Looking for Help RE: Range Level FAK - UPDATE: Kit Assembled

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BullOnParade
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Looking for Help RE: Range Level FAK - UPDATE: Kit Assembled

Post by BullOnParade » Sun Sep 21, 2014 9:30 am

I have recently been elected to the executive board of the range where I shoot most frequently. I have made it my goal to improve the facilities FAK from the booboo kit it is now (with largely expired bandages) to something that would be useful in the worst case scenario - an accidental gun shot wound. The range is located inside of a major city, two minute drive from the nearest major intersection. Figures I have heard for Toronto EMS response is as high as 9 minutes, and it probably takes 15-20 minutes to drive to the nearest hospital when you don't have use of sirens/flashing lights (so maybe 10 for an ambulance?).

Training level. "Well, I've read about it on the internet" is as far as I've got with trauma care. The majority of members won't even have that, but some members are active/retired police force. I will be pushing to have several members trained in a first response position capable of treating such an emergency. It's coming, but that sort of training takes more time and resources that I will need to persuade the other executive members to approve. My biggest concern is that no one will know what this kit is capable of.

So back to the kit; what is reasonable to treat in terms of a GSW? Main artery would call for a tourniquet, because you'll bleed out faster than EMS can be on scene. Sucking chest wound calls for seals. Are hemostatic agents worth the time in a 10 minute window?

My next concern is that EMS wouldn't be familiar with the "tactical" level of treatment I'm looking at. I've heard horror stories and debates on the use of things like celox and tourniquets in the civilian first responders kits where EMS and hospital staff don't know the product in order to get it out of the way and continue the treatment.

Any help brainstorming and debating the value/risk/reward of an advanced treatment kit would be appreciated. :words:

Edited - updated title to reflect finished product.
Last edited by BullOnParade on Sun Mar 22, 2015 8:06 pm, edited 2 times in total.
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Re: Looking for Help RE: Range Level FAK

Post by DannusMaximus » Sun Sep 21, 2014 9:48 am

A good ready-made TQ will take care of major extremity bleeds, a couple of 5 x 9 gauze pads and a roll of 4" gauze and 2" medical tape will take care of extremity wounds that are NOT major bleeds.

Chest/torso shots can be addressed with 1 or 2 trauma dressings (basically large gauze pads) and several rolls of 4" gauze if you don't want to try and mess with ready-made chest seal.

An extremity broken by the GSW can be stabilized with a ladders or SAM splint, but you don't necessarily have to do that.

With the above supplies you can really address at a basic level most things that would happen at a shooting range. For 'untrained' people, I personally think giving them limited (but effective) options is the way to go. The TQ takes a little training, but for everything that isn't an obvious TQ extremity bleed, you will essentially be telling them to grab a handful of gauze pads and press down hard on the injury. Pretty easy, and pretty effective to keep somebody alive for a 10 minute amublance response.

Include a pair of trauma shears and several pairs of medical gloves.

SO, my answer is:

2 - TQ's of your choice
10 - 4 x 4 gauze pads
4 - rolls of 4" gauze
4 - 5 x 9 gauze pads
2 - trauma pads
1 - roll 2" tape
1 - medic shears
5 or six pairs of medic gloves

ETA: Include a blanket of some type. Trauma victims turn shocky quickly, and keeping them warm is a priority. A blanket roll can also be used in conjunction with tape and gauze to stabilize a broken arm or leg.
Last edited by DannusMaximus on Sun Sep 21, 2014 12:22 pm, edited 1 time in total.
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Re: Looking for Help RE: Range Level FAK

Post by Stercutus » Sun Sep 21, 2014 9:52 am

Don't know about where you are but most places I have lived police medical training goes about as far as CPR and maybe a basic 1st Aid class, maybe. They will get you an ambulance real quick though.

So far as tourniquets and blood agents and other things go I would recommend making contact with the lost likely ED/ ER treatment facility and telling them who you are, what you are trying to do and what they recommend you provide for your staff. You are absolutely right about different skill levels, training and experiences being important. If they won't talk with you/ work with you may have to go it alone from there; but I'd be surprised if that were the case. This will also be a much easier sell to your board ie. "the ER docs at the hospital says.....".

If you have to go it alone I would recommend training and provision on the following:

- AED
- Tourniquets (CATs versions are fine but others may be better)
- Industrial size commercial 1st Aid kit (available on line lots of places)

The most important component being the training. I would definitely keep training records too.
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Re: Looking for Help RE: Range Level FAK

Post by BullOnParade » Sun Sep 21, 2014 1:33 pm

Thanks for the suggestions, some great ideas so far. I drive past a paramedic station every day, I'll stop in on my way home to see if anyone is willing to talk shop. I'll also double check that the closest hospital is the closest hospital and contact them for recommendations this week.
An AED is something else I'd like to add, it's probably more realistic that a member would have a heart attack than be shot. We have a great safety record, but the average age of our membership base is probably 60+. But that's another expense on gear that would be better invested in training more people to learn cpr.

Are izzy bandages/pressure dressings worth having in this scenario? Or are basic trauma pads and tape more simple and equally effective over a 20 minute span?
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Re: Looking for Help RE: Range Level FAK

Post by DannusMaximus » Sun Sep 21, 2014 3:04 pm

BullOnParade wrote:Are izzy bandages/pressure dressings worth having in this scenario? Or are basic trauma pads and tape more simple and equally effective over a 20 minute span?
Izzy's are great, they are basically an ace wrap with a gauze pad built in. Cheap, too. They do play the same roll as the pads and tap, though. Either are easy to use for a very basically trained person. I think it's probably a wash as far as having one over the other. Maybe get a few and when you do your training you can demonstrate techniques with both. I could possibly see a person who wasn't familiar with an Izzy having a brain spasm when faced with an 'all in one' package. Having individual components might be more intuitive (stick pad on injury, wrap up with gauze). You can't go wrong with either option, IMO, both are easy and effective.
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Watson: "Yes, I thought it as well to take them."
Holmes: "Most certainly! Keep your revolver near you night and day, and never relax your precautions..."

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Re: Looking for Help RE: Range Level FAK

Post by BullOnParade » Sun Sep 21, 2014 3:36 pm

DannusMaximus wrote:
BullOnParade wrote:Are izzy bandages/pressure dressings worth having in this scenario? Or are basic trauma pads and tape more simple and equally effective over a 20 minute span?
Izzy's are great, they are basically an ace wrap with a gauze pad built in. Cheap, too. They do play the same roll as the pads and tap, though. Either are easy to use for a very basically trained person. I think it's probably a wash as far as having one over the other. Maybe get a few and when you do your training you can demonstrate techniques with both. I could possibly see a person who wasn't familiar with an Izzy having a brain spasm when faced with an 'all in one' package. Having individual components might be more intuitive (stick pad on injury, wrap up with gauze). You can't go wrong with either option, IMO, both are easy and effective.
More or less what I was thinking. I have a personal blow out kit, I built it for my needs which are similar to the range's needs, but included longer EMS response times for when I'm shooting on private property, or at ranges that are further from city centres. My kit has izzy's, chest seals, and a CAT-T. And although I haven't taken any first aid courses where I have been taught the use of these items specifically, I a)knew they were the the best/specifically designed for the job I was looking to achieve and b) have watched the manufacturers demonstration videos enough to be confident in my abilities to give myself a good chance in the event of something going horribly wrong. I do not expect the members of my club to be interested enough to learn those skills on their own. In order to make things as simple as possible, I may just stock the kit with pads and tape until we run a course where more people than me know how to use them.
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Re: Looking for Help RE: Range Level FAK

Post by medic photog » Sun Sep 21, 2014 10:03 pm

It would be in your best interest to talk to the medics and also the ER staff. Not many are up to speed on chest seals or Izzys. I recently used an Izzy on a chain saw injury and had to hang in the ER to show the staff what it was, how it's put on and how to remove it. I know, a pair of scissors dose a fine job getting them off, but it was a never seen item and they didn't want to push their luck.

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Re: Looking for Help RE: Range Level FAK

Post by BullOnParade » Thu Sep 25, 2014 4:33 pm

So I stopped in at the EMS station on Tuesday night and spoke with a paramedic, who took my information and said she would forward it to her supervisor. We also discussed response times and she suggested worst case scenario is 15 minutes (traffic, construction, etc).

I stopped in at the nearest hospital in high hopes after such a positive experience with the paramedic. I was sadly disappointed. First I talked to a girl at the information desk, explaining who I was and who I wanted to speak with. I received a pretty blank look and she suggested I speak with a nurse in ER. The nurse in triage gave me another blank look, asked a few more questions and told me to wait until she could flag down someone who might be able to help me. The gentleman who she directed to me after about 5 minutes was very unreceptive. Treated my questions as though I were looking for confidential information, then directed me to the Internet. When I told him I wanted specific information from a person who would be working on a GSW patient, he finally clarified that trauma patients of that nature are taken to a different specific hospital. So I'm going to try emailing them, because I'm not in that neighborhood often.

I was at the range yesterday and at least the "trauma bandages" were updated to something made this decade. The old ones were actually date stamped from 1978, but I couldn't find a date on the new ones.
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Re: Looking for Help RE: Range Level FAK

Post by Stercutus » Thu Sep 25, 2014 4:48 pm

Our local hospital does not treat serious trauma either. They have to go about 50 miles (usually by air) to the large medical center in the nearby city if it is anything that requires a trauma surgeon. Most gun shot wounds will go straight there or stop briefly at the local hospital to change from ambulance to helicopter. The regional medical center covers a huge area. I have wondered what the back up plan is for a mass casualty event but have been too afraid of a disappointing answer to ask.
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Re: Looking for Help RE: Range Level FAK

Post by DannusMaximus » Thu Sep 25, 2014 5:17 pm

I'm not totally surprised at the ER response. Emergency rooms aren't really in the 'first aid' business. They are in the 'definitive care' (or close to it) business. Nurses and doctors working there might not even know how to do field level trauma care. That isn't a bust on them, it's just a fact. They aren't going to be applying a TQ, quickclot, splinting, or anything else like that. For serious GSW's they will be pumping blood and chems in through large bore IV lines, doing imaging, aggressive airway control (if needed), surgical prep, etc. For minor stuff, they will be keeping a patient from going into shock and calling on any specialists (vascular or orthopaedic surgeons) who might be needed.

It's a radically different knowledge set. One of our firefighters actually had to show a local ER doc how to take a CAT off of a patient that we helped bring into one of our hospitals. He had never seen one, no real reason for him to know about it. I've never set up a blood filter line to feed lost blood back into a patient. ER's do this regularly for trauma patients, but there isn't any need for me to know how.

Anyway, I don't think you'll learn anything new from the paramedics. They are going to tell you to get a variety of bandages and such. What they might be interested in doing is meeting with your group and giving a class on GSW initial treatment. Our local transport group is pretty good about such things - - it's good PR for them and they can usually use them for CEU's.
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Watson: "Yes, I thought it as well to take them."
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Re: Looking for Help RE: Range Level FAK

Post by Mr_Sheesh » Thu Sep 25, 2014 5:28 pm

All other things being equal, I'd rather have expired bandages etc. put on me (or anyone else needing care) than NO bandages, so long as they're not septic or the like. I figure they'd likely be cleaner than a shirt that's been worn for any part of a day, if still sealed clean inside the wrapping.

Use the expired dressings for training once you replace 'em, that's a good plan, really :)
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Re: Looking for Help RE: Range Level FAK

Post by BullOnParade » Sun Mar 22, 2015 8:05 pm

So, after several months on the executive, I've ordered and assembled a trauma kit to supplement the existing first aid kit. The following is what I've put together.

Image

Everything fits in this box, roughly 4x8" I intend to attach it above the existing kit with velcro, something that can be grabbed from the wall quickly in an emergency situation.

Image

Top left we have a gauss roll, and some 4x4 sponges, beside that is a roll of tape and several pairs of gloves. Bottom row is 35g celox, shears, chest seals, and an emergency blanket. To be added are the trauma dressings which I noted were replaced late last year, and are already at the club.

The kit packs nicely with the items you need in order of use: gloves on top, shears and sponges, celox, chest seal, trauma bandage, emergency blanket. There will be room for a tq, but I want more people to be trained in the use of that tool before we make it available.

So there's the kit I've put together, fairly simple, but I feel it suits the needs I was looking for when I started this thread. Always open to suggestions or comments.

P.S. The executive is looking into a few different options to install a AED too! Hopefully through the summer we will be putting something up. Overall the clubs safety level has improved tenfold since I've joined the executive, and I'm not patting myself on the back, the executive has been very much behind me with almost everything I've brought forward for suggestions of improvement.
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