After assisting in teaching a course this past week with another tactical medic, and fielding dozens of questions regarding kits, gear to get, gear to carry, and so on I decided to post this here for some of the guys who may be asking the same question, “What is the bare minimum kit?” (As it pertains to an Individual First Aid Kit or Trauma Blow out kit).
After 9 years to present as an active Tactical Paramedic (14 years as a paramedic), and several TCCC/LETTC week long courses I have come to the informed opinion that there are 3 items that can handle most situations, as well as be a bare minimum kit for the non-medic, regular shooter.
-CAT or SOF-T Tourniquet (1)
-QuikClot Z Fold Gauze (Hemostatic Agent) (Get the Latest Generation NOT granular or old Gen Roll)
-Olaes Bandage
The tourniquets mentioned are the best. Done.
Quikclot is now proven to be the number one hemostatic agent.
The Olaes dressing has within its contents a plastic sheet that can be used as a chest seal, extra gauze for wound packing, eye cup/pressure point, and the dressing serves as an amazing pressure dressing.
With this hardware above, and the appropriate training to get you the right “software” in your head, you can provide exceptional care to reduce the fatality rate of the most common cause of preventable death in this line of work - Exsanguination (bleeding to death).
Tourniquet early, tourniquet fast. (high and tight).
Pack that wound with QuikClot onto the vessel if possible/into the cavity and HOLD PRESSURE FOR 3 MINUTES.
Secure wound site with pressure dressing.
Hope this helps some guys out. Remember, if you carry a gun you should carry a kit, it is as important as the bullets in your mags.
How long can these items stay applied before they need to be removed? I spend a fair amount of time in the back country solo and I get into dangerous activities frequently. I spend most of my time off the beaten path so to speak. For this reason I tend to carry more aid than a typical backpacker ever would. I have all 3 items mentioned and extra gauze roles for packing /changing dressings. My biggest concern is getting caught in a situation where I’m going to be there awhile and I don’t want to rely on rescue to save my life. I try to think of long term (days) rather than hours.
Sent from my SM-G900T using Xparent BlueTapatalk 2
Aside from the multi use aspect of the Olaes (which you would still need tape for the improv chest seal, right?), what do you think about z-fold gauze and ace wrap as a low cost solution for a pressure dressing? Do you really need the pressure point/bar to make a pressure dressing work?
All of this requires as I stated, “software” aka training. I wish I could put a huge class on for the guys here on M4C for free. I literally would. You asked a good question. Tourniquets when placed by a “layperson” need to stay in place if they were placed for extreme hemorrhage. If you required a TQ, and hemostatic agent then you need immediate evac my friend. You need a SPOT device or some way to communicate that you need to get out. This type of wound needs definitive care, likely vascular surgery if an artery was involved. The rule with TQ’s is they should only be in place for 2-3 hours. The wounds I am discussing need to be addressed in a matter of hours, not days. I hope that helps answer your question.
You could secure the plastic piece in the Olaes with the wrap itself if that was the isolated injury. You could even potentially stabilize a flail chest with it if secured with additional bulky dressings. I would rather have the Olaes for as Mr. Blasty put it correctly $7. Yes and ACE wrap and Z-fold QuikClot will work. Is it the best? I don’t think so. I do carry Ace wraps in my more extensive kit however. The list I put above is what I believe is the BEST 3 items if you had to choose. TQO - Tourniquet, QuikClot, Olaes I used to put 10 pounds of shit in a 5 lb bag when I started doing this. I carry less and less as time goes on. What is the MOST LIKELY preventable cause of death scenario you will encounter in a gunfight? - Extremity wound with hemorrhage. I hope this helps. Thanks for the discussion.
As a single item for a single kit, no it’s not a big deal. But if I wanted to stock multiple kits or a large kit for multiple ppl, then it adds up pretty quick when I can make 2-3 ace/gauze wraps per every one Olaes. I do agree overall though and will have an Olaes in my EDC kit.
I can’t under any circumstances shake my personal belief that ending life and saving life should be a no expenses spared endeavor. For that reason I’ll most likely never do it professionally because then budgets and administrators are involved.
Sent from my SM-G900T using Xparent BlueTapatalk 2
SPOT is on my short list but I don’t have one yet. I fully understand the importance of getting help asap but some things end up out of ones control at times. Medical training is something both my wife and I (she does a fair amount with me) are looking to get in the short term. If you have some recommendations for training in or near Minnesota, I’m all ears. I’m pretty much a regular at the hospital. I’m particularly interested in improvised medical care and emergency care in austere conditions. Combat medical training seems to have more to offer me than a basic emt course.
Sent from my SM-G900T using Xparent BlueTapatalk 2
I understand what you’re saying but you’re acting like ace/gauze won’t work as a pressure dressing. From my limited training I’ve gotten, if I can’t stop a bleed with the pressure that I can get out of an ace bandage, then I likely need a TQ.
I do backcountry elk hunting out west and go deep off trail like you mentioned above. I’ve taken a Delorme InReach SE with me the last couple years and would highly recommend it over the SPOT. It’s more reliable (sending messages) and is a two-way communicator. Definitely gives the wife some peace of mind.
I think the question would be can a cheap ace bandage offer enough pressure over time, blood and other goo to properly keep a wound packed. I’ve had ace bandages fail to keep my ice packs in place, so I’m not 100% sure I’d want to risk my of my families life on one.
If that’s all you can afford, so be it, but IMO Id be replacing them on a monthly basis till I had all my kits stocked with dedicated gear.
I, too am a big fan of the OLAES, preferably the 4" flat pack. As an added bonus, the OLAES is available in a non-sterile training variant for less expensive practice unit replacement. I like the on-board roll of gauze within the dressing, that be used in conjunction with the wrap or separately as the wounds dictate. The plastic sheeting is also handy, especially when the dressing packaging is pre-wrapped with some tape. In it’s flat pack configuration, that’s a lot of capability in a small footprint. Add a pack of combat gauze.
Backcountry med is a different animal. Same immediate action, different long term management. A big portion of that management is evac.
Open up any IBD, Cinch-Tite, OLAES, ETD, H-Bandage, Traumedic, or other trauma dressing. They all start with an elastic (ace) wrap, add a non-adherent pad, and except for the ETD and Traumedic have some sort of gizmo that helps add pressure. Some do a better job than others, are more intuitive, or have some neater tricks and capabilities if you want to learn them. But at the end of the day, the mechanism is the same. You can do largely the same thing with a 4" or 6" roll of elastic or control wrap, boosting pressure with some half-twists or added objects. Different paths to the same end.
Do note that not all ace-type wraps are the same. For example, a roll of Control Wrap (https://www.tacmedsolutions.com/product/control-wrap/) is the start of the OLAES without the frills, a far cry from a Walmart pharmacy ankle support wrap.
My primary bags are packed with OLAESs, and smattering of others. MASCAL bags are stuffed with control wrap and rolls or vacuum packs of gauze.
Most manufacturers of the dressings above offer their own training videos. Check them out.
Thanks, that’s the point I forgot to mention, the fact that ace/gauze is pretty much made of the same stuff as a pressure bandage, just without the pressure gizmo. Pack the wound with gauze and wrap the heck out of it with the ace bandage. That said, for a low pro BOK, it’s hard to beat the versatility of the Olaes.
And yes, I’ve bought Walmart ace bandages and wouldn’t even think of trusting my life to those.
Great recommendations, these 3 are the corner stone in every med kit I have. Some kits have as much as I can squeeze in, but my EDC kit is these 3 things. I don’t have near the medical exp as TacMed (couple med classes and one TCCC) but I feel comfortable with use/application of these to stop arterial & venous bleeds. And I’m average joe so it has to be simple.
Gear can add up but over 3 years I’ve built up 4 differ med kits (plus one designated trainer TQ) ranging from bag-o-medical to EDC. Just buying what I can when I can, some were even givin as swag from classes. Expensive but worth it.
Ditch Medicine might be an option for those thinking worst case camping/hunting/etc senario. ESEE knives-RAT (Gadsden AL) http://www.eseeknives.com/index.html. offers Ditch med/survival/land nav/search-rescue/bushcraft/etc. They also team up with instuctors for Firearms/TCCC classes. Hugh Coffee teaches a hell of class and wrote the book on ditch medicine… Literally—you can buy it here http://www.amazon.com/Ditch-Medicine-Advanced-Procedures-Emergencies/dp/1581603908. There are other schools as well around country.
There are some out there, however all are expensive if you are paying your way. I have been fortunate with it being department sponsored and occasionally at regional LE conference. Best one I ever took was by ITTS - Innovative Tactical Training Solutions. Keary Miller was one of the Instructors. He was a PJ on Takur Ghar in Afghanistan participating in the rescue of Neil Roberts (Roberts Ridge). Likely the best training of its type so far and I have had several TCCC courses under my belt.
Holy crap this turning into a great thread! Med knowledge for the layman is not easy to come by and sorely lacking. Many who know it refuse to share and many non med types can’t get to quality training easily for a number of reasons. Any and all info is appreciated.
Sent from my SM-G900T using Xparent BlueTapatalk 2