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#289495 - 06/20/18 12:33 PM Customizing Your Medical Kit
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
Yesterday I received my Home & Vehicle Plus Kit.

https://www.chinookmed.com/01375/home-vehicle-plus-kit.html

Here is a list of what it comes with, straight from the factory:

MEDICAL INFORMATION
(1) Emergency First Aid Pocket Guide

PERSONAL PROTECTION
(1) Biohazard Waste Bag
(1) Hand Sanitizer, 1 oz.
(1) Rescue Mask, Soft Case
(12) Personal Antimicrobial Wipe
(4) Emergency/Survival Blanket
(4) Respirator Mask
(8) Nitrile Glove

BLEEDING
(1) SWAT-T Tourniquet
(1) QuikClot, 25 g
(2) Trauma Bandage, 4"
(2) Compressed Gauze

WOUND / BLISTER / BURN
(1) CoFlex LF2, 2" x 5 yd.
(6) Trauma Pad, 5" x 9"
(1) Burn Dressing, 4" x 4"
(3) Burn Jel, 3.5 g
(1) 30 Band-Aid, 6 Knuckle, 6 Moleskin
(1) Cloth Tape, 1" x 10 yd.
(12) Antiseptic Towelettes
(2) Benzoin Swabsticks
(2) Oval Eye Pad
(2) Petroleum Gauze, 3" x 9"
(2) Povidone-Iodine, 22 mL
(2) Wound Closure Strips, 0.25" x 4"
(6) Cotton Tipped Applicator, 6"
(6) Sterile Gauze Pad, 4" x 4"

IMMOBILIZATION
(1) Disposable Cold Pack
(1) Disposable Heat Pack
(1) Elastic Bandage Wrap, 4" x 4.5 yd.
(1) Splint, Orange, 4.25" x 36"
(2) Triangular Bandage

MEDICATION
(1) Dentemp
(1) Eye Wash, 4 oz.
(2) Glucose, 15 g
(12) Acetaminophen, 2/pk (Analgesic)
(12) Aspirin, 2/pk (Analgesic)
(12) Diamode, 1/pk (Anti-diarrheal)
(12) Diotame, 2/pk (Stomach)
(12) Diphen, 1/pk (Antihistamine)
(12) Ibuprofen, 2/pk (Anti-inflammatory)
(6) Hydrocortisone 1% Creme, 1.5 g
(6) Triple Antibiotic Ointment, 0.9 g
(2) Hydration Powder
(2) Oral Rehydration Salts
(1) Insect Bite Treatment

INSTRUMENTS
(1) Catheter Tip, 18G
(1) Digital Thermometer
(1) EMT Shears, 7.25"
(1) Irrigation Syringe, 20 mL Luer Lock Tip
(1) Tweezers
(3) Safety Pins, 2"
(1) Disposable Penlight
(1) Flat Duct Tape, 1.89" x 2 yd.

I swapped the Emergency First Aid Pocket Guide with Wilderness & Travel Medicine. And I ordered the Bear Claw Glove Kit to replace the standard issued nitril gloves.

https://www.narescue.com/adventure-rescue-products/bear-claw-glove-kit

I have ideas for additional upgrades such as getting a Bolin Chest Seal, wound seal, two nasopharyngeal airways with lube (28 Fr), 4" x 16" burn dressing, activated charcoal, Tactical Combat Casualty Reference Card, two Tactical Combat Casualty Care Cards, permanent marker and replacing the SWAT Tourniquet with a C-A-T. What I am not sure of is the Combat Eye Shield.

https://www.chinookmed.com/item/500720/h-h-medical-combat-eye-shield/1.html

The kit comes standard with oval eye pads. What I want to know is, would the Combat Eye Shields make a difference or are they no better than the oval eye pads?

I welcome suggestions for more modifications.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289496 - 06/20/18 01:04 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
hikermor Online   content
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 6536
Loc: southern Cal
I would find space for a stethoscope and BP cuff - it is a really good idea to diagnose before treatment and a careful patient survey, right at the start, is crucial. Often an obvious traumatic injury directs attention away from a more serious, but less obvious, problem (bloody arm fracture vs. potential spinal/cervical FX).

Some sort of notebook, writing instrument to record symptoms, times, and progression. This will be much appreciated as you hand off the victim for further care. OTOH, this happens so rarely, they may not know how to deal with it.

So much is situational. you would want different meds if dealing with high altitude problems, but that is probably not an issue in Florida.

You can never have too many sterile pads or kling wrap....

I don't see anything for CPR - a face mask for that purpose is not absolutely critical, but it is quite useful.
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Geezer in Chief

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#289497 - 06/20/18 01:37 PM Re: Customizing Your Medical Kit [Re: hikermor]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
Originally Posted By: hikermor
I would find space for a stethoscope and BP cuff - it is a really good idea to diagnose before treatment and a careful patient survey, right at the start, is crucial. Often an obvious traumatic injury directs attention away from a more serious, but less obvious, problem (bloody arm fracture vs. potential spinal/cervical FX).

I'm not confident I can squeeze the C-A-T in there. There's definitely no room for a stethoscope and blood pressure cuff.

Originally Posted By: hikermor
Some sort of notebook, writing instrument to record symptoms, times, and progression. This will be much appreciated as you hand off the victim for further care. OTOH, this happens so rarely, they may not know how to deal with it.

I included that in my suggested upgrades.

Originally Posted By: hikermor
So much is situational. you would want different meds if dealing with high altitude problems, but that is probably not an issue in Florida.

Even when I bug out, I will not be in a high altitude.

Originally Posted By: hikermor
I don't see anything for CPR - a face mask for that purpose is not absolutely critical, but it is quite useful.

I have it listed in the standard equipment.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289498 - 06/20/18 02:44 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
haertig Offline
Pooh-Bah

Registered: 03/13/05
Posts: 2014
Loc: Colorado
You mentioned adding nasopharyngeal airways, I would recommend oropharyngeal airways in addition (or as a replacement). They both have their pros and cons, and may be considered interchangeable (in most cases). However, in many years being a paramedic, I often times used oral airways and never once used a nasal one, although both types of airways (and more advanced ones too) were stocked on the ambulance. Just sayin' ...

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#289506 - 06/20/18 04:52 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
hikermor Online   content
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 6536
Loc: southern Cal
Who says the BP cuff and steth have to be inside the "official' container? As long as they are accessible and handy, they are available for use. That is what is important.

It all comes down to the situation in which events occur. My experience involved disabling trauma of various sorts, usually FX of various sorts and care for periods of two hours to a day or so. I eventually carried the cuff and steth, a couple of splints, a fairly small standard FAK, sterile pads, and improvisation. If I could have added more, it would have been along the lines of IV administration (both training and gear). We had many situations where IVs made a huge difference in outcome.

If you need to make space within the bag, I would remove some specialized items like the eye shields and chest seals (never used in my experience and easily improvised). I could even remove all tourniquets and the Quik Clot, based on experience.

I get the impression that you are preparing for shooting incidents, probably a wise idea if you are close to a school these days, and the kind of trauma inflicted by projectiles would dictate different modes and gear for treatment. It all comes down to the situation.

Leave books and manuals out of the bag. You won't have time to read them during an incident. Thumbing through a book does not inspire patient confidence (which actually is rather significant).

One last thing. for lighting, the kit has a disposable penlight. I trust you have readily available a good, really good headlamp, with varying intensities up to at least 500 or so lumens. Darkness and medical emergencies go together like ham and eggs. your hands will be busy dealing with problems of various sorts.


Edited by hikermor (06/20/18 05:05 PM)
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Geezer in Chief

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#289510 - 06/20/18 05:48 PM Re: Customizing Your Medical Kit [Re: hikermor]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
Originally Posted By: hikermor
Who says the BP cuff and steth have to be inside the "official' container? As long as they are accessible and handy, they are available for use. That is what is important.

Where else would I store them?

Originally Posted By: hikermor
If I could have added more, it would have been along the lines of IV administration (both training and gear). We had many situations where IVs made a huge difference in outcome.

I have personal experiences on the importance of an I.V. If there wear a way for a non-professional to get everything needed, I will find a way to get the training.

Originally Posted By: hikermor
If you need to make space within the bag, I would remove some specialized items like the eye shields and chest seals (never used in my experience and easily improvised). I could even remove all tourniquets and the Quik Clot, based on experience.

I was asking if I should get eye shields. Chest seals are so thin that I don't have to worry about space. I'm not sure I can get the C-A-T in the bag; if I cant, I'll stay with the SWAT which does not take much room.

Originally Posted By: hikermor
Leave books and manuals out of the bag. You won't have time to read them during an incident. Thumbing through a book does not inspire patient confidence (which actually is rather significant).

If I come to a situation I'm not experienced in, I would rather have the book than not. I read and practiced enough I can handle a lot of everyday situations. The only time I needed to reference something immediately after an incident was the first time I burned myself in the kitchen.

Originally Posted By: hikermor
One last thing. for lighting, the kit has a disposable penlight. I trust you have readily available a good, really good headlamp, with varying intensities up to at least 500 or so lumens. Darkness and medical emergencies go together like ham and eggs. your hands will be busy dealing with problems of various sorts.

I don't have a headlamp.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289517 - 06/20/18 08:21 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
CJK Offline
Addict

Registered: 08/14/05
Posts: 541
Loc: FL, USA
30 plus as a field medic. I've said before... I've NEVER in ll that time used or have properly seen used a tourniquet. The NPA (NasoPharyngeal Airway) I have repeatedly used. If you are using the OPA (OroPharyngeal Airway) in a situation as bad as bugging out....well my thoughts are these...if you KNOW you are going to be getting 'definitive' care SOON then the OPA is a good short term airway. We only really use them in cardiac arrests and even that is seldom used any more for the preference of the LMA (Laryngeal Mask Airway). You NEED definitive care. If you are in a 'bug out' situation then the LMA and OPA is really a 'last ditch' before pronouncing. Both of them also have a 'bad' 'side effect'....they can stimulate the gag reflex (in non dead patients).

The NPA is good and tolerated well (relatively) in conscious patients. Again though...if I NEED an adjunct to help maintain an airway......the patient NEEDS definitive care....not me.

LMAs are considered a basic airway for my department though American Heart considers them as advanced.

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#289518 - 06/20/18 08:24 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
CJK Offline
Addict

Registered: 08/14/05
Posts: 541
Loc: FL, USA
As for the IV..... to me that is a BIG....I emphasize "BIG"... thing! That is the type of thing that can REALLY turn a bad situation around to good. Severe dehydration from numerous sources can be stopped. My wife and I survived Norovirus (God help anyone who gets it) because of IV therapy.

To me IV fluid replacement is a fantastic thing to know.

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#289519 - 06/20/18 08:32 PM Re: Customizing Your Medical Kit [Re: CJK]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
Two votes against getting the C-A-T.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289520 - 06/20/18 08:35 PM Re: Customizing Your Medical Kit [Re: CJK]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
Originally Posted By: CJK
As for the IV..... to me that is a BIG....I emphasize "BIG"... thing! That is the type of thing that can REALLY turn a bad situation around to good. Severe dehydration from numerous sources can be stopped. My wife and I survived Norovirus (God help anyone who gets it) because of IV therapy.

To me IV fluid replacement is a fantastic thing to know.

Is there any way a nonprofessional could get it?

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289522 - 06/21/18 03:09 AM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
haertig Offline
Pooh-Bah

Registered: 03/13/05
Posts: 2014
Loc: Colorado
Originally Posted By: Jeanette_Isabelle
Is there any way a nonprofessional could get it?

Your doctor, nurse practitioner, physicians assistant or veterinarian can prescribe or just give it to you. But it's unlikely that they'd do that, unless they know you very well, know you have had training and experience, and trust you.

Our vet knows my wife is a nurse practitioner, ran the ICU and the ER at a level 1 trauma center, I'm an (ex) paramedic, and we both ran an ambulance service for many years. They send us home with IV supplies, injectable meds, etc. for our pets all the time (this same vet has taken care of our pets for many decades and obviously we know each other well).

It sounds like you are one of the better preppers we have here on ETS. I'd recommend that you take an EMT class and get certified. Become friends with your physician adviser (most likely this person will be an ER physician). Do some volunteer EMT work in the ER, or better yet paid work if they have it. Your knowledge will increase exponentially and so will your personal contacts for things like, "Hey, can I have a bag of NS, a drip set, and an 18ga?"

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#289523 - 06/21/18 03:46 AM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
clearwater Offline
Old Hand

Registered: 03/19/05
Posts: 1044
Loc: Channeled Scablands
If you are traveling overseas to remote areas, (mountaineering trips, mission trips, Peace Corps) and have some training, find Doctors who do the same kind of adventures, they are likely to supply you with all kinds of stuff.

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#289525 - 06/21/18 12:14 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
chaosmagnet Offline
Sheriff
Carpal Tunnel

Registered: 12/03/09
Posts: 2927
Loc: USA
For life-threatening extremity bleeding, a tourniquet applied correctly and immediately is the most likely way to save a life, at least according to CoTCCC. Medical professionals have many more tools and skills than I do and I won't second-guess them once they arrive; but as someone who isn't a medical professional I want to carry the tools and practice the skills that are most likely to solve problems.

The SWAT-T is better than nothing. Light, small, and inexpensive, it also takes two hands and significant effort to get full occlusion, and I've broken a few in training.

The CAT can be applied one-handed (for self-aid) and is easy to use correctly. Having trained quite a bit with both I made the space in my laptop bag to carry a CAT.

If you are not trained to use a tourniquet, go get trained.

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#289526 - 06/21/18 12:23 PM Re: Customizing Your Medical Kit [Re: haertig]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
Originally Posted By: haertig
It sounds like you are one of the better preppers we have here on ETS.

Thank you. I strive to work out problems I foresee.

If you look at my profile, you will see I am disabled. Even volunteer work would be a challenge. Let me explain. In 2005, Timberlawn diagnosed me as having Generalized Anxiety Disorder. It is especially difficult for me to ride in a car. I'm fine on buses and trains [That's one of the reasons I love Dallas. I could get around]. I do okay on the backroads; anything more than a couple of blocks on the main road, I would need 1 MG of Lorazepam before the trip. Due to the nature of the medication, I must use it sparingly. It is for that reason I limit my travel and have most things delivered.

If anyone is wondering how I can bug out under these conditions, I can be in a car all day if I take 1 MG of Lorazepam, 2 MG if I have to be in mid-air in an overcrowded plane. Again, I have to be careful. Lorazepam is not the type of medication that I can take more several days in a row. Otherwise, it will not be as effective.

Anyhow, for the time being, I don't see how I can get the I.V. training or supplies as much as I would love that. I try to focus on everything else I can do even if there is only a slight chance it would come in handy. I also considered getting a suture/syringe kit, that Westerners bring with them when traveling to third-world nations, on the off chance I run into someone who knows the procedure but lacks the sterile equipment.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289527 - 06/21/18 12:36 PM Re: Customizing Your Medical Kit [Re: chaosmagnet]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
Originally Posted By: chaosmagnet
The SWAT-T is better than nothing. Light, small, and inexpensive, it also takes two hands and significant effort to get full occlusion, and I've broken a few in training.

Ouch! You make a good argument for not using the SWAT Tourniquet.

Originally Posted By: chaosmagnet
The CAT can be applied one-handed (for self-aid) and is easy to use correctly. Having trained quite a bit with both I made the space in my laptop bag to carry a CAT.

If you are not trained to use a tourniquet, go get trained.

Fortunately, the C-A-T has a training version.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289531 - 06/21/18 02:31 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Russ Online   content
Carpal Tunnel

Registered: 06/02/06
Posts: 4901
Loc: SOCAL
I’m by no means an expert on tourniquets, but make sure you get a real one and not a fake. The SkinnyMedic guy in the video below indicates there are a lot of fake TQ’s on the market. STOP Buying Fake CAT Tourniquets The video is a little light on determining real from fake.

Although I was trained in my FA class to make a TQ in the field, including the windlass, that’s difficult to apply to one’s self -- possibly down to one hand, possibly not thinking clearly through pain and shock...

There are a lot of TQ’s available on Amazon. Is the TQ at: CAT Combat Application Tourniquet - GEN 7 (Gray Time-stamp) , recommended?

What brand name is recommended?

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#289535 - 06/21/18 03:19 PM Re: Customizing Your Medical Kit [Re: Russ]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
Originally Posted By: Russ
There are a lot of TQ’s available on Amazon. Is the TQ at: CAT Combat Application Tourniquet - GEN 7 (Gray Time-stamp) , recommended?

What brand name is recommended?

I don't have experience with any tourniquet, though I own a few SWAT Tourniquets. I hear more good things about the C-A-T from trusted sources, even on this forum. Another tourniquet that has received almost as many rave reviews is the SOFTT-W.

https://www.chinookmed.com/05189/softt-w-tourniquet.html

I heard arguments for both as to which is better. I've seen videos to back it up; you can apply the C-A-T a split second faster. The SOFTT-W, because of its materials, is less likely to be damaged; I never heard of a C-A-T breaking.

I would make the case it comes down to what environment are you using the tourniquet. If you are in the Battle of Armageddon (where everything that can go wrong will go wrong), give the SOFTT-W a serious consideration. For my situation, I think the C-A-T would be best.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289539 - 06/21/18 05:06 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Russ Online   content
Carpal Tunnel

Registered: 06/02/06
Posts: 4901
Loc: SOCAL
Which of those TQ’s is easier to apply to one’s self. As as example, in the video the guy applies the TQ to his left arm using only one hand.

In the Wilderness First Aid course we learned to fabricate a tourniquet from available items. IIRC I used a triangle bandage and don’t recall what was used as a windlass, but that too can be fabricated; it’s not rocket science. However, the TQ’s were being applied to another student in the class and not to ourselves. The ability to apply one to your own arm using only one hand, is a good reason to carry and practice with a purpose built item.

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#289540 - 06/21/18 05:08 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
hikermor Online   content
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 6536
Loc: southern Cal
All this emphasis on tourniquets puzzles me. In 40 years of SAR work, 15 of which was quite intensive, I never had occasion to apply a tourniquet, nor did i ever hear of one being applied. And we had plenty of bleeding wounds, almost all stopped by direct pressure, perhaps aided with a pressure bandage. Multiple, bleeding traumas were common. The worst case I recall was an arm amputation at the shoulder (ran into a moving rear helo rotor), probably clamped by involuntary muscle pressure - a good thing because there was literally no stub for a T site.

Ts seem to be very popular in combat settings. i speculate that this is because those situations are radically different from civilian accident settings in all sorts of ways. The prudent combat first responder needs to keep a low profile, is likely to be dealing with more than one patient, probably multiple injuries per patient, and needs a quick fix. While experienced in civilian accident scenes, I have no combat experience.

Just wondering that T's are useful in combat zones, but are not necessarily appropriate in relatively gentler conditions. I generally have the means to improvise a T, but for me, in the situations I have experienced, Ts are entirely too specialized to justify their inclusion in a FAK, at least one carried by a responder on foot, deep in the woods, in most situations.
_________________________
Geezer in Chief

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#289541 - 06/21/18 06:18 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Montanero Offline
Veteran

Registered: 10/14/08
Posts: 1373
Loc: North Carolina
A TQ does not weigh much, does not cost a lot, does not take up much space. It can be used to improvise a splint, to aid in constructing an effective pressure bandage, in addition to its intended purpose. I look at it this way: it is unlikely that I will need it in civilian life but when I do need it it will prevent a catastrophic result.

In my small trauma kit I carry a nasal pharyngeal airway, compressed gauze, an elastic wrap, a triangular bandage and a TQ. My larger trauma kits just have more of the same, along with chest seals, larger bandages and a decompression needle (yes I have the training), and shears.

Most people do not realize how much pressure is required to stop serious bleeding.

Yes, most of my training and experience is focused on combat zone needs.

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#289542 - 06/21/18 07:26 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
Does the QuikClot 3" x 4 yds Bleeding Control Dressing have any advantage over the QuikClot Advanced Clotting Sponge?

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289544 - 06/21/18 09:45 PM Re: Customizing Your Medical Kit [Re: Montanero]
hikermor Online   content
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 6536
Loc: southern Cal
Good post, Montanero, and your perspective is quite valuable. Basically we carry about the same things, although I do regard the T as just a bit too specialized. But we have lots of things to wrap the victim up tightly where and when necessary. I am pretty sure my omnipresent red bandanna would wind up in whatever T I might have to improvise.

I suspect there is a further difference in combat/non-combat settings. Hopefully when in combat you are not isolated and someone is handy who sees blood spurting from an artery and can apply a T fairly promptly. In a lot of outdoor situations, the trauma results from a fall of varying length, say ten to 300 feet, and considerable time may lapse before help is at hand.

I recall an instance where we were tending a fall victim (90 foot drop; she survived primarily because she landed on her companion who expired. The physician treating her called to our nearby base asking for iV fluid. "What kind?" was the immediate response. 'Anything, anything at all," just get it here quickly. She had lost so much blood from multiple breaks that the concern was to simply get enough fluid back in her system so that the heart would have something to pump. Bleeding was controlled in this case with pressure bandages and splints. Thanks to rapid helo transport and the doctors care, she did indeed survive.

I think I have the same feeling about Quik-Clot - surely useful for deep penetrating wounds, not nearly so necessary for more common (in my experience, at least) bump and bang trauma. Keep the pressure on!!

I suppose the bottom line is, since there is only so much space in one's pack, to carry what you can use, and be ready to improvise, because there is almost more than one problem. Nothing beats a good patient survey.
_________________________
Geezer in Chief

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#289546 - 06/22/18 12:34 AM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
In a long-term situation, medical tape is essential. I never needed CoFlex in the past; I did stretch gauze. I replaced the CoFlex with 3" stretch gauze. Now I have room for another roll of tape.

The kit comes with excellent bleeding control items. Why do I need six 5" x 9" trauma pads? Isn't two enough? Petroleum gauze is excellent for long-term care situations; other than as an improvised chest seal, does it belong in emergency medicine? Non-adherent dressings come in handy in first aid. I put two in the kit.

Dentemp is not huge; the awkwardly shaped packaging makes it hard to fit. I moved it to the front.

I want to get activated charcoal. I looked at two potential spots. I don't know if it will fit; I'll give it a try.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289547 - 06/22/18 01:30 AM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Montanero Offline
Veteran

Registered: 10/14/08
Posts: 1373
Loc: North Carolina
In combat, everyone is carrying a TQ, usually multiple. You have to reduce the threat before you can evacuate wounded, so if you are the wounded and are conscious, you need to be able to do as much as you can.

I have tried (on real patients) an improvised TQ, and they are not very good. It usually takes multiple tries to get it tight enough, if you can at all without ripping the material.

As for Quick-Clot, get training, use the gauze, know what you are dealing with. It works if used properly.

In military operations they do not use IVs for replacing blood loss. It just produces red "koolaide". It provides very little benefit to the casualty beyond a certain point. They use whole blood when they have it. IVs are gold for other issues, such as dehydration (which may be the most common casualty in the timing/camping world) and people suffering from biological infections, to keep them hydrated and give them some minerals and energy.

Unless there is spurting blood, I will try a pressure bandage first, except in cases where the bullets are flying and help may be a while. The SWAT-T and elastic wraps can help a lot with this. The pressure needed is great. You can't just press with your fingers if it is really serious. You are pressing with your hands, arms straight, and with your body weight behind it. It will cause pain to the casualty (as will a TQ), another person there to control the casualty is very helpful.

Blunt trauma is different from penetrating trauma. TQs may not be as necessary for blunt trauma, where pressure usually works.

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#289549 - 06/22/18 04:34 AM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
haertig Offline
Pooh-Bah

Registered: 03/13/05
Posts: 2014
Loc: Colorado
Originally Posted By: Jeanette_Isabelle
The kit comes with excellent bleeding control items. Why do I need six 5" x 9" trauma pads? Isn't two enough?

I stock my kit with feminine sanitary pads. Cheaper and easier to obtain than trauma pads.

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#289552 - 06/22/18 12:22 PM Re: Customizing Your Medical Kit [Re: haertig]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
Aside from the feminine pads being shaped to be more comfortable, I know they and trauma pads are the same. As for easier to obtain? Not really unless you are in the middle of nowhere and the only store is a gas station. Cheaper? Again, not really. There is a slight difference; not enough to impact one's decision.

Even if you are slightly OCD, your line of thinking would be feminine pads belong with other personal care items; trauma pads belong in a first aid kit.

Back to my original question. Do we need six trauma pads when the kit already has a tourniquet, QuikClot, two 4" trauma bandages and two compress gauzes?

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289553 - 06/22/18 01:08 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
hikermor Online   content
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 6536
Loc: southern Cal
It isn't that hard to exhaust the contents of any normal FAK and who says you will be dealing with only one casualty in an incident?

On one operation with one seriously banged up victim, I was now improvising splints, casting questing eyes at a small pine tree along the trail, and I had removed my pants to use them for splint padding. I had another pair in my pack and treatment and stabilization was a higher priority. This one victimnearly exhausted my fairly extensive FAK.

You might even have to use a non-sterile material to staunch blood flow in an extreme case. Not recommended,, of course but if you can deliver a patient to the ER still containing appropriate liquids, they have the resources to compensate for infection.
_________________________
Geezer in Chief

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#289554 - 06/22/18 01:20 PM Re: Customizing Your Medical Kit [Re: Montanero]
hikermor Online   content
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 6536
Loc: southern Cal
Most interesting discussion. I am intrigued by your statements about the versatility of some tourniquets. Having regarded them as very specialized items, they just might find a place in my kit.

With respect to "red Kool-aid," I am sure that is what we delivered to the ER, a 20 minute helo flight away from the scene. They had enough of the Real Thing to pull our victim through. What was really important in the successful outcome of this event was the extremely good helo pilot who landed and took off in an extremely narrow canyon.

As I understand it, rapid transport to definitive care has made a real difference in outcomes, both on the battlefield and in civilian life.

I just love helicopters.....
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Geezer in Chief

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#289557 - 06/22/18 01:53 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Montanero Offline
Veteran

Registered: 10/14/08
Posts: 1373
Loc: North Carolina
TQs are strong, long, and easy to adjust. With good padding between the limb and the splinting material they can provide a good lashing. Because they are already designed to go around a limb, and they are easy to adjust, you can use them for a pressure bandage. You do not have to tighten them all of the way. You just need the gauze and other material to put under it to press on the right spot.

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#289561 - 06/22/18 04:30 PM Re: Customizing Your Medical Kit [Re: hikermor]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
Thanks. That helps.

The other question I asked is, aside from improvising a chest seal, does petroleum gauze belong in a first aid kit? I can't think of any reason I would need other than the reason I stated.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289597 - 06/23/18 08:30 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
Originally Posted By: Jeanette_Isabelle
I ordered the Bear Claw Glove Kit to replace the standard issued nitril gloves.

https://www.narescue.com/adventure-rescue-products/bear-claw-glove-kit

I have ideas for additional upgrades such as getting a Bolin Chest Seal, wound seal, two nasopharyngeal airways with lube (28 Fr), 4" x 16" burn dressing, activated charcoal, Tactical Combat Casualty Reference Card, two Tactical Combat Casualty Care Cards, permanent marker and replacing the SWAT Tourniquet with a C-A-T.

I received the Bear Claws. Before I switched out the gloves, I sacrificed a pair by trying it out. I ordered the size I normally wear and according to the label, that is what I received; when I tried on a pair, they were a tag snug. I don't have big hands. I don't know what happened.

They are thicker than even other quality gloves I use. In spite of the tight squeeze, I could still get them on my hands. I don't know if that will be a problem. I replaced the eight gloves in my kit with four glove kits.

I have a clearer direction on how I want to further modify this kit. I'll order the supplies later.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289656 - 06/26/18 01:21 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
I really wanted stretch gauze in my medical kit, specifically two rolls; in previous attempts, I could not get two in there. I did some rearranging and was able to get them in the pocket that holds most of the wound/blister/burn items. Doing so means removing the antiseptic towelettes. Povidone-Iodine prep pads are much thinner. I will be using those instead.

One thing that bugged me is how it was organized. The cloth tape, CoFlex and duct tape were in the same pocket while the wound/blister/burn items were scattered over three pockets. The duct tape belongs in the instruments; it will not fit in that pocket. I removed the duct tape. I could not get all the wound/blister/burn items in one pocket; I was able to get them in two side by side pockets. Doing so meant removing the CoFlex (I don't use it anyway) and reducing the number of 5" x 9" trauma pads from six to two.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289657 - 06/26/18 02:06 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Russ Online   content
Carpal Tunnel

Registered: 06/02/06
Posts: 4901
Loc: SOCAL
The duct tape in my truck kit looks like a roll of duct tape you’d find at Home Depot (not affiliated, just a customer). That FAK is in a clear plastic bin with organization provided by using clear ziplock bags; I can see what is in each bag. Simple, I can thank a former nurse for that.

BTW, in any FAK, nitrile gloves should be easy to find with no digging.

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#289661 - 06/26/18 07:40 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
hikermor Online   content
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 6536
Loc: southern Cal
Behind every FAK are the fall back, second string items that very often come into use - duct tape, various items for splinting, bandannas and rages, etc. Just be sure you can find them readily when you need them. That is "when," not "if."
_________________________
Geezer in Chief

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#289665 - 06/26/18 07:46 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
TeacherRO Offline
Pooh-Bah

Registered: 03/11/05
Posts: 2315
I upgrade all my first aid kits. Most don't have enough
- exam gloves
- OTC meds
- athletic tape
- larger, waterproof band aids
- Safety pins


What do you add to yours?

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#289666 - 06/26/18 07:57 PM Re: Customizing Your Medical Kit [Re: hikermor]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
If I'm home, I already have multiple first aid kits. If I have this kit away from home, I still have the kit in my EDC bag.

The duct tape did not belong with the wound/blister/burn items and it was too big to fit where it should go: the instruments pocket.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289667 - 06/26/18 08:08 PM Re: Customizing Your Medical Kit [Re: TeacherRO]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
Originally Posted By: TeacherRO
What do you add to yours?

Today I ordered one Tactical Combat Casualty Care Reference Card.

https://www.chinookmed.com/14001/tactical-combat-casualty-care-tccc-card-pkg-of-25.html

Two Tactical Combat Casualty Care (TCCC) Cards.

https://www.chinookmed.com/14000pa/tactical-combat-casualty-care-tccc-card.html

I also added one Povidone-Iodine Prep Pads, Package of 6, one Burn Dressing - 4"x16", two Nasopharyngeal Airway w/ Lubricant, 28Fr, and one Bolin Chest Seal. The wound seal is currently out of stock.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289679 - 06/28/18 08:09 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
Originally Posted By: Jeanette_Isabelle
Today I ordered one Tactical Combat Casualty Care Reference Card.

https://www.chinookmed.com/14001/tactical-combat-casualty-care-tccc-card-pkg-of-25.html

Two Tactical Combat Casualty Care (TCCC) Cards.

https://www.chinookmed.com/14000pa/tactical-combat-casualty-care-tccc-card.html

I also added one Povidone-Iodine Prep Pads, Package of 6, one Burn Dressing - 4"x16", two Nasopharyngeal Airway w/ Lubricant, 28Fr, and one Bolin Chest Seal. The wound seal is currently out of stock.

I received the package today. The following is the current configuration of the kit. I have everything I want except for the wound seal. I cannot think of anything else I want that is able to fit.

MEDICAL INFORMATION / TRIAGE
(1) Wilderness & Travel Medicine
(1) Tactical Combat Casualty Reference Card
(2) Tactical Combat Casualty Care Card

PERSONAL PROTECTION
(1) Biohazard Waste Bag
(1) Hand Sanitizer, 1 oz.
(1) Rescue Mask, Soft Case
(12) Personal Antimicrobial Wipe
(4) Emergency/Survival Blanket
(4) Respirator Mask
(4) Bear Claw Glove Kits

BLEEDING
(1) SWAT-T Tourniquet
(1) QuikClot, 25 g
(2) Trauma Bandage, 4"
(2) Compressed Gauze

AIRWAY
(1) Bolin Chest Seal
(2) Nasopharyngeal Airway w/ Lube, 28 Fr

WOUND / BLISTER / BURN
(2) Trauma Pad, 5" x 9"
(1) Burn Dressing, 4" x 4"
(1) Burn Dressing, 4" x 16"
(3) Burn Jel, 3.5 g
(1) 30 Band-Aid, 6 Knuckle, 6 Moleskin
(1) Cloth Tape, 1" x 10 yds.
(6) Povidone-Iodine Prep Pad
(2) Benzoin Swabsticks
(2) Oval Eye Pad
(2) Petroleum Gauze, 3" x 9"
(2) Povidone-Iodine, 22 mL
(2) Wound Closure Strips, 0.25" x 4"
(6) Cotton Tipped Applicator, 6"
(6) Sterile Gauze Pad, 4" x 4"
(2) Stretch Gauze, 3"x 12 yds.

IMMOBILIZATION
(1) Disposable Cold Pack
(1) Disposable Heat Pack
(1) Elastic Bandage Wrap, 4" x 4.5 yds.
(1) Splint, Orange, 4.25" x 36"
(2) Triangular Bandage

MEDICATION
(1) Dentemp
(1) Eye Wash, 4 oz.
(2) Glucose, 15 g
(12) Acetaminophen, 2/pk (Analgesic)
(12) Aspirin, 2/pk (Analgesic)
(12) Diamode, 1/pk (Anti-diarrheal)
(12) Diotame, 2/pk (Stomach)
(12) Diphen, 1/pk (Antihistamine)
(12) Ibuprofen, 2/pk (Anti-inflammatory)
(6) Hydrocortisone 1% Creme, 1.5 g
(6) Triple Antibiotic Ointment, 0.9 g
(2) Hydration Powder
(2) Oral Rehydration Salts
(1) Insect Bite Treatment

INSTRUMENTS
(1) Catheter Tip, 18G
(1) Digital Thermometer
(1) EMT Shears, 7.25"
(1) Irrigation Syringe, 20 mL Luer Lock Tip
(1) Tweezers
(3) Safety Pins, 2"
(1) Disposable Penlight
(1) Permanent Marker, Extra Fine Point

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289680 - 06/28/18 11:52 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
Originally Posted By: Jeanette_Isabelle
I have everything I want except for the wound seal. I cannot think of anything else I want that is able to fit.

I stand corrected. I believe I can get a C-A-T in there by moving the CPR mask to a new location.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289684 - 06/29/18 06:40 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
chaosmagnet Offline
Sheriff
Carpal Tunnel

Registered: 12/03/09
Posts: 2927
Loc: USA
Originally Posted By: Jeanette_Isabelle
Does the QuikClot 3" x 4 yds Bleeding Control Dressing have any advantage over the QuikClot Advanced Clotting Sponge?


The sponge is the next best thing to worthless for serious bleeding. The gauze can be used with great effect -- but again, like with tourniquets, hands-on training is essential.

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#289687 - 06/29/18 08:02 PM Re: Customizing Your Medical Kit [Re: chaosmagnet]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
Originally Posted By: chaosmagnet
but again, like with tourniquets, hands-on training is essential.

I ordered the C-A-T trainer. Mom and I will be practicing it.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289790 - 07/07/18 01:28 AM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
acropolis5 Offline
Enthusiast

Registered: 06/18/06
Posts: 341
JI, nice kit. May I suggest that if you are carrying 6, 5”x9” trauma pads, u need more Coflex or, better yet, 2-3, 3” roles of Vet Tape, to strap on the trauma pads. Add a roll of 1” waterproof adhesive tape. It is easier to apply than duct tape and more flexible. But keep the duct tape. Did you give any thought to one or two Israeli 6” , doulble pad bandages , in place of 1-2 f the 5”x9” pads? They are the gold standard for Trauma bandaging. Inexpensive substitute for a chest seal is sterile, foil wrapped Vaseline gauze pad. Watch the U-Tube video for application instruction.

Is your tweezers needle nose. It should be for effective splinter removal. And, especially in ur part of the country , a tick key or equivalent.

In my years as an EMT and the neighborhood first-aid Dad, I found u never pack too many/ enough sterile 4”x4” gauze pads. IMO, ur 6 is too few. 10 is a minimum and 20 is better.

A headlamp keeps ur hands free to give aid. Use AA or AAA lithium batteries for long life and no corrson.

If u r going to give assistance to strangers,e.g. car accidents, I’d add a pair of swim goggles and 2-3, N-95 masks to fend off blood spatter. If you are going to rescue breath, a one way valve mask is a must. Even reusable ones aren’t too expensive and single use ones are very inexpensive. The 28 French NF airways u mentioned r a good idea.

I’d also suggest u buy or assemble a better emergency dental kit. Just Google them and pick.
,
Finally, keep 2 or more, 20oz. , push-pull drink tops of bottled water, along with a few single wrapped iodine pads. One pad in bottle for wound cleaning and one to pour in ur rehydration powder.

Misc. Edit: waterproof pad + pen, #11 disposable sterile scalpel, 6-10 Wet Wipes invidual wipes for wound/ skin cleaning, small magnifier for splinters, thin waterproof marker pen to note tourniquet application with “T” and time , on victims cheek. Make sure ur aspirin is chewable childrens’ 82mg ( 6 is suspected heart attack dose), ibuprofen and acetaminophen together in the correct dosage ( Google it) is now said to give almost as much pain relief as common opoid tablets.


Cheers



Edited by acropolis5 (07/07/18 02:22 AM)

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#289793 - 07/07/18 01:24 PM Re: Customizing Your Medical Kit [Re: acropolis5]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
Originally Posted By: acropolis5
JI, nice kit. May I suggest that if you are carrying 6, 5”x9” trauma pads, u need more Coflex or, better yet, 2-3, 3” roles of Vet Tape, to strap on the trauma pads.

I mentioned I'm modifying my kit and listed the changes along the way. On June 28 I listed what was then the current contents. I reduced the trauma pads from six to two and removed the CoFlex. For what you're mentioning, that is why a trauma bandage is there.

Originally Posted By: acropolis5
Did you give any thought to one or two Israeli 6” , doulble pad bandages , in place of 1-2 f the 5”x9” pads? They are the gold standard for Trauma bandaging.

Though they are 4" instead of 6", the trauma bandage is close to the Israeli Bandage.

Originally Posted By: acropolis5
Is your tweezers needle nose. It should be for effective splinter removal. And, especially in ur part of the country , a tick key or equivalent.

Yes.

https://www.chinookmed.com/01751/uncle-bills-tweezers.html

Originally Posted By: acropolis5
In my years as an EMT and the neighborhood first-aid Dad, I found u never pack too many/ enough sterile 4”x4” gauze pads. IMO, ur 6 is too few. 10 is a minimum and 20 is better.

Space is limited in the wound pocket.

Originally Posted By: acropolis5
A headlamp keeps ur hands free to give aid. Use AA or AAA lithium batteries for long life and no corrson.

Where in the med kit am I supposed to include a headlamp?

Originally Posted By: acropolis5
If u r going to give assistance to strangers,e.g. car accidents, I’d add a pair of swim goggles and 2-3, N-95 masks to fend off blood spatter. If you are going to rescue breath, a one way valve mask is a must. Even reusable ones aren’t too expensive and single use ones are very inexpensive.

Where, in the medical kit, would I put the safety goggles? The respirator masks are already listed. The CPR mask is also listed.

Originally Posted By: acropolis5
I’d also suggest u buy or assemble a better emergency dental kit. Just Google them and pick.

I question the usefulness of a dental kit. If I have access to a dentist, why would I need a dental kit in the first place? If I don't have access, a dental kit would only delay the inevitable.

Originally Posted By: acropolis5
Finally, keep 2 or more, 20oz. , push-pull drink tops of bottled water, along with a few single wrapped iodine pads. One pad in bottle for wound cleaning and one to pour in ur rehydration powder.

Where, in the medical kit, would I put the bottled water. I do keep an 8 OZ bottle of water in my EDC bag and I often have a second bottle of water with me. I understand why I would need bottled water with me for the hydration powder. Why would I need a sport-top water bottle for irrigating when I have an irrigation syringe listed among the instruments?

Originally Posted By: acropolis5
Misc. Edit: waterproof pad + pen,

Listed.

Originally Posted By: acropolis5
#11 disposable sterile scalpel,

That is beyond my level of training.

Originally Posted By: acropolis5
6-10 Wet Wipes invidual wipes for wound/ skin cleaning,

Listed.

Originally Posted By: acropolis5
small magnifier for splinters,

I considered a PSP, which has that.


Originally Posted By: acropolis5
thin waterproof marker pen to note tourniquet application with “T” and time , on victims cheek.

Listed.


Originally Posted By: acropolis5
Make sure ur aspirin is chewable childrens’ 82mg ( 6 is suspected heart attack dose),

The following is what the kit comes with and what I have to work with.

https://www.chinookmed.com/05193pa/aspirin-325-mg-tablets-analgesic.html

There is no room for a bottle of chewable aspirin in my kit; I do have a bottle in my EDC bag.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289794 - 07/07/18 04:48 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Russ Online   content
Carpal Tunnel

Registered: 06/02/06
Posts: 4901
Loc: SOCAL
...”Where in the med kit am I supposed to include a headlamp?”...

One option is to keep a headlamp separate from the FAK because it has more uses than lighting for field surgery.

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#289795 - 07/07/18 05:20 PM Re: Customizing Your Medical Kit [Re: Russ]
hikermor Online   content
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 6536
Loc: southern Cal
There are quite a few small headlamps that can fit in small spaces. The Fenix hL10 is a good example, but there are others as well. You definitely want both hands free in a FA situation.
_________________________
Geezer in Chief

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#289796 - 07/07/18 08:28 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
Recently I've been reading to not have anything touching the eye in the event of an injury as there could be swelling. That disqualifies eye pads. Instead, protect the eye with an eye shield. With the modifications that I'm making I had concerns with the Combat Eye Shield getting flattened because the kit is getting stuffed as it is. That leads me to believe that it would be best to skip the eye shield.

The Polycarbonate Eye Shield appears to be addressing concerns I had with the Combat Eye Shield.

https://www.chinookmed.com/item/05262pa/...d-orange/1.html

While it's probably best to wait before making this addition, I want to know what you think.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289816 - 07/09/18 02:54 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
CJK Offline
Addict

Registered: 08/14/05
Posts: 541
Loc: FL, USA
A headlamp....or any other light is useless......30 plus years on the road has proven that no matter how much light you have it will either; 1. Never be enough or 2. It can't reach where you need it.

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#289817 - 07/09/18 03:56 PM Re: Customizing Your Medical Kit [Re: CJK]
Russ Online   content
Carpal Tunnel

Registered: 06/02/06
Posts: 4901
Loc: SOCAL
So your advice is ...?

A headlamp normally used for hiking is better than no light. First aid in the dark can really suck. It’s probably tough to do surgery with just a headlamp, but for basic first aid a little light than none.

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#289818 - 07/09/18 04:36 PM Re: Customizing Your Medical Kit [Re: CJK]
hikermor Online   content
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 6536
Loc: southern Cal
I heartily disagree. In fact, it is surprising and instructive how useful even a small amount of light can be. There are occasions where you want to bring back the daylight, but they are rare.

in wild caves, a headlamp is essential, since your hands are often busy as you move over rough, varied terrain. The same is true for hiking at night, although I often hold my lamp in my hands near waist level. The variations in the ground ahead of you are much more apparent that way.

In fact, I have been disoriented, walking on smooth trails at night with a headlamp mounted on my head, unable to sense exactly where the ground lay.

I prefer a modest (less than 100 lummens) hand held headlamp, lit sparingly as night falls, so that my eyes can adjust to darkness. You can follow a well defined trail at night, especially if the sky is clear,using a light only now and then. If you have a bright moon, you will go for miles and miles with no artificial light at all.

First aid is a different story. You want LIGHT, and plenty of it. it is all too easy to miss significant injuries if there is not enough light (Don't ask me how I know this). Even the quality and character of the light can be a factor in this context..

Standard practice among cavers is to carry three independent sources of light with you at all times when in a cave. I generally follow this practice on any hike of any significant length.

These days my go to light is a Zebralight 600, powered by an 18650 li-ion battery - variable light levels (up to 1000 lumens), sturdy,light, bright, and dependable. There are other similar models on the market as well. They are all so much better than the junk available years ago....
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Geezer in Chief

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#289819 - 07/09/18 04:52 PM Re: Customizing Your Medical Kit [Re: hikermor]
Russ Online   content
Carpal Tunnel

Registered: 06/02/06
Posts: 4901
Loc: SOCAL
Hikermor - that Fenix HL-23 arrived the other day and it’s a good light. I found it while looking at your HL-10. The controls are easy and there aren’t any “special modes”; one button long press turns on/off, short press switches from Medium > Low > High — that’s it. Because it only uses one AA battery, changing one in the dark is also easy — no tools required, positive end goes in first. Simple is good.

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#289820 - 07/09/18 05:34 PM Re: Customizing Your Medical Kit [Re: hikermor]
Russ Online   content
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There’s a good article at: Tourniquet Use Should Be One of Your Basic First Aid Skills. Just another rationale for keeping a dedicated tourniquet in your FAK.

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#289821 - 07/09/18 05:35 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
hikermor Online   content
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The HL-10 has the same UI and I agree, it is very simple to actuate and use... But just think how busy your poor little finger will be if you need to send an SOS.

I wonder if there is case on record of where a light sending out an SOS actually was observed, and triggered a rescue ops. I certainly don't know of any....
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#289822 - 07/09/18 06:09 PM Re: Customizing Your Medical Kit [Re: hikermor]
M_a_x Offline
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Registered: 08/16/02
Posts: 1017
Loc: Germany
Sending the SOS might be fairly easy. Just use the shutter technique. Let the light on and put your index finger or the entire hand in front of the lens. Morse with light signals should be on a slow pace anyways.
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#289823 - 07/09/18 06:14 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Russ Online   content
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Back to modifying FAK’s...

I carry a small FAK more often than anything largish. I had been carrying an AMK Ultralight .3, but in their wisdom (and I won’t rationalize why) AMK has made the decision to shift from the small nylon pouch with a waterproof inner bag to a Waterproof DryFlex Bag. The AMK UL.5, ,7 & .9 kits still come with the nylon outer pouch.

IMO the DryFlex bag alone is not adequate. One comment on REI’s page for this kit described a sealed/unopened kit getting wet inside when his kayak capsized. Apparently the DryFlex bag’s integrity failed (pinhole?) which is why you want a tougher outer bag. So rather than buy another AMK UL.3, I’m downsizing an AMK UL.5 to carry the minimal contents of a UL.3. Okay, maybe a little more than the .3.

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#289826 - 07/09/18 08:08 PM Re: Customizing Your Medical Kit [Re: Russ]
hikermor Online   content
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I also like a small kit that is handy to a larger kit that might not be available. But I keep a big kit in my vehicle, filled with lots of dressings and bandaging material. Probably will add some CAT tourniquets....
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#289830 - 07/09/18 11:36 PM Re: Customizing Your Medical Kit [Re: hikermor]
Russ Online   content
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Speaking of truck kits... I’m adding a CAT GEN 7 tourniquet to my truck kit. The first one went in the backpack I take when hiking (not just walking), but as you indicate, your vehicle has room for a large FAK as does mine. A quality tourniquet will be a good addition.

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#289834 - 07/10/18 12:44 PM Re: Customizing Your Medical Kit [Re: Russ]
hikermor Online   content
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One thing to consider as you prepare your kit for medical situations - you will often draw on resources beyond what is carried in your FAK. The headlamps we have discussed are simply one example. In outdoor situations, you will need to consider hyper/hypo thermic conditions (if it ain't one, it's the other), hydration state, impending weather, keeping the scene safe for everybody, and the like.

It is basically a crash course in improvisation....
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#289836 - 07/10/18 01:45 PM Re: Customizing Your Medical Kit [Re: hikermor]
Russ Online   content
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Improvisation was an aspect of the Wilderness First Aid course I took — splints, neck braces, tourniquets... Every situation is different.

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#289839 - 07/10/18 03:58 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Russ Online   content
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I was going through the contents one of my commercial FAK’s and just out of curiosity decided to look closer at the meds. Look at the tablet labeled “antihistamine” — What is it? Mine was generic “Diphenhydramine Hydrochloride”. What are the side-effects? Do you feel comfortable taking these or giving them to someone else?

I have self-medicated (OTC drugs) in the past and it wasn’t always a good thing. I rarely medicate at all these days; I choose mild pain over pain-relief drugs. Relief from pain is over-rated, mild pain might keep you from doing something stupid. I love that TV commercial where the guy takes pain meds so he can keep playing basketball on a knee that maybe shouldn’t be on the B-ball court. wink

So I’m making room in what I consider to be a minimal kit and removing the pain meds and I may remove the antihistamine’s too.

Comments? Am I selling the usefulness of these drugs short?

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#289840 - 07/10/18 05:20 PM Re: Customizing Your Medical Kit [Re: Russ]
hikermor Online   content
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It is one thing to take pain meds for yourself, but an entirely different proposition if considering giving them to someone else. Generally it is not advised, especially if the individual is going to the ER or physician's care.
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#289841 - 07/10/18 10:47 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Russ Online   content
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Same AMK UltraLight/Watertight .5 FAK, but a different question. The kit comes with an unspecified length of conforming gauze bandage; what would be the pro’s/con’s of replacing that with an equal volume piece of 2" Cohesive Wrap (generic coban). Maybe also add a couple non-stick pads. Thoughts/comments?

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#289842 - 07/10/18 11:15 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
hikermor Online   content
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Since the coban is self adhering, it might be easier and quicker to apply. Does your conforming gauze bandage have the same properties?

i would just note that when I have donated blood for the last several years, coban has been in universal use = quick and effective (and the donor gets to choose the color!!)
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#289843 - 07/10/18 11:43 PM Re: Customizing Your Medical Kit [Re: hikermor]
Russ Online   content
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The gauze appears to be generic with none of the self-adhering properties of coban. The swap makes sense to me; this is the kit I’m actually carrying and there’s limited space. So while I may have a use for the generic gauze in my truck’s FA supply bin/kit, I need to keep contents of the AMK UL.5 at a higher use/cube ratio.

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#289845 - 07/11/18 03:06 AM Re: Customizing Your Medical Kit [Re: Russ]
Russ Online   content
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Done. Wrapped an equal volume of the self-adhering wrap and replaced the gauze, then added a second non-stick pad - there was one, now there are two. I’m looking at the 1/2” med tape and wondering if it would hurt to replace with the other half of the self-adhering wrap roll. For now I’ll leave as is, I’m not a fan of skinny med tape, but I’m not sure the rest of the wrap would fit in that space. 1/2” tape is a compromise that fits.

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#289846 - 07/11/18 03:09 AM Re: Customizing Your Medical Kit [Re: Russ]
Famdoc Offline
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diphenhydramine is the generic name for Benadryl. Occ. useful for systemic allergic reactions. Major side-effect is drowsiness, sleepiness for many, but not all.
It could help blunt a life threatening allergic reaction to say, bee/wasp stings, but if life is threatened the go-to drug is epinephrine injected, followed by diphenhydramine orally or IM.
Many use it help them sleep (Tylenol PM or Advil PM, etc.), but it seems to reduce REM sleep/sleep quality, and increases risk of falling during the night and into the next AM
Keep it around, it's cheap.
Like most drugs (except for nitroglycerin, aspirin, maybe tetracycline and liquid meds) diphenhydramine does not expire anywhere near the "expiration date" the manufacturer has put on the container. The manufacturers can put any date they want on the containers: an earlier date perfectly suits their desire to convince gullible consumers to replenish their stocks decades before their meds actually lose significant potency, so as to reward the company's stockholders and maintain full employment.

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#289847 - 07/11/18 11:49 AM Re: Customizing Your Medical Kit [Re: Russ]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
Originally Posted By: Russ
So I’m making room in what I consider to be a minimal kit and removing the pain meds and I may remove the antihistamine’s too.

In modifying my main kit, I'm putting more emphasis on trauma. I may end up reducing some of the medications to make room.

Jeanette Isabelle
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#289849 - 07/11/18 02:40 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
hikermor Online   content
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Different kits for different circumstances. I always carry at least a small, very basic kit,oriented toward trauma (one compression bandage and dressings, etc). If I am responsible for a large group, say on a field project of some sort, the kit is expanded; typically a SAM splint is in there somewhere (they make nice padding for the pack itself).

My SAR pack contained a stethoscope, BP cuff, pneumatic splint, and went on from there. There were occasions where the contents were exhausted completely.
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#289850 - 07/11/18 07:39 PM Re: Customizing Your Medical Kit [Re: hikermor]
Russ Online   content
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Originally Posted By: hikermor
Different kits for different circumstances. ...

The kit I carry and modified is for owwies up to short of serious trauma. This is the FAK I carry on my casual neighborhood walks, all within good cell coverage and I walk right by a fire station (around here every fireman has an EMT cert), so carrying more would only serve to weigh me down.

The truck kit OTOH has two SAM splints, two tourniquets, boxes of 4x4 ... et al.

My bicycle kit has been either an AMK Trauma kit or a slightly modified AMK Weekender — depending. As of now it also has a SWAT-T.
Comment: All the talk of tourniquets in this thread — as soon as I typed “bicycle” I knew where the SWAT-T I bought at REI would go. A friend of mine died while commuting home by bike. He was well lit up and in a bike lane, but it was night and with all the other ambient lights, the driver of a car did not see him and he bled out right there. (Did someone say texting or talking on his cellphone while driving at night? What could go wrong???)

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#289851 - 07/11/18 08:02 PM Re: Customizing Your Medical Kit [Re: CJK]
Montanero Offline
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Registered: 10/14/08
Posts: 1373
Loc: North Carolina
Originally Posted By: CJK
A headlamp....or any other light is useless......30 plus years on the road has proven that no matter how much light you have it will either; 1. Never be enough or 2. It can't reach where you need it.


Sorry all but I have been traveling.

I too strongly disagree with this. From my experience, light can be critical to saving a life. Even if it is a red lens, it is better than nothing.

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#289872 - 07/13/18 02:35 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Russ Online   content
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After reconsidering the intent of the largish FAK in my truck, I’ve decided to focus it more on wound trauma that might be encountered at a traffic accident. My bicycle kit needed a tourniquet, but so does my truck kit and there’s room. So it gets two T’s - the C-A-T that was there already and the SWAT-T that was going in my bicycle kit. The second C-A-T in the truck goes into the bike kit for now. I’m kinda liking the SWAT-T.

Around here (and elsewhere) any serious traffic accident will have LE, Fire and EMT’s responding, but that takes time and the first person on-scene is usually someone other than a professional. Any severe bleeding needs to be controlled by the first person there — certified or not — or the accident victim may not survive for the EMT’s.

So two different T’s, one will work better. I think I prefer the C-A-T because of the windlass and its ability to seriously constrict blood flow. But the SWAT-T seems to be fairly versatile and at 4” wide might be better for direct pressure where a “tourniquet” is not required. I’m not sure one is better than the other — different, not necessarily better.

In case you’re wondering, this is my version of life insurance, mine or some stranger’s. Probably cheaper than one month’s payment on the traditional $ coverage. I’m wondering why I didn’t do this before now.

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#289873 - 07/13/18 03:23 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
hikermor Online   content
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As one who is about to overcome his earlier training and include some tourniquets in his FAK, your remarks are very worthwhile to me. Also your comments about being on scene before any official first responders.

That has been my lot on at least three occasions (family emergencies excepted) and on two of them I was beaten to the victim's side by a nurse who just popped up from out of nowhere.
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#289874 - 07/13/18 05:06 PM Re: Customizing Your Medical Kit [Re: hikermor]
M_a_x Offline
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Registered: 08/16/02
Posts: 1017
Loc: Germany
Reading this forum gets kind of expensive. I have been looking for a tourniquet (for some of my hobbies the risk may be small but the potential damage could be severe) for a while and got some useful leads here.
In the vast majority of accidents the first person on the scene would be the one to call the official first responders and then keep the victim alive until the responders arrive. Odds are the first person is not an official first responder.
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#289875 - 07/13/18 05:22 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
The one area in which I cannot make up my mind is the wound/burn section. Anyone else having trouble deciding? The following is the current configuration:

WOUND / BLISTER / BURN
(2) Trauma Pad, 5" x 9"
(1) Burn Dressing, 4"x16"
(1) Burn Dressing, 4" x 4"
(3) Burn Jel, 3.5 g
(1) 30 Band-Aid, 6 Knuckle, 6 Moleskin
(1) Cloth Tape, 1" x 10 yds.
(2) Stretch Gauze, 3" x 4.1 yds.
(6) Povidone-Iodine Prep Pad
(2) Benzoin Swabsticks
(2) Oval Eye Pad
(2) Povidone-Iodine, 22 mL
(2) Wound Closure Strips, 0.25" x 4"
(6) Cotton Tipped Applicator, 6"
(2) Non-Adherent Dressing, 3" x 4"
(6) Sterile Gauze Pad, 4" x 4"

Edit: I edited my list again. Given the number of other wound items I have, six gauze pads seem to be the right amount. What about non-adherent dressing? Should I have none, two or four?

Jeanette Isabelle


Edited by Jeanette_Isabelle (07/13/18 09:51 PM)
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#289877 - 07/13/18 09:30 PM Re: Customizing Your Medical Kit [Re: hikermor]
Russ Online   content
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Decided to buy a couple more SWAT-T’s and figured I’d get a better price on Amazon - no, REI had them beat by a few cents and then when I checked out, there was a further (unexplained, possibly volume since I bought more than one) discount. — SWAT-T at REI.
Not affiliated, except that I have been a member of the co-op since the 1980’s. wink

One of these days I’ll post the truck kit’s content list... and then I’ll modify it again smile

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#289878 - 07/14/18 02:02 AM Re: Customizing Your Medical Kit [Re: Russ]
hikermor Online   content
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Thanks for the link. I will be dropping by the local REI tomorrow - garage sale!! I wonder if there will be any slightly used T's.....(or returned -"did not work' - subject bled out"....)
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#289889 - 07/15/18 12:46 PM Re: Customizing Your Medical Kit [Re: hikermor]
bacpacjac Offline
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Registered: 05/05/07
Posts: 3599
Loc: Ontario, Canada
Originally Posted By: hikermor
It isn't that hard to exhaust the contents of any normal FAK and who says you will be dealing with only one casualty in an incident?

On one operation with one seriously banged up victim, I was now improvising splints, casting questing eyes at a small pine tree along the trail, and I had removed my pants to use them for splint padding. I had another pair in my pack and treatment and stabilization was a higher priority. This one victimnearly exhausted my fairly extensive FAK.

You might even have to use a non-sterile material to staunch blood flow in an extreme case. Not recommended,, of course but if you can deliver a patient to the ER still containing appropriate liquids, they have the resources to compensate for infection.


I'm learning so much from this thread. Thanks gang!

FWIW - As first responders at a truck vs elderly pedestrian collision a few years ago, the nurse who stopped with me grabbed a package of paper towels from her trunk and told me to grab the other one instead of the gauze pads from my FAK. A whole package or four non-sterile of gauze pads would have been helpful in that case, not just a few individually wrapped pads. I've carried a couple rolls of paper towel in my vehicles ever since.
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#289890 - 07/15/18 01:02 PM Re: Customizing Your Medical Kit [Re: bacpacjac]
hikermor Online   content
Geezer in Chief
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I usually carry a bandanna in my left rear pocket - a classic multiuse item. While I prefer to apply sterile dressings over a bleeding wound, I wouldn't think twice bout slapping on that bandanna if necessary. It is usually red, so blood won't ruin it -also fairly decent color for signaling, good potholder, general padding, etc.

How many uses are there for a red bandanna, anyway??
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#289891 - 07/15/18 01:50 PM Re: Customizing Your Medical Kit [Re: hikermor]
pforeman Offline
Member

Registered: 04/23/08
Posts: 106
Loc: Iowa
I just read a magazine article last night about 100 uses for a bandana! A quick web search this morning turned up an on-line pdf document with 180 uses. Some of them, such as holding a hot branding iron, I will guess don't see much use.

As a side note, medical / FAK gear is a 'funny' thing in that it's often a product of experience, training and needs. Having had the chance to get some good training over the years I'm happy with some simple every-day supplies and rely on knowledge rather than gear.

This site also helps me expand that knowledge base every time I visit - example from today is I'm putting some paper towel rolls in the car trunk tomorrow on the way to work.

Paul -

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#289892 - 07/15/18 02:07 PM Re: Customizing Your Medical Kit [Re: hikermor]
Russ Online   content
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Registered: 06/02/06
Posts: 4901
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When I last took my Wilderness First Aid course, NOLS marketed a large orange bandana with first aid instruction imprinted. It seems to be out of stock or no longer available, shoulda bought two, maybe it’s a collectors item. cool

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#289893 - 07/15/18 02:15 PM Re: Customizing Your Medical Kit [Re: pforeman]
Russ Online   content
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Originally Posted By: pforeman
... I'm happy with some simple every-day supplies and rely on knowledge rather than gear. ...

Earlier in the thread we discussed “improvisation” and that’s always good, but improvisation takes time and sometimes that’s time the victim does not have available. A dedicated tourniquet is easier and quicker to deploy if you have one, and you don’t need to worry about your favorite belt being trashed when it arrives at the ER (you ain’t getting it back).

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#289894 - 07/15/18 02:25 PM Re: Customizing Your Medical Kit [Re: Russ]
hikermor Online   content
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Improvisation isn't necessarily slower. I understand the stethoscope was invented by a modest British physician who did not wish to place his ear on a woman's chest to determine heart sounds and rhythms.

So, if you are in a situation where you don't have a stethoscope handy, just use your ears...It's better than nothing.
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#289895 - 07/15/18 02:30 PM Re: Customizing Your Medical Kit [Re: Russ]
hikermor Online   content
Geezer in Chief
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By the way, Russ, I just placed an order for two (2)! SWAT tourniquets, thanks to your recent post, ending a long time aversion to the use of T's and reversing my earlier training.
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#289902 - 07/15/18 03:29 PM Re: Customizing Your Medical Kit [Re: hikermor]
Russ Online   content
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cool Now you don’t need to worry about your favorite belt getting trashed by an ER nurse.

FWIW, the SWAT-T I bought from REI in-store is orange, but the ones available on-line are black.

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#289905 - 07/15/18 04:07 PM Re: Customizing Your Medical Kit [Re: Russ]
Montanero Offline
Veteran

Registered: 10/14/08
Posts: 1373
Loc: North Carolina
Originally Posted By: Russ

Earlier in the thread we discussed “improvisation” and that’s always good, but improvisation takes time and sometimes that’s time the victim does not have available. A dedicated tourniquet is easier and quicker to deploy if you have one, and you don’t need to worry about your favorite belt being trashed when it arrives at the ER (you ain’t getting it back). [/quote]

A dedicated tourniquet is also more effective than most improvised ones.

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#289906 - 07/15/18 04:10 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Montanero Offline
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Registered: 10/14/08
Posts: 1373
Loc: North Carolina
The SWAT-T is good, but more difficult to stop arterial bleeding with. I prefer the CAT and the SOF Tactical Tourniquet. I do carry a SWAT-T, but do not rely on it as the primary tourniquet.

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#289910 - 07/15/18 08:06 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
hikermor Online   content
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The SWAT appeals to me because it seems somewhat more versatile. What about it makes it more difficult to retard arterial bleeding?

This is intriguing; I was trained during a phase when tourniquets were regarded askance; they are now currently in favor. I have stopped a lot of bleeding and I think it is time to include a T in my kit. A lot of this seems to be due to gunshots (Montenaro's ) vs mine (almost no gunshots, just blunt trauma).
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#289911 - 07/15/18 08:23 PM Re: Customizing Your Medical Kit [Re: hikermor]
Russ Online   content
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Direct pressure will probably work for the majority of serious bleeding wounds and for those I like the SWAT-T’s 4” width which happens to be the width of a 4x4 gauze pad or a 4x3 non-stick pad. Apply direct pressure to stop the bleeding and then you get your hands back.

Self-adherent wraps apply some pressure, but with the SWAT-T you can dial it up to the point of constriction if necessary. Not sure a self-adherent wrap will get that tight without failing.

The CAT otoh is a dedicated tourniquet, if I decide to go with that option, my intent is no pulse below the TQ.

There are places on the body where no pulse past a certain point means you kill the patient; it’s really really bad form to kill the patient. For those situations, DP is the only way to go — think neck wounds.

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#289912 - 07/15/18 08:49 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Montanero Offline
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Registered: 10/14/08
Posts: 1373
Loc: North Carolina
The only place a tourniquet will kill the patient is on the neck, and EVERYBODY knows you do not put a tourniquet on the neck

The SWAT-T is great for pressure dressings, also a good elastic bandage. These are also very helpful when you need to put pressure on the femoral artery high up in the groin area, where a tourniquet will not work.

The CAT is very light and packs small, where the SOF tourniquet is a bit heavier and bulkier. The CAT can fail in the plastic bar you use to torque the pressure (the windlass), it can break, but the newer ones are stronger. It usually only happens if it is used multiple times (such as training). I have never seen a new one fail.

For torso wounds, obviously, a tourniquet will not work and direct pressure, a clotting agent or surgical methods are the only options.

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#289946 - 07/17/18 06:16 PM Re: Customizing Your Medical Kit [Re: hikermor]
Russ Online   content
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Just so you know, despite the picture on the REI SWAT-T page which shows packaging for the black SWAT-T, they shipped orange which is a good thing imo.

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#289947 - 07/17/18 09:19 PM Re: Customizing Your Medical Kit [Re: Russ]
hikermor Online   content
Geezer in Chief
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Registered: 08/26/06
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Loc: southern Cal
Got a couple of orange ones today and just finished watching the training videos - looks like the SWAT-T will be a useful addition.

About where to apply a tourniquet, or not, my first EMT instructor mentioned a time when he rode in the mbulance with the victim, clamping the carotid artery with his fingers until they got to the ER.He was later sued because of excessive facial disfigurement (unsuccessfully).

Thinking hard about adding a CAT....
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#289948 - 07/17/18 10:00 PM Re: Customizing Your Medical Kit [Re: hikermor]
Russ Online   content
Carpal Tunnel

Registered: 06/02/06
Posts: 4901
Loc: SOCAL
My bicycle kit is shifting more to a focus on trauma with a reduction on owwies, based on Montanero’s comments, the it will probably have both a SWAT-T and a C-A-T. My collision with another bike (BTDT) resulted in a big owwie to my left forearm that really hurt but wasn’t enough to stop me from riding home; a collision with a car might need a TQ, big pressure wraps and 9-1-1. Just over-thinking.

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#289950 - 07/17/18 10:54 PM Re: Customizing Your Medical Kit [Re: hikermor]
chaosmagnet Offline
Sheriff
Carpal Tunnel

Registered: 12/03/09
Posts: 2927
Loc: USA
Originally Posted By: hikermor
The SWAT appeals to me because it seems somewhat more versatile. What about it makes it more difficult to retard arterial bleeding?


It has no windlass.

It requires two hands to apply as a tourniquet.

It breaks easily when attempting to apply sufficient pressure to achieve occlusion, especially on thighs.

While the SWAT-T is better than nothing, I strongly urge the CAT for everyone other than medical professionals. The SOFTT-W is preferred by medical professionals I know and trust for buddy aid, but the CAT is the only CoTCCC approved tourniquet that works well one-handed for self aid.

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#289952 - 07/18/18 01:45 PM Re: Customizing Your Medical Kit [Re: chaosmagnet]
Russ Online   content
Carpal Tunnel

Registered: 06/02/06
Posts: 4901
Loc: SOCAL
Thanks, good post. There’s an article at wiki/Emergency_tourniquet
Quote:
...Results from laboratory and field testing suggest that windlass and pneumatic mechanisms are effective where other systems fail due to excessive pain, slipping, inadequate force, or mechanical failure. ...
...Pressure underneath a tourniquet cuff is not evenly distributed, with the highest pressures localized around the cuff centerline and decreasing to zero near the cuff edges.[7] A high rate of change of pressure across the cuff width, or a high cuff pressure gradient, is a leading cause of nerve and muscle injury from tourniquet use.[7] Tourniquets with wider straps or cuffs, especially those with pneumatic actuation in contrast to mechanical force, distribute pressure more evenly and produce lower pressure gradients.[7] They are therefore more likely to stop bleeding and less likely to cause damage to underlying tissue, in addition to being significantly less painful than tourniquets with narrow straps and bands.[4][8] Overpressure protection in certain emergency tourniquets also help to prevent excessive force from damaging the limb. ...

I like the SWAT-T because it’s 4” wide and should make an excellent aid for direct pressure, but that article indicates I may need to get a 3rd TQ besides the SWAT-T’s. The SOFTT-W looks good and is mentioned in the article as is the C-A-T.

Some may ask why and that was discussed earlier in this thread. It’s usually a layman who is first to an accident scene. That person dials 9-1-1 and then what?? It would be a good thing if that layman had first aid training and also had the ability to stop serious blood flow. That’s how I and I think others here are approaching this.

Taking the thread off on this TQ tangent for so many posts, it should have been a separate thread, but it is what it is.

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#289953 - 07/18/18 02:48 PM Re: Customizing Your Medical Kit [Re: Russ]
M_a_x Offline
Old Hand

Registered: 08/16/02
Posts: 1017
Loc: Germany
Originally Posted By: Russ

Some may ask why and that was discussed earlier in this thread. It’s usually a layman who is first to an accident scene. That person dials 9-1-1 and then what?? It would be a good thing if that layman had first aid training and also had the ability to stop serious blood flow. That’s how I and I think others here are approaching this.


If someone needs encouragement to go for a first aid training it is good to keep in mind that the odds are at about 80% that the skill will be used on someone you care about.
I know a motorcycle club that requires a yearly refresher for the members (usually taken at a club event). Their approach is: "if you don´t care enough for your fellow people to take that training, you´re not fit to ride with us". Those people carry a customized FAK when they ride too.
_________________________
If it isn´t broken, it doesn´t have enough features yet.

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#289954 - 07/18/18 03:00 PM Re: Customizing Your Medical Kit [Re: Russ]
hikermor Online   content
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 6536
Loc: southern Cal
This has been a most informative thread and has resulted in my first ever purchase of a dedicated TQ (I probably will add another model, as well, most likely the CAT).

But let's do keep this in perspective - most bleeding can be stopped with direct pressure. That has been my experience attending to well over 100 accident scenes with blood flow.

And no system is perfect - windlasses can break. Pneumatics have their problems as well. Imagine applying a pneumatic at 4,000 feet to a patient who will ascend to 8,000 feet, to eventually land at a hospital at 2,500 feet (been there, done that).

If there is one significant injury, there is probably another, potentially even more serious, problem with the victim that is easy to overlook (often a spinal complication) that require careful handling.

Max makes an excellent point about treating someone close to you. In fact, if you have any, it will probably be your offspring. So handle your DNA with care!


Edited by hikermor (07/18/18 03:21 PM)
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#289969 - 07/18/18 07:37 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Montanero Offline
Veteran

Registered: 10/14/08
Posts: 1373
Loc: North Carolina
The CAT is light, effective, not too expensive. It is not a burden to include in your kit.

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#289973 - 07/19/18 12:59 AM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Jeanette_Isabelle Online   content
Pooh-Bah

Registered: 11/13/06
Posts: 1840
Loc: Emerald City, OZ
I may add two more TCC care cards (they take up no room) and replace the QuikClot, 25 g with QuikClot Combat Gauze, Z-Fold; that would be it. After the tug-a-war in my mind, especially over the wound care items, I think I have it.

MEDICAL INFORMATION / TRIAGE
(1) Wilderness & Travel Medicine
(1) Tactical Combat Casualty Reference Card
(2) Tactical Combat Casualty Care Card

PERSONAL PROTECTION
(1) Biohazard Waste Bag
(1) Rescue Mask, Soft Case
(6) Personal Antimicrobial Wipe
(2) Emergency/Survival Blanket
(2) Respirator Mask
(2) Bear Claw Glove Kit

BLEEDING
(2) Combat Application Tourniquet, Rescue Orange
(1) QuikClot, 25 g
(2) Trauma Bandage, 4"
(4) Compressed Gauze

AIRWAY
(1) Bolin Chest Seal
(1) Hyfin Vent Chest Seal Twin Pack
(2) Nasopharyngeal Airway w/ Lube, 28 Fr

WOUND / BLISTER / BURN
(2) Trauma Pad, 5" x 9"
(1) Burn Dressing, 2" x 6"
(3) Burn Jel, 3.5 g
(1) 30 Band-Aid, 6 Knuckle, 6 Moleskin
(1) Cloth Tape, 1" x 10 yds.
(1) Stretch Gauze, 3" x 4.1 yds.
(1) Wound Closure Strips, 0.25" x 4"
(12) Antiseptic Towelettes
(2) Benzoin Swabsticks
(2) Oval Eye Pad
(2) Petroleum Gauze, 3" x 9"
(2) Povidone-Iodine, 22 mL
(4) Cotton-Tipped Applicator, 6"
(4) Non-Adherent Dressing, 3" x 4"
(4) Sterile Gauze Pad, 4" x 4"

IMMOBILIZATION
(1) Disposable Cold Pack
(1) Disposable Heat Pack
(1) Elastic Bandage Wrap, 4" x 4.5 yds.
(1) Splint, Orange, 4.25" x 36"
(2) Cravat Triangular Bandage

MEDICATION
(1) Eye Wash, 4 oz.
(2) Glucose, 15 g
(6) Aspirin, 2/pk (Analgesic)
(6) Diamode, 1/pk (Anti-diarrheal)
(6) Diotame, 2/pk (Stomach)
(6) Diphen, 1/pk (Antihistamine)
(6) Hydrocortisone 1% Creme, 1.5 g
(6) Ibuprofen, 2/pk (Anti-inflammatory)
(6) Triple Antibiotic Ointment, 0.9 g
(2) Hydration Powder
(1) Insect Bite Treatment

INSTRUMENTS
(1) Catheter Tip, 18G
(1) Digital Thermometer
(1) EMT Shears, 7.25"
(1) Irrigation Syringe, 20 mL Luer Lock Tip
(1) Tweezers
(3) Safety Pins, 2"
(1) Disposable Penlight
(1) Permanent Marker, Extra Fine Point

I also got the C-A-T trainer, practiced with it and demonstrated it to Mom. It's easy to use. The hard part was figuring out how to fold it, correctly, after practice.

The car kit is the next project; before I do anything, Mom wants to go to look at the current car kit to see what we have.

Jeanette Isabelle
_________________________
"When you're up to your [neck] in alligators, it's hard to remember that your initial objective was to drain the swamp." -- Floridian proverb

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#289974 - 07/19/18 12:06 PM Re: Customizing Your Medical Kit [Re: Jeanette_Isabelle]
Ian Offline
Member

Registered: 05/15/07
Posts: 185
Loc: Scotland
I regard 'First Aid' as aid to an injured person to keep them alive until 'Secondary Aid' arrives. i.e. not paper cuts or sprains.

A well ironed largish handkerchief and training are all I feel I need.

1. We are never far from secondary aid. No wilderness or ocean use, that is a different requirement.

2. I naturally always carry a handkerchief anyway.

3. Can be deployed in fractions of a second.

4. It will double as an expedient particulate mask with, surprisingly, a good protective factor. (yes, I have tested them professionally)

5. Does not generate any liability of use. Easily counts as 'good samaritan' in UK case law.

6. In almost 70 years of life I have never needed anything else, which may be a fact of living in the UK or luck. I doubt if I shall be challenged with needing more in my lifetime.

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#289975 - 07/19/18 01:12 PM Re: Customizing Your Medical Kit [Re: Ian]
hikermor Online   content
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 6536
Loc: southern Cal
I agree about the utility of a handkerchief or something similar, but the most worthwhile days are spent on the water or in wilderness - either on just a personal basis or professional..... And then there are cases like the lady who drove off a cliff, spending seven days before discovery and treatment.
_________________________
Geezer in Chief

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