Kit for an ICU Doc

[ST911]

Your wife is the doctor. Why are you trying to tell her what she needs, should have or should do?

You might be surprised at the disconnect some have with the pre-hospital environment, current standards of care in the field, TCCC/TECC concepts, scene safety and patient interaction, how to use an IFAK, etc. It can be profound.

If the person is so far from help that an ambulance or air evac can’t get there and so severely injured that they won’t survive without advanced life support, they’re not going to make it anyway.

That's a maybe, but I understand what you're saying.

[3 AE]

When I lived in Oregon, an acquaintance of mine is a retired US Army doctor who treated combat casualties and also a teacher at a medical college. I showed him my "trauma kit" that I keep in my car for emergencies. Showed him the contents of the kit, TQs, pressure dressings, rolled gauze, gauze pads, tape, hemostatics, emergency blanket, gloves, large printed "Stop the Bleed" flow chart in sheet protectors. etc., etc. Asked him if there was anything he could recommend to be added and what he kept in his vehicle. His response was that my kit was good to go but he only kept a very basic first aid kit with band-aids, some OTC meds and wound wipes. I was surprised and asked why not have a more expansive kit. He said that he never gave it much thought after he retired and that medical help response was usually quick in his location.

Here in Wyoming, the distances between towns and cities that have medical facilities can be quite far. Response times could be prolonged. Figured anything I can do to extend life is moving in the right direction. I'm not a medical professional, but I did sleep at a Holiday Inn Express a few times.

[FromMyColdDeadHand]

Your wife is the doctor. Why are you trying to tell her what she needs, should have or should do?

As a practical matter, chuck is right. Anything too exotic is impractical.

If the person is so far from help that an ambulance or air evac can’t get there and so severely injured that they won’t survive without advanced life support, they’re not going to make it anyway.

She won’t engage on the issue. Like I said, she might have a pair of gloves. I’m not talking exotic, the intubating was just a skill that her co-workers bring up at dinners and I know that airway is important. Like I said, I just want what she could use and not look back and think that she could have saved one of us “if only”.

When I lived in Oregon, an acquaintance of mine is a retired US Army doctor who treated combat casualties and also a teacher at a medical college. I showed him my "trauma kit" that I keep in my car for emergencies. Showed him the contents of the kit, TQs, pressure dressings, rolled gauze, gauze pads, tape, hemostatics, emergency blanket, gloves, large printed "Stop the Bleed" flow chart in sheet protectors. etc., etc. Asked him if there was anything he could recommend to be added and what he kept in his vehicle. His response was that my kit was good to go but he only kept a very basic first aid kit with band-aids, some OTC meds and wound wipes. I was surprised and asked why not have a more expansive kit. He said that he never gave it much thought after he retired and that medical help response was usually quick in his location.

Here in Wyoming, the distances between towns and cities that have medical facilities can be quite far. Response times could be prolonged. Figured anything I can do to extend life is moving in the right direction. I'm not a medical professional, but I did sleep at a Holiday Inn Express a few times.

We spend gobs of money on security and insurance, I thought throwing a couple of hundred into this would be money well spent.

[HKGuns]

Why don't you just put one together for her as a gift? Might be a fun project and be something she may appreciate and use at some point.

I've not found anything available that is better than the kit I assembled for my truck. Start with a good TQ, scissors and gloves and build from there.

My kit sits in the backpack I have permanently in my truck and is in this pouch.

https://www.vanquest.com/best-seller...zer-organizer/

[chuckman]

"We" always think about TQs because "we" think in terms of penetrating/perforating trauma. For general trauma 1st aid and for wilderness medicine, it's a tool to have but rarely a priority of care because P/P trauma isn't as common. For OOC in general and 'back country' certainly it's a balance between C-ABCDE and the probability matrix of events (injuries and illnesses). TQs are cheap and small, no reason to not have one or two, but also not a likely tool to need.

[FromMyColdDeadHand]

HK and Chuck, that’s what I was thinking, but just don’t know what put in it. I agree on the TQs, but we are around guns so good to have a couple. Loooking at the kits, I see a lot of cleaning and wipes, and frankly, my thought was how to keep someone alive for 30min to a couple of hours- let the hospital juice them with miracle antibiotics to fix things. Gunshot wound, a nasty knife cut/stabbing, birthing a baby. Work a chest wound. Car accident where you might not be able to get the person out. Broken bones and burns- stabilize?
Retractors, clamps, couple of scalpels. Tubing?.
In her residency she was at one of the busiest ERs in the country, and I mention the ICU just because she isn’t just a pill pushing diagnostician - but yes, she isn’t a ER doc or a trauma surgeon- but she can use her hands and get medieval on things if needed.
But like I said, hard to get her to engage. Might use Father’s Day to get her to play along.
THX

[chuckman]

HK and Chuck, that’s what I was thinking, but just don’t know what put in it. I agree on the TQs, but we are around guns so good to have a couple. Loooking at the kits, I see a lot of cleaning and wipes, and frankly, my thought was how to keep someone alive for 30min to a couple of hours- let the hospital juice them with miracle antibiotics to fix things. Gunshot wound, a nasty knife cut/stabbing, birthing a baby. Work a chest wound. Car accident where you might not be able to get the person out. Broken bones and burns- stabilize?
Retractors, clamps, couple of scalpels. Tubing?.
In her residency she was at one of the busiest ERs in the country, and I mention the ICU just because she isn’t just a pill pushing diagnostician - but yes, she isn’t a ER doc or a trauma surgeon- but she can use her hands and get medieval on things if needed.
But like I said, hard to get her to engage. Might use Father’s Day to get her to play along.
THX

You can be a trauma surgeon, EM doc, 18D, PJ, or whatever...all the 'higher' speed stuff isn't worth a damn if you don't have the logistics to back it up: advanced airway; OK, but with what do you ventilate? Are you going to use room air (21% oxygen)?

The goal of OOH care is to keep the person alive, to which you alluded. The brilliance is in the basics. Catch a baby? Two clamps, scissors, blankies, bulb suction. Keeps someone's guts on the inside? ABD dressings, saran wrap, foil. Sick people--especially trauma--die from hypothermia, so some mylar blankets.

If you look in this kit, it's all basics: https://www.narescue.com/all-product...-kit-ecrk.html

If you want something more-than-basic, with her license she can buy IV solutions; always good for heat casualties, hypovolemia. A basic surgical airway kit (a 11 blade, a Trousseau dilator, a tracheal hook, and a 6.5 ETT--KISS applies here). A suture kit with lidocaine.

Basic splints for fractures. She can purchase epi pen for anaphylaxis. Basic meds like benadryl, zantac, a broad spectrum antibiotic for open wounds.

All that said, 99% of her effectiveness is in a basic kit + her knowledge.

[WillBrink]

You might be surprised at the disconnect some have with the pre-hospital environment, current standards of care in the field, TCCC/TECC concepts, scene safety and patient interaction, how to use an IFAK, etc. It can be profound.
.

Not unlike EMT's who have nothing with them once works ends, and LEO's who don't carry off duty, there's something happening under the hood psychologically speaking happening there. It's a level of denial and disconnect and mindset I can't fathom.

The world does not end when the shift does. I have been with off duty LEO's where i was the only one armed, the only one with a band aid in my car, etc.

[Eric]

Not unlike EMT's who have nothing with them once works ends, and LEO's who don't carry off duty, there's something happening under the hood psychologically speaking happening there. It's a level of denial and disconnect and mindset I can't fathom.

The world does not end when the shift does. I have been with off duty LEO's where i was the only one armed, the only one with a band aid in my car, etc.

This. Folks need to know ahead of time what they're capable of doing (hardware and software wise), as well as what they're willing to do. Part of this plan becomes an ethical/moral decision that should be made in advance. I can't see myself only calling 911 when the dude next to me is bleeding out from a round through the thigh at a public range, knowing I have a TQ in my bag. Of course response will be situation dependant.