IFAK / First Aid

[2ndovc]

Good morning, guys!

Back home last night from another two week stay in the hospital. This one started out really bad, but I feel better now than I have in a long time!
While I was there, when I could get a connection, I was able to get into the site now and then, but not often.
The reason for this topic is, when we got home last night. I had found that one of the bandages that the nurse had put on over an IV that she'd removed, was soaked ( really soaked) in blood. I hadn't noticed and I was wearing a black sweatshirt. When I'd asked my wife for some large band aids, I saw that our first aid kit was nearly empty, and had been inadequate to start with.

My question is; would you guys buy a pre-filled first aid kit, or put together one of your own. I know, either way, they need to be tailored to and individual's personal needs as well, but where to start?
Going to start with two. One large one for home and also a smaller one that can fit into or stay strapped to my backpack, since it pretty much goes with me everywhere.

You all stay safe out there!

Jason

[Tycer]

I carry these in every vehicle and one and one on each floor of the house.
https://shop.soarescue.com/products/med ... c-preorder
I carry them in this
https://shop.soarescue.com/products/the-medmag-mount-m3
I keep a bigger box in our road trip vehicle.

[Gunstore Commando]

would you guys buy a pre-filled first aid kit, or put together one of your own.

Put one together myself.

Most premade kits are heavy on minor boo-boos, and somewhere between light and "not present" on major stuff. You can buy better ones, but any of the heavy duty ones I am aware of have stuff that requires a *lot* of training to use, like pneumo darts and crike kits [[insert horrified emoticon here]].

Anyone involved in shooting sports or hunting needs to be able to handle major stuff. Your own gun-handling is assumed to be impeccable, but I can assure you, based on recent professional experience, that the guy hunting over in the next section is not nearly as careful with firearms as you are.

This is leading us, irresistably, to the question of training. Without wishing to go too far down that particular rabbit-hole, yeah, get some. Which will answer a lot of questions about what *you* need in *your* kits.

But to get you started...Job One is always looking out for Numero Uno. A couple of pairs of non-latex gloves. A pair of Mechanixwear gloves for dealing with twisted metal or broken glass. An N95 mask for any procedures, like chest compressions, that might aerosolize Bad Things. Safety goggles to keep Bad Things out of your eyes.

All that is important enough to me that I keep all of it, other than the glasses, in my cargo pants pockets. And I usually have a pair of sunglasses or something within reach that will likely be better than nothing.

[marlinman93]

I've always started with pre made kits, and over time made changes or removed things I never used, and replaced them with things I wanted.
Working construction I was amazed at how often during demolition I saw wall mounted first aid kits being tossed in businesses, or commercial rebuilds. I guess they figured the things inside were old and it was time to replace them anyway? I grabbed them many times, and put them in my shop and garage to use. I still have several that I've refilled as I use them over many decades.

[jeepnik]

My background is a bit different than most. While enlisted I started taking EMT classes at a local college. The USAF didn’t have paramedics yet (still a very new concept and the medics were trained mostly for hospital and clinic duty.

The hospital commander thought it was a great idea and gave myself and others who followed a lot of support. Being military we had much more latitude in field treatment. Some of the things we did were way outside what is allowed today. Things like IA’s (think IV but in an artery) and using drugs not allowed to civilian paramedics.

Because of this, I keep some pretty extensive med kits in my vehicles and home.

Most commercial “first aid” kits are woefully inadequate for much more than a paper cut. Good ones are expensive but often have things most folks have no idea how to use.

Then too, most folks buy a kit stuff it in the trunk or bathroom cabinet and expect it to be useable years later. By which time they are about useless.

You’re better off putting together a kit that suits your needs and skill level and keeping it fresh than buying an expensive prepackaged kit. You’ll probably throw most of it away as it ages.

While smaller quantities usually cost more buying in bulk just means you’ll throw more away. Oh, check dates on what you buy. Especially on line. Brick and mortar stores keep stock until it falls apart and some online outfits knowingly sell old stock they buy cheap.

BUT, BEFORE YOU SPEND A DIME SPEND SOME TIME AND LEARN WHAT TO DO AND HOW TO DO IT.

[Grizz]

we have some little kits in our vehicles and on boats, but they aren't sufficient for actual emergencies, like when a boom drops on someone's head, or someone tries to cut off his thumb with a chain saw, a mile into the woods . . etc.

in the chainsaw incident my son's freshly washed tee shirt was the primary bleed stopper. nothing I've ever seen in a kit would cover that situation.

someone later added injury to insult by using a hunting knife to slip into the same bone as the chain saw, while boning venison in the kitchen sink. this was a home repair job, but again the small stuff couldn't close this up.

now I keep fresh super glue to close up cuts that need pressure to stop bleeding. that would have worked with the knife cut, but no way with the chain saw.

I've used black plastic electrical tape numerous times to keep pressure on a gauze pad. And I use hydrogen peroxide liberally around the house, had it on the boat, but never carried it in a pack. I nick myself often wrenching on vehicles and use the 1"x3" bandaids to keep dings clean while working. . .

so, it's "what's the worst that can happen"? most little kits we've seen are inadequate for the kinds of injuries we've seen, but a good roll of tape, and good size gauze pads, and clean water, and free bleeding all help keep wounds clean. a strong diagonal plyer for disconnecting fish hooks helps. and clean rags.

[GunnyMack]

Jason, two words-
DUCT TAPE

Sure it's not sterile but it covers large areas fast and easy.

Another thing to keep on hand is crazy glue.

Back in the 70s when it was starting to get used by doctors/hospitals someone stated the fact that it wasn't sterile. I know a retired J&J exec who was on the panel trying to figure out how to sterilize the crazy glue and they found it couldn't be done.

I also buy rolls of cloth athletic tape for covering up where I've lost chunks of flesh.
You as well as I that us carpenters tend to have bits of skin fall off or part ways- as long as it's not dangling just tape and get back to work.

We keep boxes of the flexible fabric band aids on the truck.

Oh and DO NOT use Gorrilla tape! ( it's too hard to tear if you are trying to repair yourself! )

[2ndovc]

Most commercial “first aid” kits are woefully inadequate for much more than a paper cut. Good ones are expensive but often have things most folks have no idea how to use.

Then too, most folks buy a kit stuff it in the trunk or bathroom cabinet and expect it to be useable years later. By which time they are about useless.

You’re better off putting together a kit that suits your needs and skill level and keeping it fresh than buying an expensive prepackaged kit. You’ll probably throw most of it away as it ages.

While smaller quantities usually cost more buying in bulk just means you’ll throw more away. Oh, check dates on what you buy. Especially on line. Brick and mortar stores keep stock until it falls apart and some online outfits knowingly sell old stock they buy cheap.

BUT, BEFORE YOU SPEND A DIME SPEND SOME TIME AND LEARN WHAT TO DO AND HOW TO DO IT.

I sent this same question to two long time friends, who are also in the medical field and I got a very similar answer to Jeepnik's.
One is a Doc, in a small rural ER and the other is an RN at one of Cleveland's busiest Emergency rooms. They goth have some nasty stories to tell.
They want me to make a list of what I think I need and we'll go from there, getting most of it from amazon and walmart. I have had a couple of first aid classes, but that was high school/ college days. Time for a refresher.

Appreciate the feedback guys!!

jb

[AJMD429]

.
I agree that the kits I've seen are either just glorified packs of band-aids, or stuff that gets really tricky to use without specific training. And just being a nurse or a physician like myself doesn't mean one has much experience with 'trauma'. I've been in practice 35 years and might claim to be quite good at managing hypertension or dyslipidemia or insulin resistance, and have probably done around 15,000 pap smears and prostate exams, but I have yet to have to insert a chest tube in the office...!

Keep in mind that first aid usually refers to the basics as "ABC" for airway, breathing, and circulation. You pretty much have to be able to address those things, and do so quickly.

For airway & breathing, that's pretty much a matter of unclogging it and keeping it open and pushing air into it, which if you think about it requires basic things like a headlamp or flashlight so you can see, some gloves so you don't catch cooties, maybe a pair of forceps, and one of those little one-way valve masks. That would be good stuff to have on your person or in a vehicle. Maybe consider an epinephrine inhaler and or an EpiPen. The ability to seal a perforating chest wound would be nice, and has been successfully done with duct tape and a sandwich bag from somebody's lunch, but there are slap on bandages made for that purpose that have a one-way valve to at least theoretically help the lung reinflate. Ask someone said earlier, don't forget that duct tape...!

When you're talking about a kit to have at your home, I would recommend a nebulizer and masks and also an ambu bag and oxygen. None of that is likely to be necessary if you can get an ambulance quickly and there isn't social breakdown, but if you live in a remote area or times have gotten wonky, those would all be good things.

For the circulation part of things, the two problems are either that blood is leaking out of the tubing (vessels), or it's not getting pumped (heart failing). Learn enough anatomy to know where the closest pressure-accessible artery would be to any given body part, although with enough trauma venous bleeding can really be just as much of a problem. Tourniquets need to be applied fast, as in really really fast, if there is arterial bleeding that is major. If there are two people there one can be finding the artery closest by and getting a thumb on it or something while the other one gets a tourniquet ready and applies it. It's true that you can make a tourniquet out of about any kind of cord, but when you only have a few seconds because the patient is bleeding rapidly, you don't have time to rummage around and find some cordage to cut off of something, you just need a tourniquet to grab and apply. I just bought some off of Amazon that looked pretty good but I want to test them because I'm not convinced they wouldn't break under extreme torque. With any type of tourniquet, you may have to put something underneath it right over the artery to really get the compression you need where you need it.

Keep in mind a person might have more than one site of extensive bleeding, and although you may not want to carry several prefab tourniquets, at least have some pre-cut lengths of cordage like parachute cord that you could press into service if need be.

I've never had to use thrombin gauze or any of the stuff that is sold to stop bleeding that way, so would have to defer to medics and their experience, but it seems like that stuff would be useful. That would be something with an expiration date and probably not inexpensive, but clearly could save a life.

The other consideration is internal bleeding, which you're not likely to be in a position to do anything to stop, but if you suspect that, you need to make sure the patient gets to a hospital immediately and doesn't just get propped up with some liquids to sip while they recover from the other wounds you noticed.

If they are not pumping, that goes back to the CPR concept and it would be a good idea if everyone took a basic life support course such as the ones from the red cross. It does seem like every couple years they change some detail of the protocol that seems silly and maybe insignificant, but the basics generally remain the same.

Other things to consider are the fact that eye injuries are common and although you can't do a lot for them in the field, copious amounts of saline irrigation may be useful, and generally a clean lot of gauze packed up against the closed eyelid with some duct tape over it will protect the eye until they can get into professional hands.

As others have mentioned, not a huge lot of 'stuff' is required for basic first aid and trauma in a situation where ambulance level care is ten minutes or so away, but duct tape, 'surgical' gloves to keep cooties away and heavier gloves for probing, and ziplock bags and a headlamp (check batteries and keep separate) and a pair of forceps and a 16 gauge hypodermic needle (they are AMAZING splinter removal tools, and in case you're wondering, no the 18 gauge ones are not nearly as useful. 14 and 16 are awesome) and some 55 gallon drum liner or heavy trash bags are useful for all sorts of things, from wrapping a large area to keep away debris, to simply putting someone's clothing and personal items in if they have to be removed. Just having a roll of paper towels can be super useful, and so there is a lot of stuff that good to have on hand, but can be staged nearby versus on your person.

There are too many different body parts that might need splints to really have any kind of prefabricated splints on hand I would think, although the aluminum finger splints with foam on one side are probably inexpensive and a couple of those could be stowed away fairly compactly.

If you think about the things that you might encounter at a shooting range, or family picnic (I'm not sure there is a difference in our family between the two), and what you would be able to have someone dash to your vehicle to get versus what you would need faster than that, the main items would be water to immediately throw on a burn or eye chemical exposure, and a tourniquet. You may need airway management pretty quickly though, so if it's more than a quick dash to a vehicle or the household medicine cabinet, the other things all come into play pretty quickly.

I think with emergency equipment, whether it is for first aid, or self-defense, or communication, it makes some sense to layer the kits.

In other words, your household medical kit might be a toolbox with all of the stuff that you would need for major cardio respiratory stuff, including nitroglycerin pills and nebulizers, and possibly even IV fluids, and another toolbox you would grab that would have more advanced trauma stuff including suture material and local anesthetic and so on. Ideally, to the extent affordable I think it would make sense to have a duplicate of your field kit in each of the bigger kits, in case something happens where more material is needed or something happened where the field kit was unavailable.

It seems like two things should be at the top of any kit. The first thing would be the thing you need the most immediately, which I think in a first aid situation would probably be the tourniquet and a bottle of eye wash saline. The second thing that should be on top, or at least separated and easily inspected, would be everything in the kit that expires. So medications, and batteries, in particular, seem like they should be kept in a separate bag or container so you know that every 3 months or whatever it's time to look that stuff over to see if there's been any deterioration or expiration.

For a field kit, anything that needs to be kept dry, should obviously be packaged accordingly. And batteries seem to love to corrode and explode so they should be kept in something where they won't screw other stuff up.

Lately I've been putting all of my AA & AAA batteries in old prescription pill bottles because one bottle will usually hold enough batteries for whatever the equipment is (if not just use several bottles), and they are generally well sealed enough to keep the corrosion from messing other stuff up.

Anyway, that's thought I've been going through recently as we have tried to get a little more focused on being prepared for emergencies.

Stuff like antibiotics and IV fluids, aren't exactly things to just be done frivolously, because it wouldn't be too hard to injure or kill somebody by using either incorrectly. However, I'm an advocate of people having supplies for emergencies, because if nothing else, and there is social breakdown, it is possible you might be in a position where you simply have to use your best judgment, although it is much more likely that in your circle of friends and family there will be people who have medical experience and can guide you in the usage of such things, but that doesn't do any good if those things aren't physically present. In order for someone to legally prescribe antibiotics or other prescription items, they do have to have established a legal doctor patient relationship, although I think there are people taking the risk and prescribing stuff over the internet, just like they do Viagra now days. If you have a reasonable relationship with your physician, you might be able to get them to prescribe stuff for emergencies with the admonition that before using it they would want you to contact them for detailed instructions individualized to your situation.

[marlinman93]

I was an electrician, so our first aid kit on the job was a roll of Scotch 33+ and a paper towel from the bathroom. Then back to work.

[jeepnik]

Docs got good words of wisdom. Whether you can really do any good in a bad situation comes down to individual willingness to do what’s needed.

First aid is messy. Back when it was CPR it wasn’t uncommon (you’ll never see this in TV) for air to get into the stomach and result in regurgitation. The airway would need to be cleared. The okd finger wipe just pushed it in further. The way to clear it was with suction. You provided the suction. Suck, spit (often puke yourself) and keep on going.

[2ndovc]

Thanks Doc, there's some good info in there. I have a lot of the things you mentioned in a dry box in my truck. Rubber gloves, respirators, N95s, goggles etc. Tools of the trade.

MM
I grew up in construction and like you said, some tape and paper towels and back to work. I got whacked in the leg by a roof slate one day. Thought someone had kicked me until I saw the 9" long hole in my calf. Had to drive myself to the ER because none of the roofers could drive a stick. Wrapped it in a towel and tape then drove to the ER.
It's a whole different world when you're in your 20s.

jb

[Drawdown]

Doc hope you doing better! My dad was close to bleeding to death once in hospital of an IV, that IDK, came out in his sleep? Anyways a nurse checking found it, sounded like in nick of time!

[Walt]

I drove an ambulance in the early 70s and saw a fair number of fractures to limbs. I have to admit that my employer, a privately owned ambulance company was kind of a shoestring outfit with not a lot of fancy equipment. One of the things I took away from that time is that in the absence of a recognizably professional splint, a piece of heavy corrugated cardboard works very well. Cut to size, wrapped around a broken arm or leg and taped firmly in place, it provides rigidity and reasonable comfort. I had occasion to use it with my own kids when they were young and it works.

[Ysabel Kid]

Jason, as mentioned by others, I have found that most of the pre-filled kits are just generic first aid kits with maybe a larger bandage or two. I actually have it on my "to-do" list to assemble two kits - one a trauma bag to have at home and carry in my vehicle when out, especially to the range. The other will be an ankle IFAK to wear when doing church security.

Like your EDC knife and gun, it the IFAK is too big to comfortably carry, you won't have it on you when you need it. My IFAK will be focused on "stopping the bleed" to get me to better care (kind of like your pistol is there to allow you to fight to your rifle ).

[Ysabel Kid]

And happy to hear you are home from the hospital!!!

[AJMD429]

.
I chainsawed my leg just enough to SEE the muscle in a 2 inch hole, but the saw miraculously didn't nick the muscle (if it had I'll bet it would have locked up and I'd not been able to crawl out of the thicket I was in and would have bled till someone found me).

As it was I managed to limp home, and had enough lidocaine and vodka to suture it up.

Definitely a close one.

[galatin]

I follow a youtube channel called "elk talk podcast" ep 009 On this hunt an arrow falls out of bow quiver point up and hunter strides into it, broadhead and a little bit of shaft go into his leg below the knee. the camera never stops, you see and hear what happens, their first aid kits were better than mine, mine was, a handful of bandaids held with a rubber band, a couple of gauze squares and black elect. tape. I was very impressed by the four guys in the hunting party ,turns out a bleed between the the tibia and the smaller fibula makes it hard to control ,hard to apply enough pressure. the video is four years ago, scroll down to the surgeon and the army medics comments. I asked my daughter about some of the named items recommended, "have you ever used quikclot I asked, every weekend she replied. You do, I exclaimed thinking her hospital was a quiet rural place. " Mostly knife wounds and gunshots she replied. I learned how easy it is to hurt yourself and need to get to an E.R. I have a very good first aid kit now

[Old No7]

Interesting info above, thanks.

Here's some photos of results using Medical-grade SuperGlue (yes there is such a thing!) -- on a dog.

My lab suffered 2 cuts to his face from the heads of exposed nails on a dock he was swimming from and jumping off of, so we rinsed the wound well and used SuperGlue which my wife had from her office (it had expired, but was still useable). You can see how well his cut healed up from late July to late September, just 2 months later (two summers ago), and even today, there are no white hairs or any scarring where the largest cut was on his cheek.

Awful close to his eyes though -- that could have been so much worse...

Old No7

Jack Eye 01 sm.jpg

Jack Eye 05 sm.jpg

[jeepnik]

Adequate first aid kits (actually good ones go well beyond “first aid”) are a must. Training to use the stuff inside is a must. But even more important are two things. The mindset to use the kit and acceptance that you can’t save everyone. The last is a really hard lesson to learn.

[Streetstar]

I have a big pre-made kit from Costco that covers the “band aids and boo-boo’s” adequately but have supplemented it with rolls of ace bandages, neosporin, several otc pain relievers larger gauze pads, super glue, quick clot , and 3 tourniquets

Vehicle has the same only with the addition of some bug spray, sunscreen and sunburn balm, behind the back seat

Smaller basic kit and a tourniquet are in the glovebox

[2ndovc]

Still working on mine. My Dr. friend invited me out to his place next week to help me work on what I need as well as a First Aid class. There also just happens to be a very nice gun shop out there. Mostly high end shotguns, but it's fun to look.

jb

[lthardman]

I purchased a couple of pre-assembled kits, but I purchased mine from a supplier who specializes in trauma set-ups for First Responders. It is the same supplier we use to fit out our FD Rescue apparatus. To those kits I added some instant cold packs, some instant hot packs, some large trauma dressings, a quick clot kit w/tourniquets, N95 Masks, a bottle of sterile water, a bag/valve/mask with both oropharangeal and nasal pharangeal airways, and a small oxygen tank.

Remember that many of the items in your kit have expiration dates. They need to be inspected at least annually. While I think some of the expiration dates on some items are BS, they exist. (How does a sealed bottle of sterile water expire?)

While I obviously don't carry all of that with me, my truck is usually not too far away from wherever I am.