Had a adolescent bust up her ankle at my wife's church the other day. (probably badly sprained, but xrays were needed to confirm no fracture).

By the time I wandered over, a former Firefighter already on the scene, immobilized the ankle, had ice on it and had individuals getting her grandfather to get the car to transport to ER.

What was there left for me to do (except stand there and look pretty?). I know! I can get an ACE wrap out of my car's FAK and let the firefighter use it to better secure the ankle. At least then I can feel like I contributed something except my good looks.

To my horrors, my car's FAK a victim of "being a work in progress". The ACE wrap on my shopping list had not made it into the FAK itself.

I did have a shemagh in the car's BOB that could be used as a triangle bandage. By the time I made it back to the scene, he had the young lady loaded up on grandpa's car and rolling to the ER.

Glad the FF was there to save the day. Regretting I had nothing to offer him in the way of assist.

Something similar happened to me. I went to DW office to bring her a cup of coffee. Seconds before I walked in the door, she had slipped on a stair seriously damaged her ankle, probably broken (it was) and massively swollen already, not to mention tremendous pain.

She was lying on the ground with 5-6 people attempting to provided comfort or gawking. Someone had run off to get some ice.

I got her laughing and out of fear of shock while the ice arrived but no way to attach it to a swelling foot. My EDC pack nearby provided a buff headwear that I used as a temporary hold then grabbed a shirt hanging on the wall as a secure dressing. Her medical insurance did not cover ambulance travel and we did not want to incur a several hundred dollar bill for a three mile trip to the ER.

As we picked up DW to go to the hospital she got woozy and we had no way to carry her to our van. I recalled the office plan and had someone run and get a rolling office chair and we sat her in that for transport.

I suppose its tooting my own horn, but the next week when she went back, the staff couldn't believe how calm, cool and MacGuyer I was in an emergency of my own wife.

It's always so nice to see a guy step right up to the plate and take care of business! Kinda makes a person feel all warm and fuzzy.

Too many just dither and ask stupid questions, unfortunately.

Not the ETS people, of course.

As long as you were there and at least tried to help, rationally and sensibly, you shouldn't feel bad about it. ACE wrap or not, a shemagh would've worked just as well in a pinch.

On the other hand, a lot of people these days are not only totally unprepared to offer any kind of assistance but even seem reluctant to step in. Some years ago there was a freak accident in my hometown. From what I've heard, a speeding car turned over and hit a passerby waiting at the traffic lights. The unfortunate guy had his leg severed above the knee and was bleeding heavily. There were plenty of people around but nobody did anything whatsoever to help. Somebody was actually heard saying he didn't want to get his clothes dirty. It was not until the ambulance arrived some 10 minutes later that the victim was finally given first aid. Hard to understand but goes to show what our society is like nowadays.

A Litigious one I'm afraid.

If the injury was servere such as femoral arterial bleed and the bleed had already left a couple of pints of blood of the roadside do you risk applying a tourniquet then getting potentially sued for saving a life but losing a leg. Dead people can't sue you for just being a witness to their own demise.

Yea, a real man would pull an X-ray machine out of their hip pocket and...

I wouldn't worry too much about not having everything. It would be nice to have a complete kit but given the way life is the kit won't be anywhere near where you are, or it got lost when the boat tipped over, or your trying to make do treating a dozen people with a small kit so you out of everything.

IMHO how people handle things when they don't have all the supplies says more about them. Quick, given the same injury, and a more desperate situation, but no kit or firemen, think of three ways of using materials on hand to treat the injury.

My solution:
1) Using a magazine from the front seat of the car and socks from me and the guy next to me I form a splint and pressure bandage. Elastic socks make good pressure bandages and magazine make good splints.

Your clothing, and the clothing of anyone around you, can be used as raw materials. A library card might be used to seal a sucking chest wound. A leg from a pair of pants makes a nice selection of bandages. A severed vein can be tied off with a shoelace.

2) Using the ladies pantyhose I create a pressure bandage. Nylon hose makes good pressure bandages. Better at holding bandages on difficult wounds than many normal supplies. Lots of uses for pantyhose.

3) Using the drapes from the church I rip them into strips and use those as a pressure wrap by carefully keeping the cloth tight as I wrap and using several layers. That is how pressure bandages were done before they had ACE bandages.

IMHO the ability to adapt and use available materials is better than being dependent on any kit. It is a skill that gets seldom practiced as people get used to having 'just the right thing'. Ripping up curtains probably wouldn't go over well in anything less than a major casualty situation.

As for the question of the tourniquet? The evidence is that if the person gets to a hospital in less than an half and hour, some say an hour, the odds are a tourniquet will do little harm even if it was not called for.

The old logic was that you never used a tourniquet unless you had tried direct pressure and failed. Then tried direct pressure and elevating the wound and failed. And then tried a pressure point and failed. By then they had likely bled to death.

The old reasoning was that a tourniquet caused a lot of damage, that there was a huge risk the veins wouldn't reopen, and that a limb deprived of blood flow rapidly died. Tourniquets are still serious business but we have found out that limbs can often go far longer than previously thought without blood flow. Medical science has learned how to repair damaged veins. And we now know that one of the greatest predictors of traumatic death is how much blood the person loses. There is simply no substitute for keeping the blood in the body.

Newer protocols, and what experienced medics had been doing all along, go the other way. If it looks like a serious wound that might need a tourniquet you apply one first thing. When you have time, and possibly handled several other patients, you might back off the tourniquet. That can be risky. More typically you simply let it ride to the trauma center as-is.

I carry in my car various sizes of AMK SAM splints. I'm prone to ankle and knee injuries and you never know what you're going to happen upon:


http://www.rei.com/product/407040

http://www.rei.com/product/743235

http://www.rei.com/product/743236


I've always assumed the First Aid gear in my car is more likely to be need by others than by myself.

Yeah, that's happened once or twice, but fortunately to myself only.

My big thing is I want some antibiotics in my kit. Don't really have a primary doc, not allowed to prescribe it to myself, and don't feel like vet meds.

But good job on stepping up. hope you've filled the FAK since posting this!

Don't know what they call it in the Navy (you are in correct?), but go on sick call (Army term) and request a professional courtesy from the PA.

Re: tourniquet, aside from being less of a problem if applied only for a short time, it doesn't have to be fully tightened to still have some effect. Also, applying pressure alone to a large open wound would be a lot better than doing nothing at all.