It has been a few days since Doug emailed me the link to this thread. I have drafted a number of responses, but when I came back and reread them after being interrupted none of them seemed appropriate. What kept upsetting me was the viciousness of some of the responses. So, I figure I will address this first and then move on… One of my major dislikes of internet forums is how many people are willing to attack people for one reason or a number. Comfortably hidden behind the anonymity of the internet these individuals post comments that they would never say in person. I have left or avoided many forums because this behavior… Please don’t bring that behavior in here. I have been working with Doug for a few years now to know how much time and effort he puts into ETS and what the Foundation stands for, those few individuals that are posting that garbage are not only disrespecting the individual they are attacking or responding too but they are also disrespecting the others who post here, the moderators, Doug and ETSF.

Now with that off my chest.

Paragon,
As others have said, you have put together a very comprehensive kit. I can see a few things I would add, but in the end those items wouldn’t really “improve” the kit just make it more suitable for me . It is obvious that you put considerable time and money into making it and for that I give you Kudos! Extra Kudos for the outstanding time and effort that you put into an exceptional series of posts!

As I understand your purpose for this kit, you built as a SHTF huge FAK that would allow a more experience/trained provider to provide more than basic first aid. It should suit that purpose very well. Just to reiterate what Chris reminded everyone, “Do No Harm” is the cardinal rule of patient care… just because you have something doesn’t mean you can or should use it if you don’t know how, especially on others (that wasn’t directed at Paragon, but the forum as a whole…).

The first bit of advice I have for you is to add a manual suction device ASAP, that is an important airway management device. The Res-Q-Vac you mentioned is a good device, I carry one in my aid station and truck kits, but you might also want to look at the Squid suction device (I believe NARP carries them).

Next I would reorganize your kit into two or three smaller kits. You already have the IFAK on the outside of the kit, but I would organize the rest into two other kits, or even three. The main problem I see with your kit is that it would be difficult to work out of. While it is really neat and organized, it is organized like it would be used as an aid-station kit vs. a field trauma kit. While this will work, it will become frustrating when working on a crappy patient in less than ideal conditions. A common mistake when less experienced providers build a kit is they tend to put as much stuff anywhere it can fit, rather than organizing it so that the items you will need NOW are easy to access. I would arrange the kit so that everything you need to manage your ABC’s are quickly accessible, everything else can wait. While the IFAK on the front is a good start the rest of the kit is kind of scattered. An example of this would be the Endotracheal tube (more on that later) in one spot while your Laryngoscope is in another. What you may want to do is find someone to help you rearrange your kit, someone with experience in provide care in the field like an EMS provider or military provider. A Doctor or nurse that has only worked in the hospital, even the ED, won’t have the experience to help you organize a kit like this. Even if you intend to use one of the other, smaller kits you mentioned for immediate care I would still reorganize this kit to make working out of it easier and quicker.
I would like to mention a few things about the medications in the kit. First, I do know of more than one MD who has written prescriptions for some of the items and medications that are in this kit. Typically these kits are for travelers, expeditions, sailing, etc. where medical facilities and/or supplies may be hours away if they are even available… On the assumption that you have a prescription for all these medications my second medication comment is in reference to the Morphine and Narcan… Paragon, you have 300mg or Morphine and only 0.4mg of Narcan. I would suggest at a minimum 10mg of Narcan. On an adult we typically use 2mg as the FIRST dose of Narcan and have had more than one patient that have required 6mg or more before their respirator effort returned to adequate.

Switching the topic to airway management, you have only a 9.0mm endotracheal tube. That is a big tube, and it would be unusable on many adults. In my wilderness kit, where space and weight are an issue I carry a 6.0, 7.0 and 8.0 tubes for adults. These three sizes are useable on all but a small population of adults. Personally, I would dump your intubation equipment and simply carry the King airway devices in more sizes. The Kings are simpler, safer and quicker to use and are pretty darn effective in the emergency setting (especially for lesser experienced providers).

Without repeating others, that is about all I have. The last bit of advice I have is get some more training… it can only help! Even a 40hr first responder course or wilderness first responder course would be a great addition to your toolbox of education.

Now, where did you get those iGo boxes? My Google-fu is weak today!