Topic: Stepping up my first aid game

[JFanaselle]

With the spring wheeling season upon us, I've already got the urge to get out there and do some exploring. I've been going through all my gear over the past week and prepping for some fun. But it really made me realize how under-prepared I am for emergencies - particularly the type we should expect to encounter at one point or another when we're far from civilization. This goes for both myself and my family, anyone else in a group I'm traveling with, and even other outdoor folks who we may come upon in the back country.

Most first aid kits that you can buy, even the $200 to $300 "comprehensive" kits, don't really include much in the way of trauma care supplies. If you think about it, how many of us are prepared for someone with a partially severed limb following a vehicle rollover down a hillside? Or to care for someone who trips and falls into a campfire? Or someone who has a penetrating chest wound, either from a sharp part of a vehicle following an accident, or a shooting incident (for those of us who do recreational shooting or hunting)? I understand that we're not doctors or paramedics (I do know there are a few EMTs in the group), but some basic supplies can really increase chances of survival in an incident like these. If we're in the middle of the Mojave Preserve, or 40 miles east of the Salton Sea, or in the back trails north of Big Bear, we really should be prepared to care for these types of injuries for the better part of an hour or more before more skilled care can arrive. Even longer if you have to travel any distance before you can even alert the authorities of your situation.

So, I got to thinking about the types of injuries that are likely to happen, and what kinds of basic supplies I should carry in order to be ready. I decided on some basic trauma supplies, and purchased everything you see in the photos below from Amazon. All told, I spent about $150, and I could have even saved a few dollars if I used other sellers instead of processing my whole order through Amazon Prime. Here's what I ended up with:

1: Basic Trauma Kit for $40 - this came with:
     *A zippered "Molle" pouch
     *A cheap pair of trauma shears (scissors)
     *A 6" hemmorage control bandage (also known as an Israeli bandage)
     *A very low quality tourniquet
     *A pack of gauze
     *A nasopharyngeal airway and some lube
     *And a "Trauma Pak with Quik Clot" made by Adventure Medical Kits - which includes some bandage materials, bleeding control supplies (including a "Quick Clot" clotting sponge), gloves, a triangular bandage, and some instructions on how to treat traumatic injuries. This entire kit was only $40 shipped. I was originally only going to purchase just the Trauma Pak for about $20, as it's highly recommended as good set of trauma supplies. But when I saw this full kit including a carrying case for $40, I couldn't pass it up.
2: A CPR "pocket mask", for performing mouth to mouth on a complete stranger - This was $8, and includes both a children's size and adult size.
3: A military-grade combat application tourniquet (the one in the $40 kit isn't very good) - this was about $18
4: A "Sam Splint", which is a 36" rolled piece of thin aluminum and padding that is designed to become very rigid once it's folded into certain shapes. This was $9
5: A 2 pack of sucking chest wound patches (designed to treat both an entry and exit wound on the same victim, or two points where the chest has been penetrated). These were $9 for the 2 pack.
6: A couple of rolls of 3M "Vetwrap," which is a breathable tape that is used on humans and livestock to wrap extremities and what not. Great for holding gauze over a bleeidng wound, or for holding the Sam Splint in place on a broken bone. These were about $5 per roll.
7: A 4 pack of burn dressing patches. These are great for treating second or even third degree burns, and they're soaked in a burn treatment gel that is designed to disinfect, comfort/cool, and not stick to burn wounds. The 4 of them would be large enough to cover an entire arm or one side of a leg. This 4 pack was about $20
8: A Sawyer bite and sting kit - for snake bites. This kit was $15
9: Probably my favorite item in the whole batch - a copy of Adventure Medical Kits' "Wilderness and Travel Medicine, 4th edition." This very small book is highly regarded as one of the best resources for treating minor and major injuries when you're far from civilization. Typically, first aid books fall into two categories - the first one is designed for workplaces and other areas where liability is the biggest concern, and basically just says "check for (some symptom) and (some other symptom). If present, call 911 immediately." The others are designed for doctors and contain more latin words than english ones, and basically give you the play by play on how to perform a tracheostomy or how to successfully amputate a limb. This book is the very rare in-between, which gives you practical methods for treating common and serious injures that people experience in the wilderness or while traveling, while still encouraging you to get help in key situations. This book used to only come with Adventure Medical Kits' expensive comprehensive first aid kits, but can now be purchased individually. I paid about $15 for it.

One thing to remember is that even if you don't know how to use any of this equipment (for example - I have no clue how to insert that nasal airway the proper way), other people in your group or that you encounter may know how to. Or a 911 operator may be able to walk you through the process to use it. Or the Medical Guide may also give you the steps needed. It's better to have something and not need it, than it is to need it and not have it. I know it looks like a ton of stuff the way I have it all laid out, but I'm pretty sure I can fit most (or all) of this in my regular first aid kit in my hatch. I'm also considering purchasing a DepHep Molle rear window panel, so I can separate some of the supplies into different packs for different types of injuries (such as my very basic tylenol and bandages vs. the hardcore trauma supplies that you only need for major injuries).

If anyone has any questions or wants links to any of this equipment (or even has suggestions for more must-have items), feel free to speak up!

Some photos:

Here's all the stuff I'm adding to the basic first aid kit:
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Here's a breakdown of what was included with the $40 trauma kit. If you're only going to add one thing to your arsenal, this is a good choice because it includes a lot of items for most types of traumatic injuries:
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Here's the book, worth it's weight in gold for sure:
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[Celt]

Joe, I'd be glad to show you how to insert the NPA. They are easier than you might think. If I might offer a suggestion on the tourniquet. Getting the best one you can is the best idea. High quality ones are  not that expensive at all. When you need one you want to be able to be sure you can get the blood shut off and placing it in the proper spot proximal to the wound is important. One of those constricting bands just isn't going to do much other than slow blood down a little. If you have arterial bleeding you need to shut it off like a hose and fast. If you are dealing with an amputation or even partial you also have to be equipped to deal with a bone bleed that the tourniquet will not stop but can be dealt with by your pressure dressings or blood clotting sponges. Chest injuries are super common especially in vehicles and can lead to a pneumothorax which can become life threatening so recognizing the signs of one is really important. That being said, chest needle decompression is needed but is generally well beyond the scope of training outside any present/former military/Paramedic etc. but the information is out there and so is the training. Those chest seals can sure come in handy for any holes in the chest and there are plenty occlusive dressings on the market. In a pinch saran wrap and duct tape can save a life. I have a saying that I tell all my new little minions. Never leave the medics empty handed. They are a great source of supplies and picking their brains for the latest and greatest in medicine advancements is invaluable. It's great you are thinking about this because far too many people in my opinion just throw a first aid kit into their vehicle if even that and figure that's going to do it much less learning how to use the stuff. One of these food truck meet ups I'd be glad to bring a bag along just to share what I like to carry and get ideas from other folks.

[Ghost65]

Excellent thread and post Joe...and thanks for the additional thoughts Erik.  I know both of you have extensive exposure through work to some serious emergency medecine scenarios.

This is a topic that is always in the back of my mind as a previous/future trail leader, and goes back to my days as a "be prepared" BSA loyalist.

Some of my thoughts on this topic...

This thread authored by Dave Bennett (Navy Corpsman) over on AA is chock full of solid information and equipment:

First Aid Kid Thread from American Adventurist

A subtle cross forum plug here...if you haven't joined the American Adventurist forum or donated a little scratch over there...threads and information like the one above are but one of the many reasons to do so.  So just do it. 

I'd also like to add another publication to everyone's bookshelf, Buck Tilton's:

Wilderness First Responder - Emergencies - Backcountry

This has been an excellent source for many, and is the publication used as a textbook for the REI Outdoor School's WFR two day certification courses.

I'd love to hear more from others on what they source/use in the event of a wilderness trauma...and again, thanks Joe for opening your kit for all of us to ogle! 

EDIT:  Gonna make this a stickie for easier reference...

[JFanaselle]

If I might offer a suggestion on the tourniquet. Getting the best one you can is the best idea. High quality ones are  not that expensive at all. When you need one you want to be able to be sure you can get the blood shut off and placing it in the proper spot proximal to the wound is important. One of those constricting bands just isn't going to do much other than slow blood down a little. If you have arterial bleeding you need to shut it off like a hose and fast.

Celt, I agree with you 100%. It may have been lost in my super long original post, but I did say that the one that comes with the trauma kit is just junk and that I ordered a true high quality Combat Application Tourniquet instead. Specifically, I ordered this one: https://www.amazon.com/Tourniquet-Application-Lightweight-Hemorrhage-Registration/dp/B01ETMVQOI/ref=sr_1_1?ie=UTF8&qid=1489171741&sr=8-1-spons&keywords=combat+application+tourniquet&psc=1

Ghost - I really want to take one of those wilderness first aid courses offered by REI. Even with my background, there are many ways I'd still benefit from it. For starters, all of my training was generic and for typical first-responder type situations, there the training and instruction offered in these courses is very specific to the types of injuries one can expect while off-roading, hiking or otherwise traveling in remote areas. Second, things change ALL THE TIME - a lot of the techniques and practices that I learned in my Medical First Responder courses have surely changed over the past 14 years or so. With any luck, I'll get the chance to enroll in one sometime this year.

[Ghost65]

From the AA FAK thread:

First, a few rules about first aid kits:

Contents expire. Check them twice a year at least.

Contents don't like being stored in a 120 degree vehicle - they expire faster if left in the truck full time so check them more often if you do.

Medications are specific to your needs - ensure they are not expired.

NEVER administer any medications to anyone if you are unsure if they have any drug allergies.

TRAINING is key. You can have a million dollar kit with all the widgets and still be clueless. Start with a basic first aid class and CPR and go from there.

REFRESHER training is key. Even for me. Just because you were Johnny Trauma Paramedic Guy "back in the day" doesn't mean you're up to speed today. Best practices are constantly evolving.

authored by Dave B @American Adventurist

I want a morale patch with "Johnny Trauma Paramedic Guy" on it now. 

[RikRong]

I like that CAT.  It seems to be a pretty good copy of the actual, military-issue CAT.  Going through first aid classes, we get the chance to use that tourniquet (on dummies) and you can really crank it down.  Plus, it's so easy, a soldier can figure out how to use it. 

One suggestion, that I didn't see in a quick skim of the thread, is some sort of electrolyte pack.  Our IFAKs contain some high-potency packs that can be used if you happen to come upon someone that is severely dehydrated or that can used for yourself if you're stuck out there.  A space blanket would also be great for covering someone that is in shock, if you don't have a real blanket in the truck.   

[LupinOne]

Here's a LINK to the med kit I carry from Thomas EMS.

I also carry an AED from Dixie Med. They offer re-certified AEDs at significant discounts. http://www.aed.com/re-certified-aeds.html

John

[JFanaselle]

That's a pretty nice pack John, and the price isn't bad at all for a pre-filled one. It does come with more of the trauma-type supplies that we'd be more likely to need (airways, inhalants, SAM splint, etc). The AED is awesome too, and is likely to save more lives out in the wilderness than anything else really. But even those re-certified units are a bit out of my price range still.

On a side note - I've decided to add some additional burn supplies to my setup. In fact, I'm doing my best to replicate a full CalFire burn kit from an engine company, and will keep it in the rig as well. I dug through some of my old fire academy materials and found the breakdown of the burn kit and how to prep a burn victim with it. The tripping into a campfire scenario is pretty realistic, and the immediate sterilization of significant and wide-spread 3rd degree burns (as well as correct prep/protection for eventual transport) really is the difference between life and death from resulting infection. Plus, with my moonlight gig as a public safety photographer, I figured I'm in the path of wildfires enough to justify carrying a full burn pack in the rig now. I've already acquired a couple of full size sterile burn sheets, a couple of large (18") burn gel pads/bandages, and some good eye wash. Just need to pack it up good and include a space blanket, and it should serve it's purpose.

[Celt]

That's a pretty nice pack John, and the price isn't bad at all for a pre-filled one. This one does come with more of the trauma-type supplies that we'd be more likely to need (airways, inhalants, SAM splint, etc). The AED is awesome too, and is likely to save more lives out in the wilderness than anything else really. But even those re-certified units are a bit out of my price range still.

On a side note - I've decided to add some additional burn supplies to my setup. In fact, I'm doing my best to replicate a full CalFire burn kit from an engine company, and will keep it in the rig as well. I dug through some of my old fire academy materials and found the breakdown of the burn kit and how to prep a burn victim with it. The tripping into a campfire scenario is pretty realistic, and the immediate sterilization of significant and wide-spread 3rd degree burns (as well as correct prep/protection for eventual transport) really is the difference between life and death from resulting infection. Plus, with my moonlight gig as a public safety photographer, I figured I'm in the path of wildfires enough to justify carrying a full burn pack in the rig now. I've already acquired a couple of full size sterile burn sheets, a couple of large (18") burn gel pads/bandages, and some good eye wash. Just need to pack it up good and include a space blanket, and it should serve it's purpose.

 Amen Brother since Fire Jenga seems to be the preferred campsite pastime with this crew some burn dressings are not a bad idea at all....

[JFanaselle]

I'm resurrecting a very old thread here, but it's a good time to reiterate the importance of having a quality first aid kit with you when you're wheeling or camping. As my original post indicates, I pieced together a nice kit a few years back. I knew that it wasn't a matter of "if" this stuff would ever need to be used, but rather "when" it would need to be used. When I left the Xterra platform and got into my Tacoma last year, I transferred the kit to some new packaging and kept it behind the back seats of the truck.

Just over a week ago, on the Sunday before Christmas, I was off-roading in the Calico Mountains along with my cousin and some of his Jeep buddies. I had Gavin with me (my 9 year old son), and we stopped for lunch at the old Calico mine sites. After eating, we had plenty of time to walk around and explore. For those who have never been to the area, the mines are these large, open caverns in the sides of a mountainside, with a few narrow mineshafts that extend a few hundred feet or less. My son and my cousin's wife decided to walk back to the truck for a snack, and I continued to explore with the group. We entered one of the narrow shafts, and I bumped my head on a rock protruding from the ceiling. It wasn't a hard bump, but just enough to startle me and make me step backwards. As I stepped back unexpectedly, my right foot got caught between a couple of basketball-sized rocks that were strewn about the floor, and I lost my balance and fell over. As my body fell, my foot stayed firmly planted between the rocks, and I heard a pair of very loud "snap! snap!" sounds as I went down, followed by an immediate sensation of warmth in my lower leg and foot. The group rushed to my aid and slowly helped me to my feet, as I assured them that it was broken.

It took 20 agonizing minutes to hike back out of the mine and down to our vehicles, even with the significant assistance of several guys who were there. Once we got back to my truck, I sat on the tailgate and instructed someone to grab my kit from behind the seats. One of the guys there was a former military medic, and he used my Sam Splint and a couple of rolls of vet wrap to immobilize the break. We packed a few of the instant ice packs (the kind you crush and shake) in with the vet wrap, to help control the swelling. I also took a healthy (unhealthy?) dose of Tylenol and Advil to help with the pain.

With the break immobilized, I was able to drive my truck back out to the hardball (remember, this is my right foot that was injured), where my cousin aired up my tires for me. His wife was comfortable driving his jeep on the highway, so he took over in the driver seat of my truck, and I rode in the back seat with my leg up on the seat. Not too trusting of the medical care that I would receive in Barstow or Victorville, we decided to drive all the way back to the Temecula Valley to visit my local ER. This was also the better option for my son, as he was able to go home to my wife instead of having to sit with me for hours. With the Sunday Vegas traffic and the extended duration to get me out of the mountains, it was almost 6 hours after the injury that I was in the ER lobby. But thanks to the first aid that was administered, there were no complications other than extreme pain and discomfort.

Final diagnosis was multiple fractures to the fibula. I'm happy to report that the orthopedic surgeon says no surgery necessary, and that with a little luck, I'll probably only be in a cast for about 6 weeks.

TLDR: if you don't have a Sam Splint in your vehicle by now, please pick one up along with some vet wrap. You can find them pretty cheap on Amazon: https://www.amazon.com/SPLINT-COMBO-ORANGE-SPLINTS-COHESIVE/dp/B0093NZPCS/ref=asc_df_B0093NZPCS/?tag=hyprod-20&linkCode=df0&hvadid=312061207123&hvpos&hvnetw=g&hvrand=2667091652578667661&hvpone&hvptwo&hvqmt&hvdev=c&hvdvcmdl&hvlocint&hvlocphy=9031508&hvtargid=pla-569874470599&psc=1&fbclid=IwAR1frxMjxXUWk4Sir0ptbbGe3e4eaOOKjexRk1mjIMPAYTZhsW0mYZDTxQM

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[Celt]

Buddy, let me start off with I'm happy the break was minor and that you do not require surgery. I have been pushing for years and years about the benefits of an extensive lifesaving kit. Not only having it but knowing when and how to use everything. Through my civilian life and military I have learned so much when it comes to these issues. For anything more advanced I' recommend you get the right training and sustain it. When the issue happens is not the time to be consulting  with the iphone idiot box or whatever other material you can use to try and figure out your situation.

 The good things that come out of these events is the people around see the injury and learn to work together under someone who has the training and skill to not only fix you but to get you out. Some of those folks sitting by the wayside will either sit back but others will get involved and learn. I have seen some really nasty things out in the field. The best tool you have at your disposal is a calm mind to address the issues. I was taught a long time ago to plug the holes and keep them breathing. If you can just do those two things well the chances of getting to definitive care experientially  rise during the golden hour. Having and maintaining a good comprehensive medical kit shouldn't break the bank but knowing what and how to do with everything you will be leaps and bounds over others.

P.S. Joe, I'm glad you are ok.

[Jayrat]

Hey Joe , glad your ok Buddy.
Unfortunately your incident is our reminder, we need to stay on our kits

[SuperSlideStyle]

Good info.  I had already been gathering that stuff for a while.  Most is in stock at millitary surplus stores locally.  I go to M&I Millitary Surplus in Pomona, CA.  HUGE store, great inventory, lots to see & buy.

I liked the book suggestion.  Found it on ebay, used for $5.

https://m.facebook.com/M-I-Surplus-154793764555990/

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[Jayrat]

Good info.  I had already been gathering that stuff for a while.  Most is in stock at millitary surplus stores locally.  I go to M&I Millitary Surplus in Pomona, CA.  HUGE store, great inventory, lots to see & buy.

I liked the book suggestion.  Found it on ebay, used for $5.

https://m.facebook.com/M-I-Surplus-154793764555990/

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A medical ,candy store