Accident trauma kit

Last year, A good friend of mine was taking his family on a camping trip when he happened across an accident that had just occurred. A van had skidded off the road and overturned. With no one else in sight he called 911, and grabbed his FAK to help the overturned vehicles occupants. Although no one inside was seriously hurt there were some wounds which required him to tear up his jacket to stop bleeding. When talking to me later, he confided to me that he wished he had better items in his FAK in case this should happen again sometime.

This of course, got me questioning the first aid items held in my truck and wondering if they would be adequate in case of the same type of incident. I decided to make two FAKs for my truck. 1 kit for the small, ordinary items used everyday like band-aids, prep pads etc, and a second kit to hold trauma items in the event of a serious accident. Upon doing my last check of this trauma kit I can't shake the feeling that I am overlooking something very important in this kit. With icy roads here for winter, and the never ending supply of stupid, careless Edmonton drivers this kit has been brought back to the top of this months preparedness priority list. This is what I currently have inside:

1. Quick splint x 1
2. CPR mask, standard x 1
3. triangular bandages x 2(Canadian Military issue)
4. 2 pairs HD surgical gloves
5. Israeli shell dressings x 4(Canadian Military issue)
6. C-A-T tourniquet x 1 (Canadian Military issue)
7. quick clot (Canadian Military issue) x 2 pouches

This kit is designed to provide first aid at the scene of a vehicle accident to my family or someone else until the pros arrive so I am not concerned about stuff like cleaning wounds etc. Most of the items I can get free through the Army, plus I am trained in their use so that is why they are in the kit. I have seen personally while overseas that quick clot works to stop major bleeding(although it hurts like hell once applied) And more than one Soldiers life has been saved by a C-A-T tourniquet. I am trained in Standard first aid, and combat Casualty care which mostly deals with battlefield injuries but that is as fancy as I get. I do not wish to add items that I am untrained to use or which are overly complicated. I would also like to keep it as small as possible for ease or storage. I have all items currently packed in zip-loc bags and then placed inside an LMG ammo pouch. I would like to add a Gerber Hinderer rescue knife or a life hammer(still have not decided what would be best yet) and a plastic airway tube to the kit as well.

I have a feeling I am overlooking something though. Am I missing a vital component??? Any advice, especially from the Para-medic types on the forum would be appreciated.

Taurus, you are way more prepared than I am in this regard, but I do see one simple thing that you might consider adding, which is a blanket. Almost anyone suffering from such injuries, those serious enough to use any of the things mentioned as being in your kit, is likely to also be suffering from shock. And I'm sure my training is not as extensive as yours, nor is it as recent I bet, but keeping a shock victim warm has always been something I understood was important.

I've left one old, wool blanket on a road after an accident. I doubt the kid who passed me on the sportbike moments before he broke his leg can recall anything about the blanket.

Anyway, maybe you should add a mylar blanket or keep an older one on hand.

First I would like to say that your idea of a trauma car-FAK is a very good idea. A car-crash is a good place for many people to get very hurt.. I've got one myself.

Your list also seems good. Some things you should add:

- Gauze, lots of the stuff. Make sure you have 4x4 and kerlix-rolls. The more, the better
- more gloves and a pair of working gloves
- flashlight and safety-vest
- lots and lots of tape. a Roll of Duct-tape is also usefull
- blankets, both wool and mylar


Also, realise that quick-clot and CAT are last-resort means to stop a bleed. Use them only when all other methodes fail.

Good point.
I actually have a couple of space blankets and one Army issued ranger blanket in the truck but they are packed in my Emergency breakdown kit under the back seats.(I love kits) I never actually considered them for use as a trauma item before. Its funny how regardless of training or experience that sometimes we just overlook what is painfully obvious. I wonder if a space blanket is good enough for this purpose??

We always overlook things.

As I wrote the post above, it occurred to me that I had overlooked something. My stuff lacked one of the things I always use or tell someone to use; a cold pack. I've got them in the freezer at all times, but there might be any myriad of reasons that they may be unable to be used. So, I went out this at lunch and bought some, which I will divide between the bags I've got prepared for my wife and myself. Mayeb it's not a trauma item, but a cold pack helps with all kinds of injuries.

I think using a space blanket beats using nothing, but analyzing the kind of job one might do is not my forte.

Anyway, I overlooked the entire idea of a trauma kit like you have. Now, I've found some things that need to be added to the car, thanks to the comments of both Taurus and JIM.

I would say no, a space blanket is not enough.

Add a wool or “disaster blanket” which are generally wool blends and are fairly cheap (under $10 USD). Use the wool/disaster blanket first, making sure to cover the head (with the face exposed) and truck of the body if there is not enough of the blanket, actually two blankets in an overlapping “T” pattern, with the top (which is double layered) of the “T” for the upper body works best and the space/mylar blanket wrapped around the blanked patient, acting as a vapor/wind/rain/etc. barrier.

If it is real cold, you can add a couple of towel wrapped heat packs (to prevent burns) under the blankets.

Pete

Once again, Thanks for the ideas. Its Great to draw from professional experience. I am by no means an expert.
I wanted to keep the kit small enough to keep in the front of my truck in the console, so if I am the one in the accident it is within my easy reach. If I am hurt it would be very hard to crawl to the back of my quad cab to grab the kit from under the rear seat storage bin. Weight is not an issue as I won't be carrying it, but size is. I didn't add any gauze as the shell dressings appeared to be enough, and to keep the size down. There are some items that are always stored in the truck such as an LED headlamp, duct tape, gloves, etc which would always be of use. I don't have a safety vest but I always have road flares. The quick clot and C-A-T tourniquet I use because I have training to use them and I can get them, along with the shell dressings and triangular bandages for free. I hope to never have to use quick lot on a stranger though, especially if it was a child. I have seen a hard core soldier bust into tears and scream at the top of his lungs when the Medics had to close a wound with quick clot.

Good idea with the ice packs. Its appears to be more of a normal item than a trauma item but it sure would be handy to have. I store my items under the center console between the driver and passenger seats of my Ram. That way its within easy reach of me or the wife if we are the ones in the accident. Space is a big issue if I want to use the console as the rest of the available space in the truck is filled with hunting/survival stuff. I wonder if those packs would be affected by constant freezing and thawing by having the truck outside in freezing temp, and then parking it in my garage overnight ??

The ones I bought do caution against exposing them to freezing temperatures and temperatures in excess of 104F/40C. So maybe, this is not an item to keep in a vehicle.

I agree that they are a normal item, not really a trauma item. However, a member of one of my crew's years ago might disagree. Some helped him keep two of his fingers.

I cannot comment on the Good Samaritan Laws in Canada (or any state other then Maryland for that matter) and what if any protection they might afford with respect to both criminal and civil liabilities, but many will not protect you if you exceed your level of training and Scope of Practice.

What does that mean, while you may have had the training in the military, if you are not authorized (Scope of Practice - certification/license) by whatever governmental agency (Public Health Department, EMS, Medical Licensing Board) having the controlling legal authority and go ahead and implement a medical procedure or utilize a medic device on a person that exceeds your Scope of Practice, you may not be covered by the Good Samaritan Law. While it is unlikely (especially if the outcome is positive) you would be prosecuted or sued, the potential is present.

I certainly will not discourage you from using any medical procedure or medical device in a life threatening situation, just be aware of unexpected consequences of such actions.

Pete

Very good point. As far as I know the laws here are very good in that regard. I am not anywhere near the level of training as someone like yourself. My training involved mostly battlefield injury, such as shrapnel wounds, burns and moving soldiers out of armoured vehicles by pulling on TAC vest straps and the like. Most of this has little place in the Civilian world. Maybe I should find a suitable replacement for the quick clot.

HemCon-bandages (shrimp-bandages) and Gauze have their own place. Furthermore, HemCon is $80/100 per bandage and they do the same thing as Quick-Clot. I would suggest that you pick just 1 and definately get some gauze. 2-3 rolls of Kerlix will get you a long way, won't break your bank ($2-3 a roll) and if you get Pri-Med gauze (wich is even cheaper), it packs down quite small (a deck of cards).

Also, what kind of Quick-Clot do you have? The original,powder form does get quite hot, as oppose to the newer ACS+ and 1st-Response versions.

I only have the original stuff. It is Currently Army issue and comes in small olive drab vacuum sealed pouches. I use it only because it is available. It does get very hot when it is applied to wounds. I have only seen it used once to close a wound, and I won't be forgetting that anytime soon. I think the guy actually passed out from the pain, but he lived.

Mylar emergency blankets can also be used to keep rain and snow off a victim, and off the people caring for him. I passed an accident once where it looked like a couple of civilians were stretching an emergency blanket over the victim and the paramedics caring for him (or her) in the rain.

It may not be a necessity, but it certainly could be a kindness. In bad weather, I'll be those paramedics run from one accident to the next, without taking time to change to dry clothes.

Sue

I'll agree with the gauze, blankets, GLOVES and ice packs. Also, given you're in Canada, how about some of the heat packs? 1 in each armpit and 2 in the groin can help maintain heat.

Ace bandages- you can't sit there holding pressure all day if there are multiple wounds.
4x4's. They're dirt cheap, and you can save the bigger trauma bandages for the real nasty wounds.
Second duct tape.
If you're comfortable, a C-collar. Just beware of the legal ramifications of leaving somone alone that you've applied a collar to.

One of these days I'll get around to posting my car's FAK.

After spending 30+ years responding to traffic accidents, more than 20 of them as an EMT, I figured out what I needed more than anything, so, even tho I had a pretty good kit, compete with oxygen, hard collars, etc, what I stuck right on top, for easy access, a bunch of ziploc bags, each one packed with a stack of 4x4's, a roll of Kling (or whatever is available now, a roll of stick to itself gauze), a roll of surgical tape with one corner turned under (peeling up the end of tape with gloves on is a bummer), and a pair of those gloves. Add a pocket mask, with one way valve, if you know CPR, and a pair of EMT shears. We had "body blankets" in the vehicles, but add anything to help keep body heat in and the weather out. Down a tad deeper a couple of sanitary pads, for lacerations larger than a 4x4.

If you have the trng, some vaseline gauze for a sucking chest wound, and some sterile saline if you are lucky enough to encounter an abdominal evisceration. But with enough of those 4x4's you can do a lot of good...

The training I have with sucking chest wounds is strictly of a military nature, Bullets or frag as opposed to shattered ribs against a steering wheel. As such I carry an Asherman chest seal in my hunting packs trauma kit (the self adhesive one with the little rubber valve in the middle) I don't have it in the truck because It is designed for a single puncture, as which could result in a hunting accident. Maybe I will toss one in the truck if it is something common to vehicle accidents though. I am not trained to use I.V, saline, or fancy stuff and as such I will stay in my own lane and do only what I know. I would hate to make matters worse for someone. The whole point of the kit is only to keep an airway open, stop bleeding and prevent shock until the professionals arrive on the scene. As such, the first thing I plan to do is call, or have someone else call 911. I have seen some bad things in my time, but was always fortunate to have a Medic at hand. I honestly wouldn't know how to handle an abdominal evisceration.

Just a quick question OBG. Would you recommend a rescue knife, like the Gerber hinderer or a life hammer to be the better tool?? I figure the first thing after calling for help would be to get the person out of the vehicle somehow. With 30 plus years under your belt, you must have done it more than a few times. I carry a bunch of tools in the Ram, but none are specifically designed for rescue. I plan to add one of these to have within easy reach, just in case.

I'll second the Ziploc bag method.
The big kit is totally secondary to the bag of stuff to stop the leaks and plugs the holes - and the majority of that is 4x4 and 6x6 sponges, tape, Sticky Gauze, Shears, Mask and Nitrile Gloves. Under that is a blanket and a towell. I do the current version of CPR - compressions only - and don't need/have the CPR mask anymore.

I used this kit at a motorcycle wreck I happened upon in New York City not too long ago, it did exactly what I needed and best of all the paramedics that showed up replenished my kit for me from their stock right there on the scene!

wool blankets are constantly on sale at Sportsmansguide.com - that's where we buy ours for the fire company.

I third the ziploc method.

To get people out of the car? Try opening the door. Really, a little muscle goes a long way. If you can't get them out that way, you probably shouldn't be getting them out. Let the professionals do that. I don't think Good Sam laws will do much good after you've paralyzed someone by enthusiastically "rescuing" them when they were trapped but in no danger.

I don't know what the roads are like where you are, but on some of the long isolated stretches of road I travel on( especially in winter) accidents usually involve smashed, overturned vehicles which have hit black ice and either hit another vehicle head on, or skidded off the road to hit a tree or slide down an embankment. On any Canadian Highway there are frequent collisions with Moose or deer and these are normally very serious if not fatal. At any rate, the accidents are more than the fender benders usually found in the city. If the Dammed person wasn't in any danger as you put it, then they would be able to open the door and walk out themselves. The Trauma kit is something that I designed to put in my vehicle in the event that I happen across someone who has suffered TRAUMA. This alone might indicate that they are in danger. If you can open the door of a car that is smashed, upside down and in three feet of snow using "muscle power" and then somehow chew through a stuck seat belt, then you are a better person that I am. For the rest of us, that is why they invented rescue tools. I do not pretend to be EMT, or a para-medic etc, but I don't expect professional help to arrive for at least 30 minutes depending where I am.

Don't forget eye protection (as I was reminded by some blood splatter last weekend bandaging up my anxious son's finger).

The point that MD is trying to make is this:

Is the person in IMMEDIATE danger from a condition that they can only be protected from by removing them from the vehicle? If the answer is no, don't bloody move them.

The only time I'd ever pull someone out is if the vehicle was in immediate danger of catching fire or they were about to need gills. And I've had training for vehicle extractions. I don't care if it is getting cold- manage their hypothermia by bringing heat to them, not them to heat. I wouldn't even pull them out if the car was about to go over a cliff- I'll stabilize the vehicle first. There is more to this than just spine issues- a broken rib can puncture the lung or pericardium. A broken femur or humerus can cut a major vessel leading to a internal bleed out in minutes, or sever a major nerve. I don't even care if I can't tell what is leg and what is dashboard any more- I'll get the bleeding stopped as best I can, but I'm not pulling them out, I don't have the proper equipment to extract them without probably worsening their situation. After I get the door open for them (pry bar, not chainsaw), if they can't get out on their own, they are staying there until the guys with the big truck show up. I'll do everything in my power to keep them alive, warm and from freaking out, but I will not endanger someone that way.

You are relying on military training. I hate to tell people this, but there is a lot of times where military training teaches you the wrong damn thing. No one is lobbing HE at you, there aren't snipers about, and odds are the vehicle isn't about to burst into flames- you don't have to pull them out. Dig in, keep them alive where they are, and call for the cavalry. I get basically the same kind of weather you do here, and I know all about places where you can spend an hour or three and not see another car on that stretch of road. You get the stable, keep them warm, mark the position from the road as best you can, and if no one is with you and you can't get a call out, you tell them you are going to get help, make sure they understand that, and you go.

You make a very valid point.
I should have been a little more specific in regards to why I wanted to add a rescue tool to the kit. I am a big WHAT IF kind of person. Just like everyone else here I suppose. I wanted to add such an item just in case I had to get someone out of a vehicle in a hurry. If there is no immediate danger to remove them then of course I won't. The biggest reason for me adding it would be in the event that I need to get myself out of my truck after an accident. After reading back through the post I realize that I never really pointed that out. I never intended on busting windows and pulling people out of their vehicles without so much as checking or asking if they were alright!!

Seems to me that a rescue tool would be a good thing to have. It’s not about moving the victim; it’s about getting to the victim to render aid. Basic medical aid calls for not moving the victim unless they are immediate danger from being inside the car. Moving the victim unnecessarily can cause (further) back and neck injury. But if you see blood spurting and the door won’t open, the window needs to go.

For your own personal protection, either a Life Hammer or a rescue knife would do fine. If you are going to use something so help someone else, better stick to the rescue knife. It’s much more versatile than the Life Hammer.

"...I do the current version of CPR - compressions only..."

I have read about this here more than once, but when I checked the American Red Cross website, among others, I can find nothing official about it. Can you give me some hints as to where to find info on compression only CPR???

"...I figure the first thing after calling for help would be to get the person out of the vehicle somehow..."

Actually, unless there is a threat of fire, getting the person out of the vehicle should be waaayyyyy down on your priority list. The victim could have all kinds of C-spine type injuries, and if you go yanking him/her out of the vehicle without proper immobilization, you could turn him/her into a quadraped, or worse. Stabilize, insure a clear airway, stop major bleeds, and wait for the professionals with hard collars, back boards, IV's, etc etc etc.

You even have to be careful just breaking a side window to gain access to the victim. If there are open wounds, glass frags can get into them. Glass does not show up on x-rays, is very hard for a doctor to see, and can remain in a now-closed wound, causing all kinds of problems in the days to come. I used to carry a bunch of CHP give away bumper stickers with me, if I had to break a side window with a victim inside, I would plaster it with stickers first, then break it with my spring loaded centerpunch (without a doubt the easiest way to break a tempered glass window). Instead of breaking into a jillion pieces, it would be pretty much held in one piece by the stickers, and could be lifted out away from the victim...

"...at least 30 minutes..."

I used to work I-5 in central CA, and a 30 min eta for an ambulance was FAST. I have had to wait, in fog season, for over two HOURS for an ambulance to arrive. But still, in almost 100% of those cases, leaving the victim in the vehicle is the way to go. It is possible to do CPR on a person still upright in a car seat. Not easy, but doable. If you do have to remove a person from a vehicle, you need to know the proper procedure to do so which will cause the least amount of additional damage. And I know of more than one case where a victim, thinking that he/she was OK, hopped out of the vehicle with a cracked vertebrae, then suddenly collapsed, never to walk again. In any collision, maybe excepting a real minor fender bender, you have to assume a possible c-spine injury...

I have learned a lot of good things from the info given on this thread so far. Thanks a bunch to all.

I have decided after listening to the experts on this subject to make some changes to the kit in my truck. First of all, I will dump the quick clot. As some of you have pointed out, there is a world of difference between Military training and what one will face in the Civilian world. The quick clot I have causes severe pain when applied. Maybe I will find an alternative item to replace it with later. I have decided to dump the quick splint for space reasons, as I can improvise one easily enough IF I had to. I will add a roll of gauze, and maybe a gel burn dressing. The C-A-T tourniquet will most likely be dumped as well, as they can be improvised with just about anything. I upgraded the fire extinguisher that I carry in the truck. It doesn't hurt to have a quality fire extinguisher in any situation. I have decided on the Gerber hinderer rescue knife over the lifehammer. Although more costly it is also more versatile. An ex Army friend of mine who is now an Edmonton City cop told me it is what a lot of the police and the firefighters use and it has never failed them. I listened to the advise of the folks who use them almost on a daily basis. And most of all, I plan to take a week long basic first responder course in the new year. Although not part of the kit per se it is probably going to be the most important factor in actually carrying it in the truck in the first place. This course covers the basics in emergency first aid administered at the scene of a vehicle accident. I hate to always bring up army training, but that is what I know. I always default back to it without realizing it.
Once again, for all the help. Thanks

The pain Quick-clot causes mostly has to do with the way how it's used IOW not removing exces blood before applying it (once again, gauze-pads are used for this).


So you now have:

. CPR mask, standard x 1
. triangular bandages x 2(Canadian Military issue)
. 2 pairs HD surgical gloves
. Israeli dressings x 4(Canadian Military issue)
. Gauze rolls
. Burn-dressings

Good, now you should get:

- More of everything, especially gauze, according to how much space you have.
- EMT-sheers (cutting clothes with a knife isn't ideal)

And I would call it a job well done Don't forget to post the pics of the kit on this forum!

[img][IMG]http://i252.photobucket.com/albums/hh19/zazabu531/th_trucktraumakit.jpg[/img][/img]

This is the truck trauma kit as it stands now. Not show is the plastic airway tube (I need a new one) and the Gerber hinderer rescue knife, which will be kept in the cubby hole in the drivers door of the truck when it arrives in the mail. I have added two rolls of gauze pictured top left, and a chest seal similar to the one I carry in my hunting backpack first aid kit. I tossed in a heavy duty set of medical scissors, and upped the medical gloves to three pairs (not shown) I also added 2 more shell dressings.


[img][IMG]http://i252.photobucket.com/albums/hh19/zazabu531/th_removeditems.jpg[/img][/img]



These are the items removed from the kit. C-A-T tourniquet, Quick clot and quick splint.



[img][IMG]http://i252.photobucket.com/albums/hh19/zazabu531/th_smalltruckkit.jpg[/img][/img]

This is the smaller kit that I was talking about. This is for the normal every day first aid.
In no particular order:
1. Knuckle bandage x 3
2. Band-aids x 10
3. Gauze pads x 3, assorted sizes
4. No.4 pressure bandages x 2
5. Butterfly sutures x 2
6. Assorted safety pins x 10(not shown)
7. Adhesive dressing strips x 2
8. Alcohol prep pads x 10
9. Ammonia inhalant crush vial x 1
10. SS tweezers
11. Surgical tape, wrapped around card board to save space
12. Gauze roller bandage,1 inch x 5 yards
13. Tablets (Imodium x 2, pepto tabs x 6, Ex strength Tylenol x 12, Gravol x 4)
14. SS needles x 2
When hunting or backpacking, this kit goes in my pack as well as my hunting trauma kit which holds items specific to hunting related injuries(not shown)



[img][IMG]http://i252.photobucket.com/albums/hh19/zazabu531/th_medkitsizecomp.jpg[/img][/img]



Last is a size comparison pic showing the trauma kit(all items packed in zip bags and then placed in LMG pouch) The red pouch is the normal first aid kit. The LMG pouch fits nicely in the centre console of my truck and has a shoulder strap. I have it marked with the standard red cross in case I need to tell someone else what to grab out of the truck. It is a lot easier than trying to describe what an LMG pouch is. I use these pouches for a lot of other stuff,so This just avoids the confusion, and is easy to see in the dark.

For the most part, I worked in an urban environment. I did a few calls out in the sticks, but like OBG, I was in California. So weather concerns weren't usually an issue. And I've never worked an auto-vs-moose But a wreck is a wreck, with many similar concerns. I'm glad that others have echo'd what I said, that keeping the person from moving is usually the best course if you're by yourself. After all, the first thing you'll learn in your First Responder course is SCENE SAFETY. Probably in those exact words. So in addition to hurting the patient, you don't want to throw your back out either...

Anyway, I'm probably going to start beating a dead horse here in a second. Hopefully I didn't offend; if so, my apologies.

I'm actually in the midst of taking pictures of my car FAK, so hopefully it'll be up in a few hours, and we can stimulate some more pros/cons of kits.

[quote=MDinana
Hopefully I didn't offend; if so, my apologies.

[/quote]

Oh hell no!! I wasn’t offended in the least! It is hard to show the mood you are in when you are halfway across the world from someone via computer screen. If I feel someone is being sarcastic with me then I enjoy shooting it back at them that’s all. Much the same way I would if talking with any of my friends. Sarcasm is the most enjoyable form of humor in my opinion. At any rate, I wasn’t trying to offend either. I actually enjoy getting burned on the forum by someone, it keeps me on my toes and it is usually all in good fun.

From OBG:
"I used to carry a bunch of CHP give away bumper stickers with me, if I had to break a side window with a victim inside, I would plaster it with stickers first, then break it with my spring loaded centerpunch (without a doubt the easiest way to break a tempered glass window). Instead of breaking into a jillion pieces, it would be pretty much held in one piece by the stickers, and could be lifted out away from the victim..."


Great idea. note to self: use roll of duct tape in car kit to serve the same purpose.


I took a BASIC First Aid Class recently, and it was a little frustrating. It seemed like the instructor just kept saying "make them comfortable and call 911." I wanted to learn how to use the SAM splint everyone has in THEIR kit, and other REAL first aid stuff. Then I remembered what I had learned here about not overestimating my ability...and I took her point.

Now that you have taken the Basic, try to find an advanced First Aid Course. That should cover the splinting, sucking chest wounds, pressure points, etc.