[Koefe]

With everyone stocking beans and bullets, do you have a stock of medical equipment you keep on hand?

I mean not just basic medical,for those of you a ways off from a hospital, do you carry or keep a trauma kit nearby?
Do you know how and when to use it?

97% of preventable deaths occur from bleeding out. What is your hemorrhage control and plan to stop the bleeding?
I believe at minimum everyone should have close at hand a TQ, Compressed gauze, Chest seals, and Elastic bandages. Add on any extra kit you are trained to use or may be useful in your situation.

NPA’s and NCD’s do NOT belong in your IFAK,

Any medics in here with some input? Your preps are useless if you slip and fall on your knife and bleed out.

 

[Koefe]

68%+/- die from bleeding out, not 97%.

97 out of 100 patients who die from blood loss could have been saved by proper and immediate pre hospital treatment. i understand how i worded it makes it sound.

anything else to add bud? can you perhaps share some of your medical wisdom on trauma care with the class?

 

[Koefe]

As a retired PH I always carried a trauma kit in the field, which was generally 90 days straight. In 2021 (after my neighbor got mauled to death and eaten in our backyard) I set about building a serious trauma kit. I lucked out and received a lot of badly needed help.

It ended up quite huge, I had to cull it into two "Step" kits. First step for serious wilderness trauma (hopefully to allow crawling to the plane or truck. Then a second step-up kit to enhance probability of making it 110 miles to hospital by road, or 300 miles by aircraft.

Could you elaborate on some of the things you carry for wilderness trauma? i am still in the process of building a better kit for being in the wilderness and could use some insight. thanks for your response.

 

[Koefe]

The three most common injuries leading to death that could be prevented, according to DoD statistics on soldiers, is:
1. Exsanguination (bleeding out)
2. Tension pneumothorax (collapsed lung with air intake in chest cavity)
3. Airway obstruction

I have booboo kits and household first aid kits. These have normal items for the most common of household injuries. (cuts, scrapes, bug bites, cold compress, etc)
But for my IFAK, both on person and in bags, I have the necessary equipment to address the above three causes of preventable death. (tourniquets/pressure bandages, decompression needle and chest seals, airway kits)
I carry my on-body IFAK when I have a firearm. I have a truck bag with one when I'm not, which isn't often.
Why do you recommend that NPAs not be included in IFAKs? What would you recommend for airway obstruction?
Full disclosure, I don't use NPAs, but rather Berman type oral airway kits.

I don’t recommend NPA’s in an IFAK for a couple reasons which are fairly simple.

The first is that an IFAK is your personal medical kit, to be used on yourself available with either hand. If I am in a position to need an NPA I won’t be the one able to insert it, therefore taking up unnecessary space on my kit.
Instead I try to recommend people use the recovery position for a patient, which is fairly successful at keeping airways clear.

 

[Koefe]

I don’t recommend NPA’s in an IFAK for a couple reasons which are fairly simple.

The first is that an IFAK is your personal medical kit, to be used on yourself available with either hand. If I am in a position to need an NPA I won’t be the one able to insert it, therefore taking up unnecessary space on my kit.
Instead I try to recommend people use the recovery position for a patient, which is fairly successful at keeping airways clear.

with that being said, whatever medic is on your team should be carrying an aid bag with multiple sized NPA’s and lubricant, as well as NCD’s.

Most professionals don’t get NCD deployment right, or TPT properly diagnosed on sight without many years of experience.

 

[Koefe]

Having all sorts of great first aid equipment is wonderful. How many of you really now how to use it, without harming the patient?

that is the real question to pose,

When I say I don’t recommend almost anyone carry NCD’s or NPA’s in their IFAK’s is because I do not want some guy who took a basic red cross first aid class 4 years ago sticking me with a chest dart. I also don’t want some random inserting my NPA incorrectly either. Because items on an IFAK are what I’m supposed to be using on myself, I don’t carry those items on my IFAK and used the save space for extra hemorrhage control, extra TQ, something along those lines.

 

[Koefe]

It is a long held practice for a person responding to a medical emergency to use the injured person's IFAK to render aid to them.
This prevents their own IFAK from being utilized in case the threat remains and it may still be needed.
For this purpose, your IFAK should contain everything you can self-administer, as well as what can be administered to you if you are unable.
Take an example of a concealed carrier responding to an active shooter. The concealed carrier receives an injury, but a bystander is medically trained. The bystander has no equipment, since they didn't anticipate needing it. But the concealed carrier has the equipment needed. They may have just saved their own life by having that equipment ready for another to use.

Do you disagree with this practice?

I do not disagree, you are correct in that obviously if you are unable to render aid to yourself that your own ifak would be used on you instead of another’s, that’s the whole purpose they serve.

I do however believe that in almost all scenarios, a bystander in an active shooting that receives an injury is unlikely to have someone nearby who correctly knows how to use some of the medical equipment, and any medic you ask will typically not render a chest dart or NPA to an individual they are not familiar with for liability reasons. In cases like an active shooter there will typically be an EMS response fast enough to not warrant a NCD or NPA, therefore i believe that the recovery position is best practice in this situation as well as initial hemorrhage control for the GSW or whatever.

The unfortunate truth in a active shooter situation is if you have a patient who has an airway obstruction, and injuries severe enough they cannot be moved into a recovery position, and at the point they need a chest dart before they can get to the proper care, they are likely going to die.

To answer your question about carrying items another medic may be able to use, I do not recommend carrying anything in your medical kit in any circumstance that you are not trained in the proper use of. The only exception I see is if you know a person or people on your team are trained in their use and it would be reasonable to believe they would be the ones rendering your aid.

For an active shooter kit I would be carrying as many TQ’s as i could, as well as compressed/hemostatic gauze, and chest seals. This is a type of kit you can carry and forget, doesn’t take up as much room as full medical kit.

Now if you are trained in the use of NPA’s and NCD’s and are comfortable with the use of them and comfortable with the idea that the person you are trying to save very well might sue you, then they should be carried in an aid bag in addition to normal kit.

 

[Koefe]

I greatly appreciate this response.
Well thought through and informative.

thank you for your insight as well. I appreciate your response and input.

 

[Koefe]

"that is the real question to pose,

When I say I don’t recommend almost anyone carry NCD’s or NPA’s in their IFAK’s is because I do not want some guy who took a basic red cross first aid class 4 years ago sticking me with a chest dart. I also don’t want some random inserting my NPA incorrectly either. Because items on an IFAK are what I’m supposed to be using on myself, I don’t carry those items on my IFAK and used the save space for extra hemorrhage control, extra TQ, something along those lines."

Are you accomplishing something with all the letter abbreviations? Did you just recently become a paramedic? Its like you are speaking lingo for new emts or something?

no friend, i use the abbreviations because i have fingers like microwaved hotdogs and it gets old typing it over and over again, so the abbreviations help with saving myself time and if i type it my phone with automatically capitalize it.

if you can’t understand those abbreviations, and are seriously prepping, I would recommend getting some training on medical care. i apologize if any of the information came off confusing

as stated above,
IFAK - individual first aid kit, for 1 person, being yourself.
TQ - Tourniquet, cuts blood circulation to a limb, also cutting off blood flow to an injury.
NPA- Nasopharyngeal Airway, opens the airway inserted in through the nose
NCD - Chest decompression needle. inserted into the rib cage to prevent tension pneumothorax