Realistic Medical 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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Mr. Salty
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Realistic Medical Kit

Post by Mr. Salty » Sun Dec 11, 2011 12:26 am

OK.

So I have to confess - I love the first aid section!

I have gotten a lot of useful tips and suggestions that I will incorporate into my kit.

My background is that I am in a medical unit attached to the national guard. I teach the combat lifesaver course and routinely carry a medical pack when we are at annual training - usually in suppoort of another guard unit. In a past life I rode a box in a volunteer fire department and responded to a multitude of different medical calls.


So here is my question:

What should you realistically pack in your medical kit to deal with a natural disaster/SHTF situation when you are going to be the first responder?

In other words - I have a lot of items in my pack right now that would deal effectively with GSW - think quiklclot, israeli bandage, hextend, etc. As I live on the west coast the most likely scenario would be an earthquake that would result in crush injuries, dehydration, etc.

What I would appreciate is feedback from people who actually have been in disaster situations before in a medical capacity to respond in reference to what they believe would be the most important items in an emergency for a first responder to carry. My guess is that is things are really bad it's going to be less important whether or not I carry an Otoscope or intubation gear and more important that I carry splint/bandaids -etc.

While I know there asre many fine suggestioons out there from non medical people that have built kits - I really want to hear from the first responders that have been there in a licensed or permitted medical capacity. (Think EMT, Nurse, parmedic, doctor or red cross volunteer.)

Thanks!

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Re: Realistic Medical Kit

Post by JIM » Sun Dec 11, 2011 6:57 am

Honestly, I think you would be better off asking the same question on the numerous Ems, fire and CERT forums online.

This is a forum in which both 'normal people' and professional responders try to prepare themselves for natural and man-made disasters. Therefor, I would appreciate everybodies input.
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Re: Realistic Medical Kit

Post by PotatoMuncher » Sun Dec 11, 2011 9:40 am

I guess it largely depends on what youre comfortable and trained with using, and what you have available.
Sure, GSW's might be present, but think of broken limbs, infected wounds, people left without their medication (diabetics, asthmatics, etc), and so on.

The bag you have also counts, space-wise.
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Re: Realistic Medical Kit

Post by Mr. Salty » Sun Dec 11, 2011 11:25 am

OK,

So let me re-phrase.

In answer to one post I am comfortable with standard and and a good amount of advanced procedures BUT my guess is in the case of a large earthquake or disaster on the west coast most likely I would be dealing with splinting and bandaging. I might have to start and maintain IV's due to dehydration.

Because of the large number of potential wounded and the lack of access to evac, the reality may be that the type of gear I cary to maximum effect would be different.

It is often said that gear is mission dependent.

I meant no offense to "normal" people as I consider myself one as well. :D

BUT - I will point out hte fact that I routinely see medical packs and kits on this site that in a disaster situation seem to be either overkill or unrealistic. Once you have the exciting and fun filled experience of moving an casualty over uneven ground for two plus miles to an evac area you tend to want to reassess what gear you are carrying. Ounces equal pounds and pounds equal pain.

So with that in mind when I see kits that look like they could weigh more than two diesel truck batteries taped toegether I kind of wonder what type of mobility the person has that will be wearing this thing.

So back to my original question. You are tasked as a first respoinder in a disaster situation. Think hurricane, earthquake, etc. You may be called on to treat a large number of casualties quickly. Stabilization is really all you can hope for as evac will be delayed for some of the tougher cases. With that in mind and mindful of the fact that the pack you are going to be carrrying has to go with you everywhere what would you carry?

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Re: Realistic Medical Kit

Post by JIM » Sun Dec 11, 2011 11:45 am

- water bottles
- duct tape rolls
- large amount of gauze pads/rolls or bandanna's
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Re: Realistic Medical Kit

Post by fourway » Sun Dec 11, 2011 12:35 pm

I like Yunnan Baiyao.
It's cheap as dirt, it takes up very little space and it works like crazy.
As with many chinese medicines, westerners tend to extremely suspicious of it and rightly so... a lot of eastern medicine is bunk.
Yunnan Baiyao isn't bunk.
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Re: Realistic Medical Kit

Post by TacAir » Sun Dec 11, 2011 1:45 pm

Maybe I can help you,

It helps to draw a bright line before planning.
IF you are to provide care as part of an organization (Army, CERT, Martian Doctors w/o borders) The organization will - should really - provide you with the materials they want you to carry. They will define protocols, procedures, etc, etc. The best of all possible worlds, eh?

IF you are planning on providing care where the seriously injured will be transferred to an aid station/CASH or hospital, determine where and when the hand-off will be made. IF you are required to transport, you have a whole new set of issues to deal with.

IF you are planning to provide care without the possibility of a hand-off, decide now what you are willing to deal with.

With 5 major hospitals in our small (geographic) area - our plan is self-aid/family support so as to reduce the demand on the critical care facilities in say, another earthquake.
My kit is set to provide care for serious care, for up to a week, and anything critical would be transported... We have everything to handle the usual 'sick call' stuff.

Good luck.

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Last edited by TacAir on Sun Dec 11, 2011 6:34 pm, edited 1 time in total.
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Re: Realistic Medical Kit

Post by K9medic » Sun Dec 11, 2011 3:18 pm

I may be looking at it from a very different view point from someone living on the “west coast”, but over here in the UK, I suspect in a SHTF situation my biggest problem will be maintaining body temperature.

If we work on the general idea that “professional help” is 72 hours away, then I suspect anyone who needs more than general dressing / immobilisation probably isn’t going to make it. To that end my bag would be full of strapping, pads, splints and lots and lots of survival bags.
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Re: Realistic Medical Kit

Post by Doctorr Fabulous » Sun Dec 11, 2011 4:26 pm

To echo TacAir, if you are working as a first responder, your guard unit should have a basic issue kit. Use that as your baseline, and work off of what your veteran seniors can tell you. Go watch Black Hawk Down, and see why i amke all my new Marines watch it. There's several reasons that your unit mandated kit is mandated, not the least of which is "This is what we expect you to have and need to use."

Never take anything OUT of your unit medbag/IFAK unless you are replacing it with something that your medics have given you that replaces it.
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Re: Realistic Medical Kit

Post by IANMCDEVITT » Sun Dec 11, 2011 5:44 pm

wow Fourway, I am really suprised to see you use that stuff. I only have experience using it on dogs and small companion animals when I was a Vet Tech. It does work.

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Re: Realistic Medical Kit

Post by Mr. Salty » Sun Dec 11, 2011 5:45 pm

Thankls for the input!

As always, the prtocals of your unit will apply when responding to a disaster situation - I get that.

I wanted to get some others take on what they believe should be packed.

My personal guess is that BLS care would probably be the only thing you could provide until and unless you were able to make contact with your unit.

My second thought would be that unless you were a viable patient and by viable I mean that BLS would allow you to have a good outcome - you probably are not going to make it.

In my case if the eathquake is large enough it really won't matter how many hospitals I have near me as they will quickly be over loaded assuming they survive the event.

Anyway - thanks for all the comments!

:)

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Re: Realistic Medical Kit

Post by Kommander » Sun Dec 11, 2011 5:47 pm

This Yunnan Baiyao, first I have heard of it. What is it supposed to do and how does it work?
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Re: Realistic Medical Kit

Post by fourway » Sun Dec 11, 2011 10:54 pm

Kommander wrote:This Yunnan Baiyao, first I have heard of it. What is it supposed to do and how does it work?
The chinese make a number of claims for it, enough that it becomes obvious that they must be overstating things.
Mainly it is used to stop bleeding quickly.
It works extremely well for that.
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Re: Realistic Medical Kit

Post by Kommander » Mon Dec 12, 2011 2:00 am

So it's like quick clot then.
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Re: Realistic Medical Kit

Post by Doctorr Fabulous » Mon Dec 12, 2011 2:11 am

Kommander wrote:So it's like quick clot then.
It's ancient Chinese quik-clot! Ancient wonder chinese quikclot! Yeah, I'll stick with QC myself.
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Re: Realistic Medical Kit

Post by Adam03 » Thu Dec 15, 2011 1:51 am

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Re: Realistic Medical Kit

Post by JustInCase » Thu Dec 15, 2011 12:09 pm

In natural disasters I would guess the most common type of injuries would be

Cuts, Abrasions, Punctures, Lacerations, Incisions, and Punctures
Burns
Sprains
Broken Bones
Hypothermia
Hyperthermia
Shock

Building a basic kit to address the above would most likely address 90% of the problems encountered. I also think that basic first aid and/or CERT training would be adaquate for initial treatment.
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Re: Realistic Medical Kit

Post by Coal-Cracker » Sat Dec 17, 2011 6:54 am

Adam03 wrote:A mortar attack takes place and a casualty is identified. A Soldier is trying to place a tourniquet when the attack resumes and the casualty must be moved to the bunker. Once inside the darkness of the bunker, the casualty begins to have trouble breathing and the Soldier places a nasopharyngeal airway from his Improved First-Aid Kit (IFAK) to ensure the casualty can breathe.

It sounds like a situation one would find in war, and that's the intent. In reality, it's what happens with the use of the Mobile Trauma Training Platform created by Bravo Company, Troop Command, Madigan Healthcare System.

The MTTP is a trailer outfitted with a computer-controlled mannequin that speaks, breathes and bleeds like a person. The platform was created to train Soldiers how to use their IFAK . The kit is often introduced but not often put into real-life training situations. Wounds simulated include amputations, sucking chest wounds and airway compromise.

"The Soldiers we have run through the training said they gained a lot out of the knowledge we've taught them for using the IFAK," said Staff Sgt. David Barnett, noncommissioned officer in charge of Neurology. "Soldiers often have the IFAK, have inspected it on a weekly basis, but they never knew how to use some of the things in it. This gave them a chance to actually use the interventions and put them into a scenario where they would use it."

The MTTP was created for around $2,000 according to 1st Sgt. Kristopher Rick. If he were to have purchased all of the items for use, it would have cost the Army nearly $150,000. Instead, he identified resources that were no longer being used by units at Joint Base Lewis-McChord and pieced the platform together for significantly less.

Four evaluators or controllers are in place to assist units interested in training their troops with the MTTP. The Soldiers use the MTTP at the ranges at JBLM and at the Medical Simulation Training Center during weapons qualification or Army Warrior Training. The MTTP is often used to complement other training opportunities.

"We talked with the MSTC about what kind of plans they had from a mobile aspect and then developed this concept," Rick said. "What we are trying to do is make sure we don't deviate from what Big Army and the MSTC are going to do to standardize mobile trauma training so that when they create a standard, we can adjust slightly but stay on the same glide path as what they decide."

The MTTP is not reserved for just medics training. It's used for all Soldiers who need training on combat casualty care. The goal is for all Soldiers to have a chance to train in basic use of the IFAK in a simulated combat situation. In the 11 months since the MTTP was created, it has seen a great deal of use.

"We had this [MTTP] put together in about 30 days in January," Barnett said. "It's used on average once a month for a total of about 200 Soldiers so far this year."

The platform marries required training with active use of the IFAK. It goes beyond a computer-based presentation or briefing by a senior Soldier. Instead, it puts a Soldier in an active scenario where they learn to operate within a stressful environment they might see on deployment.
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Mr. Salty,
You might want to check on IVs and whether you'd even be authorized to initiate one, especially if you aren't in uniform at the time. I'm a 68W and on the civilian side (rated only as EMT-B) IVs are above my scope of practice.
Do I know how? Absolutely.
Advanced airway? Yep.
Push Meds? Yessir.
But not as a civilian. Strange ground we walk on.

Maybe I'm confused as to whether or not you would be responding as a civilian or NG.
When I instructed CLS (last year), IVs had been removed from that level of training. Are you guys still training IVs for CLS?
Are you a whiskey? I ask because you mention intubation and I know that was never taught at the CLS level.
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Re: Realistic Medical Kit

Post by Gyrfalcon » Sat Dec 17, 2011 11:08 pm

Doc Torr wrote:
Kommander wrote:So it's like quick clot then.
It's ancient Chinese quik-clot! Ancient wonder chinese quikclot! Yeah, I'll stick with QC myself.
While it is good to be cautious about many things that China exports, I wouldn't be so quick to dismiss this concoction out of hand. It would be unscientific to do so. We might not have a smallpox vaccine if it weren't for Dr. Edward Jenner being humble enough to listen to a milkmaid who said she wasn't worried about getting smallpox because she'd already had cowpox.

And I personally knew a man who was an Army physician during the Korean War, who saw many troops getting terrible burns that wouldn't heal. These burns were caused by stoves and miniature heaters, some of local manufacture. In that climate and at that altitude, the wounds simply wouldn't heal with the across-the-board superior Western medicine. So this doctor, instead of scorning the locals, said to himself, "These people have been living with these stoves for years. They must get burned, too. I wonder how they treat their burns?" He approached some of the locals, and they showed him the only treatment that worked to heal this particular kind of burn in that climate. The remedy was put into the Army's medical texts, and as far as I know, it's still there.

Speaking of Asian medicine, MRI studies have also shown activity changes in areas of the brain indicating a reduction in pain corresponding to the relief claimed by the patients.

Studies have been done that show one of the main ingredients in Yunnan Baiyao, Notoginseng, is indeed an efficacious hemostatic agent. I would be reluctant to dismiss the substance out of hand as hogwash or quackery.

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Re: Realistic Medical Kit

Post by duodecima » Sat Dec 17, 2011 11:56 pm

Gyrfalcon wrote:
Doc Torr wrote:
Kommander wrote:So it's like quick clot then.
It's ancient Chinese quik-clot! Ancient wonder chinese quikclot! Yeah, I'll stick with QC myself.
(SNIP)
Studies have been done that show one of the main ingredients in Yunnan Baiyao, Notoginseng, is indeed an efficacious hemostatic agent. I would be reluctant to dismiss the substance out of hand as hogwash or quackery.
I think the point may have been that if you really NEED the quick-clot, it's not for a paper cut or even a moderate laceration. This stuff may turn out to be literally a lifesaver on further investigation but... If you're going to die if the treatment doesn't work, and proven treatment is available, it's not be the time to break out a remedy (of any origin) which hasn't already demonstrated equivalency or superiority.
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Re: Realistic Medical Kit

Post by Gyrfalcon » Sun Dec 18, 2011 8:05 am

duodecima wrote:
Gyrfalcon wrote:
Doc Torr wrote:
Kommander wrote:So it's like quick clot then.
It's ancient Chinese quik-clot! Ancient wonder chinese quikclot! Yeah, I'll stick with QC myself.
(SNIP)
Studies have been done that show one of the main ingredients in Yunnan Baiyao, Notoginseng, is indeed an efficacious hemostatic agent. I would be reluctant to dismiss the substance out of hand as hogwash or quackery.
I think the point may have been that if you really NEED the quick-clot, it's not for a paper cut or even a moderate laceration. This stuff may turn out to be literally a lifesaver on further investigation but... If you're going to die if the treatment doesn't work, and proven treatment is available, it's not be the time to break out a remedy (of any origin) which hasn't already demonstrated equivalency or superiority.
If that was what he meant to say and how he meant to say it, I wholeheartedly agree.

But the person who mentioned the stuff also said it works very well for him. Whether or not controlled studies have caught up with it, it has demonstrated its capability to him. Additionally, while Quik-Clot is not intended to be ingested, Yunnan Baiyao, taken orally, can allegedly stop internal bleeding. That is something that QC, by all accounts, cannot do.

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Re: Realistic Medical Kit

Post by DannusMaximus » Sun Dec 18, 2011 7:47 pm

Mr. Salty wrote:So back to my original question. You are tasked as a first respoinder in a disaster situation. Think hurricane, earthquake, etc. You may be called on to treat a large number of casualties quickly. Stabilization is really all you can hope for as evac will be delayed for some of the tougher cases. With that in mind and mindful of the fact that the pack you are going to be carrrying has to go with you everywhere what would you carry?
My experience? You CAN'T expect to treat a 'large number of casualties' with what you can realistically carry. The burn rate on trauma supplies (splints, dressings, bandages) is shockingly high when you've got multiple patients after a natural disaster. We had a really terrible tornado a few years back, ended up killing 25 or so people, dozens more were injured. Our medical bags (my FD runs BLS assist with a local private ambulance) were gutted after just a few patients. When you're triaging a mass-casualty incident, you've got to be very, VERY selective on who you're treating and what you're treating them for. You could very easily dump an entire first-in bag on a single patient if you tried to stop the bleeding from every cut they have or splint every fracture.

I wasn't a responder on the tornado, but my truck was one of the first ones there (I wasn't on shift that day). I got a lot of first hand after action reports from the guys going off-shift the next day. The guys and gals were getting real creative patching people up and getting them out of the impact zone - - litters made out of house doors that had been torn off, tearing up clothes and bedding for bandages and dressings, using busted PVC piping for splints, etc.

IMHO, field trauma care is one of very few medical branches where knowledge and the ability to keep your head and ass wired together trumps gear. Almost any patient who has suviveable injuries can be patched up and stabilized with the contents of any suburban bedroom (sheets, shirts, belts, etc.), no fancy sealed gauze packs needed.

However, to answer your questions, If I was being sent into a disaster zone with only what I could carry, I would grab a 3 day pack and stuff it with as many trauma pads, packs of 4" roll gauze, triangular bandages and duct tape as I could get into it, then throw a pair of medic shears in my pocket and head in. If you can't treat the patient with those items and field expedient materials they probably aren't going to survive (unless it's a very localized disaster) long enough to get to the hospital.
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Re: Realistic Medical Kit

Post by Bubba Enfield » Mon Dec 19, 2011 11:22 am

DannusMaximus wrote:
Mr. Salty wrote:So back to my original question. You are tasked as a first respoinder in a disaster situation. Think hurricane, earthquake, etc. You may be called on to treat a large number of casualties quickly. Stabilization is really all you can hope for as evac will be delayed for some of the tougher cases. With that in mind and mindful of the fact that the pack you are going to be carrrying has to go with you everywhere what would you carry?
My experience? You CAN'T expect to treat a 'large number of casualties' with what you can realistically carry. The burn rate on trauma supplies (splints, dressings, bandages) is shockingly high when you've got multiple patients after a natural disaster... When you're triaging a mass-casualty incident, you've got to be very, VERY selective on who you're treating and what you're treating them for. You could very easily dump an entire first-in bag on a single patient if you tried to stop the bleeding from every cut they have or splint every fracture...litters made out of house doors that had been torn off, tearing up clothes and bedding for bandages and dressings, using busted PVC piping for splints, etc.

IMHO, field trauma care is one of very few medical branches where knowledge and the ability to keep your head and ass wired together trumps gear. Almost any patient who has suviveable injuries can be patched up and stabilized with the contents of any suburban bedroom (sheets, shirts, belts, etc.), no fancy sealed gauze packs needed.

However, to answer your questions, If I was being sent into a disaster zone with only what I could carry, I would grab a 3 day pack and stuff it with as many trauma pads, packs of 4" roll gauze, triangular bandages and duct tape as I could get into it, then throw a pair of medic shears in my pocket and head in. If you can't treat the patient with those items and field expedient materials they probably aren't going to survive (unless it's a very localized disaster) long enough to get to the hospital.
I completely agree. The two most important items are 1)knowledge of first aid, and 2)experience providing first aid. (You don't get #2 until after you need it). After those, work boots/gloves and a reflective/high-viz vest. All the triangulars, gauze, and tape I can carry. Shears and a flashlight. Strength and fitness levels sufficient to carry people around with crappy footing. Masks for personal use.

I'd only have IV's etc. if I was working. Those things probably work best when there's a good hospital close by, and not a huge number of patients. By disaster I assume those resources will be missing or overwhelmed.
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Re: Realistic Medical Kit

Post by DannusMaximus » Mon Dec 19, 2011 2:49 pm

Bubba Enfield wrote:I completely agree. The two most important items are 1)knowledge of first aid, and 2)experience providing first aid. (You don't get #2 until after you need it). After those, work boots/gloves and a reflective/high-viz vest. All the triangulars, gauze, and tape I can carry. Shears and a flashlight. Strength and fitness levels sufficient to carry people around with crappy footing. Masks for personal use.
Great additions, I should have thought of them. Also, rubber gloves to wear under my work gloves so I don't get other people's goop on my hands.
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