :lol:

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PostPosted: Mon Jun 16, 2014 8:44 pm 
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DannusMaximus wrote:
woodsghost wrote:
I still have not fixed my problem, but at least now I'm aware of it.

Fix the damn problem, woodsghost!! :lol:


Dammit. Now you talked me into it. I need to go shopping. :D Or look at what I got and see if I can make something work RIGHT, rather than half-way right.

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PostPosted: Tue Jun 17, 2014 12:56 pm 
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Here's my thread on what I developed over the course of a few years as I learned more and more about handling trauma:
Murph's GSW Blow Out Trauma Kit
viewtopic.php?p=1500616

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PostPosted: Wed Jun 18, 2014 9:31 am 
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The contents of the current US Army Combat Lifesaver Kit (Appendix A) are a great place to start. I trained with and used this kit in Iraq and Afghanistan for three years, since my hobbies now include reloading, hunting, and target shooting it is still appropriate for my needs. With the addition of some Band-Aids and a pocket mask you are good to go. I recently went through my bag from Afghanistan and replaced expired items from Rescue Essentials.

NOTE: You may want to skip the hemostatics (Quik Clot), needle decompression devices (14GA catheters), and possibly the airway adjuncts (nasal trumpet 28 Fr sterile lubricant) since they fall well outside of Good Samaritan Statutes. Everything else pretty much falls under basic Red Cross first aid training.

APPENDIX A
COMBAT LIFESAVER MEDICAL EQUIPMENT SET
    FSC NIIN Long Nomenclature Amount
    6510 009268884 Adhesive Tape Surgical Porous Woven 3 inches by 10 yards 1 spool
    6545 015370686 Bag, TC3, Combat Casualty Care V2 1
    6510 009355823 Bandage Elastic Flesh Rolled Nonsterile 6 inches by 4.5 yards 1
    6510 015032117 Bandage Gauze Cotton 6-Ply White 4.5 inches by 4.1 yards (Compressed) 2
    6510 015623325 Bandage Gauze Impregnated 3 inches by 4 yards Kaolin Hemostatic Quik Clot 2
    6510 014922275 Bandage Kit Elastic 2
    6510 015326656 Bandage Kit Elastic Abdominal Wound F/Trauma Kit 1
    6510 002011755 Bandage Muslin Compressed Olive Drab 37X37X52 inches Triangular with Safety Pins 3
    6532 015254062 Blanket Heating Disposable 90 cm by 90 cm Water Repellent 1
    6532 015246932 Blanket Survival Blizzard Pack Reflexcell Military Green 1
    6510 015730300 Dressing Chest Wound Seal Pack 2
    6515 015251975 Glove Patient Examining and Treatment Size X-Large Latex/Powder Free 4
    6515 015407226 Leash Shears Trauma Black High Break Strength 2
    7520 003126124 Marker Tube Type Fine Tip Black Permanent No Odor Dries Instantly (Sharpie) 2
    6515 015291187 Nasal Trumpet 28 Fr Sterile (NARP with Lubricant) 1
    6515 015410635 Needle Decompression Device 14 Gauge by 3.25 inches 2
    6510 007863736 Pad Isopropyl Alcohol Impregnated Nonwoven Cotton/Rayon White 5
    6515 009357138 Scissors Bandage 7.25 inches Large Angle to Handle 1.5 inches Cut Large Blunt Pts Crs 1
    6515 014491016 Shield Eye Surgical Fox Single Natural Aluminum 1
    6515 014941951 Splint Universal Aluminum 36 inches Long 4.25 inches Wide Gray and Olive Drab Reuse 1
    4240 015683219 Strap Cutter, Combat 1
    6515 015217976 Tourniquet Combat Application One-Handed 2
    Field Medical Card (Pack) 1

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PostPosted: Wed Jun 18, 2014 6:23 pm 
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I looked into and will likely be taking a local Red Cross class with my girlfriend soon. I should have specified more my skill level and intention of the kit. This kit is intended for a one time use for myself or 1 other person. To me the sole purpose would be to control the bleeding from a single, likely accidental, GSW or nicked artery in the field just to stabilize long enough to get into town. Is the best solution for this just pressure, like the Israeli bandage?

If that is the case, what purpose do products like Celox serve?

I need to look into taking basic first aid and then taking a course or two focused on controlling bleeding and GSWs. I really do think training is invaluable but I would still like to have a basic idea of how to use the products I own in the mean time. My understanding of treating a wound like this is to first apply PPE, get as much blood out of the wound area as possible with gauze, pour the Celox onto the wound, apply izzy bandage over that and get to a hospital ASAP. Is that incorrect? Very well could be.


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PostPosted: Wed Jun 18, 2014 7:31 pm 
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AS556 wrote:
I looked into and will likely be taking a local Red Cross class with my girlfriend soon. I should have specified more my skill level and intention of the kit. This kit is intended for a one time use for myself or 1 other person. To me the sole purpose would be to control the bleeding from a single, likely accidental, GSW or nicked artery in the field just to stabilize long enough to get into town. Is the best solution for this just pressure, like the Israeli bandage?

If that is the case, what purpose do products like Celox serve?

I need to look into taking basic first aid and then taking a course or two focused on controlling bleeding and GSWs. I really do think training is invaluable but I would still like to have a basic idea of how to use the products I own in the mean time. My understanding of treating a wound like this is to first apply PPE, get as much blood out of the wound area as possible with gauze, pour the Celox onto the wound, apply izzy bandage over that and get to a hospital ASAP. Is that incorrect? Very well could be.


Sorta. Here's an interesting story about a now product.

The hemorrhaging caused by gunshot wounds is a leading cause of death for soldiers in the battlefield. The current emergency treatment method is almost worse than getting shot. A medic must force gauze into the bullet wound to stop arterial bleeding, sometimes as far as five inches into the body. If this intervention fails to stop the bleeding within three minutes, the gauze must be torn out and fresh gauze inserted, an agonizing procedure to an already injured soldier.

“(Y)ou take the guy’s gun away first,” said former U.S. Army Special Operations medic John Steinbaugh to Popular Science.

The technique yields mixed results. Some wounds are simply too much for gauze alone.

“Gauze bandages just don’t work for anything serious,” Steinbaugh said. He treated injured soldiers in the field in Iraq and Afghanistan before retiring with a head injury.

Steinbaugh joined other combat medics, engineers, doctors and scientists at a startup named RevMedx, where they dedicated themselves to finding a new, more reliable way to stop bleeding. They needed something they could spray into a wound that would expand quickly like Fix-a-Flat, which rapidly expands to make a leaking tire airtight again.

“That’s what we pictured as the perfect solution: something you could spray in, it would expand, and bleeding stops,” Steinbaugh said. “But we found that blood pressure is so high, blood would wash the foam right out.”

The team started with regular sponges from a hardware store, which they cut into one centimeter cubes. The idea proved to be fortuitous. When sponges were injected into animal injuries, bleeding stopped.

Regular household sponges, however, weren’t safe to inject into the body. The team worked with engineers to create sponges that are sterile, fast-expanding and compatible with human tissue. The resulting device is called XStat.

XStat looks like a large syringe full of pills, but the pill-shaped objects are in fact fast-expanding sponges that go from compressed to full expansion in 15 seconds. Each sponge is marked with an “X” that is visible on x-rays to keep them from being left behind in the body by surgeons.

The device is considerably smaller than the five bulky rolls of gauze each medic normally carries. RevMedx has submitted the XStat — as well as a smaller version for narrower injuries such as shrapnel and small-caliber bullets — to the FDA for approval. If the devices are approved, they could revolutionize battlefield trauma care and ultimately save lives in the civilian world as well.

RevMedx hopes to apply the sponge technology to the treatment of postpartum bleeding and to treat larger injuries such as those sustained by victims of land mines. Steinbaugh said that his experiences in combat are what drives him and the team.

“I spent the whole war on terror in the Middle East, so I know what a medic needs when someone has been shot, ” he told Popular Science. “I’ve treated lots of guys who would have benefitted from this product. That’s what drives me.”

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PostPosted: Wed Jun 18, 2014 7:56 pm 
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AS556 wrote:
Is the best solution for this just pressure, like the Israeli bandage?

Not always... I really depends on the wound, what caused it, where it is, and a multitude of other factors. Knowing how to properly assess injuries is just as important has knowing how to treat them...
Two quick examples:
1 - You wouldn't want to apply pressure to a compound fracture.
2 - An Israeli bandage won't help someone who isn't breathing.
I hate to say it, but it sounds like you're at the point were "you don't even know what you don't know." A Red Cross First Aid & CPR course is a great place to start. They even include tourniquet usage in their manual these days. From there, look for a repuatable tacmed training course.

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PostPosted: Thu Jun 19, 2014 6:03 pm 
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Murph wrote:
AS556 wrote:
Is the best solution for this just pressure, like the Israeli bandage?

Not always... I really depends on the wound, what caused it, where it is, and a multitude of other factors. Knowing how to properly assess injuries is just as important has knowing how to treat them...
Two quick examples:
1 - You wouldn't want to apply pressure to a compound fracture.
2 - An Israeli bandage won't help someone who isn't breathing.
I hate to say it, but it sounds like you're at the point were "you don't even know what you don't know." A Red Cross First Aid & CPR course is a great place to start. They even include tourniquet usage in their manual these days. From there, look for a repuatable tacmed training course.

When did ARC add TQ use back in the First Aid course? AHA and ARC work together on new first aid guidelines and I haven't seen anything come across in training memos about First Aid covering TQs again on the AHA side.

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I agree with many of the previous posters about how important training is compared to gear. You can have the coolest first aid bag in the world but it won't do you a lick of good if you don't have the training to go along with it. First Responder courses are often available from your local community college. That being said, your existing kit isn't too bad of a start. I would say most of the comfort items(chapstick, sunscreen, hand sanitizer, etc...) are good to have but can go into a seperate pouch or area since they can get into the way of you being able to easily access the important items in a high stress situation. Though I doubt you will ever need to use smelling salts, I don't think I have seen anyone use them since I was a martial arts teacher almost 10 years ago.


weatherdude wrote:
When did ARC add TQ use back in the First Aid course? AHA and ARC work together on new first aid guidelines and I haven't seen anything come across in training memos about First Aid covering TQs again on the AHA side.

Speaking from National Registry(which is heavily influenced by AHA guidelines) the traumatic blood loss management guidelines for EMT's is now.



-BSI & Scene Safety
-Cover wound Site with Sterile Gauze and Apply manual Pressure
-If Profuse Bleeding Continues THEN move right to applying a Tourniquet Proximal to the wound. Make note of time of application(or mark it on the patient) also make sure to leave TQ visable(don't roll patient sleeve down over it, don't cover TQ with gauze, etc.....)
-Treat for shock (Elevate legs on non-spinal injury patient, Cover with blanket to conserve body heat, Administer high flow O2 "when available")
-Rapid Transport


They totally skip the old school AHA steps of elevating the wound after applying pressure. Now its just Apply Pressure and if that doesn't work, then apply a TQ proximal to the wound and move on to the next life threat.

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PostPosted: Fri Jun 20, 2014 7:54 am 
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weatherdude wrote:
When did ARC add TQ use back in the First Aid course? AHA and ARC work together on new first aid guidelines and I haven't seen anything come across in training memos about First Aid covering TQs again on the AHA side.


I'm not sure when exactly, but it is in the First Aid/CPR/AED Participant's Manual (ISBN: 978-1-58480-479-6) under the Soft Tissue Injuries chapter. It's at least been there since February 2013.

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When treating pt's I generally dump much of the contents in their lap or to the side, so finding shit in a hurry isn't an issue. Some say that boo-boo gear has no place in a life saving kit, 9 times out of 10 you'll be reaching for a bandaid or some ibuprofen though. So it stays in mine. Just stick it in a side pouch or something.

I'd probably start off on a first aid/CPR course and then go from there. From what I understand they also have EMT-B courses online now. Generally no matter what you're talking about the answer to the question is training. For the time being it doesn't take much training to throw gauze at a bleed, so that's where I'd start for now as far as the hardware goes along with gloves.

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On my two rigs (battle belt and FLC), I have a BOK and a separate boo boo kit. The BOK is solely for GSW/major trauma (which will probably never get used) and the boo boo kit is in a Zip loc bag ia GP pouch. The Boo Boo kit will see much more use.

First and foremost, a legit training class is in order. Not for nothing, but YouTube and the interwebs is no where near sufficient as a starting point for training. Not saying that is your plan, but real training is VERY important. Secondly, it seems what you have listed is more along the lines of a hybrid CLS/ large first aid kit. Israeli dressings, CATs, hemostatic dressings, and such should be on a quick to grab spot. Everything else can be packed in a fashion that is accessible, but separate from major trauma items. In the event of a major traumatic injury, you have no need for band aids, neosporin, or Aleve.


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Good tips all around. I did unwrap an Izzy bandage and practiced with it, so I have a decent idea of how to use it. I really do need a class, too.

I think with a bit of streamlining and a couple additions my kit will be decent, it's off to an OK start. Though as I get more training I'll likely tweak things for quite some time.


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PostPosted: Fri Jun 27, 2014 10:53 pm 
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Murph wrote:
weatherdude wrote:
When did ARC add TQ use back in the First Aid course? AHA and ARC work together on new first aid guidelines and I haven't seen anything come across in training memos about First Aid covering TQs again on the AHA side.


I'm not sure when exactly, but it is in the First Aid/CPR/AED Participant's Manual (ISBN: 978-1-58480-479-6) under the Soft Tissue Injuries chapter. It's at least been there since February 2013.

Really? I didn't know that....I'll ask my Training Center Coordinator (American Heart Assoc.) if it's coming in the 2015 guidelines. Thanks for letting me know ARC brought them back. Did they mention anywhere about hemostatics like QuikClot or Celox?

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PostPosted: Sat Jun 28, 2014 4:04 pm 
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I took a combat trauma medicine class last summer worth 16 credit hours EMT. In the words of my instructors it's all about the ABC's.

I have one of those TEOTWAWKI FAK's in each of my vehicles. Way overkill and too heavy for EDC. So what do my instructors carry? A few boo boo items, couple of slim tourniquet's, Celox or Quick Clot gauze roll, Nasalpharyngeal airway, some have an Israeli bandage and that's about it. In other words a blowout kit.


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PostPosted: Sun Jun 29, 2014 7:20 am 
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I have been going through my Combat Lifesaver Bags and IFAK replacing outdated items and things that have lost the vacuum seal. The old items do not go to waste however, I use them for practice. After trying the outdated chest seals on myself I look like the man-o-lantern from the 40 Year Old Virgin, those things are really sticky. As well the 4 and 6" NAR pressure dressings along with a SAM splint work great for treating various fractures.

GOOGLE SUBCOURSE IS0871 EDITION C for a PDF of the Combat Lifesave Course - Self Study Guide

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W-W

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PostPosted: Sun Jun 29, 2014 12:36 pm 
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weatherdude wrote:
Murph wrote:
weatherdude wrote:
When did ARC add TQ use back in the First Aid course? AHA and ARC work together on new first aid guidelines and I haven't seen anything come across in training memos about First Aid covering TQs again on the AHA side.


I'm not sure when exactly, but it is in the First Aid/CPR/AED Participant's Manual (ISBN: 978-1-58480-479-6) under the Soft Tissue Injuries chapter. It's at least been there since February 2013.

Really? I didn't know that....I'll ask my Training Center Coordinator (American Heart Assoc.) if it's coming in the 2015 guidelines. Thanks for letting me know ARC brought them back. Did they mention anywhere about hemostatics like QuikClot or Celox?


Hemostatics get a two paragraph mention, one to explain what they are/do, and the next to they're "intended for use by professional rescuers" and "the routine use of hemostatic agents in first aid settings is not recommend."

*shrug*

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PostPosted: Sun Jun 29, 2014 6:54 pm 
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Murph wrote:
weatherdude wrote:
Murph wrote:
weatherdude wrote:
When did ARC add TQ use back in the First Aid course? AHA and ARC work together on new first aid guidelines and I haven't seen anything come across in training memos about First Aid covering TQs again on the AHA side.


I'm not sure when exactly, but it is in the First Aid/CPR/AED Participant's Manual (ISBN: 978-1-58480-479-6) under the Soft Tissue Injuries chapter. It's at least been there since February 2013.

Really? I didn't know that....I'll ask my Training Center Coordinator (American Heart Assoc.) if it's coming in the 2015 guidelines. Thanks for letting me know ARC brought them back. Did they mention anywhere about hemostatics like QuikClot or Celox?


Hemostatics get a two paragraph mention, one to explain what they are/do, and the next to they're "intended for use by professional rescuers" and "the routine use of hemostatic agents in first aid settings is not recommend."

*shrug*

Thanks for telling me....idk why. Are the guys in the sandbox with the req. TC3 training who aren't medics "professional rescuers"?
As for OP....training and gear is better than gear and no training every day of the week. WFR would be a GREAT course if you have the time and funding. Alternatively the ARC has an Emergency Medical Responders course which satisfies the NREMT's requirements for the certification for EMR.

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