Medical bag or Trauma Bag

[jasmap]

I have been tasked with upgrading our sorry excuse for a medical bag for the firearms unit at work. I opened the bag the other day for a bandaid for a shooter and I could hardly find anything that wasn't empty or completely out of order. Nothing was labeled on the outside of the bag, empty saline, etc....

I will be going to the EMT's to get more advice but does anyone have any info on a really good medical bag to start with and where to find it? This will be for the firing range specifically but obviously other needs could arise.

I'd prefer a bag that is or can be labeled externally and that is well stocked to begin with.

Edited March 23, 2009 by jasmap

[SA Friday]

Unfortunately, I haven't really seen a great firearms range medical kit out there. It might be best to get a standard first aid kit like a Dyna-Med 100 person first aid kit, and then upgrade it with additional materials. Dyna-med makes a couple of empty first aid kit bags that could be used for this.

I'm assuming this is at the range since it's in your firearms Unit's section. I would recommend some of the following materials be available:

Asherman chest seal

Quik-Clot

C-A-T tourniquet http://www.combattourniquet.com/

Israeli bandage/compression bandage, maybe two or three.

small burn blanket

really good tweezers

Good eye wash bottle

CPR mask

The problem is the enviornment you will have it in can see problems from cuts and scrapes all the way up to GSW's. Pretty tough to get something pre-made for that. When GSW is involved, you really have to be prepared to prevent exsanguination. At the very least make sure you cover that. It sounds a little paranoid, but very recent events have shown it isn't that far off from possible reality at all. I carry a C-A-T tourniquet, Quik-Clot and bandaids in my range bag. I also carry a military style combat first aid kit and generic first aid kit in my truck. I just spend too much time at the range to not have GSW treating materials around.

[jasmap]

Well when it comes to serious injury or death then I don't believe you are being paranoid, just prepared. Our EMT's have the C-A-T tourniquet and I am sure I will add one to the bag. If there isn't a range specific medical bag out there then maybe we should get going on that.

Thanks for the info so far. This will help.

[STInky]

The C-A-T tourniquets are great....We issue them to every one on our tactical team. We also all carry the Israeli Bandage . These are both quick and easy first aid items and both can be applied to ones self if you suffer an injury. Don't forget some medical scissors to cut through the clothing to get to the wound.

[Nik Habicht]

For planning: If you have access to radios and vehicles with lights/sirens --- KNOW whether you're better off activating EMS --- or loading and making a run for the nearest TRAUMA CENTER, not the local ER, using the radio to get dispatch to call the Trauma Center and alert them to the imminent arrival. Advance notice lets them activate the Trauma Team internally.....

Knowing will probably involve assessing EMS/ALS response times to the range, driving time to the Trauma Center, and a conversation with Medics, regarding what they would want done if they were the victim....

[smokshwn]

Unfortunately, I haven't really seen a great firearms range medical kit out there. It might be best to get a standard first aid kit like a Dyna-Med 100 person first aid kit, and then upgrade it with additional materials. Dyna-med makes a couple of empty first aid kit bags that could be used for this.

I'm assuming this is at the range since it's in your firearms Unit's section. I would recommend some of the following materials be available:

Asherman chest seal

Quik-Clot

C-A-T tourniquet http://www.combattourniquet.com/

Israeli bandage/compression bandage, maybe two or three.

small burn blanket

really good tweezers

Good eye wash bottle

CPR mask

The problem is the enviornment you will have it in can see problems from cuts and scrapes all the way up to GSW's. Pretty tough to get something pre-made for that. When GSW is involved, you really have to be prepared to prevent exsanguination. At the very least make sure you cover that. It sounds a little paranoid, but very recent events have shown it isn't that far off from possible reality at all. I carry a C-A-T tourniquet, Quik-Clot and bandaids in my range bag. I also carry a military style combat first aid kit and generic first aid kit in my truck. I just spend too much time at the range to not have GSW treating materials around.

+1 to the above with respect to gear. There are several tourniquets on the market right now (MAT, SOFFT, SWAT-T, CAT, etc). ALL of them have strength's and weaknesses. Some require more training/practice than others .

Hear is a link to a couple of TQ's that are very easy to use for folks who don't deliver EMS for a living. I really like the first one as it is multi functional, small, and easy to apply for laypeople.

http://www.mat-tourniquet.com/

Without sounding too harsh most folks I have encountered worry way too much about WHAT is in the bag and far too little about how to use the products. Don't forget the training end of the equation. Utilize your local resources to get your club officer's/range staff a little training time to make sure everyone knows how to use the products in your kit and understands the plan to handle a more serious accident at your range.

As far as which bag.......there are way too many to list. You can look at Thomas Packs. They are a little spendy but tend to hold up fairly well. If it was for my club I would also look at the pelican case options as they are damn near indestructible and keep out all the dust, dirt and water you can throw at them.

http://www.thomasems.com/index.html

Edited March 23, 2009 by smokshwn

[uscbigdawg]

jasmap,

Contact Russell at Cavalry Arms. They're trauma kits are the heat and their tourniquet design is pretty darn sweet. I keep a couple of "toss kits" in my aid bag, left over from A-Stan that compromised of an IV kit, tourniquet, Kerlix and a CATT that I would 'toss' to CLS's or ground medics when we arrived on scene.

If there's help or training that you or your team would like to receive, feel free to contact me any time.

Rich

[jasmap]

jasmap,

Contact Russell at Cavalry Arms. They're trauma kits are the heat and their tourniquet design is pretty darn sweet. I keep a couple of "toss kits" in my aid bag, left over from A-Stan that compromised of an IV kit, tourniquet, Kerlix and a CATT that I would 'toss' to CLS's or ground medics when we arrived on scene.

If there's help or training that you or your team would like to receive, feel free to contact me any time.

Rich

Thanks Rich. We have several certified EMT's at work and I will definitely go over this with a couple of them that are good guys but I was deathly afraid they would get ahold of this and pursue the cheapest avenue to impress the brass rather than get what will be the best avenue. That's why when I was asked I jumped all over it. Thanks!

[uscbigdawg]

No problemo. A couple of years in the box and training over 6k soldiers on CLS and other advanced trauma is normal for me. Ever since getting out, the pace is just slower is all.

Off still stands.

Rich

[jasmap]

No problemo. A couple of years in the box and training over 6k soldiers on CLS and other advanced trauma is normal for me. Ever since getting out, the pace is just slower is all.

Off still stands.

Rich

Thanks. If I can't get them to pull through for me then I will see if our Agent in Charge will let someone come in. Thanks brother!

[John Heiter]

My medical training consists of a YMCA CPR certification about ten years ago so, for what it's worth... I've heard lots of debate on the quick clot stuff.

Some seem to really like it. Others don't.

Problems mentioned were things like:

Introducing a foreign element into the wound that will require surgical care is not a good idea.

The quick clot is really just a bandage that will still require a good bandage over the top so why not just apply a good bandage.

It produces an exothermic reaction and burns have been reported.

It produces a plug which can be dislodged.

I mention this because I've got a small kit I keep in the truck when I go to matches and I thought the quick clot idea sounded great but now I'm not sure.

[uscbigdawg]

Celox is exponentially better than Quik Clot. Probably the worst thing to happen to real trauma med care with regards to GSW's was the movie, "Shooter". Marky Mark can be as tough as he wants, but good luck pouring QC on yourself. You are too tough for me.

The first time I used it I had 2 large rolls of Kerlix between my gloved hand and the QC and it still was freakin' hot! As for needing surgery upon arrival, you betcha, but you're alive.

Rich

[kimel]

Trauma kits are all well and good but don't forget the simple stuff like band-aids, insect sting swabs, eye wash, cold packs, etc.

Forget the fancy kits with sutures, I.V. setups, etc. unless you are trained in their use. You can actually do an amazing amount of harm with that stuff if you do not know what you are doing. Good Sam laws only go so far if you start doing invasive procedures (placing an IV is considered invasive) and aren't trained/certified to do it. In the typical field setting at any civilian shooting range in the US a suture kit has no place. Sutures aren't generally considered to be first aid items.

And of course the #1 most important thing to do is to not panic. Yeah, it is way easier to type it than to do it.

Also be advised that EMTs are bound by protocols and they cannot legally step outside them. So, if they don't have QC or Celox in their protocols you can hand it to them but they cannot use it. I am an EMT and QC and Celox are not in my protocols so I legally cannot use it. Same goes for a host of other things. It all depends on the local medical director. Not saying I agree with it and not saying that if the situation warranted it I wouldn't use it and risk the consequences later if it really was life and death.

Last time I did ER rounds I was chatting with the doc I was working with over coffee and asked him about QC and Celox. He was of the opinion it should never had been released to the civilian market because people are using it on everything from minor cuts/scrapes to road rash causing a whole lot of other issues and actually making things worse. He had only seen one case where its use was justified and possibly saved the victim's life.

Also, QC and Celox are expensive. Your standard issue tampon is a whole lot cheaper and will do an adequate job in many penetrating injury situations.

[SharonAnne9x23]

+1 on the tampon. Also do not overlook sanitary napkins as sterile absorbent dressings.

[FranDoc]

do not overlook sanitary napkins as sterile absorbent dressings.

Sanitary napkins aren't truly 'sterile', but they're darned good at absorbing blood. You can also place an Israeli bandage over one.

As an ER doc, I'm a fan of simplicity for range kits -- assemble stuff that everybody knows how to use. Unless you have a TRAINED trauma medical professional in your cadre, skip the QC/Celox, fancy airway management devices, IV sets, tourniquets, etc. I've seen too much secondary injury -- inflicted by well-meaning people who are not adequately trained. These injuries are entirely preventable. Using any of these devices/medications without the appropriate training may get you sued, REGARDLESS of the medical outcome.

The vast majority of range injuries are not catastrophic exsanguination, but rather are lacerations that could become infected or strains/sprains that benefit from immediate first-aid level attention. Invest in bandages, soap, gauze and chemical cold packs. I'm a fan of Coban/Co-Flex/Vet-wrap (same stuff, multiple names). Sticks to you without leaving adhesive residue, sticks to hairy skin and does not pull hair off when removed, relatively abrasion- and water-resistant, flexible enough not to impede either arterial or venous blood flow unless you apply it way too tight. Get a couple litre bottles of saline or sterile water to wash out wounds. Most ranges do not have clean running water.

If you're truly out in Timbuktu, assess your local resources and transportation options. GET training rather than assuming that you'll know how to spring into action when the blood starts flying or when somone's airway shuts down. Get the gear that YOU know how to use. Know when to get the heck outta Dodge and how to call for evac.

What I'm suggesting isn't 'really cool', I've already had an earful from med kit vendors who insist that all the latest gadgets are the 'only way to go'. I have to disagree. Know what you can reasonably take care of, know when you have to move, don't let your ego get in the way of making a decision that's right for the patient.

[Graham Smith]

It's been a very long while while since I had to set up anything like this, so things have probably changed a lot, but.... It's worth considering breaking this down in much the same way as you would standard triage. You want a small kit for minor injuries, a kit for moderate injuries and a major trauma kit.

What works well for a small kit is a plastic box with a tight sealing lid and compartments (adjustable are great). There are no end of such to be found in hardware and sporting goods. Stock this with the routine bandaids, antiseptic, sterile pads, tape. Butterfly's are great for things like cuts that are too small for a small cut and too big to open the medium injury box. This box can easily be self serve (and be sure and ask people to leave a little donation for restocking).

The moderately serious injuries are often the most difficult to deal with. By definition don't warrant an ambulance but someone is probably going to have to go to a doctor after the immediate situation is resolved. Most of this may be found in the local drug store, but before you spend big bucks for a trauma kit you might want to touch base with the local emt/fire/rescue. They sometimes have bandages that they need to rotate out of supply and will donate to your club. Just be sure to keep track of the expiration date.

In some ways, serious injuries are the easiest to stock for. Odds are (and gods willing) this kit will never be used. But all you really need is something to staunch the bleeding and prevent shock. This means compression pads, super blanket, and airways (an ambubag is nice as well).

One last thing, your club should have a good working relationship with the local emergency responder. Make sure they know where you are and how best to get to range. Also work out in advance an emergency plan to find out from them what they want you to do. For example: Get someone on 911 immediately. Send another person to the entrance to the range to escort the ambulance. If necessary, station several sentries to point the driver in the right direction. etc.

[dajarrel]

Exellent replies. I really like FranDoc's suggestion of keeping it simple. That has always worked for me. As a matter of fact, when I first got my EMT license (which I have since let lapse) my son brought a kid up that needed a band-aid for a small blister on his heel from skating. Much to my embarrisment, I didn't have any plain old band-aids in my kit. I remidied that problem that day and if you need one now, I have it....now

One point that has been kinda overlooked and was an issue with the original poster.

"...I opened the bag the other day for a bandaid for a shooter and I could hardly find anything that wasn't empty or completely out of order..."

This is probably one of the biggest drawbacks to a publically accessable first aid/trauma kit. Someone has to be responsable to periodically check and replenish the consumed supplies. If you use something from the kit, try to remember to either replace it yourself or let someone else know it's been used.

fwiw

dj

[uscbigdawg]

Absolutely...simplicity is your friend and why I never can stress enough that people get trained in this stuff. Here in northern CA, we're actually in pretty good locations for our outdoor ranges. However, our largest facility is an easy 20-30 minute helicopter ride (each way) from a level of care that can handle anything serious.

Carrying tons of gauze and Co-ban is definitely a great way to go. Like kimel said, EMT's are more than bound by protocals. Luckily Uncle Sugar didn't have those same things (within reason) on us.

Above everything else, Rule #1 of emergency medicine is that, "it's not our emergency". Meaning, stay calm and fix the patient...you're fine.

Rich

[SA Friday]

Unfortunately, I haven't really seen a great firearms range medical kit out there. It might be best to get a standard first aid kit like a Dyna-Med 100 person first aid kit, and then upgrade it with additional materials. Dyna-med makes a couple of empty first aid kit bags that could be used for this.

I'm assuming this is at the range since it's in your firearms Unit's section. I would recommend some of the following materials be available:

Asherman chest seal

Quik-Clot

C-A-T tourniquet http://www.combattourniquet.com/

Israeli bandage/compression bandage, maybe two or three.

small burn blanket

really good tweezers

Good eye wash bottle

CPR mask

The problem is the enviornment you will have it in can see problems from cuts and scrapes all the way up to GSW's. Pretty tough to get something pre-made for that. When GSW is involved, you really have to be prepared to prevent exsanguination. At the very least make sure you cover that. It sounds a little paranoid, but very recent events have shown it isn't that far off from possible reality at all. I carry a C-A-T tourniquet, Quik-Clot and bandaids in my range bag. I also carry a military style combat first aid kit and generic first aid kit in my truck. I just spend too much time at the range to not have GSW treating materials around.

Actually, it was.

See, told you some think a tourniquet and QC was excessive Training on treating bleeding is the key, not disregarding fairly cheap equipment. The only reason I don't have an Israeli bandage in there is I'm waiting for mine to get back with my other equipment from the sandbox. I do have one in my truck's kit along with a chest seal. May they all rot from lack of use, just like my carry guns.

I've used the band aids the most, followed by the tweezers, and over the counter pain meds a close third...

[K Norris]

Just finished a Pre Hospital Trauma Life Support class last week and can say the hemostatic agents like celox are falling out of favor but due to new research coming from the military tourniquets are back in. The order of bleeding control NAMET was espousing (not legally binding mind you) is direct pressure, tq. No pressure points or elevation. The chest seals are great, but don't do anything that Vaseline gauze or even saran wrap won't. And lastly, nothing beats training and remembering your basics, keep the airway open, support breathing and stop the bleeding.

[smokshwn]

Never ceases to amaze me how there is a universal truth to performance....whether it be shooting, golfing, EMS, etc. etc. .... all the high speed gear in the world is pretty much useless unless you get some TRAINING...

[Patrick Sweeney]

"went into the bag for some bandaids...."

Use a separate bag on the outside: the snivel bag. Bandaids, cough drops, bug spray, etc. Impress on the users to the point of electric shock, they can go into the small bags (mark them with an obvious ID) any time they want.

If someone goes into the main bag, it had better be while they're screaming for an ambulance, or there will be hell to pay.

If you don't do this, you'll find Israeli bandages on minor road rash and bug bites, etc.

Training, education and repetition are your friends.

[SA Friday]

"went into the bag for some bandaids...."

Use a separate bag on the outside: the snivel bag. Bandaids, cough drops, bug spray, etc. Impress on the users to the point of electric shock, they can go into the small bags (mark them with an obvious ID) any time they want.

If someone goes into the main bag, it had better be while they're screaming for an ambulance, or there will be hell to pay.

If you don't do this, you'll find Israeli bandages on minor road rash and bug bites, etc.

Training, education and repetition are your friends.

Oh ya, I like that. Damn good idea there.

[uscbigdawg]

Patrick - That's perfect!

Rich

[Patrick Sweeney]

All part of the service.

It only works if you make a really messy example of the first miscreant.