What's in your... IFAK?

This. This. I can’t tell you how many combat lifesaver classes I’ve been through and I probably would still feel not a 100% doing it in real life.

I would caution anybody without training (YouTube doesn’t count) to use some of this stuff.

Last thing we need is a bunch of non-trained individuals putting on a tourniquet and not marking the time.

 

Exactly, def agree with this. Nope to IVs unless they are family or really close friends. Remember, a lot of that cool gee wiz stuff if for you, not others. Control the bleeding, keep the patient awake. Otherwise I think the next potential issues would be cold or hot weather injuries.

 

As a military Trauma nurse for all those super "tacticool" folks out there keep your first aid kits basic unless you have REAL medical training and knowledge to understand the implications of what you are doing. Such as the needle decompression, where the arteries lie under the ribs and they the patient will need a chest tube soon after.


A basic kit that will get most people out of trouble, safely will include a Pressure/combat/isreali dressing, CAT (I reccomend 2-3) or any TQ you're comfortable with, combat gauze (has quick clot in it, and a radiopaque stripe so I can see it on x-ray if you go stuffing it into someone's wound and it gets covered and hidden, gloves, cpr mask, gauze, tape, trauma shears, space blanket and a SAM Splint and a bottle of sterile saline/ sterile water.

Anything else and your asking for trouble for the untrained person. (Don't go shoving NPAs up people with basilar skull fractures or La Forte's... )

 

Truthfully the time doesn't matter too much. We've had patients in the field with TQs for hours. We haven't lost a limb due to a TQ. It was an older school of thought when they taught "if you put a TQ on a limb, they lose it."

The new train of thought is when in doubt put it on. We'll take it down in the trauma bay to determine if it's arterial or venous flow. We teach the local police and SWAT to carry and apply them and they've had an uptake in saves due to it. I had a poor guy in Afghanistan come to me with 6... Yes. 6 TQs on. Not a single one was required. But when you're getting shot at and shits exploding it's easier to apply one and move than to fuck around deciding if you need it or not.

 

My personal kit has chest seals, NPA/OPA. IV supplies, combat guaze, pressure dressings, water based cooling dressing for burns, scissors, strap cutter, CPR mask, gloves, tape, duct tape, gauze, bandages and a few other odds and ends... Anything else is probably useless without the support of an ambulance or hospital. Even the IVs are useless unless I have fluids. Which I don't because my vehicle isn't a stable temperature and fluids technically "expire" in a fluid warmer after 2 weeks. I only Carry the IVs so I can establish one PTA of EMS crews if needed. But it's far more important to control bleeding and prevent shock than it is for you to get an IV. The ALS rig will have an Intraosseous access... They'll drill em and move on.

 

If I’m conscious when you make it to me with your playskool kit full of quickclot and bolin/ashermans im gonna be swatting at you with my feet.

Put that needle away. I sprained my ankle Holmes.

 

i like this pouch, does it come in black? and where did you get it?

 

That is why I went to a TCCC class and still haven't got it yet. Thought I was uncomfortable with that despite the training. But, now of the mindset to carry it with me in case there is someone nearby who has the practical experience can perform it.

 

It’s a 5.11 molle pouch and it comes in many colors including black. Google “5.11 medical pouch”

 

Tampons. I know you're laughing right now, but they are perfect for gunshot wounds. I used to carry at least two in my kit downrange.

 

Performing first aid and doing it wrong because of lack of adequate training also opens one up to all sorts of legal liability. If the ungrateful bitch you just tried to save survives, and decides to sue you and you were not qualified and/or certified, they will win. I promise it has happened.

 

Exactly. Worst situation I’ve ever come across was a couple guys on motor cycles without helmets. Seen the dust cloud way ahead of us. Pulled over and ran up, sent the wife to get the kit. Guy was on his back with his nose crushed, barely breathing. I was more then happy when a couple people showed up a split second behind me and said they were off duty EMTs. My confidence level would’ve only resulted in placing some stuff on the sides of his head to stabilize it. Big difference between no one coming for hours or days vs 2-3 min. This is not a combat scenario. Btw- even then the guy died in the hospital a couple days later.

Like you, stun gun and the medics all said. Us average people should only be controlling the bleeding, keeping the patient awake and warm/cold. Let the pros do the other stuff.

My “cool guy” stuff is for me or my wife and even then, there is virtually zero expectation of ever using it. ESPECIALLY if there is a cell signal.

Also keep in mind, an IFAK by definition is for you to used on yourself or others to use on you.

 

And for the pros; be careful about what you do also. You go decompressing somebody or doing a cut down, out of your duty to act and without medical control, you could be in some trouble too. I’m sure it differs from state to state. It is very hard to prove malpractice, but I certainly wouldn’t want to be in a situation where I’d need to defend myself.

 

Yup, Good Samaritan laws very by state.

 

From my build thread:

Because someone asked me about my first aid bag today:

First Aid

I keep this in the back passenger side seat pretty much all the time. Between guns, mountain bikes, skiing, etc somebody's bound to get hurt sometime. Cost me less than the ready made kits and much better. I operate on the principle that IFAK / Med Kits are to treat ME. I figure a little extra effort is gonna pay off if a friend ever has to start reaching for chest seals & CATs...

Biggest thing I can possibly advocate is EDUCATE YOURSELF. Learn how to use the things you carry. I see people that carry chest decompression needles that I don't trust with an ace bandage. I'm not saying to go get an EMT cert (unless you want to) but a basic cpr / first aid course goes a long ways. I had the chance to take a cheap and relatively quick WFA course that focused more on first aid out in the backcountry, and it had a lot of good advice. What if someone has an allergic reaction, and you are 4 hours from a hospital? I'll give you a hint: that epipen isn't gonna work like in the movies.

Only really had to use it once during an MVA in So Cal last year, plus doing minor trailhead surgery after a friend OTB'd big time in Park City.

Big bleeder / penetrating stuff on the front along with chemlight + IR strobe:


Front pouch carries my quick grab stuff that I don't wanna open the pack for: CPR Mask, Boo-boo / Ouch Kit, gloves, notepad, TCCC cards


In the main compartment: less urgent med supplies: light, safety pin, tape, shears, gauze, irrigation, hot/cold treatment kits, and splints big and small with vet wrap.
Grey pouch is an IV bag pouch turned into a hypothermia grab bag. 2x Space blankets, handwarmers, tape. Lastly some light reading / references JIC.
Educate yourself: https://www.ems1.com/trauma-assessment/articles/319159048-EMS-trauma-care-ABCs-vs-MARCH/


close up of main compartments:

 

One thing to keep in mind is that the IFAK came to life under tccc guidelines, which is in general combat medicine... how to prioritize addressable injury while literally on the x and in surrounding combat.

A truck kit may look completely different. Like an earlier poster mentioned, there probably aren't many scenarios where a civilian needs to be relieving a tension pneuomthorax by pushing a 14g needle thru someone's chest cavity because they watched a YouTube video and their kit came with it.

Do carry tourniquets. CAT and SOFTT are king of the hill. And I wouldn't prioritize spending my money on celox/combat guaze if $ is a concern over a bunch of normal guaze. A pack of celox doesn't go far.

 

Yeah. I’m down with that. I battle polytrauma with gorilla tape. You can make an occlusive bandage, pack wounds, close wounds, TQ, you know. Whatever. It’s good for a truck. Unless you’re about to die, I’m gonna hold your hand until the emts get there. You’re better off. 1) I’m not a meatball surgeon 2) you don’t want my hands anywhere near your wounds. Unless you’re dying. Then you do.


The same way overlanders want a pull out 5 star kitchen, preppers and lunatics want a pull out role 3 hospital. As if.

 

Tampons are about as useful as a pile of shit for any GSW.

 

The tampon myth/argument. Classic.

 

I read on a very reputable Russian site that pouring gun power in a wound and igniting it is the fastest and most sanitary method of stopping major bleeding. Not just a SHTF scenario but a good modern medical practice. They just don’t publicize it because we would stop going to hospitals.

Really only need gun powder and onion tonic.