1. Are you a current member with account or password issues?

    Please visit following page for more information

    Dismiss Notice

Car FAK - Just stop the bleeding?

Discussion in 'First Aid Station' started by FrozenMuffin, Jan 25, 2013.

  1. FrozenMuffin

    FrozenMuffin Loaded Pockets

    Joined:
    Nov 7, 2012
    Messages:
    89
    Likes Received:
    167
    After reading this very interesting thread I decided to add a fak in my car, but I'm not entirely sure what to include. So far I have a couple abd pads, 2 pairs of gloves, 2 rolls of gauze and some shears. It's fairly compact and I'm planning on putting it in the center console of my car in a clear ziplock style bag. I'm going to the store tomorrow to get a few things and figured I could get whatever I need to finish this kit.The only thing I could think of was some quick-clot and maybe another abd pad or two. The main purpose would be to stop bleeding until FR's arrive, so anything like a sam splint, meds or disinfectant would be useless. So is that really all there is to a car fak? Just stopping the bleeding? It seems like you would need a bigger kit to treat anything serious and by the time you treated anything more than a flesh wound EMS would be there.

    Anybody carry a kit in their car? I'd love to see some pictures :D
     
  2. jp2515

    jp2515 Loaded Pockets

    Joined:
    May 26, 2008
    Messages:
    1,650
    Likes Received:
    94
    For a no nonsense kit, I think you got the basics to stop bleeding. I would add some Rolled Gauze as well.

    Or when you really need to stop the bleeding, a trauma dressing will do. I recommend having an extra one of these or two.
     
  3. batteur
    • GITD Manix 2XL Owner
    • In Omnia Paratus

    batteur Loaded Pockets

    Joined:
    Sep 3, 2012
    Messages:
    2,553
    Likes Received:
    15,305
    Here in Germany all cars are required to have a FAK, in fact there’s a federal norm for that and we can be fined if it fails to conform with that norm.
     
  4. paaiyan

    paaiyan Loaded Pockets

    Joined:
    Jul 26, 2011
    Messages:
    437
    Likes Received:
    477
    In mine I keep an Israeli Battle Dressing, lots of gauze (rolled and pads), self-adhering wrap, tape, alcohol, iodine, ibuprofen, several pairs of gloves and Celox. I don't have much to work on fractures or anything of the sort. Like your thread title says, I'm mostly concerned about keeping someone from bleeding out before someone with more ability than me shows up.

    The guy I cleaned up wasn't in dander of dying or anything. I mostly put the gauze pad on to keep the blood from coming down over his eye and caking up. I'm sure that would have been less than comfortable.
     
  5. VinnyP
    • In Omnia Paratus

    VinnyP Loaded Pockets

    Joined:
    Aug 18, 2006
    Messages:
    612
    Likes Received:
    112
    As you say if you are in a car then you are accessible to emergency services, so you only need to cope until they arrive, I think it is a good idea to concentrate on survivable injuries that will kill or do serious harm before they arrive. First up definitely look at catastrophic bleeds so a good pressure dressing tourniquet then hemostatics if you like. If you know how to use it some kind of airway is good; preferably a variety. Next on my list is tension pneumothorax. I keep the basics to deal with all the above boo boos along with gloves and a CPR shield in a small pouch in the passenger compartment. In the boot/trunk I have a slightly larger kit for multiple and more complex casualties. I also keep an AED there. The other thing I try to remember is to keep the environment safe if there has been an accident so warning triangle chem lights hi viz jackets and road flares if they are legal where you are. Finally sometimes you may need to load and go so some kind of litter/stretcher will make that easier.
     
  6. TangoAlpha

    TangoAlpha Loaded Pockets

    Joined:
    Jan 14, 2013
    Messages:
    37
    Likes Received:
    277
    Buy an off the shelf FAK then add some Quickclot/ Celox and any meds that you think you or your family might need.
     
  7. MedicInTraining
    • In Omnia Paratus

    MedicInTraining Loaded Pockets

    Joined:
    Jun 27, 2012
    Messages:
    689
    Likes Received:
    650
    I think the extent of your kit should reflect the extent of your training. If you are trained to put a collar on then include a collar in your kit, if you are trained in the insertion of airways then include a few oropharyngeal airways or nasopharyngeal airways, if you are trained in chest decompression then include a 14G needle, if not don't include these things unless you prescribed to the 'someone on scene will know what to do with it' theory.

    I'm on board however with VinnyP's scene safety suggestion. Your safety is paramount if you're first on scene to a RTC because you don't have an ambulance to shield you or anything like that. I would definitely include a reflective vest and a light source of some kind to alert traffic that there is an accident up ahead. You can position your car to protect yourself but nothing is better than some reflective activity!

    I would also include a headlamp for you. There is nothing worse than attending an accident at night time with no light source or a light source that requires you to tie up a hand or two.

    From a medical perspective- pads pads pads pads pads! Stop the bleeding and at the end of the day you'll be giving the patient the best chance you can. If they don't have blood to circulate then everything is over! If you've got the skills to apply a tourniquet then I would get one of those and throw it in otherwise you can always fashion one using a triangular bandage. I would put in some shears because exposure is everything in order to determine other injuries.
     
    Mudinyeri and FrozenMuffin like this.
  8. smellypaddler

    smellypaddler Loaded Pockets

    Joined:
    Jan 15, 2010
    Messages:
    158
    Likes Received:
    79
    Excellent timing. I'm currently setting up a car first aid kit that can permanently live in the car. It will be designed so that anybody can use it and so I don't have to have my massive trauma kit with me. Sure it would be nice to have a full airway kit and steth, sphyg etc but I just find it too impractical to carry that all around. So far my idea is to set it up in a medium size pelican case that will fit under one of the front seats. I'm going to make 4 individual vac sealed bags that are labelled Patient 1, Patient 2 etc. Each bag will contain a gloves, flashlight, reflective vest, trauma shears, foil blanket (Definitely recommend one of these for your kit as trauma patients need to stay warm), 2 x 20x 20cm wound pads, 2 x 10x 10cm wound pads, 2 x #15 trauma dressings, 4 x conforming bandages, a texter pen and a basic laminated patient info sheet that a lay responder can use to record info such as name, DOB, allergies, meds, past history etc

    In the spare space in the kit I'll put some quickclot, tourniquet, 40x90cm trauma pad, a couple of OPA airways and a CPR face mask.

    My theory is that on arrival at the scene of an accident I can utilise other bystanders or passengers by giving them a kit to initially manage each patient. Then I have some spare bits and pieces left in the central kit to deal with anyone more seriously injured. The contents aren't too daunting or complicated for my wife or anyone else to use and if I am on scene I can manage the incident more effectively without getting bogged down in individual patient management unless required.

    Scene safety is paramount which is why everyone gets reflective vests and flashlights and there will be some flashing signal lights and glow sticks in the kit as well. I'm just starting to collect everything together and will post a pic of the kit in a few weeks time.

    What if there are more than 4 patients on scene? Well what if I come across bus wreck? I'll just adapt, improvise and overcome :)
     
    FrozenMuffin and don Roberto like this.
  9. nemoaz

    nemoaz Loaded Pockets

    Joined:
    Dec 20, 2012
    Messages:
    21
    Likes Received:
    17
    I don't keep quickclot/celox in my car kits. It's not a great idea to put that in a wound in most domestic scenarios in which ems will be there shortly and the hospital isn't too far away. Most untrained wouldn't know when to use it or not. It's for life threatening bleeding that can't be controlled by direct pressure only. The untrained usually greatly over-estimate the threat of bleeding.

    My jump bag is in my trunk. I haven't used it in years. I certainly wouldn't keep it in my console. That's where the stuff I use everyday goes.

    I agree that the kit should be commensurate with your skill level, but just being trained on chest decompression (many soldiers are trained to do that in combat situations) doesn't mean you should be doing it in the field in domestic situations. Even a paramedics often don't have protocols (written orders from physicians) to do advanced procedures in first responder situations.

    Also, remember that the first thing the paramedics will do when they arrive is to remove your dressing to see the injury site (unless maybe they know you and trust your judgment)... it's also what happens again when the patient arrives at the ER. Just throwing some 4x4 or abd pads, holding direct pressure and elevating for 3-5 minutes is often all you need to do. Other times just holding the cervical spine still and or holding the airway open manually is all that needs to be done.
     
    Dapple and keeper like this.
  10. VinnyP
    • In Omnia Paratus

    VinnyP Loaded Pockets

    Joined:
    Aug 18, 2006
    Messages:
    612
    Likes Received:
    112

    A few things, I agree that untrained people can overestimate the threat of bleeding but I'm not untrained nor is my wife, if you need hemostatics and you were partially right they are for extremity life threating bleeding, but when direct pressure or a tourniquet can't stop it then waiting for the EMS is probably too long. Unnecessary use is not the problem it once was

    Keeping some kind of kit in the passenger compartment is highly recommended. If you are trapped or are too injured to get out you can self treat, treat your passengers or be treated by them. Its much quicker to access when time is of the essence and you can still get to it when you can't access the trunk following an accident. It's also useful as a second kit if there are multiple responders.

    Lastly elevation went out in 2006 along with indirect pressure.
     
    Last edited by VinnyP, Jan 27, 2013
  11. nemoaz

    nemoaz Loaded Pockets

    Joined:
    Dec 20, 2012
    Messages:
    21
    Likes Received:
    17
    Went out in 2006? Do you mean out of the Red Cross curriculum or something? There are plenty of times when you need all the above (including tourniquets) to get the job done, so I don't much care about the newer simplified curriculums. If you have a limb blown off, you may have to use indirect pressure/pressure point until you get the tourniquet on or you may even find you don't have enough limb left to put the tourniquet on. Or a big laceration to the neck and a severed EJ? You better be holding pressure indirect or direct pressure (and be precise about the location with respect to the EJ). I know that both are unlikely and neither of us will probably ever see something like that again, but I've seen both and this forum serves a wide audience some of whom may be current military.

    I keep a blow out kit on my raid gear, but I don't have kits in my console of my car. It's just a cost/benefit thing. Your assessment may be different.
     
    Last edited by nemoaz, Jan 27, 2013
  12. smellypaddler

    smellypaddler Loaded Pockets

    Joined:
    Jan 15, 2010
    Messages:
    158
    Likes Received:
    79
    I don't think VinnyP (correct me if I'm wrong Vinny) is talking about the red cross curriculum. I think he is talking more about best evidence based practice medicine. The likes of AHA, ARC, ERC & ILCOR. These are the major national organisations that study the literature on subjects such as catastrophic haemorrhage coming out of studies from Iraq and Afghanistan.

    Indirect pressure may have worked for you in the past but that doesn't mean that it is the most effective treatment method available. In terms of catastrophic haemorrhage any time spent messing around with anything other than a TQ is clotting factors and fluid lost. Indirect pressure if used with a bandage and something under the bandage at a pressure point can actually increase bleeding due to the increase in arterial pressure by blocking venous return. I think that you use whatever you have available at the time that is in the best interest of the patient but current best evidence says that indirect pressure is ineffective in the management of exsanguinating haemorrhage.
     
    VinnyP likes this.
  13. VinnyP
    • In Omnia Paratus

    VinnyP Loaded Pockets

    Joined:
    Aug 18, 2006
    Messages:
    612
    Likes Received:
    112
    Yep smellyp is right I chose 2006 because that is when the PHTLS revised the recommendations based on that evidence including the military protcols.
     
  14. FrozenMuffin

    FrozenMuffin Loaded Pockets

    Joined:
    Nov 7, 2012
    Messages:
    89
    Likes Received:
    167
    That's precisely why I'm not including any long term dressings, disinfectant or meds.

    Included so far:
    2 abdominal pads
    2 6x6 non-adherent gauze pads
    4 pairs of nitrile gloves (One pair is in a pouch right on the front of the kit)
    1 Israeli trauma bandage
    Flashlight and shears are both on the outside of the kit as well.

    Yet to be added are a couple more pads, a couple red kem lights, a reflective vest, some quikclot and a tourniquet.

    Thanks gents. Lots of good input here.
     
  15. Random Dan

    Random Dan Loaded Pockets

    Joined:
    Jan 5, 2013
    Messages:
    535
    Likes Received:
    1,859
    Right now my first aid kit is a roll of ducktape.
     
  16. keeper
    • In Omnia Paratus

    keeper Loaded Pockets

    Joined:
    Sep 18, 2012
    Messages:
    753
    Likes Received:
    782
    bandaids, probably the item you will use the most!
     
  17. nemoaz

    nemoaz Loaded Pockets

    Joined:
    Dec 20, 2012
    Messages:
    21
    Likes Received:
    17
    Fair enough, but there are many times when a tourniquet won't work (you can't get the limb or there is no limb or not enough limb) for it to stay on OR it's in an area where you can't use a tourniquet (neck) OR there are people who simply aren't trained in tourniquet use OR they don't have a tourniquet or enough tourniquets. Direct pressure, or indirect pressure (I'm talking pressure points on an artery here), are little more than the caveman version of a tourniquet. Also remember that in a civilian setting you are much less likely to be in a hostile area taking fire and/or have multiple casualties, thus the need to apply the tourniquet and potentially leave the patient doesn't exist.

    Any way, Your Mileage Still Varies.
     
    Last edited by nemoaz, Jan 30, 2013
  18. nemoaz

    nemoaz Loaded Pockets

    Joined:
    Dec 20, 2012
    Messages:
    21
    Likes Received:
    17
    I'm not a fan, specifically for field or car kits. I can make a bandaid out of a 4x4 or other large dressing and some tape, but I can't do anything useful with a bandaid for anything larger than a boo boo.
     
  19. Zatx

    Zatx Loaded Pockets

    Joined:
    May 17, 2011
    Messages:
    428
    Likes Received:
    115

    Really? The OP, based on his questions, has no formal training as such the advice given to him should be what you would give an untrained person. Airways? Tourniquets? Hemostats? Flares? Litter? Stretcher? Hell you just listed more things than we even have on our ambulances.

    Here is a list of the best things you can keep in your vehicle:

    • A trained first responder. (That's you... go out and get yourself some training, it will do more to save a life than any other tool, bandage, tourniquet, etc.)
    • Personal Protective Equipment for you, i.e. gloves and a high visibility vest.
    • As mentioned by others... gauze... in the form of some rolls and 4x4 pads.


    Stopping bleeding is pretty basic.. apply pressure, elevation, and time. Most bleeding will even stop on its own if the patient is healthy and not taking medication which thins their blood. Adding the pressure and elevation will take care of most of the remaining 98% of the population. Even the bleeding associated with an amputation can be stopped with these techniques in most instances.

    Don't get too wrapped up in gear. Almost anything found at the scene of an accident can be used in some fashion to care for the patient in the few minutes it takes for the professionals to get there. No gauze? Take your shirt off. No neck collar? You or a bystander hold traction. No tourniquet? Good... apply pressure and elevate.

    Use your brain and the training you have received.
     
    Dapple, Dok J, keeper and 1 other person like this.
  20. chmsam

    chmsam Loaded Pockets

    Joined:
    May 28, 2007
    Messages:
    1,411
    Likes Received:
    4,427
    Just cuz I've had the opportunity to happen upon a few wrecks, I'll toss in a few thoughts.

    The average person coming upon an accident would be best served (and the victims, too) be making sure that they are safe (vests if you are going to be even close to the road, lots of light at night, flares even in the daytime, etc.), that everything and everyone is as far out of the way of other traffic as possible, and that oncoming traffic is alerted as far ahead of the scene as is possible.

    Keep waaaayyyyy off the side of the road especially in winter conditions. I have seen vehicles travel more than 30 feet off of the roadway while trying to avoid a crash scene. Best to keep people in the vehicles (which will take an impact far better than a person standing by their car) and if they are out of the vehicle(s), keep people far from the road and NEVER allow anyone to stand between vehicles at a scene. If something gets hit at the scene it will move forward and crush anyone standing between vehicles.

    People will want to get out of their cars at the scene. This goes for victims and people stopping to look. Do not let them unless you want more victims. Most folks can't walk and chew gum at the same time. It's bad mojo to add to the workload of the rescue crews.

    Warn oncoming traffic!!! I've seen flares dropped no farther then 10 feet from the wreck. I've seen no flares or lights at an accident on a blind corner at night. This is a recipe for further disaster -- actually it's a really, really good way to get people killed. Warn others by placing flares or triangles at least 100 feet ahead of the scene. One flare or one triangle is not enough -- lots of attention is a good thing when you are trying to warn people. You do not need more drama at an accident.

    NEVER TURN YOUR BACK TO ONCOMING TRAFFIC. Most people on the road are idiots at best. Do not trust them to think logically.


    As for what you keep in your car, the passenger compartment or trunk is going to see a wide range of temperataures depending on where you live. There are meds that do not like being outside of a specific range so know what you've got and be advised that the minus whatever in the winter to the 100+ F ranges can be bad news. This goes for a lot of medical supplies as well as for meds.

    Check the dates on what you've got in your FAK. Out of sight, out of mind, out of "use by date" happens way too often. Something that's 5 years beyond its useful life could be worse than useless.



    As has been said keep the gear within the scope of your abilities. Stay within your abilities. Do no harm.

    Just keep things calm, safe, and contained until the pros get there.

    In my experience most accidents that the average schmuck can deal with will need little more than direct pressure with clean gauze or even just clean towels and a calm voice with a little hand holding. So keep safe, keep the victims from moving, and make sure there isn't anymore damage being done by other vehicles or by untrained folks who want to help.

    Just keep yourself safe, keep the scene from getting worse, and keep the hurt people stable and do not move them.
     
    Aranatha, Dapple, Dok J and 2 others like this.