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-   -   Med kits and training (http://www.risingsun4x4club.org/forum2/showthread.php?t=18695)

smslavin 10-26-2012 09:03 AM

Med kits and training
The events of last weekend made me realize that the current med kit I have in the truck is woefully inadequate. That situation was beyond my control but anything beyond a small cut/scrape and I'd be hosed. I'd like the kit to be able to handle the usual bumps, bruises and scrapes but given our outdoor lifestyle (kids included), it's also important to handle multiple scenarios that we might come upon on the trail. Fractures, sprains, dislocations, possible puncture wounds, exposure.

Travis posted a list on my other thread and I've copied it here as a starting point. One thing I'm considering adding is QuikClot. Does anyone have any thoughts on airway management?

1. Medical Gloves
2. Pocket CPR mask
3. Epi Pen (allergic reaction)
4. Benadryl (allergic reaction)
5. Trauma Shears (Cutting Clothes)
6. Tourniquet/constricting bandage
7. SAM Splint
8. Triangle bandage (sling)
9. Roll of Gauze
10. Gauze pads
11. Eye washer
12. Ice packs
13. Glucose (diabetic/low blood sugar)
14. Tweezers (splinters, thorns, glass removal, etc)
15. Band-Aids, Hydrogen Peroxide, Neosporin
16. Thermal/Emergency Sleeping Bag

The other side of this first aid training. I've been through an EMT course but it's been years and I didn't keep up with the certification. Given work and family life, finding time to go through a full class is not really in the cards. There's a Wilderness First Aid class coming up at REI Boulder in December. I'm thinking of starting there and then finding a provider for the Wilderness First Responder course.

Comments? Opinions? Advice?

coax 10-26-2012 09:51 AM

Two quick thoughts, and this comes from a perspective of only having a WFA/SAR training.

1. Airway management could get tricky, both practically and legally speaking. I would imagine there could be a number of complications from tubes/etc? Just something I read on a few posts online, so some of the folks with higher certification could speak better to this.

2. I keep a c-collar in the car. Mostly because I do a fair bit of driving by my self and with so many activities here in colorado could have an MOI associated with spinal damage, it would be nice to be able to stabilize the neck and then have hands free to do other first aid while waiting for additional assistance. Plus a c collar is cheap, and packs flat. I got this one: http://www.amazon.com/LAERDAL-STIFNE.../dp/B000FPZI0M

SteveH 10-26-2012 09:56 AM

The list is good! I put together a kit like that a few years ago, with things like a pocketknife (for cutting bandages), a big chunk of a white tee-shirt (for big bleeding), gauze pads, smack-and-chill type ice pack, etc. FWIW - an Epipen requires a prescription, and I wouldn't use one on someone else (non-family member) unless I knew their exact allergy situation.

I put my 'kit' inside a plastic clamshell pistol case, so that it would be in a stout box that could get knocked around and not pop open and spill. Witness the chintzy plastic cases in which most commercial 'first aid' kits are stored. The downside is that this pistol case would be hard to open if you had a hand injury. An old cosmetics case of some sort might work, too.

You can't ever have everything you need, but going beyond the lame first aid kits most people have seems wise. I made two of these kits and keep one in each vehicle that we use for kid/family trips. Bigger stuff like sleeping bags isn't in my picture here, but should be, especially for the winter.

It's good to see some discussion on this - I should upgrade a few of the lame items in my kit and be sure the rest hasn't expired.

Gerdo 10-26-2012 09:59 AM

Good info. I did read your other post. Tough situation.
The thing that gets me is the rush. In the rush to assist, grabbing gloves usually doesn't happen. This is a bad thing. I'm not sure what the answer is. When in a vehicle, gloves could be in the door pocket but when working/hiking/bike riding etc, what is the answer?

farnhamstj 10-26-2012 10:02 AM

I don't believe you can carry an Epi pen without a prescription. Maybe with EMT cert, but not with AED/First Aid training.

add to list:
Aspirin (low dosage)

I'll say that this list is a little over the top for most people.

!!!!!!!!!Everyone take a basic First Aid/AED course!!!!!!!!

And eat healthy, and get some exercise.

Some things I've learned:

It ain't like TV.
People choke on things. Especially drunk dudes eating bratwurst.
People go into cardiac arrest, due to poor lifestyle choices.
Know how to identify a stroke.
you wil break ribs doing CRP; broken ribs or death?
Most people you do CPR on will die.

Get some post-event professional counseling.

Jenny Cruiser 10-26-2012 10:09 AM

Your list looks fine. NPA, OPA and whatever airway management system you're proficient with. I would skip the QuickClot and Chitosan dressings if I were you. I don't know if pressure bandages were on your list, but that would be worth having as well as a liberal amount of Kerlix and some Ace wraps. For bleeding a couple of pairs of hemostats should be good and maybe some 3.0 nylon with a decent size needle to close up the big stuff. If you're still feeling a little high speed maybe have a saline lock and a 14G or 16G cath ready to go. Maybe a 10G for NCD, but the likelihood of you actually having to do a decompression is extremely low.

Nothing you do in the field saves lives. It can only hasten or retard how long it takes for them to die. Trauma surgeons save lives. I think it's 0.3% per minute is the rate of decline on average for abdominal bleeds. In otherwords, for every minute that goes by the patient has 0.3% less of a chance of surviving.

Snowrun 10-26-2012 11:38 AM

This is my favorite kit for the cruiser. http://www.adventuremedicalkits.com/...ic&product=94#
(You can find it cheaper elsewhere)

Smslavin if you take that wilderness first aid class let us know what you think of it. I have been kicking around taking it as well. I took the complete Redcross first aid/aed etc... class earlier in the year and was disappointed.

nuclearlemon 10-26-2012 12:36 PM


Originally Posted by farnhamstj (Post 220826)
And eat healthy, and get some exercise.

People go into cardiac arrest, due to poor lifestyle choices.

yea, be like jim fixx. oh wait, he died of a heart attack. chuck hughes. oh wait, he had a heart attack during a football game. frank hayes...nope. only jockey to win a race posthumously...had a heart attack in the saddle. reggie lewis, 27 years old when he had a heart attack practicing for a basketball game.

heck, even patrick nagel succumbed to cardiac arrest after a guest spot on an aerobics show;)

poor lifestyle choices aren't the only things that cause heart attacks

Air Randy 10-26-2012 01:52 PM

I was a police officer for 13 years and an EMT for 10 of those. I had a 2 year old girl die in my arms on the side of the road, which is what prompted me to get EMT trained, so I know exactly how you are feeling right now.

I can tell you that I worked on countless trauma patients with every type of injury you can imagine. Every single one of them that was core 0 and required CPR died anyways. That is not unexpected. CPR rarely is succesful unless the stoppage is due to a heart attack or electric shock. The only "save" out of 30+ applications of CPR I had was for 1 heart attack victim.

I guess my message to you is: It is excellent for you to advance your first aid training and carry a more comprehensive first aid kit. It will help a lot if you need to deal with minor issues. But for major trauma the chances are very slim your kit will make a difference. I only came to that conclusion after going through extensive EMT training and carrying a full jump kit for years myself.

Learn the basics: Stabilize the patient in situ and don't move them unless the car is on fire. Keep their head still and manage their airway. Put direct pressure on severe bleeding. Talk to them even if they are unconcious and do your best to keep them calm until advanced life support units arrive. Even though Colorado is a Good Samaritan state, which theoretically protects you from liability if you try to help someone, I would not advise trying to use any advanced airway management tools unless you have certified training in them. You may win the lawsuit but you might still have to suffer through going to court.

The other thing I gained from the training was the knowledge that I did everything humanly possible and there was no reason for me to feel guilty because they didnt make it. Lots of times these folks could have this same accident on the steps of a level III trauma center and they still wouldnt survive. Its good you're doing things in response to your experience but dont beat yourself up over it.

smslavin 10-26-2012 02:39 PM


Originally Posted by Air Randy (Post 220852)
I can tell you that I worked on countless trauma patients with every type of injury you can imagine. Every single one of them that was core 0 and required CPR died anyways. That is not unexpected. CPR rarely is succesful unless the stoppage is due to a heart attack or electric shock. The only "save" out of 30+ applications of CPR I had was for 1 heart attack victim.

Total agreement with you on CPR. I've only had to use it maybe 5 times, including last weekend, and only 1 come out successful.

Thanks for everyone's input. It is much appreciated.

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