Check your kits!

So I'm out running an errand last night, and I come across a man lying in the middle of the road. There was quite a bit of blood. Apparently, he'd been hit, badly, by a car that had fled the scene. I call in a trauma alert, grab my first aid kit and start to glove up. Each glove I pull on instantly tears! I went through at least 10 gloves before I had two working ones, and one of those tore up by the wrist. The thing is, I already knew that gloves stored in my kit decayed fairly rapidly, and I'd checked things not that long ago, but obviously not recently enough! Drat! I hate it when I have only myself to blame.

Other observations: My "suction device" consisting of a 60cc syringe attached to 8" of suction tubing worked well to clear blood from the oropharynx. Wished I'd had a BVM (the squeeze bag to face mask thingie) since he went into respiratory arrest before the first fire/rescue folks arrived, although I do have a pocket mask. I probably need to add a reflective safety vest. My tiny AAA Fenix penlight gave all the light I really needed.

good work!!--thank God there are still people like you left in the world...

Kudos for getting involved and helping, Jeff.

One question: was it dark enough that you really had to use your light? If so, how did you hold it?

That's something I always wonder about and it's not like they ever mention lighting in any first aid course. I'm just wondering, short of using a headlamp or having someone else hold the light, if there's a "best" way to illuminate a wound that you're working on? Most people probably think about a mouth hold with a small light like a Fenix (assuming that they even have a flashlight at all), but that's not a good idea when working around someone else's fluids. Or do you just hand hold the light to survey things first, then put it down on the ground to provide just enough light to go to work? Just curious.

Good job, Jeff.

Good advice too. I'm embarrassed to admit that I went out in a spring snowstorm a couple of months ago, buried the car in a drift, flagged down a neighbour with a 4x4, went to my trunk and ... the towrope wasn't there! Some knucklehead (puts hand up) moved it to another vehicle. Argh!

Good work Jeff!

In a pinch a 30Fr or 32Fr NPA works on the end of the 60cc syringe for suction. Definitely add a reflective vest and a headlamp (with lithium cells) to your car kit. A Laerdal disposable BVM bag folds into itself pretty compactly. Use it with the pocket mask instead of a dedicated BVM mask; the fittings are the same.

Never lay your PSK Altoids tin next to an Altoids tin with product in it.BTDT

Nice Job Jeff! I want you around the next time I do something stupid!

I have had the same trouble with decaying gloves in my belt pouch, tougher versions are also thicker so you cannot store as many, it's a compromise.

Good to know the Fenix AAA was enough light, I also EDC a Fenix L0D.

Mike

There was some ambient light, so it wasn't pitch dark. I just hand held for my initial assessment and set it on the ground to do interventions. There is an upconverted MiniMag in the kit, but the Fenix is my EDC, so I never touched it. I actually pulled the Fenix out at first to see into my kit. There are usually enough bystanders willing to pitch in and hold a flashlight for you. In this case, I set them to cutting the guy's clothes off.

I have some headlamps, and have used them in the past. They'd be great in a FAK. My kit was assembled/evolved from whatever I happened to have on hand at the time, with an eye to keeping the size reasonable, hence no BVM.

Ideally, you want intense spot and flood light to evaluate and treat injures. Ever notice the huge overhead and stand lights in every ER? More is better. I think your idea of a headlamp is probably the best compromise for a FAK, with maybe a low power cheapie for checking pupillary response.

Hey Jeff,

Good idea about the reflective safety vest.

A story from many years ago. My fathers coworker's son had a flat tire at night on an overpass north of Toronto. While changing the tire he was hit by a passing car, thrown over the gaurd rail and stuck again by a vehile below. He was wearing dark clothing at the time; after hearing the story I added a reflective vest to both my vehicle kits.

Mike

Jeff -- many thanks for the tip! Hope the guy is recovering OK...

I tend to not store first aid ointments and medications in my car kit out of concern for extreme temperature fluctuations, but hadn't considered glove deterioration. Also, I only tend to carry no more than 2-3 pairs at a time.

What kind of gloves did you have, if you don't mind my asking, and how old were they? Is there a variety that might possibly be better than others in regards to storage?

One thing I have in my jeep, for reflective material, is an army issue running belt. It is highly reflective, and rolls up to store neatly out of the way. If I need to use it, I just unroll it & wear it over the shoulder and across my body. It is nice & easy to put on, and doesnt get in the way.

Good job, Jeff. Very valuable observation about the gloves. From now on I will keep an eye on this potential problem.

Yeah, gloves go quick. Great job, btw!

Yeah, a BVM is a great thing. I found that out when I had a gal w/ multiple facial fractures, and each breath caused blood to spray everywhere (literally). thank goodness my face wasn't near that, I'd have had blood in my eyes, nose, mouth, ears... etc.

Don't forget some oropharyngeal airways if you do buy a BVM...

Also, a turkey baster works well as a suction device.

I'm not sure which type of gloves you use but here is a recommendation I have learned from lab work and wearing gloves daily.

Nitrile gloves last longer and are more durable than latex. Also what usually degrades the gloves is oxidation (exposure to air). If you can vacuum seal your gloves or put them in a ziploc and remove as much air as possible. As a caveat to the plastic wrap be sure the gloves can still quickly be removed in an emergency situation.

Nitrile gloves wrapped air tight in plastic tend to last dramatically longer (several years). In my experience Latex gloves exposed to air break down the fastest and have about a 3 month or less reliable shelf life. Also Latex can give some folks a rash after use.

Cheers and great job on the rescue! You inspire us all!
~Logan.

One quick question - Guy make it?

No. I read in the paper he died later that evening. I would have been surprised if he did survive. He met trauma alert criteria, had an obvious CBI and a low Glascow score, and suffered respiratory arrest in the field, so his odds were very low to begin with. All that's left is to find and prosecute the SOB who ran him down and took off. Usually they do.

I was using latex. I usually just grab a fistful out of the box every month a two and stuff them into my kit, relegating the old ones to kitty litter duty. Nitrile gloves are tougher, at the expense of some sensitivity. I'll try vacuum sealing some latex ones, labeled with the date, test them over a hot Florida summer, and see how they do. Thanks for the tip.

Atleast you gave it your best shot. Sucks - Hope they find the driver and charge with Murder (which they never do, but)

Good Job Jeff!!!!

Because of Latex allergies, we use the vinyl gloves instead of the latex ones. I've found that they last longer in storage than the latex ones did.

Great points about checking your equipment. There are many things that tend to deteriorate, especially with the heat here in AZ. Gloves, BVM's, oral glucose, etc. I use nitrile gloves and they tend to hold up pretty well. In terms of lighting, lights that use 123A cells tend to hold up the best with a 10+ year shelf life as well as performing in cold temps.

and that why I always carer my fist aid kit

My CPR instructor advised we carry a ziplock with a white cotton washcloth wrapped around a pair of nitrile gloves in the map slot in the door of the car. The ziplock keeps the oxygen from the gloves and the cloth keeps the gloves from sticking to the ziplock. You can glove up as you are getting out of the car and going for a larger kit, and the cloth can be used to control bleeding in more minor applications than the one you came across.

Great job! Thank you for all you do. 'Glad there are those out there like you!