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#211928 - 11/26/10 01:44 PM Re: Range Trauma Kit - Need Some Help. [Re: cliff]
LesSnyder Offline
Pooh-Bah

Registered: 07/11/10
Posts: 1639
Loc: New Port Richey, Fla
I go with all the gadgets I can...syringe for irrigation, Celox, Israeli dressing, Kerlix gauze and roll, stretch cling tape, Betadine, petroleum gauze for sucking chest wound... will add nasalpharangeal airway and something to reduce tension pneumothorax (I collapsed my own lung in a scooter accident)....I'm good at listen carefully to professionals when need be...can't think of a side effect worse than death....to aid aerial medevac a couple of chemlights and piece of weighted string to circle overhead to indicate a hazard clear LZ if needed....from previous post, nitrile gloves (3)pair, and small bottle of Clorox/water for me..

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#211931 - 11/26/10 03:32 PM Re: Range Trauma Kit - Need Some Help. [Re: cliff]
hikermor Offline
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 7373
Loc: southern Cal
Just one thought. Be sure to include some band-aids along with the more serious items. You will probably see about two dozen bloody hangnails for every gunshot wound, even at the range.
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#211932 - 11/26/10 04:03 PM Re: Range Trauma Kit - Need Some Help. [Re: hikermor]
chaosmagnet Offline
Sheriff
Carpal Tunnel

Registered: 12/03/09
Posts: 3436
Loc: USA
Originally Posted By: hikermor
Just one thought. Be sure to include some band-aids along with the more serious items. You will probably see about two dozen bloody hangnails for every gunshot wound, even at the range.


We tend to keep our first aid kits for minor issues separate from the trauma kits, when on the range. I've treated any number of boo-boos on the range without ever once (thankfully) going into the trauma kit.

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#211946 - 11/26/10 10:03 PM Re: Range Trauma Kit - Need Some Help. [Re: cliff]
MDinana Offline
Pooh-Bah

Registered: 03/08/07
Posts: 2196
Loc: Beer&Cheese country
Skip the quick clot granules. The bandages are *probably* OK - it doesn't really matter which size, as long as you're comfortable with it. But if you're going to worry, just get "the biggest one." That being said, the military is going towards Combat Gauze, so that should tell you something. Pretty much it's like Kling or 4x4's, you shove it like crazy INTO the wound, then pressure on top. Don't ditch those 90's era bandages, since the Israeli bandage is just a fancier version of it.

Buy a dedicated tourniquet. It's been covered before on ETS fairly recently.

Buying one of those Asherman bandages is up to you. Personally, I've never seen one used - vaseline gauze and tape seems to be good enough still in the civilian EMS realm for chest wounds.

Which blood thinner are you on? Pretty much no matter what, it's going to be a PITA to stop your bleeding. But you should probably carry something in your kit about your meds, so if you're injured, those responding will know why you're bleeding so much. Plus, there are some ways to counter certain drugs that the ER can do.

I'd personally carry more supplies, including ALS level, but I have lots of medical training.... which is my subtle hint (like everyone else) that you should update your knowledge base!

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#211961 - 11/27/10 05:20 AM Re: Range Trauma Kit - Need Some Help. [Re: cliff]
Alan_Romania Offline

Addict

Registered: 06/29/05
Posts: 631
Loc: Arizona
This has been covered pretty well here, there are a couple points I would like to highlight or discuss more, in no particular order:

Training: Get some training and practice with the supplies you will have in your kits. Not all dressings or tourniquets are the same.

Occlusive Dressings:
Asherman chest seals are not worth it. There have been and continue to be serious issues with the adhesive, without backing them up with tape they are useless. The newer Bolin Chest seals are better, but for the money Halo Chest Seals are a much better choice. The Halo seals work better and the packaging is more robust.

For a simple and cheap occlusive dressing, I put 2 4"x4" gauze pads and 2' of 3" tape in a zip-lock bag. Place the gauze pads on the wound and tape the plastic bag over it to make an air tight seal.

Hemostatics

Like MDinana typed, if you do decided to carry a hemostatic the impregnated dressings are the way to go. While there is still a time and place for some of the loose granules or powdered hemostatics, their applications in both the civilian and military realm is limited significantly and should be used only by advanced providers. Both QuickClot and Celox have reasonably priced hemostatic dressings, the best bang for the buck is the rolled gauze hemostatic dressings.

Quote:
Perhaps the most important question would be, "How long would it take for a capable paramedic to respond to your 911 call?" Transport in a private vehicle might or might not be a good idea. The paramedic will be in communication with the ER, and will have expanded capabilities over even a well trained layperson. They can best utilize the "Golden Hour."


In response to this question, the answer would have to be how close exactly are you to the ED? If you are across the street from a Hospital with a bleeding patient and there is no concern for neck/back or head injuries, then maybe it may not be bad idea to just get the patient to the ED as best as you can. In most other situations, it is probably best to call 911. One thing most don't consider; is the closest ED the right one? In the end, definitive care for significant trauma is SURGERY and not every hospital has the capability to get a patient in front of a surgeon quick enough.

You can facilitate how quickly EMS crews can find you: know the address of where you are. Seriously, we have been dispatched to 2 calls today where the caller didn't know the address of where they were. For more remote locations, GPS coordinates are very helpful.

What I carry in my Range Kit

This kit fits in a 8"x4"x14" pouch that can fit in my range bag, it is for just BAD stuff. A modified AMK 0.5 lightweight kit is also in my range bag for boo-boo stuff.

2- "H" Compression Bandages
2- Halo Bandages
2- Z-PAK Gauze Dressing
1- Celox Trauma Gauze (3"x6')
2- Halo Seals
1- 30fr NPA
1- 28fr NPA
1- Surgical Airway Kit
1- Needle Chest Decompression Kit
1- Trauma Shears
4- sets of EMS gloves
2- TK4 Tourniquets
1- small roll duct tape
1- Pocket BVM

I do carry an IFAK on my belt when using firearms in remote areas and for some classes etc. This kit I carry in a small IFAK pouch made by High Speed Gear. I keep this kit simple and carry:

1- "H" Compression Bandages
1- 14g IV cath for chest decompression
1- 30fr NPA
1- Pair EMS gloves
1- Trauma Shears
1- McMillian Tourniquet (attached to the outside)
1- 24" duct tape

Keep you IFAKs simple, clean and streamlined. It will make it easier to find what you need when you need it.



Edited by Alan_Romania (12/16/10 05:13 PM)
_________________________
"Trust in God --and press-check. You cannot ignore danger and call it faith." -Duke

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#211964 - 11/27/10 06:03 AM Re: Range Trauma Kit - Need Some Help. [Re: cliff]
Alan_Romania Offline

Addict

Registered: 06/29/05
Posts: 631
Loc: Arizona
About Bleeding Control

Stop profuse bleeding first. A patent airway is useless if the patients ability to carry oxygen to their cells is a sticky messy puddle on the ground.

Commercial military style compression bandages and tourniquets are you best investments. Hemostatics do work, but pressure dressings and tourniquets are more durable and more likely to be what you'll need. For the cost of 1 Celox Trauma Gauze you can get 2 - Compressions Dressings AND 2 - TK4 tourniquets.

For extremity wounds, if pressure doesn't stop the bleeding use the tourniquet. If the limb was savable prior to tourniquet application it still will be for HOURS after application.

Commercial tourniquets work better and are simpler (i.e. quicker) to apply. You don't need the most expensive models, the $5 TK4 work well. If you do want a more robust tourniquet, stick with models that don't have ratchets or cranks that could easily break. In my opnion, besides the TK4, CAT, SOF-T or the McMillian Tourniquet are the only decent tourniquets on the market. BE WARY of knockoffs!
_________________________
"Trust in God --and press-check. You cannot ignore danger and call it faith." -Duke

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#211975 - 11/27/10 01:46 PM Re: Range Trauma Kit - Need Some Help. [Re: Alan_Romania]
hikermor Offline
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 7373
Loc: southern Cal
Thank you very much, AR. Just the kind of comment I was hoping for.

Really appreciate the comment about knowing the address of your location. Simple, elementary, and obviously true.

One further question. For backwoods locations, what system do agencies prefer? Is there a standard? I use UTM routinely, but here in coastal Southern California and on the islands, the Coast Guard prefers decimal lat/lon. What do they use in Minnesota and elsewhere?
_________________________
Geezer in Chief

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#211982 - 11/27/10 03:17 PM Re: Range Trauma Kit - Need Some Help. [Re: hikermor]
MDinana Offline
Pooh-Bah

Registered: 03/08/07
Posts: 2196
Loc: Beer&Cheese country
AR makes some good points. His IFAK list is pretty spot on, and what I'd carry if deployed (and essentially all of which is in my trauma kits). Though I'd add a couple extra supplies to start IV locks. Something that can be connected to an IV fluid if needed. The rationale being, it's easier to get a line in someone when they've got more blood in them. 30 minutes of blood loss can seriously diminish your chances for a good line, and most civilian EMS places aren't trained up on using interosseous lines in adults. (Just one more thing the military's been trying lately - better medicine through death)

The CAT and the SOF-T are the ones that the US military uses. Both one-handed and fairly easy to apply. The SOF-T are preferred but apparently harder to find (the metal bar makes it slightly more robust).


Edited by MDinana (11/28/10 04:13 PM)

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#211987 - 11/27/10 04:44 PM Re: Range Trauma Kit - Need Some Help. [Re: cliff]
Alan_Romania Offline

Addict

Registered: 06/29/05
Posts: 631
Loc: Arizona
GPS Coordinates

The "standard" for emergency response is supposed to be Degrees Decimal Minutes (ddd mm.mmm"). But, and Degrees format should be fine. I know I can put ant Decimal Format into the MCT (Mobile Computer Terminal) on my Engine. I have setup my GPS handhelds to display this format and UTM (which I prefer to use with paper maps).

Obviously, you want the Datum set to the paper map you are using but the responding units may be on a different Datum. WGS84 is the Datum to use when given GPS coordinates to Aircraft.

IV start Stuff

Mdiananna is correct, it is much easier to get IV access early in a patient with significant trauma. In my range bag, I didn't add IV start stuff due to a space/room requirement I set for my self (wanting the kit to fit in my range bag). I decided that with the urban ranges I shoot at being very close to paramedic units (3-5 minutes if they are in quarters) and since I would typically be on scene at the time of injury by the time I was at the point I would be getting ready to start an IV help would be arriving.

In the remote setting, I carry much more including IV supplies. I have the luxury of being able to be bring a full complement of advanced life support equipment including a medications, ECG/defibrillator or AED. However, I typically stick to a larger version of my Range Kit that adds more advanced airway management, IV supplies, basic complement of medications and larger quantities of bleeding control stuff. This kit also includes a cheap GPS (an old eTrex) with spare batteries and set to the right coordinate system and datum, signal gear (a strobe, smoke and signal panel) and stuff to keep a patient warm.
_________________________
"Trust in God --and press-check. You cannot ignore danger and call it faith." -Duke

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#211999 - 11/27/10 11:55 PM Re: Range Trauma Kit - Need Some Help. [Re: Alan_Romania]
cliff Offline
Sultan of Spiffy
Enthusiast

Registered: 05/12/01
Posts: 271
Loc: Louisiana
Alan!!

Long time! You going to be there in January again?

.....CLIFF
(like, who else?)

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