Not trained, what should be in my urban FAK?

I am not a medical professional and have only a little, outdated first aid knowledge.

What should I have in my urban FAK, how should it be organized?

How big will this be? Where do you plan on keeping it? Personal use, or treating others? If your training is minimal (ie, Boy Scouts or something similar), I'd stick with gauze, tape and a CPR mask.

Personal use primarily and maybe cigar box size.

Mini-triage means what exactly?

So how would you orgainize the urban FAK?

[And yes I will ask about a wildernass FAK some time and place later.]

Note Well: I am not a medical professional and all advice I give about this should be independently verified.

The first thing is to update and hopefully upgrade your first aid training. The kit between your ears matters far more than the kit in your pack.

Gloves should be in your kit. You can do first aid without them, but they give you much more peace of mind when working on strangers.

You should have a watch for reading the pulse rate and a notebook with a pen to write it down with.

A cigar box should be big enough for a pair of crash scissors (bandage scissors?).
If you need to cut clothing they are less scary than a knife.

Sticky band-aids are good for minor cuts.
Include a few aspirins and something sweet. Aspirin is for pain, but also for heart attack victims. At the first symptoms of a heart attack the victim should chew one tablet of aspirin for 1/2 a minute then swallow it. You can use Alka-Seltzer tablets the same way.
Candy or sugar can be given to diabetics if they are going into shock. If they are low on sugar it will help them, and if they have too much sugar it will not hurt them.

You should also have a charged cell phone.
If you regularly carry a cell phone then it is taken care of, but if you don't then you can get an old one just for emergency use. It does not need to have any minutes on it. It does not even need to have an account. So long as it is charged you can dial 911. Even if you have a cord to plug it into a car lighter socket or a wall charger it is fine.
I would not try carrying a lot of bulky bandage material, there is usually more than enough stuff around to use for bandages, padding, slings or splints. A small roll of adhesive tape might be handy.


Remember that you are just doing first aid. If it is at all serious they need to get proper medical attention as soon as possible. Since it is an urban kit this is easier.
So you do not need to spend time cleaning wounds. The hospital will do that and load them up with whatever drugs they think are right too, so no antibiotics, heavy painkillers or even wound cleaning if you can help it.
That eliminates a lot of stuff.

If you (or maybe your family members) have a problem like allergies and need an EpiPen it should be in your kit. The same for any other special meds they might need.
A small pair of tweezers would be good for splinters, but don't dig or cut to get a splinter out. Splinters usually just pus up and come out on their own.

Of course, I love it when you talk big words that I don't understand. But does "cricothyroidotomy " mean the cut throat to put in air tube procedure?

Huh? Who doesn't have that in their kit?

Another way of organizing your first aid kit is by having what you'll most likely need first on top. If you don't know what you'll most likely need first, there's the first problem. :-)

As another has said, the most important part of the first aid kit is your knowledge of how and when to use the stuff in the box. I've lost track of how many first aid courses I've taken, but it's remarkable how similar they've gotten over the decades. The people who do the training have gotten together and come up with fundamental principles and training, so the basics are being taught pretty much the same. This gives me confidence that I'm at least getting the standard first aid practices.

I'd really recommend a wilderness first aid course, even if you live in a city. I took a 2-day wilderness course that was the most thorough training I've had - much better than a 1-day overview, with lots more time to practice techniques. Practicing application of the bandaging and splinting is very important.

I'm in a CERT group, and our local fire department gives us annual training for free; check your local fire department for their offerings. They include urban search and rescue.

I'm not sure how widespread this opinion is, but the last guy I had a first aid course from did not hold Red Cross first aid training in high regard, and he thought their CPR techniques were behind current standards. shrug - I haven't had a Red Cross course in over 10 years, so I can't compare them to current training.

Good luck and have fun.

The first FAK-related item you should procure is the receipt from the training class you took. The next item would be the well-read, dogeared textbook from your class.

It's easy to buy gear. It's harder to get educated. Do the hard thing.

Please be careful doing this.

As a former EMT, unless remaining in the vehicle will further endanger them, fire..water..not breathing..etc., if you are not trained in removing an injured person from a vehicle, you shouldn't.

Triage: When there is more injuries than personnel one has to figure out which patients to treat first.

http://en.wikipedia.org/wiki/Triage


I'm all for attending a first aid course. There's no way you can read yourself the skills of CPR, which saves lives. As with several other life saving skills, techniques and methods.


On the other hand there is no magic involved in treating burns (cool it - NOW!), cuts (clean it! cover it!) and other small injuries.


My favorite items are:
- Sterile bandadas (yep, the big triangle cloth). Much easier to apply to basically anything than bandages. Much more versatile.
- Some band-aid and steri strips for minor cuts.
- tweezers
- Aloe vera gel (for itches and burns)
- Something to clean / sterilize wounds.
- Sportstape.
- Any personal medication that you are dependent on.

If you give someone a medication, (i.e. aspirin for a heart attack) are you protected by the good samaritan laws? The reason I ask is that I'm on an emergency response team at my job. We keep fairly well stocked first aid cabinets throughout the campus, but we are strongly discouraged from actually giving someone a medication. We are trained in CPR and basic first aid. Med administration is outside of our scope of practice. The meds in the cabinets are there for someone to pick out for themselves.

Which brings up another interesting point. There have been discussions of putting medications in some sort of vending machine where there is a miniscule charge to buy them. Not for financial reasons, but rather to get them shows a determined effort. Otherwise, if someone were to take a handful of Ibuprofen home and then have an allergic reaction, the company could conceivable be held liable.

Madness .....

Thanks,
LW

We are very strongly advised against medications here too.

The last three times I re-certified for my first aid tickets the only two medications they suggested were sugar if you were dealing with a diabetic starting to have seizures, and aspirin for heart problems (chest pains).
With both of these the drug does no harm if they don't need it and does good if they do need it.

We are severely warned against doing anything invasive like cutting into their airway to insert a tube. You are not a surgeon so don't do it.
The same thing goes for amateur IV.

Even the plastic airways that you put in from the mouth require special training.
It is easy to put them in wrong and open a way into their stomach instead of their lungs.

We are not even supposed to give a person medications that they have with them.
Not even nitroglycerin heart pills or hitting them with an EpiPen if they are having an allergy problem.

We are able to help them take them but not to administer them ourselves.

In California the "Good Samaritan" laws were recently crippled by our state Supreme Court. A person who pulled someone from a vehicle they thought was going to catch fire was sued by the person they rescued. The victim ended up paralyzed, and doctors weren't sure if it was from the original crash or from the removal. CA Supreme court allowed the suit, 4-3. They ruled the Good Samaritan law only protects you when you are giving "emergency medical care", and not for any other acts.

Search for "California Good Samaritan Law" if you want to be further appalled.

I guess as wrong as it seems to be, in this context it makes sense. I googled Good Samaritan Laws and found this on Wikipedeia.

"Good Samaritan provisions are not universal in application. The legal principle of imminent peril may also apply.[8] In the absence of imminent peril, the actions of a rescuer may be perceived by the courts to be reckless and not worthy of protection. To illustrate, a motor vehicle collision occurs, but there is no fire, no immediate life threat from injuries and no danger of a second collision. If a 'good Samaritan' elects to 'rescue' the victim from the wreckage, causing paralysis or some other injury, a court may rule that good Samaritan laws do not apply because the victim was not in imminent peril and hold the actions of the rescuer as 'reckless' and unnecessary"

It makes it difficult to decide what to do. I dunno .... However, I have strayed from the original question about first aid kits. Perhaps this is a topic for further discussion in a different post. Apologies to the original poster for the thread hijack.

LW

Again I am not a medical professional so take any advice I give with two grains of salt and call me tomorrow if it gives you indigestion.

LW, You didn't stray far and I might have helped hijack Dwestes thread too.
I don't think he will mind much. I think he posted it to get people discussing it.

What you should not have in your kit should be as valid of a consideration as what you want in it, especially if space is limited.

I have read other forums and it is very common to see people listing huge kits full of material which the person carrying it has no training for so they wouldn't know how to use it anyhow.
Even if they were trained to use it usually the gear is not stuff that you would use unless you were in a hospital setting.

Here is Doug's basic medical kit from this site here
http://www.equipped.org/survlkit.htm



It is worth noting how simple his kit really is.

He lists 4 prescription items but in an urban setting antibiotics are not needed. The doctors can prescribe medications soon enough to handle secondary infections if they are needed. You should not be giving people narcotics either. Pain managment is more critical if you are in a remote location but painkillers can hurt a person's chances in some cases so it is better to let them hurt a bit until the ambulance gets there.
Even the wound washing material and the bezoin for gluing adhesive tape to skin can be left out in a small kit.

I think people should distinguish between home treatment for minor injuries and emergency first aid too.

From my experiences Medical personnel hated seeing drugs, creams, and lotions used by first aiders.
Here they even tell first aiders not to worry about wound cleaning very much because dousing a wound with antiseptics usually kills more tissue than it saves. Then they have to wash the iodine, betadine or peroxide out of the wound when they treat it anyhow.
They would rather see a simple water rinse and only see that if there is some kind of chemical like an acid, a caustic or a fuel that had to be flushed away.

I followed Mr. Ritter's lead in putting my larger kits together. Please "hijack" away, you guys are doing great.

That is a good link NightHiker.
I found it a good reminder for parts of a course I took 5 years ago.
I was surprised at how much I had forgot.
I guess it is long past time for me to do that course again.

I do remember that one of the problems pointed out in the course was getting responders to move on after the assessment to the next victim instead of continuing to do treatment on the first one they came to.

I think that is primarily due to having it drilled into us that once you establish contact with a victim/patient leaving them is abandonment. In a MCI, aside from the emotional enormity of encountering such an incident, it can take great willpower to override that sense of duty to a particular individual and move on to the next victim/patient.

Pete

Supposedly physicians are terrible at triage, for the same reason. It just takes a different mindset, doing the most good for the most people.

Just to hammer a point made earlier, NEVER do more than you are trained to do, regardless of good samaritan laws, you can easily do more harm than good. The only time you should ever consider removing someone from an automobile after an accident is if you believe they are more likely to sustain a life threatening injury by remaining in the vehicle - i.e. the vehicle is on fire - otherwise do what you can to support life with them in place.

First Aid Kit should contain only products that you are confident in using. If you don't know what it is and how to use it, it shouldn't be in there. Stick with the absolute basics of ABCs, as mentioned earlier.

Airway - held-tilt chin-lift or jaw thrust maneuver - no equipment for layperson is needed - you will NOT being doing a cricoidotomy! - although, I often wonder about suction... very useful, but suction devices are bulky.
Breathing - pocket valve mask, anyone trained in CPR should carry one of these or equivalent
Circulation - bandages in varying size (2x2s, 4x4s, abdominal pads), tape, gauze, trauma shears, cohesive bandages (ACE wrap), tin foil (for occlusive dressings), tourniquet -> only if bleeding cannot be controlled with direct pressure, elevation and use of pressure points!

EDIT: forgot to mention PPE!! I carry 2 pairs of nitrile gloves, a couple face masks (droplet precaution only), and safety glasses.

Never give meds unless they have a prescription for it, and are carrying it, just too risky.

That being said, I do carry a bottle of Benadryl, tylenol, chewable aspirin, and a tube of glutose for low blood sugars. Some people also carry activated charcoal for overdoses, but it's messy, tastes disgusting and people often vomit it back up regardless.

Are the face masks regular N95s?

the greatest kit in the world is useless if you don't know how to use it. the red cross has frist aid class almost ever where I've lost court how many time I've take it and still lean some thing new ever time I take it agian , after that they are some great books the one I like the best is Medical for the Outdoors by Paul S. Auerbach, M.D 4 edition .the best kit I can think of is the one you make up your self . I have a few kits my self the ong I like the best is the M-3 medic bag it's about the size of A lady's pocketbook hold a lot of stuff you'll save your self some money and buy the bag emetiy and fill it up as you go or need thing . good luck

OK folks - someone decided to notify me as a moderator over the lasts posts bad spelling.

I will notedit/block a post over bad spelling (unless the bosses tell me I should)

Charlie

Yup, Raven has terrible spelling.
What Raven said in the post makes sense though.

No. True airborne protection (surgical N95s) are supposed to be fitted and airflow tested - at least in hospitals... I often wonder how effective they are if they are not? So, the masks I carry will not protect me from TB (airborne), but it will offer protection against bugs like the flu and meningitis (both are droplet). I guess it wouldn't hurt at all to carry N95s, since I'm sure they protect against droplet transmitted diseases, and may afford additional protection against airborne disease, regardless of whether or not they have been fitted.

So, what are you using as face protection?

I would say yes and no. I would agree totally, that if a victim is breathing and no life threatening conditions exist such as fire or a leaking fuel tank, you should wait for Emergency Services. However, if a patient is not breathing, has no pulse and the need for CPR has been established, you should as carefully as possible, maintaining some time of C-spine control, get them out of the vehicle ASAP. Remember the adage “life over limb”; if CPR is required leaving them in place is only going to result in death. Effective CPR cannot be readily performed while they are in the vehicle.


Pete

One other consideration is any personal emergency medical needs that you have. I picked this principle up from the military IFAK where each soldier carries a compression bandage, tourniquet, quikclot, etc. on the front of their uniform in case they are hit.

If you are diabetic, have angina, are allergic to bee stings, etc, those items that treat your unique health risks should be in your personal first aid kit. We're not talking chapstick and sunblock. Glucose tabs, nitro, epipens, rescue inhalers should be in your kit so that someone can help you.

You should also consider the sort of work you do and what active risks you take. If you sit in an office, that presents different medical issues than if you are an arborist or go on frequent hikes.

I would add to Pete's comment.
If they are not breathing or beating then they are already dead and you can not kill an already dead person.
CPR needs them on a solid surface to work, and it needs to happen right away to have even a slight hope of working.
In multiple victim scenes the triage system tells you to not even start on them until you have attended to life threatening injuries affecting other victims who are breathing and beating.

Is there a "Triage for Dummies Civilians"?

Yes. First, call 911. Then, if their dead you move on to the next victim. If they look like their going to die from their injuries, you move on to the next. If they look like you can provide aid with what you got, you help them. If there is multiple people and you can do it, write down what you do to the victim and put it where a 1st Responder can see when they get there.

Yes this is cavalier, but its honest. You can't save everyone all the time, and you shouldn't treat outside your ability.

Unless you've got a corpuls in your car

Sure is. Holler at the top of your lungs, like you're in charge, "Everyone that can walk, meet up over here!" Then point to some highly visible landmark.

Bam, you've just gotten your walking wounded out of the way. Everyone else is dead or actually hurt.

The START algorithm is based on "30-2-Can Do." If they're breathing over 30 breaths/min, have a capillary refill >2seconds, or can't follow commands, they're either red (high acuity) or dead. If they pass all 3, but weren't one of the folks that walked to the side of the road, they're intermediate. It's that easy.

The big thing about triage though, is that you keep doing it. Everyone seems to forget (or at least not mention when we discuss it here) that it's an ongoing process. You constantly re-triage based on ongoing medical/traumatic complaints, body's decompensating, resources changing, etc.

In a real world professionally-run event, there's usually one paramedic/EMT running each triage "center" and someone over them, someone coordinating ambulances/helos, someone being gopher, people under the triage "boss" doing the actual hands-on patient care... it's actually rather complex.

Carp, I don't want to totally hijack Dweste's excellent thread, but I really want to pursue this.

Should I repost as a new thread, and you each post your replies, or can the mods move us to a new thread, "Triage for Civilians"? Which is preferred?

2009.09.04: started new thread here: Triage for Civilians

Typed labels might speed things up...

Agreed. A simple class will cover the basics in a couple of hours.

What you're really talking about here is two things: a kit to carry and one for the car or office.

the carry kit is small; meds, some band-aids, misc supplies.

with an office or car kit, just get a commercial one - spend $10-20 at Target or wal-mart and that should suffice.

But the training (and the practice and the reference book/ cards) are the key...take the class.

Going to my CERT application meeting next week.

Hope to get training to assist paramedics.

Dweste, sorry I haven't followed the whole thread but

- taking CERT: realize the first aid instruction in CERT is minimal and focussed mass care triage (greatest good for greatest number). By CERT rules you will leave a fair number of injured to die, and frankly aside from some tips on applying pressure and keeping fields more or less sterile, its kind of a disjointed view of First Aid, I think CERT assumes you've had an actual First Aid course to be effective. In real life you want to have some instruction on how to keep everyone you encounter alive, since not nearly every first aid scenario is a CERT scenario. Red Cross offers a good generalized First Aid / CPR / AED course as an introduction. I heartily recommend a (2-3 day)Wilderness First Aid (WFA) course from someone like NOLS for some practical FA treatment that addresses issues outside the wilderness, such as in the event of a urban disaster when you are on your own with your patients for 24+ hrs.

- assist paramedics: this is specialized training, in the EMT-B (or C?) series. I have seen it at local community colleges, and if I have time and opportunity I might take it for background. By assisting paramedics I assume you mean you want to work as a volunteer EMT, not to be capable of assising paramedics in a rescue situation. Training is nice, but wouldn't qualify you to work with paramedics - they show up, you should be prepared to step aside.

Well, I'm just stating the obvious like a schmuck who just walked into a conversation, which is who I am on this thread, but figured I had better say it anyway.

Thanks for taking the time to say!

My impression, soon to be better informed, is that our class 1 fire department trains willing CERT volunteers in just about everything over time, including several first aid courses.

As it has already been said, knowledge is the best tool. I've taken first aid and have read other first aid guides but nothing I have come across yet compares with A Comprehensive Guide to Wilderness & Travel Medicine by Eric A. Weiss, MD

A roll of medical tape and EMT sheers always comes in handy. The splinter picker/tick remover forceps, found in the Pocket Medic, Ultralight .5 and higher kits, is the best thing I found for removing splinters.

A little more than two years ago, I was running on a sidewalk, tripped and really scraped up my knees. At that time I had with me my EMT sheers and a Pocket Medic modified with a roll of medical tape. That provided the bare minimal to patch me up.

Experience has taught to go with the Ultralight .5. It comes with a roll of medical tape so no modification is needed. If you have ever tried to shoehorn a roll of tape into the Pocket Medic, you would know it's best to go with the Ultralight .5.

Edit: The safety pins in the Pocket Medic and Ultralight .5 are also handy in the event of a wardrobe emergency such as at a wedding. I speak from experience.

Jeanette Isabelle

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Weiss is a good book, I keep one in every backpacking FAK I put together - and when things are slow and when I'm in my tent and its raining, or I'm waiting for my dinner to cook or water to boil (usualy the same thing), I take it out and re-read sections as a refresher.

For less portable Wilderness First Aid books I'm partial to any book in the NOLS WFA series by Tod Schimelpfenig. I happened to take a WFA course from Tod back in pre-history when WFA seemed new, and his direct and practical brand of medicine has seemed to stick through 3 refresher courses since. Can't say it too loud or strongly enough, get thee to a Wilderness first Aid course if you want some decent instruction on treating patients in hard times, eg.post-disaster, or 24 hours up a trail with a bunch of Scouts who are your responsibility. (Disclaimer: no money or consideration from NOLS, just thanks for the solitude their training has given me in tough situations.)

Now back to your post
1St. If you have little first aid knowage. Get some. There are a lot of free first aid classes in most towns. Fire and police sometimes give them also the Red Cross.

2Nd. as for your kit, with your lack or knowlage use the KISS system (keep it simple stuped) a basic kit as Doug's basic kit should do it. After you get training you can up grade the kit.

3rd. As to organization, what ever flots your boat. seperate it any way you like. When you make your own kit you will know where every thing is. I personaly use an old tackle box.

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Guys, be nice -

Probably a MAC. My MAC catches most, (but not all) of my typing/spelling errors as I go, and places a red dashed underscore beneath the word. Then I "right click" on a track pad with only one button, and it gives me suggestions.

Which word processing program do you use? I have tested several word processing programs for Windows and Linux. In my opinion Word Perfect is the best.

Jeanette Isabelle