Industrial Use First Repsonder and Emergency Kit

Discussions of the best (or worst) equipment to have on hand for use in the event of an injury during an emergency.

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Industrial Use First Repsonder and Emergency Kit

Post by Red_Snow » Wed May 31, 2017 3:30 pm

I am currently in the planning stages right now, and none of these supplies have been purchased as of yet. Looking for a critique of the items chosen so far as well as pointing out of any weak spots in the load-out.

The primary use of this kit would be for Industrial use, I spend most of my life on processing facilities anymore so it brings its own set of primary injury risks. Most commercial "OSHA Approved" kits are really just overpriced booboo kits.

Risk assessment:
Our highest risks are as follows, in descending order of likelyhood:
  • Eye injury; generally foreign body or exposure
  • Hand Injuries; small lacerations, and pinch points
  • Small Burns; Generally1st and 2nd degree burns from steam piping and instrumentation
  • Heat/Cold Casualties
Secondary concerns would be:
  • Blunt force trauma (e.g. falling object that bypassed PPE)
  • Broken Bones
  • Accidental dismemberment
  • Degloving
  • Post explosion/fire initial care while waiting on EMS
The as-planed load-out list:
Basic Wound Management
  • Adhesive Bandages (assortment, mainly fingertip and knuckle)
  • Blister Management
  • Durapore Tape
  • 4x4 Gauze Pads
  • 3x4 Non-Adherent Dressing
  • 2" Elastic Bandage
  • Antimicrobial Wipes
  • Chinook OTC Medical Module
Advanced Wound Management
  • Burn Jel
  • 4x4 Burn Dressing
  • 2x6 Burn Dressing
  • Chinook ToolPak - Includes EMT shears, Thermometer, duct tape, etc
  • Hydratiton Powder (Oral Re-hydration Salts)
  • Eye Wash
Emergency Supplies
  • CPR Mask
  • 4" Olaes Bandage
  • Celox Z-Fold Rapid Gauze
  • QuickClot 1st Response (redundant, haven't decided between QC or Celox)
  • CAT Tourniquet
What am I missing?
Last edited by Red_Snow on Thu Jun 01, 2017 3:01 pm, edited 2 times in total.
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Re: Industiral Use First Repsonder and Emergency Kit

Post by taipan821 » Wed May 31, 2017 8:03 pm

I'm not aware of what sort of OSHA kit would be suitable for a high risk environment. If you look into your relevant Workplace Health and Safety (OHSA for americans) you'll find requirements for on-site medical equipment. Does your kit meet requirements? How far away are medical services? do you have an evacuation plan?

Workplace medical support is more than just a kit, in Australia you need an action plan for nearly every medical emergency
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Re: Industiral Use First Repsonder and Emergency Kit

Post by Red_Snow » Thu Jun 01, 2017 11:47 am

taipan821 wrote:I'm not aware of what sort of OSHA kit would be suitable for a high risk environment. If you look into your relevant Workplace Health and Safety (OHSA for americans) you'll find requirements for on-site medical equipment. Does your kit meet requirements? How far away are medical services? do you have an evacuation plan?
See below for the OSHA requirements. I don't have a splint in my list as our plan is to stabilize in place until EMS can show up, we also have innumerable field expedient splints in my truck from pry bars to probes. Blanket is covered in a different portion of my personal preps that live in the work truck.
OSHA wrote:The following list sets forth the minimally acceptable number and type of first-aid supplies for first-aid kits required under paragraph (d)(2) of the logging standard. The contents of the first-aid kit listed should be adequate for small work sites, consisting of approximately two to three employees. When larger operations or multiple operations are being conducted at the same location, additional first-aid kits should be provided at the work site or additional quantities of supplies should be included in the first-aid kits:
1. Gauze pads (at least 4 x 4 inches).
2. Two large gauze pads (at least 8 x 10 inches).
3. Box adhesive bandages (band-aids).
4. One package gauze roller bandage at least 2 inches wide.
5. Two triangular bandages.
6. Wound cleaning agent such as sealed moistened towelettes.
7. Scissors.
8. At least one blanket.
9. Tweezers.
10. Adhesive tape.
11. Latex gloves.
12. Resuscitation equipment such as resuscitation bag, airway, or pocket mask.
13. Two elastic wraps.
14. Splint.
15. Directions for requesting emergency assistance.

[59 FR 51672, Oct. 12, 1994; 60 FR 47022, Sept. 8, 1995]
taipan821 wrote:Workplace medical support is more than just a kit, in Australia you need an action plan for nearly every medical emergency
Action plans are a facility level prep, which means it usually involves "Evacuate, if unable to evacuate wait for rescue" for us "non-essential personnel." They are more concerned about having an incident labeled as a "First Aid" (did not require stitches, prescription meds, etc) rather than a "Recordable" or a "Lost Time Incident" and less likely to plan for a major medical emergency.

The other side of this, is that I'm not on the facility 24/7, we travel anywhere in North America depending on where the contract is. Where would the workplace action plan help me if I'm 300 miles away from the next workplace?
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Re: Industrial Use First Repsonder and Emergency Kit

Post by Confucius » Thu Jun 01, 2017 3:18 pm

If the industrial setting you're going to be in has a HF alkylation unit, Calcium Gluconate Gel and eyedrops along with milk of magnesia and eucalyptus oil would be a good precaution. Although any site handling HF will almost certainly have their own kits staged everywhere...

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Re: Industrial Use First Repsonder and Emergency Kit

Post by Red_Snow » Thu Jun 01, 2017 5:32 pm

Confucius wrote:If the industrial setting you're going to be in has a HF alkylation unit, Calcium Gluconate Gel and eyedrops along with milk of magnesia and eucalyptus oil would be a good precaution. Although any site handling HF will almost certainly have their own kits staged everywhere...
Thankfully we primarily deal with Sulfuric Alky units, there are only 2 HF's left on the facilities we normally work on. I will have to dig back through my HF training, as I seem to recall that some of those treatments for exposure need to be refrigerated. And you are correct that our customers that handle HF have treatment kits throughout the units.
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Re: Industrial Use First Repsonder and Emergency Kit

Post by SteelWolf » Wed May 02, 2018 12:24 am

Red_Snow wrote:I am currently in the planning stages right now, and none of these supplies have been purchased as of yet. Looking for a critique of the items chosen so far as well as pointing out of any weak spots in the load-out.

The primary use of this kit would be for Industrial use, I spend most of my life on processing facilities anymore so it brings its own set of primary injury risks. Most commercial "OSHA Approved" kits are really just overpriced booboo kits.

HELLO!
My friend, I am deeply sorry for the long delay in reply. Especially after you emailed me asking for my input. I've been busy with back to back disaster mobilizations and some military travels for my wife have kept us busy. Anyway, lets have a look. Most OSHA Kits are either overpriced, or, woefully inadequate. I'll throw some suggestions your way by going line by line.

Risk assessment:
Our highest risks are as follows, in descending order of likelyhood:
  • Eye injury; generally foreign body or exposure

    I recommend a rigid, breathable eye shield. Fox makes some good quality ones that aren't too expensive. H&H and NAR both make polycarbonate ones for around $10-ish. We stock the H&H Combat Eye Shield, which is based around the Fox Eye Shield and has a nice Hydrogel adhesive ring to keep the shield in place.
    https://archangeldynamics.com/products/ ... eye-shield
  • Hand Injuries; small lacerations, and pinch points
  • Small Burns; Generally1st and 2nd degree burns from steam piping and instrumentation

    Small lacerations can easily be handled with your standard bandaids, 4x4s, etc. As for burns, stock sterile burn sheets. I love the H&H Super Combat Cravat, as it is a sterile triangular bandage (think: multi use item. Burn sheet and can be used for sling immobilizer for fractures and dislocations).
    https://archangeldynamics.com/products/ ... n-dressing
  • Heat/Cold Casualties
Store cold packs, and a few hypothermia blankets.

Secondary concerns would be:
  • Blunt force trauma (e.g. falling object that bypassed PPE)
  • Broken Bones
  • Accidental dismemberment
  • Degloving
  • Post explosion/fire initial care while waiting on EMS
The as-planed load-out list:
Basic Wound Management
  • Adhesive Bandages (assortment, mainly fingertip and knuckle)
  • Blister Management
    Consider Moleskin.
  • Durapore Tape
    There is no better medical tape in my opinion. Good choice.
  • 4x4 Gauze Pads
  • 3x4 Non-Adherent Dressing
  • 2" Elastic Bandage

    I'd recommend something a little larger, 3-6" performs very well as a pressure bandage as well. 2" is rather small.
  • Antimicrobial Wipes
  • Chinook OTC Medical Module
Advanced Wound Management
  • Burn Jel

    The science is always in flux, but, current PHTLS / TCCC / ATLS guidelines recommend dry, sterile dressings for burns, once the burning process has stopped. Wet dressings can precipitate hypothermia, which is a killer in burns. So couple that with the high cost of a burn gel kit? I'd avoid this and just get plenty of burn dressings.
  • 4x4 Burn Dressing
  • 2x6 Burn Dressing
  • Chinook ToolPak - Includes EMT shears, Thermometer, duct tape, etc
  • Hydratiton Powder (Oral Re-hydration Salts)
  • Eye Wash
Emergency Supplies
  • CPR Mask
  • 4" Olaes Bandage

    Store a few of these, or have a look at the new T3 Israeli Bandage, or consider some H&H Bandages.
    https://archangeldynamics.com/t/pressur ... --bandages
  • Celox Z-Fold Rapid Gauze
  • QuickClot 1st Response (redundant, haven't decided between QC or Celox)

    Both perform admirably. Some research shows that Celox is superior in the anticoagulated patient, or the patient with a significant coagulopathy due to massive hemorrhage. Ultimately, both are CoTCCC recommended and both have an excellent track record.
  • CAT Tourniquet
What am I missing?


I would recommend at least one SAM Splint, and maybe a Pelvic Binder of some type, as pelvis fractures are fairly common around falls, and are quite life threatening. Sling material (Triangular bandage, or the Super Combat Cravat). A means to carry someone, like a nylon litter, these run sub $25 and are a great way to move someone a fair distance. A chest seal of some type for penetrating torso trauma, we stock the Wound Seal Duo and are awaiting shipment on the new H-Vent, both from H&H.
https://archangeldynamics.com/products/ ... d-seal-duo

Stock antidotes for any specific threats you may deal with (industrial corrosive or caustic agents).

It looks like your list hits all of the major points. Well done one compiling a REAL Austere Trauma Kit here, looks good!!
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Re: Industrial Use First Repsonder and Emergency Kit

Post by SteelWolf » Wed May 02, 2018 12:25 am

I'll also add, if trained personnel are on scene, some type of diagnostic equipment. Even something as simple as a stethoscope, blood pressure cuff and pulse oximeter can be very beneficial.
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Re: Industrial Use First Repsonder and Emergency Kit

Post by VXMerlinXV » Thu May 10, 2018 1:41 pm

Only things I would think about are a SAM splint, and swapping some if the 2" elastic bandage for wider sizes. If I could only carry one, it would be 4".
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Re: Industrial Use First Repsonder and Emergency Kit

Post by taipan821 » Fri May 11, 2018 5:54 am

I've recently started working as a first aider in a meat processing plant.

most of the injuries we see are soft tissue injuries (sore muscles, tenderness etc). and the most common item we use is vet wrap.
sticks to itself, does not hold water and easy to apply quickly.

We also have dedicated laceration kits (small, medium, large) and burn kits (small, large) on hand near the door. Each kit has everything we need in it so we can grab and run. Having now worked in the field for a bit I'll adjust my comment.

1. whoever is responsible for the first aid team, get to know them
2. whoever is the safety office, get to know them well.
3. be proactive about preventative measures, its easy to prevent something than deal with an incident, also, a few cents in preventative can save dollars of incident management.
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Re: Industrial Use First Repsonder and Emergency Kit

Post by DrJack » Fri May 18, 2018 8:32 am

Everything has been covered fairly well above.

2nd on carrying 4" instead of 2".
2 Sam splints and 1 pelvic binder (I like SAM's best) is about right.

As far as Olaes or ETB/Israeli bandages, I would prefer a roll of gauze and an ACE wrap. Cheaper and more versatile, can accomplish the same job.

Again, as stated above, having a dedicated plan of action for treatment after injury is often the largest lacking point I see in my clinic. (My day job is occupational health).

Immediate 1st aid is almost always "O.K." but where we get frustrated is.

1: People finishing up a shift before coming in for injury. I understand you have a job to do, but when given a choice between making the rest of your team's job harder and making the Doctor/Physical Therapist's job harder... please make the teams job harder.

2: Documentation. We deal with about a thousand different companies and each one has different protocols for treating injuries, reporting, post accident Drug and Alcohol testing, billing, etc. Have a packet made up, scrub it for all the stupid redundancies and contradictory information on it. (This is more for HR/management/safety team types, but bring it up to them)

3: MSDS for chemical exposure. About once a week we get someone coming in with a splash to their eyes. They can always tell us it is "Processor Fluid" or "Cleaner" or something like that, but never have an MSDS with them and frequently a call back to the site yields no result. Before starting at any location have copies for the chemicals you will be working with tucked in with the 1st aid kit.

4: General cleanliness. People seem to only get lacerations on their fingers when they are caked with grease, grime, and road dirt up to their elbows. They then come into the clinic without even washing their hands. Now, we will scrub you clean before you get stitches, but seriously.... you'll feel better if you do it yourself first. And a lot of this can be avoided if you just wear your damn gloves when you are supposed to.

Anyhow the take away is, for any jobsite make sure everyone knows the closest Emergency Department for major trauma, I would recommend an Occupational Health/Urgent Care clinic for lesser trauma. Know which injuries need to go to which one, and have alternate locations for each as a contingency. Print a strip map and leave in the truck.
YOGLO!

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