Trauma packs ( dealing with not causing)

#1
Ladies and Gentlemen.
I'm hoping to tap into the collective wisdom of the ARRSE medical fraternity.

I went through my trauma/'first aid' pack yesterday and noticed that a lot of it is getting a bit elderly.

At the risk of sounding Walty it was originally put together by a ex SF medic a few years ago and seemed pretty comprehensive. I've rarely had to use it (apart from rehydration purposes and a nasty RTA in Mexico) but it sits in my run bag just in case.

I'll chuck all the pills but the plastic bits, bandages, metal bits, bendy splints seem fine.

What should I definitely have in the kit (Slightly smaller than a shoe box)?
Does QuikClot have a shelf life?
Is the non-burning QuikClot in general use (if there is such a thing)?

I'm doing a HEFAT refresher in March but I want to get everything squared away before Israel gives Iran what for.

Thanks. BE
 
#2
Is it to be a trauma pack or a first aid pack, as IMO they are quite different things. Also what's the intended use, as in, carriage, self treatment or for treating others, and what is your level of skill/training?

JP
 
#3
Indeed. In the wrong hands (and I'm not saying yours are) some kit is worse than no kit. Esp clotting agents - although the bean bags are an improvement on the granules.
 
#5
If you can be casevaced quickly in a press vehicle to a reasonably good medical station then just prioritise trauma stuff like compression bandages, tourniquet, perhaps a SAM splint. Include plenty to go round (ie enough Tourniquets for all your limbs, including two per leg, plus enough to deal with enough casualties around you). Big fúck off scissors too. If you're remote then additional signal stuff to draw attention from air rescue (long strips of luminous material).

Everything else is your own choice and down to what you're trained in. Saline tubes are useful to irrigate shit out of wounds and you'll need the normal pills that any normal journey would necessitate.

If you're proper remote then I haven't got a scoobies.
 
#6
Context in which you'll use it - military on battlefield, travel in hotspots, working somewhere dangerous etc etc..
Skill level that you work to - what training do you have or are willing to get.
Role that you have in your job/unit - as in are you a medic expected to deal with others, or is it for use on yourself/maybe one other.
Amount of space you have free to fill with medical kit and how much cash you want to spend.
Type of medical/trauma you're expecting to have to deal with - illness, bangs and scrapes, blasts/gunshots.
Distance/time to definitive care.
 
#7
Excellent points from JayPee630.

I would re-inforce the mission specific configuration of your medical pack, like you do with the rest of your gear. As an additional point, particulatly if you are travelling light and small, choose kit that can be used, with a bit of immagination, for different purposes. Again, it depends on your quals and skills.

I'm not, or never was, RAMC. I was just a patrol medic, now a qualified doctor in emergency medicne and aero-medical. I'm happy to give you sone pointers.
 
#8
Thanks everyone - really helpful stuff.

As Jonno suggested it will be travelling as a news crew.

Most of the broadcasters I travel with are very good at supplying PPE, medical kits AND most importantly, someone to look after us. (i.e preventing the Journo from getting us into proper bother.) Our advisers will always have a reasonable level of medical experience.

Jaypee360 - It was recommended that we carry a basic trauma kit for use on ourselves by someone else. My training is limited to a first aid course every year and a HEFAT course every 4 years - so limited is the operative word. Sadly I have had to use some of my scant knowledge on ungrateful colleagues but I have trouble remembering what I've been taught. How many 'first aiders' can recall the correct compression to breath ratio etc.

Boxy - thanks very much. I'm going to contact AKE who supplied the kit in the first place - I'm doing my refresher with them in any case.

Friendly Fire - I googled the bean bag thing but all I came up with was your post on here. What is this stuff please?

Jonno/OOh Matron - Thanks very much. My run bag is full of all manner of walty stuff including survival blankets which I have used to mark a LZ for an air ambulance. Pride of place is my very battered copy of Lofty Wiseman's bible.

I don't actually know where I'm going -twice now I've been cancelled on the way to the airport: CAF and Mali respectively - but to date the worst injury I've sustained was in the UK - a bloody student hit me with a stick. As mentioned I'll always be travelling with a sensible wise person.

Charliec - Thanks , I appreciate your offer.
 
#9
Briefly then (and apologies if my questions came across as brusque) I would divide the kit into 2.

I'd take an everyday first aid kit to deal with cuts, bangs, headaches, D&V, and that kinda thing which wouldn't be much different from a kit in boot of a car or medicine cabinet at home in the UK. This could live in a pack anywhere in your stuff.

As well as that I'd take a trauma kit, something to deal with GSW, blast injuries, etc. etc. It'd live in a small easily accessible pouch on you at all times. Would contain shears, gloves, various trauma dressings, CATs, NPA/OPA airways, and some chest/needle decompression stuff.

Have a read of this Supplement: War on Trauma - Journal of Emergency Medical Services (JEMS) @ JEMS.com

HTH
 
#10
Great stuff JayPee - thanks very much.
 

Grumblegrunt

LE
Book Reviewer
#11
they put quik clot into a bean bag because hospitals not used to it weren't irrigating it out properly and often had to cut out the quik clot where it burnt the tissue surrounding the wound which it cauterises - mind you if it saved the life. quik clot still has a use but cayenne pepper is finding a use as a natural replacement which can be left in place which causes the blood to clot naturally clogging the wound, celox is the pad stuff IIRC which works the came way as the pepper to encourage a clot. israeli dressings are cheapest from st johns but available all over. they changed the thinking after the falklands about blood loss and major trauma when triaged patients left for dead were still alive and starting to heal after a week on the cold hills.

I agree with a small boo boo bag with personal meds, then a trauma/blowout kit. you can carry an IV in a vehicle kit or learn about rectal infusion and have a camelbak handy. you cant force fluids in the same way but its the second fastest way of rehydration and you don't need a sterile fluid. just remove the bite valve first.

a good knowledge of improvisation and what you carry in the broadcast kit can cut down on what bulky kit you carry, its amazing what you can do with duct tape and a bit of imagination :)

just having this discussion at home as the missus is going with 74 teenagers to madagascar and has just done a 'wilderness first aid course' statistically they will get one death and 3 hospital cases so she is in a panic now. the problem is all the first aid at work and first response courses she has done over the years have switched off the actual first aid training beyond cpr and seem to be more about ringing for an ambulance and avoiding getting sued than helping people.

20 years ago first aid at work was a serious course which took months to pass, now its an afternoon.
 
#12
Great stuff GG.

I had know idea about rectal infusian - I thought this caused an explosive evacuation of the bowels.
 

Grumblegrunt

LE
Book Reviewer
#13
that's colonic irrigation, if you read the action reports from the FI, troops had so much clothing on or were so cold that finding a vein was impossible. so you set up an IV pull down they trousers and stick it up where they probably dont want it.

it also made it easier to locate casualties by their white bottoms sticking up.
 

Grumblegrunt

LE
Book Reviewer
#14
#16
I've never believed that "correct" really matters, if it gets to that stage just try your best.
I hear what you say - but in order to sound like you've been paying attention on the course you'll have to remember the recognized ratio. I did a 2 day RAMC course years ago, complete with prosthetic make up and bangs and smoke and I vaguely remember they were teaching 50/50. Although all I'm sure of is that if you pull the knife out of the wound instead of putting a donut bandage around the blade it's best not to try to stick it back in again.
 

Grumblegrunt

LE
Book Reviewer
#18
Sadly I'm now single again so I won't be able to have a crack at this.
never do anything you wont confidentally try on yourself :)

take camelbak and remove bite valve. stick end if pipe up bottom and sit comfortably.

fill camelbak with diet coke, drop in a mento and screw tight.

[video=youtube;hKoB0MHVBvM]http://www.youtube.com/watch?v=hKoB0MHVBvM[/video]
 
#20
Thanks everyone - really helpful stuff.

As Jonno suggested it will be travelling as a news crew.

Most of the broadcasters I travel with are very good at supplying PPE, medical kits AND most importantly, someone to look after us. (i.e preventing the Journo from getting us into proper bother.) Our advisers will always have a reasonable level of medical experience.

Jaypee360 - It was recommended that we carry a basic trauma kit for use on ourselves by someone else. My training is limited to a first aid course every year and a HEFAT course every 4 years - so limited is the operative word. Sadly I have had to use some of my scant knowledge on ungrateful colleagues but I have trouble remembering what I've been taught. How many 'first aiders' can recall the correct compression to breath ratio etc.

Boxy - thanks very much. I'm going to contact AKE who supplied the kit in the first place - I'm doing my refresher with them in any case.

Friendly Fire - I googled the bean bag thing but all I came up with was your post on here. What is this stuff please?

Jonno/OOh Matron - Thanks very much. My run bag is full of all manner of walty stuff including survival blankets which I have used to mark a LZ for an air ambulance. Pride of place is my very battered copy of Lofty Wiseman's bible.

I don't actually know where I'm going -twice now I've been cancelled on the way to the airport: CAF and Mali respectively - but to date the worst injury I've sustained was in the UK - a bloody student hit me with a stick. As mentioned I'll always be travelling with a sensible wise person.

Charliec - Thanks , I appreciate your offer.

Sounds like space and weight aren't going to be a huge issue. Most of the time, you don't need fancy (=expensive!!) stuff. A good supply of basic gear to deal with blisters, minor cuts, sprains etc will usually suffice, with a few well chosen special items.

Stuff like Quickclot is good for big bleeding wounds - the civillian version is in little gauze pouches, but you can get the larger packs. The gauze bags can be cut open, so you can still pour the granules in to a wound. Somebody suggested a SAM splint, which s excellent and packs small and light - can be used to splint 2 legs, of course.

Stuff to clean and close a wound or cut. Steristrips are OK, but fall off easily. Steristrips and wound glue combo works better. How's your sewing? Put a few stitches in your pack. If you can't use them, somebody else can.

The Laerdal Pocket Mask is a device you blow into when doing CPR, saves you getting dead man's gop in your face.

Maybe think about putting stuff in there that you can't use but a paramedic or doctor could - especially sterile needles, cannulas and fluids.

Consider simple drugs, especially pain killers and antibiotics. Customs might be an issue, but if you get a friendly doc to give you a private prescription and a letter stating "for emergency use" etc, that shouldn't be a problem. This is simple stuff that would be unavailable in some places and could stop you getting sick.

Probably the most important item is a decent bag to put it all in. The best thing is something that has different sized pouches and compartments - nothing worse than having to delve through a cavernous bag looking for a sticking plaster.
 

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