Supernachos:
This is one of the topics I love covering at the end of my course. Throughout the course, you learn what the basic items needed in a trauma situation and that there really isn't too much expense to build a first response bag. Without fail, the most expensive part of the kit will be the bag itself or the QuikClot Gauze.
The picture I attached shows both of the bags that I carried with me in Afghanistan and/or Iraq. As well, the flack vest that the rifle is leaning on has medical pouches attached to it. My flack carried everything that would be immediately necessary, i.e. tourniquets, QuikClot Gauze, pressure bandages. On every patrol came the smaller tan shoulder bag you see on the left. That has enough supplies in it to treat 1 horrible casualty, 2 serious or plenty of cotton candy ankles (so weak they twist easier than cotton candy would). The large green bag was my mass casualty and resupply. Working out of bases with a maximum of 45 people, I carried as much medical equipment to each location as I could. This allowed me to resupply myself and my team without dipping into the limited local stock, as well as providing a supply and rally point for mass casualties both on base and during a convoy. The only time I actually carried that behemoth was as part of a TRAP (Tactical Recovery of Aircraft and Personnel) team when we were on standby for downed helicopters.
Any time you're making a bag you need to look at what the primary use will be. For a range bag, your needs are relatively simple: stop bleeding, maintain airway. As long as you can do both of those things you're giving the victim a very good chance of living.
For the equipment list, tmcguff had a good basic load out but I'd like to make a few tweaks.
~Instead of the CAT tourniquet I prefer the SOF-T Wide (no velcro, metal construction that doesn't degrade from the elements or snap from over tightening, quick buckle that doesn't need to be threaded) The CAT is good, and if you have it don't get rid of it, I just prefer the SOF-T Wide, and if you're in the market, it's cheaper as well.
~Rather than a valved occlusive dressing like a Bolin or Asherman chest seal just block it off completely with a HALO dressing or AED defibrillator pads (similarly priced). They stick like mouse traps and give you less to worry about. The doctors are gonna rip them off when the patient gets in the ER/OR and insert a chest tube regardless.
~Lots of compressed/Z-folded gauze. QuikClot gauze is great for those huge bleeders but it's expensive, limited and not necessary for every application.
~Ace Bandages, and lots of them. Make sure they have velcro on them so you're not fumbling with the metal hooks.
I'm not going to get into specific application of each bandage here. I could upload the PowerPoint for my class but I think the file's a little bit too big. Regardless, there are considerations to take into account regarding tourniquets and pressure dressings as well as wound packing and airway stabilization. You may notice that I don't include any airway devices. The NPA is a great tool for redundancy but does more to calm the responder than help the patient. Essential Trauma Management, Long Term Care will go into patent airways, but you have to remember that patent airways are very invasive and potentially traumatic in and of themselves.
For the tourniquets: 2 HOURS! Golden rule, you START tissue damage at 2 hours, do not exceed that without potential loss of limb. Tourniquets are situation dictating and at the discretion of the responder. This is something that I cover in depth in the course because there are a lot of things to consider when using a tourniquet. They are a first and list line of defense (prior Navy Corpsman with Infantry deployments)
Being prepared with the supplies is a good step but unless you know how to properly use the equipment and are comfortable and confident with your skills you might as well hand the bag to someone else. Please, either sign up for some sort of first aid/first responder course which will use equipment that you are carrying or buy extras to familiarize yourself with.
If you have any other questions, please feel free to reach me at Doc9POINT5-TASC@yahoo.com
Doc 9POINT5
Lead Medical Instructor
The Academy of Saint Crispian
