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I recently got hit by a car. I have a brand new piece of titanium in my shoulder. I know it isn't SHTF stuff, but you know what I wished I had prepped? A good orthopedist, a good lawyer, a plan to have somebody take care of the kids, and good insurance.

Finding a lawyer is tough. You want to take your time and interview a bunch of people and feel then out. But there are time limits on the insurance. The adjuster is pressuring you to make a statement. You have to file to preserve the cops body cam and dash cam footage before they delete it. You have to work fast. And you can't even drive.

Also, I recommend having a backup plan for getting in touch with you wife if she doesn't answer her cell phone. I wish I had one of her co-workers' phone numbers or something.

Hand Shoulder Dress shirt Neck Sleeve
 

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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.
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?
 

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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?
In basic combat first aid, we were taught to use the wounded soldier's battle dressing on him - not your own.
You might just need yours in another few minutes.
 

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Discussion Starter · #24 ·
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.
 

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

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"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?
 

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What's a NCD? And a NPA? I'm assuming TQ is a tourniquet is that right?
Where would someone even go to get training on the use of such things?
NCD - Needle Chest Decompression
NPA - NasoPharyngeal Airway
TQ - tourniquet

Every two years SOMA (Special Operations Medical Association) does a multi-injury group of scenarios. They do that to evaluate whether current TCCC (Tactical Combat Casualty Care) protocols are meeting the need and whether changes should happen. They used the Blackhawk Down battle one year. These ongoing reviews by very dedicated people are how things like NCD got put in. Or wounded but alert and coherent gets a saline lock instead of an IV

The use the wounded persons stuff first rule s still in effect.

Self training?
My opinion - start with a download of the free book Survival and Austere Medicine.

There are any number of good manuals you can learn from. This one is in Version 3 and still is free. We’re currently working on V4.
 

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NCD - Needle Chest Decompression
NPA - NasoPharyngeal Airway
TQ - tourniquet

Every two years SOMA (Special Operations Medical Association) does a multi-injury group of scenarios. They do that to evaluate whether current TCCC (Tactical Combat Casualty Care) protocols are meeting the need and whether changes should happen. They used the Blackhawk Down battle one year. These ongoing reviews by very dedicated people are how things like NCD got put in. Or wounded but alert and coherent gets a saline lock instead of an IV

The use the wounded persons stuff first rule s still in effect.

Self training?
My opinion - start with a download of the free book Survival and Austere Medicine.

There are any number of good manuals you can learn from. This one is in Version 3 and still is free. We’re currently working on V4.
Oh cool! That was a ton of information, I appreciate you taking the time to answer my questions. I will download the ebook, if it isn't too long I would like to print it out, or maybe just print parts out for now. Is there a safe download site you'd recommend? I could buy a tourniquet now or soon, but the chest decompression and airway stuff I would have no clue what to do with until I can do some reading.
Thank you again!!
 

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Discussion Starter · #33 ·
"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
 

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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
Im a physician, in medicine 40 years. I have comprehension and i think thats it. Certificate people demonstrate knowledge by mnemonics and slogans, it helps them remember their ABC's - it just seemed like a conversation between paramedics more than educating and if it is a bunch of noobs you address, maybe a jargon class first, like certificate people get, would be a better place to start?
Those letter ditties, like protocols, change constantly and most people just say "airway" or "first aid kit" unless they are "current on jargon".
Jargon is how we confuse and impress, so they need to be "insiders" first is all.
 
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