From the TCCC:
60% Extremity Hemorrhage
33% Tension Pneumothorax
6% Airway Obstruction
Let’s assume, for the purposes here, that we’re talking about being stateside and with 30 minute response time from EMS and 60 minutes to get to an emergency room or trauma center.
Let’s also have a goal of an AR double-mag pouch (or triple if needed) as a size limit.
I think anyone/everyone would include a tourniquet or two.
Trauma dressing (Israeli, Oales, Cinch-Tight, Thin-Cinch, 4" vs 6", etc.) seems to be a common theme.
NPA?
Better to use a dedicated chest seal or rely on the wrapper from the trauma bandage and some tape?
Hemostatics seem to illicit some controversy, but better to have and not need? Worthless stateside with 30 minute EMS response?
You have, no doubt, already read the Doc Gunn AAR on p. 72 of the Dec. SWAT, an issue in which you have an article.
He recommends a tourniquet on the vest or in the range bag along with the basic kit.
The key is having the skill to identify which tool needs to be used and how to properly use it. Tools can be good or better. What do you want to do and how much do you want to spend to do it?
But you already knew this.
ETA: I went with the IBD because there is cheap training available which has recently been updated:
The six inch IBD (with slider,) NPA, and catheter, all wrapped with three strips of tape, will fit in single Eagle M4 pouch. There is room for an Ascherman if you desire. With a TK-4 in a Blue Force Tourniquet NOW! StrapTM and the Eagle single, you have used three vertical PAL rows.
I have a small one in my range box at home. It’s geared mostly toward being shot once accidentally, rather then someone trying to riddle either myself or my wife or someone else with holes.
Kerlix
Ace Wrap
TQ
Hyfin dressing
Three Inch Med Tape
NPA and lube
Celox
No.7 hook
I’d also be interested to know how quickly tension pneumothorax kills. If it takes hours, and stateside EMT response is 60 minutes or less, then it may not be needed in the kind of range kit I’m thinking of for use on established ranges.
Obviously there is an argument to be made that if you’re on an established range why not have a full bag with 2-3 of everything you might ever need, but I’d like to skip that argument for now.
Good question! This wasn’t addressed. I surmise that it can be quick; otherwise the catheter would not be included in the kit. Let me contact him and find out what he says.
No. It is a tight wrap. The outer cover has instructions. The tear points are on the ends so the wrapper is large enough to use for the Ascherman substitute. The tear point on the inner wrap is in the center and makes the inner wrap virtually unusable.
One more point: medical supply houses generally say federal law requires them to have a prescription before hey will ship catheters. Tactical Response sells the same 3.25-inch decompression needle included in their VOK without a prescription. It is needle only, though, no catheter.
Not only that, but often there are people there that might be better trained then you are. Those people, may not have their own kit with them, or their kit may not be close by.
And it can fit the items that you are most likely to need:
Pressure Dressing (I like the H-bandage)
Quikclot Combat Gauze
TK-4
NPA
Decompression Needle
As for how quickly a Tension Pneumo kills it really depends.
By definition you have a tension pneumo before you show signs, how quickly it progresses from there depends on the injury. In my experience once the signs are obvious you’re behind the curve.
My sense is that you’re talking about an open pneumo thorax caused by penetrating trauma rather than a closed pneumo caused by a car accident/paper bag effect or coughing. You can sometimes decompress an open pneumo without a needle by releasing the air then sealing the system with a flapper valve of sorts. You need a needle for a closed pneumo.
A lot of variables there to apply to a barebones kit. Since you’re talking about GSW’s I’d think a needle kit is less applicable for bare bones.
For the sake to the topic at hand let’s assume that you’re going to start with a GSW. While the current trend towards more and more theatrics in training may one day reach the point of car races resulting in the potential for a car crash, let’s assume that the worst injury you’ll sustain on the range is still the GSW.
The statistics you provided from TCCC shows that penetrating trauma/hemorrhage is more lethal than all other causes combined.
Since you’re keeping it to the range, rather than a SHTF scenario, and EMS is more or less in close proximity to provide higher orders of tx, for “bare bones” (bare minimum) I’d concentrate on hemorrhage control.
Tourniquet, pressure dressing, maybe hemostat has the most applicability and will treat the most likely injuries.
I don’t take it that way at all. It’s no different than someone asking a question on the firearm side of the forum and some of us saying “go take a class”.
By all means get training anyways, but lack of formal training is no reason not to have a bare bones kit.
A bare bones kit of a tourniquet, dressing and perhaps a hemostat requires very little training. Any FR class will make you reasonably competent in their use if you’re not clever enough to figure it out on your own (I’m pretty sure everyone here is competent enough).
Needle kits and other more advanced techniques certainly do require training but I wouldn’t call that bare bones. That’s a pretty specialized technique.
