What do you add or improve when you get a commercial kit?

Here is what I've added

- Name brand band aids(tm)
- Exam gloves
- button light
- waterproof or dust proof case
- Large bleed pads

There is already a thread on how I took an off-the-shelf kit and modified it. The links are what I added to it.

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

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

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

AIRWAY
(2) Bolin Chest Seal
(1) Hyfin Vent Chest Seal Twin Pack
(2) Nasopharyngeal Airway w/ Lube, 28 Fr
(2) ARS Decompression Needle, 10 g x 3.25"

WOUND / BLISTER / BURN
(3) Burn Jel, 3.5 g
(1) 30 Band-Aid, 6 Knuckle, 6 Moleskin
(1) Durapore Tape, 1"
(1) Stretch Gauze, 3" x 12 yds.
(1) Wound Closure Strips, 0.25" x 4"
(2) Non-Adherent Dressing, 3" x 4"
(5) Sterile Gauze Pad, 3" x 3"
(6) Povidone-Iodine Prep Pad

IMMOBILIZATION
(1) Elastic Bandage Wrap, 3" 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
(1) Activated Charcoal

INSTRUMENTS
(1) Catheter Tip, 18G
(1) Digital Thermometer
(1) EMT Shears, 7.25"
(1) Irrigation Syringe, 20 mL, Luer Lock Tip
(1) Scalpel, Sterile, #11
(1) Tweezers
(3) Safety Pins, 2"
(1) Blood Pressure Kit
(1) Disposable Penlight
(1) Stethoscope, Sprague
(1) Flat Duct Tape, 1.89" x 2 yds.
(1) Hemostat, Kelly Forceps Straight, 5.5"

LIGHTS
(1) SYNC 200

Jeanette Isabelle

JI: Good kit mods. Well equipped, without going overboard. If I may, based on my past experience as an EMT in a busy urban area in the. NY-NJ Metro Area. ,U are woefully short of 3”x3” or better yet ,4”x4” sterile gauze pads. For a kit the size of yours , I would suggest 15-20. In a relal trauma situation, u will use up individual gauze pads rapidly ,for multiple purposes.

Likewise u need more Kling type guuze rolls or equivalent. My kit, about the size of yours, has 2x3”” kling guaze rolls and 2-3 , 3” self adhering stretch bandage. Vet wrap is cheap and perfect. To save space, I take it of the cardboard roll and make either flat rolls or round rolls ,without a center piece.

In meds, u need 8-16 , 81mg. chewable children’s Aspirin, to be given if someone is experiencing heart attack symptoms. The faster the administrated the better. Look-up dosages per use.

Latest studies indicate and the FDA has approved and confirmed that you can get pain killing power approaching opiates, from the correct mix of Tylenol and Advil. Check out the internet for correct mix. There re lnow commercial mixes in tablet form, available OTC. I also add to my kit pseudofedrine tablets and caffeine tablets . The pseudo. for nasal congestion and in combo with caffine tablets,, for an emergency boost. This I not my idea. I read about its in the Cody Lundin,book, i“98.6 The art of Keeping Your Ass Alve, ( Alternative Recipe at the end of the book). Use assumes no medical contraindications. Check with your doctor as to safety fro you. You assume your own risk of use. I’m not a doctor or a medical professional. Last, if legal in your jurisdiction , give consideration to 1or 2 Naxolene inhalers to counter opiate and some other drug overdoses. Note , I myself have not taken the step to add Naxolene. I’m still considering it.

Finally, add a small headlamp and a small powerful pea- less whistle. ( check ou the whistle test on this Nd other sites.If you have to give first-aid t at night ,in the wood or car week,etc. It will always be dark/ windy/ raining and you will be working off- trail or road. Tyoull need light ,bothhnds free Nd n easy way to let in-coming rescuers know where you are, I.e. blow the whirle in short bursts of three blows.... pause and repeat , as necessary.

Agreed with Acropolis. Also, consider adding more BZK wipes. If Dr. Bones and Nurse Amy (https://www.doomandbloom.net/) come to your neck of the woods, I would strongly recommend their class on wound closure in austere conditions (no affiliation).

The space in the WOUND / BLISTER / BURN pocket is limited. I had to replace the included 4" x 4" with 3" x 3" to get everything into one pocket.


I have that in my EDC bag.


Space is limited in the MEDICATION pocket as it is.


I have a headlamp listed under LIGHTS and I have a Fox 40 as part of my EDC.

Jeanette Isabelle

I have Personal Antimicrobial Wipes and Povidone-Iodine Prep Pads in their respective pockets. Space is limited in those pockets as it is.

Jeanette Isabelle

Also, far too many commercial kits think 2-6 ibuprofen is enough.
I like a bottle of 30.

Jeanette, et al,

My latest IFAK is much more of a trauma kit than a boo boo kit so have been adding chest vents, CAT TQs, Izzy bandages, Celox and the like. While researching I see many people carry the following as you do.

(2) Nasopharyngeal Airway w/ Lube, 28 Fr
(2) ARS Decompression Needle, 10 g x 3.25"

My question:
1. What situations are these used?
2. Does one need serious medical training to use? Or are there some video-training guides you recommend?

Training is absolutely essential. It is more important than the gizmos in the FAK. For one thing diagnosis, recognition of the condition, is the first step in rendering aid. If you don't recognize the problem, how are you going to treat it? A good course will provide you with a systematic, relatively thorough process so that you consider all the possibilities.

In many major trauma situations, you will face the decision to more or not to move the victim. This can be very tricky - there is an obvious injury, but also a more subtle injury which can be aggravated by improper handling. You often should delay movement until proper resources are available.

If I should be the victim, I would rather be treated by a trained, knowledgeable person without a FAK than an untrained person with a complete assortment of goodies. Of course, the best situation is training plus good, appropriate gear.

I'm not certified to use a decompression needle, but to answer your second question, high-level training is needed. You can't get it by watching a video. I have those needles in the event I'm on a scene in which a person has the training but not the tools with them. Lower-level training is needed for the nasal airway.

To answer your second question, a nasal airway is a tube-like device inserted through a nostril to open up a blocked or collapsed airway. A decompression needle releases trapped air in the chest cavity. Trapped air in the chest cavity is a life-threatening situation. It prevents the lungs from expanding, thereby the patient has difficulty or is unable to breathe.

Jeanette Isabelle

I have been in this situation. Years ago we were at the local gun range and someone had their face to close to the scope when they pulled the trigger, the scope hit him right between the eyes. The wound was deep enough to need stitching. There were about a dozen people there including a medical doctor and I was the only one with a first aid kit. Which wasn't much more than a boo boo kit. After stopping the bleeding and a cursory exam the Dr sent him to the ER to get cleaned up and stitched up. With close and readily available medical care on a non life threatening issue it wasn't a problem. But it is eye opening that no one else had anything with them. So even if you don't have have the training it isn't a bad idea to have the tools available just in case.

What about the Nasopharyngeal tube? Is this another "special training" item or is this something which is practical for me to carry with the intent to use given YouTube level of training?

I'm not sure about that. If you do learn at home, you will need the dummy to practice. That or you will need a volunteer. The following video will explain why it would be difficult to get a volunteer.

https://www.youtube.com/watch?v=yrXD1ryCD1o

Jeanette Isabelle

Ideally, you would find a TCCC instructor and take a class to learn how to use an nasopharyngeal airway (NPA). There should be a training dummy involved. In one class I took, there was an adjunct instructor who let us practice NPA deployment on him (and no, it was not enjoyable for him).

I often re-pac a kit in to a waterproof/dustproof case

1) I always add a small surgical kit including needle holders, a range of sutures, scalpel blades etc. I used to work in a Vet clinic and have had to use the sutures for cuts and minor stab wounds a few times. A quick suture if you know what you are doing, while the tissue is still largely numb from shock, is much less traumatic than a visit to the emergency room and the 4 or 5 hour wait... more needles and then a quick sewing job that could be done at home. (if you have the skills)

2) I add SILVERLON compression bandage material in sealed packs which is used on burns and to help regeneration of wounds. This is self sterilizing and can be reused many many times. When kept damp it keeps the wound free from bacteria and fungal growth allowing largely scar free regeneration to the tissue. (DO NOT USE SALINE WITH IT THOUGH)

3) I like to have cayenne pepper in a large vial which is useful in case of internal bleeding and it also helps with blood clots in veins and increases restricted blood flow.

4) I always carry either a V-Zap unit or similar spark generator unit to treat venomous bites and stings. I have lost count of the number of times that I have needed them for everything from allergic reaction to mosquito bites to spider and snake bite. Living in Australia this is my absolute must have for my emergency kit.

5) I have a stethoscope, several digital thermometers, a blood pressure meter and at least one pair of bandage scissors.

I have been considering adding some Israeli bandages and an air splint as well...

I keep the entire lot in a backpack that I can grab when I need it. The hardest thing is keeping my youngsters out of it, to them it is a wonderful collection of things. I need to restock my sutures after finding them scattered around the house in an opened state... Grrrr. I guess I will have to get a practice surgical kit and start teaching them emergency suturing

WOW, I'm at a loss here! A lot of this will get you in trouble here in the States! Israeli Bandages are great, Air splints cause compartment syndrome and have been removed from care for over a decade! Look at SAM splints or Vacuum splints. Suturing in the field is risky and you better know your wound care or you just made things worse. V-Zap, not touching that one. Changed my mind, Get them to a hospital with anti-venom, don't play doctor!

20
Paramedic

It's "update the geezer time"....

I have often applied air splints successfully 9bck in the 1980's), typically in the mountains with rapid transport, usually helo, to a lower elevation ER. Naturally pressure required adjustment during transport and all were well award of this. Typically we did not achieve a definitive diagnosis in the field and splint application was a cautionary measure. Compound, grossly distorted fx's were a different story.

A quick peek on the internet evidently shows air splints stil eing marketed. Whose call has made them obsolete?

this is a straightforward request for current information. i am well aware that protocols change with time.

Agree that many of the practices advocated in the post you responded to do seem a bit far out. Guess they play by different rules down under....

Due to the fact that air splints completely encircle the extremity and use pressure for rigidity you have basically placed a pressure device. It doesn't take a whole lot of pressure to stop venus blood return. When that is stoped you started the cycle of compartment syndrome. I'm not sure of the events that started the removal of air splints from use, but it has been covered in our Continuing Ed training for over 10 years and we have had them removed from our protocols for use.

20

In reference to Air Splints.
You can still buy them and there are people still using them however they considered antiquated and most EMS agencies have removed them from their equipment or they have been proscribed in protocols.

There are a few reasons that Air Splint have go by the wayside:

• They are limited in their utility compared to other options like SAM Splints or Vacum Splints.
• They have contraindications that other types of splints don't have due to the splints fully encapsulating the extremities. Compartment syndrome is a real concern with long times to definitive care.
• While you can visualize the extremity better with an air splint, other reassessments can be more difficult than with other properly applied splints.
• MOST providers do not properly reassess the pressure of the splint but simply assess for distal pulses. Venous flow is restricted before arterial flow is; compartment syndrome can be developing with a distal pulse present. This issue is compounded in air medical evacuations.

People do still use them, but there are a lot of treatments that are still being performed that aren't considered best practices.

Personally, I have never been a fan of air splints. They are easy to apply and that's it. They were an ok option for a long time, but newer technologies have improved the options.

If room and weight aren't an issue, vacuum splints are significantly better; they aren't affected by temperature or elevation and most can be manipulated to fit the patient's needs.

If room and weight is an issue, I am going with SAM splints. While more difficult to apply than a vacuum splint, they can be manipulated to fit the patient's need and are lighter and more compact.

If you search the internet you can find some cool pictures of a hydration bladder being used as an improvised splint... in wilderness and survival medicine. Improvised splinting is the standard I don't carry too much in the way of splinting supplies when I am in the backcountry in a non-professional role like backpacking.

Since Doug alerted me about this thread I have started typing a number of replies but to sum them all up; Training is more important than equipment. You can carry whatever you want in a kit, just make sure you have the training to utilize it. On that note, make sure you understand the ramifications of performing treatments that may be legally regulated.

On the cayenne pepper issue; I think your priority of carrying it and not have a compress dressing like the Israeli dressing is backward. There is a lot of anecdotal information that cayenne pepper can slow bleeding and improve clotting but no actual evidence. Again you can carry whatever you want in your own kit, but for the others here that are considering carrying cayenne pepper for medical purposes please do a lot of research before doing so.

Quoted for emphasis.

Thank you for your insights. Incidentally, for normal backpcking usage, I have been carrying a SAM splint for the last several years - a really versatile item.

Training, training, uber alles.....

absolutely true, especially with lots of practical exercises.

Air splints need to be used carefully for sure, but they also have the benefit of being able to stabilize low blood pressure due to shock in emergencies. They can save a life and have literally done that when used carefully for set periods of time. Naturally for too long or too much pressure can cause compartment syndrome and careful attention to pressure due to altitude and atmospheric pressure changes are needed. Training is the most important thing.

Training and practice are also very important when it comes to suturing in the field, proper practice and wound care are essential. Naturally the larger the wound and the deeper the wound the more skill and knowledge is required.

As far as the V-Zap and such devices, I have used this method to treat snake bite, many spider bites and numerous other venomous stings over the years all with great success. This was after there was significant swelling and pain.

I know of several doctors who have used this method many times with great success and I know personally the doctor who cured river blindness and supervised a 30 year long program using this method in Ecuador. I know several missionaries who use this method all the time to treat snake bite and regularly save lives even when limbs would normally require fasciotomy. The swelling immediately starts to go down, the skin wrinkles up again and the pain goes away very quickly.

All that to say that it does work, and it works well if you do it properly. The V-zap is a lower voltage higher frequency unit and is my preferred device for a first aid kit as it works best for kids and those who are sensitive to electricity. Anyone who can use a TENS unit can use the V-zap, which is not the same for improvised treatment using small petrol engine spark systems which however require fewer treatment cycles.

I understand your view and normally I would agree. But I normally have a brick of 4 inch gauze pads in there and several compression bandages as part of the first aid backpack, so I already have that emergency capability. The idea of the Israeli bandage is simply to speed things up in applying first aid when needed. Seconds save lives and so it is one thing that I plan on adding.

Cayenne pepper is one thing that I have used with success to dissolve blood clots in the body and overcome thromboses. It works topically to help with bleeding and it has been used for emergency application (by mouth in water) to cause rapid clotting of internal bleeding which has been lifesaving by herbalists for many years. I am not sure of any major studies either but I do know that it works and when someone is dying, if you have it, it may very well make the difference of saving their life or bleeding out. But the main reason that I have it is much less extreme. I have used it to treat thrombosis in a family member twice with great success. Also I have used it to clear out fully blocked arteries after heart surgery of another relative... extended and careful use of course, when the doctors could do no more for him. Of course it is important to not use cayenne pepper with people who are taking decent doses of blood thinners.. that can thin the blood too much so I would not give it internally but pour it into the wound as a final resort.

If you are going to use things of course it is essential that you don't go off half cocked and that you are knowledgeable in the use of such tools and treatments. Everything that is in your first aid kit you should be fully skilled and practiced in the use of.

As an aside, some local fire fighters who work with EMS / Search and Rescue, carry a bag of sugar in the truck with them. For deep wounds with internal bleeding that can't be stopped they take a cup of sugar and pour it in the wound and bandage on top it works like a treat according to them, it also helps with edema. Google scholar search for sugar and wounds is an interesting read...

Please read this before you try to use an air splint to bring up low blood pressure! EMS Myth -Medical Anti-Shock Trousers. We stopped using MAST/PASG pants in the early 2000 because they don't work.

20

There is a TON of evidence that MAST/PASG devices do not work and may do more harm than good in many circumstances. I don't even know how many patients I have put them on in years past, but we know better now. I don't buy into the "it has always worked for me" mentality of medicine. I am of the school of Evidence-based medicine... prove it works!

Sugar and more specifically Honey have been proven effective for wound management and healing... Bleeding control is another issue altogether. In a survival situation, making do with what you have is one thing but there is NO EXCUSE for professional rescuers/healthcare providers to be carrying sugar for bleeding control when there are a number of highly effective hemostatics available.

"The problem with Evidence Based Medicine is really the clinicians" Shyan Goh (Orthopaedic Surgeon - Sydney, Australia)
Don't be the provider that gets in the way of good medicine because "it always worked".

Seems like a rather glaring contradiction here? On the one hand you claim cayenne pepper dissolves blood clots. In the next sentence you claim it causes rapid clotting of internal bleeding.

Is it a "coagulant" which increases the formation of blood clot?
Or is it an "anticoagulant" which reduces the tendency to clot (but does not dissolve clots that have already formed).
Or is it a "thrombolytic" which actually dissolves clots that have formed?

It can't be all three at once.

Thanks KR20 for your link, I look forward to checking it out and seeing what the current research shows.

ASKAR, I suggest that you check out the affects of Cayenne pepper in the body, it is a very remarkable compound. It thins the blood slightly allowing proper blood flow, it cleans out the vascular system allowing better circulation and dissolving clots over time in the blood vessels. It also aids in clotting where there is internal injuries or wounds. The action internal to the vascular system of dissolving clots is a much slower one and is part of the healing processes in the body from what I understand. As far as the actual biological mechanism, I am not aware of how it does it's job exactly, but it does work and future research is warranted, but unlikely to happen seeing there is no money in it and most research requires a monetary carrot in order for it to be performed these days.

What are the specific references you would have AKSAR (not ASkAR) check out? Please cite them.

Basically you are claiming that Cayenne pepper can perform at least two diametrically opposed functions. That is indeed remarkable, if true.

I work in a field with a close relationship to science (archaeology) and I have done enough research-like activity to assert that research doesn't require money so much as it requires good records and clear logic, especially for pioneering efforts on which you base future grant requests.

For the moment, please color me skeptical....

Just did a quick search of 'cayenne pepper" and encountered this article which discusses health benefits -
https://www.medicalnewstoday.com/articles/267248. No mention of clotting ability, although it may retard Alzheimer's, a subject of great concern to geezers like me. The Wikipedia article on cayenne does not mention any health benefits at all

I do research in Archaeometallurgy and agree that research does not require the result to be profitable in these areas. However I have also worked on the fringes of medical research and I have noticed that most of the research that is done is only done because there is the potential of money being made. There are many areas of research where cheap and simple cures have been shut down because it competes with more lucrative treatments which are not as successful.

I suggest you dig deeper.. wikipedia is not the best source for accurate information on non mainstream medical treatments...
Have fun researching.

So where are your refeereences?

I said previously that I am unaware of peer reviewed research on cayenne pepper but that it has been used in the alternative (traditional) medicine field for a long time with success. I also mentioned that it is an area that should be studied more to determine the exact mechanism of action. There hasn't been any research which has disproven the claims of natural medicine about this compound either.

I will say that the information that Snopes talks about in that link is total quackery. That website had no idea what they were talking about. However no published research doesn't mean that it doesn't affect clotting or internal bleeding, it just means that mainstream medicine has ignored this herb which has been used in traditional medicine for a long time. Don't forget that a large number of drugs are synthetic versions of compounds which were isolated from herbs and plants used in traditional medicine.

Did I say that everyone should use it? No. Did I say that it works? Yes. Did I say that it needs to be studied to fully document how it works... sure did. I think I have covered all bases. If you are interested then dive down the natural medicine rabbit hole.. it can be rewarding. Otherwise don't add it to your kit

No references, no dice. Over and out.

I suffered a DVT a while ago. Went to the ER where it was treated promptly and effectively. Since then, no further problems.

In regards to scientific research on herbs, please do NOT use Wikipedia or Snopes. Search the National Library of Medicine's PubMed research database. It covers pretty much all scientific journals and if the research was done using government funds usually the full paper is available to download. If not, at least the abstract is posted.

Here's a good example: Capsaicin Supplementation Reduces Physical fatigue and Improves Performance in Mice

-Blast

Thanks for the reference. Good to know....

Not exactly within the topic of FAK upgrade, but not outside the subject either.

One time I injured my arm bad, and had to use one hand to put a gauze pad and wrap the arm with gauze roll. It wasn't easy. It was both frustrating and funny.

So, how do you aid yourself in such a situation?? And are there specific tools to help in "self-help" scenarios that are different from when someone is helping someone else ??

One example is adding a mirror to see yourself if you have injury in the face.

I am almost abidextrous and I practiced wrapping gauze one handed with either hand. One of the tricks is to fixate the roll in a way that will allow you to reach around and change grip, e. g. pinch it in the ellbow or hand. It is a knack thing.
A mirror is a good idea. I usually have one in some pocket. Adding one to the FAK wont break the bank. I have a sheet intended to replace the glass of side mirrors of vehicles. Dropping such a mirror wont break it. I used my mirror once when I was fly fishing and firmly planted a streamer on a #1 hook in my cheek. I was really glad that I joined the barbless community way before this event. Hemostats help a lot with the extraction too.

I like the giant island plaster (not sure if that is the proper translation). Just pull the backing off and slap it on. Stays on moving bits better too.

Another thing is the 'premade bandage'; gauze and gauze roll in one thing.

Both make it easier with one hand. Both make it far easier when it's windy and are quicker.

TIP: A cell phone camera can stand in for a camera when looking for injuries (or ticks.)

If you are in cactus country, a comb in your FAK is a great tool for removing Cholla cactus balls.


20

You probably have either a signal mirror or a compass with a mirror, or both. This comes under the heading of "gear items that are useful in first aid" - improvised splinting materials and the like.

As others have noted, having a premade/commercial trauma dressing that is bandage and dressing in one can be a big help in self-aid. My preferred dressings are the Tactical Medical Solutions OLES Bandage or if I need a more compact and lighter dressing I like the H&H Mini Compression Bandage.

+1
This is very helpful in more ways than you can imagine. Even more useful than a mirror sometimes. One time I had a problem in my toe (under the toenail) and at the same time, I was suffering from a problem in my hip (not to mention a big belly). It wasn't easy to bend and see the toe problem clearly. So, I took a few close up pictures with the cell phone camera and examined them before putting some ointment.

A camera is also very good for "preventive measures" that will help you NOT to need first aid in the first place. One day I was looking for some items and thought they might be on top of a cupboard. Due to my health problems (knee, hip ..etc. ) I avoid using tall ladders. So I used a short ladder to almost reach the top of the cupboard and photographed the blind area instead of climbing higher to see with my own eyes.

This is not exactly "first aid", it is "accident prevention" which is also important.

Depending on your health and other circumstances, I think "aid" is a very wide subject. I am planning a home building project within a few months (depending on the pandemic situation). And although my knee and hip are better nowadays but I plan on using a cane while I am in the building site. It is true that I can walk without it, but with all the debris and scattered stuff on the ground, it is wise to have a "third leg" to add to stability and prevent possible falls.

I also plan on carrying a "survival necklace" containing a flashlight and whistle. If something happens, I can call for help.

A hiking staff, cane, or whatever you care to call it, is a highly useful item, especially on uneven terrain. Recovering from a recent hip replacement, I find one even more useful.

I have used a staff for about the last three decades when hiking. They are really useful when fording a stream or poking through brush in snake country. An old room handles is just about as effective as the swanky hiking staffs, which can cost nearly $200 in some stores.