Medical bag or Trauma Bag

[uscbigdawg]

Absolutely. The first one is the sacraficial lamb (or practice...depending on your perspective ).

Rich

[Graham Smith]

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.

This is why I like a separate small first aid kit. Keeping it separate from the bigger stuff pretty much guarantees that no one uses the expensive stuff if they don't really need it.

In all honesty, some sterile 2x2's, some antibiotic ointment, and some surgical tape is good for almost every cut or scrape you are going to see.

[Patrick Sweeney]

The separate kit is a good idea, but someone always leaves it in the car/truck, or it is "too far away" or whatever.

They'll go trolling for the big bag, and if there is a small one on it, they can be diverted. Especially if they have the example of the first guy fresh in mind.....

[FranDoc]

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.

Yup, like it. The 'side saddle' bag with the minor stuff is what you'll need most of the time.

There was a mention in a prior post re: CPR shields and mechanical airways. The CPR shields or pocket masks MAY BE a good idea, but get used to using one on 'Annie' before you try it on a slobbering/vomiting human -- they slide out of place -- ask me how I know this ....

If you're going to play with ANY mechanical airway -- bite stick, oro-pharyngeal, naso-pharyngeal or (I shudder to think of these in a range bag) an EOA/EGTA/ET/LMA, make absolutely certain that these are accessible ONLY by people who have been specifically trained in their use. [There's that "training" mantra again]. If they're in 'right', they can help. If they're in wrong ... prepare to call your defense lawyer.

The biggest morbidity/mortality (in the scenarios we all hope never to face) is exsanguination. Get the 'bleeding control' gear handy, use a CAT (or tourniquet of preference) if you've taken the few hours to learn how to do it right. If a GSW impacts the airway or significantly impacts the thorax/chest, there may not be anything you can really do in the field. Don't play with the toys in the 'trauma bag'. Get to some communication device, get help coming, start your own evac, keep your head screwed on. Unless this is what you do in 'real life', don't delay transport while you play with the gear. Getting the injured to an ambulance or the chopper ALIVE is the best thing that you can do.

As always, prevention is not glamorous, but it's generally the best option. Do everything possible to avoid GSW's in the first place. Stay safe, keep you head on and your radar 'up'.

[uscbigdawg]

Absolutely spot on Doc.

Get the big guns rollin' before anything else. My rule was when I dropped people off at the CSH was as long as they were alive when I handed them off, I did my job.

Rich

[kimel]

*IF* you decide you must transport and not wait for the ambulance stay in contact with dispatch as much as possible about your location. Do not take "shortcuts"; stay on the main roads and arrange for a rendezvous. DO NOT think "but if I stop it will waste time and I can get there faster if I just keep going."

There is very little in this world as frustrating as chasing a patient in a private vehicle with the ambulance. There was a freak hunting accident near here a couple years ago and the driver blew right by the ambulance and kept on going. Law enforcement finally got him stopped after several miles at high speed. The victim would probably have not survived the car ride (about 45 more minutes to the nearest hospital, which was NOT a trauma center) but the ambulance got him stable enough to put on the bird and he was in the trauma center, not the community hospital, about 30 minutes later receiving a high level of care enroute.

Like Fran said, those CPR barrier things are a real trick to use. Find someone with an airway trainer and dump half a can of vegetable soup in the airway. Now, clear the airway and try and do proper CPR with one of those shields. It's an eye opener. A pocket mask is a MUCH better alternative even if they are bulky but you have to know how to really use them for them to be effective.

Train, train, train. There is a reason EMTs are constantly training. Much like shooting it is practice like you perform and perform like you practice.

[uscbigdawg]

...Find someone with an airway trainer and dump half a can of vegetable soup in the airway. Now, clear the airway and try and do proper CPR with one of those shields....

THAT'S AWESOME!!! I thought we were the only ones that did that!!!

:roflol:

Rich

[FranDoc]

A bit off the topic of "med kit", but something that we've mentioned above ...

Next time you're at the range, wander around with your cell phone - or whatever device you'd use to communicate with emergency dispatch - and see exactly how well it might work.

Example: every time I shoot at Rayner's, my cell phone goes to 'power save' mode because there is NO signal from anywhere. Fortunately, there's a hard line phone at the house down the hill (they own the range, they're around if we're shooting). Reception may vary depending upon your cellular network.

As previously, check this BEFORE you really need it. Can you stand up on the ridge and get reception? How about if it's rainy? Try it when the trees are bare and when you have a full canopy of leaves overhead (if that applies to you). Can you reasonably run out to the road/entry gate and get better reception there?

One more component to preparation.

PS: LOVE the can-of-soup idea. Never did that in training. Cleared out WAY too much spaghetti and alcohol in real life (is the red stuff tomato sauce, or blood due to a traumatic intubation?). I'll stop the 'war stories' before they get too graphic for the Forum ....

[kimel]

THAT'S AWESOME!!! I thought we were the only ones that did that!!!

I read about that in some article somewhere and decided I had to try it. I suggested it to one of my instructors during training a couple years back who said "good idea, I'll get some soup for next time" to which I produced a can of soup from my jacket and away we went. For some reason I got to clean out the airway dummy afterward though. Hmmm....

It is also on tap for training night with my local unit next month too just to keep everyone in practice. Too often in training suction isn't used to suck anything but gloved fingers or maybe water. Then the newbie hits the field and is faced with a real obstruction and hasn't a clue.

[JKSNIPER]

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....

Agree with Nik here 100%

We have all volunteers here on our Ambulance crews and the quality of the people they have varies greatly.

I have seen at scenes where the amb crew arrives and BOOM they're doing the job and packaging the victim and gone like a silver bullet.

Excellent.

Others who ....well we we refer to one as "The Foreign Legion Death Squad"

They stood over a guy once who had been STABBED bad.

I mean blood all over the place and he was CUT UP.

The stabber definitely wanted tis guy to die.

Theres 3 in the amb crew and all 3 are cataloging the injuries.

One is taking notes while the other 2 just hunt for wounds.

"Hes got a bi-lateral this and a penetrating that....."

I finally interuppted by suggesting that they actually DO something about the wounds leaking all that red stuff all over the place otherwise it will stop leaking all by itself and the victim won't care if you missed one minor "Owee" because he'll BE DEAD!

WHat a concept! Actually plugging up the holes will cause less red stuff to come out! Holy shite!

Tampons for GSWs are good but very painful to apply.

Get ready for the shock of all the blood and then someone screaming when you apply treatment to the wound.

Don't be like the one well meaning volly I saw. She would start to raise this poor guys leg (broken) the guy would scream.

She would stop...then start to lower the leg. Guy would scream again.

She would then pick the leg up and ...well you get the picture.

I said "Hey if you want to torture the guy? .....I have a taser. Other wise hows about you make up your mind over where you want his leg to be and have him scream ONCE about it?"

Patients will scream at times.

Thats what the O2 mask is for...so you don't upset the crowd watching.

I highly advise that you not waste time with protocols. Sorry but generally they're bullshit.

I've seen amb crews literally stabilize patients to death.

They get a severly injured person in the rig...and it sits there....and sits there....and sits there....if you need a driver grab a cop to do the driving so the junior doctor Kildares can play "E.R." in the back with the patient WHILE ITS MOVING.

Once you get the guy in the rig MOVE OUT to the trauma center.

Every minute delayed is one less the true medical pros have to work with to save that guy/gals life.

Have a seperate "Owee" bag or kit.

Get a tackle box and fill it with bandaids and tweezers and all that basic first aid stuff.

Paint a red cross on it and the word "Owee" on it so everyone knows its for the dings and scrapes and owees.

Blackhawk makes a nice bag for a true medical kit.

Get it, stock it and as Shawn suggested TRAIN for the bad thing to happen.

Someone else suggested trying out your cell phones/ rados on the range where the accidents will actually happen and thats also an excellent suggestion.

Comms go to shite when the guy speaking is yelling but they're even worse where you get NOTHING.

If you're having a match...notify the local amb crew ahead of time and pick out an L.Z. for the chopper.

No sorry...don't pick the LZ...walk the area with the medevac pilots and let them tell you where they want the LZ to be.

Have the PILOTS pick the LZ because they will have to land in it.

Check ahead of time for possible F.O.D. stuff on the ground and those annoying high tension wires and tree branches, barb wire and snow fencing.

You haven't lived until a section of snow fence gets sucked up by rotor wash.

Man thats FUN!

Don't rope it off, put out cones, or crime scene type tape to keep it pristine. ALl that stuff can become a problem for the pilot trying to land.

Pilots are notorious for disregarding instructions from us earthbound misfits concerning minor things like LZs.

They tend to get upset with us for not noticing stuff that can knock their little tinkertoy out of the sky.

Also don't try to help the pilot by shining your 1 jiggawat super tacticool flashlight at the bird to show them where you are.

Bettwe to do is hook a chem light to a piece of para-cord. Crack the light open and whirl the cord around .

It will make a "disc" of light which any pilot can see and they won't be blinded by it.

Good luck and I hope you never have to use your medical kit or the training but if you do you'll be glad you trained ahead of time.

JK

[goalie62]

Agreed with about all.

I worked prehospital EMS for about 12 years. Keep it simple. Forget the Tampons, just use feminine napkins if it's bleeding that hard. I like Kerlix better than Co Ban. I never liked how stretchy coban is. If you're going to put up a kit, put up a kit designed for stupid people to use. Why? because even the brightest bulb in the string will blink into darkness when confronted with buckets of blood and little or no training.

A basic American Red Cross first aid class is really all you need.

Having worked both...Basic EMT's are better with trauma than Paramedics. The medics tend to go all ALS on you and forget the basic stuff that really kills the patient. Simple attention to the ABC's is all you need until you get an ambulance out there.